Q: Our 6 yo siamese mix, Kenji was recently diagnosed with CKD. His troubles were initially diagnosed as hypercalcemia that would cause kidney disease. An internal medicine specialist has told us, it's kidney disease that likely caused the high calcium values. From the first blood test to the next, three weeks later, Kenji's kidney values went pretty high. His appetite was getting worse and he was dehydrated most of the time.

Because there was an acute aspect to the situation, a diuresis was suggested, and we agreed. Kenji now has a feeding tube. It's been three weeks now and it has been a roller coaster ride. We'll have several days of being able to feed him as expected and he feels better, but then he'll have a day or two of feisty that means we can't get him to sit still for the feedings. One of our reasons for agreeing to the feeding tube was that we knew trying to do SQ fluids was probably not going to go well, so we thought it would be a lot easier to do water via the e-tube. He is a hands-off cat that will cuddle and purr when it's his idea, but he really doesn't like to be handled.

How do we get him to relax and sit through the feedings consistently?

Thank you, Anne

Kenji kenji kenji!

He’s lucky to have you. And you are lucky to have him, right? And you know what? We have something in common. We both really like feisty cats. Many people don’t, and they can’t be blamed for that. It’s not for everyone. But to love and respect a cat that is feisty, or “difficult” is to have a mindset that sets you apart from the rest. Because there is empathy, understanding, and a determination to make something good happen above and beyond the frustration or set-backs.

Which is essentially just like life.

I can hear the budding solution to Kenji’s reluctance to accept the tube in your own words: He will cuddle and purr when it’s his idea, but otherwise, he doesn't like to be handled.

I have a rule. I call it your cat’s 80% Rule. What it means is that 80% of your success when administering a medication happens before we ever touch your cat. In Kenji’s situation, that means before the syringe is attached to the feeding tube (this is what a feeding tube is and what it does: http://www.iwillhelpyourcat.com/videos/#/new-page/), certain things must be accomplished in order for Kenji to think that it’s his idea.

Kenji is like this:

And we need to start asking him questions like:

  • What is your vertical height and room preference?
  • Is your nose (and what you smell before getting medications) and pathway towards acceptance?
  • Are you positive for towel comfort, or do you resent being touched that way?
  • Does pressure or pinch inhibition completely take his resistance and stress away like you are in a 1980’s calgon ad?  

These are just some of the questions I would ask Kenji, and Kenji would be compelled to give the answer. Kenji would be informing me of his preferred handling technique. And he would probably do it within a day. And by this point, we have removed the vast majority of reasons why Kenji does not want us to use his feeding tube.

It’s 2016, and that means it’s rare to leave a vet clinic with this kind of information worked out for you. My vision is to change that. Feisty cat’s need help as much as any.

You need to figure out his handling technique, then counter condition Kenji to the syringe and tube. I wish I could tell you exactly how to do it right here, right now.  But in reality, it’s a “choose your own adventure” book. Kenji does this, so you do that, back and forth with real time feedback, following the path to his acceptance.

Not being able to share these kind of techniques is frustrating. You are trying. And Kenji is trying. Us vet’s need to try to help you with this too. I did create STS specifically for people like you and cats like Kenji (click here). If you think of his feeding tube as his “medication” or “treatment”, you can follow the system there to find out what Kenji really has to say about what he needs to get more comfortable with the tube.

Best of luck,

Dr. Kris