Sunday, July 18, 2010

Day 13 to 18 (13 to 18 Jul 10) - All is well? Fingers crossed

12 Jul 10 (Mon) was the last time we sub-Qed her. For the rest of the days this week, she remained well hydrated. However, I had still stocked up 10 packs of sub-Q supplies just in case. Anytime she gets dehydrated and unwell, I will sub-Q her until we can get her to the vet.

She was alert and bright the whole week. She had started eating her Waltham's renal dry food again although we still make sure she is syringe-fed her Science Diet k/d wet food at least twice a day until her hydration levels stays at a good manageable level.

Slowly, we are letting her spend more time with the rest of the gang. And for some reason, she had actually stopped hissing and chasing MM after the hospitalization. She had used to harass MM at least once or twice a day before her relapse. I am not sure of the reason at all since XX looks and behaves as if she has fully recovered. Let's hope that this will continue.

I am not sure if this is the end of the relapse episode. Hopefully it is and there will be no further relapse for the next few years.

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Monday, July 12, 2010

Day 11 & 12 (11 & 12 Jul 10) - First sub-Q after 2 years

Day 11 (11 Jul 10)
She remained very hydrated throughout the whole day after yesterday's sub-Q at the vet. She was bright and alert and was very co-operative when we syringe-fed her. Even though she was well hydrated, she drank quite a lot on her own and we offered her fresh water a few times a day to tempt her to drink more.

By evening, she was approximately 1% dehydrated. After 2 long years of no sub-Q at home, I finally did my home sub-Q treatment again. And in went 200ml smoothly while my wild pumping heart slowed down to the normal rate. My "first" time went well. Lucky me.

Day 12 ( 12 Jul 10)
Her condition is similar to yesterday. Alert and bright though she spent a lot of time resting in her carrier. She even ate some dry food on her own.

Although she is well hydrated even by 10pm, we decided to sub-Q her 100ml, just in case she gets dehydrated tomorrow when we are not around.

The Wife fell sick last night, vomiting violently into the toilet bowl. She was diagnosed to be suffering the after effects of the tremendous stress built up since the start of the month. The only good thing to come out of it is that she had 1 day MC and was able to spend the day monitoring XX's condition.

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Saturday, July 10, 2010

Day 9 & 10 (9 & 10 Jul 10) - Another re-learning experience

Day 9 (9 Jul 10)
She looked alright and alert in the morning with no sign of dehydration. Although she was breathing fast while resting, it was regular and not ragged.

We still had to syringe feed her and from today onwards, we had split her 2 meals to 4 smaller meals. It worked. She did not vomit anymore.

Day 10 (10 Jul 10)
She did not look well in the morning. She was about 2% dehydrated. After her early morning feed, she looked slightly better but appeared lethargic again by mid morning. She looked worse than when she was discharged 4 days ago.

We scheduled another visit to the vet in the afternoon. One thing we knew for sure was that she requires a sub-Q for her dehydration. We also wanted to make sure that the vet checked her to rule out other issues. When we checked our sub-Q supplies, we realized those we had bought in Jul 08 had all expired.

We saw another vet at the practice as XX's regular vet was not in. He injected 200ml of solution into her. XX looked refresh almost immediately after the sub-Q. When we syringe her again half an hour at home, she even had the strength to struggle. And soon after that, she was walking around the house again while before that, she was so tired that she was just hiding in a dark corner.

I had to re-learn the whole sub-Q process again as I had forgotten the procedures I had learned 2 years ago. I really don't look forward to that as I remember how stressful it was for XX and me at the precise moment the needle breaks the skin. I can almost hear her meowing softly in pain.

What is my lesson re-learned? Hydration is very important for a kidney patient cat. It must always be well hydrated to function normally. Whether I like it or not, I will always have to be ready to give her a sub-Q even before she becomes dehydrated.

