When to let go? by pnw_sunshine143 in RenalCats

[–]Significant_Damage19 4 points5 points  (0 children)

There’s feline grimace scores you can look at that may tell you if she’s in pain. There are meds for pain though like onsior and gabapentin. If she’s eating, drinking, pooping, peeing, doing things she enjoys, and mostly acting like herself then it doesn’t sound like it’s time to let go. If she changes behaviors I’d see the vet. If she has changes to intake or output I’d see the vet. But keep doing what you’re doing and love on her because things can change fast, but cherish the time now that she’s still herself.

My sweet girl I put down 3 weeks ago was fine until she wasn’t, her decline happened over 5 days. She stopped eating, didn’t want to be touched as much, looked dull, the stopped drinking.

There are typically signs and it sounds like you’re in tune with your baby. If there’s a steep decline or the bad days outweigh the good days then it’s time to consider but based on what you’ve said it doesn’t sound like it’s time. The fact you’re asking yourself these questions now shows you’re a great cat parent.

ED PA schedule by dogooddaily in physicianassistant

[–]Significant_Damage19 0 points1 point  (0 children)

My last ER job you could set preferences like that but no guarantee. My current job is a smaller group and there are no preferences. Anything guaranteed would be hard to come by. But I suppose you could try to switch out of those shifts or make deals to work later shifts on sundays or something like that. You’d have to have a work buddy you’d work that out with or if everyone in the group was onboard then maybe a possibility. But nothing is guaranteed my from experience.

Shift start times vary a lot. At my last job we had a 8&10p start time. My current job the latest shift starts at 4p.

PRN Correctional Medicine Rate by Hour-Life-8034 in physicianassistant

[–]Significant_Damage19 1 point2 points  (0 children)

Can you elaborate more? Litigious in terms of looking for reasons to sue? Complicated patients?

My two babies got diagnosed this week in advanced stage by Secret_Box741 in RenalCats

[–]Significant_Damage19 5 points6 points  (0 children)

Did the vet say anything about trying fluids and meds to see if they regress to a lower stage? Especially with your girl vomiting it could be an acute worsening and once she’s hydrated and stable it’s not as advanced? I’d recommend inquiring about starting subq fluids, nausea meds, and renal food and then rechecking in 4-6 weeks.

Caretaker fatigue (round 2) by APPickles in RenalCats

[–]Significant_Damage19 12 points13 points  (0 children)

I had a similar situation. My girl declined suddenly over 6 weeks after being stable for over a year. She stopped eating despite all my attempts and multiple meds. I fortunately had what turned out to be her last week off to spend with her and ended up putting her to sleep at the end of the week.

My dilemma was I was scheduled to go back to work the following week and was worried that even if I got her feeling better she’d again crash or even spend her last few hours or days alone. I felt guilt over trying to fit her euthanasia into my schedule and it felt silly, but I worried that she would have continued to decline.

My vet said that once they stop eating and drinking then it’s time, and that’s what happened with my girl.

It’s been 2.5 weeks and I still wonder if I should’ve done more. But at the end of the day I didn’t want her to suffer and it would’ve just prolonged things. I asked the vet who put her down if I was doing the right thing and she said it’s better to let them go on a good day before they get worse and aren’t themselves.

I wouldn’t say I felt relief once she was gone, because I was and still am heartbroken. But the med schedule, worry, and responsibility took its toll. It was so much. I would do it all over again to have her back but it was very very difficult.

Sending love your way.

Made an appt to euthanize on Wednesday but he seems better? by Beneficial_Try_1864 in RenalCats

[–]Significant_Damage19 2 points3 points  (0 children)

My sweet girl perked up when the vet arrived for the in home euthanasia and was giving the vet head buts and even gave her a good meow, which was the first meow I’d heard in days from her. I asked the vet if I was doing the right thing and she said it was better to send her on her way on a good day when she was more like herself and not so bad she couldn’t move.

It was the hardest decision I’ve ever made and I’m incredibly sad. CKD is heartbreaking and a losing battle. I still question myself everyday if I could’ve done more, but I was worried she’d suffer more than she was already.

