15 year old cat in lots of pain - Need help

ihaveaquestion

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Our cat has been showing signs of lots of discomfort and pain this last week, but it's been off and on so I delayed a vet visit. Yesterday and today she seemed really bad and we took her in and got some urine tests done, but the results won't be back until Monday or Tuesday. Right now I'm not sure if she will make it to Monday, but don't want to take her into a vet hospital on Sunday (tomorrow) and pay extra money for nothing.

I am wondering if anyone here can tell from experience if they know what these symptoms are and if they are life threatening, or something that can await the test results, which I am currently guessing is either a urinary tract infection or kidney failure.

She has had arthritis in his legs for a while now so some pain and discomfort is not unusual, but this seems different. Over the last few months she has apparently been drinking and urinating a bit more than usual. However, in the last week the drinking increased even more so and so did the urination, only it was only a little bit at a time and she attempted to go in other locations other than her litter box. These were mostly plants but I don't think she went in them just attempted to, which leads me to think shes in pain when urinating. Yesterday and today she would not move from a spot and was showing signs of a lot of pain. Her head is down and she never really lays flat, more so in a "meatloaf"(?) position (or something similar). Her eyes seem very sunken and she is constantly licking her lips (seems nauseous). She is still eating (only soft though) and drinking.

Right now I'm not sure if shes just in immense pain from an infection and/or arthritis.

She has some bowel or urinary tract blockage or problem.

Kidney failure.

Digestion problems due to new-ish food. She is on Royal Canin (hard) but I read a lot of people having bad problems with it so I'm leaving this option open.

Anyone have any ideas? We are a bit strapped for cash and don't want to pay for a lot of tests to tell us shes on her way out. We will get pain medication or any other meds needed on Monday, but for now I'm not sure what to do.

Thanks for your help.
 

vball91

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I am really surprised that the vet you took her to didn't give her any pain meds given her symptoms. She is clearly in pain from what you describe. Unfortunately, she could have kidney issues or urinary issues or both from your description. It's really impossible to say since none of us are vets and haven't seen your cat. I don't mean to come off as uncaring but online advice really can't replace vet care. Having said that, kidney issues can be managed with extra fluids if caught in the early stages. Urinary tract disorders are also manageable if caught early. If she is not peeing at all, you could be facing a blockage although it is more rare in females.

I do understand financial considerations, but if she's in pain, I don't know that I would wait until Monday. At a minimum, you could visit a e-vet and get a pain med like buprenex until you can get her to your regular vet on Monday. Did the vet who took the urine sample say anything about her condition and what you can do to make her more comfortable?
 
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ihaveaquestion

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Because shes been on and off with the pain and the way shes been acting currently, the 2 times we took her to the vet (first time they couldn't get a sample) they offered some pain meds but when we took her in she seemed ok so I decided not to get he meds, which were for the arthritis. So i'm not surprised they weren't overly concerned since her condition wasn't that bad during the first visit. We can probably find some pain meds in the mean time but I was more concerned if this was a sign that she needs to see a vet now or we could lose her.
 

I wasn't there for the 2nd time she was brought in so I'm not sure what they said. The things they offered were mostly for arthritis since that was the only thing we knew she had wrong with her. We already have some minor meds that helped a lot, so that's why it seemed odd she suddenly is in massive pain. I also understand this is just a forum but I use these tools for many things because of the collection of different people experiencing different things that can sometimes be more helpful than an expert or vet.
 
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vball91

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A lot of the symptoms you describe do not seem related to arthritis. There is something else clearly going on. What that is, I don't know. My guesses would be kidney disease and/or urinary tract issues.
 
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ihaveaquestion

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That's what I was figuring too. Do you think waiting until Monday is a good idea? Or should we take her somewhere tomorrow?
 

maewkaew

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Besides pain ,  there are 2  main things I  would be worried about right now.  One is dehydration.     which could make her absolutely miserable and  past a certain point is  dangerous.

The other would depend on whether she might have diabetes  which is a possibility from some of the symptoms.  

but I will tell you some things to check. 

 If you think the cat is in a lot of pain   I do think it would be a good idea to at least try to get her in to the emergency vet to get some buprenex or something similar. 

   Dehydration  When a cat has pu/pd  ( polyuria / polydipsia = peeing a lot / drinking a lot) ,  they're at risk of getting dehydrated.    And you also mentioned sunken eyes:   that is often a sign of dehydration. 

