The topic of hyperthyroidism as a possibility of something which Vincent might came up in our discussion and Vincent’s vet said I could get the test done at another clinic if I wanted to though he didn’t think Vincent had it. He also did not have the test.

I did want to rule that out. So, we went to get that done today.

It was quite a long way, and I had to totally rely on Waze. Waze and I don’t exactly have a good relationship, unfortunately. But thankfully, we got there.

Waiting for our turn.

This is going to be a rather long narrative.

The vet suggested we test Vincent for diabetes and FIV/FeLV as well, since we were already there. Also, to test Vincent’s urine to see if it has protein urea. This is something we definitely need to do for kidney disease. The amount of protein urea will tell us how advanced the kidney disease is, how bad the kidneys are.

I was supposed to get a urine sample from Vincent (when he pees), but I haven’t been able to do this.

The vet says she would stick a needle into Vincent’s bladder and take a urine sample. We did this and the urine looked very clear, as expected.

The vet also said Vincent is extremely dehydrated (yes, we know) and she suggested that we put in 250ml of fluids for the daily subcuts instead of just 150ml. It is obvious even from the pinch test that 150ml just isn’t enough to hydrate him. He needs more. I didn’t know more was possible.

I requested that the vet do the subcut for today. At least it saves us one session.  The vet used the pink needle (the thick one) and did it in a different spot, higher up, somewhere in the middle. Good to do it in a new spot. Vincent was totally cooperative and it was over in a very short while (because of the thick needle).

The vet also examined Vincent’s mouth ulcers and remarked how good Vincent was. The mouth ulcers were “so bad” and yet, Vincent allowed her to examine. The vet also explained that there are ‘indentations” in the ulcers already and it must be very painful.

Poor boy….

For this, the vet suggested a change of antibiotics to address the mouth ulcers – metronidazole, and a pain-killer to numb the pain. I welcome this very much.

I asked how the ulcers came to be and why it is so bad. The vet said it is most likely due to the kidney malfunction, elevating the BUN and creatinine which is toxic. So these toxins destroy the mouth and creates ulcers. It is also an auto-immune response of the body.

The vet took a ear-prick sample of Vincent’s blood to check under the microscope. There is a huge presence of white blood cells, but not indicative of leukemia. It shows a bacteria infection. This, again, is due to the mouth ulcers.

The vet also took Vincent’s body temperature to check for fever. It was 37 degrees which is rather low for a cat. So, the vet suggested we keep Vincent warm. He must be feeling cold. (But Vincent seems to like cold places at home, like out in the patio and on the landing, and he doesn’t want blankets. Oh well, a cat knows what he wants.)

After the subcut and taking of blood (from the leg and an ear prick) and urine samples, we waited for the results.

Vincent was so good. He didn’t make any fuss at all.

Then, the results came.

The good ones first:

(1) FIV/FeLV was confirmed negative. We waited for longer, in case it turned, but it didn’t. Confirmed FIV or FeLV negative.

(2) Diabetes was negative.

(3) Hyperthyroidism test was negative.

The very bad one:

(4) Vincent’s protein urea is EXCEEDINGLY high. The normal reading should be less than 0.5 but Vincent’s is 3.98. This means his kidneys are literally “porous”. Protein is leaking out at an alarming rate.

Well, this explains a lot of things – the weight loss, the rapid loss of muscle mass, etc.

This reading puts Vincent’s kidney disease at a “very end stage”. The tail end.

I wasn’t shocked, since we already know it’s bad and it’s terminal. Now, it’s confirmed that it’s very terminal and at a “very end stage”.

The vet says we have to do something to stop or reduce the protein leakage. To do this, Vincent has to be well-hydrated first. Hence, the 250ml daily subcut from today onwards.

I told the vet we just want to help him and make him as comfortable as we can for his remaining time. She understands this and prescribed what may be helpful for this purpose.

In short:

(1) Change antibiotics to metronidazole for the mouth ulcers.

(2) An antacid which will soothe the stomach but also functions as a phosphate binder at the same time. This is good as I was looking for a phosphate binder and was just about to order Epakitin online. The vet said better not to as Vincent’s phosphate level is high, but not alarmingly high, and this antacid does the job, anyway. Also, Vincent might not be able to finish the Epakitin as it is a big bottle. However, the antacid is in liquid form so it’s going to be a real challenge to administer it.

(3) A cream to be rubbed onto his inner ear to numb pain. It’s a painkiller. This was exactly what a friend was telling me about sometime ago. It has a sort of sedative effect too. Hopefully he can eat better with the pain being numbed.

(4) Do daily subcut of 250ml for five days, then go back and check hydration level. If hydrated enough, we might start on Fortekor. Fortekor can only be given to a well-hydrated animal. Fortekor is the medicine that will reduce the leakage of protein from the kidneys. We could also use Semintra, but the vet said it’s a big bottle and again, we might not finish it. Fortekor does the job. Let’s just hope Vincent can retain enough hydration so that this can be started and hopefully, he can gain back some muscle mass and protein that he consumes won’t be all wasted (as it is now).

We discussed Vincent’s food choices as well. Whatever protein he takes in has been leaking out from his kidneys, so now we know why he is losing so much weight and muscle mass. The vet asked if Vincent was willing to eat the renal diet (but no) and if he would be willing to eat cooked food (also no, unless it’s canned – then maybe) and if I could add some carbs like potato to his diet (I doubt it).

I did ask the vet why and how Vincent came to be in this condition. The vet said most likely, it’s an auto-immune response of his own body.

Yes, there are so many things beyond our control.

The vet also checked Vincent’s teeth and remarked that he is probably a very old cat. At least 10 years old. Well, we don’t know how old Vincent is as he came to us in 2013.

All said, the vet did remind me again that Vincent is at a very end stage, so we have to face the reality.

I know this.

We will do all that is necessary and appropriate to make Vincent’s remaining time as comfortable and happy as possible.

Vincent weighed about 2.7kg, taken at the clinic, which also means that our scale at home is correct (we carry him and take the difference of the weight).

We made the trip home and it felt a long way too.

We are home! Ginger and Tabs came to greet us.

Vincent was glad to be home too. He pee-ed in his carrier twice so I cleaned him up.

Vincent later asked for food so I gave him whatever he wanted – his raw meat and liver. I know now that whatever protein he eats will be leaked out through the liver, but hopefully, he gets the vitamins and minerals. Maybe Monge would be good too as it has some rice in it.

While we now know he isn’t getting any proteins from his raw meat, at least he is able to eat, if only to satiate his appetite, to fill his stomach and to be happy for the moment. Whatever happens to the food once it leaves the mouth and enters the stomach, we have no control over.

Be respectful to your pets, say Dr Pierson and Dr Becker. Do not force.

Vincent wants to eat raw meat, let him eat it.

Going out to the sun and scratching at the pandan roots.

Life is to be lived to the fullest. Life is fleeting and we don’t know how long it will last. Let each moment count.

“Life is mostly froth and bubble,
Two things stand like stone.
Kindness in another’s trouble,
Courage in your own.”

― Adam Lindsay Gordon

Doesn’t this describe Vincent so aptly? Despite his condition, he is so courageous and brave.

Most animals are, aren’t they? It’s we humans who aren’t.

We have lots to learn from them, don’t we?

Source: https://myanimalcare.org/2018/09/23/vincents-urine-test-and-..

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