I could really use help and advice on further dealing w CRF

[Joe_Danger]

Hey guys, I apologize up front for the long post and for my first post on these new forums being about something negative like this but I could really use any and all advice you have as vets in my country are rather incompetent at offering any substantial help or advice it seems.

I made a fairly lengthy topic about my CRF cat, Anastasia and her strange and to her harmful behavior when it comes to drinking water on the old forum and I got some wonderful advice but since she is a rather stubborn cat none of it worked for her
http://www.catchat.org/discus/messages/ ... 1393793550" onclick="window.open(this.href);return false;

Fortunately in the past few months she stopped behaving like that and started drinking water normally from the tap, kept herself hydrated and everything was fine..until some 4 dago when she started acting up again. This unfortunately now led to her dehydrating herself and yesterday she had what appeared to be a short siesta, I was studying for my finals when I heard two loud mews and found her collappsed in the bathroom with a trail of urine behind her. Naturally the vet was rather letharic, I didn't want to bad mouth my vet in the old topic but the truth is in my country, Macedonia, finding a good knowledgeable vet when it comes to cats and cat behavior seems to be a rather difficult task to say the least.

He took some blood for her, said the results from the bloodwork would be in today and he wasn't very eager to offer any advice, much less offer to administer sub-q fluids and the like, in fact he outright refused saying it would just cause more harm and wouldn't do much for her, even though she was dehydrated to heck and back.

The results came today and as expected she has anemia, which of course this vet says is untreatable despite me having read that it can be managed and my aunt who is a doctor(human doctor) also says it can be managed. Again, in all his usual rudness he didn't even offer any advice on how to manage her new condition or how to get her to drink water and everything.
He pretty much wrote the cat off much like he did in 2012 when she was diagnosed with CRF.

I took the results to a different vet, she was far nicer and far more talkative, she didn't offer much help when it came to the anemnia but she did say that instead of IV fluids/sub-q it's best to try and hydrate her orally, to buy electrolytes for kids and use those. This morning I read the same thing online so at least we were on the right track with this vet it seems.
She said the anemia at this point isn't as big an issue but on Monday or Tuesday if the cat perks up to bring her in and she would give her B-12 vitamin shots to help with the anemia.
She told me to give her 200ml electrolytes today which seemed a bit excessive to me but what the heck she is the doctor, online I read to administer them in 2-4ml doses every hour...but without passing the blame on anyone she ended up taking in 70ml in 3 hours....bad move, but that's what happens when my mom and girlfriend panic and don't listen to what I'm telling them.

She did perk up, she did start being very alert, started walking around, went to eat on her own...but she also peed twice on this one bed we don't use and she peed without even realizing it, she has never, in her entire 7 year life made a mistake like this, if her pee so much as slips outside of the litterbox, it happens sometimes as she doesn't always get in properly she gets upset and demands it's cleaned up immediately, yet now she didn't even notice there was pee under her.

I called my aunt and grandparents, they're actually knowledgeable doctors who constantly read and keep themselves up to date on everything and she said there probably is no reason for concern and she might have just taken in more water than she could handle, however she did warn me it might cause permanent damage in the long run if it keeps happening.

Now my cat seems much better than she was yesterday, she went to eat on her own, went to pee in the bathroom and all, but I don't think we're out of the woods just yet.
She is lying on my bed now looking around, fairly alert...hope she doesn't do her business there.

Any help or advice would be appreciated

[Joe_Danger]

I'd like to share the results of the bloodwork from yesterday:
http://s27.postimg.org/h52l4o82p/DSC03174.jpg" onclick="window.open(this.href);return false;
The thing is in Macedonian but the results themselves are I believe in latin and they're more or less the same words so you guys should be able to tell what's what

Now here are the results from when she was first diagnosed in September 2012
http://s24.postimg.org/d1kx45sib/DSC03179.jpg" onclick="window.open(this.href);return false;
And results from December the 3rd 2013 when she wasn't feeling too well, but she pulled through that in no time
http://s13.postimg.org/ctz664egl/DSC03176.jpg" onclick="window.open(this.href);return false;

Sorry I didn't resize the images, I just don't have the strength to do anything, I'm under insane amounts of stress and pressure from all this.

