32 Flavours...and then Some!

Things did not improve after his last vet visit and the daily sub-q fluids. His appetite still waned despite the Mirtazepine appetite stimulant kick-starter, which was a concern. What sealed the deal was yesterday morning when he both downloaded a watery deuce in the litter box and followed it up by vomiting what remained of his dinner the night before twice about five minutes after that.

While we could explain away the diarrhea (his constipation med is stimulated by hydration, so with the added hydration of the daily sub-qs along with not lowering the dose of his constipation med...that could be an explanation), we could NOT explain away the vomiting. Vomiting in a CRF kitty can be a sign of worsening renal failure (more toxins in the body making kitty sick), so I called Brookville and go Lars squeezed in onto Harlow's already scheduled laser therapy appointment.

Physical exam was unremarkable, but Dr. E agreed that we were probably right that something might be up, especially in light of the recent discover of all the stones in his bladder and working kidney. A blood chem panel was in order.

Results were not good. Kidney values continue to worsen, and badly. Dr. E and Dr. L talked about things and they both agreed that it's a pretty good bet that Lars probably has some sort of blockage in his urinary tract/system from one of the stones, and that surgery is probably indicated, and soon. The thing is, neither of them is willing to do it with their skill sets on such a chronically ill cat...

Dr. E said, given the worsening numbers, the best bet would be to bring Lars out to VCA Aurora or Arboretum View to one of the specialists for a more experienced/skilled vet's look see. We've been going out to VCA Aurora to Dr. Medinger for awhile for Lars' myriad health issues, but Dr. E likes the specialist (whose name escapes me right now) out at Arboretum View better because he's got "a much better bedside manner". We've never really had a problem with Dr. M out at Aurora, save for he talks too fast sometimes and he's always in way too much of a hurry, but...yeah...We're going to stick with Dr. M and VCA Aurora because they know Lars and his issues pretty well...

I was actually able to get Lars into Dr. M's schedule tomorrow at 1100 for a longer initial consult appointment for his current issues. Whew! I'm to bring all of Lars' current meds with us and to arrive 15 minutes early for paperwork. Can do, though it might be interesting, what with me having to wrangle him by myself as J absolutely cannot take tomorrow off. The cage puttings in are going to be the hardest, I think. I think I can handle the meds carrying by putting everything in a backpack, LOL; the hardest thing to tote will be the fluids bag, which is sorta too big to safely put into even my biggest purse.

So...yeah...Preparing for A Large Vet Bill tomorrow, as well as Really Bad News about my boy. I'm heartbroken, scared, and totally worried for my Lars cat. :o( I simply cannot fathom life without this floofer nutter. I just can't. :o(

If you're the praying/chanting/candle lighting type, could you please add Lars to your healing energy rituals for awhile? If you're not into that sort of thing, could you send some good thoughts his way anyway? We'd all appreciate it out here... :o/ <3

As per Dr. B's wishes, I contacted VCA Aurora's internal medicine department to see if they wanted to do a more intensive cardiac study on Lars before we begin administering any quantity of subcutaneous fluids. Yes, Dr. M would like to do a full cardiac study on Lars before we do any fluid therapy with him to make sure his heart can handle it. Our appointment is scheduled for noon on 12 August when J will be on vacation to help me wrangle the wildebeast into and and out of his carrier. Yet another specialist's visit that's gonna Cost Me. My boy is worth it, though. They usually have a cardiologist proper on staff out there to do the exam, but their new cardiologist doesn't start until the end of the month and Dr. M doesn't want to wait that long for the work-up so he'll be doing it. A friend had to bring her boy out there for a similar cardiac exam to what Lars can expect and it was done by Dr. M, so I have faith that he's got the skills to do it.

Onward to the food conundrum...

