Kidney disease - what to expect and when to know it is time?

[kpc1024]

Hello all,
I am looking to you all for some information and guidance. My old boy (15 years) Rascal, was diagnosed with stage 4 kidney disease,. It went pretty fast and it is also possible the vet missed it and we didn’t intervene early enough. But here we are. I don’t know what to expect. I am scared I am going to find him having a seizure or something horrible. I don’t want him to die from toxins overwhelming his system, but I also don’t want to give up. Right now, his creatinine level is 7 and the other values aren’t looking good, but I dont remember them off the top of my head. How symptoms currently, are lethargy, sad sighs, and not purring much. The positives are that he eats, not as much as he should, but he never was a huge eater even though he was previously a very big guy. He was obese, over 20 lbs (no matter what diet), but in the last two years shrunk down to 10 lbs as he hit stage 4, he still jumps onto the bed and his little tail shakes in happiness/interest when looking out the window or I bring him out on to the walled in terrace (dont take my eye off him, he just walks a bit and plops down in the sun) So, going forward, I don’t know what getting worse will look like and I don’t know when is the right time to let him go. I know it is a personal decision, but if someone here can share how they made their decision, that would help. Thank you for reading this, I appreciate any replies.

 

[T.O.]

I don’t know about the stages, I’ve never had a vet state my cat was in any stage. But I nursed a few cats to the end stages of a few different diseases including one who was in renal failure.
It is always quality of life over quantity. Are they enjoying food? Are you able to mitigate pain? Can they navigate using the liter box?
With cats it’s pain. It’s hard to control pain without causing more problems. They can get mouth sores among other painful symptoms with renal failure.
If your cat seems comfortable and still gets enjoyment from life then give it time. But have a plan ready with your vet. Pay attention to fluid intake and urine output, a sudden change there will key you into what’s going on. I fed watered down wet food to mine, she was a senior cat with little interest in drinking.

 

[neely]

I'm sorry you are going through this difficult time with Rascal. Unfortunately there's no simple answer and since you know him best you have to help make this decision for him. A good friend once told me better a day too soon than to suffer in pain. However, from what you posted, e.g. jumps on the bed, walks a little then plops down in the sun, shakes his tail when happy, interested to look out the window, etc., it sounds like he still has some quality of life. I know you mentioned your vet may have missed the early stages of his kidney disease but can you talk to them about making him comfortable?

Here is an Article that discusses when is it time to make the difficult decision that may have some helpful information for you:
When Is It Time? – Making The Difficult Decision – TheCatSite Articles

Best wishes to Rascal and you, please keep us updated on his condition.

 

[di and bob]

Get something high in calories and easy to eat, like Hartz Delectable Lickabels in the stew flavors. They can be found usually at Walmart and Dollar General, and online. He will pull away from you and start hiding, stop eating when his life comes to the point he is existing. I would have some kind of cream or patch pain meds handy for the end in case he is in pain. Emergencies happen with vets and my boy suffered, I wouldn't wish that on anyone. As long as he enjoys being with you, and laying in the sun, he has some quality of life left. Bless you, for being with him and loving him......

 

[kpc1024]

Get something high in calories and easy to eat, like Hartz Delectable Lickabels in the stew flavors. They can be found usually at Walmart and Dollar General, and online. He will pull away from you and start hiding, stop eating when his life comes to the point he is existing. I would have some kind of cream or patch pain meds handy for the end in case he is in pain. Emergencies happen with vets and my boy suffered, I wouldn't wish that on anyone. As long as he enjoys being with you, and laying in the sun, he has some quality of life left. Bless you, for being with him and loving him......

Thank you so much. The advice is helpful and I appreciate it

 

[kpc1024]

I'm sorry you are going through this difficult time with Rascal. Unfortunately there's no simple answer and since you know him best you have to help make this decision for him. A good friend once told me better a day too soon than to suffer in pain. However, from what you posted, e.g. jumps on the bed, walks a little then plops down in the sun, shakes his tail when happy, interested to look out the window, etc., it sounds like he still has some quality of life. I know you mentioned your vet may have missed the early stages of his kidney disease but can you talk to them about making him comfortable?

Here is an Article that discusses when is it time to make the difficult decision that may have some helpful information for you:
When Is It Time? – Making The Difficult Decision – TheCatSite Articles

Best wishes to Rascal and you, please keep us updated on his condition.

Thank you so very much, will keep you posted.

