If you haven't done the bloodwork, have it done. You said she lost weight. Something is definitely going on. If it were me, I would invest in the x-rays and all reasonable tests to find out what is going on. I am sure you don't want your pet to be in pain and your description of her current behavior sounds like a pet with pain ,or at the very least some kind of health issue.

Perhaps you could take her to a vet who specializes in treating only cats. I am not feeling very confident with your vet's advice, which to me sounds like he hasn't given you any advice, or has he and I am just not reading your post correctly. Yes, tests are costly, but to get to the bottom of a health issue, you may have to have these done. It sounds to me like your vet is discouraging you from testing. I think you and your vet are not on the same page. It sounds to me like your vet has chalked it up to your pet is near the end of its life, and you are not ready for that to be the case. The only way to know what is really going on is to do some testing.

I do know how you feel, I have gone through having a pet for what seems forever, who was a very important part of my life, get sick and need serious treatment. I did do the x-rays and the ultrasounds and everything possible and the result was still not what I had hoped. Life sometimes stinks. However, I did everything possible and that did help me deal with the ultimate outcome. The alternative would be to do nothing and I don't think that would be fair to your cat. It's not good for your cat to be dehydrated either.

My feeling is your cat is 18 years old. She obviously has been well taken care of all of her life to make it to this age. This is truly a testiment to your good pet parenting. Its really tough to go through this, but its a road you are now facing, you have to take the emotion out of it and do what is best for your pet.

I wish you all the best.

Hi - so sorry about your baby. My oldest is only 7 but has had some recent health issues and I know I'ld be a mess if I was in your shoes. My heart goes out to you.

You mention you did blood and urine work. Do you know what blood tests were performed? One of the things I've noticed is people sometimes compare costs of blood work but then find out they aren't comparing apples to apples. For example, my vet has three different levels of blood work. Level 1 test barely anything. Level 3 is used for older cats or those with health issues and tests everthing (it is also around $200).

I agree with labmomma. It sounds as if your vet is ready to give it up. There are cats that live into their 20's so I would go ahead with the testing. We've had both xrays and ultrasounds done on our cats and although they cost more than a basic visit, they aren't that expensive. They will also give you the answers you need to make the right decisions.

I think labmomma also has a good idea regarding a cat only vet. Do you have any in your area that specializes in cats? The one I go to is cat only (and also has two of the only board certified feline specialists in our state). It might be good to search out a cat only vet if you can as my understanding is that ultrasounds require a high level of skill.

Good luck - and please give us an update!

Kidney failure is serious but doesn't have to be a death sentence. I agree that you should find a vet who specializes in cats and get bloodwork done. Your kitty could be nauseated from her kidney problems.

Here is a link that might be useful: cat kidney failure website

Mokanee,

Go ahead and do the xrays. If there's a chance that she has asthma and that the xrays can diagnose it, then you can treat it and make her more comfortable. It's true that if she has something like a tumor there's probably not anything you can do about it at her age, but asthma is manageable.

There is also a great deal you can do to help manage her renal failure and make her more comfortable, the most critical of which is learning to administer subQ fluids at home to keep her properly hydrated. Don't be fooled by the fact that she seems to be drinking normally. A cat with compromised kidneys can not utilize fluids properly. She can not drink enough water to keep the toxins flushed from her system, so she will become dehydrated, constipated, and sick. In fact it sounds like she's already there based on the way she is isolating herself from you. SubQ fluids are the cornerstone of CRF management. They'll make Jelika feel so much better. Your vet can teach you how to administer them at home and set you up with the necessary supplies.

It's also very important to keep copies of all of Jelika's test results so that you know exactly what you're dealing with. The website buyorsell1888 linked for you above is incredibly informative and can help you understand Jelika's test results and provide you with all sorts of information to discuss with your vet. Please spend some significant time reading through it so that you understand how critical it is to keep track of Jelika's blood values during the course of this disease.

Sadly, I, too, have encountered vets who essentially lose interest or give up on geriatric animals. Or perhaps they just assume that the owners don't want to invest the time and money in caring for ailing elderly pets, so vets just don't bother to offer available treatment options. You may find that you need to be a very proactive advocate for Jelika's health care. Your first step is self education.

In rereading your initial post, it just struck me how you wrote that Jelika is very lethargic and only wanting to spend time in her bed by the fireplace. Anemia is quite common in CRF cats and would account for her lethargy and heat-seeking. Did your vet run a CBC, and if so, were her blood counts within normal ranges?

There's a lot for you to learn about CRF and its associated challenges, and a lot you can do to make Jelika feel better.

Please post again when you have copies of her blood test results. I'd be interested in knowing where her values are now.

All the best,

Laurie

Have the bloodwork done. The vet can't really diagnose anything without seeing those results. I just had this done with my doggie. Make sure you are feeding her wet food as that will give her a little more moisture in her diet.

Thank you all so far for your quick and very helpful and informative responses.

I actually did have the blood work done when I was at the vet's last thursday, only I can't post any definitive values because the vet just told me the results over the phone and I was out so I couldn't write them down. I think I will go back there after work today and see if I can get printouts of all her tests over the past year and a bit (three should be 3) so I can see how and where she has deteriorated.

And now that I think about it Laurief, I can't beleive that my vet didn't give her any SubQ fluids. I remeber that the previous vet that I saw 6 months ago (at the same office) DID give her a shot of fluids. So I think when I go back today I will ask about them and if I can administer them at home.

