Phoebe had her one-month follow-up vet visit today. I captured her quite easily as she had been napping, and noted on the 10-minute drive to the vet, she meowed very loudly, in a way I haven't heard for some time. So, clearly, she feels better.
She's better with her litter box usage (less peeing outside the box), the contents in the box look more normal, she's vomiting less (four times in the last two weeks, and "normal" cat vomit like hairballs and undigested food), and she's more active.
They took another blood draw to see what the numbers showed from last month and weighed her again. She's down 3 ounces (~90 g) which is a bit troubling, one out-of-range parameter went down although is still high, and the other rose at a faster rate than the vet expected.
I did ask some of the harder questions. What's the prognosis? Are we looking at one or two months?
The meds are obviously doing something favourable, as she's more active, her coat is shinier, she's vomiting less. The higher creatinine level indicates that she needs to eat the low-protein food more often. I'd been working it in once every three days, but once a day at least may really be needed.
And what if she doesn't like the low-protein food once a day? If she doesn't like something, she WON'T eat it, and she can't afford to lose more weight. What's the best course for me to take? Food she'll eat that's harder on her kidneys but will stave off weight loss or food she doesn't want to eat that's easier on her system but results in weight loss while she's turning up her nose? And she likes variety and is used to that. The vet mentioned there are different kinds. Yes. Two. She's used to getting about 12 different kinds and i purposely mix them up so they don't get bored eating the same thing.
There is no easy answer. We can try and see how things go. Similarly, there's no clear answer on prognosis. While this jump seems a lot in a month, it could be that it now stabilises for a bit, or things could go into a quick decline. Clearly, she's feeling better, so if she's logy all of a sudden, that'll be a better indication than anything.
I did say first and foremost, i want quality of life for her. As she loves the pocket pill treats, it's not hardship to give her meds, she and JoJo both love getting the fish oil everyday, so again, that's not a problem. But, i don't see her being willing to sit still while i give her a needle for subcutaneous fluids (something the vet said could be available) or how successful i'll be chasing her about the house to give her a phosphorus binder if her phosphorus levels go out of whack (currently they are okay).
He did say her genetics may be programmed to say, "Once you hit 15, your kidneys will start to fail, and there's not much we can do about that." He did chuckle as she scratched on each door in the examination room, hoping someone would open up the door and let her out. She also meowed quite loudly when her door scratchings did not give her the desired outcome. I told the vet as noisome as that was, this was in a way music to my ears because she had this much energy to complain, just like before. She complained most of the way home, too, but within an hour of being back home, she looked quite pleased with herself and welcomed the head rubs i gave her.
I have a plan in place, which i know is subject to change. I shall endeavour to juggle what's best for her with what she wants and to let go when it's time.