Caring for a chronic condition - can anyone relate?

[Puppylucky]

Hi
Posting here for moral support as everyone was so kind last time. My young male cat Elton was diagnosed with stage 3 CKD in Jan and since then it feels like we've been on a rollercoaster. Following the diagnosis we switched him to a renal diet which improved his scores at his last blood test (good news). However, he also has painful joints, that cause him to limp and become sad and withdrawn. We have treated him in the past with Loxicam which is like a miracle drug, giving him freedom from pain and making him playful and lively again. Unfortunately, Loxicam is bad for his kidneys and we have been advised by the vets to avoid using it if possible (bad news). A few weeks ago he started to limp really badly and was clearly really unhappy so we dosed him with Loxicam for a very short period and again the miracle happened as he regained mobility. However I am very nervous about doing this too frequently, and so we are at the moment watching him decline again. He has also taken against the renal food he was heartily enjoying until a week ago and is making himself sick by eating grass so something is obviously not quite right with his tummy (bad news). I know another trip to the vet is probably in order, but he hates it so much that he has to be sedated - which is another drug for me to administer and another distressing experience for him. I keep breaking down in tears as I am really struggling with dealing with his health issues all the time. I'm an inexperienced cat owner and don't know what to do for the best most of the time. He is such a loving and beautiful boy but I can't enjoy him as I am constantly on edge for the next problem. Can anyone else relate? Apologies for the ramble - cat tax attached so you can all admire my beautiful boy ❣️

What a beautiful cat you have. I had one like this - one problem after the other. In the end we put him to sleep when he was 15. He wasn't having a good quality of life after many years of problems. Can you talk to the vet about how hard you are finding it all? Is there a treatment they can recommend that will make it easier for you?

Thank you so much for responding @ForestBather . If Elton was older then it might be easier, but he's only 2 🙁. I find that our vet whilst very caring and conscientious, does tend to pass the buck back to the owner in terms of treatment decisions . Their approach seems to be that we know our cat best, but we've only had him for a few months (rescue cat) so we don't know him either!

Puppy, ask your vet for solensia. We give it to Boone and it is amazing for sore joints. Boone also has strange kidney markers (raised, but have been his whole life). Anyway, solensia doesn’t go through the kidneys as it is an injection.
I know he doesn’t like going to the vet which makes the injection tricky, however the last time I was at my vet she asked if I wanted to do the injections at home! So you could ask about getting the injections and being trained to do them yourself? Ideally it is every 3 weeks but as they’re expensive (£100) we only do it every 4 weeks.

Oh he’s beautiful! Our cat has multiple allergies and cystitis, so although it’s not the same issue, I have had 7 years(so far!) or dealing with chronic conditions. When her allergies flare, she refuses to eat which means it’s a nightmare getting medication in her. She also hates the vet and generally needs sedating. We did try injections for the allergies, and I was taught to do them myself which in theory is easy, but she is not an easy cat to handle! It was a 2 person job and unfortunately they didn’t work for her.

she’s now on a medication that’s only licensed for use in dogs, and steroids. she is currently well and has good quality of life. We arrived at this point when I bluntly asked the vet what they would do if she was their cat - yes you know your own cat, but they are the expert in treating animals. I explained that while she may not have the longest life (thanks to long term steroids), I want her to have the best quality we can give her where she’s not in pain and starving herself. The vet agreed and here we are.

Oh thank you both for replying and being so understanding! @LostCats you mentioned Solensia on a previous thread I think, so I am definitely going to ask the vet about that. I am starting to agree with you @BlueRidgeMountain that at this point, I want to discuss quality of life with the vet as much as anything. The problem with kidney disease is pretty much everything can make it worse, but at the moment he's not happy anyway, so maybe trying a few things that aren't so good for him, but will make him happier is the right thing to do.

Should also have said that Boone was born with a flat vertebrae in his neck which caused his legs to collapse 1.5 years ago. With steroids it has made a huge difference but it is really just quality of life now as we know every day could be the last. We have basically just bent our entire lives around what he wants to make every day happy for him. He is a hugely grumpy devil. Always has been. And we absolutely adore him so although he should be grateful he isn’t 🤣

Yes Elton isn't noticeably grateful for the effort we are putting in either!

