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Monday 23 July 2018

Couscous: my nervous cat with failing kidneys

Couscous likes being on her own for most of the time.
Couscous likes being on her own for most of the time.

Pete Wedderburn - Animal Doctor

I have written previously about my own pets, and the most common prompt for me to do this has been when my own animals have reached the end of their lives. For me, it has been a type of grief therapy sometimes, with the opportunity to write an obituary for an animal that's been an important part of my life.

This week, the good news is that this is not an obituary. One of my two cats, Couscous, has been unwell, but so far, treatment has been successful, so this is a tale about her illness, not about her death.

Couscous came into my life as a very young kitten. She had been found abandoned, too young to survive on her own. The team at my clinic had taken pity on her, and they'd nurtured her, bottle-feeding her at first, then weaning her on to solid food. She was an affectionate kitten with an ultra-loud purr, and that's what I found so appealing. I brought her home one weekend to do my share of caring for her, and while she was with me, she purred so loudly that I decided to keep her. That was over thirteen years ago.

As Couscous grew older, she turned out to be an exceptionally nervous, flighty type of cat. She still purrs loudly with people that she knows well, but if a stranger ever visits our house, Couscous vanishes. She hightails out of the cat flap, and rushes out into the garden, hiding out of sight. We've had other cats over the years who have been far more relaxed and sociable, but Couscous has always had the gentle charm of a shy animal. It's a real honour if she trusts you enough to sit beside you, purring loudly.

Couscous was always a fit, lean animal, and she managed to avoid major health crises. The only problem she suffered from was sunburn on her left ear tip. Her ear tip is white, and that means it contains no skin pigment to protect it from the ultraviolet radiation of the sun. Every summer, the tip of the ear has turned a red colour, and every winter, it has returned to normal. Ideally, I know that she ought to have had regular sun block applied to that ear tip, to protect it. The challenge for us, as owners, has been that Couscous is so nervous that whenever anyone approached her with sun cream, she rushed away before she could be caught and held still. And we knew that if we did manage to corner her, and apply the stuff, she would head off on her own for several days. And the next time she saw anyone approaching her, she'd be doubly impossible to catch. For this reason, we adopted a "monitoring from a distance" approach. Couscous was fortunate in that her mild sunburn never progressed to cancer, which would have meant that she'd have had to have her ear amputated.

A few weeks ago, we suspected that one of our animals was drinking more water than usual: at first, we didn't actually see any of them doing this, but we did notice that the bowl needed to be filled up more frequently. We started to keep a careful watch of each of the two dogs and the two cats. After a few days, it was clear: Couscous was sneaking up to the water bowl at times when she thought there was no-one watching, and she was definitely lapping up the liquid for longer than normal.

If someone told me that their pet was doing this, I would recommend a visit to the vet. Luckily for Couscous, this did not mean a trip in a car (the stress of this would have upset her a lot). Instead, I brought my stethoscope home and checked her out right beside her own bed. There was nothing obvious wrong with her, so I collected a blood and urine sample for analysis. Couscous did not enjoy this process, but it was all over very quickly.

The test results gave me the diagnosis of her problem: her blood parameters were all normal, but her urine was much too dilute. She was suffering from early kidney failure, one of the most common illnesses of older cats.

Kidney failure can be difficult to treat: in advanced cases, intravenous fluid therapy is needed, with long stays at the vet while the kidneys are flushed out. In the USA, kidney transplants can be given, costing tens of thousands of dollars, and with limited success, giving cats less than a year of extra life. In Europe, this is not considered to be enough of a benefit, and the procedure is not available.

Fortunately for Couscous, the problem is still in the early stages: she would not cope well with prolonged stays and repeated visits to the vet. We are treating her with the simplest therapy of all: a special low-protein, low-phosphorus diet designed for cats with kidney failure. Studies have shown that dietary therapy of this type can double the life expectancy of cats in early kidney failure.

She is still drinking more than usual, but she has a good appetite, and she's enjoying the special diet. The saddest aspect of her diagnosis is that it does mean that she's unlikely to live to a great old age. My parent's cat lived till she was twenty three years old; with her kidney disease, Couscous will be lucky if she reaches fifteen.

The focus for us is to give this timid creature the best life she can have with the least possible human intervention. She's happy in her own space, and out of respect to her, we are going to continue to honour her wish to be on her own. Unless of course, she wants to sit beside us and purr. We never say no to her lovely rumbling purr!

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