Unfortunately she is still heaving when she purrs, but not ALL the time in the past few days.. she has had a few purring moments where she has controlled the heaving... I don't know if that means it may have just been some sort of weird cold.. or if she is just managing to live with it.

Also she has turned her nose up at wet cat foods her whole life and even now it is quite difficult to get her to eat any. I am having trouble finding one that she will even attempt to eat. But I feel I should find one because it will also help keep her a little more hydrated. Last year when I learned about her kidneys I tried the vet recommended (and of course only sold at the vet's office) food. She wouldn't eat it, so I had to go back to feeding her Science Diet Senior (Sometimes the Advanced Formula). She at least eats that.

But I do have a ray of hope! Last night she actually got out of her bed and came over and jumped up on the couch with me! And then she did come to the bed at night. She didn't come very close to me, but she still came :)

So for an update I will go to the vet's today and get copies of her blood work, and ask about the SubQ fluids for dehydration. I may wait until tomorrow to decide about the X-Ray's as it seems there is a glimmer of hope that the heaving may pass on it's own.

Please keep writing and I will give you an update shortly.

Thank you all!

I don't know if this is way off base, but is it possible she got into something poisonous? Or ate something that gave her a reaction??

Cats may not react the same way as dogs, so I could definately be way off.

My boyfriend's dad's older dog, started retching when he was happy, and became really detatched and avoided the family. They took him the vet, and best guess was that he got into some sort of poison or anti-freeze. And after a while he stopped the retching too, and went back to his old self.

I'm not sure if it works that way for cats, though, or if there was something in the blood work that led them to believe it was poison.

I'm glad to hear that Jelika's heaving seems to be subsiding a bit. It's entirely possible that she has an upper respiratory infection. Those can cause all sorts of odd breathing abnormalities. Perhaps you could ask your vet for a round of antibiotics just to be on the safe side.

Again I will urge you to read the website posted earlier in this thread. It offers advice on all aspects of CRF, including the proper way to administer subQ fluids along with lots of helpful hints you may not learn from your vet.

As far as food is concerned, it would be best if she would eat one of the prescription renal diets, but it's not essential. It's far more important that she continue eating something than that she eat nothing. Several different companies make prescription renal food - Hill's, Purina, Eukanuba - in both dry and canned formulas. Call around to your area vets and see if you can find them and try them all out with your girl. If you're lucky, you'll find one that she'll eat.

If she won't eat any of the renal foods, try soaking her regular kibble in hot water until it's good and mushy. If she'll eat it that way, at least you can increase her fluid intake a little.

Laurie

So glad to hear Jelika is doing better. I also have a picky cat with health issues (pancreatitis, Irritable Bowel Disease). Like Laurie sayss, getting them to eat is the best thing. However, most of the times vets will have multiple choices of food to try. So, you may want to see if there are other options available. Our one cat has been through four different foods for his condition - although most of the time he insists on eating the weight control food the others do.

I am so sorry and feel your pain when my 22 year old cat started getting sick and we went to the vet I broke down hysterically, because I couldnt comprehend my life without him amd felt so selfish. ( poor Vet) he sent us home and my cat snapped out of it, he passed away eventually.Old age creeps up on all of us, you will know when its time . Thinking of both of you.

Ok, I have a little more news.

Went to the vet yesterday and got my print outs and spoke with the Veterinary Assistant (who seemed to know a lot about CRF thankfully). She said that for a cat of her age (18) Jelika's blood work is actually quite good. Most results landed in the normal range, but here are the ones that were not:

BUN: (Jan '06)14.9 mmol/l, (Jul'06)16.6, (Mar '07)13.9
Creatinine: (Jan '06)313 umol/l, (Jul'06)317, (Mar '07)284

(The normal values stated on these tests for BUN is 5.0-12.5 and for Creatinine it is 83-181)

The following results are in order of Jan '06, Jul '06, Mar '07

Mean Corp Vol 45 (normal) 41 (normal) 39.4 (low)
M C Hemoglobin 13.7 (normal) 13.1 (low) 13.2 (low)
Platelet count no result no result 193 (low)
Calcium 2.61 (normal) 2.71 (normal) 2.77 (high)

So her BUN and Creatinine is a little high but I don't really know HOW high that is in comparison, however it really has not seemed to have gotten any WORSE over the last 14 months, if anything it seems to have gotten a little better?!?

The Comments section on her most recent test (last week) says: Platelets OK (Clumped). Mild Azotemia and Hypercalcemia with low urine S.G is consistent with Renal Disease. Otherwise Unremarkable.

P.S. Her SG is 1.014

All these numbers don't mean too much to me yet (and yes the website reference earlier in this string is VERY helpful and complete, and I am sure I will read through the whole thing before long) and my heart goes out to anyone whose furbaby has to go through CRF, but the webiste does give me hope that cats who are properly treated can go on to lead normal lives (or as normal as can be)

Can anyone who is familiar with these numbers and values let me know if my vet (assistant) is giving me false hope by telling me that she actually looks pretty good?

