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(long) CRF, kidney stones and a urinary blockage that just won't go away.

post #1 of 9
Thread Starter 
My Toby was diagnosed with CRF back in November. All told, it hasn't been a bad month. He took well to a switch to the K/D diet, and actually became more active than he had been in a while. He started to act poorly again about two weeks ago, and I took him in again. They redid his blook work, and it actually showed he hand improved, and gave him fluids, as he was dehidrated. I took him home again, and he did well for a couple of days, but then started to do poorly again. This time, the vet thought the symptoms pointed to a UTI, so I left him at the vets during the day, and picked him up again after work. They were hoping to get a urine sample, but he did not oblige. That was on the 12th.
When I got him home, he went right to the litter box, and then stayed their for half an hour, but produced nothing. I called the vet back, and took him back in that night. They catherized him, and ran a culture on what he produced. Nothing grew from that, but they put him on antibiotics anyway. Over the weekend things cleared up, and they removed the cathater on Monday, the 15th. He was able to urinate on his own, and I took him home that night. A few hours after I got home, though, he again was unable to produce any urine. I called them up again, and they suggested that it might be because of stress, and to wait out the night. If he hadn't done anything by Tuesday morning, I was to bring him back in.
Toby had a very poor night. He made frequent, useless attempts at using the litter box. In between, he just laid down, exhausted. I couldn't get a purr, or a meow out of him. He drank a lot of water, but refused to eat anything. I had him back at the vets the minute they opened in the morning. Again, they catherized him. Tuesday and wednesday after work I went in to visit with him for an hour. His mood seemed much improved, though he looked terrible and miserable with the cathater and collar on.
Thursday the office was closed, so I did not go to visit him, though they called me three times with updates on how he was doing. Friday they removed the catheter again, and I got to hold him. He purrred a lot, and was very interested in everything. Again, he was using the litter box on his own, but the vet wanted to keep him one more night, because of what had happened the first time. He said if all was well, I could pick him up on Saturday.
All was not well. He again was blocked Saturday morning. At this point, they did x-rays, trying to find something, and they found kidney stones. They explained to me that kidney stones are very rare in cats, but at this point they believed that this is what was causing Toby's problems. The only option they could give me was to surgically remove the stones, which scared me, and I think also scared them. My vet has never removed kidney stones before, though there is another vet in the area who has, and has agreed to help.
I visited with Toby again, who now was very tired from his (again) full bladder. They were going to catherize him again when I left. We made plans to go ahead with the surgery on Monday (today)
Sunday the tech called me, to give me an update. She said that when they inserted the catheter this time, it went in much easier than the previous times, plus, there has been no blood in the urine, unlike the other times. The vet thinks it might have just been a matter of getting Toby to relax enough, so they were going to try giving him valium through the day, to see if they can get his muscles to let go, and let him pee. That did not work, but my vet had read about another drug that might help. Turns out though, that it isn't carried in this area. So, he is trying to find it somewhere, and in the mean time the surgery is postponed.
Toby remains at the vets office.
I am very worried right now. I knew when he was diagnosed with CRF that we had limited time left, but I did not expect to have something like this happen. It doesn't seem like we can figure out what is causing Toby's problems right now, and I am hoping that someone here might have some insight. I want my baby to come home.
post #2 of 9
Sending good vibes to Toby. I've been thru ureter stones with my Frantic. {{HUGS}} to you too. After all you've been thru you need support just as much as Toby does.
post #3 of 9
I'm sorry to hear that Toby is having such a rough time of it. I have a sweetiepie named Patrick who has had crf for over 1 1/2 years, and is doing well on his regimen of pepcid ac, sub-q fluids and calcitriol.

Are you familiar with some of the great websites on crf, or are you on any support lists for this? If not, I can send you some recommendations for superb sites and a great, extremely informative list.

Let me know (nothing worse than having the same addresses sent to you if you already know about them),

best wishes for your Toby being able to come home soon and doing well without needing surgery,
post #4 of 9
Thread Starter 
Thank you both for your replies.

I have found a couple CRF websites that I've found helpful.. the felinecrf.com and .org sites in particular. And I am on list for CRF, which I have gotten some good advise from.

I think this particular situation is just frightening, mainly for me because there don't seem to be too many people who have gone through it. It's like walking in the dark; I really have no idea where we are going.

As for Toby, he is still at the vets. The kidney stone surgery was cancelled, for the time being. The vet feels its too risky, I believe. He did perform surgery monday, but not on the kidneys. Toby had a perineal urethrostomy. Basically, my vet described it as a sex change operation, making the male genitalia more like the female, which is supposed to keep him from getting blocked in the future. I'm keeping my fingers crossed.

Now I'm just waiting for him to come home. He had a rough time of it today, was going downhill for a little while, but he did stabalize, finally. He's had a rough time of it all around, since this all started. I'll see him tomorrow morning, then it's off to my parents to celebrate christmas. I just hope I can find enough cheer not to bring my family down. It's hard, when all I want is my kitty to come home.
post #5 of 9

I realized later after I posted that I had seen you on the crf list I am on....I hope you will find it as helpful as I have.

I wish Toby all the best, try to take some comfort in knowing that you are giving him every chance to continue to have a good life with you, love him up when you see him, and hopefully he'll be home with you soon.
post #6 of 9
Today I was upstairs taking care of my cats. I notice my Popie going to one litter box to the other.Last year he had surgery for ( stones. The vet could only get 7 out. So she left 2 insideof the kindeys. Well He is trying to block on me. So I will have him at the vets at 7:00 am. See I have have heard of the sex change operation. It dose work. Iam ready for my Popie to have it done.The vet told me she didnt think these stones would move.It always happens on the hoidays.I had some medication so I start him on it. Good lucky with your kitty
post #7 of 9
Jeamy, I'm really surprised your vet proceded with a p/u before opting for a contrast cystography to monitor those stones first (where exactly were these stones located...near the kidney or were they actually passing? Did your vet say how many there were and their size?). I would be concerned with such a radical surgery (the p/u) and yet, this doesn't truly address the stones at all. If your vet saw kidney stones clearly on the x-rays, and knew they would not drop and pass through the urethra, his initial feeling on the surgical removal was probably correct. Why he chose a p/u is quite strange.

I can understand his reluctance to perform kidney stone removal on Monday, as it is an invasive and risky procedure, and given the current health condition, was probably not in kitty's best interests at that time. However, p/u's are usually reserved for cats suffering chronic FLUTD, or those cats who have a history of blockages, struvites, oxalates, etc and who can actually benefit from a shortened urethra to pass these crystals easier. Since you never mentioned the possibility of struvites or oxalates (did your vet actually find any crystals or any gritty substance from the repeated catheterizations?), I have to wonder why he opted for a p/u at all. It actually seems counterproductive given the symptoms and condition you've described.

Is there something missing here? What is the current progress in treatment right now? How does he feel this p/u is going to affect the dissolution of kidney stones? Or, did he feel the p/u was warranted simply because of the repeated urinary blockages, and is he still contemplating kidney stone removal?......................Traci
post #8 of 9
Thread Starter 
Toby passed on yesterday at 10 am. I had the privilege of being with him when he left. Though he was very ill, and very tired, he purred softly for me while I held him. I am grateful to him for that.

Thank you all for your advise and kindness. I am going to take a break from the lists for now.
post #9 of 9
I'm so sorry Jeamy
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