 The classic way to check for dehydration is to gently take a pinch of skin from her back or between the shoulder blades, pull it up away from the body   then let go.   In a properly hydrated cat , the skin should SNAP back into place instantly  --  in a split second.  

  If it takes longer than a second to settle back into place,  the cat is already pretty dehydrated.   If it takes  longer than 2 seconds   I would get her to a vet.  If it just stays up  --  that is an absolute emergency  , she is likely to go into shock soon. 

 ( or some vets say it's actually better to try this with the skin on the top of the head;  I guess you could try both ways )  

2.    Feel the gums.  they should feel rather slick.  not dry or sticky.

3.  Capillary refill.   Raise her upper lip,  press your fingernail against her gum.  When you take your finger away there will be a white spot , but the color should fill back in within a second or two. 

I was going to say that if she is urinating and defecating OK  and still eating and drinking,  and is able to walk  to her food and litterbox ,  she could probably make it through the weekend.   ( but I hate to think of her suffering) .  

However  ify  she is severely dehydrated that could cause things to spiral downhill very quickly.  

If  signs show she is dehydrated but not yet horribly -- for example if it takes around 1.5. seconds for the skin to go back down --  you could get some plain Pedialyte and an oral syringe and give her some of that every 15 min. 

Diabetes  & DKA

vball has mentioned some likely diagnoses.   Diabetes mellitus is another possibility that occurs to me because of the various symptoms.    

drinking more and urinating more,

weakness in the legs   that can be mistaken for arthritis ( it's due to nerve damage , but it is often reversible if th to e blood sugar gets under control & there's a supplement that can help) 

lethargy

 It can also make urinary tract infections much more likely because  high blood sugar causes the kidneys to spill sugar into the urine which  makes it a "friendly" environment for bacteria.  

Diabetes is also usually very  treatable with  a long acting insulin such as Lantus (glargine)  and a very low-carb diet, and it helps to learn to test blood glucose at home.    In fact,  with that kind of treatment, MANY cats go into remission --   the cat's pancreas is often able to heal within a few months andf they are then able to wean off the insulin and just stay controlled with the low carb diet.  

 Sometimes all it even takes is a diet change,  especially if the cat's been on high carb  food.    

 DKA (Diabetic ketoacidosis)  is a life-threatening complication that happens with untreated  or poorly managed diabetes,  and is made more likely if the cat stops eating and/ or if there' s infection / inflammation going on.

IF she has diabetes,  going into DKA   could potentially kill her over the weekend  -- or could cost very much to treat.      Symptoms include dehydration, nausea,  lethargy / weakness,  breath may smell like nail polish remover, she  may breathe in a way that seems like "sighing";  her  heartbeat may be irregular. 

HOW TO CHECK:   There's something you could do to rule this out.     You can test her urine for glucose and ketones.   Especially ketones.       There are test strips / sticks  available at pharmacies  for humans to use,  and they work for animals too.  

 If she will let you  ( I thought my cat wouldn't but he didn't seem to mind!)  you can either hold the stick right in her urine stream as she pees ,   or try to catch some urine in a cup and test that,  or you can do something to try to trap some urine when she pees in the litterbox ( like spread some plastic wrap over the litter and hope some urine will get caught on that)   and test it soon after.  ( it has to be VERY soon  to be an accurate test for ketones,  because they are very volatile and will evaporate quickly when exposed to air. )

There are some kinds that just test glucose,  some that just test ketones,  some that test both  http://www.drugstore.com/chemstrip-ugk-urine-test-strips-for-glucose-and-ketones/qxp40025  (that would be best)  ,  and some that test both of those plus a bunch of other things.   There are different brands.   Make sure to get one that at least tests for ketones.  

      WIth the test strips that test urine for a whole bunch of things,    the disadvantage is you have to stick practically the whole strip in urine  so  it might be harder to do that  while holding in a cat's  urine stream.   Or if you only caught a few drops  of urine in a cup or in plastic wrap in the litterbox,, you would have to be careful to drop it on the right places on the strip to test those 2 values. 

