There has been a side effect to Pandora’s health problems I had not anticipated: jaw dislocation. According to the vet, renal failure causes calcium-phosphorus imbalances that can lead to bones softening or changing shape. In Pandora’s case her jaw sometimes has these infrequent but alarming moments of orthopedic disengagement (don’t watch if you’re squeamish about injured cats making bone-grindy noises):
The clicky grinding noises you hear are her joints not meeting properly, and you’ll notice she actually paws at her mouth trying to self-correct the error. Smart cat. She was able to fix her own jaw after a minute, but I did take her to the vet after this incident. The vet said she couldn’t find evidence of injury or inflammation, and was very thankful for the video to help her diagnosis.
Additionally Pandora has been experiencing occasional litterbox aversion, and has urinated on the couch more than once recently. Fortunately we had anticipated this given her age, and the couch is lined with machine-washable waterproof changing pads just for such occurrences. The vet says these episodes are most likely caused by urinary tract infections, to which Pandora is now more susceptible due to renal failure making her urine more watery and less germicidal.
Pandora will soon need subcutaneous fluid therapy to help her kidneys along. This will involve home injections of medicated solution directly into her tissues; she’ll find it unpleasant at first, but hopefully the added fluids will prolong her life without pain for years yet. We’ll see how good I am at injecting a cat with a large needle.