we may be nearing the time...

...that i'll be needing to give my precious little snick 'the final kindness'.

many of you may know that my girl has fought a good fight against chronic kidney disease for over 4 years now. snick has been so brave and so very good, always allowing me to give her sub-q's and is a very easy girl to 'pill' too. snick has been on at-home/hospice care for just over a year now, and our vet's have been there for her/for us this whole time. i've made many calls to them, either of the two vet's in the practice, over this past year and they never fail to return my call as soon as they're able to.

snick currently has what the vet and i agree is probably a low-grade UTI, and just started on antibiotic for it today. so i'm hoping that this new may be the reason she's struggling to eat. i'm not sure that my hope is realistic at this point though. now snick is eating, and she does want to eat. it's that she hasn't been eating enough for the last few days. she nibbles on her food here and there, and i bring her dish to her and encourage her to eat many times each day -- and she will eat some for me, varying amounts. i have three different 'toppers' i've been using to help entice my snick to eat better -- crumbled real freeze dried chicken and freeze dried salmon treats, chicken instinct dry cat food, and crumbled instinct raw boost treats. these toppers have helped somewhat, but she's still not eating as much as she needs to. this losing of appetite has come up starting 3-4 days ago. snick is more frail now, has become more so in the last several months. now she's definitely not 'skin and bones', but she's losing muscle weight and so the vet and i estimate a loss of weight from 12 lbs a year ago in november to approximately 8 or 9 lbs currently. this weight loss has been very gradual over this last year.

this past week i've found myself wondering several times if my pretty girl will be with me and our jaspurr for this Christmas; snick absolutely loves Christmas. i can see the 'tired' in her eyes; she's having much more need for the 1/4 tablets of pepcid ac (having more acidy tummy); she's tried to come snuggle in bed with me in her favorite spots a couple times and didn't stay long, most nights she doesn't come to bed with me -- and she has slept snuggled under the covers in bed with me every night since our mickey crossed the bridge over 3 1/2 years ago; she's made a few sudden and sharp cries, which i believe is an indication of discomfort; and she's been drinking more water, two or three times each day she'll drink deeply and for several minutes from her water dish (she hadn't been drinking this much water or this much all at one time before this past week) -- which i believe indicates that her chronic kidney disease has progressed more. my precious girl's litter box output has changed a bit too. other than the one round of 'in and out of the litter box' over 20 times in one hour with only a very small amount of urine output on wednesday (two days ago; and she's just today started antibiotic for the low-grade UTI her vet and i suspect), snick now is urinating twice per 24 hour period and very large amounts (from the sub-q fluids given her every day). she had previously been urinating 3 or 4 times, sometimes 5 times, per 24 hour period.

on the other side of the coin, snick still will have short periods of 'zooming' from the living room to the kitchen and back, and has had a few of these this past week. she's alert and aware of her surroundings. though she has been slowly losing mental acuity, she still knows me and our jaspurr, where her litter box and food/water dishes are and how to get to them and etc -- she's still able to function.

it's yesterday and today, and snick's not eating well but particularly that the toppers aren't even enticing her to want to eat or to eat much when i bring her food to her, that has me very concerned. she'll still want to eat and even 'ask' for food, but she smells her food and then will either take a few bites and walk away or just walk away.

overall, i think i'm seeing a distinct 'downward' turn in my snick's health/condition.

i'm telling myself that my little sweet pea will either be with me and our jaspurr for Christmas, or with her beloved brother/litter mate mickey for Christmas.

i'm not so much asking for advice, although it's certainly welcome. i guess i just feel the need to get all this out, out from rolling around in my head, with people who love their cats and so can understand.

at this point, i'd like to give it the weekend and see how my pretty princess is doing by monday. and i'll be calling our vet to discuss these things on monday too.

ohhhhh....I am so sorry to read this...

I do not know what to say...(((hugs)))

I know how much you love Snicks...You have been so good to her...Your love and dedication has be unending and unfailing...I know how hard a decision this is to make.

I'm so sorry to hear Snick isn't feeling well. Fingers crossed that she pulls out of it as the UTI treatment takes effect. You have taken such good care of that dear little girl and I know how difficult this is. My heart goes out to you during this time.

The ups and downs with a chronically ill cat are very wearing. You know you're facing the inevitable, but the good days make you hope it's not that time yet. When Jamie was declining due to severe HCM, we kept asking ourselves whether the good days were still outweighing the bad. Fortunately, he made it clear when he'd had enough. :cross: that Snick does the same.

Thinking of you and Snick and wishing you both well, and here is a hug from me too. Just love that baby up....as I am sure you do. 

I'm so sorry, but I am thankful that you're expressing your concerns and getting it out of your head.

In December, 2010, I lost my Callie to CRF, after a 5 year battle.  She started failing about a week or two before Christmas, so we put her on fluids and nursed her through Christmas.  I went through many of the same things as you.  The only reason we put her on fluids was so that I could spend a little more time with her on my days off from work. (I worked retail at the time.)  Callie had pretty much stopped grooming herself, stopped eating, and wasn't using the box as often.  She would shiver because her body was unable to filter out the toxins any longer.  She also had that look in her eye, so I knew it was time for her, but not for me.  There's never enough time with out beloved pets. 

As you are doing, start planning for the future, but know it's always possible that she will kick the URI and continue to do well for a little bit longer.  If you feed canned food, heating it up a bit will help enhance the aroma and might entice her to eat. 

