Monday turned out to be long...
Himself and I took a taxi ride to the vets in the afternoon. That was the high point. His relative quiet during our adventure in traffic escalated quickly upon entering the building and having his belly palpated. The vet, very gentle and soft-spoken, looked at me and asked whether he might possibly be defecating in a location other than his box as she felt very little. After reassurances that this was not the case, a side view radiograph confirmed that the boy was indeed full. Another enema was given while he howled in protest and I waited anxiously in another room.
That done, the vet and I went on to discuss his habits, diet, behavior and the contents of the radiograph. He is not a candidate for surgery to remove kidney stones. His water is passed out in copious amounts due to the state of his slowly declining kidneys, leaving little to facilitate transit through his intestine, hence the constipation. Wet food and pain medication were talked about and the vet asked permission to repeat his blood work and other tests to see where things are now versus three months ago. Her efforts were met with such overt hostility from Jacob that she was unable to do anything more and requested that he stay the night so that she could try again in the morning and get the results the next afternoon.
Things were eventually completed but the results did not arrive until the day after originally expected, and by then, my cat had had a somewhat lengthy staycation at Hotel VCA. He was found to have another urinary tract infection, so antibiotic therapy was started as was pain medication. Unfortunately, the compounded pain meds are liquid and even after telling this vet that I cannot shove things in his cheek without risk of injury, no other alternative was suggested.
I pill him with chicken flavored pockets and he has no problem with that. I will try putting the tuna flavored concoction on food or alone in a bowl but given his past track record and my lack of expertise at manipulating his mouth or being able to hold him still when he is annoyed, I hold out no hope of success.
Meanwhile, he still enjoys his food though I can now predict with reasonable certainty that in two to three days, this scenario will be supplanted by sluggishness and relative inappetence due to a full belly. We may once again be wending our way to the vets in search of subcutaneous fluids and the traumatic relief supplied via enema.
I can see that in the longer term these stop gap efforts, provided to assure comfort, will result in nothing but misery for us both, especially as I've not been taught to give fluids with needle and tube at home. My vet did tell me about an animal hospice, a practice that for a fee, sends a veterinarian to an animal's home to either provide limited palliative care or gentle euthanasia. They will also talk with pet guardians about determining the "right" time for the latter, hopefully reducing the fear and anxiety for the animal. I have made preliminary contact with the organization and have been assured by others I know that they are kind and compassionate to both guardian and pet.
For the moment, my precious boy is happy to be home, joyful in my lap and purring away.