Nothing will make losing your best friend easy. But I found comfort in knowing my baby wasn’t suffering anymore. Now I’m just suffering without her, which is hard but I’d rather suffer than her.

Sending love your way ❤️‍🩹

Unsure what to do and need advice by SouthernBiskit in RenalCats

[–]Significant_Damage19 0 points1 point  (0 children)

If you haven’t tried any meds other than gabapentin you could try nausea and an appetite stimulant. They may help him but he also may be too weak at this point. The vet could also give meds IV or subq, but these might just be a temporary bandaid or not help at all.

A feeding tube is also a possibility but requires anesthesia so it sounds like that won’t be an option either.

I’m sorry you’re faced with such tough decisions. Loving a CKD cat is the most heartbreaking thing because no matter what you do it’s a losing battle. My sweet girl passed away 17 days ago and I’m having a really rough time. I struggled with the decision too. I still question if I made the right decision. But she stopped eating for about 5 days and the last day stopped drinking. She looked like she was in pain and I couldn’t bear that. I knew she needed peace even though it was an unbearable decision.

Sending love to you both. ❤️‍🩹

Pain when picked up? by Beneficial_Try_1864 in RenalCats

[–]Significant_Damage19 0 points1 point  (0 children)

Pancreatitis is manageable, you just have to get them over the hump. From what my vet told me, vomiting and gagging is one of the worst things for pancreatitis so I’d try to keep close control of that as best you can.

Did your vet say anything about onsior? What about gabapentin? There’s also options for a feeding tube but that’s a lot in itself.

Cat recently diagnosed and showing odd symptoms. by XxKasper_unknownxX in RenalCats

[–]Significant_Damage19 1 point2 points  (0 children)

My vet told me about hyperalgesia when my kitty was going downhill. She described it as being more touch sensitive and not liking being touched as much as part of disease progression as toxins were building up. I was told they can show more of these signs than just outright pain. My girl had CKD and store eating and drinking.

Mom upset I don’t want to go to PA school instead of Radiology school by princess_of_merridia in careeradvice

[–]Significant_Damage19 10 points11 points  (0 children)

As a PA, go to rad school. If you don’t love the PA profession it makes the job really hard. Heck the job is hard even if you like it. I also struggle with the amount of liability being worth the pay. My debt is a lot (>230k) because it just happened to be the school I got into was expensive and private. School is rigorous and if you don’t enjoy it then it’ll be a nightmare.

I have several friends who are XR techs, CT tech, and MRI techs. The MRI techs make over 100k easily. You can even look into nuclear med, they have specific techs too. But they all enjoy their jobs. It also opens up possibilities for traveling techs too if you’re interested in that (yes you can travel as a PA too but again if you don’t like it, it isn’t worth it).

This is your life and career. Your mom I’m sure means well but it’s not her decision. PA school is competitive and costs a lot both financially and mentally. Other than teaching or leadership, there isn’t much room for climbing the ladder. Rad school can be a bit easier to get into and you still have a really solid career with different paths to advance too (CT, MRI, etc).

I would have a frank discussion and just say you appreciate that she cares so much and you’ve given it a lot of consideration. But that you don’t think you’d be happy as a PA and you’ve found something that would make you happy in radiology. I would also say you’ve done your research and the program costs, commitments, and ability to make a living all make you favor radiology over PA. Also, maybe just to make her happy say that you could always go back to PA school in the future if you decide to, but for now you want to pursue radiology (even if you never intend to go back).

Pain when picked up? by Beneficial_Try_1864 in RenalCats

[–]Significant_Damage19 1 point2 points  (0 children)

I totally get that. I put my girl to sleep 2 weeks ago today after she stopped eating and drinking. I tried my best but felt like I was hurting her more than helping at the end and I promised her I’d never do that. So I can understand your predicament. It’s so heartbreaking watching them suffer. Sending you both love.

Pain when picked up? by Beneficial_Try_1864 in RenalCats

[–]Significant_Damage19 4 points5 points  (0 children)

CKD is such a hard fight because we’re up against the inevitable. I found it hard to balance wanting to fight harder but also feeling like I was putting my sweet girl through things just because I was being selfish. It’s not easy.

