Hi Krista,

I discovered your YouTube videos yesterday and found your advice on cat care incredibly helpful. My wife and I are caring for our 18-year-old Birman cat, who is in stage 4 kidney disease with significant muscle loss. She’s also struggling with constipation and has other health issues, including high blood pressure and a heart murmur.

Currently, we’re feeding her a mix of wet food (chicken broth, chicken, pumpkin, and egg yolk), and providing SubCut fluids (50ml/day), along with the following supplements:

– Epakitin (0.5g/day)
– Pet-Tinic (2ml/day)
– Lactulose (3ml/day)
– Phos-Bind (0.2g/day)
– Potassium chloride (0.19g/day mixed in the broth – though we’re concerned she’s not getting the full amount since she’s unable to finish the broth).
– In addition, she’s on Amlodipine (0.25ml/day) to manage her high blood pressure.

Despite this, her weight has decreased significantly over the past year. She was once 3.3kg, but a year ago dropped to 2.5kg, and three weeks ago, it dropped again to 1.8kg, despite our best efforts to feed her.

A week ago, we had an enema done at the vet, which relieved some diarrhea, but there was still hardened stool near her anus. We’ve been massaging her abdomen and anus daily to stimulate defecation, and were able to help her pass a large, hard stool last Wednesday. Since then, she’s only passed small amounts of stool – mostly liquid or dark – and has had a lot of difficulty.

Today, we used a Pedia-Lax suppository (1ml), and after about 30 minutes, she passed a larger stool with dark liquid diarrhea. The stool was slightly hard, dark, and very smelly. She’s now very exhausted and resting, but did purr a bit before falling asleep.

For hydration, I gave her 10ml of SubCut fluids before the suppository to prevent dehydration. We’ve seen three different vets, but none have been able to provide lasting relief.

We’re reaching out for advice on whether we’re on the right track and if there’s anything else we can do to help her feel better and poop more easily. Any suggestions, given the circumstances, would be greatly appreciated.

Thank you so much for your time and any guidance you can offer.

Warm regards,

Joel and Sonia

My initial question : https://www.pawbly.com/question/hello-i-live-in-san-jose-california-and-need-urgent-help-with-my-male-7yr-old

Update: My cat went through a cystotomy on Friday, the surgery went well and he was sent home the same day. Unfortunately he was still blocked as the surgeon did not remove the stones in his urethra (He did not take any xrays after the surgery and also discharged my cat without making him pee on his own). I rushed him to the ER as he was very restless and trying to pee, the ER doctor immediately unblocked him with a catheter and while doing so, she was able to push the stones back into the bladder. Xrays (attached) were taken which shows three stones in the bladder. As the cost of ER was adding up and the surgeon who did his surgery was not available over the weekend, I decided to shift him with the catheter on to the hospital where his surgery was done. I would like to add that in the initial surgery, the surgeon successfully removed all the stones in his bladder but the stones in the urethra were left behind even though he said he flushed them. The ER doctor is very certain that she pushed those stones back into the bladder while unblocking him the second time when he landed in the ER post the surgery.

My cat is currently doing well, he is on Ivy and has a catheter on. He is on CD food since two days. The urine color has improved from bloody to fairly clear. Urinalysis results showed struvite (Ammonium Mg Phosphate) crystals . I will be meeting the surgeon tomorrow and need your advice on what should be the next steps for my cat. Which of the following would you advise?

1. Re surgery to remove the remaining three stones from the bladder. After the initial surgery, the surgeon had mentioned that my cats heart is weak and hence he had to adjust the anesthesia to a lower level (1 instead of the usual 2), though the ER doctor does not see why would that be the case as there is no murmur seen in his reports and he has taken the sedation well while he was unblocked twice in the ER.

2. CD food therapy: Urinalysis results showed struvite (Ammonium Mg Phosphate) crystals. Should we remove the catheter, make him pee on his own at the hospital and then get him home. Watch closely for re blockage while continuing his CD diet. What are the chances of his re blockage? Will the bladder have greater chances of rupture if he gets re blocked since he just had surgery?

Please advise.