I'm worried about the whole anemia thing, I hope this other vet, the nice lady is going to help us through it and manage it, but she didn't say anything about potential treatment or management either

Thanks in advance

Edit: Update - I don't want to speak too soon, but she seems rather well now
it's 1:12AM where I live and I was working on some illustrations I do and noticed she got up, went to one of the water bowls she hasn't used in God knows how long and had a drink from it.

My vet was going to kill her
when she was first diagonsed he offered no advice or help on how to keep her hydrated, his response was a rude
"it's a cat haha, if she wants to drink water she will drink, if she doesn't need to she won't"
He completely ignored any further questions regarding the subject over the past year and yesterday when I told him how she collapsed and probably had a seizure the guy just said she was probably in pain and didn't offer a single word of advice on how to keep her hydrated or anything at all.

He is supposedly a good vet who studied abroad and has done hart surgeries and what not on pets with a very high success rate, so I tried not to talk poorly of the guy but too much is too much.
He never once offered any advice, only thing he does for us is import the special food she needs and even that he wasn't willing to do much about when shipments of the food wouldn't come to our country last summer.

Every vet I've been to over the years about pets, nice or rude have had the same or a similar attitude, they're very nice to the animals but show severe lack of knowledge when it comes to animal behavior, psychology or certain issues such as in this case renal failure.
He knows the basics, he knows the gist of it but he offers no help or advice and pretty much writes my cat off as dead.

[MarkB]

Hi - I remember your posts on the old forum. Although I have a lot of experience in dealing with cats with CRF, I never took too much notice of readings.

I can't really advise on anaemia, one of my cats was given B12 with something else in the later stages.

Has your vet heard of a new CRF drug called Semintra? - it came on the market last November. My vet said it is an excellent treatment and stops the disease in its tracks. He was going to start one of my cats on it instead of Fortekor, until he discovered that my cat had been misdiagnosed by my previous vet, and didn't have kidney disease at all, but he had diabetes insipidus, which causes excessive drinking and urinating (now under control with DDAVP hormone treatment)

Anyway, I would seriously consider looking into this as apparently it is the new wonder drug.

http://www.semintra.co.uk/" onclick="window.open(this.href);return false;

[Joe_Danger]

oh god, if that thing is real and it helps I'd love to have it.
I believe my cats kidney's are beyond saving at this point though, I'd read up on it but...atm I'm too emotional to do any reading lol
I'm a weird guy, I take these things very very poorly, we discussed it on the old forums and you guys were tremendous help with that.

So this thing, even though her kidneys are already smaller/shriveled up it could help?

edit: alright so it wasn't much reading, I've been reading for my finals all day so I didn't know if I could follow more in this state.

Basically it reduces the loss of protein, which is good
but it doesn't say anything about it dealing with the toxins in a cat's blood
I wouldn't say it stops the disease dead in its tracks from what little I read but it's something we desperately need regardless.

Of course my dumb vet hasn't heard of it
he offers no advice or help, he literally just waits for the cat to die.

[Joe_Danger]

The new vet said she will look into the Semintra thing, I hope importing it to my country won't be a problem but I somehow doubt that. She also said the anemia wasn't so bad and that the cat was just dehydrated after giving her a thorough check up.
In other news Anastasia seems to have made a complete recovery and has been acting perfectly normal today, she doesn't eat as much and she has yet to do #2 but the vet said she will come around.

And get this, some people there also had a terrible experience with my first vet, yet he was recommended to us as knowledgeable and what not, they pretty much had the exact same experience as we did.

I dunno this new lady vet says the cat can live for years if all goes well

[MarkB]

It sounds like your new vet is more knowledgeable (and caring!) than the previous one. One of my cats survived 5 years from diagnosis, so there is always hope

[lilynmitz]

The course of this disease varies from one cat to another, but my tiny cat Lily has kept going for around 4 years since diagnosis, despite her frailty and many other medical conditions, so don't despair.

[Joe_Danger]

The biggest problem with mine is her water drinking issues.
Now she is at a point where she simply won't drink water from anything, tap water included.
She comes up to the faucet, wants to drink, but the moment you turn it on she looks away and stays that way, completely frozen, I've left her there and she does not even attempt to drink anymore.

The moment you turn the water off, she starts licking the tap, and that's it.
There is nothing that can be done, this is how she dehydrated herself, she was perfectly fine until then.

Now she only drinks water from a srynge, not because she can't any other way, but because that's the only solution at the moment.
She isn't weak, lethargic or ill any more, she is perfectly fine, active and generally normal as she was before, but god forbid she drinks water properly.

