Urgent advice please - Polly at emergency vet - PKD/kidneys

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Suze
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Urgent advice please - Polly at emergency vet - PKD/kidneys

Post by Suze »

Hi everyone. I'm really hoping someone is around as I could very much use some urgent advice.

My 14 year old petite girlie Polly was diagnosed with polycystic kidney disease a couple of months back. Bloods in July showed early renal failure but numbers were not considered bad enough to start any treatment. Everything was in normal range apart from creatinine which was around 220 I think (normal they said was up to 190). Also her potassium was a little bit low but she was started on 1ml of oral potassium supplement twice a day which brought her levels back up to normal.

Polly had been doing very well up until yesterday. She's been very happy, very cuddly, following me around & jumping on my lap at every given opportunity. Food wise she'd been eating, not as much as we'd like, but nevertheless eating. Cat food wasn't her first choice & we did accidentally discover she had a liking for spaghetti with crayfish & cornflakes!

She had a routine appointment with one of my vets on Friday & had a repeat ultrasound which showed that one of her kidneys really wasn't functioning but the other did have some function. We came home, she was happy enough & she ate a whole can of the new kattovit renal we bought to try.

Saturday morning however she was sick & brought up a little clear liquid. She didn't want breakfast but later had some tuna and the new renal biscuits. She wasn't herself & was lethargic but still giving me headbutts & wanting fuss. Yesterday evening, she ate a teaspoon of tuna with her potassium supplement & a few biscuits. She barely ate any supper before bed & this morning only a little tuna & a few biscuits. She also didnt appear yo be drinking and felt dehydrated. We tried everything from white fish to venison but she sniffs & turns away.

After a few issues on the telephone I finally got her down to the egency vet who confirmed dehydration. I am not altogether happy with the vet but I have no other option. I feel like I'm very much being pushed to put her to sleep. He's said we can't cure her & I need to be thinking about her quality of life.

She's currently on a drip to try & rehydrate her but he's being very negative. Bloods have been run & show her creatinine is 400 but her urea is off the scale. I've asked about treatment and he's basically said no, just the drip & the oral potassium. I've asked about an appetite stimulant & again he's said not at the moment.

I don't know what I should be doing. When he rang me with the blood results 15 minutes ago, he was again talking about quality of life and pts, made me feel awful for wanting to give her a chance.

Surely she deserves a chance & surely there should be some medication given to her. Any advice gratefully received as I really am in a mess.
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Re: Urgent advice please - Polly at emergency vet - PKD/kidn

Post by Jacks »

Oh Suze - so sorry to hear what you are going through with your darling girl Polly. I don't have any experience of PKD or kidney disease, although I'm sure others on here have. What I think is important at this time is that you get another opinion. It certainly sounds as if your little girl's body is not coping and her kidneys are failing, but all of us will feel with you that we would want to give out kitties a chance of recovery if at all possible.

It may be that this is not possible, of course, because the damage is too great - but I think you need to be sure for both Polly and for your own peace of mind - so that if you do decide to help her on her way in the kindest way possible you know it was the right decision, and don't feel that you were forced into it. Can you speak to the vet nurse and ask if there is someone else who could see her as well? Are you able to talk to your vet and explain how you are feeling and your dilemma at this time?

Thinking of you and your darling little girl. x
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Re: Urgent advice please - Polly at emergency vet - PKD/kidn

Post by Suze »

Thank you for your kind words. I'm struggling with what the vet was saying as he hadn't seen her 24/36 hours previously & didn't seem to have the same opinions as my vet who said we would treat symptoms as they arose as with any kidney disease. This guy was very much, it's not curable so why prolong the inevitable, or at least that's how he came across. Unfortunately, it's a large chain of out of hours vets that take over at my vets & I am far from impressed with them but there is little choice but to use them. The fee just to hospitalise her for just over a day & a half until my vet is back in is over £500 exclusive of any actual treatment.

I spoke to the night vet at 11 & they said she was settled, fluids going in, heart rate 180, urine a bit dilute but not as bad as many kidney cats, temperature normal. She said she hadn't eaten & asked what might tempt her. I said I'd taken a bag in with various pouches & cans plus cooked coley, venison & turkey. The day staff hadn't even passed that information on. The nurse popped some of the coley & turkey in whilst I was on the phone & said she had started to eat it. I did request that they consider syringe feeding something if she wasn't eating but they seem very reluctant. We'll see where we are tomorrow & hopefully I can go & see her & get an idea of how she is in herself. I just wish I could get hold of either of my 2 regular vets.
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Re: Urgent advice please - Polly at emergency vet - PKD/kidn

Post by booktigger »

I'm sorry to hear this, I hope she can rally round but figures going up that quickly in such a short space of time as well as the ultrasound showing a decline doesn't sound good unfortunately. I'm sure you know that they can function with no symptoms until 20% function remains and they often do end up with a crisis. Fingers crossed tomorrow brings better news
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Re: Urgent advice please - Polly at emergency vet - PKD/kidn

Post by Suze »

Thank you Desley. I really don't know at the moment. When my vet did the ultrasound on Friday he said that the kidneys didn't look any different on the ultrasound aside from the larger outer cysts which had increased in diameter. He said the amount of functioning kidney was the same as the previous scan so I'm not sure what has triggered what seems like a sudden crash to us. I don't think they've checked her BP as that can cause high urea too, can't it?
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Re: Urgent advice please - Polly at emergency vet - PKD/kidn

Post by greenkitty »

I'm sorry to hear this Suze and sorry I can't be of more help, I just don't understand enough about this condition at the moment. Have you found Tanya's CRF site yet? They have a forum, perhaps someone on there will be able to give some advice. Keeping everything crossed for Polly x
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Re: Urgent advice please - Polly at emergency vet - PKD/kidn

Post by Crewella »

I'm so very sorry Suze, it's a rotten situation. I do think it's a good idea to get a second opinion, if only for your peace of mind.

