The Cat

When I left you last time it was with the news that the Cat was to be taken to see Four Under Nine, the Vet, for a last ditch steroid injection in the hope that the end stage renal failure she was in could be delayed. As a family we were particularly keen that this should work as Strider was coming over at the end of the week and she dotes on the Cat as much as I do, albeit in a wusy “That Cat Food Smells Disgusting and I’m Not Coming Back Into This Kitchen Until The Back Door Has Been Open Half An Hour” kind of way.
Sadly, the cat did not respond to the treatment and died at home on Sunday morning.

One of the most difficult things from our perspective was knowing when the time had arrived to take her up to Four Under Nine for euthanasia. Right up until Saturday night it seemed as though it could have gone either way, she was responsive and interested in everything. She hadn’t gone to hide in a cupboard or behind the curtains; instead she remained on her doormat chirruping at anybody who gave her a stroke on their way past. We went to bed on Saturday night eighty percent sure we would be calling on Brian the Vet the following day, but in the end it wasn’t needed.

On Friday night when I was seeking out information about her condition, I came across an excellent website called Tanya’s Feline CRF Centre (www.felinecrf.org) which I would recommend without hesitation to anybody with an elderly cat. My cat was diagnosed with renal failure 5 years ago but apart from prising her from the ceiling to administer drugs on a nightly basis, she showed few effects up until the last few weeks. The CRF Centre website contains a wealth of information about diet and care in addition to detailed symptoms and their causes.
The page detailing the effects of the end stages of Chronic Renal Failure was incredibly helpful and the advice and personal stories regarding the time for euthanasia invaluable. It is because of this that I am now going to tell our story so that if you have stumbled here from a Google search for “Renal Failure in Cats”, you will have a clearer picture of what happens. We were supremely fortunate but if you are easily upset (or you are having a bad day), you might want to pause here and come back next time.

As I mentioned last time, we were aware something was seriously wrong when the cat stopped eating properly. We were encouraged that she was enormously keen on being fed Whiskers Cat Milk from a syringe on her Mammy’s lap and rather puzzled that she appeared to want food, she just didn’t want to eat it. The last thing she ate properly was teabag sized amount of turkey on Thursday night.
On Friday, He Who Knows Everything took her to the Vet who took a sample of blood for testing. On Friday evening he called us to let us know that her levels were off the chart.
On Saturday morning he gave her fluids and an anabolic steroid in the hope it would give her a boost but unfortunately, she did not respond to the treatment.

What was most distressing for us was her difficulty in walking. Her back legs didn’t want to work properly (which can be due to a number of different factors) and she had difficulty in lying down and became dependent on gravity to do the work for her. Despite this she was determined to go where she wanted to, including a final jaunt outside for a wee on Friday, even though she was so weak and wobbly the wind shunted her sideways on her way back into the house. What can I say? The cat wanted what she wanted.
In her final week, she was also drinking a fairly large amount. It was only in the last 6 months that she began to drink water from her bowl, prior to that she would have the occasional drink from a fresh puddle or, when we still lived in the UK, the stream in the back garden. On one occasion she managed to fall in and became slightly less keen on it after that.

Anyway, on Saturday, she was perky and tried to escape from the Hateful Box Of Horridness before we could put her in it. Then she tried to bite Four Under Nine when he gave her the injections. Then she tried to make a break for it from the examination table. When she got home, she returned to her doormat and had a nap, no doubt exhausted by all of the excitement of trying to bite people.
Throughout the day she frequently got up and sat down again, unable to find a fully comfortable position. This is common in CRF cats. She also felt the cold and began to make her way to the sunroom for a sunbathe. I lifted her most of the way as soon as I realised that was where she wanted to go and she spent an hour alternating between the rug in there and the patches of intermittent sunshine.

I was able to give her three more syringes of the cat milk which she enjoyed but by two o’clock, she no longer wanted any.
At five, having moved back into the main hall, she stood up and forcibly vomited a large amount of watery liquid which was followed immediately by a significant urination. She was able to stand up for this and I was on hand to lift her away from it as soon as she was done. Many CRF cats become unable to stand up and may urinate where they lie. This was the moment I knew that she would not get any better. Even so, she remained as perky as ever and was able to move more easily without a belly full of liquid.
At some point during the day her sight had deteriorated significantly. She was still able to see to some degree as she responded to movement and knew which of us was which, but her pupil was no longer contracting in light.

We put her to bed on her doormat that night knowing we would probably have to take her to see the Vet the following day. Sometime between midnight and six, she fell into a coma.
She had either vomited or urinated on the floor, moved away from it and lay down. While in the coma, she would defacate (although there was not much in her to come out) and drool copiously. We had cloths on hand to wipe as much of it up as we could, but she was damper than an ideal world would permit. That said, she was a very, very long way from what most CRF cats go through.
Although this sounds as though this would be awful, it wasn’t. She didn’t smell any more abominable than she had the day before (this is due to the toxins in the blood stream) and she was, in a very real sense, already dead. She just hadn’t bothered to stop breathing yet.

I know that she was in no pain and I am so thankful for that. A cat in pain will purr. Odd, but true. When she had her eye out, you had only to poke her and she would erupt like a lawnmower. My cat did not purr in her last days.

I had read about the fits and twitching CRF cats experience and I was concerned about what would happen if she had a fit. I’ve seen grand mal epileptic seizures first hand and they are enormously distressing things to watch. She did twitch during her coma but it was only slightly more violent than the movements she would make while dreaming.

When she died, her breathing slowed and stopped completely. Her body convulsed violently half a dozen times; the best way I can describe it is that it was the same as a retching motion. Her body then went into cardiac arrest. All of her muscles became tense so her back legs were stretched out behind her and her front legs in front of her and her body trembled very slightly.
I could see her heart beating highly rapidly for perhaps ten seconds before it stopped completely. I stroked her head with one finger as she died the way I did when she was sleeping and I didn’t want to disturb her with a proper head squadge.

Even after the heart and lungs have stopped, the body still moves. The muscles relax and any waste products are expelled (in less delicate terms, more defecation if there is anything left in there). This was something I found hard. As I have said above, I knew she was dead when I saw her in the coma. She didn’t look like my cat looked, if that makes sense. Heaven knows my cat could not be roused when she was deeply asleep – I could pick her head up and she wouldn’t wake up, she’d just start licking my hand in her sleep – but the coma was different.
What was difficult was knowing when it was “okay” to wrap her up and get on with the cleaning up. As it happens, getting up, getting a towel and coming back was how long it took. Not long at all.

I am so grateful for all of the care she received from our Veterinary Surgery. It made a huge difference knowing we could totally trust Brian with her welfare and knowing that he would not have allowed us to let her suffer just so that we could have a few more days. I always had total faith in him to make the right decisions for her, indeed total faith in every single member of the Veterinary Centre in Wexford. Brian, Richard (the rugby physiqued vet), Dan et al, I salute you now. Thank you for everything you did for her.

Although I am sad that she is gone, I’m also happy that she was able to go more easily than some do. She had a good life. She began as the runt in a dumped litter, rescued by the Cats Protection League and she ended surrounded by people who loved her. She is done now.
I miss her, but I’m glad I knew her.

3 comments:

Anonymous said...

Thank you. My 13 year old rescue cat Jo-Jo (Female DSH,angel on earth, kind soul, happy little girl, my soulmate) was just diagnosed with CRF 5 days ago). She was OK until the day after diagnosis when we started her on Fortekol, and she had some SubQ's, then the next day a two week antibiotic injection because we couldn't get the anti pills in to her. Since then, she has become a bit listless, doesn't want to eat, and hasn't pooped since Saturday - oh and after the subQ;s, that evening I found her laying in a puddle twice - didn't smell of wee but I think it was the subQ's coming out - vet agreed. Tonight her front right leg has started shaking - I'm sure it's an imbalance of something, so will have to take her back to the vets tomorrow. Thanks for describing what happened to your baby - I think my girl may be further down the CRF route than we realised only a few short days ago. BUN 26.8, creatinine 372 - that was a week and a half ago when the bloods were taken - God knows what it is now. Hope you are comforted by knowing you were there for your baby at the end.

