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Old April 10 2014, 07:20 PM   #1
Ro_Laren
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Have U Ever Had a Cat w/Kidney Failure? Advice Needed for My Cat!

Sorry, this is going to be a long post. I know that there are a lot of cat fans on this board and I thought that maybe some of you have had a cat that was diagnosed with kidney failure (i.e. renal failure). I wanted to tell you about my cat and ask for treatment advice. I've also posted this the forum of Tanya's Feline CKD Support Group. My 14 year old Russian Blue male cat named Sugar was diagnosed with kidney failure years ago. He has really taken a turn for the worst this past year. He was a little over 9 lbs. in November and is now at 7.3 lbs. Lately, he hasn't been drinking as much and also doesn't eat much. I have resorted to giving him Fancy Feast and try to heat up a little bit of it (to make it smell yummy) and try to bring him some every couple hours. Sugar seems really weak, not even able to jump on the bathroom counter without falling. He's been really lethargic and his favorite hiding spots have been a dark corner and way up high on top of a bookshelf where he rarely went when he was healthy (I have to help him get up there).



We took Sugar to the vet yesterday and the vet was surprised at how rapidly Sugar has deteriorated. They gave him some fluids and noted that his urine was clear (i.e. not yellow concentrated urine). They ran his blood work and called today with the results (unfortunately I wasn't able to speak with my regular vet because it was her day off). Sugar's kidney results were high: he has significant kidney failure (end stage). The vet said so much that it was hard to take in. She said:
  • One of his kidney values that is supposed to be 36 was 187 and one that was supposed to be 2 was 11.
  • Sugar has high phosphorous levels
  • His ? electrolyte levels are off
  • Sugar is mildly anemic
When I asked how long he had to live the vet said that she didn't know: it could be a few weeks or it could be a few months. But, she recommended that we try the following treatment for a week and then check his blood work to see if Sugar makes any improvements:
  • Let him eat fancy feast for a week, but after that try to get him onto a kidney friendly diet (i.e. prescription food)
  • An appetite stimulant so he'll eat
  • Nausea medicine because kidney failure can make cats nauseated
  • Daily IV fluid treatment (they'll teach me how)
  • Eppetine? powder for his food twice a day to help him absorb phosphorous
If his levels improve, the vet said that we can maybe give him IV fluid treatment every other day, but that we'll have to do that for the rest of his life. The doctor couldn't give any sort of estimate as to how long a cat can live with this treatment, but did note that she has seen other cat's kidney values significantly drop (i.e. make a significant improvement) with this treatment. The vet said that the treatment probably wouldn't help with his anemia, so he would likely need injects. I'm not sure how many injections he would need or how often he would need them.

Unfortunately, when I look at this treatment I can't help but wonder about the costs. You see, my family has spent a lot of money the last 1 1/2 years because of our animals. My dog R.J. was really sick in 2012 with seizures, etc. They had tests done, but he was in so much pain that he had to be put to sleep on December 23, 2012. This was super hard on our family, especially since it was the third animal that we've had to put to sleep. We thought that maybe a purebred dog would do better health wise , so for the first time ever we decided to get a purebred lab, from a breeder that is a family friend. $1,000 and 2 out-of-state drives (9 hours each way) later, we have our dog. He's definitely a handful, and it is amazing how expensive puppies can be. Our cat Max, a shelter cat from the same litter as Sugar, was throwing up a lot last year. Our former vet thought it could be a tooth problem so we paid like $800 in 2012 to get it extracted. It didn't help and in 2013 Max started to lose a lot of weight and painfully throwing up each day. We changed vets and after more tests learned that Max had hyperthryoidism. After looking at our options (giving him a daily pill or cream or radiation treatment), we opted for $1,000 radiation treatment. This option was cheaper in the long-run and was supposed to have the best results. Thankfully Max is healthy now!!

And now our poor Sugar was sick. I hate to think about the fact that we've spent so much money on our other pets that now we don't know how we are going to be able to afford to help Sugar. Our first cat lived 19 years old and so I can't help but think that at 14 years old Sugar is too young to die. The vet gave me the following cost estimates:
  • The IV fluid cost is $30 a week. This includes the fluid, line, and needle. I'm not sure if this is just one line, needle, and bag. But can they last / be resused to last a whole week? The vet said that it will obviously be cheaper if we learn that Sugar only needs an IV every other day.
  • The eppepiten? powder for his phosphorus is $30, but I'm not sure how much powder that is (or how long Sugar needs it)
  • The appetite stimulant is $15. Is this just a one-time cost to get him to eat at first, or will he need it a lot?
  • The blood work is $50. He needs it after his first week of treatment, then every 7 to 10 days, then once a month.
  • Prescription food for the rest of his life (we didn't get a cost estimate).
  • We don't know how much the nausea (acid reducer) medicine costs. How often would Sugar need this? Is this just famotidine, which we can by over-the-counter?
Can anyone give me any recommendations? How long have you seen cats live on this treatment? Is there a way that I can get the fluid, line, and needle cheaper? Do I need a prescription to do so? Can I get the medicine cheaper somewhere? Does that need a prescription?