@KristaMagnifico

My cat is 12 years old. We noticed she had lost some weight over a short period of time and booked a visit to see our vet on Monday. Then she stopped eating over the weekend and became lethargic so we took her to the ER vet. They diagnosed her with CKD and it is very advanced. Her values were so high they needed to dilute their sample to get a reading. We were told it would not be inappropriate to euthanize her right then and there or we could hospitalize her but she might not handle the treatment well because of her heart murmur. It was such a shock I had no idea she was so unwell, but I couldn’t put her down without trying anything. She was admitted for 2 days and hydrated and while she did perk up and start eating, her numbers did not go down significantly. She came home and was perky for roughly 45 minutes, then laid down to sleep on our sofa and has been using that spot as home base for the last 2 days. She’ll get up to drink and use the litterbox and greet us but then promptly returns to her spot. She is grooming herself. These are some good signs. What worries me is she has already gone off eating. She didn’t have much the first day but today she licked some gravy off some wet food and has had a few treats. She is less perky already. The vet sent us home with mirtazpine ointment and subQ fluids… but nothing for nausea. My question is: should I force feed her? Should I have a tube put in? Should I let her go? I don’t want her to suffer if it’s her time but I also want to give her a chance if she can still lead a good life. She’s an agreable cat and tolérâtes the sub Q fluids well, though I don’t think she would like to be force fed. I won’t give up on her but I don’t want her to suffer either by putting in a tube or force feeding if it will only keep her with me another week.

Hello. My vet suspects my cat has one or more nasal polyps. I’ve been going through this process of getting towards his surgery for a while. The vet told us he has a heart murmur, but only a grade 1 out of 6, I brought him to a 2nd vet and they said his heart sounds great, I went back to the first vet and they looked at him again and the doctor said he has a murmur and even his vet tech looked over it and didn’t hear it the first time and the doctor had to tell her where to listen and she finally heard it. They said we would need some test on his heart before during surgery to make sure his heart doesn’t fail while under anesthesia. I got an x-ray done of his heart which came back fine and i also got blood test done which came back fine. The test he got were included in the basic wellness screen. I’m thinking he has a intermittent heart murmur because of his heart rate going up due to stress of being in the car and at the vet. The vet is still telling me i can have an echocardiogram done to be really sure his heart is really fine. That’s another $390 on top of the $500 i’ve already spent and i just can’t afford it. I believe if 2 vets could simply look over it, and it’s only a grade 1/6, and the test and x-rays came back fine so far, he should be good… right? Well another thing is they don’t know how many polyps he has or where exactly they’re located, we asked for a throat/head xray and they told us they can only do it if he’s under anesthesia first. They are adding on so much stuff i feel like he doesn’t even need and gave us a price estimate from $450-$1,500. We asked the other vet and they said they can do a head x-ray, but they don’t even know if the procedure of removing the polyps is even anything they can do, and he might have to go to a specialist. Can the polyps for sure be seen on the x-rays because i really don’t want to waste any more money on something that doesn’t even help get down to the problem. I’m thinking i can just skip over the echocardiogram because it doesn’t seem it’s really needed, i get an x-ray of his head, find the size, how many, and where the polyps are located, then get a real price estimate. Can someone please answer my questions or give any advice! Thanks:)

My dog Sampson is a 15 year old boxer/pittie mix(50 pounds). Has had diabetes for 7 years. Been on arthritis pain meds the last year.. Has become very sluggish the past 2-3 weeks. Vet diagnosed him with a early stage heart murmur and slight anemia. Changed his arthritis pain meds to Gabapentin. It made him so drowsy that he fell asleep while eating. Became unable to walk without assistance. We weaned him off the Gabapentin and back on the old pain meds. His walking has improved a little but still is wobbly. Yesterday he refused to eat, which is highly unusual for him. Still drinking, but not eating today. He sleeps a lot but also has 30-60 minute spells of restless/repetitive behavior. I’m thinking he may have dementia. Any suggestions on how to help him?

I inherited a healthy, except for a slight heart murmur, 10 year old chihuahua. She is current on shots and had no reaction to them. She ate small breed pedigree at first, but now feed Lotus good grain chicken kibble and pet plate topper (left over from a dog that died). I noticed she scratched her back alot, but didn’t see fleas, hair loss, a rash, and she mostly scratches after coming in from walks or arriving anyplace other than home. For a month, I left her home with my 7 year old chihuahua. They had the run of the house. One day I noticed pieces of my carpet in the hall. Now a whole corner of the rug is gone. I crated her. She screamed and whined and eventually escaped. I secured the crate with a carabiner. I came home to a crime scene. The bridge of her nose was bloodied and one of her nails was pulled out. I am taking her to work with me at a doggy daycare and boarding facility. Her nose has hair missing. I want to treat it, but with what and when will the hair grow back? Money is an issue because my hours are severely deceased now