Anonymous said...

I'm deeply saddened by your experience. my cat, Boo Boo, not technically diagnosed, is likely suffering from chronic renal failure. every day I cope home from work and worry that she won't be alive. I've ordered her special treats with all the necessary vitamins and taurine, a high calorie supplement, a vitamin gel, pepcid ac for her upset tummy, meat
baby foods, pedialite, syringe feeding
her, sub q fluids twice a day. I even put a girl in the bathtub so her water stays fresh and clean for her. she still won't eat. not unless I syringe fed her, which she hates and growls at me before I can get one teaspoon in her (twice a day). luckily I have the vitamin and high cal gel and pedialite to mix in to help. she acts interested in food but once she smells it, she acts like she's
going to gag. I don't want her to throw up everything I just fed her and all the water she drank bc I pushed 1/2 tsp too much. but I'm not home all day to feed her more often. I'm poor, which is why I can't afford the blood tests and urinalysis to get a proper diagnosis, but the vet did say her kidneys felt shrunken and the right one felt smaller than the left. she still cuddles and sleeps right next to me at night, she purrs when I pet her, she head butts my hand for more loves.she hasn't willingly eaten anything since sunday (5 days ago) and even that was just licking gravy off the canned food. I heard about a newer low cost very and might check it out as see if their lab rates are any more affordable to get get a proper diagnosis, if it's not already too late. will prob have to get a payday loan, if I can, to pay the vet and my rent and phone. I'm just so worried and stressed out. my baby is 11 years old and I got her 7 years ago (she was 4 when I got her). she's not really that old for a house cat. I hope I can help her feel better and give her a little more time and a better quality of life. any advice is appreciated.

Theo said...

Hi second Anonymous person.

I'm so sorry to hear about Boo. Even though it's been a good few years since this post was written, I still remember what it was like at that time, so I appreciate how difficult it is for you right now.

I have to be honest with you because I'd be doing us both a disservice if I wasn't.

My advice is to think very carefully about whether you are able to do you best for Boo.

I am concerned that she hasn't been able to eat for 5 days but your financial constraints are such that you haven't been able to take her to the Vet. My heart goes out to you because I have a fairly hand-to-mouth existence myself right now.

If Boo does have CRF, her condition cannot be cured, it will need to be managed. This will mean regular Vet visits and daily medication. Are you able to commit to this financially? Delaying her treatment until you have the money may cause her to need more treatment, which will be more costly.

Payday loans are bad news and I urge you to do whatever you can to avoid using them. Have you anything you can Ebay? Or have a yard sale? Could your work advance you some pay? Or is there anything you can cut back on with grocery shopping? I spent a lot of time being vegetarian this past summer because I got hit with some unexpected costs to the car. I'm very glad I know enough about cooking to be able to go to the supermarket and build a meal around whatever is on special offer this week. I don't know if you have Credit Unions where you are, but they are usually far better for small, short term loans than these payday loan companies.

I know you love her, but please, sit down and have a good look at your finances. When you take her to the Vet, be open about what you can afford and take their advice. As I said in this post I'm lucky with my Vets, they know the score and aren't shy about the money. They don't want animals to suffer because somebody is scared of the bill.

If you can't afford her treatment, please consider whether keeping her alive is the best thing. From what you've said her condition is quite serious (and she may have mouth ulcers which is why she's growling at the syringe).

I know how difficult this must be for you. Whatever you chose to do, I hope it works out. I'm sure you'll do your best for Boo.

(hugs)

Theo