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> Renal Failure And Pain, Why do people assume wrongly?
Furkidlets' Mom
post Mar 19 2009, 07:15 AM
Post #1





Group: Pet Lovers
Posts: 1,208
Joined: 21-June 05
From: Canada
Member No.: 961



Many folks here don't wish their animal companions to suffer unduly before physical death, and that's perfectly understandable and even laudable, of course. Many also get irate when they think (or assume) that someone has allowed their animal to live TOO long -- not that this is an easy thing to gauge for certain in most cases. However, why is it that many people don't seem to take into as equal a consideration the opposite side of the coin? In our bid to try and negate undue suffering for our companions, are too many people "jumping the gun" and making false assumptions about the quality of their lives?

Since this is one condition I came to learn much about, I have to ask: Why do people seem to assume that cats (this likely applies to dogs as well) who have failing kidneys are going to be in dire pain, and so decide to euthanize them, perhaps long before they have to? I'm finding this quite distressing as I hear people speak all too often of making this decision without getting all the facts straight first, thereby possibly not only ending their animal's life too early, but also thereby giving rise to beginning their grief earlier than was necessary as well. I find it all so sad.

Having gone the total distance with my own feline daughter and her own kidney disease, I'd questioned both of her main holistic vets on just this issue, well in advance, so I'd know what to expect, and just as importantly, what NOT to (falsely) expect! This saved me unnecessary worry and false projection, which also of course benefited my girl's quality of life.

It seemed to be pretty standard knowledge that cats with failing kidneys do NOT normally have great pain issues, at least not from that issue by itself. And keep in mind that both of our vets, most especially our distance homeopathic vet, had an eye towards balancing ALL aspects of an animal's quality of life and so were not generally prone to EITHER dismiss their pain issues, nor jump the gun on euthanasia, as long as the client was willing to provide the proper healthcare protocols at home. We discussed HOW they knew this, and not only has there been evidence supplied by humans who've had kidney failure themselves, but also factored was clinical evidence of animals not seeming to exhibit classic signs of pain, until possibly the very end stages of kidney failure, a stage that, with the proper support, may take quite a long time to develop......as proven by mine & my own girl's story.

To help support this point, here are just two quotes from other vets that support this fact:



CRF is a terminal disease. The only questions are how long and how well the patient will live until the end. With proper treatment, the cat may have from months to years of relatively high-quality life. As the cat's caregiver(s), it is up to you to determine when the quality of life has decreased to a point at which prolonging life no longer has value.

As CRF progresses and toxin levels rise, cats become more uncomfortable with an overall sensation of feeling unwell. Human patients with a similar condition don't report "pain" but describe their condition as feeling poorly. Dehydration, in particular, can make the patient very uncomfortable. Aggressively treating CRF, especially with subcutaneous fluid therapy, should not be thought of as "prolonging the agony" as there is no significant pain associated with kidney failure until the end-stage. Even then, unless the patient convulses, the chief symptoms will be malaise, weakness, nausea and discomfort.
- from the Feline CRF Information Center


AND,

I have asked a couple of people I knew who had kidney failure what it felt like. They said it is not painful in the sense of sharp pain but that it was uncomfortable, like having the flu, when it was time for dialysis. Since we don't do dialysis in cats I suspect that they may feel under the weather a little bit most of the time. But since we can give fluids daily this is probably a relatively minor discomfort until the kidneys get bad enough that they don't respond to fluid therapy anymore.

The most reliable sign of discomfort associated with kidney failure is usually lack of appetite but cats vary a lot in how they respond to this problem. Some eat right up until the time their kidneys fail completely and others are picky even when they only have slight elevations in enzymes related to kidney function. It is necessary to use your knowledge of your cat to decide when the situation has become intolerable to her. I really think that most pets who are close to their owners figure out a way to tell them that they are uncomfortable too often. Some cats being to avoid contact, some hide, some just stop responding to their owners and almost all of them stop eating.
-Mike Richards, DVM



The more positive parts of the above were, overall, certainly true for my own girl, who was still up and about, doing most of the things she'd always done for all of her 19+ years, right up until the last 3 days of her life, and this DESPITE having the additional issues of high blood pressure associated with kidney disease, being blind in one eye (a secondary complication of the CRF/CRD), plus whatever it really was that caused her to be peeing some blood for the last few weeks of her life. (an undetected bladder tumor was one possibility, among others) She also kept eating, albeit totally hand-fed at the end, right up until the last day, and even the day before, her food intake was not that far off par and the only thing I stopped were her supplements (already having booked her home euthanasia appt.) because they were then pointless to give and I had replaced them with a homeopathic remedy & flower essence protocol to address any possible pain issues, but, according to what I'd been told about what to watch for, she never did seem to be in any pain.

So I would encourage anyone who is dealing with CRF/CRD to get very well-informed, ask around (your vet(s); others who've been taken this to the 'final chapter'; online resources/forums on CRF) about any and ALL related issues to CRF (including finding out what those related issues even ARE!) and thereby save yourself a lot of second-guessing when the time comes to make the kinds of decisions you can't take back.


Also from the Feline CRF Information Center, is this informative article on "The Emotional Roller Coaster" of caring for a cat (or other animal) with CRF, to which I could quite highly relate. See that link here.

At the end of this article, there's also another link to a pretty good article on grief in animals, which I will post as separate topic.


--------------------
"I dropped a tear in the ocean. The day you find it is the day I will stop missing you."

[center]~Anonymous~


<div align="center">"Not flesh of my flesh, Nor bone of my bone,
But still miraculously my own.
Never forget for a single minute,
You didn't grow under my heart - but in it"[/center]

~Fleur Conkling Heylinger~


>^..^< >^..^< >^..^< >^..^< >^..^<


"For one species to mourn the death of another is a noble thing"

~Aldo Leopold~

<span style='font-size:9pt;line-height:100%'>Life is life - whether in a cat, or dog or man. There is no difference there between a cat or a man. The idea of difference is a human conception for man's own advantage. ~Sri Aurobindo

Spay now or pay later, the interest is killing us.


</span></div>
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