Also, on the heaving issue. She is still dry heaving when purring, but it seems to be slowly abating. She seemed a little perkier last night and this morning, she came to the couch and I got her to eat some wet cat food and some treats.. but I haven't been able to monitor her drinking/urination all that well. She is still somewhat lethargic and aloof but seeming to come out of it (I guess she just doesn't have the energy to bounce back the way she once did)

I am still concerned about the dehydration though and am thinking of getting my vet to show me how to do the sub-Q injections at home, as I have heard that it really helps some older cats with their hydration and activity levels..

If anyone can help me with the test results it would be great. PS I live in Canada so I don't believe the values are the same as the ones taken in the United States..

Again thank you everyone for your comments and encouragement. I don't remember much from before I was 12 years old, and Jelika has been with me since then. I have found it difficult to describe the kind of unconditional love you get from your pet to a person who has never had one. But everyone here understands, I'm sure, when I say that I just can't imagine my world without her.

Mokanee, email me privately, and I can provide you with some additional information that you will find very helpful. My email addy is laurie@lfrazer.com

Laurie

Update:

I spent the entire weekend at home so that I could monitor Jelika. She looks a little more alert and I saw her eating (albeit very little) dry food, and drinking a little water. To supplement this I have been trying a variety of wet foods that you get in the pouches (she won't touch pate style soft food). So she has eaten a little bit of soft food with the gravy. Although I still don't think this is good enough to reverse the effects of dehydration.

So I went to the vet on Saturday just to talk to her, but she wasn't there. But the assistant said that it sounded like I shouldn't wait to bring her in (as my vet won't be in til wednesday) and so I scheduled an x-ray for this afternoon (monday) and also so that they can show me how to administer the Sub-Q fluids at home if needed.

I really hope the x-ray tells me something useful.

She also seems pretty constipated as I only witnessed her having one tiny bowel movement all weekend long, although she seems to be urinating on a somewhat consistant basis. I have been giving her some Tonic Lax for the past 3 days. I hope that helps some.

In general she is still heaving, but not quite as much. Her purr is still somewhat rough and high pitched, and her mouth still opens when she's purring, but the heaving itself seems to have abated somewhat. She still won't cuddle up on my lap, but she will come and sit next to me.

I hope the trip to the vet today will be more productive and help me understand more what is going on with my cat. I don't mind giving her medication and realizing that she is a really old senior citizen. I can adjust and make her life more comfortable.. I just need to know what to do!

I will update when I have more info..

Thank you for the support!

Mokanee,

I wish I had seen your post earlier. I would have urged you STRONGLY to INSIST that they give her fluids at the vet's office this afternoon. I certainly hope they taught you to give her subQs at home and sold you the necessary supplies. Her constipation is a direct result of her continuing, and probably worsening, state of dehydration. Constipation is extremely painful and will frequently cause inappetance in a cat. Once you get her properly hydrated (and keep her that way), the constipation will abate, and her appetite may return. The more dehydrated she becomes, the sicker she will get. You CAN NOT get enough fluids into her orally. You MUST provide supplemental subQ fluids if you want to improve her overall condition.

I don't know how else to convey the vital importance of doing whatever is necessary to get and keep Jelika hydrated. Please don't allow your vet to overlook this essential treatment for one more day!

Laurie

Hi Laurie,

Thank you for the advice and yes indeed I got them to give her a shot of the fluids. However they did not show me how to do them at home and did not sell me any supplies. But here's why:

I got the x-rays done and apparently her kidneys are the last things I have to worry about. My poor baby has LUNG CANCER!!! I am such a wreck. I just got home from the vet and Jelika is resting at the moment. But her x-rays showed little white blobs ALL over her lungs, with her right lung being worse than her left, as it is more shrunken and has a build up of fluid around it (pleural effusion). So the vet said that the sub-Q's would be good for the dehydration (which she didn't think was too severe) but there was a chance they would drip around her lungs, and the last thing Jelika needs is more fluid around her lungs. Apparently she is spending all of her time sitting in the "meatloaf" or "Sphynx" position because that puts the least amount of pressure on her lungs. Also the tough time purring, and having her mouth open when she does it means that she is having difficulty getting enough oxygen. This really, really sucks.

This was a different vet than the one from 2 weeks ago. She was much nicer and much more informative.

So she is suggesting that the best thing for Jelika would be to go on low doses of Prednizone. I am a little hesitant because I have been told that prednizone will almost certainly cause diabetes in older cats. She says since Jelika's glucose levels are pretty normal this may not be the case. She also said that it will make Jelika feel better for the time she has left since we are basically only looking at providing pallative care at this point.

She says it could be anywhere from a few weeks to a couple of months. I feel like my heart is being ripped from my chest. It hurts so much. I love her so much. I hate this.

Hi Mokanee,

I'm really sorry that you are going through this. I know exactly what it's like - it's eerily similar to what I went through with Kitty.

I think my cat also had lung cancer, though we never really knew for sure. She was raised in a smoking household, and now my mom has it so it could have happened.

I wanted to respond about the Prednizone. We didn't have an official diagnosis, but my cat was put on Prednizone for 10 days. I had to go out of town so she was boarded at the vet for 7 of those days and given prednisone. She was relatively fine when she went in, and when I picked her up, I brought her home and she was seizing and couldn't control her bladder. It wasn't long after that when we found out she wasn't producing enough blood cells and platelets, which ultimately ended with us deciding to put her down.