The moment you turn the water on, regardless of the amount, she freezes up, shuts her mouth and looks away and stays that way, frozen.
IF I'm lucky and she has positioned herself right, I can give her a nudge or turn her around so when the water touches her mouth she starts drinking, gets some water in herself, then stops again and won't do it on her own, but if she isn't positioned in a way where this can be done with a simple nudge it's a no go.

I know it sounds crazy, but that's the way she is
nothing works and there is no way to get her to drink water, no tricks, no nothing.

Water bowls are pretty much air to her at this point

[Baggypants]

One of my cats Elsie rarely drinks water so when she had cystitis and I wanted to get liquid into her I would give her some wet food and add extra water so it was quite sloppy and she'd happily lap up the meaty-flavoured water. Perhaps you can try adding water to her food?

[Janey]

I wonder whether leaving the tap just dripping for a while would help? I've also found some cats like water fountains, or 'their own mug' left on the floor with some water in is really tempting for many cats over their water dish! Those things worked for my crf cats, although I never had to syringe water in, if your vet advised you to do that I wonder whether that may be causing the fear - if so it's trying other ways to get the water in.

[Joe_Danger]

Thanks guys, you're all so nice and helpful every time but we're dealing with a rather stubborn cat here

leaving the tap to drip used to work but not any more, she only liked it while it was dripping for a while, now even that's off the menu.
I'd buy a fountain but she doesn't so much as approach any kind of moving water or still water for that matter any more, fountains here are kind of expensive and given her behavior there's a good chance she will ignore it, I've made makeshift fountains of sorts for her with 100% fresh water coming out, she ignores them or stares at them and walks away.

If for some reason getting water through a syringe also becomes impossible a fountain will be our last resort, but for now she seems to enjoy this and gets hydrated well.

Wet food is an absolute no go, ever since she was little I tried to get her to eat wet instead of dry food, the cat I had before her didn't care what he ate as long as it was food, but this one is so stubborn when it comes to food and water she'd rather starve herself or as we saw dehydrate herself to death and not eat or drink something she doesn't want to.
Trucks like putting water in her dry food? That's just makes her turn up her nose and leave lol, literally that's what she does. Mixing in the wet and dry food? She might sniff the thing and walk away or carefully pick out only the dry food and leave all the wet one to dry out and go bad but she won't eat it.

I've had her for 7 years, she's been like this since she was little.
I'd love to be able to trick her and make her eat something or drink something that way but it doesn't work.

Online I always come across these copy-pasted "10 ways to get your cat to drink more water" "18 ways to get your cat to drink more water " 6 easy steps to get your cat to drink more water" and my blood boils in anger when I see the same few things copied and pasted on every site none of which have even remotely worked for her.

You can't put an ice cube and expect her to lick it, believe me I tried everything.
You can't "flavor" her water with something she might enjoy, if the water doesn't smell like water is supposed to or if it so much as looks slightly different she turns up her nose and leaves, if not she stares at it but won't drink, might take a few licks and that's it.
Changing the water temperature? Doesn't work for her
Getting new bowls? No sir, not that, it works the first time but every new bowls becomes old and non existed after the very first time it's introduced to her lol

I understand my refusal to invest in a fountain might seem odd to you, but believe me if she wanted to drink from any kind of moving water she would've been drinking tap water and from other "moving" water sources, she doesn't any more.

The problem is she is thirsty and wants to, but something stops her from doing it

edit: and the syringe thing came AFTER she dehydrated because she refused any and all other water sources, she isn't afraid of it at all, for now all I need to do is show it to her and she immediately wants to drink. She's been in rather perfect health except for the CRF so she doesn't really know what syringes are for and she doesn't even get to see them during vaccination lol so for now, to her that's just another water source.