BTW, it has always been very hard to "force feed" our cat, so I don't know how easy it would be to syringe feed him or give him pills. He's a nice cat and doesn't bite or scratch, but moves around a whole lot when you try to "force feed" him. I'm not sure how well he would handle getting an IV everyday. Do you guys find that even the most stubborn cat will give in and let you give them an IV since they can physically feel it helping them??

Oh, I forgot to mention that Sugar did a lot better yesterday after he got fluids at the vet. He has been eating and drinking more. Most importantly, I was able to hear him purr when I picked him up. He has always been a loud purring kitty, but you couldn't even hear him purr the last week.

Thank you in advance for your advice!
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Old April 10 2014, 09:59 PM   #2
Spot's Meow
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Re: Have U Ever Had a Cat w/Kidney Failure? Advice Needed for My Cat!

I would say that you are very lucky that Sugar has survived this long with this problem. I had a cat that was very young and had renal failure and although we began giving her medication, she passed away within just 3 months of the diagnosis.

I can say that I have had to give a different cat medicine through a syringe and it was no easy feat. I had to lay on top of him and hold him down, wearing long sleeves to avoid scratches, and shove it into the side of his mouth between his gritted teeth. We eventually figured out how to do it but he gave us a good fight!

You are also very lucky that your previous cat lived to be 19 years old. The average lifespan for an indoor cat is about 14-15 years.

I'm sorry I don't have more detailed advice to give.
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Old April 10 2014, 10:05 PM   #3
Ro_Laren
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Re: Have U Ever Had a Cat w/Kidney Failure? Advice Needed for My Cat!

Spot's Meow wrote: View Post
I would say that you are very lucky that Sugar has survived this long with this problem. I had a cat that was very young and had renal failure and although we began giving her medication, she passed away within just 3 months of the diagnosis.

I can say that I have had to give a different cat medicine through a syringe and it was no easy feat. I had to lay on top of him and hold him down, wearing long sleeves to avoid scratches, and shove it into the side of his mouth between his gritted teeth. We eventually figured out how to do it but he gave us a good fight!

You are also very lucky that your previous cat lived to be 19 years old. The average lifespan for an indoor cat is about 14-15 years.

I'm sorry I don't have more detailed advice to give.
Thanks for your thoughts. I'm sorry for your loss of your poor kitty. I'm not afraid of Sugar scratching me to death, rather of him hurting himself by trying to squirm out of my arms. He is so fragile!

By the way, here is a scanned copy of his blood work (lab work) results:

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Old April 10 2014, 11:11 PM   #4
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Re: Have U Ever Had a Cat w/Kidney Failure? Advice Needed for My Cat!

Wishing you the best for Sugar. We lost a cat to renal failure when she was 10. Abbie had last seen the vet during the summer for her vaccinations and all was well, but by Christmas that same year her kidney function had dropped to less than 30%. The vet told us he'd hardly ever seen renal failure become so bad so quickly. Sadly she didn't respond to medication and we had her put to sleep on New Year's Day.

A friend of mine, however, had a cat some years ago in much the same situation as your Sugar. She gave her cat the fluid treatment amongst other treatments, and her cat lived for at least another year (the pet insurance she'd had for her cat paid for most of it). Her cat had a good quality of life during that year, so there certainly is hope.
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Old April 11 2014, 02:26 AM   #5
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Re: Have U Ever Had a Cat w/Kidney Failure? Advice Needed for My Cat!

I work in intensive care for grown ups, so take these comments as you will.

I think it's spectacularly important to realise when you're doing harm by accident, and very easy to do. I'm not sure if I was a cat that I'd enjoy daily IV therapy (I wouldn't care for that as a human), my food spoilt with phosphate binders, and regular blood tests. None of those things are likely to be curative either, if I read you rightly? It is absolutely that decision but keep that in mind. We shouldn't give treatment to human relatives when they don't want it, I guess it's the same for cats too.
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Old April 11 2014, 04:54 AM   #6
Peach Wookiee
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Re: Have U Ever Had a Cat w/Kidney Failure? Advice Needed for My Cat!

Ro, I know this is something you may not be ready to consider, but you might need to ask yourself if it's better to put Sugar down.
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Old April 11 2014, 10:49 AM   #7
J. Allen
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Re: Have U Ever Had a Cat w/Kidney Failure? Advice Needed for My Cat!

Poor kitty. I wish I had some kind of advice to offer.
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Old April 11 2014, 11:15 AM   #8
2takesfrakes
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Re: Have U Ever Had a Cat w/Kidney Failure? Advice Needed for My Cat!

Peach Wookiee wrote: View Post
Ro, I know this is something you may not be ready to consider, but you might need to ask yourself if it's better to put Sugar down.
I am forced to agree, with complete sympathy for the original question. It's very painful letting go of someone or something you love, even when you're watching them suffer. But when an animal is past healing, when its suffering can only continue, when no treatment will return it to its former self, the question must be asked, "is it fair to the animal?". Or to yourself, for that matter? Unfortunately, this infliction isn't at all uncommon with cats - or dogs, for that matter.

