my cat pumpkin !

Question
i am a cat lover and rescued pumpkin 4 months ago. she is 13 and had been diagnosed with hyperthyroidism and possibly kidney disease. she previously was an outdoor cat that had been neglected and abused. i am doing my best to save her. she is indoors now, and i keep her warm and safe. she is very small, only a bit over 5 pounds and so i am always trying to feed her healthy and kidney appropriate foods. she gets sub q fluids daily and does not seem to mind it. i have become very adept !!! she also gets topazol, 1/2 every 12 hrs. we did try to increase it twice and had trouble with her appetite and vomiting when we did so. i guess i need to know what else i can do. i research the internet and ask questions during vet exams, but still i am unsure about what can be done and what is inevitable. i feel helpless and worry about her suffering.

in the past 12 hrs. there has been a new problem. she is peeing and cannot seem to make it to the litter box. these are very small puddles and clear rather than yellow. she also seems stiff in her hip joints and moves a bit more slowly than usual. though there was blood in her urine in december i have not seen evidence of this since then. is this the next step and sign of a further decline ??? is she in pain or discomfort ? what else can i do for her ? thank you. please let me know if you have and ideas. kindest regards, suzanne

Answer
It is hard to bring an ill cat into your life so I commend you for opening your heart so wide for Pumpkin.
A cat with a combination of failing kidneys and hyperthyroidism is not going to be easy to take care of and the prognosis for this is not good. At 13 kidney failure is very common and she is already having issues with filtering wastes from her blood now, so the Tapazole is really hard on top of that. It is hard for an otherwise healthy cat to cat let alone one with kidney disease.

Vomiting and inappetance are the side effects of Tapazole. If you can maintain her with a 1/2 pill every twelve hours you are doing well. There isn't a whole lot you can do for this disease except what you are doing now. There is no diet for hyperthyroidism.

Now for the kidney failure, you need to keep her on a diet that is made for this disease, such as K/d from Hill's Prescription diet. That food will help prolong her life if she eats it and nothing else. I had a cat live to be 19 years old eating K/D.

In regards to the latest development- her kidneys might be getting worse very quickly. When a cat passes clear urine it means that they are not filtering it hardly at all. It's called urine concentration. When the urine in more yellow it is concentrated because the kidneys have pushed the blood through and filtered out the toxins and combine it with water so that it comes out through the bladder as waste. When the urine is clear or near clear it is just water that is filtering through and none of the toxins are being pulled out because the kidneys are not working at all.

The stiffness is not necessarily in her hips but her kidneys might be hurting her a lot which will make them walk that way. The muscles in the small of the back (right above her hips) will feel sore to her when the kidneys are shrunken and hard.

If you haven't yet, she should see the vet on Monday and have him feel her kidneys. If they have stopped working, she will get sicker and sicker as she is poisoned from within with her own toxins.

This is the time you may need to make a very hard choice Suzanne. You have done a kind and wonderful thing bringing Pumpkin out from the cold. You will also be able to give her the ultimate gift of ending her suffering when the time comes.

It's never an easy choice to make, but it is the ultimate gift of kindness and love.
I hope that she hangs in there for you a bit longer, but you need to be preparing yourself for the final choice.

Good luck and please let me know how she does.