TBT: Ayla and Laz visit the vet later today. Ayla for a "6 month senior exam". Laz for us trying to find out why he attacks Ayla and Lori sometimes. We will be discussing behaviour-modification, meds, etc. Wish us well...
Marley visited the vet yesterday for a new blood test. In his last annual visit this Spring, his BUN and creatine levels were elevated, though everything else seemed OK.
He went back in June to see if things had changed. They had, but the vet seemed thought there were some issues with "fatty blood". I had "fasted"him 12 hours before the appointment, as requested. They suggested waiting 8 weeks and fasting him 14 hours and to stop giving him kibbles. They really don't like feeding cats kibbles. Protein, protein, protein.
That's OK. Decades ago I fed my cats my cats kibble. It was all I could afford and they seemed to like it. But I switched to canned in the 90s. But Laz grew up on kibble and adores the stuff. So I bought some again, for him. And when he had some, the rest had to have some. All The Mews enjoyed one kibble meal per day.
But my new vet says there are too many fillers and carbs in kibbles, so protein, protein, protein again. Marley and Ayla eat anything. Laz and Lori are fussier (Lori always checks to see what Laz eats). So sometimes I have to give them a few kibbles on the canned stuff to get them started eating...
I weaned Marley from the kibbles over a few weeks, and he hadn't had any in August (and seems fine with that).. Ayla doesn't seem to mind not having kibbles either. But being told to wean Marley off kibbles will seem a little odd later in the post...
So Marley had his blood tested again yesterday ("renal panel"). He lost a couple of ounces since the June weigh-in, but he was "fasted" for 14 hours, so that doesn't mean much. His BUN and creatine levels were slightly worse than in June and about same as in Spring. But "same" doesn't mean "good".
From what I recall from the test page of the past 3 visits, he is about double the level he should be at for both. The result is that the vet says Marley needs sub-cutaneous fluid injections 2x a week. And they can do it or I can. The cost is the same.
I would pay for the fluid and needles and drip line, and they will administer it to him at no additional cost. But I have to visit them for that. Or I can learn to do it myself (and I don't have the steadiest hands - finger tremors due to DDT exposure as a teen).
Well, the fluid injection is not exactly micro-surgery. I watched them do it. But there is some procedures to it that I'm not familiar with. There is an order of needle-attachment, clamping and unclamping the drip line, needle-insertions etc that I need to become familiar with.
So the plan is that I will bring Marley to them 2x a week for 4 weeks and watch the procedure. As a practical matter, the clinic is a busy place. I spent 2 1/4 hours total leaving, staying and returning home yesterday. Renal panels and drip-lines fluidization are not fast. Doing it myself seems a lot better. But I need to be sure what I am doing.
Then (after 4 weeks) they will do another renal panel test. If it is helping him (and apparently sometimes it does not) we will continue. IF it is helping him, we will continue until, (on the last couple of times) I will actually do it myself under their supervision a couple of times and learn to feel confident enough to try it on my own.
If fluidization helps him after 4 weeks, I will clear the top of my dresser. It's the right height. I will clear the top and make it his special place for the injections. Cats like routine, and the bedroom is a "safe" place to all The Mews. I will hang a hook to support the fluid bag (it lasts 5 weeks) up high (it drips in faster with height). I will also hang a log-page to record the injections (my memory has never been the greatest). I will have a closable container or new needles and one for old ones (for hazardous waste removal). A bag of cotton balls to hold over the injection site (tiny amount of bleeding involved). Apparently, when done properly, the fluid does not require refrigeration but remains sterile from lack of exposure to air.
But if the fluidization is not helping him (kidneys failing beyond assistance), Marley will live out his life not being stabbed 2x a week. He is 13. That is not quite "old", but it is not like he hasn't already had a pretty full life. When the time comes and his problems grow worse (in that sad case), I will have the vet release him from pain.
I have gone through this before with Skeeter. His kidneys were failing at 16. The vet I had at the time said he would do the fluid shots once a week, and never suggested I could do it myself. I declined the procedure, thinking of it as too stressful in his old age as weekly vet visits seemed very stressful to him (I would reconsider that now). Skeeter had a 6-month decline.
When Skeeter suddenly started falling over or leaning against the walls, the vet agreed it was "his time". According to a chart my new vet has on the wall, 16 1/2 is something like 86 in human years. I'll be glad to reach that age myself.
Marley is younger than Skeeter was, so I hope to give him some more years. This is not the time to discuss grief (though I feel it coming). So let's hope the fluids help him thought some more years and relative health.
I mentioned "But being told to wean Marley off kibbles will seem a little odd later in the post..." The vet recommended a "kidney disease" cat food from Hill's or Royal Canin. "Odd" because it has less protein and more carbs (which sounds like kibbles). Which seems like exactly the opposite advice they gave about protein, protein, protein. But maybe there are some differences...
I hate things that seem illogical, but maybe the un-improved renal panel results changed their evaluation of "best treatment". Well, I'm not a vet and I suppose previous advice can be overcome by new test results... *sigh*
As always, if anyone has some practical experience in this situation, I would love to hear from you by blog comment or email. Good hopes and encouragements are also appreciated...