My parents had a very sweet chow that had to be put down, because of it. Understand, I am not a dog lover. But when this happened to her, it really pissed me off. It was unfair; it shouldn't have happened. It was very upsetting, the whole thing and they could've saved her from a lot of suffering, but they waited until she was in complete agony, because they didn't want to let her go. There is no solution that is going to make anyone happy in this situation, least of all the animal. And I'm sorry for what your'e going through.
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Old April 11 2014, 11:55 AM   #9
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Re: Have U Ever Had a Cat w/Kidney Failure? Advice Needed for My Cat!

I've lost two cats to that over the years. As house cats that aren't exposed to a lot of other things, they have to eventually have SOMETHING, and it seems that's where mine end up.

You said it was diagnosed a while back, was he already not moved to the K/D food at that time? Not trying to blame or anything, but would have thought that would have been the move then. Mine lived for a few years after the initial kidney failure diagnosis with the K/D food. Doesn't improve anything, but keeps the toxin intake down. Even then, they get worse over time, so a couple years later...

My last cat also developed hyper-thyroid towards the end, so there was a lot of weight loss, no interest in eating, etc. Once she wasn't eating regularly, and starting having balance issues, knew it was time. She had gone from 9-10 lbs down to 5.5, and just hid a lot of it under the fluff.

My other cat (previous cat's mother) also died from kidney failure. Same thing with the food and whatnot, but she did do the IV drip for a while. It wasn't so hard, and the cat didn't mind it so much. Bought her a little time, but it's up to you on that. Obviously cost/pain there for both of you.

14 is a little young, but it's up to you how far you want to take this, and what you judge his quality of life to be. If you can afford to do it, and he seems ok with it, worth trying for a while. If he's no longer himself, or it's going to be impossible for you, it's not the wrong choice to avoid it.
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Old April 11 2014, 12:43 PM   #10
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Re: Have U Ever Had a Cat w/Kidney Failure? Advice Needed for My Cat!

Our previous cat, Tillie, died at age 20 from basically not even having kidneys anymore. The vet said they had shriveled up so small he couldn't find them. She ended up drinking and peeing pretty much constantly at the end, and because her teeth had gone bad as well, she would only eat the canned food (Fancy Feast and others). We were kind of surprised she ended up dying of something like that, as she'd been partly outdoors and had gotten an eye scratched, broken a leg, all kinds of rough things, in her life. We figured she was 20, so we weren't going to bother with any treatment. We just made sure to have plenty of water for her, kept the litter boxes clean (we had 4 at that time), and in the end, she spent an evening saying goodbye, killed one last mouse for us and then quietly died overnight in my father's workshop (so Mom wouldn't be the one to find her - this cat seriously thought of everything).

Anyway, my point is, you have the same three choices as you would with a human: life-prolonging measures, hospice, or assisted suicide (put him down). (Okay, maybe we don't have the choice of assisted suicide with humans.) We opted for hospice, which was the least expensive and made sense since she was almost record-breaking old already. We made her comfortable and she let us know what she needed. Plus I think if we'd tried to do at-home treatments, she would have scratched us bloody, never mind trying to herd her into the carrier regularly to see the vet for treatment. It depends on your cat's temperament, and he is probably already trying to tell you what he wants you to do. You just have to interpret that and make your decision that way. "Good luck" isn't exactly what I want to say, but... I hope you can make the decision that is best for Sugar and for your family.
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Old April 11 2014, 01:49 PM   #11
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Re: Have U Ever Had a Cat w/Kidney Failure? Advice Needed for My Cat!

Feline renal failure will, unfortunately, do nothing but drain your pocket book. This cat is most likely not going to get better. One important question is, "Is Sugar in pain?". If the answer is yes, then the choice is self evident.
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Old April 11 2014, 04:52 PM   #12
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Re: Have U Ever Had a Cat w/Kidney Failure? Advice Needed for My Cat!

My buddy at work gave his cat daily IV for kidney failure. Basically you kind of hold him down while you give him the fluid.

You need to do what you feel is right for you and your cat. That being said.. I agree with Peach/2takes/BB. I'd put the cat down. In the long run it's a losing battle. Better to remember the fun and good times then watch the poor thing waste away.
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Old April 11 2014, 06:54 PM   #13
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Re: Have U Ever Had a Cat w/Kidney Failure? Advice Needed for My Cat!

I advise it, having had to make the choice with my cat a year ago when a blood clot got her. And I had another kitty that we put down 17 years ago. Sonya had diabetes toward the end of her life and organ failure started despite our best efforts. She was in pain and I realized after the fact that we'd only prolonged her life and pain. That haunted me and I swore I would never again do that to another pet.
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Old April 11 2014, 11:35 PM   #14
Ro_Laren
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Re: Have U Ever Had a Cat w/Kidney Failure? Advice Needed for My Cat!

Thank you everyone for your advice. Sugar actually seemed happy after we gave him fluids at the vet the other day. He was also eating a lot more when I brought him home. I have decided to do a trial period. I'll give him daily IV's (only 150 CC's of fluid) - less than 5 minutes) for a week and then bring him into the vet to run new blood work. If Sugar seems to respond well (physically and emotionally), then I'll just go from there.
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