Losing Erik to Feline Chronic Kidney Disease/Chronic Renal Failure

You might have stumbled upon this because you’re searching for information about feline chronic kidney disease (CKD) or chronic renal failure (CRF). You might be frantically reaching out for any bit of recent-real-life information like I was.

I want this information to be an account of what happened to our family and to our sweet boy.

It happened so fast, and he exhibited only a few of the physical symptoms that vets tell you to look for.

Even on his very last day the vet wasn’t sure that it was time just by looking at his bright eyes and cheerful, active body language and attitude.

But it was time. And I want other people to learn from our experience.

In mid-August 2015 our battle with feline chronic kidney failure began.. only we didn’t know that’s what was happening.

I took details notes about his symptoms, behavior, and the resources I found, so I thought someone else might find them useful.

I included our story and also specific examples of behavior like eating, litterbox, etc. If you’re more interested in that just scroll to the bottom.

RESOURCES

Before I share our experience I wanted to be sure to provide this well known site that thoroughly discusses feline kidney failure.

This online guide was essential as my husband and I learned how to care for Erik throughout his disease. It also helped us prepare for what it would be like to euthanize a pet and what we should expect, since neither of us had ever experienced that.

I highly recommend reading every inch of this website.

Tanya’s Comprehensive Guide to Feline Chronic Kidney Disease

 

TIMELINE

August/September:

In August our otherwise big, healthy, loving boy had been hiding from us. Erik loved people, though, so he eventually came out and sat on his heating pad.

I went to cuddle him as usual and felt his paws and ears- they were almost ice cold. He was alert, sitting up, and showing no signs of distress. I fully expected he had a cold or something very minor, but I still took him in right away.

When we got there they said his blood pressure was dangerously low and that he was severely dehydrated, which came as a huge shock to us. How did this happen? What was wrong? We still don’t know what happened.

They gave him fluids and ran blood tests, ultrasounds, and x-rays. He was back to normal and they sent him home with us that night.

At that point I thought maybe he had acute kidney failure, but to this day I have no idea what would have caused it, as there was nothing that he appeared to “get in to”, eat, etc. and we don’t have any dangerous chemicals in the house.

He was perfectly fine from then on. Like it never happened, until a few weeks later I noticed he was drinking more water than usual. He and his brother always loved to play in the sink and the bathtub, but this was different somehow.

I thought he was just not wanting to drink from the fountain. Their water fountain was old, so I thought maybe buying a new ceramic one might help.

It didn’t. He was constantly  jumping in the bathroom sink and tub.

Then maybe 3 weeks later I noticed he appeared to be losing weight little by little. Then later the obvious food-pickyness started. Erik LOVED to eat. He loved all kinds of food and was an adventurous eater. But when he started to turn up his nose at even his favorite foods I was concerned.

During all this time he had a few followups and  I had been researching the symptoms. His blood work was normal. At his first episode I thought he had liver problems, but the vet said that was not the case.

October:

Then, 2 days before we left for our vacation in October I noticed more pronounced weight loss around his spine and hips.

The food pickyness had gotten worse. His attitude never changed. He wasn’t laid out, he wasn’t lethargic. He wasn’t crying or showing any distress…but he was dehydrated again and his BUN and creatine were stage IV kidney failure.

Erik needed to be hospitalized and given IV fluids and observed. We cancelled our vacation and visited him every day of his 12 day hospitalization. He didn’t want to eat until we visited.

He was released after his blood work seemed stable. He would bounce stage II and III depending on the day of the blood work. We started subQ fluids at home after that.

November:

Around mid-November I noticed he was a little wobbly. He was still walking, but he just didn’t seem as sure footed as usual. I thought it might be because of his weight loss.

His coat was still bright and soft, though his fur was a bit spaced out where we were giving him his subQ fluids.

Erik had  to be hospitalized a few more times between October and December. The vet tried hormone therapy, but he didn’t respond as well as we had hoped.

IMG_9753

Erik loved to snuggle

At one of our followups the vet also discovered that he had severe anemia that had not been present in previous blood work. This surprised everyone because he never showed the tell-tale signs of anemia except for the slight wobbliness.

Since he slept with us we lowered our bed to the floor to make it easier for him. We tried everything we could think of to make his daily life easier. We kept him warm and tried to bring things to him so he didn’t have to do too much.

We were presented with a last-ditch option- a transfusion. At first we said no, because it was highly invasive for both Erik and his brother, and it was only going to give him a few more months, at most.

After thinking about it we did try it. And we are glad we did. It gave us almost 2 extra weeks with him. In those 2 weeks even though his health quickly deteriorated he remained bright, loving, and cheerful.

December:

He had one major seizure 5 days before we said goodbye. Though he was awake he was rigid and urinated freely. It lasted only a few seconds and he acted like nothing happened afterwards.

In his last week he was passing blood in his urine in both large clots and in liquid, and the vet said that was to be expected due to his condition and the recent transfusion.

