The peaks and valleys of caring for cats with chronic illness can be extremely challenging for their owners. This unique roller-coaster ride can cause extraordinary emotional stress, and can easily wear down the spirit and energy of even the most devoted and motivated owners.
According to Arnold Plotnick, MS, DVM, DACVIM, feline specialist and the owner of the feline-only practice, Manhattan Cat Specialists, “Although young cats can become seriously ill, elderly cats are obviously at greater risk for succumbing to complicated medical conditions. Several of the more common chronic illnesses that older cats may develop include arthritis, hyperthyroidism, diabetes, chronic kidney disease (CKD), high blood pressure (usually the result of hyperthyroidism or kidney failure), dental disease, inflammatory bowel disease, pancreatitis and cancer. Additionally, the immune system in older cats is weaker than younger cats, thus making it less effective for them to fight off disease.
“To help maintain a more comfortable quality of life, cats with serious, chronic medical conditions will often need nursing care at home. However, tending to a cat with chronic medical conditions can be extremely stressful for both the cat and the owner. When owners must repeatedly administer medications to their cats requiring complex medical treatments, it can be a daunting task. This can quickly become exhausting and immensely frustrating — especially when things aren’t going really well. However, home nursing not only can save cats’ lives; it can absolutely extend and greatly improve their quality of life.” [See article on hospice care in the September, 2016 issue of Catnip.]
Care for kidney disease
According to Dr. Plotnick, “Kidney disease is a very common finding in the older cat. Cats with chronic kidney disease quickly become dehydrated because they pass copious amounts of urine. Using a water fountain and placing several bowls filled with fresh clean water around the house may encourage them to drink more. Unfortunately, cats with this condition very often don’t want to eat or drink sufficiently to ward off dehydration, so it becomes essential to keep the cat hydrated.”
“Administering subcutaneous fluids (a combination of fluids and electrolytes) on a regular basis can help sustain proper hydration. This will assist the function of failing kidneys and help your cat feel a lot better. Depending on the stage of the cat’s kidney disease, the veterinarian will prescribe a specific treatment schedule in order to maintain appropriate hydration. However, subcutaneous fluids are generally only a part of treating feline kidney disease. Other treatments might include antacids, phosphate binders, potassium supplements, anti-nausea medications, appetite stimulants and blood pressure medications.”
Treatment can be intimidating
Administering daily medication is one thing — but when veterinarians suggest that subcutaneous fluids are necessary, fear is the initial reaction that many owners experience. This knee-jerk response may be caused when the owners assume that they would never be able to stick a needle into their cat on a regular basis.
In reality, giving subcutaneous fluids at home does become easier with experience, and this supportive therapy is relatively painless for the cat. The veterinarian will prescribe the appropriate type of fluid, provide the owner with careful instructions on how to administer it and will provide all of the necessary fluid bags, drip lines and needles (experts feel that extra thin-walled 20 or 21 gauge sharp needles are preferable since they are more comfortable for the cat).
For owners who still feel extremely uncomfortable about administering subcutaneous fluids to their cat, here is some good advice from Stephanie Borns-Weil, DVM, a faculty member in animal behavior at the Cummings School of Veterinary Medicine at Tufts University. “Until you have gained enough confidence about giving your cat subcutaneous fluids, you can always bring your cat to your veterinarian’s clinic for treatment. However, this can be quite costly over time, so a more cost-effective option is to hire a vet tech to come to your home to do the procedure. Many vet techs are willing to make house calls to help treat your cat for a very reasonable fee until you are more confident.”
How to make the task easier
Dr. Borns-Weil suggests purchasing an IV pole because it is more stable than hanging the fluid bag over a shower curtain rod or a doorknob. Because the pole is on wheels, it can easily be moved to different locations. This way, you can move the apparatus to your cat’s favorite spots at different times of the day, rather than disrupting and moving your cat. (Reasonably priced IV poles can be found on eBay.) And since many felines resent being confined, the “EZ IV Harness” can be a useful device that allows your cat to move around the house while being hydrated.” (Visit www.ezivharness.com.)
“Additionally, some cats respond well to being safely snuggled into the bottom of a hard carrier with the top removed, while others may feel safer and more secure in an open-topped cardboard box lined with a soft blanket or pillow,” explains Dr. Borns-Weil.
As far as pills or liquid medications are concerned, owners may initially have some difficulty administering them, particularly to cats who resist being given oral medications. Just the memory of the bitter taste of a liquid medication can result in the cat running away and hiding under the bed when she sees the owner holding a syringe. What often makes matters worse is that instead of the cat swallowing the liquid, the majority of the medication ends up on the floor or on the cat.
Compounding to the rescue
The good news is that there are several techniques — and resources — that can help reduce stress for both the owner and the cat. Compounding pharmacies now make these tasks simpler by preparing medications as flavored liquids, transdermal gels and chewable treats. It can be nerve-wracking to attempt to cut pills in half or quarters when it is essential that your cat receive the correct dose. Custom-compounded medications are specifically made for your cat. Although many veterinary clinics are able to compound their medications, there are those that don’t provide this service. You can ask your veterinarian to call in the prescription to a compounding pharmacy.
A popular method is to hide a pill in canned food or into a pill pocket. This can work very well, but make sure that the cat doesn’t learn how to eat around the pill. Another method that you can try is crushing the pill and blending it into canned cat food. (However, not all pills should be crushed, so check with your veterinarian before using this method.) You can add the medication to a small amount of favorite food, watch her finish it and then give her the remainder of the meal.
“Although cats may not understand our words, they are extremely sensitive to the tone of our voice, and our emotions,” stresses Dr. Borns-Weil. “If we are calm and relaxed, it will help your cat stay calm and relaxed. Keep talking to your cat and get her accustomed to being handled as though it’s not a big deal. Reassure her by explaining what you are doing and why you are doing it. Owners can also learn how to counter-condition a nervous cat into one that is cooperative and easy to handle by associating treatment with something positive. For example: Is your cat a foodie? Offer food or treats to your cat while hydrating her. If your cat doesn’t have an appetite, find something to offer your cat that he really enjoys, such as petting.”
Dr. Borns-Weil advises owners to learn how to mold their cat’s behavior. “When preparing to give medication to your cat, rather than just grabbing her, you can train her to approach you. One way to facilitate molding behavior is with clicker training. Click and reward. This is extremely advantageous in helping the cat to associate pleasant things with treatment. Cats quickly learn that a click is followed with a reward. This method is also effective in training cats to get into carriers without a struggle.
“What does your cat enjoy that will distract her? The perfect place to treat your cat may be near a window where she can watch the squirrels, birds and other wildlife. Having soft, soothing music playing in the background can help both you and your cat to relax. Playing a bird and/or wildlife DVD can often be distracting and entertaining for cats.”
Find a support group
Both you and your cat can benefit greatly from the time and effort you put into mastering the required skills for treating chronic health conditions. Additionally, there are various Facebook and online support groups started by people who have experience working with chronically ill cats (try visiting groups.yahoo.com). They provide information, build confidence and offer much-needed emotional support to their members. Just remember to rely on your veterinarian for medical advice. — Jo Singer