Dr Krista – I am a YouTube watcher with a 22yo cat that may have nasal or ear polyps. We have spent 8 weeks trying every antibiotic, nasal steroid drop, antibac nasal drop and still fighting the snorking sound and her inability to breathe. Did nasal swab wk of 4/20 – found 2 bacteria, getting compounded anti bacs at this point since both bacs are super resistant apparently – Citrobacter freundii and pseudeomonas species. Antibacs will arrive to me in California by Thur 4/30 . She has a grade 3 heart murmur and hyper thyroid (on 5mg Methimazole daily). Just as your YouTube vid about Stripes with polyps (2/23/2018), I think I may be in the same situation – I have a vet telling me to go to a specialist for $$$ because everything we are throwing at this isn’t working. How in the world do I find someone like you who is willing to help me for a reasonable cost? I am calling all over for vets and everyone is ‘specialist focused’. Do you have tips on what to ask, experience, and honestly, I need someone with your confidence to do this. Or I need you 🙂 I have been in cat rescue over 30 yrs and ‘get; the lingo but have never had such difficulty finding a vet who could assist. Thank you in advance!

is there any symptoms of my cat having a heart murmur that i could tell at home?

My vet thinks my cat has a nasopharyngeal polyp but he needs to go under anesthesia so he they can know for sure and get it out, but he was also listening to my cats heart and said he has a grade one mitral heart murmur and that he needs to have xrays and ultrasounds and such done to make sure his heart is ok before going into surgery because they said his heart could fail while under anesthesia and he could die. My dad said they we should just go ahead with the surgery without spending $550 extra dollars because he doesn’t think he has anything serious wrong his heart considering it was only a grade one heart murmur and my cat was already very nervous about the car ride and being at the vet and that could have caused his heart rate to be off a little. Would it be necessary to look into his heart further or just go ahead with the surgery considering it would only be a 20-60 minute surgery? Would a cat with any type of heart conditions die during surgery? What should I do next?

Hi, I have a 16 yr old shih tzu that has had brain tumour surgery but had complication of regrowth of a cyst several times and went for fine needle cyst drainage quite a few times. She has degraded to the point of being totally non-ambulatory except for some head movements. She has to have her urine and stools expressed everytime and she has to be handfed. But she still eats very very well. I need advise on what my pet needs at this point and whether is there any reason/last wish that is making her hang on so dearly to her life despite her quality of life and body already failing her? Shes like a family. i am torn between keeping her alive and letting her go if shes suffering but my love for her and our bonds is muddling my thoughts and decisions. I have taken care of her intensely for almost a year now from prior surgery to post surgery and she had so many complications, cyst regowth several times, loss n regain limbs ability, pneumonia, anemia. She always pulled through but now shes at a stage where shes really just hanging onto her dear life i feel, lying the whole day, only able to move her head during mealtimes when she is hungry. I have spent over 30 thousand dollars this while for her medications and procedures and vet visits, she even goes for rehab/pt/accupuncture and hyperbaric which are very costly. It has gotten to a point that I am spending more than I earned every month on her rehab (even though she cannot move, she still does ultrasound therapy on her severely arthritic joints and some accupuncture to relieve any pain from not moving everyday and her mountain of medications and supplements. I really cannot imagine life without her, she is my pillar of hope and support in my dark and depressed life and family full of issues. Now my pillar is crumbling. I still take care of her, i dont care about my finances, i stopped going out except to work, i bring her everywhere whenever i can in a dog pram she just lies motionless. Its amazing how she would wake and eat so very very well and finish all her big plate of food every day twice a day but lies motionless and tired after that. Its amazing how she would use her whatever remaining energy to poop when i try to rub and stimulate her anus once everyday without fail. She would be so tired after all that. It kills me to see her like this. Before that she can move n walk or at least drag ard the hse n look happy still so its ok worth all these. I wake up 3 4 times every night to help her drink water eat snacks she would wake from hunger and pant everynight even now maybe from prednisolone. But now shes just motionless and heart murmur has reached grade 5 or 6 and anemic and totally cannot move at all but still eats super well and pee poo normal with help express. A part of me feels like euthanasing her to end her misery and my own heartache seeing her suffer yet i cant bring myself to do it thinking that she would be reallly gone and that i might have done it wrong because shes still wants to be ard and live that is why she is hanging on so dearly. Please advice me..please. i am so loss and torn between choices its killing me every moment im awake.