He had very small seizures, too, but I don’t remember how many. My husband would whistle and sing to him and we’d pat him until he seemed like he could see us again. We think that he had high blood pressure at the end, as well.

Next he started bleeding from his gums a little bit. I knew it would be happening soon, so I was doing everything I could to help my family emotionally prepare.

Erik loved to sleep on my chest and 1 day after the light bleeding started I woke up to find blood on my chest, my face, the comforter, and his little chin. I was too shocked to panic, and he just looked up and me and smiled, snuggling against my face.

I wrestled with my gut vs. my heart. I couldn’t believe it was time. I wanted more time. I needed more time. But when we saw him go to the litterbox then come back and lie down, turn his head slightly (as if he was having a light seizure) and cry my husband and I rushed him to the vet and prepared ourselves.

Making the decision to say goodbye when your pet has such a will to live but his body is dying is the most painful experience of my life so far. He was not ready to go, but his body would not have lasted much longer. CKD cats can go peacefully on their own, but the likelihood of him having a heart attack, more seizures, and other episodes like that was just too much to risk. Neither of us wanted him to suffer more than he already was.

It seems that, for us, his kidney failure related anemia is what took him. He could no longer filter his own blood.

In the end he had lost at least 2-3 kg. We actually didn’t ask what his weight as at his death, but I know he was a fraction of the big, beefy boy he had once been.

Eriksgoodbye

Saying goodbye

This is the last photo we have of him. As we waited for the vet to arrive we sat in the car to keep him away from unnecessary stress.

Shortly before it was time to go inside he weakly reached over and put his paw on my husband’s hand, gripping it tightly. Erik-chan loved to grip us when we held his paws or held him in general, so this was a special moment for us all.

I wish we could do more for him. I wish there was more that can be done for every cat who gets this condition. I want there to be other options, and I hope they’re available in the coming years.

Progressive, degenerative diseases with no cure, both human and animal, bring sadness and loss wherever they’re found. I hope that someday that will not longer be the case.

 

AT HOME CARE

We gave him nightly 200 cc of nightly subQ fluids. He received 1 kidney pill and 1 vitamin daily (both Japanese medication) and was usually such a good boy about taking them.

I would sit behind him, placed my hand through his arms so my arm was on his chest and my hand could tilt his head back.

Throw the pill in there, and blow on his nose or put water or food on it to get him to lick and ensure that your cat swallows the pill.

At times Erik was the master of stashing the pill in his cheek and spitting it out when I wasn’t looking, so just make sure it’s been taken. To be sure I started giving him a treat afterwards. If the pill fell out we started the process again.

LITTERBOX

I’m including a bit about the litterbox because I didn’t see this in any of my research.

Once the nightly subQ treatment started Erik started using the bathroom more frequently. I expected that due to the nature of the therapy.

He flooded the litterbox, which we read about but didn’t know what to make of it until we saw it.

What this meant was that he urinated to often and so much that it meant we had to change the litter much more often. Almost daily. To avoid this we added a layer of baking soda and litter. Then we placed a cheap dish-drying tray on top of that and covered it with litter.

That seemed to work well and prevented us from changing it so much.

Another thing I had never see before was the way the urine “leaked” through regular hefty trash bags, but it never had before. We used the same bags as we did before he got sick, but once his condition worsened we found that the urine literally leaked through the trash bags.

We had to double bag and put it in a cardboard box just to make sure nothing got through as we were changing the litter.

EATING

Eating became an exhausting daily battle of trial and error.

IMG_1589

We tried buffet style daily to figure out what he would eat.

Every day was different. I bought baby food. I bought kitten food. I bought every kind of canned food available to me. My family is stationed overseas so we didn’t have many options, but I bought them all. I tried everything to get him to eat.

He rejected the recommended Science Diet KD and Royal Canin. He would nibble if I added tuna juice, but that’s all. He wouldn’t eat much of it.

I baked chicken, and he wouldn’t touch it. So I bought a turkey and baked it. I found that he would eat bits of roasted turkey if I sat by him and hand fed him. Then he stopped wanting to eat that, too.

Eventually I decided to try Japanese wet cat food. Same thing- I bought 1 of every small can.

We found that he loved the Japanese version of Sheba and he heartily ate that until he left us.

KIDNEY TRANSPLANTS

Depending on where you live kidney transplants may be an option. I am in Japan, and this is not a common procedure.

I found 1 university several hours away from me, but they said due to his age and advanced kidney failure that a transplant would be much more risky- that he would likely die from the operation instead of kidney failure.

If you can catch it early and find a medical school or clinic that will agree to do this you might consider it. It is expensive (I was quoted something like $15k.), but at this point I was desperate and didn’t care. I just wanted to try my best to do everything I could for my baby.

 

SOME PHOTOS OF ERIK-CHAN

Rest well, sweet boy. We love you so much. You brought us almost 11 years of joy, love, and laughter.

 

 

 

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