I'm not a vet and I don't have a medical background, but in my opinion, the prednisone seemed to accelerate her health problems. Maybe it was a coincidence but she went downhill FAST. I just wanted to throw that out there. Of course your vet would know best but it might be something to think about.

I'm really sorry...I know it seemed like the end of the world. I was stunned for about 4 days. I would go somewhere like the grocery store and be so shocked that people were laughing and talking and getting on with their lives. I was convinced the world should have stopped. But it does get better, and now I can remember the good times without crying.

Hang in there - this is a great place for support.

Hi Chi,

Thanks for the support. It's good to know that maybe, at some point in the future my heart won't feel like it has been slowly ripped from my body. But I think it will take a long time.

It's just so wierd that only 3 weeks ago my life was normal and I had 2 (seemingly) healthy, happy cats to share my life with. Then the heaving started (which in hindsight I guess could have been a horrible coughing). Then I brought her in and nothing was really said about the heaving, but her other signs showed that she was CRF (even though her bloodwork was fairly OK). So then I was panicking and crying about that.. and then this past monday I bring her in for X-Rays to see what is really going on with her kidneys, and the vet tells me that the kidneys are basically fine, but that she has quite advanced stages of lung cancer! I just can't beleive it.

But no matter how much pain this is causing me, I would not trade one single solitary moment that I've had with my best friend of the last 18 and a half years!

If someone can tell me how to post a picture here, I would gladly post one of my beloved Jelika. She is such a pretty Calico.

I also have high concerns about using the prednizone, but the vet really thinks it will help make her end days easier by increasing her appetite and generally increasing her mood. And if I can just continue to make her comfortable I think I might do it.

I have sent the x-rays off to a cat radiology specialist for a second opinion and am expecting the results today.. but I certainly don't have my hopes up.

Will post when the results are in.

Again thank you.

Hi Mokanee,

I'm so very sorry you and Jelika are going thru this. I know it hurts (((Mokanee & Jelika))) , and she's lucky she has you to take such good care of her.

Check out the link below so you could post your baby's pic. This forum doesn't allow direct upload from the PC, so you'll have to upload the pics first to the Net - there's Photobucket, YahooPhotos, etc.

Here is a link that might be useful: Posting pics on threads

Ok, here goes..

This is my baby! Not a very good picture, and you can tell she was sitting on her favorite chair! I will bring some more photos in to work with me and see if I can't do her any more justice.

Jelika
Born September 1989

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Hi Mokanee. I'm so sorry to hear about Jelika. How difficult it must be for you. I can only imagine since my three are still young. I don't know much about pred in older cats, but my Cougar has IBD and pancreatitis and has been on pred for 3 years now. It sounds like you have a good vet - I'm glad this one seems informed. Please give us an update as you have it.

I have a bit of an update.

Talked to vet again yesterday about the results of the feline radiologist's findings about Jellies x-ray. The cancer in her lungs is metastatic (sp?) and it moved there from her liver. So not only does she have lung cancer, she has liver cancer. All in all her outlook is not good. I am going to the vet today to pick up the pred. I will give it to her because I want to make her as comfortable as possible and in as little pain as possible. Side effects be damned I guess.

Anyway here are a couple more pictures of my sweetheart (and my other baby, Kitty, who I guess isn't so much of a baby anymore either.. she's 12 now)

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{{gwi:2011192}}

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I'm so sorry to hear about Jelika's cancer. You're right to just make her as comfortable as possible. I got my love-of-my-life-cat when I was 12, too. I think I know how you must be feeling. Mine died when I was 30 and her baby (number-two-love-of-my-life-cat) died a year later.

Update:

Got the report back from the radiologist. I will re-print the conclusion here. Good thing I've decided to go ahead with the pred.. cause I don't think she is coming back from this.

Conclusion: There are multiple pulmonary nodules and free pleural fluid as described. This most likely represents metastatic lung disease. Given that there are suspect changes associated with the liver it is possible that this represents a primary lesion. There may also be in a different unidentified primary neoplasia in this patient. Given the history of voice change, an upper airway mass must also be considered. With multifocal nodules within the thorax, granulomatous disease can never be definitively excluded without histologic samples however this is certainly thought to be a less likely differential in this patient. There are renal changes consistent with chronic renal disease.

So my poor baby's entire body just seems to be giving out. I know she is dying and I know that some people think that I should probably put her down now, but I can't. Not until the end. As long as she seems comfortable and can still eat and use the litter box, and enjoys being petted, and purrs for me I want to keep her around. It's true she has trouble getting enough air when she purrs, but otherwise her breathing seems fine. The vet says that once the mass(es) get too large, she will start having trouble breathing all the time (she will have her mouth open, trying to get more air). When this happens, then I will know that it is time.

Again, I am glad I found this forum and I really appreciate everyone's thoughts and prayers. I thank everyone for the input and advice they have given me. I will update when there is anything more to tell.

Mokanee, I am sending you and Jellie the biggest of furbaby hugs and sandpaper kisses. What a sorrow, but you can be happy that you gave her the absolute best care and life a kitty can have. It is the worst thing in the world when "that time" comes, we are all here for you. Enjoy Jellika as you have for the past years, she is a beautiful cat and will be in your heart forever.

Hugs,
Michelle

Something I wish I knew/thought about years ago when my cats and dogs were so sick toward the end.