  If  it tested that she had glucose in her urine,  that would be a sign she has  has diabetes and her blood glucose is high enough that her kidneys are dumping glucose into the urine to try to get it out of the blood.    ( NOT  having glucose in the urine would not be definite proof she does not have diabetes  because she could have the blood glucose  way above normal  but not yet quite so high that it's going into the urine.)    But that alone wouldn't be an emergency that meant she had to go to the vet immediately. 

  If it tested that she had more than "trace" ketones in the urine,  that WOULD mean she had to go to the vet immediately.  

Hope this will turn out to be something treatable and you'll be able to help her feel better very soon. 
   
 
 
 
 
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ihaveaquestion

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I appreciate the useful information, but we actually decided to not wait until tomorrow or Monday and went to a 24/7 vet hospital. They didn't do any tests but she apparently had a fever and started her on some UTI meds and gave some short term pain medication. We will still await the results to see what it is for sure, but this vet was confident she had an infection due to the fever so the meds should be all that is needed for a full recovery

I appreciate the help though. I can update later but she should be fine now.

Thanks again!
 

white shadow

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Hi Ihaveaquestion !
..... They didn't do any tests but she apparently had a fever and started her on some UTI meds and gave some short term pain medication.
Could I ask you, exactly what is that pain med?

(I'm only asking because there's a commonly-prescribed pain med....which isn't safe for cats. It's a drug that's similar to the human NSAIDs, like Advil)....and, yes, some Vets do prescribe these for cats!)
 
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ihaveaquestion

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It is Buprenorphine in liquid form that we put along her gum line every 12 or so hours. So far we have only done it once and i don't think we did it too well, but she seems better already so maybe it worked. It is also a super low dose according to him (0.20 cc). We only have 4 doses, or 2 days worth.
 
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denice

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That is the right pain med, it's very effective and you were told the right way to use it. 
 

maewkaew

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I'm glad you did get her to the emergency vet and so glad to hear she seems to feel easier.    

That's a fairly low dose and a conservative schedule  but Bup is very effective if absorbed through the lining of the mouth.     I am so glad this vet did not tell you to give  it under her tongue  like  some people have been told,    and while it certainly would be absorbed well from that spot,  the problem is GETTING it there because the cat usually struggles .  and you risk 

When I've given Buprenorphine,  i make sure to drip it in very slowly into the side of the mouth .  You don't have to actually touch the gumline -- if you get it in the pocket of the cheek  between the cheek and teeth,  that is fine.       The point to remember is that it is highly effective when absorbed via the mucus membranes of the mouth.  but very poorly absorbed via the digestive tract..   So you have to make sure not to  just squirt it down the throat  because it does not work well at all that way.  

It can actually be given more often if needed.     The most often I have ever given it is every 6 hours in a severe pancreatitis flare up.   Usually i gave it every 8 hours,   but if every 12 hours controls the pain  that's great.      Obviously IF you think it is not controlling the pain at that dose or dosing schedule,  you should talk to your vet.     ( I"m not suggesting you just give it more without asking )    but hopefully that will be fine..  

Keep us posted on her test results. 
 
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ihaveaquestion

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Sorry to bump this but I have a question about medication. I don't know if its the baytril or the buprenorphine but the cat has been aimlessly wandering around meowing like mad. She did this yesterday and again tonight (about 5 hours after we gave her buprenorphine). It's becoming concerning because of how much meowing and what looks like agitation. She won't sleep and just keeps moving around meowing. Is this a odd side effect? I think I'm going to stop giving her the buprenorphine and see if it stops.
 

white shadow

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Buprenorphine given like that is known to be effective for up to six hours.....so, I'm inclined to think that at the time this behaviour starts, the bup is actually waring off....she may be starting to have pain again.

If this were happening earlier into the dose, then I might wonder if the drug was responsible.

You said above that the Vet described the dose as "super low"........perhaps, then it is too low.

Do you know her weight?

Forgot to say: NO NEED to apologize for questions and, it is best to post related ?? in the same thread!
 
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maewkaew

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 Doesn't it sometimes work up to 8 hours?   For example i the Merck Veterinary Manual it says  dosed every 4 to 8 hours.   

I should have said that the only times i gave it every 12 was when the pain seemed to be on and off and i was just giving it as needed.  

.     

  I think the amount may be OK but the frequency  maybe should be more.     

But she may have been to the other vet today,  or anyway got her test results back?    It would be good to hear an update... 
 
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