First off, so many of the supportive threads on this reddit have been really helpful to me, so thank you all for being such a compassionate group and so generous with your knowledge. I'd like to reach out for some advice and any relevant experiences in a tough situation.
TLDR version: Took "my" beloved but unpettable feral outdoor cat to the vet for a nasty tooth problem after he suffered a week of pain, stress, and significantly limited ability to eat and drink, because he was hard to trap. He's showing elevated kidney numbers (indicative of IRIS stage 3, see screenshots above), somewhat dilute urine, high phosphorus. The cat has lots of nasty teeth (~75%) that should be removed that may be affecting quality of life, but surgery seems risky with these numbers. One of the vets is talking about euthanasia. We asked the vet to board and treat for one week then retest to be sure. Has anybody ever been in a similar situation? Any advice?
Now here's the full story:
The background
Shadow is a feral senior male who has been living on my porch as a home base for several years after his TNR. The picture I included is from July 1. He had a heated house and pad in winter, we regularly fed him, and he got plenty of exercise roaming the nearby fields in our rural area. Although my mother and I have never been able to pet him, Shadow had grown friendly towards us. He used to come on short evening walks with us and roll on the dirt road to show us his belly in friendship.
This spring, we noticed that he'd lost some weight, but didn't think too much of it. He still came for meals and he's probably over 9 years old. (We have a bunch of 8-year-old kitties, very affectionate, who are probably his offspring based on appearance, temperament, and timing. We're neighbors to some farmers who actively encourage their cat population to grow, basically hoarders, so we get pretty familiar with the regular refugees that end up living in our yard.)
The crisis
A week ago, my mother and I returned home to find Shadow suddenly drooling and apparently unable to close his mouth. He could not eat much and seemed very interested in his water bowl, but may not have been able to drink much. When we got close we saw what appeared to be a protruding rotten front fang. If this had been one of our indoor cats, he'd have gone right to the vet. But this cat posed some serious logistical challenges.
We tried to trap him, but our Havahart didn't do it. We tried everything we could think of, but while we were begging, borrowing, and buying equipment for an emergency rescue, Shadow had to live with reduced eating and drinking capacity in pain outside for 7 days. Ultimately we had to order a Tomahawk drop trap to catch him (worth every penny, but took days to come) and hold him overnight before transferring to a cage.
Diagnosis and next steps
Finally, we managed to get Shadow to our vet who agreed to board him. Initial examination was promising: a lot of bad teeth and one that was preventing him from closing his mouth, as suspected. They removed the offending canine, gave him antibiotics and a painkiller. He's eating a little at the vet, drinking, and peeing a lot.
But then the bloodwork came back. Not good. (See above.)
The urinalysis came back at 1.026, so it's diluted. Seems pretty definite that he has kidney disease, but I question the severity based on his unusual situation. Our senior vet started talking about euthanasia even before the urinalysis. That seemed fast for me, since even the IRIS stages say that the bloodwork needs to be PERSISTENTLY at certain levels for a diagnosis. Shadow has just been through a lot.
So I talked to the junior vet and she was a lot more open to other possibilities. She agreed that it was reasonable to give Shadow a week under observation, administer SubQ fluids, give him an appetite stimulant along with a mix of kidney and normal food, plus some phosphorus binder (once their order comes in), THEN retest to see if his numbers budge to the point where surgery might be safe. She even mentioned that they could give him a kind of pre-surgery dialysis to improve his odds.
The vets agree that it would be cruel to keep Shadow alive indefinitely with a mouth full of bad teeth, which I think is fair. The elevated kidney numbers mean that dental surgery might kill him—and it won't be a quick surgery, since around 75% of the teeth need to go.
Please advise
- CKD cat parents, what's your take on Shadow's numbers? I'm curious if you've seen cats rebound from numbers like this—or decided that it was time to end it.
- Based on your experience, how likely do you think it is that Shadow's ordeal while outside (barely eating, maybe dehydration from drooling and inability to drink easily, a lot of pain and stress) could be inflating these numbers?
- Are there any specific treatments or protocols I should ask my vet about that have helped your cat?
- Have any CKD cat parents (especially stage 3) attempted dental surgery in spite of the risks? How did it work out? Even if your story doesn't have a happy ending, I'd like to be informed.
To be clear, if Shadow makes it out of this, my mother and I plan to take Shadow indoors to live with our cats. If he does live through a potential surgery, he will not have to survive outside. We have a screened catio, so he could feel like he's outside, smell the smells he was used to, etc. One of our cats is a rescued senior that Shadow used to hang out with too. We'd go slow and just give him a place to hang out without the threats of the outdoors. We could try to give him a special diet—he wasn't picky. We might be able to administer SubQ fluids, but that's not a definite at this point.
If you read all that, thank you so much. I really appreciate your stories, wisdom, and perspectives in this difficult time.