Cats eh! But do let us know what the vet says for Elton. He really is so beautiful

Oh he's such a beautiful boy and so young.My old cat had stage 3 kidney disease, but she was 11 years old which I still thought was fairly young.
We tried every renal diet on this planet but couldn't get her to eat it.
It was so stressful and we loved her so much.
In the end the vet said get whatever food down her that you can.
She had 2 reasonable years before we put her to sleep.She was 13.
What I found helpful was Tanya's CKD website.It's brilliant and full of honest but also reassuring advice.
Good luck

Yes I have discovered Tanya's website (via MN) and it's brilliant. Her view on Loxicam is if the cat needs it for quality of life then it should be given regardless of the risks so I am trying to take this POV on board it's just hard when you want to do everything right for them .

Our vet had the same view. Harry had CKD and developed arthritis so he was put on a low dose of metacam, I believe the dose was for a 3kg cat although he was 5kg. It made a huge difference to him as at one point he was in so much pain we thought we would have to have him put to sleep.

Regarding the renal food, has your vet mentioned any supplements? Harry refused point blank to eat a renal diet so we gave him Ipakitine powder in his food. The vet at that time wasn't best pleased as 'there are better things out there' but as I pointed out they are only better if he'll eat them! His readings improved and remained stable so I must have done something right.

I used Tanya's website a lot when I had a CKD cat. OK I thought some of the advice was going too far, but the nutrition advice is great.

My cat made it very clear she would choose death rather than eat any sort of renal cat food. So we focussed on stuff she would eat, and keeping weight on her and Tanya's website was invaluable for that.

I did find I had to argue sometimes with the vet about things like pain relief- from the cat's perspective, she didn't care about living longer, she cared about being in pain.

@PinkSparklyPussyCat Thank you so much ! I've only just learned that the dietary issue with a CKD cat is reducing potassium not protein necessarily. The commercial CKD cats are all very low protein as low protein=low potassium. We have been looking for a potassium blocker as Elton is very young to have CKD and I can really see the effect that such a low protein diet is having on his musculature. The only one we've found tastes and (presumably tastes) like mud and he hates it so I will definitely try the powder and add a little more protein to his diet.

Not potassium , phosphates!

Am sure on Tanya's website she says renal cats get more fussy. I think I bought every single type of renal cat food and cat said no to all of it.

She only wanted to eat Sheba Cat Soup and so that is what she got.

Luckily I had another cat who is a dustbin in cat form, who was perfectly happy eating the rejected renal food. So there are cats who will eat it, just not necessarily the cat it was bought for.

My boy (16) has CKD and he flat out refused to eat any renal food. He has lost a lot of weight, so the vet said it's better that he at least eats something. We have been giving him the Ipakitine powder (phosphate binder) mixed with Lick-e-lix for the past couple of months. He doesn't taste it at all. We're also giving him Kidney Support Gold drops. He hasn't had his bloods redone yet so I'm not fully sure of the impact, but he seems really well in himself and has put some weight back on.

I had a cat years ago who had kidney failure due to FIV. He was 10 when we devastatingly had to have him pts. He stoically refused to eat any renal diet, so we figured he might as well have what he enjoyed while he could.

Our late DCat was on Loxicom long-term though he was already old before he started on it. I think his kidneys were about the only thing that was still functioning reasonably well, as everything else had gone to pot, god love him!

Update : Elton has decided to start eating his renal loaf again as long as it has a tiny dribble of cat soup added! He is obviously desperate for protein though so I'm going to try the powder so that I can add in some higher protein foods to his diet.

One more update as you were all so kind with your time and advice! Elton started vomiting yesterday, so we whisked him off to the vets. He's had an anti nausea injection and seems much brighter, so hopefully it was just a protest against the Felix soup. However, the big news is we also had him injected with Solensia and the impact so far has been dramatic. He's walking more easily and is just more engaged with us and the world. He's lost weight due to his nausea and he's hungry all the time, so I'm going to add a bit more protein to his diet and use Ipakatine to try and balance out the effects. But all in all it's a much happier night in the Little Elton House so thanks for all your advice and kind words !

Oh wow what a great update!

Oh that’s absolutely fabulous!!