Chronic Kidney Disease: first symptoms
We knew very little about Chronic Kidney Disease in cats until Snejli was diagnosed with it in 2019.
Snejli had started drinking a ton of water (she would drink out of the toilet if we didn’t refresh her water every couple of hours!), had constant diarrhea, and vomited daily. After her diagnosis, we started giving her Phos-Bind, but it made things worse (chalky vomit!). The new diet wasn’t effective, either. Later, when we brought her to a different vet to treat a UTI, they told us her kidneys were fine! We were confused. Needless to say we also didn’t know which vet to trust. Snejli might actually have had diabetes, or hyperthyroidism, or IBD.
In early 2021, we noticed that Alasdair now too was drinking more water and peeing a lot more. Our experience with Snejli taught us that cats get old, and their organs start working less well - and that’s normal. We weren’t thrilled to now experiment on Alasdair with various treatments and diet changes, too. So we decided to monitor for now and act if it seems like any of his symptoms got significantly worse.
In the 4 or so years that he likely had CKD, he very gradually slowed down and started doing fewer of his usual things (no more rolling around on his back, less playing with Orla). There were moments we worried about him because his appetite changed or his tummy seemed upset, but he always bounced back pretty quickly.
Our vet visit philosophy
Us pet owners all have to decide for ourselves when we we want to take our kitties to the vet. There is no right or wrong way, it’s a very personal decision.
Luckily, in our home we were aligned on our philosophy: only take a cat to the vet when it seems absolutely necessary.
We think vet visits are stressful for our cats. Proposed treatment options often seem too generic and/or designed to generate profit.
Alasdair is probably an especially extreme case, but in the 15.5 years I had him, I only took him to the vet 6 times total:
2009: 1 x to get him neutered
2014: 1 x to get his health checkup for international travel + 2 x for a urinary blockage with a follow-up check-up
2015: 1 x to get his Urinary SO prescription renewed
2025: 1 x to get him euthanized
We understand that if we had brought Alasdair in sooner, we could have provided additional treatment in the years leading to his passing. At the same time, there is no way to know for sure that it would have prolonged his life, or made the quality of his and our lives better. He seemed very happy and healthy until his last week and we feel good about not having intervened with what mostly seemed like general signs of aging and slowing down.
Days leading up to Urgent Care visit
We noticed that Alasdair started to act differently a few days before we took him to the vet.
Roughly a week before the vet visit, we noticed that he ate much less of his 5am breakfast. He ate some, so we were not alarmed. Maybe he just didn’t like that particular type of food anymore? When he stopped asking for his 5am breakfast altogether, we did start worrying. This was VERY unusual for him.
On February 11, he started sneaking under the comforter at night to sleep next to me. He had not done that in a long time (Orla doesn’t usually let him!).
On February 14, he went to hide under the comforter and did not ask for his 10pm dinner. This seemed extremely worrisome and we agreed that if his appetite didn’t bounce back, we had to do something about it.
He was still drinking a lot of water, going to the bathroom, walking around and engaging with all of us, though much less than we were used to.
For example, when we watched a movie the night of February 13, he did not come from his cat tree to sit on our lap.
He was however still getting up to say good morning and greeting me after coming home from my walk until February 14.
February 15: Urgent Care visit
On Saturday morning, Alasdair did not come to flop down next to me after I got up. I went to the living room to find him sitting on the sofa. I did not know this at the time, but he was in a meatloaf position, a sign that something was up. I petted him and he acknowledged me but did not get up to cuddle or interact with me.
After I got back from my run, it was time for his lunch. He took a couple of bites, then anxiously walked around the kitchen but refused to eat more.
I was extremely worried but my knee jerk reaction was to just offer him some treats instead. He got VERY excited and happily gobbled them down.
After that, he retreated to the cave in his cat tree. He seemed pretty checked out and we agreed that unless he got up to ask for food in the afternoon we had to take him to the vet.
We lured him out of the cave with more treats and put him in his carrier, then called an Uber Pets (we don’t have a car).
At OakVet in West Oakland, they did a quick initial assessment shortly after we arrived. His vitals looked good and the staff didn’t seem super concerned. Therefore, many other pets in more critical conditions saw the doctor first.
We finally got to meet with the doctor to discuss his bloodwork results 7 hours after we first arrived. Oof!
His results were all awful. We did not write down the details, but some of the kidney values were off-the-scale bad. Because we had not taken Alasdair to the vet to get his kidneys checked previously, they had no baseline and speculated that this might be an acute kidney infection.
They suggested keeping Alasdair at the hospital for 48 hours to give him fluids, antibiotics, and an appetite stimulant.
We were sad not to be able to take Alasdair back home, but we felt he was in good hands and looked forward to visiting him on Sunday.
February 16: significant worsening of Alasdair’s condition
On Sunday morning, we received a text from the overnight doctor at OakVet. She let us know that he was tolerating the fluids and eating. This seemed like good news!
They scheduled more bloodwork for the afternoon and told us they’d give us a call then. We decided to go visit him because we missed him very badly and the doctor agreed to discuss the latest results with us then.
Seeing him was a bit of a shock. He was weak, barely moved and looked very out of it. We figured it was probably just because he was doped up af. He seemed to recognize us and purred as we were petting him.
When the doctor came in to discuss the results, she admitted that she was concerned. There was zero improvement in any of his numbers and she pretty strongly felt that Alasdair had final stage Chronic Kidney Disease and not “just” an infection.
She suggested that we leave Alasdair there for an extra night, then take him home to take care of him for the last few weeks of his life - if that was something we were OK with. Even though the idea of torturing my beloved cat with fluid injections always seemed insane to me, I agreed to learn how to do it so we could hopefully have a few more weeks at home with him.
We were incredibly sad but had not fully given up hope yet. We even planned a trip to the pet store to get him a litter box that would be easier to get into and a bed to put on the floor in case he couldn’t climb up his tree anymore.
February 17: time to say goodbye
On Monday, we woke up to a much less detailed text from the overnight doctor, simply stating that Alasdair had eaten 50% of his food and was “stable”.
In the early afternoon, we got a call from the vet. We knew this was likely bad news. She gave a very detailed overview of Alasdair’s situation and presented us with a few options:
Take him home with us, hope that he might start improving after being in his familiar surroundings
Take him home with us and arrange at-home euthanasia whenever we feel ready
Take him home with us to say our proper goodbyes, and bring him back for euthanasia at the hospital
Arrange the euthanasia at the hospital
The doctor said Alasdair was not responding to any of the treatment he had been given, so taking him home and continuing with fluids, appetite stimulants, etc. seemed unnecessary.
We were absolutely devastated to hear all this and agreed to make our decision after our visit with Alasdair.
Nothing could have prepared me for how much worse he was on Monday compared to even just the day before, but especially to a week prior!
He couldn’t move, he did not respond to our pets, his eyes were completely lifeless, he was peeing himself, he had developed an ulcer in his mouth, and was barely conscious. He was clearly in so much pain and done with life. It broke our heart.
While we would have liked for Orla to be able to say goodbye to her older brother (who she’d spent her entire life with), any minute of keeping him alive for our own selfish reasons seemed absolutely cruel. We decided to do the euthanasia at the clinic.
We talked to him for about an hour, played his favorite song for him, kissed his head many times, and finally decided it was time. I held him in my lap as he took his final breaths.
We were astonished by how suddenly it all ended up happening. Cats are so good at hiding that they are in pain, until they can’t anymore - and that’s when you know you have to act. We were relieved that we could help end his suffering even though the world fell completely apart for us that day. We will forever miss him 💔
