Sadie’s urine culture and urinalysis came back negative. Which means she doesn’t have pyelonephritis (kidney infection). The good news is, we stopped the antibiotic so I no longer have to put her (and me) through the trauma of giving her the nasty Baytril tablet. The bad news is, Sadie has chronic kidney disease (CKD).
The signs were there for quite some time, I just had no idea she was so sick.
Drinking a lot of water
Sadie drank more water than the other kitties for quite a while. I just thought she was more fascinated with the bathroom faucet and the fountain.
Urinating a lot
Recently I noticed a lot more (and larger) pee clumps in the litter box. I use World’s Best Cat Litter, which makes better pee clumps than any litter I’ve ever used. So when I started scooping out massive pee clumps, I knew something was going on.
Hanging out in litter box
Sadie hung out in her litter box a few times. She just sat there in the morning when I was getting ready for work, blinking at me. “What are you doing sitting in the litter box? Silly kitty.” If only I spoke cat, I would have understood she was telling me, “Mom, I can’t poo. I’m totally constipated. Give me some Miralax, will you?” (This can also be a sign of a urinary tract infection, so if you see this behavior, get kitty checked by the vet.)
Pooping outside the litter box
Recently, I began finding poo on the floor near the litter box (and sometimes, not so near). I figured this was more litter box shenanigans caused by Sophie’s (the former stray) presence in our household. Once Sophie became more adventuresome (which took nearly two years) and starting exploring the upstairs and using all the litter boxes, Sally retaliated. Sally began lifting her bottom at the end of a pee, shooting jets of urine onto the floor around the boxes. Sometimes I catch her in the act, and gently push her bottom down below the side of the box. More often, I’m mopping up little puddles of urine, followed up by spritzes of Nature’s Miracle. So, when I began seeing poo several weeks ago, I figured Sally had escalated. It turns out, poo outside the box is another sign of constipation. Poor Sadie.
Loss of appetite
Sadie is a chubber. She eats anything. She begs like a dog, staring at me, transfixed, when I eat my dinner. So when she began turning her nose up at poached chicken and tuna, I knew something was up. She’d walk up to the food saucer, take a bite or two, or just lick the broth, and walk away. Or sniff the food and take no bites, and walk away. Finally, a sign I could not ignore.
Sadie appeared to have lost some weight. I wasn’t sure, seeing as she’s quite fluffy, and also, as I mentioned, she’s a chubber. So I initially thought, if she had slimmed down a bit, this was a good thing. As it turns out, it was yet another sign something was wrong.
The vet suspected pyelonephritis or CKD. Until we got the urine culture and urinalysis results on Monday, I was holding out hope Sadie had a kidney infection. A kidney infection is curable. CKD is not. CKD can be treated, however. Learning to do that is how I’ve spent my Christmas vacation.
Sadie and I went to the vet on Monday so they could teach me how to give her subcutaneous fluids. This entails injecting fluids under Sadie’s skin with a small needle. If you want to see how this is done, watch this video of a cute kitty named Gus. I watched this before I gave them to Sadie for the first time, and based on how she reacted to being given pills, I figured there was no way she’d be as chill as Gus. In the vet’s office, Sadie stayed in her carrier, which is soft-sided and zips open on top, giving me access to administer the fluids. I made the skin tent on her back near her shoulders, took a deep breath, and slid the needle in. Sadie remained calm. The vet tech was holding the IV bag, and began squeezing it to make the fluids flow more quickly. Sadie appeared to be a little uncomfortable at one point, but she didn’t move or try to escape. I gave her pets and talked softly to her, and before I knew it, we were done. I gave her some treats, which she wasn’t interested in. But it’s the thought that counts.
The vet gave us samples of various prescription kidney diets, the bag of fluids, and a baggie full of clean needles, and instructed me to give Sadie 100 ml every day for the next six days (for a total of seven days straight). We are to go back on Monday for a retest of her blood work. The hope is that after a week of fluid therapy, Sadie’s BUN, and more importantly, her creatinine levels will go down.
