Working
with Your Veterinarian
CRF
is a progressive disease and your relationship with your
veterinarian may be a long-term one. Therefore, it's absolutely
essential to establish a good rapport right away. Some
vets feel that it is better to not treat a fatal illness
and may recommend euthanasia immediately upon the diagnosis
of feline CRF. Be sure your vet understands how much you
are willing to do to help your cat. Many cats that were
in extremely serious condition when first diagnosed have
lived with a good quality of life for months (and even
years) after diagnosis because their condition was treated
immediately and aggressively. If you feel that your vet
is not as knowledgeable about CRF as he/she should be
or if he/she does not want to aggressively treat your
cat's CRF and you do, seek a second opinion and seriously
consider changing vets.
Choosing
a vet
You
may find that the best way to look for a good vet is word
of mouth with friends, co-workers and relatives. You will
want a vet who is knowledgeable about CRF, experienced
with CRF cats (and geriatric cats) and up-to-date on current
feline CRF treatments and medications. Once you choose
a vet, it is a good idea to first schedule a consultation
appointment without your cat. You can address all of your
concerns about your CRF cat one-on-one with the vet, get
a guided tour of the facility and meet the staff. Be sure
to bring copies of your cat's records for their files.
(for information on how to keep detailed records, see
our Keeping
Records section).
Alternatively,
you can call a vet's office and request a phone interview.
Many vets do not mind taking the time to talk on the phone
with potential clients. You may decide to go to a cats-only
clinic if there is one available in your area. Some other
facilities have separate doors and separate waiting rooms
for cats and dogs. This greatly eliminates stress on your
cat and also is an indication that the practice is sensitive
to the feelings of both feline and canine clientele.
Your
relationship with your vet
Communication
and trust are the most important factors in your relationship
with your vet. You need to feel at ease, talk freely,
ask questions and get answers. If you don't understand
the answers, you must feel comfortable enough to say so.
Your vet must be willing to listen to you and be receptive
to any suggestions or information that you have to offer.
It may even be helpful to make copies of the information
in this web site to use as a basis for discussions about
treatments. Many years ago when we inquired about a drug
for Avatar, our vet was not familiar with it. Within a
few hours, she had consulted her peers, was up-to-date
and ready to prescribe it. She never talked down to us
and always showed us respect. If she didn't know something
we asked about, she would research it and get back to
us as soon as she could. She was never defensive or disturbed
when we challenged her with new information. The relationship
was excellent and nearly eight years after we lost Avatar
and made a cross-country move, we still keep in touch
with her.
Your
cat's relationship with your vet
You
will know immediately whether or not your vet truly cares
about your cat and whether your cat is comfortable around
your vet. We saw three vets before we chose a fourth.
The fourth vet just happened to be filling in for one
of the others during one of our appointments. When she
left the room, David and I turned to each other and exclaimed
that we REALLY liked her and so did Avatar. All four of
us were immediately comfortable with each other. It was
obvious that she genuinely cared about Avatar and we did
not get that same feeling from the three other vets. It
was not a problem to switch vets within the same practice.
Emergencies
Find
out who to contact if you have an emergency both during
the day and after your vet's office is closed for the
day. Some vet offices handle emergencies during their
normal hours and some don't. There may be a veterinarian
on call after hours or an emergency clinic may be the
only option. Keep a record of the emergency clinic telephone
number and address handy and make sure you know how to
find the office in a hurry.
CRF
Treatments and Procedures
If
your cat needs to be kept overnight for IV fluids at the
vet's office, find out if there is qualified staff on
the premises all night. When Avatar was on IV fluids,
we brought him home each night rather than leave him alone
overnight.
Ask
if the vet techs warm sub-Q fluids. This was important
to us since Avatar received all of his sub-Qs at the vet's
office. This was noted in his file and all of the techs
knew to warm the fluids and had them warmed when he arrived
for his appointment.
We
requested that we be allowed to stay in the room while
procedures were being performed on Avatar - i.e, blood
pressure check, blood draw, sub-Qs, etc. We made sure
that the vet and staff knew our wishes. There were times
when we were not permitted to be with him during x-rays
and ultrasounds in other rooms but some facilities may
allow this if you ask. This type of request should be
noted in your cat's file so there is never any question
regardless of which vet or tech you are dealing with.
You
may wish to have your cat examined by an internal medicine
specialist or a nephrologist. Your veterinarian should
be able to refer you to one locally or have information
as to where one can be located. A specialist may be more
current on all of the latest treatments and can do more
extensive testing on your cat, including taking blood
pressure and checking blood gases. You may not find out
anything new, but it is sometimes worth the time and additional
money to have the peace of mind that comes with knowing
that you have done all you possibly could to help your
cat. While the initial visit may be costly, follow-up
visits are usually quite reasonable.
Travel
If
you travel frequently, inquire if there is a vet tech
who would be willing come to your house to care for your
cat if you have to be away for any length of time.
Costs
Aggressive
treatment of feline CRF means there will be ongoing costs
for blood tests, check-ups, sub-Qs, medications, etc.
Financial arrangements should be discussed openly with
your veterinarian if needed. Some veterinary offices offer
payment plans.
It
can be less inexpensive to get CRF supplies through sources
other than your vet, either online or locally. Find out
if your vet is willing to write prescriptions for you
to buy supplies elsewhere. This may become very important
as time goes on and the frequency of sub-Q fluids increases
and medications become necessary.
If
you take your cat on a regular basis for sub-Q fluids,
find out if you can get a discount on the price. Our vet's
office was happy to do this for us.
Final
Preparations
Though
it is uncomfortable to discuss euthanasia, it is a good
idea to find out in advance what your vet's policy is.
We had an understanding with our vet that she would come
to our house when we made the final decision. It was comforting
to know that she was always there for us as Avatar's illness
progressed. Also find out what the procedure will be at
that time. Our vet used a tranquilizer before the final
injection for a gentler passing. She let us have as much
time as we wanted to spend with Avatar both before and
after the injection.
For
additional information, we suggest that you take a look
at the following websites:
