As of the last couple of weeks, Lars' appetite has been less than optimal. We've tried introducing different, non-Rx food, which he really appreciated initially, but then quickly became disinterested in. So...A trip to the vet was in order.

Took him in last Saturday. Physical exam was uneventful, though he'd lost a couple of ounces from the last time he was seen. Dr. E suggested a short blood draw to make sure his kidney functions were still stable. Nope--his kidney values were a slightly elevated, as was his calcium levels, which could indicate dehydration, or, obviously, that his kidneys were getting worse. Switch from diabetic diet to renal diet, and introduce twice weekly sub-q fluids.

At first Lars ate the renal stuff, especially the kibble, with a fair amount of gusto. But that only lasted the first few days. Then...Meh. Call Dr. E back. She asks if Lars pees a lot. Of course he does--he's both diabetic and in stage 2 renal failure! Could you bring him back in for a urinalysis? Sure!

Urinalysis shows visual signs of blood and, of course test positive for same. X-rays are done to determine if there's any crystals or stones in the bladder/kidneys/urinary tract. Jackpot! Several small stones in both the good kidney and in the bladder, and a undefined blob in the bladder that could either be an uncalcified stone or, more likely a blood clot. Ultrasound could be done to try to determine the exact nature of the blob, but it'll probably come back inconclusive and Dr. E doesn't want to waste our time or money on that just yet.

The usual course of action for so many stones in the bladder especially is surgical removal. Because of Lars' multiple health issues (asthma, diabetes, stage 2 renal failure, stage 2 heart murmur, etc), he's not a good candidate for surgery as he might not survive anesthesia. The second course of action is daily sub-q fluids to flush out the stones, which brings the obvious risk of urinary tract blockage, especially in a male cat. :o( Our choice, as Henry Rollins' old monologue bit goes, is fish--it's got to be the sub-qs for now. We're to administer 100=150ccs of fluids every day for a week, then return for follow-up x-rays to see how many stones have been evacuated.

How the hell did we miss this? Lars has been straining in the litter box for awhile, but he's got chronic constipation among his chronic health issues, too, so we thought he was straining from not being able to poop. The blood? Well, we use a combination of grey colored Cat Attract litter and brown colored World's Best cat litter and the brown stuff turns a lovely dark brown, which to mind, disguised any signs of blood that might have been present. Sigh.

All that on top of J and me being distracted with my recovery from my back surgery...yeah...We've now got a fairly seriously sick(er) cat. My heart is breaking and I feel like a rotten cat parent for not noticing sooner and taking action sooner. I know, I know--cats are good at hiding their discomfort and illness, we're dealing with multiple illnesses to boot with him so it's harder to tease out what might be wrong, we've got our own life distractions in the way, etc. But...yeah...Still beating myself up for this.

Will keep y'all posted on what happens... :o/
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