Big hugs to you.  It's not an easy thing, but Snitch is so fortunate to have you to love her.

It's the hardest decision we ever have to make for our furbabies, but only you can make that decision because you know her best- my heart goes out to  you.  In no way am I trying to tell you what to do, but i am wondering if your vet had you giving your girl something for anti-nausea, Ondansetron or Cerenia can help CKD kitties, and also I don't know how long your girl has been on Pepcid AC, but it can not work as well over time, maybe a switch to Ranitidine could be helpful. My Tiger had CKD, diabetes, hypothyroid and IBD early stages, but it was pancreatic cancer that ended her life this past July.  I took to sleeping downstairs with her on the couch and me on the floor(!!) during her last year and I don't regret one single minute of that time I was able to spend cuddling and loving her. I'm sure you have seen links like this but I will send them anyway, there are assessments for those unsure when that time is near:

http://www.lapoflove.com/Pet_Quality_of_Life_Scale.pdf

http://www.thecatsite.com/t/237066/when-the-moment-comes

I hope and pray the antibiotic takes care of her UTI and you and snitch will be in my thoughts and prayers.

I'm so sorry Snick isn't feeling well. As the others have said, I hope the antibiotics kick in & really help her pull through this.
I think RuthM has some understanding from experience, & some good ideas. You have taken such good care of her.
You & Snick will be in my prayers. BIG HUGS to you both!!!!

I knew you were preparing yourself for this eventuality but I didn't realise it would be so soon.
You know snicks so well and you'll know when the time is right to send her to Rainbow Bridge. I'll be thinking of the three of you.

I hope that this is just a bump in the road and she recovers from the UTI. My boy refused to eat and was lethargic as a result of the antibiotics. What antibiotic is she on? Praying she can beat this.

I know this pain so well, and so recently. Keeping you and your little family in my thoughts. {{hugs}}

thank all of you for your caring, supportive, and encouraging words and thoughts!

@stephanietx -- thank you for mentioning a URI! i had been so focused on dealing with my snick's UTI symptoms and worried about her appetite that it just never 'registered' that snick's little sneezes here and there for the past several days, coupled with her lessened appetite, would be symptoms of a URI. the antibiotic snick is taking is one we've used to treat her UTI's successfully before, and it's also an antibiotic that's prescribed to treat URI's -- so in this case, it turns out to be an ideal medication.

@RuthM   -- thank you for mentioning the anti-nausea medications. my little snick has been taking pepcid on and off/as needed for over a year -- at one time, years ago, she was taking pepcid every other day (she has IBD). she had been doing very well/only needing a 1/4 tablet maybe once every 4 or 5 months for well over a year now. it's just recently that she's seeming to have acidy tummy more often (more lip licking), and the pepcid seems to do a very good job of relieving that for snick. i will discuss the possible use of other anti-nausea medication with our vet on monday, see what she thinks. thank you for posting those links -- it's been a while since i've looked at a quality of life scale. snick generally seems to fall into the 'intervention needed' category at this time.

@Zed Xyzed   -- snick's on a generic (compounded at a local compounding pharmacy) version of baytril. i was extremely careful to make sure the dosage is correct and appropriate for her weight and (medical) condition.

UPDATE:  well, now i have more of a little glimmer of hope that my sweet pea will pull through this. she's only made a few little sneezes in the last two days, just this morning. no UTI symptoms have appeared again. and she seems ( ) to have her appetite at least trying to pick up/increase again.

Yay! Thats wonderful to hear. I pray she continues to stay on the mend. Kisses to Snick!

Yay!!! that is a wonderful update. Snick you keep fighting a getting better 

I'm so happy to read your last post, and I want to apologize if in any way I sounded like I am judging you, it is exactly the opposite, you are doing an exemplary job of caring for your baby. It is the hardest thing we ever have to do, trying to keep our babies comfortable as possible and recognizing when their quality of life isn't there. Thanks so much for your update and please know you and your loved one will be in our hearts and prayers. hugs!

This is such fantastic news! [emoji]128077[/emoji]. Fingers crossed that Snick continues to improve!

[emoji]128573[/emoji][emoji]128573[/emoji][emoji]128573[/emoji] I hope Snick continues to improve. No matter how we try to rationise it, we're never really ready to let go. [emoji]128575[/emoji]

So glad to hear this!! almost time for a happy dance!!

Artie has IBD. He is currently taking 1/2 pepcid pill daily. When he first started the IBD medication, he was taking Cerenia for 5 days, off for 2. The off days he was taking Zofran for the nausea. 

Hopefully, Snicks will be able to have some sort of ant-nausea med to help her....

Yay for snicks, his mum who works so hardn make snick'a life more comfortable and to jaspurr who works hard to keep their spirits up.

@mickNsnicks2mom ...Sending you thoughts and prayers for strength, peace and love for you, Snick, and Jaspurr.     

(My Rainbow cat Spotty was given Amphojel for mouth ulcers, which tastes like 'milk of magnesia', along with the Pepcid. It was the Ammonia not being filtered out of the kidneys that caused the ulcers, according to my vet. He hated the taste, so my vet said to only try it once, if need be.)

(I don't know if an appetite stimulant would work, because it can cause 'spacey' side effects, and can cause lethargy, so then we don't know if it's the disease or the meds causing unwanted symptoms.)

I'm hoping that your Snick continues to feel better from the antibiotic, and this in turn, causes her to regain her appetite, more and more.