Farther Along the Path

 

Path-PeachesCloseup

I feel like crap. Can't you do something about it?

 

This past weekend I thought I might be saying farewell to Peaches very soon. She wasn’t eating, was occasionally vomiting and was one moment constipated and another with uncontrollable runny diarrhea, her sub-q fluids pooled up in her right front leg and paw for nearly 18 hours and I could hear gurgling in her abdomen that made me think I heard the toilet running.

But instead of reading the “I am preparing for my transition” which I expected, her expression read, “I feel like crap. Can’t you do something about it?”

Peaches may be 20, weighing in at 4.8 lbs. at her last exam, a little wobbly, pretty deaf with bad eyesight and sometimes confused, but she is one feisty, resilient kitty. Determining her state of mind at this point is a little different from others I’ve known, having only known her for the past five years. Most of the cats I’ve had previous to this I’ve taken in as adults, but I’ve still had more years of a relationship and can draw on that to help me read where they are now.

 

catphoto-peaches

Peaches, Feline Photographer

 

Peaches chose to have a new life

Peaches has a very direct personality, though, and once she decided—yes, she decided—to become a member of this household (“This will do,” she said to herself) I got the feeling she had also decided to make a change in her self. The woman who had given her to me told me that Peaches had always been shy and fearful, was rarely seen by guests and her sister seemed to dominate her. The Peaches who emerged from the spare kitty room, however, was social with all the other kitties, friendly with guests, and devoted to me, curiously exploring her surroundings and enjoying every moment of every day. Once the Fantastic Four came along with their energy and lust for life, she ignored their childish taunts and found a use for them in keeping her warm and comfortable as they cuddled around her. This was not a tiny, fearful senior kitty.

So I don’t think Peaches feels she’s ready for any transition but wants to enjoy this incarnation a little longer. My job is to help her stay as healthy and comfortable as possible until she’s ready to move on. I trust her to let me know.

Caring for the geriatric chronic kidney failure kitty

To say I’ve been preoccupied with Peaches lately is to make a great understatement. A cat who is dealing with chronic kidney failure can’t really maintain her own internal balance and to a smaller or greater extent needs assistance from her person. In order to keep kidney function as stable as possible, that balance includes not only hydration but also diet, activity level and, well, I’ll say “output” because “elimination” sounds a little too grim. One element too far away from center can throw the whole body off, and if it persists for too long balance sometimes can’t be restored.

I work with my veterinarian in all my observations and decisions regarding Peaches, and the poor woman will often get several calls in a day or several days in a row as I’m working with a condition, but she always patiently returns my call and helps me to the next step when I need guidance beyond what she’s already taught me. She usually uses observation and physical exam for diagnosis and avoids testing where the condition is obvious. Where Peaches is concerned, we don’t test for kidney values since I can’t imagine taking blood from little Peaches as often as we’d need to, and her skin is so thin now that I have difficulty properly inserting the needle to administer fluids let alone my veterinarian extracting blood from her tiny veins. These levels can fluctuate even through the course of a day and observation of her physical and social activity is usually an adequate indicator of her current condition because I adjust her treatment as I see a change.

 

peaches and giuseppe

Giuseppe comforts Peaches.

 

Assessing with both physical and social cues

Every day begins and ends with an assessment of Peaches’ condition and in between are constant checks of how she’s doing, what she’s doing, if she’s hungry, if she’s not, if she’s produced anything or not, whether she is active or not, all determined by the actual activity and social cues—if she looks comfortable, if she’s curled normally or sleeping in her normal spot, if she went back upstairs for her morning nap in the bathroom, if she joins me at my desk and so on. Cats are masters at hiding things and simply dealing with sometimes horrible discomfort, so the social cues are just as important as the obvious physical ones and are sometimes an early clue to a later change in her condition.

As I had written earlier, she was greatly weakened by our infestation of fleas, resulting in greater anemia. We resolved the fleas, but rebuilding her strength with diet and fluids took a while. Peaches has always been troubled by constipation and any vitamin supplement exacerbates this so the process of rebuilding her strength and a putting a little more meat on her bones was an especially slow process.

The most Peaches ever weighed while with me was six pounds so reducing by 1.4 lbs. was significant. When I carry her I tell her she just feels like a handful of dryer lint especially considering her dilute calico fur, but her fragility is almost frightening, her bones feel rubbery and birdlike and there’s not enough of her to fill both of my hands.

