Déjà vu- all over again, again, again and again.

You could be forgiven for thinking you hear an echo, let me explain.

Three weeks, 6 veterinary visits, 3 hospitalizations, 6 x-rays, 1 ultrasound, 1 sedation, 1 spleen biopsy, 3 different injections in the clinic, 4 at-home injections, 1 enema, 2 urine analyses, 1 feline blood panel, 1 geriatric blood panel, 1 cystocentesis, 1 radiographic written report, several rounds of subcutaneous fluids plus multiple prescriptions of cisapride, cyproheptadine, famotidine, adequan, sulcrate suspension, rhus toxicodendron homeopathic anti-inflammatory medication..... oh and a running total of about $3082 later......and we just might have identified a couple of things up with Mishka, albeit still no official conclusion at to why she constantly refuses to eat but often barfs if/when she does! Yikes, did I manage to say all that in one breath? Not without breaking a nervous sweat, I assure you.

This has been an expensive and frustrating month - actually 3 weeks - of exploring different things in a partially futile attempt to figure out what's going on with her. Heck I might as well sign over my paycheque directly to the vet, except that it's already exceeded my average take-home pay for the month. And while I know it's really not about the money per se, since I wholeheartedly accept full responsibility for Mishka's care, health and well-being - just wanting to find out what's wrong with her and what, if anything, can be done to improve her health and quality of life - it's still a huge chunk of money in a short space of time, especially right after Christmas and especially when we haven't really found the root cause of her gastro-intestinal issues.

Anyhooo, in pursuing chest/hip x-rays out of fear/suspicion something more ominous might yet be lurking there, we did discover that Mishka has something whacky going on with her front right shoulder joint in addition to definite signs of osteo-arthritis in both hips. At 13.5yrs old, the 'baby' of our feline family is sadly starting to show her age and in more ways than one. A specialist review of her x-rays determined that the look of breadcrumbs around her right shoulder area and a little on the left, is typical of a condition known as osteochondromatosis - calcifications/small particles of bone around the synovial fluid in her joints which are no doubt causing her some stiffness and discomfort and, along with the arthritis now showing in her hips, explains why she's much slower and hesitant lately when going up/down the stairs at home. Alas, the best we can do is give her anti-inflammatory and/or pain management medication (adequan), although a couple of injections of the latter seemed to make her lethargic, depressed and withdrawn, so we've had to hold off for now.

On top of that, when she finished off her first round of anti-nausea and appetite stimulant meds last week, she immediately began to go downhill. We noticed her drinking water profusely, refusing to eat for several days (again) and then barfing what little we even managed to force feed her (again).

Back to the vet we went and now, after further blood and urine tests this week, we received the added diagnosis that she is indeed at stage 1 of Chronic Renal Failure (CRF). Hence the echo-effect in the title of this post, since this is now the 4th time we're encountering this terminal disease; first Molly, then Otto, Kramer is presently at stage 3 and now it's Mishka's turn. It's a very sad diagnosis and not what you want to hear but if there's any 'benefit' to having gone through this already, it's that we know what to expect, we know how to handle it as best we can and we have a better understanding of the (unfortunate) limits of our own powers to heal or evade this degenerative condition. We can, however, help slow down it's progression - somewhat anyway. With regular doses of subcutaneous fluids, cats with CRF can continue to lead a very happy and largely healthy life for several more years and are generally not in too much discomfort, except for sometimes feeling unwell, until the end stage (stage 4) of the disease.

So now we have to add Mishka to the regular thrice-weekly rotation of subcutaneous (sub-Q) fluids that we've been giving Kramer for the past 18 months. Lorne runs the fluid while I'm the bearer of the needle, but both cats handle it very well, as did Otto before them, and are surprisingly easy-going about it, perhaps because it makes them feel better. (Unlike Molly who would literally fight us tooth and nail in that first year of giving her fluids.)

I'm not sure how I feel. I'm naturally a little frustrated that we haven't quite figured out Mishka's GI problems, but I'm also quite concerned about the bone degeneration and how that might progress and affect her mobility. Moreover, while CRF is nothing new in our house, it still adds a renewed and deep-seated sense of being so horribly powerless to prevent any of it. Our committment to giving them sub-Q fluids will help stabilize their condition but there's that nagging familiarity of just what lies ahead juxtaposed with the present unknown of how well Mishka might even respond to treatment or how fast her ailments might/might not progress.

The melancholy side of my nature feels acutely aware that this is the inevitable start to a slow but steady decline, but I have to enjoy each precious moment and accept that Lorne and I are equally committed to doing everything within our powers to keep our furry friends with us for as long as they are happy, comfortable and able to stay.

Yup, it sure feels like déjà vu.

We love - and have loved - them all dearly. Helping them in whatever way we can, especially when they need us most, is the least and regrettably the most we can do.