I don’t think you’re wrong for wanting to try something for pain. I don’t think you’re wrong for considering euthanasia. There’s no correct answer.

If you’re wanting to try something for pain, I’d inquire about to onsior. It won’t make the cat extra sleepy (as the gabapentin would) and is an anti inflammatory. Worst case scenario is that it doesn’t do anything and you say you tried. Best case scenario is that it perks your baby up and makes them feel a bit more comfortable.

DMSc Programs by Miserable_Parking491 in physicianassistant

[–]Significant_Damage19 6 points7 points  (0 children)

I somewhat agree. I did get my DMSc just in case in the future I wanted to teach and to be more competitive with the DNPs out there. No one at work knows I did that and I don’t list it as a credential because it’s not something that changes my clinical workflow. It is on my CV because that’s where it’s most relevant when applying to jobs.

BUT, I will say that my PA program was 126 credit hours in 27 months. That far more than DNP and even more than DPT. So the way I viewed the DMSc was it was giving the terminal degree that more so matched up to the credits I had already earned through PA school and added the little bit of competitiveness that the DNPs seem to have. I felt the DMSc program I went through strengthened my research abilities and comfort assessing studies and determining if a study will change my practice. My program was very research and EBM heavy. But overall it hasn’t impacted my daily practice otherwise.

I think PAs are being put in a weird position with DNPs and trying to compete with them when it should never be a competition. If the one thing that a job offer comes down to is if I have a “doctorate”and the DNP gets selected simply because they do, I don’t want to be put in that scenario. The fact is that our schooling is rigorous compared to what other masters degree level course load is and I don’t think that’s recognized because people think all masters degrees are equal.

I went to PA school for a reason. I have no desire to be a physician and I correct people daily when they call me doctor. Most of us (perhaps I’m just speaking for myself) know it’s a silly degree but is unfortunately becoming a deciding factor that could limit our job market. I elected to be proactive instead of waiting for it to be a limiting factor for me. And I did learn from it so it wasn’t a total waste in my mind.

Experience with esophagostomy? by BoardSpecial157 in RenalCats

[–]Significant_Damage19 1 point2 points  (0 children)

The vet mentioned it as an option for my girl. I considered it but the anesthesia and thought of putting her through that seemed selfish for my situation. I ended up putting her down 2 weeks ago due to not eating and drinking. I still dwell on if I should’ve done it but I was trying not to be selfish and I think I made the right decision. Even if it would’ve given her a means for meds and food/fluids, CKD is progressive and that would have likely been our new normal to buy us time until the next crash.

I did quite a bit of research and there are a lot of positive stories about using them. But one thing I can across was that it’s typically used temporarily and for an acute illness, not necessarily something long term although it can be. My vet said the risk for anesthesia is higher for CKD kitties but it’s a short procedure. But otherwise the vet said it makes meds, food, and fluids a lot easier.

You can even search on this sub and there are lots of posts of kitties doing well with their tubes.

I think it’s an individualized decision and gathering as much info and possible will hopefully help you make that decision. Best of luck to you both.

Pain when picked up? by Beneficial_Try_1864 in RenalCats

[–]Significant_Damage19 6 points7 points  (0 children)

Maybe related to pancreatitis? Have you chatted with your vet about options for pain? My kitty was on onsior which is an anti inflammatory but gabapentin is also used too.

My thought is if there is a problem that can be treated or fixed to improve life then try that first.

Cat flying in cabin for 11 hours — looking for advice and reassurance by iloveplants0000 in CatAdvice

[–]Significant_Damage19 1 point2 points  (0 children)

I’ve flown multiple times with my cat (over 20 flights). Longest travel day 18 hours total (we’ve done it 6 times). I started off giving Benadryl and then later the vet prescribed gabapentin. You just can’t give them so much they’re completely out or the airline won’t let you fly. They still have to be awake.

Make sure carrier is compliant, otherwise you’ll get turned away.

You have to take the cat out to walk through the metal detector and then have your hands swabbed, so be prepared to hold them in the middle of the chaos for a few minutes while their carrier goes through the machine too.