Tried in vain to get a small bag of Royal Canin Renal formula kibble from Dr. B, but they were out and told me it would take a few days to get more in stock, so I gave Brookville Animal Hosptial (Harlow's vet) a call to see if they had any--they did, and sample packs of the stuff, even! Turns out, Royal Canin recently overhauled their Renal formula line to three different flavors/types of kibble and three different types/flavors of gushy fud. They all have weird names, LOL, like "aromatic" and "savory" to name a few, instead of being named by their meaty flavoring, which is kind of strange. To paraphrase their sales tagline "what good is a renal food diet if a cat won't eat it?" AMEN, Royal Canin! Amen! Name your food whatever you want to if my cat'll eat it! :)

Had Dr B fax Brookville a scrip for the renal food and we went over to pick up the sample box after J picked his truck up from his mechanic dude (that's another story, but short story--it seems to be repaired and among the living again!). The sample pack is the CUTEST thing--the small bags of kibble are about 2 pounds each, enough for several of Lars' kibble feeds and there are two small cans each of two of the flavors and one big can of another. No charge for that, though I offered something for their trouble, which they refused. J mentioned picking up at least a couple of needles in order to have fresh ones for Lars' possible eventual sub-qs; they asked us what size (!?), which was curious, because I thought the only optimal choice was 18 gauge. Turns out they offer the slightly thinner 20 gauge as well, so we got 2 of the 18s and 1 20 to try to see which one Lars responds better to. That, too, was at no cost to us, and they didn't ask us to contact Dr. B to send over a scrip for the needles, either. They are too damned good to us over at Brookville--I think between Ra's and Harlow's "Frequent Flyer" miles with them we've probably earned the rock star treatment, LOL, but...yeah, it's nice.

Aside...

So, last night we installed and deployed the window AC unit we bought Sunday night in the kitchen and the kitchen cooled down nicely, the den became more comfortable, too, and the living room a little bit more tolerable. All four cats spent a bit more time in the kitchen and den after we had it fired up for awhile, too...

Back to the food story...

Then came food time. Lars got to try Royal Canin Renal formula A kibble last night and he snarfed it down really well--only leaving a couple kibbles behind. This morning was even better. I put down a bowl of K/D gushy food (futilely I thought) and he ate 3/4 of the serving I gave him! He did well with his Royal Canin Renal formula A kibble this AM, too! :) So that tells me that the stuffiness/warmth in the house was negatively affecting his appetite to at least some degree! I knew it! Thank Bast for that AC unit!

He's acting more himself, too, if not even a bit more feisty than normal. In the middle of the night he tried rousting me for some affections/lovins by jumping all over me and finally biting me on my left wrist where my FitBit sleeping band was. OUCH! Little bastard. ;) He also gave me love nips on my nose later in the morning to help wake me up so I could fetch him his breakfast. That's something he used to do more consistently before, but kind of fell out of favor after he started not feeling well these past few weeks.

So, yeah. I'm cautiously optimistic about the food sampler pack yielding a new fave food choice for Lars. At the very least, with it being somewhat cooler in parts of the house, he's feeling better in general so he'll likely just plain eat better because of feeling okay. YAY!! :)

***fingers crossed***

I called VCA Aurora on Monday to update them about Lars' newly discovered renal failure diagnosis because I figured they might want to know for their records for their ongoing care with his ongoing digestive issues they're still helping Dr. B treat. Told them his creatinine levels and that I didn't know his BUN, but that it was high end of normal, that Dr. B felt it was very early stage renal failure, that Lars had been prescribed Hills K/D, and to contact Aurora Cat Clinic for more information if they needed it.

Cindy from VCA called me back on Tuesday. She said Dr. M called Dr. B and they'd discussed the labs and, according to the one set of very specific guidelines for renal failure staging they go by, Lars was not in stage one renal failure, but square in the middle of the range for stage two instead. :/ Stage TWO?!!? Sweet Bast, there's only FOUR stages to this fucking disease and he's already halfway gone???

Sigh...

To say J and I are dismayed is beyond an understatement. Lars is only six fucking years old and shouldn't even be in stage one yet for fuck's sake!!

I talked to Cindy again today to double check to see if Dr. B's got Lars on the correct treatment and she surprised me by saying that Dr. B is actually going pretty aggressive--most of the time Dr. M doesn't start Rx food or any other treatment for the renal failure until the beginning of stage three. I found that to be interesting. And, no--we're not taking Lars off the Rx food! He actually *enjoys* the food so far and it can only do his numbers good. It's a balanced food otherwise, too, so he'll be fine on it.

I've joined the two feline renal failure groups on Facebook and have sought out more information on the rather popular layman's site--Tanya's Comprehensive Guide to Feline Chronic Kidney Disease that I used to frequent when I was dealing with Jazz's and Diva's renal failure. Gotta get myself re-acclimated to the logistics of the disease and care for same...

What is it with us and Broken Cats? I tell ya, we fairly seem to attract them...:/