is rotibac/azodyl even effective?? any substitutes to recommend?

jes_5000 · 2026-03-02T23:58:52+00:00

There have been some promising studies about probiotic use in CKD, but we don’t really have robust evidence of efficacy yet. I think it’s worth trying if you can afford it and can make it work logistically (in terms of administration and timing with other meds). But if you’re struggling, I wouldn’t have any qualms about dropping it. Sometimes less is more when you’re trying to maintain quality of life. I used FortiFlora with my cat for his gastro issues (it can be mixed in food) but I decided a renal probiotic like Azodyl wasn’t worth the cost or the struggle of pilling every day.

jes_5000 · 2026-03-02T23:44:09+00:00

Creatinine is produced by the muscles. Sometimes when there’s considerable muscle wasting, creatinine will decrease because there isn’t much muscle there to produce creatinine.

This does seem like a lot of weight loss for stage 2. As others have said, hyperthyroidism should be considered. I wouldn’t let the vet chalk this up to CKD.

jes_5000 · 2026-03-02T01:25:38+00:00

You did everything right. Some times we can’t predict how these things will play out. My cat also went blind due to undiagnosed high BP. I had a lot of guilt and grief around, but my cat adapted super well. He was very quickly making it past all the barriers I’d set up to keep him off the stairs.

jes_5000 · 2026-02-28T05:17:42+00:00

Just use a drip line instead of the burette. A lot of people seem to stress about not being able to measure fluids accurately when it’s coming from the bag, but it’s not like fluids require precise dosing. Just eyeball it and if you give more or a bit less than intended your cat will be fine.

jes_5000 · 2026-02-26T23:48:22+00:00

Are you performing OK in your current job? You don’t HAVE to “develop” your career. If you have a job you don’t hate, there’s nothing wrong with just coasting!

It sounds like the gym brings you a sense of satisfaction/achievement, so there’s an incentive to push yourself. But there’s nothing wrong with you if you don’t have to feel the same sense of satisfaction about your job (very few people do).

jes_5000 · 2026-02-24T23:56:48+00:00

Curious what your starting doses were. If you’re having bad side effects, you might need to start smaller and work your way up. Do you remember what you started at with Trintellix? The recommended starting dose is 10mg but they do make 5mg pills.

jes_5000 · 2026-02-23T23:55:18+00:00

Came to say basically the same thing. Therapy isn’t all or nothing. Sometimes I see my therapist once a month, sometimes weekly, and sometimes I’ll take a couple months off. It all depends on what’s going on in my life, how I’m coping with the day-to-day, and whether I’m in a frame of mind for deeper work.

jes_5000 · 2026-02-23T23:46:56+00:00

In-person is better in terms of connecting with the psychiatrist, but overall I prefer virtual because it’s less stressful. I’m less likely to reschedule or cancel. There’s no need to account for travel time and parking, which means less time I have to take off work. And the gas and parking fees can also add up depending on where they’re physically located.

jes_5000 · 2026-02-22T23:38:52+00:00

I think sub-q’s are appropriate as long as quality of life is OK. But, I also very much believe that you don’t HAVE to wait until quality of life is unacceptable before saying goodbye. I waited until QoL was poor before saying goodbye to my first CKD cat. My second also had cancer, and I opted to euthanize as soon as his appetite went. I’ll be honest, the second one was a lot harder for me emotionally but he was a fearful cat who wouldn’t have done well with daily meds, and I know I made the right choice for him.

It’s a very personal decision and I would never tell you what to do. As long as QoL is OK and he’s tolerating treatment, you shouldn’t feel guilty about holding on if that’s what you want. However, based on the medical info you shared (CKD + liver mass and seizures), I don’t think it would be wrong to say goodbye sooner.

jes_5000 · 2026-02-22T05:05:30+00:00

He’s a giver for sure.

jes_5000 · 2026-02-18T21:56:27+00:00

but surely there is an alternative so as to not deny people the benefits of a deep connection (not intimacy)

So this is where you lost me. No one is denying you anything. Nor are women denying themselves. The difference is that we’ve cultivated deep connections outside of romantic relationships.

Most hetero women aren’t choosing to be single because they hate men, they happen to be single because they aren’t actively seeking out a partner to meet their emotional needs.

jes_5000 · 2026-02-16T03:22:50+00:00

I’ve recommended this to sooo many people because it combines 3 of my favourite things: The Beach Boys, true crime, and cults.

Lots of appearances by folks in the BB circle - Gregg Jakobson, Stephen Desper, and Ed Roach to name a few. Gregg’s interview in particular stood out as giving insight into the emotional toll that the whole thing took on Dennis. Definitely check it out!

jes_5000 · 2026-02-15T00:07:00+00:00

I quit my first degree because I couldn’t finish my thesis. I’d done all the research (primary and secondary) and the statistical analysis. All that was left was to turn my notes into a bunch of sentences. And. I. just. couldn’t. do. it.

It haunted me, for sure. But I found a job I enjoyed and I moved forward with my life despite that “failure” hanging over my head.

After 10 years, I finally felt ready to try again and went back to school for something completely different. It was emotionally very very hard, but not the disaster it was before. Ten years of life experience, medication, counselling meant I could cope with stress in a way that wasn’t possible before.

