Olivia, Six Months Later

It's somewhere north of six a.m. The sun won't be up for another hour or so. I'm semi-awake, but hoping to nod back off again before the alarm goes off at 6:30.

Olivia has other ideas. She walks up alongside my head, sticks her face close to mine, and starts meowing. I roll over and turn my head to the other side. This does not deter her in the least--she pads across the pillow above my head and resumes pleading her case to be fed now. Not when the sun rises, nor when the alarm goes off--NOW.

I throw the top sheet off, toss aside the sleep mask (it gets really bright in my bedroom in the morning) and stumble toward the kitchen. I'm not grumbling, though, as I flip the switch and see that Olivia has cleaned her plate of the previous evening's kibble, and certainly not as I empty a fresh pouch of Friskies Gravy Sensations onto the English salad plate as the furry body at my feet rubs against my legs and purrs so hard that I can hear her all the way up here.

I'm not grumbling because I remember what happened April 13 and know how much worse it can be.

That was the day--Friday the 13th, no less--that I took Olivia to the vet because she was not eating and was losing weight. That was the day the vet told me that it was serious, that Olivia was in kidney failure and had lost about 75% of her kidney function, that Olivia needed to be admitted immediately for emergency IV fluid therapy (she was severely dehydrated) and that we were in for "an uphill battle."

And the vet was right about that. An uphill battle it was. Olivia wound up on that IV in the hospital for a week. During that week, I visited her as often as I could, and she did indeed look and sound better each time, but I remained a nervous wreck. I stopped eating. I lost weight. I cried a lot.

Once Olivia was released from the hospital, she struggled for weeks after. It seemed like every time we got one aspect of the disease under control, another would run wild. Her appetite went up (when I gave up on the prescription foods, which she wouldn't touch, and gave her the Friskies she craved), but so did her phosphorus level. We gave her aluminum hydroxide (Maalox without the calcium) and her phosphorus went down, but her creatinine level went back up. Her appetite continued to waver, and her stimulant dosage was upped to once every 48 hours (from once every 72 hours).

For much of this time, I was just trying to get her from one signpost to another. I wasn't sure she'd make it to my birthday, just about three weeks after her diagnosis. But then she did, so I tried to get her to her one-month diagnosis anniversary, then to Memorial Day, then to each holiday or anniversary thereafter. I felt relieved every time we made it to another signpost, but despaired with each new setback or challenge, most especially with that increase in her creatinine--creatinine levels usually start to rise, in spite of all treatments, when a cat has reached the final stage of the disease--so this latest setback had me more than a little bit freaked out.

That spike in her creatinine happened Memorial Day weekend.

Then, something happened. Something wonderful.

Olivia took a turn--for the better.

With the increase in her appetite stimulant, her eating habits more or less returned to what they were before she became sick. (She still has "bad days" once in a while where she picks at her food and eventually throws up, but they are now fewer and farther between.) In fact, her appetite is so good that we've backed off her stimulant and only give it to her once every three days again (sometimes once every four days, when her chowing down is especially robust).

With the increase in subcutaneous fluids after the rise in creatinine before Memorial Day, her creatinine dropped dramatically (from over 7 to 4.4 in three weeks) and has continued downward ever since. Her calcium level spiked a few weeks ago and remains slightly elevated, but the vet prescribed Metamucil to bring it down. (If that doesn't work, there are other treatments we can try.)

Most important (and delightful) of all, Olivia is back to running around the apartment, chasing her toys with enthusiasm, jumping up and down off the furniture at full speed and hitting the top of the exercycle seat on a straight jump from the floor. (These days, she spends more time in that seat than I do.)

In fact, if I did not have to medicate this cat every morning and every night, I would not know that she's sick at all.

I don't want to get cocky, though. There are still challenges ahead and always will be. When we reach the top of one hill, we'll see another hill after, and another after that. Chronic feline kidney disease doesn't go away. It's permanent. And, ultimately, it's terminal. Either the CKD will kill Olivia, or one of any number of related diseases will. We are holding back the inevitable.

But those are thoughts for another day. Right now, Olivia is head-down in her morning meal (yay!) and will soon be in the bathroom to receive her antacid injection, aluminum hydroxide oral meds and 100CCs of lactated ringers (boo). She'll cry and argue and try to make a dash for it when I put the needle in the scruff of her tortie fur. And tomorrow, the six-month anniversary of her diagnosis, she and I will go through the same routine.

And, with some work and love and just a touch of luck, we'll go through that routine for many more mornings to come.