Tabs stopped eating nine days ago, but after two days, she started eating again. It was only small amounts, but she was eating at least a little bit, a few times a day.
Initially she only wanted Cindy’s baby food paste, but she later ate some canned food as well. I offered whatever foods we had, as long as she was willing to eat it. She was also on Gabapentin for pain and her usual kidney supplements even though at this stage, I wonder if any of it helped anymore. Tabs had outlived her PKD for a long time now, so the fact that she was still “normal” and eating happily for the last two years was already a bonus.
But now, she has suddenly become very weak, especially in her hind legs. This happened a day after she was given Gabapentin. I did not know there was a connection, but there is (see below, please). I only know that kidney problems can lead to weak hind legs, so I thought that was the cause.
We kept her as comfortable as we could.
However, Tabs started to have urinary problems. She would pass urine, and the volume was a lot, but after that, she would squat and strain, as though still trying to urinate. This problem would happen once a day. I gave her Prazosin for this and it helped. I also added Beazyme as an anti-inflammatory.
But for more than a week now, she has not defecated. I know the amount of food consumed is very little, but it was worrying, so we took her to the vet’s today. There’s also the urinary problems to address.
True enough, Tabs was constipated. The vet also checked her bladder using ultrasound, and there were just some crystals, but not much inflammation. Since the straining does not happen daily (it also did not happen today), we will just use Prazosin whenever the need arises. Tabs’ bladder is not blocked since she is able to urinate several times daily.
For the constipation, it had to be cleared. So the vet gave Tabs a mild enema. She helped to manually evacuate the first blob of faeces and thankfully, after that, Tabs was able to clear her bowels over the next 50 minutes. I was so worried she would not have the strength to push the faeces out, but she did, with the help of the mild enema.
For this problem, the vet prescribed 1.5ml Lactulose daily for Tabs.
As for the weak hind legs, the Gabapentin dosage prescribed by the previous vet was too high; it should only be 1/3 of the dosage, so we will reduce the dosage and hopefully, the weakness of the hind legs will improve. Maybe the Gabapentin is causing a general weakness in Tabs as well. But the vet did say that the weak hind legs could also be due to other causes like low potassium or it could be just general muscle loss in Tabs which is definitely happening. Kidney problems also lead to weak hind legs.
Potassium supplementation cannot be given without a blood test to check the electrolyte level. Kidney patients sometimes have high potassium especially if they are already on ACE inhibitors like Fortekor of which Tabs is. Also, the kidneys are needed to remove potassium from the blood, so when the kidneys have failed, it is possible that the patient already has a high level of potassium. Any supplementation would be very dangerous and can cause a heart attack. This is why potassium supplementation cannot be given without a blood test to check the potassium level. We tried our best to avoid having to draw blood from Tabs today, so the vet said to try reducing the Gabapentin dosage first.
We are home now and Tabs wanted to sit in the sun for awhile.
She also ate a bit of food after that.
Taking a nap now. Hopefully Tabs feels much better after her bowels are cleared. The vet has also adjusted the dosage of some of her medication because of the loss in weight. Prazosin and Mirtazapine will only be used as needed.