A few weeks ago she began an odd seizure-like activity in which it seemed her right hind leg had just given way unexpectedly and she stumbled sideways and fell several times. A physical exam didn’t find anything, and the stress of putting little Peaches though diagnostic tests would likely not have found anything, or found any condition we could do anything about. I continued to observe her, but it simply stopped after about a week. It was likely neurological and related to her weakened condition and I’ll still be looking for it as her condition continues.

Not the end, just a really upset stomach

This past weekend, the nausea associated with kidney failure had finally gotten the best of her, though it took me a while to determine this. The reflux was likely burning her throat and causing a stomach upset that made eating out of the question, resulting in all the gurgling noises I heard, and her continued lack of eating made the condition worse as her stomach became completely empty and the constipation turned to a frequent diarrhea, dangerously dehydrating her. She was rapidly losing any nutritional and functional balance and, uncontrolled, this could easily weaken her enough that balance couldn’t be restored, and I could easily lose her to this downward spiral. While it might have been a virus of some sort, treating the symptoms she responded readily pretty much ruling out a virus.

I always have on hand a mixture of allopathic and naturopathic, pre-packaged and homemade treatments. The first thing to tackle was the reflux, so out came the Pepcid, one-quarter pill dissolved in water and put in her mouth with a syringe to neutralize the existing stomach acid (I always picture putting out a fire). A little later this was followed by a strong lukewarm tea made from slippery elm bark to coat the mucous membranes of her mouth, throat, esophagus and stomach which were probably raw from the reflux. In the meantime 50ml of sub-q fluids; though 100ml is usually the minimum therapeutic dose, this is all she can absorb at one time at this point, and I could give her another dose a little later once she’d absorbed these. I want her to be well right away, but I have to relax and space these treatments so I don’t upset her either with my handling or my own fears.

 

calico cat looking up

Can I come out now? I feel better.

 

Though stewed pumpkin helps elimination problems of both constipation and diarrhea, Peaches can’t eat enough pumpkin to make a difference, so I was hoping that treating the major symptom would help to resolve the others. Still, a little of this and a little of that. I keep CatSure on hand though it’s heavily milk-based because Peaches will usually lap up a little bit. The extra fluid doesn’t hurt, nor do the extra carbs to give her energy and perhaps a little weight as she metabolizes it, but the recommended amount is way too much. I also have Nutri-Cal which she enjoys and which has the side effect of also helping to settle her stomach and coat those raw mucous membranes, though I sometimes need to take it up in a syringe to get a bit in her mouth.

Neither of those is a substitute for real food, though, so next is a fresh jar of baby food, chicken or turkey with broth.  Her interest in this shows me her progress, and once she’s eating her baby food with some enthusiasm I offer little chips of raw salmon or venison which I’ve thawed in my fingers. If she gets to this point I know we’re on the way to recovery. I have to be careful with the amount of raw meat, though, because it’s difficult for her to digest, but as long as she can digest it, it’s like a direct injection of real and fresh nutrients. I also have canned cat food on hand in addition to this. Since she seems to love salmon they are usually salmon-based varieties, and while I try to keep with grain-free organic brands of food, usually Wellness, I’ll admit I’ll feed her whatever it is she wants to eat if that’s what she wants at the moment—eating something is better than not eating at all if that’s the choice to be made, and my goal is to get her back on the best diet she can possibly eat and digest.

Imagine the reaction of the rest of my household as I pull out all the appetizers and entrees for Peaches! Oh they’d love some CatSure, they certainly wouldn’t let any go to waste like Peaches does! And the NutriCal, just a taste—please! Baby food, oh the smell is heavenly! I do usually hand out raw salmon and venison; I actually try to feed it to them as often as possible though it’s difficult for eight cats.

I’m extremely careful with the canned food though, especially the non-Wellness varieties. I’ve had several male cats through the years who suffered from persistent urinary tract issues, and aside from a raw diet, Wellness was the only food that kept them consistently clear. Jelly Bean is very sensitive and a very clever food thief and had apparently been stealing more of Peaches’ food than I knew, especially the non-Wellness varieties, because he paid for it in some extreme urinary distress, also this weekend! That’s another story, but all of it together kept me pretty busy checking litterboxes and conditions.

