I stared at the YouTube video on my phone of a cute pig eating a cookie, attempting to distract myself from the heavy dread I felt. I tuned out the irritated meows coming from Midnight’s carrier and tried to believe her blood work results were going to be fine. Even after two years of surprisingly well maintained kidney levels, I knew chronic renal disease is irreversible and worried our days of great blood work could be over.
Once Dr. Bilhartz returned to our exam room with the results, he told me Midnight’s blood work indicated that it was time to consider subcutaneous fluids (“subcutaneous”, also called subQ, means under the skin). To give subQ fluids, a needle connected to a fluid bag is inserted beneath the skin. Because many cats with chronic renal disease eventually become so dehydrated that they are unable to drink enough water, the fluids keep them hydrated while helping their body deal with toxins.
Although subQ fluids could lengthen Midnight’s life by slowing additional damage to her kidneys, Dr. Bilhartz explained “Giving fluids is a different decision for every family. Some cats handle the treatment very well, and others don’t. It is not automatically the ‘right’ decision for every cat. Just because you can do it doesn’t always mean you should”. I already suspected Midnight’s infamous obstinacy would influence a negative reaction to the treatment. But I still wrestled with this important decision for weeks. I felt the weight of my responsibility for Midnight’s health and happiness, and wished she could just tell me what she wanted.
I have heard several stories about cats who receive subQ fluids, adjust to the process, and consider it to be a normal part of their routine for years. I hoped Midnight would help make this process easier and be like one of those cats, so I decided to try a trial to see if she could adjust too. Carey, the lead veterinary technician at LazyPaw Animal Hospitals, taught me how to administer fluids at home so we could avoid the additional stressor of frequent vet visits. She showed me how to hold Midnight so she couldn’t easily run away, how to hold the needle at the correct angle, where to insert the needle beneath her skin, and the amount of fluid I should give each time. She also told me it’s helpful to hang the fluid bag from a clothes hanger so the fluid moves quickly. Carey emphasized what I found to be the most important tip: “Even you don’t feel confident, at least pretend you’re confident. If you’re nervous, she’ll know and it’ll make her nervous too”.
Once I understood each step, I began our trial of giving fluids at home every other day. I pretended to be confident even though my hands shook at the thought of inserting the needle. The first time didn’t go as well as I hoped it would and I considered quitting the trial altogether. But I figured that if I didn’t at least give Midnight a chance to adjust, I might one day regret not completing the trial. We continued to improve our routine, and after a bit of practice I didn’t have to pretend so much. But despite my determination to make it work, Midnight confirmed my original suspicion and was not one of those cats from the success stories I heard. Despite the increased hydration, her emotional quality of life decreased and she actually appeared to feel worse.
Even though the trial was a difficult process for Midnight and I, it was a necessary part of making sure I made the decision which will allow her a happy and fulfilled life. Observing Midnight’s reaction reminded me that cats are individuals with different interests. Something that might not affect one cat very much might be a powerful influence on another cat’s wellbeing. As Dr. Bilhartz said: just because you can doesn’t always mean you should.
Each cat should be considered as an individual when deciding to begin fluid treatment. Some cats feel physically better as a result of the hydration and receive an enhanced physical quality of life. Other cats are unable to emotionally adjust and experience a decrease in emotional quality of life as a result. Observe the effect the treatment has on your cat when considering subcutaneous fluids. If your cat is unable to tolerate subQ fluids, discuss alternatives with her vet.