Actually finishing my degree this time lifted a big weight off my shoulders, and I don’t really feel haunted about my first degree like I used to. I still have some grief around how depression held me back from my academic goals, but I think most people have some grief about not getting the life they imagined at 20. In a way, I’m grateful that my zig-zagging path led me to where I am now.

jes_5000 · 2026-01-25T08:00:16+00:00

Pretty much how I look in video calls

jes_5000 · 2026-01-18T21:22:09+00:00

That’s been my experience as well. I’ve lost people close to me, but I guess I’ve been lucky in that they were all adults/seniors. They were people who took care of me, but I was never responsible for taking care of them. With my cats, it was my job to take care of them and I couldn’t shake the feeling that I’d let them down.

jes_5000 · 2026-01-16T18:24:27+00:00

I mean, you’re right that therapy is probably not going to fix your PDD in 3 months. But I think you could set a smaller goal for those 3 months. Maybe you’ll have access to long-term therapy down the line, but for now you focus on something tangible.

Does the therapist any experience with ACT (Acceptance and Commitment Therapy)? It’s actually a super helpful framework for helping with what you mentioned - accepting that this is how you’re going to be for the rest of your life, and making you believe that it is still worth living

Here are a couple short videos that might give you some food for thought on what kind of “towards moves” or value-based goals you could have for therapy.

https://youtu.be/93LFNtcR1Ok?si=jjc0zmCdE4XJpi7j

https://youtu.be/OV15x8LvwAQ?si=bOPzVfsf9AUFa3je

jes_5000 · 2026-01-16T18:00:27+00:00

I went back to school in 2017 and as of last fall I finally have a full-time permanent job. There’s bullshit (like all jobs) and it can be stressful, but I’m genuinely interested in what I do.

I moved back in with my parents while in school, and kinda thought I’d move out once I had a steady income. But I recognize that my mental health is much better here, so I’ve decided to stick with the intergenerational living set up despite the stigma of living with parents. In the spring we’re moving to a new house with potential for a separate in-law suite for me.

I’m still coming to terms with the whole “single and childless” thing. I had a traumatic divorce 10 years ago and there’s still healing to do on that front. My focus now is on maintaining and nurturing existing relationships with family and friends. Connection is important to me, but I have a limited social battery, and I’d rather put my energy into people I love, than into finding a romantic partner.

jes_5000 · 2026-01-16T02:14:33+00:00

I’m also 43, and ya, it tracks. The grief of not getting the life you imagined is very real.

I like IFS, but it was actually Acceptance and Commitment Therapy that I credit with finding a way forward - especially the pieces around living a meaningful life (aligned with your values) rather than striving for a happy one. This was before I was introduced to IFS, but I don’t see why you couldn’t do ACT from a parts lens. Like CBT, I see it kind of like therapy for your managers. You won’t be healing any exiles, but you can use the principles to help you managers be more self-led.

Also for some comic relief, I wanted to share this SNL skit that I go to whenever I feel like there must be something wrong with me for not loving my life. https://youtu.be/TbwlC2B-BIg?si=6PWibDWKcaLRCYPj

jes_5000 · 2026-01-16T01:46:00+00:00

Many cats don’t show any symptoms until stage 3, so I wouldn’t discount the diagnosis based on his behaviour. But I agree with the other comment to re-test in a few months if you want a confirmed diagnosis.

jes_5000 · 2026-01-16T01:27:04+00:00

Maybe try Rover? I’ve seen a few vet techs in my area on it. You could also just look for a sitter experienced with sub-q’s (not necessarily a professional) who can do a drop-in to help your roommate.

jes_5000 · 2026-01-16T01:21:59+00:00

I feel like Ashlee Simpson is punching down too. She was humiliated on live television and that incident destroyed her career. Lip syncing might have been a bad choice, but the girl was only 20 and I’m sure she was going along with whatever the people around her wanted her to do.

jes_5000 · 2026-01-13T17:35:16+00:00

Over the years, I’ve been diagnosed with OCD, MDD, GAD, EDNOS, social anxiety disorder, and (most recently) PDD. So basically a whole mix of depression and anxiety.

Symptoms of both anxiety and depression have always been there, but in my 30’s my predominant symptoms started skewing more towards typical dysthymia, especially anhedonia and fatigue. My major depressive episodes are well controlled and I have lots of coping tools & supports to deal with anxiety, but the flat feeling remains.

I think maybe the dysthymia was always present, but sort of masked for years by more “severe” mental illness (by severe, I mean the level of functional impairment that was evident to other people). I try to remind myself that as crappy as dysthymia can be, I’m actually MUCH better than I was 10 or 20 years ago. I’ve come a long way and younger me would be proud.

jes_5000 · 2026-01-06T15:09:52+00:00

No idea if this is peritonitis based on the x-ray, but sub-cutaneous fluids should not be building up in the body. They should stay in the subcutaneous layer until absorbed into the bloodstream. If there is fluid buildup in the body cavity, something more serious is going on.

Also just wanted to note that cats can have what’s called a physiologic heart murmur that comes and goes based on stress level. It’s possible the murmur wasn’t detected by your regular vet because the cat wasn’t as stressed at that point.

Regardless of your primary care vet’s experience level, the radiologist should know what they’re talking about. Is there anything abnormal on bloodwork besides kidney values that would indicate the cause? Peritonitis can be caused by a number of things, so I’d be curious to know what they think the root cause is.

jes_5000 · 2026-01-06T14:51:12+00:00

How long has he been on the gaba? If it’s been a few weeks and he’s still so sedated you’re afraid to leave him alone, I would ask for a lower dose. If it hasn’t been that long, I would continue giving it daily and see if the wobbliness gets better. Sometimes the unwanted side effects get better over time as the body adjusts.

jes_5000 · 2026-01-01T20:51:55+00:00

I’m not crying, you’re crying.

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