Ask the vet for heavy sedatives soon to keep at home, so that when the time comes, you can give them to your cat at home and be with her until she's "out". That way, she can go gently and lovingly with you at home. When she's completely knocked out (not dead, I'm talking about deeply asleep from the sedative), you can take her to the vet to be put to sleep.

The last thing you want is to get her stressed out with a trip to the vet's as she's dying.

Jelika is a beautiful cat. I am sorry for what you're going thru. I see nothing wrong in waiting till things get worse to put her to sleep. It's heartbreaking, I know. I have an 18 year old too who is chronically ill. Two years ago i didn't go on vacation because I thought he might die when I was gone. He's very thin, but eats, drinks, and uses the litter box. When that stops it will be time. Hopefully some night, he'll pass away here at home . He hates the vets so much. I dread the day if I need to make his last hours even worse. Just know there are many of us who have been there and sympathize with you and your dear cat. I have often thought that if Louie was my child he'd be graduating from high school this year. And I was so young when I got him at 4 months.

listen...ur cat is old right? my cat had the same problem, wheezing and coughing. he even had spaz attacks and did backflips down the stairs!(its sad, but kinda funny) and well...we didnt want to let him suffer...so we took him to the vet to put him down. if your not quite sure if u should, take him to the vet and ask advice.

Mokanee, Jelika is beautiful. She's also lucky, she has lived a long and happy life with you. Her age shows the care and love you've given her.

You're making every effort to keep her as comfortable as you can, in her present condition. She'll always be in your heart.

Bbaird has a good suggestion there regarding heavy sedatives to keep at home for later, when you know it's time. It's never easy but just the most unselfish thing we could do for our babies who are in pain.

Hugs, Pranjal

Thank you all so much for your comments. We certainly appreciate them!

The sedative idea is definitely an interesting one. I never thought about that. But I think I am pretty sure that I will ask my vet to come to my home to do it when the time comes.

So we had an ok weekend. A couple of things happened on Sunday. Jelika has not been eating well at all these past couple of weeks. She doesn't want her kibble food anymore and I have never been able to find a soft food she likes. I thought she had been eating the pouches of Hill's special renal food, but it turns out she was just licking the gravy off and leaving the food itself so she has barely had any solids in her stomach for about the past week. So I dug deep into my cupboards and found a last can of food that I had tried a while ago that she seemed to like, but at that point she was still eating her solids. So as a last ditch I opened it up and to my surprise she gobbled it right down! (Only about a quarter can mind you, but still she was actually EATING!) The miracle food is a cheapo can from Petcetera (don't know if you can buy it anywhere else) made by FORTUM that is made with real tuna and salmon (and shrimp & crab as well as shrimp & whitefish are available). So I rushed right out and bought a whole bunch more cans because I was so overjoyed that she was eating! And it seemed that immediately her energy level went up! In the afternoon I was sitting outside on the balcony, and she actually came out to sit with me. Not only did she come out, but she actually, amazingly, JUMPED UP ONTO MY LAP! It was incredible. Just for a moment I had my old Jelika back.

So I am certainly not deluding myself into thinking she will miraculously get better, but I am thankful for the small miracles that I have left. I am going to take each day that I am given and enjoy them to the fullest.

PS Another tasty treat that she seems to like is Whiskas CatMilk that I can find at my local grocery store (Safeway). I know none of these foods is good for CRF cats, but at this point I'm just glad she's eating.

Again thank you for your support and comments. I will update shortly.

Mokanee - thank you for the continued updates. I think I would do the same - keep her alive as long as she is comfortable. I have you and your cat in my prayers.

So. Things are going as well as they could at this point I think. Jelika is eating (now that I found a food she will eat), drinking, and using the litter box for No.1. But she is very very constipated. I have been shoving Tonic-Lax down her throat, and it seems to make her want to "go" but nothing comes out.

Is there another home-remedy I could try that anyone knows of? At this stage I really really don't want to stress her out AGAIN with another trip to the vet. It takes her almost a week to come out of her shell after a trip there. And I don't know how many weeks I have left.

Any suggestions on how to make her more comfortable would be greatly appreciated.

P.S Her breathing is still the same, only raspy and high pitched with open mouth while she is purring. Other times she breathes normally. Also I can't really tell if the prednisone is doing anything or not but I will leave her on it just in case it's helping.

Thanks again.

Mokanee,

Didn't you receive the emails I sent you privately? In one of them, I recommended having your vet write a prescription for Lactulose for Jelika. Lactulose is a sugar (looks and tastes like Karo Syrup) that has a strong laxative effect and will not adversely affect her kidneys even when given daily. It will definitely help with her constipation and make her much more comfortable in that regard. You can pick it up at any pharmacy but will need a prescription from your vet. Your vet would not have to see Jelika in order to write the script.

I wish you and Jelika all the best.

Laurie

P.S. If you do decide to take Jelika off of Pred at some point, make sure you follow veterinary instructions exactly. It is not safe to stop Pred cold turkey. She will need to be weaned off of it gradually.

i've been reading these posts and I am so sorry about Jelika. I had a dog about 20 years ago who had lung cancer that spread to her brain. When she started having seizures,I had the vet come to the house to put her down. it was heartbreaking. I've lost several cats to kidney and liver failure. Currently,my cat Whisper, who is only 15, is in kidney failure. she drinks lots of water and urinates a lot, and she has lost a lot of weight but she still will eat her favorite food, Fancy Feast flavors with gravy. She licks off all the gravy and then eats some of the solid. I know she's never going to get better, but as long as she walks around and uses the litter box, purrs and interacts with me, her quality of life is good, I will keep her with me. When she stops purring and eating,I will know "it's time". Believe me, I know you only want the best for Jelika. Keep her with you as long as you can and she's not obviously suffering. I wish you both the best.