It takes time, lots of it

And all of this means time spent observing often to the exclusion of other things, late nights and early mornings, leaving my desk repeatedly during the day, following Peaches around while I’m on the phone with someone, postponing appointments and scheduling around how she feels. Some days not much gets done, but Peaches is taken care of.

 

calico cat

Peaches checks on me.

 

Peaches, though, is quite well right now. I’m working upstairs this afternoon and she just came trotting up the stairs, output some positive stuff in the bathroom and came to check on whether or not I intended to feed her any time soon or if she was expected to starve.

As the end inevitably draws closer, love, don’t fear

I have always found it ironic that, as one of my kitty’s lives apparently draws to a close, we grow ever closer, communicate more clearly, share deeper expressions even as we are certain we’ll soon part. While I think of all my other cats through the day, I am constantly aware of Peaches and her condition, and I think she is of me. At this point, as Peaches and I walk a little farther along the path together, we grow close in a way that wasn’t possible earlier because we know what is ahead. The trick of it is to use that knowledge for good and not ill, for our mutual wellness and not to give into sadness and the fear of loss but to celebrate each other for as long as we can.

Peaches may last quite a while longer, but this last waltz, the quick changes in health, the need for greater care, constantly looking for the sign from Peaches, while they are the sweetest time we’ll ever spend together are indeed the most difficult. And again, I thank those who’ve gone before and taught me what to look for and what to do, and not to fear but to love.

Right now Peaches is sitting on my keyboard shelf demanding food. I’m so glad we have a little more time.

______________________________________

You can read more about Peaches’ condition in these articles:

Get Well Wishes for Peaches

Peaches Says, “Thanks for all the good wishes, they worked!”

How Peaches Stole My Heart

A Day in the Life Of a Senior Kitty and Her Mom

It’s Peaches’ 100th Birthday!

Bastet and Freya, Do Us a Favor


Peaches Says, “Thanks for all the good wishes, they worked!”

photo of cat on table

Your 42 minutes is up.

Well, I think I lost a few days in there, but at my age I don’t really care about time, except for when it’s time to eat, which is still every 42 minutes.

But I felt pretty bad for a while there. My mom kept waking me up and looking at me and smelling my breath, and then she’d follow me around and watch me in the litterbox—please! some privacy for a dignified older kitty! Then we would go into the kitchen, and I would get up on my counter to eat but I just felt crappy and even though I was hungry nothing tasted good. Then I’d go back to sleep some more, but I wouldn’t get any peace because mom would wake me up again.

Even before this I’ve had some bad days now and then. My tummy would gurgle and I’d throw up everything I ate, and it would be really hard to do, you know, number 2. I always thought that was the way it was supposed to be because I was 15 when I came here and it had been that way for years, even with my other mom when my sister was still around.

But this mom would have none of it and let me out of the room here but left my sister in so she could watch just me. I thought I had gotten used to my sister pushing me around and stealing food, but no one did that here and finally I could eat a whole meal and use the litterbox without anyone chasing me in the middle of…you know. Wow, I really started to enjoy mealtime and not worry so much.

cat peaking over blanket

If you don't get up I will dig you out.

Then my sister was gone and my mom started feeding me all sorts of different food “to see what works for you,” she said. That was nice. I really liked everything, but anything with salmon was the best. I felt very special, and I could eat whenever I wanted, well, almost.

Still, I would have days when nothing agreed with me and mom would hover. I just wanted to tell her to leave me alone and I would be okay.

And that’s the way this started out. I was comfortable curled on mom’s lap and she seemed relaxed about it. I had contacted Eva about the job opening for an office assistant and it seemed like that was going well, and I was trying to keep it a secret. Mom was at her computer all day, Cookie was mad because I was on mom’s lap all the time so she walked on me, and I figured I would be okay again in a day or two.

cat on blanket

Will you please get up?

But it went on longer than usual. I knew I felt bad when Giuseppe tried to curl up with me on mom’s lap and I just didn’t feel like moving to make room, and he licked my face but I didn’t even have the energy to look up at him. About that time I started losing track of things and I knew I was really sick.

All I wanted to do was sleep, especially after mom and that lady that smells funny and the guy that comes with her were talking about “kidney failure” and all teamed up on me in the kitchen and tried to make me into a kitty sacrifice or something, sticking needles into me and filling me up like a water balloon. When I woke up later, I was really hungry and ate for the first time in I-don’t-know-how-long, and I felt a lot better too. Mom was so happy when I woke her up the next morning. I was hungry!

cat at top of stairs

The kitchen is this way.

