Home > Management of CRF > Working with Your Veterinarian

Management of CRF

Working with Your Veterinarian Subcutaneous Fluid Therapy Intravenous Fluids Dietary Management Dialysis Keeping Records General

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:

 


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