Hi Laurie,

Sorry yes I did receive your email.. I was just very high strung when I read it and so a lot of it I don't think sank in very well..

But I just got off the phone with my vet's office and asked about the Lactulose. One of the vets there will call me back today and let me know if this is a good option for Jelika. I will let you know if I get it and if it works (I really hope it does).

I really appreciate your continued support. I have a very small family (I have NO cousins of any sort) and no one that has been all that close to me has ever died before. So this is a first for me and I am not coping very well.

Thank You.

It's OK, Mokanee. I understand how difficult it is for you to make sense of any of this and to keep a level head.

You are in a position now with Jelika of needing to identify the lesser of evils in terms of her care. Cancer cells feed off of sugar, so your vet may not want to prescribe Lactulose for that reason. BUT, constipation is extremely painful for a cat in Jelika's condition, and it's very likely that the constipation will cause her to lose her appetite completely and permanently. You know that Jelika's time is very limited under any circumstances, so it would seem to me that alleviating her constipation pain should be top priority.

None of the cat-lax type products will resolve her constipation. The only options I know of for effective constipation relief are enemas (which would require a trip back to the vet for administration) and Lactulose. If your vet balks at prescribing Lactulose, make sure you get a full and complete explanation of the refusal. If the explanation doesn't make sense to you, don't hesitate to get pushy with your vet about it. You need to advocate for Jelika.

Please let us know what the vet says.

Take care,

Laurie

I am going to pick up the lactulose today. vet said to try 10 ml a day to start and see how it goes. She also said that it could be dehydrating, and affect sugar levels. Not so good.

However she also said that a good "home remedy" laxative for cats is.... canned pumpkin!

Just wondering if anyone else has heard of/tried this? I might pick up a can of that and see if she'll eat it before I try the lactulose..

Pumpkin is used to add fiber to the diet. It bulks up and softens the stool to a certain extent, but only if the cat will eat it. If you want to try the fiber route, it might be easier to buy a jar of unflavored Metamucil and add 1/4 tsp to her food daily. It can be easily mixed into her food, she'll never taste it, and it'll have the same effect as pumpkin. If you prefer to try pumpkin, though, make sure you buy pure pumpkin with no other ingredients added, NOT pumpkin pie filling.

I would still recommend Lactulose, which can be given in conjunction with fiber. Lactulose will soften her up and resolve the constipation much more quickly. It is also a "dose to effect" med, so you can adjust the dose back to the minimum that keeps her stool soft. Until you figure out the proper dose, I would recommend splitting that initial 10 ml dose into two, 5 ml doses per day, spaced a couple of hours either before or after meals. Do not give Lactulose with meals until you have the dose properly regulated. If the starting dose turns out to be too much, she will develop diarrhea and pass food through her system before her body can digest it. In that case, just lower the dose until her stool returns to an acceptable soft-firm consistency. When you have her stool the way it should be, then you can go ahead and give the Lactulose with her meals, if you prefer.

In terms of Jelika's dehydration, are you still mixing warm water into her canned food to increase her water intake?

Laurie

I don't have any info to add. Just support and cyber hugs. This thread touched a nerve with me since my sweet cat is 19 and I'm sure I'll be facing a similar situation in the future.

Best of luck to you and Jelika.

AM

Yes, try the canned pumpkin, hopefully she will eat it. (Be sure it's plain, not sweetened pie filling.) It helps with constipation *and* loose stools, not sure why it would help both, but it does.

I've used pumpkin for that purpose, too. The trouble was, my cats got fussy. They quickly decided not to eat the canned stuff any more, but they love that Japanese squash called "kabocha" if I cook (boil) it at home.

Jelika is beautiful--strikingly good colors. I'm so sorry you have to go through this. At least our pets do not worry about their diagnosis or what might happen, the way a human would, so they are spared some mental suffering.

I am on my 14th and 15th cats now, in my old age, and as one is 13&1/2 and the other close to 16 years old, I also sometimes worry about the problems that probably lie ahead. The 15-year-old, a stray I picked up from the street in Japan when his eyes had barely opened, has been the love of my life, the most intelligent and unusual cat I've ever had.

Many of our cats happen to have died at home, but it is not easy, whatever way they go. My only consolation is to keep in mind what a vet once said to me: It's better that we outlive them, in spite of the grief, because we can be around to keep them happy for most of their lives and ease their passing. You have surely given Jelika a wonderful happy life. Here's hoping the various treatments and foods you are trying will give her and you some more quality time together.

Hello again all,

I have been taking these past few days one at a time. Some are good days and some are bad days (both for me and Jelika). But we are trudging onward. I am so grateful that I can come here and read all your posts of encouragement. It appears I am not the only one who has gone through this type of pain (even though some days it feels like no one in the world can understand what I'm going through). I am so glad that there are so many pets out there that have good and obviously loving homes. It makes me feel better.

Biwako, my hat is off to you for bringing 15 deserving kitties into your life.. I don't know if my heart could stand losing that many...