When we got home, Sadie casually exited the carrier and walked straight to the food bowl. I opened up a can of Hill’s k/d and spooned a little onto the saucer. What happened next was astonishing: the kitty who has been disinterested in food for days began chowing down. She ate nearly three-quarters of a can in one sitting. I was jubilant. The last time Sadie ate with any gusto was when she returned home from the vet after her initial testing. She’d had sub-Q fluids that day, too, but I didn’t fully understand how beneficial it was until this moment.
On Tuesday afternoon, it was time for me to give Sadie her sub-Q fluids for the first time at home, without the vet tech’s supervision. I was a little nervous, but determined not to show it, lest Sadie pick up on it. I warmed the fluids (which the vet tech did not do) and brought the bag upstairs and hung it on Sadie’s very own IV pole ($30 from Amazon). I put her carrier on her favorite sheepskin window seat, thinking this would help keep her in one place during the treatment. I put a handful of Greenie’s in the carrier and went downstairs to fetch Sadie. I carried her upstairs, set her in the carrier, made the tent, slid the needle in, opened the flow valve, and waited. Sadie was totally chill. It was as if she’d channeled Gus. I watched the level on the bag drop, and when she’d gotten her 100 ml, I turned off the valve, slid the needle out, and reminded Sadie of the treats. Instead, she jumped out of the carrier and went downstairs. I figured she was headed for the food bowl, but she curled up on her furry blanket on the back of the sofa and went to sleep.
Uh oh. Had I done it wrong? Why wasn’t she eating? Was 100 ml two days in a row too much? Was she dying? Was she unconscious? Every now and then I’d give her a pet, which she’d barely acknowledge, and go on sleeping. I fretted while she slept and googled, “Kitty sleeping after subcutaneous fluids.” I learned that while many kitties are quite active and hungry after fluids, some are not. Still, I thought maybe I’d done something wrong, since she was so energetic the day before when I’d given them. After an hour of stressing over the sleeping (dying?) cat, Sadie awoke and nonchalantly walked into the kitchen, and proceeded to devour the food on her saucer.
Yesterday’s sub-Q session did not go as well. My neighbor, back from England, came by, and I decided to show her how it’s done. Sadie growled and flinched when the needle went in, and took off out of her carrier shortly after the fluids began to flow. (Sadie never growls at me.) I gave up and decided to try again later without my neighbor present, after Sadie had calmed down. (It later occurred to me the fluids may have been too warm.) When I tried again, I did not put Sadie in her carrier, figuring we’d likely formed a bad association during the last session. I set her on her sheep skin on her window seat and piled some Greenie’s in front of her. This time, it went off without a hitch. Sadie lay still. She did not flinch when the needle went in, she did not try to escape, and she actually ate treats during the process. The only snafu occurred when I took the needle out and forgot to turn off the port, squirting the fluid around my bedroom like a broken fire hose. All the while, Sadie lay on her sheep skin and ate the rest of her Greenies. When she finished them, she went downstairs and ate a bit of food before settling down for her long nap. This time, I didn’t worry death was imminent.
Aside from giving sub-Q fluids, I’ve spent these past days experimenting with various foods (she likes the Hill’s k/d best), and holding Sadie while I read. She’s always been a cuddler, but she seems a bit clingier than normal. I have no objection, except I hate disturbing her when I need to get up.
On Monday, we’ll get a better picture of how far along Sadie is on the CKD scale, based on the IRIS staging system. The vet said based on her current levels, she thinks Sadie is a 2-3. Some cats can live many years at this level. So I’ll do my best to not catastrophize, and instead direct that energy toward helping Sadie feel better.
Who knew I’d be so cool with poking a needle into my cat? If I didn’t know before I’m a strong amazing woman, I know it now.
Along with my vet, this site on CKD cats has been an incredible resource to help me understand the signs and symptoms of CKD, and how to treat Sadie and make her feel better: www.felinecrf.org.