[Willowgill]

Hi Joe - I've been away and only just seen your post - sounds like you have a bit of a diva on your hands - I have one of those so know the problems
Re the water thing have you tried mixing a little warm water in with her dry food (not cold)- not enough to make it sloppy but sufficient to make it moist? It shouldn't alter the taste or the texture too much and I was told warming food makes it smell more appetising. Will she eat tuna? Again warmed up a little seemed to work. Coincidentally I have just had my oldest cat hospitalised all day today and amongst other things have been given Fortikor for him both for failing kidneys and also for a heart problem. I have also got some kidney food and was asked whether he ate wet or dry food so there must be a dry variety. Max has always had a thing for water so I haven't had the problem of making him drink - just the opposite in fact but we have a water fountain and he does sit by it for ages just playing in it as well as drinking it - there are different types. We used to have one which was a ball with water trickling over it so it wasn't really a fountain as such - maybe that would work better than a real running water one as they just lick the ball. I also lost a cat 2 years ago to CRF and the deterioration in the last three months was pretty dramatic - I couldn't get him to eat but he was constantly craving water from the taps, the bath, shower. If your girl isn't doing this it doesn't sound to me as though she's so far advanced as i think with CRF they have an overwhelming obsession with water. Have you tried cat milk - I don't know if you can get that where you are but it's available in most supermarkets here so you should be able to find it. It would be another way of getting liquid into her. At the end of the day if a syringe is the only way then you probably have to stick with it. I hope your new vet can offer a treatment for the anaemia - she sounds more sympathetic than the other one. Good luck.

[Joe_Danger]

Thanks for your response, I hope your cat gets better soon, I know how hard it is to deal with this kinda stuff.

I tried mixing water in with the food, different amounts of water, just a few drops to moisturize the food, warm, cold, but it's a no go, something that even remotely doesn't resemble what she is used to means she isn't putting it in her mouth, which tbh has been a blessing until now.
We've never had a problem with her wanting or trying to eat human food, you can leave food outside and she won't even look at it, she might smell it from a distance and move on.

As for milk, I haven't seen cat milk here but I have yet to own a cat that is intolerant to regular milk, dunno why it's bad for them but here people give their cats milk and they're fine, when she is being very stubborn with water I give her some milk sometimes but that can't be an every day thing, she is going to drink it up once, then the next day she won't even look at it, same as with water.
She usually gets some milk every few weeks either as a treat or when needed.

As for the fountains I know only of one place that sells them there, they're not the cheapest and I believe they only carry one type maybe two tops...you can easily find the latest video games and consoles and computer parts in macedonia but good luck finding sufficient help for a cat much less a person who understands cat behavior properly.

For now the syringe thing works like a charm, she likes it, accepts it and well seems to be working for the time being, as I said I'm putting the fountain off because I know she will either accept it for a while then drop it or not accept it at all, so I keep it as a very last resort.

Now there's another issue though
she started missing her litterbox by a few inches, which is dumb, she goes in, thinks she is all settled in but half of her pee goes in and the other half out...and this is happening every time now.
I'd say it's a medical issue but her vet made sure it wasn't, she just got used to a certain position and when she is in that particular position she now always does this.

I dunno she is so weird
she learns something, some type of behavior or something and there's no unlearning that

With the litterbox thing she isn't in pain or anything, she goes in, normally, then goes out and looks at the mess she's made and you can tell she isn't happy about it.
Problem is she really does think she is inside.

I'll try and get her a bigger one but she always pees near the edge so regardless of how big it is this is bound to happen again, this one isn't small or anything.

[Joe_Danger]

Alright guys, so I just watched her pee, I was right next to her.
She got inside her litter box as always, she was in perfectly well as she normally is but it all sprayed outside.

I don't understand why this is happened, her positioning doesn't seem to be any different from what it normally is, she always pees near the edges and only the edges, but I watched it happen now and she was positioned as she always has been for 7 years and it all sprayed outside.

The vet didn't see any infections or anything
this is strange

[Joe_Danger]

Sorry if I'm being annoying, for the sake of keeping track of her I figured I'd post an update.

Anastasia is doing amazingly well, she is active, eats normally and well, from what the vet says the peeing over the box is just a behavioral quirk and a taller littlebox will fix it since she doesn't appear to have anything wrong with her atm, she just doesn't seem to squat low enough as I saw.
I tried the warm water and slightly moist food to of course no avail the other day, she sniffed the food a couple times turned up her tail and walked away.

Of course drinking water from anything but the syringe is a big no no, however she loves it this way, comes running as soon as you rattle the srygne and call her so for now, until she somehow ends up refusing to drink from this too it's all good.
A shame really that the old vet let her deteriorate and never so much as suggested on how to get her re-hydrated.

I really hope it all goes well
I'll keep y'all updated if that's ok since you guys are very knowledgeable and well it's nice to have someone who knows about these things for a change to offer some advice.

Thanks for all the patience