Yesterday was a bad day. I came home and Jelika did not want to eat or get up all that much. But Saturday was a relatively good day. Again we went outside in the sunshine and just sat there (which was nice because we have had about 35 solid days of rain here.. and she so loves to sit in the sun).

She is still on Pred.. this coming weekend I may start the weaning dose... the vet wants her to come in for another check up but I just don't know if I can do that to her. She hates it so much. She may be getting slightly more dehydrated though so I should bring her in for a shot of the sub-q's. I really don't know why they didn't show me how to do it at home when i specifically asked them to last time (so that I wouldn't have to bring her in again for it!). Grrrr. It is so frustrating.

Also, I am experiencing a problem that may be of my own making. My other cat, Kitty, has started "attacking" Jelika a little more lately.. and she has been acting like she's holding a grudge.. which she may be. I know I have been ignoring her a bit lately because I want to spend all my time petting/being with Jelika. Because I just can't stand the thought that one day soon there won't be a Jelika there to pet anymore. I do try to make a little "Kitty time" each day. But because I have to feed Jelika special food (stuff that Kitty really likes too, but she's a little too..uh...healthy (read fat) to eat it all the time) So she just sits there and watches me feed Jelika. I do try to give her a couple of "treats" at the same time so that she doesn't feel too left out, but I think she does anyway. I feel really bad about it. They have never been the best of friends, and Jelika has ALWAYS been jealous of any time that I spend with Kitty. If she ever saw Kitty in my lap cuddling, Jelika would come right up and sit even higher up on my lap or chest.. to get in front of Kitty (as if she OWNS me.. well I guess she does :)

So anyways I have this dilemna because I don't want Jelika to see me spending too much time with Kitty in what could be her (Jelika's) last few weeks, but I also don't want to ignore Kitty too much and alienate her... I mean they do get along and they are friends.. but there has always been a bit of rivalry going on as well...

Anyway I will update shortly.

P.S I haven't tried pumpkin yet, but the lactulose seems to be working.. however it is dehydrating so i have only been giving it once a day instead of two.. I think I will try the pumpkin.

I'm sorry for what you're going thru. Just wanted to ask why the vet wants to wean her off the Pred if it's helping in some way? IMO, any benefit from it would outweigh any long term problems from using Pred.

Since her lungs are compromised, that may be why they didn't suggest you give her sub-Q at home. She's got a lot going on and you can only do the best you can at this point.

The other cat attacking her may be from the fact that she knows someting is wrong with Jelinka. My DIL's small dogs did that to each other during the last stages of cancer.

Hi Ann,

Thank you for your kind comments. I am not weaning her "off" pred.. just to a lower dose.. unfortunately I think she will be on it for as long as she has left.

Also when I asked my vet about the sub-Q's she said it wasn't a good idea because some fluid may hang around the lungs, and we definitely don't want that. But she also said that perhaps a dose once a week wouldn't hurt too much either.. which is why I wanted to be able to do it at home when needed..

Hello again, just wanted to give a quick update.

If you all can remember back from my first post, I told you a story about how Jelika came back against all odds with her torn cruciate ligament and within about 3-4 months she could walk and jump like nothing had ever happened.. I wanted you to know what a fighter she was.. well she is surprising me once again!

Although I have no delusions about the cancer going into remission or anything she is learning about her condition and doing the best she can with it.

1) She has learned that when she purrs it hurts (the dry heaving/coughing). So she has minimized the time that she spends purring. Although she lets it be known that she enjoys the attention and pettings in other ways, ie: she rubs her chin against your hand and indicates she wants MORE! I am just so impressed that she can adapt so well!

2) She realizes she can't eat solid foods anymore so she has learned to signal when she wants food by going over to the kitchen and just waiting at the edge of it. (She has never had to do this before as I always made sure that food and water were available at all times)

3) AND even though this isn't a new development I am still happy to report that when Kitty does attack her, she is still quick to swing back and hold her own! Even in her old age and illness she won't be pushed around by the "newcomer" (I've had Kitty for 10 years!)

And although she can no longer jump up on the couch to enjoy a good cuddling, she does appreciate it when you come down to her level and pet her on the floor. She also still enjoys basking in the sun on a sunny day.

The only things I am still pretty concerned about are her dehydration and her constipation. Although when I give her the lactulose she does eventually end up passing stool, I am wary about giving it too often as I've read that it is quite dehydrating. I think I need to bring her in to get a shot of the sub-Q's possibly this weekend (the last shot was March 12). Maybe one shot every 2 weeks won't hurt too much (with fluid build up around the lungs).

So that's the update so far. We thank you for all your support, good wishes, kindness, and prayers.

I'm glad to read that Jelika is making necessary adjustments and living without too much obvious discomfort.

In terms of constipation and dehydration, success is all in the dosing. Rather than giving her a big dose of Lactulose when you know she's constipated, give her 1/2 doses frequently enough to maintain acceptably soft stools without waiting until she becomes uncomfortably constipated. And if you haven't started her on pumpkin or unflavored Metamucil yet, do that, too. It'll help maintain softer stools.

Same strategy works with fluid administration. MAKE your vet teach you how to administer subQs at home, then set up a fluid schedule with your vet that will provide Jelika with small doses of supplemental fluids (maybe 50 ml at a time) that she should be able to absorb without complications.