But it didn’t last all day. Mom tried to do the same voodoo thing to me and I said there was no way I was going to put up with that again so she didn’t get too far with it. Later my mom pulled some stranger in off the street about whom she said something like “vet tech school graduate” and “glad to find her and she lives just around the corner” to help her but I stopped that before they were done too. I may only be 5.4 pounds, but I know how to fling all four paws at once and throw everyone off. Mom said that was probably enough and they talked about how kitties “had to get used to this”—as if we’d ever get used to torture like that! Enough torture, just bring on the salmon pate! I’ll eat already!

I started out okay the next day and got right back to work pushing papers around on the desk and walking on the keyboard, but by later on I felt crappy again. It was really dark and everyone else was sleeping and I heard mom on the phone telling someone that she really didn’t want to wait until the next night when she’d “have someone to help her”, and suddenly I was in a plastic carrier with a warm blanket and we were moving!

cat on landing waiting

I am losing patience.

I never did figure it out, but we ended up in a strange place with lots of lights that smelled like more things than I could figure out and we were doing the needle thing again. Many hands were petting me and telling me how cute I was and what a strong kitty I was to have lived this long and they were sure I’d be fine. I wanted to tell them they had no idea what I did all day, that I am one hard-working kitty! And at my age yet!

I think we had a little snack when we got home, then the next morning I sat on mom until she got up and this time I was good all day. In the evening the same stranger came around who had tried to torture me with the needle a few days before, but she and mom just talked and petted me, and then they petted everyone else and I knew I was off the hook.

cat on crochet project

Peaches keeps my crochet project from getting away.

So I got to eat some pretty good stuff, that pureed chicken in the little jar that mom feeds me off a spoon, and all sorts of salmon pate, even little bits of cooked real salmon and, most exciting, real raw meat, little slivers of salmon and venison that mom warms up in her fingers. Mom gives me this now and then already, and I can’t eat too much of it but I don’t need to. I feel supercharged after I eat it.

And I got back to work and worked all week, helping around the house and I don’t know if mom would ever stop dawdling upstairs in the morning if I didn’t coax her down. Mom kept an eye on me, and that was a problem because I could barely get back to Eva to tell her I was well again and we should get back to our interview thing.

Near the end of the week, though, I started to slow down again and mom kept pulling at the skin around my shoulders and frowning and saying, “Hmmm.”

peaches and Kelly on the butterfly rug

Peaches and Kelly

Then Kelly, who usually eats with me and curls up on the butterfly rug with me, wasn’t feeling well and I discovered she was upstairs in the bathroom. Mom called that stranger, who I guess isn’t a stranger anymore but this time she didn’t just visit, they did the voodoo needle thing again, both me and Kelly.

Maybe I really am getting used to it, and I also remember that after I had a nap and slept it off I felt really good, so I just put up a little fuss so they wouldn’t think I liked it or anything but I didn’t make them stop. Mom had me in a death grip against her chest, anyway, so I couldn’t even wave a paw, and she kept talking and talking which was really nice because she was warm and it felt like she was purring.

cats on desk

Dinner, now.

So now I’m waiting for dinner, and not only do I have to wait longer than usual but one of those annoying young cats is taking up her entire lap. The only good thing about them is that they are warm and soft and don’t mind when I touch them, not like Cookie or Kelly who can sometimes be prickly, but when I try to walk on him he squirms around and I land on the keyboard and mom picks me up and puts me back on her desk.

But it looks like mom is getting up now and dinnertime looks imminent.

And I got get well wishes from Daniela and Eva and Ingrid and Amber and Marg’s Pets who sent us “lots and lots of purrs, 2 woofies, 2 Heehaws and 1 Baa” and Allia and Bogey from My Three Cats who always sends us cool toys and everyone else who wished me well and so many others, and it made me feel so good that everything seemed normal again. Read the comments in “Get Well Wishes for Peaches”. What’s a kitty to do without the internet these days?

I’ll be in touch Eva!

Read about what started it all in “Get Well Wishes for Peaches”.

P.S. Peaches’ mom thanks everyone too! Your support was just as important to me as it was to Peaches!