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Friday, July 09, 2010

Day 7 & 8 (7 & 8 Jul 10): Re-learning experience

Day 7 (7 Jul 10)
It was generally an ok day for both XX and us. She ate dry food on her own and walked around the house when she was not resting.

Day 8 (8 Jul 10)
We syringe fed her almost half a can of blended Sc Diet k/d before we left for work as she only had a handful of dry Renal food. When I came back to check up on her during lunch, she had vomited all the food, including the morning's medication. Luckily, she was not dehydrated. She looked tired and rested after eating some dry food.

She spent the whole afternoon resting until I gave her some favorite non-kidney food which she devoured in less than 1 min. That showed that she was hungry, but was not willing to eat her kidney food.

We syringed fed her twice during the night, small portions both times. The Wife had reminded me that XX did vomit for almost 1 week when she first came home from hospitalisation 2 years ago. We checked out her old health and food records and indeed she was right. I had forgotten about it totally.

This is a lesson I had to totally re-learn. To feed XX in small portions throughout the day until she is well enough to eat 3 biggers meals.

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Tuesday, July 06, 2010

2nd Year Anniversay

14 Jun 2010 came and passed. It was Xin Xin's 2nd year anniversary since she was diagnosed with CRF and HCM in 2008. We were very glad she passed that milestone as the vet had mentioned that cats with such conditions rarely live past another 2 years. Various literature on the web had also mentioned the same 2 year milestone.

Last Thur (1 Jul), I had noticed there was vomit when I reached home. I did not think anything of it as Chang Chang has a rather weak stomach and often vomits his food. All 6 f them were eating, playing and behaving normally. We thought nothing of it.

When we reached home on Fri (2 Jul), we noted that Xin Xin did not greet us at the door. We became worried immediately as she will always be the first one to squeeze her head past the opening door to greet us. We found vomit again and this time we found undigested medicine. The vomit could only be hers as she is the only one on daily medication.

Xin Xin was hiding in the cat tree situated in their room. This was highly unusual as she had seldom been seen in that area. When we tried to scoop her out, she ran out to the kitchen, her stomach almost touching the ground.

And from that point, her condition deteriorated throughout the whole night. She went from being fully hydrated to dehydrated. We kept her in our room with us so that we could monitor her. We awoke several times during the night as she called out in agony, cries so untypical of her.

3 Jul 10, Sat
We sent her to the vet first thing in the morning. The blood test confirmed our worst fear. She had suffered a relapse. Her creatinine and BUN levels shot through the roof.
  1. BUN (10 - 30 normal): Off the chart (Sat 14 Jun 08); 180 (Wed 18 Jun 08); 70 (Mon 23 Jun 08); 25 (Sun 6 Jul 08). It was 13.8 on Sat, 3 Jul 10. According to a website, we need to bring it down to 60 - 80 for a kidney patient.
  2. Creatinine (0.3 - 2.0 normal): 19 (Sat 14 Jun 08); 10.9 (Wed 18 Jun 08); 3.3 (Mon 23 Jun 08); 2.2 (Sun 6 Jul 08). It was 149 on Sat, 3 Jul 10.
  3. Phosporous (3.4 - 8.5 normal): 8.7 (Wed 18 Jun 08); 6.1 (Mon 23 Jun 08); 5.9 (Sun 6 Jul 08). It was 6.2 on Sat, 3 Jul 10.
  4. Calcium (8.0 - 11.8 normal): 12.0 (Wed 18 Jun 08); 11.9 (Mon 23 Jun 08); 11.5 (Sun 6 Jul 08). It was 8.8 on Sat, 3 Jul 10.
She was hospitalized immediately and put on a drip with Ringer solution. The vet told us she had suffered an acute kidney failure again, is slightly dehydrated and has a heartbeat of 240 (compared to her normal vet visits which were in the region of between 180 to 210). Her weight had dropped to 3.95kg from the normal 4.2kg.

Our hearts went down to the pits. Although her numb
ers were better than that in Jun 08, she was on medication now and somehow, the medication does not seem to be supporting her organs from failing. When we visited her in the evening, she looked slightly better though she was still not eating. Her breathing had become less ragged.

