Dodo was puking more frequently than usual the last few weeks, and occasionally I’d find a hairball in it so I wouldn’t worry about it, but at the end of last week, in one morning he’d left 5 piles of vomit, and a lot of it was just yellow bile. Knowing this is a symptom of his progressive kidney disease, I increased his antacid prescription med (fantomidine, aka Pepcid) to twice daily (which was the original prescribed amount, but I’d only been using it as-needed with the vet’s approval) and made him an appointment for a kidney re-check for yesterday. Over the weekend, he didn’t vomit once, so I figure I’ve updated his antacid to his current needed amount, but it’d still be a good idea to do a blood test anyway to make sure his other daily prescription meds, amlodipine for high blood pressure and a supplement of potassium, are still within the proper amount as his last checkup was last April.

Dodo’s blood pressure at the vet was super-high again, 220/200. The doctor told me to increase amlodipine from 0.25 ml per dose to 0.3 ml per dose, and meanwhile they took his bloodwork.

For the past 2 days since I’d increased his amlodipine by a measly 0.05 ml, he has completely STOPPED yowling. I thought it was just part of his feeding routine, since he’ll get up, eat food and/or drink water, then come back to his sleeping spot and yowl at the top of his lungs 8-12 times, then settle down and go back to sleep. He’s been doing this for over a year. Both vets at the current animal hospital Dodo goes to have told me yowling may be a sign of headaches caused by high blood pressure, but since he only did it as part of his feeding routine, we sort of just dismissed it as one of his quirks now. Maybe it HAD been a headache issue the past year+. That makes me feel bad, because now I’m wondering if his amlodipine amount was never high enough, since the blood pressure machine was broken when we went back for a recheck last year after he started his meds. We didn’t worry about his blood pressure too much despite being in the dark about what it actually was, because blood test results then came back within normal ranges after he started meds.

The vet called with blood test results yesterday. Dodo’s kidney disease has progressed in the last year — his calcium levels are elevated so the kidneys aren’t filtering out as much calcium as they need to; he’s extremely anemic because his kidneys aren’t producing the hormone that tells his bones to make red blood cells; one of his kidney enzyme values has now gone past normal and into “high.” Lowering his blood pressure back into normal would slow down the disease again and it would be less like “blasting a fire hydrant into a weak filter.” Hopefully the kidney enzyme levels would go back into the normal range with that alone. As for the anemia, I’m going to have to do a 2-week course of subcutaneous injections on Dodo to add the “make red blood cells” hormone back into his system, and the vet says I should see an energy spike and hopefully also an increased appetite after that, and the injection would only be given on a rare “as needed” basis thereafter. The vet thought Dodo’s kidneys felt like they were within a normal size range, an improvement over the enlarged kidneys the other vet had found a year ago, when the disease was not yet treated.

To help Dodo’s constipation (since the kidneys don’t leave enough fluid in his system thanks to the disease), I’ve been giving him prescription canned “wet food” the past few days in addition to his prescription dry kibbles. Unfortunately, the wet food is in pate form, and Dodo has never done well with pates. He likes them and will eat them, but his tongue doesn’t seem to know how to bring the food up into his mouth. He ends up smashing the food into the bottom and lower walls of the bowl. I often fluff the food back up with a spoon and sit it loosely in a pile like a mountain, and he’ll go at it again, smashing the food back down instead of picking it up. I followed the vet’s suggestion the past 2 nights of putting the wet food on top of some dry food to keep it off the bottom of the bowl, and that’s worked better. Dodo loves it; he purrs so loudly when he’s working at his wet food, and his poops did seem to be less dry. (Sorry for the scatology report.) Poor little kitty had never strained and grunted while in the litter box before this stupid kidney disease. The vet also suggested squirting some mineral oil (about 1 ml) into his food to help moisturize, so I’ll have to go find some mineral oil. It’s so much nicer to lure Dodo out to be medicated by the scent of yummy food, instead of by picking him up and out against his will. And immediately giving him the bowl of wet food after medicating him is a much better and more effective distraction to keep him from trying to puke his meds back up. (I used to try to get him to drink water, pet him, if he’s gagging already I’d pick him up and rock him, or I’d q-tip his ears.)

This weekend, I get to go get “trained” on kitty injections. I guess I’m grateful I was my own guinea pig first. I’ve stabbed myself with enough subcutaneous syringes to know that it doesn’t hurt. Usually.