If I can be honest, and I thought long and hard before posting this, from what you say I'm afraid my gut feeling is that your vet is probably right. It's a very fine balance between 'giving them a chance' and prolonging their agony, and you need to make absolutely sure that, if you do push ahead for treatment, it really is in her best interests and not because it's just too hard a decision to make to call it a day. I've lost a cat to acute renal failure myself, and I remember how miserable he was - he hated the vets, and though it was tough I'm quite sure we did the right thing. The alternative to PTS would have been a lot of unpleasant treatment for very little reward and little chance of a positive outcome.

Please don't think me unsympathetic, I lost my old boy Pugwash last week and I really feel for you. It's a horrible decision to have to make, and you need to be very clear in your head that you're doing the right thing. I would get a second opinion, and talk it through with the second vet. It sounds as though you don't have much of a rapport with the vet you saw before, and that really doesn't help - I've been in that position, where you don't really feel the vet is giving you their best attention and is just going for the easy option, and that's no help at all.

It goes without saying, of course, that I hope there is another option and that you will be able to help Polly and love her for a little longer, but either way I think another vet's opinion would really help.

(((hugs))) and a gentle fuss to Polly. xx
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Re: Urgent advice please - Polly at emergency vet - PKD/kidn

Post by Suze »

Thank you Julia. I don't really think I have the best understanding of PKD either. Kidney failure is hard enough to understand without the complication of the cysts too.

I've read quite a bit from Tanya's CRF site but I find it quite hard to take in. Do you? It was Tanya's site that made me want to try and treat this crash she seems to be going through & give her a chance. It gave me the impression that there was at least a chance she could come back from this. I guess we still have to wait & see on that front.

I'm going to go in a see her in a bit. As of 1 o'clock, they said she was eating well, purring, passing quite a bit of urine. The latest urine test showed specific gravity of 1.016, there was also a bit of protein in & glucose in it but they haven't suggested any medication as yet. She's got repeat bloods due at 4 o'clock so that will give a bit more information.

Just looking forward to seeing her & very much hoping that one of my vets is in in the morning.
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Re: Urgent advice please - Polly at emergency vet - PKD/kidn

Post by Suze »

Thank you too Crewella. I do appreciate your comments. At the moment, they've said she's improved from yesterday & I think the question is whether she can maintain it or not. If you'd seen her in the weeks previous, she'd been on such good form character wise. I just feel I owe it to her to give her a chance.

I wasn't comfortable that the emergency vet was on the same page & my own vets & it unnerved me a bit. I also wasn't convinced in their ability, as harsh as that may sound. I had to qquestion some of the bloods/urine info as the numbers didn't make any sense.

I've not lost a cat to kidney problems before but I did have to put my beautiful old collie boy to sleep due to acute renal failure 7 years ago now so if that's what I need to do again for Polly, then we will. I just didn't feel, based on previous discussions with my vet & the information I'd read online, that we were necessarily there yet. If I get there today & I feel she's had enough, then we'll see but they're not giving me that impression at the moment.
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Re: Urgent advice please - Polly at emergency vet - PKD/kidn

Post by Crewella »

I think you're absolutely right to be looking into it properly and making sure you understand all the facts. Nobody will fight her corner the way a loving owner will, and you clearly have her best interests at heart and are trying your best for her. Thank you for understanding what I was trying to say - thinking of you both and rooting for a positive outcome. xx
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Re: Urgent advice please - Polly at emergency vet - PKD/kidn

Post by Crewella »

By the way, I came across this page and found it useful in understanding PKD, so am posting the link in case you've not seen it yourself:

http://my.erinet.com/~lebordo/PKD/pkdfaq.html" onclick="window.open(this.href);return false;
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Re: Urgent advice please - Polly at emergency vet - PKD/kidn

Post by greenkitty »

TBH I find Tanya's forum quite hard to follow, they all seem to know what they're talking about and are quoting stuff I know nothing about plus it seems to move really quick and I couldn't keep up! I would at least speak to your normal vet if you trust and have a good relationship with them, hopefully you saw someone different today when you went in to see Polly today.

When Tig was first diagnosed the vet said there was medication he could have when his kidney's start to fail, I don't know what that is (he's not at that stage yet) but there must be something else to consider before PTS?

Hope your visit went ok and that your girl was pleased to see you x
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Re: Urgent advice please - Polly at emergency vet - PKD/kidn

Post by Jan »

I'm another who finds Tanya's site hard to follow too .... I can only offer 'tea and sympathy' regretfully - knowing I'll be facing the same situation at some point as Blackie was diagnosed with Stage I kidney disease about 5 months ago - due for another complete blood/urine test in a couple of weeks ... am dreading it.

Definitely would get a 2nd opinion - as I intend to do when the time comes.

Thinking of you and Polly x
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