As I mentioned before, I had the same sort of balancing act with Bitsy. When he was first diagnosed with CRF, he was severely dehydrated, and my vet told me to give him 300 ml of fluids for 5 days to rehydrate him. After the fourth day, Bitsy went into respiratory and cardiac distress, and I nearly lost him as a result of fluid build-up around his lungs. He was drowning in excess fluid that he simply wasn't able to absorb quickly enough. We administered a diuretic several times over the next 12 hrs to pull the fluid out of his system and get him past the crisis.

As a result of Bitsy's inability to absorb fluids at a normal rate, we adjusted his fluid schedule, and I watched him closely for signs of overhydration. We lowered his fluid dose to 100 ml every other day ... barely enough to keep him marginally hydrated. After a few weeks of successful administration at that dose, I increased it to 100 ml for 2 days, then a day off to absorb any residual fluids. After another week or two, I increased it again to 100 ml for 3 days, then a day off. I think by the time I lost him to other CRF complications, I was giving him 100 ml for 5 days, then a day off.

There is no magic formula for this sort of thing, mokanee. You just have to play it by ear, with your vet's guidance, to find the meds and supportive care that balance each other properly and give Jelika the best quality of life for the time she has left. Dehydration will make her feel lousy, as will constipation. Supplemental fluids will help ease both conditions. Talk this through with your vet and see if the two of you can come up with a fluid schedule that Jelika's body can handle safely.

Hang in there,

Laurie

we are thinking of you and have been as a family keeping our fingers crossed that you get a bit longer with jelika. We send our love and hugs to you both

Thank you ILUV MY CATS! I'm hoping I get a bit longer with her too.

Took her to the vet yesterday to get another shot of sub-Q's and I made them show me how to do it at home. I think we've decided that if I give her 100 ml approximately once a week it should be enough to keep her somewhat hydrated and not enough to drown her lungs.

As I've mentioned she is a fighter and I wouldn't be too shocked if she surprised us all and lasted another (hopefully) few months or longer! But again I am preparing for the worst but hoping for the best.

Thank you so much for your support. It means a lot to both of us.

Another update.. wow I can't beleive it's been a month since my first post.. how much my life has changed :(

Here is a question.. During the past 3-4 days Jelika has started doing something a bit strange. She has started to rest her head on the edge of her water bowl. Sometimes when I go to pet her, the whole side of her head and neck and under her chin is SOAKING wet. And right now she is just resting her head on the edge of it (not drinking anything).

I re-read the part in the website linked at the beginning of this thread and it suggested that this is a sign of stomach acid. Is this the only thing it might signify?

I am a bit confused because if so then it is also one of the symptoms of CRF... and my vet said I didn't have to worry about CRF at this stage. I will probably call her, but the vets at the clinic never take phone calls, they only return calls at the end of the business day. But my question is, would I be complicating things too much if I started to give her half a tablet of pepcid a/c? (Years ago another vet told me it was not harmful to cats).

I will call my vet, but normally you guys are so much quicker to respond (esp Laurie..thank you!)

Happy Easter everyone.

Hi Mokanee,

I'm afraid I'm not familiar with the behavior of resting the head on a water bowl. My guess would be that it indicates thirst and dehydration, but I really don't know. The only time I ever saw one of my animals hold her mouth under water was when one of my horses severely cut her tongue. She would stand with her mouth deep in the water tank, apparently because it offered some pain relief for her tongue.

Have you checked Jelika's hydration level? Pinch up the skin on the back of her neck and note how long it takes to flatten back out when you release it. It will flatten immediately if she is properly hydrated. If she is dehydrated, the skin will remain somewhat tented for one or more seconds before flattening. You should also check her gums. When you touch her gums with your finger, they should feel slimey. If they feel tacky, instead, that is another sign of dehydration.

If you think she is dehydrated, talk to your vet about possibly increasing her subQ fluids to twice a week or maybe to just 50 ml every other day.

As far as stomach acid is concerned, that's a very common problem with CRF cats. Pepcid AC is commonly used to treat stomach acid, but it can cause problems. Read this:

Pepcid AC use in controlling stomach acid in CRF cats

then talk to your vet before starting her on a low dose of Pepcid AC if your vet feels it's advisable. Note on the page linked above that the recommended starting dose of Pepcid AC is 1/4 of a 10 mg tablet once every other day. Note also that Pepcid AC can be problematic in cats with high creatinine levels and/or heart rhythm problems. Even if your vet does recommend Pepcid AC or another stomach acid med, you will need to schedule its administration properly so that it doesn't interfere with the absorbtion of any other meds or supplements she's getting.

I don't know why your vet is telling you not to worry about the CRF. I'm guessing it's because your vet feels her cancer is the greater concern, and it may be. However, the many complications of CRF can make a cat feel really lousy, so I personally think it would be advisable to treat the CRF-related conditions, as well. After all, you're trying to keep her as comfortable as possible.

The problem with managing CRF is that you need to have her blood tested regularly because CRF can cause blood values to shift pretty much overnight, which in turn will necessitate adjustments in her meds and supplements to try to rebalance her system.

Hang in there,

Laurie

She started mouth breathing on Saturday. Am taking her to get her lungs tapped tomorrow morning. Once only. So hopefully she can go peacefully at home. If/when it starts again I will have to say goodbye.