4 Jul 10, Sun

We visited her in the afternoon. This time, she looked much better. She ate some 20 kibbles from our hands willingly and was able to pace around the vet's table unaided. Her breathing had also improved.

Our hopes went up a little.

5 Jul 10, Mon

We visited her in the evening. She looked alert and bright. She walked around the vet table, stretched and groomed, all with the drip stuck to her front leg. Her breathing had improved a little.
She ate 20 another kibbles from our hands willingly though we still syringe fed her half a can of k/d wet food as we knew she may not have eaten much on her own. Although the vet assistants tried, we knew that they were not very successful in syringe feeding her as well. Xin Xin has always been a stubborn little girl and will only yield in our hands.

Our hopes went up a little again.

6 Jul 10, Tue

As I was blending the k/d wet food at home to bring to the vet, Dr Miles called. He said he had good news. A miracle he said. He conducted a blood test on Xin Xin in the afternoon and all the critical indicators were within the normal healthy range. He wanted us to bring her back home that same evening as he felt that she would be less stressed than at the vet.

(10 - 30 normal):
  • Off the chart (Sat 14 Jun 08);
  • 180 (Wed 18 Jun 08);
  • 70 (Mon 23 Jun 08);
  • 25 (Sun 6 Jul 08);
  • 149 (Sat, 3 Jul 10);
  • 18 (Tue, 6 Jul 10)
  • According to a website, we need to bring it down to 60 - 80 for a kidney patient.
Creatinine (0.3 - 2.0 normal):
  • 19 (Sat 14 Jun 08);
  • 10.9 (Wed 18 Jun 08);
  • 3.3 (Mon 23 Jun 08);
  • 2.2 (Sun 6 Jul 08);
  • 13.9 (Sat, 3 Jul 10);
  • 1.9 (Tue, 6 Jul 10)
Phosporous (3.4 - 8.5 normal):
  • 8.7 (Wed 18 Jun 08);
  • 6.1 (Mon 23 Jun 08);
  • 5.9 (Sun 6 Jul 08).
  • 6.2 (Sat, 3 Jul 10);
  • 5.8 (Tue, 6 Jul 10)
Calcium (8.0 - 11.8 normal):
  • 12.0 (Wed 18 Jun 08);
  • 11.9 (Mon 23 Jun 08);
  • 11.5 (Sun 6 Jul 08);
  • 8.8 (Sat, 3 Jul 10);
  • 11.6 (Tue, 6 Jul 10)
She's home again finally. She is now weighing 3.9kg, losing 50g in those few days. Her eyes look bright and alert. Her breathing is now back to that of her pre-hospitalization days.

She went around the whole house, sniffing and rubbing scent. She has a very confident stance. Her strides look strong and purposeful. She could even jump up to the bed though we do not want her to.

The gang was a little hesitant as she smells so much different. However, they are slowly accepting her back.

The vet was not able to confirm what triggered her relapse, if you can even call it a relapse. There was no poisoning from the results of the blood test. He said the only logical explanation may be that it is accumulated stress etc which made the heart pump less efficiently, thereby depriving the kidneys of the much required blood which in turn caused the kidneys not to function normally in processing the urine in her.

We are not sure of the exact cause either. It could be added stress since she is not really fond of May May which joined us this Apr. She views MM as direct competition for our affection and time. XX can be a very jealous girl.

The only other change was that we introduced a new wet food to XX last Wed night. She liked it and ate everything given. We are not sure if it could be that new food which induced the vomiting which in turn made her throw up her undigested medicine which made her kidneys work so much harder. The vet does not think that missing one or two medication is the cause. We are not too sure ourselves but whatever it is, that wet food will no longer be fed to the whole gang.

They say cats have 9 lives. I think XX is now well into her 3rd life. Hopefully, she will still have another 6 to go. Fingers crossed.

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