Elderly cat with severe kidney infection

[tootyfruitypickle]

I just wrote an entire huge post and lost it - so apologies if this pops up twice!

My cat is 19, she has a heart issue (well managed for past 6 years), severe kidney disease, and high blood pressure (this is now well managed).

She had bladder worms a month ago (vet disagreed it was possible, but I saw them!) , now for the past week has had a UTI. Last week I took a urine sample, and the vet prescribed antibiotic tablets. She had been passing extremely bloody urine but it has cleared the past few days. However yesterday, she didn't wee, eat or drink. When she did finally wee it had blood in it again, soI took her to the vet.

The vet wanted to keep her in for 3-4 days for fluids and antibiotics. I disagreed - this is an elderly, slightly confused cat, who is very clingy and has a very definite routine. She would absolutely hate being kept in and it's a very different ballgame to keeping a young cat in (I have done this in the past). The vet wanted to keep her in as it was her best chance of beating the infection - however it may not work. In the end, they gave an injection of antibiotics, and fluids, and I took her home, with instructions to call in the morning for a new tablet prescription if she was stable (obviously she wasn't expected to get through the night).

She's had a comfortable night, and has woken up , eaten two pouches, drunk a ton and had a big wee. Obviously I know this may not last.

I guess I'm just looking for reassurance about my decision. I appreciate following vet advice gives her the best chance, but we've been at the vet at least every 2 months for different crises since January, something, at some point, is going to force me to make the decision to let her go, and I absolutely do not want her last few days or weeks to be spent confused and scared in a vet hospital.

Incidentally - it would have cost £1k. The vet didnt even seem to think this would be an issue! It cost me £250 last night as they charged two consultations - one of which was a 5 minute chat in the waiting room about the bloods (which showed she had severe kidney disease and an infection - which I already knew!) and with me explaining I'd decided to take her home - against advice. I'm a single mum, £1k is all I have in savings, it's not a small issue to spend it all although I would of course have done so with a younger cat. I don't have insurance because I used it on her conditions and it only paid out for a year for each, so it seemed pointless to continue it.

My mind has been spinning all night with whether I'm doing the right thing here.

NC

Threads like these are never easy and I am completely empathetic to your situation. I have an elderly cat also with chronic renal problems. My little guy is still doing okay, but he's not as old as yours.

If it were me, I would make the hard decision now. She's very old, and from what you have said, she's very ill. She's lucky to have had you to live and care for her, but she has come to the end of life and postponing is not in her best interests. She won't recover much for long, and if it were me, I would let her go now, before she deteriorated further and the decision is taken out of my hands.

I was in a similar position with my elderly lady 3 years ago. She was also 19. When cats have renal disease there comes a time when they contract infection after infection. Cats very good at hiding pain and my vet said if she was still eating, drinking and finding her place in the sun, she was probably happy enough, but continual infections and issues were distressing for her along with each subsequent visit to the vet which she really hated. I decided it was kinder to have her PTS and the vet agreed, saying that this is what he would have done had it been his cat. It was devastating, but it was better for her not to be suffering any more painful ailments. to you - it's not an easy decision to make.

Given her kidney and urinary problems, iv fluids are her best chance right now. You can give fluids subcutaneously at home if you're able, your vet can show you how. But yes it does sound like she's near the end and personally I wouldn't wait until her condition gets worse. Failing kidneys means there will be a build up of toxins in her system which will be making her feel pretty awful.

So sorry OP, it's really tough.

I have made the decision to cancel my 19 year old girls pet insurance which is approaching £150 with a £200 excess and 20% of all treatments not covered as it is no longer tenable.

She won't be going into the vet hospital for any reason as she's just too old and has had every illness known to cat, she has cost the insurance compamy around £10,000.

I've decided the next illness is going to be the last one and will be managed at home and if it can't be then that will be it.

It is just such a hard decision to make but with my cat the time has come. I'll be putting that £150 into the bank every month to cover any emergency treatment such as infections.

there will be a build up of toxins in her system which will be making her feel pretty awful.

I agree, my last cat had chronic kidney disease at 19 and I left it too long. At the end the toxins built up so much she was completely confused, tried to eat a baked potato and was walking round in circles. That night she died in her sleep. That isn't going to happen again to this cat.

Thank you. Yes I know she is near the end as I can smell the toxins coming off her, and my feeling is also that even if she beats this, there will be more UTIs. DD had recurrent utis for a while and so I really feels it’s unlikely an elderly cat can clear them.

I think I am going to try another week of tablets, and then if the blood / loss of appetite returns, I will let her go immediately. As shes picked up this morning, I can’t bring myself to do it today, but I will act quickly if it starts to go the other way.

The vet is also letting me in with her now. I feel there a short window of this, and this is important to me , to be there with her.

So sorry, we love them so much and it's so very hard to know when we should do it but I think you're right.

Well she’s perked up considerably for now! Very much happier, so she seems to be on top of the infection at the moment. Taking it a day at time and making sure she has good days. Also changed her cat food to even posher so she is loving that !!