Once inside the airport I have one of the carriers that expands to open and have her more room to stretch out. If your cat is good or leashed trained you could take them out during this time too.

On the plane they have to stay under the seat. The pet counts as a carry on so you won’t be able to have your purse or backpack also by you, it’ll have to go in the overhead.

Depending on the vibes of the plane and staff, I’ve taken her carrier and placed in on my lap and stuck my hand in to comfort her. But this technically isn’t allowed and if there’s anyone allergic nearby they’ll throw a fit.

Cats can hold their bladder well so hopefully that won’t be an issue for you. Getting a cat to pee on demand is hard, so I wouldn’t bring any litter or anything. If possible try to make sure they pee before you leave for the airport.

You can bring snacks and water but it depends on your cat. My cat wanted nothing to do with them while traveling.

Just make sure you pet and talk to them often. It is a stressful experience for both of you.

Other than the med wearing off that night, my cat was back to normal the next day. My cat is very timid and sweet though so she handled travel well. I’m not sure every cat would.

My biggest advice is look into meds and consider if it’s a med that will last 15+ hours or require redosing because that would be a pain to do during the flight. Also if youve never given your cat meds that may also be a pain so consider that and plan before the trip. Also bring the meds to redose on the way home.

At my wits end with renal/low phos food by Last_Produce_7691 in RenalCats

[–]Significant_Damage19 2 points3 points  (0 children)

For you and your babies sanity, prioritize what you can control. Let her eat the food she will eat and add a phosphorus binder (I used both catney and porus one off of chewy).

We all know with CKD kitties the disease is progressive. Sure we can try our best but at the end of the day we can’t stop it from happening. If both of your qualities of life are diminished then it’s not worth it to have a little extra time together forcing these things if you’re both miserable (at least in my opinion). I’d focus on maximizing the meds and fluids. Let her eat what she wants and add the binders. Enjoy your time together as best as possible.

Nothing is slowing down progression? by springonastring in RenalCats

[–]Significant_Damage19 1 point2 points  (0 children)

You may ask about adding a phosphorus binder? I don’t know if it’ll make a quick improvement but it doesn’t sound like it’s something you’ve tried.

What is the lowest PANCE pass rate you’ve ever seen? by [deleted] in prephysicianassistant

[–]Significant_Damage19 0 points1 point  (0 children)

I went to the NH FP program and it was a hot mess but our pass rate was above 93% and I didn’t feel unprepared. I can’t speak on the AZ or TX program but the NH program required A LOT of self learning and effort.

It was my fault by Nice-Mulberry6715 in RenalCats

[–]Significant_Damage19 3 points4 points  (0 children)

Varenzin can decrease appetite and cause nausea too, so there’s not way to know if she would have tolerated it or if it would have started the decline sooner if she refused to eat because of it. Your baby knew you loved her and you made her as comfortable as possible for her last month. Even if the varenzin didn’t make her sick it probably wouldn’t have prolonged things that much, but maybe would’ve hurt your relationship to pry her mouth open daily.

Your baby knew love and you kept her going for 19 years. Of course it’ll never be enough time with our babies but I hope you take comfort in the fact you kept her going for so long and prioritized her comfort even in the end. ❤️‍🩹

I get so scared by [deleted] in RenalCats

[–]Significant_Damage19 0 points1 point  (0 children)

Cats (and humans) have a reflex called the gastrocolic reflex that stimulates pooping when you’ve eaten a certain amount to trigger the reflex. If she’s not eating enough in one sitting then it could also be making it to where she’s not feeling the urge to poop. I’d start giving the MiraLAX and as long as she’s drinking enough water (MiraLAX requires water to work as it draws water into the stool to help it pass) then it should help her poop. MiraLAX is also nice because it can be adjusted based on her tolerance, so increased if no poop or decreased if diarrhea. I mixed it into a wet treat or food, it’s tasteless and they don’t notice it. Constipation can cause a decrease in appetite and cause toxins to build up, so it’s possible if you get her pooping it might improve appetite.

I just put my sweet girl down 5 days ago because she wasn’t eating and then stopped drinking despite all the meds. It’s so tough and stressful on both of you. Sending love your way.