 

[kpc1024]

I don’t know about the stages, I’ve never had a vet state my cat was in any stage. But I nursed a few cats to the end stages of a few different diseases including one who was in renal failure.
It is always quality of life over quantity. Are they enjoying food? Are you able to mitigate pain? Can they navigate using the liter box?
With cats it’s pain. It’s hard to control pain without causing more problems. They can get mouth sores among other painful symptoms with renal failure.
If your cat seems comfortable and still gets enjoyment from life then give it time. But have a plan ready with your vet. Pay attention to fluid intake and urine output, a sudden change there will key you into what’s going on. I fed watered down wet food to mine, she was a senior cat with little interest in drinking.

I haven;t seen any mouth sores or anything. I will be more attentive to his mouth health. Thanks.

 

[gilmargl]

I am sorry that you and your cat are having to go through this. I have a foster cat who has just been diagnosed with the early stages of CKD and I'm not looking forward to going through the procedure yet again.
I have already owned 2 cats with kidney disease. There were never other symptoms apart from losing weight, vomiting, eating very little and finally not eating anything at all.

In Lucy's case the problem was discovered very late. She had already started hiding when I took her to an emergency clinic. One of her kidneys was extremely enlarged. The next ten days were particularly stressful as it was the holiday period and we were left to force feed her and give her fluids with little (and ever-changing) veterinary support. She started vomiting black, sticky vomit and needed carrying to the litter box (she refused to use one placed next to her so we were carrying her down a flight of stairs to the other boxes). I then stopped force feeding her although the vet said I could continue. She became more relaxed but hid under my bed and refused to take any food. The vet saw her once more and we arranged a date for euthanasia. Her last few days were spent under my bed. At least she died at the vet peacefully.

In the second case, Lilly's kidney defect was discovered early. As a young cat she was always drinking water so we had her tested. No idea about stages but it took quite a few years before she had phases of vomitting and refusing to eat. Blood analyses showed that things were getting worse, but vets were always optimistic that it wasn't the end just yet. In fact one vet wanted to thoroughly re-examine the few teeth she still had. I told the vet to get her suitably fit before he sedated her yet again. In spite of medication, her general condition did not improve. She would eat small amounts, was sometimes very friendly settling on anybody's lap but othertimes she would disappear into the cellar and I would sit with her there. Unfortunately, it was late one Sunday night when I knew she was suffering badly. I found her lying in the litter box unable to move her back legs. The all-night vet clinics are more than an hour's drive away, and I do not drive at night. I decided to phone the local vet first thing on Monday morning and to spend the night with her. I put her back in her basket and tried to keep her warm. She was dreadfully nervous and couldn't settle down. She died at about midnight after suffering 2 or 3 violent seizures causing her to scream. I certainly don't want any of my cats to have to go through such a painful and scary death. Although no-one likes to have a cat euthanised, I am relieved that, apart from Lilly, all my other very senior cats and terminally sick foster cats and kittens, could be quickly put out of their misery.

I wish you and Rascal some good times together and, when the time comes, a peaceful parting.

 

[Jem]

When my boy had CKD, we managed to keep him going for almost 4 years with proper treatment. The last year and a half or so of his life he was in stage 4, but he unfortunately developed CHF, and it wasn't long after that, that he declined and we put him down.
The biggest thing that kept him happy and feeling good was sub-Q fluids, so I would talk to your vet about that if they haven't mentioned it yet.

 

[Jem]

Also, if you want some excellent information, go to this site...it was my savior when researching this disease.
Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Everything You Need to Know to Help Your Cat

 

[kpc1024]

When my boy had CKD, we managed to keep him going for almost 4 years with proper treatment. The last year and a half or so of his life he was in stage 4, but he unfortunately developed CHF, and it wasn't long after that, that he declined and we put him down.
The biggest thing that kept him happy and feeling good was sub-Q fluids, so I would talk to your vet about that if they haven't mentioned it yet.

Thank you, I am going to speak with her about the fluids. I think that is a great Idea. Did you have any problems with food pickiness? It is so hard to get him to eat, he appears excited to see food and then I put the food in front of him and he walks away.

 

[kpc1024]

I am sorry that you and your cat are having to go through this. I have a foster cat who has just been diagnosed with the early stages of CKD and I'm not looking forward to going through the procedure yet again.
I have already owned 2 cats with kidney disease. There were never other symptoms apart from losing weight, vomiting, eating very little and finally not eating anything at all.

In Lucy's case the problem was discovered very late. She had already started hiding when I took her to an emergency clinic. One of her kidneys was extremely enlarged. The next ten days were particularly stressful as it was the holiday period and we were left to force feed her and give her fluids with little (and ever-changing) veterinary support. She started vomiting black, sticky vomit and needed carrying to the litter box (she refused to use one placed next to her so we were carrying her down a flight of stairs to the other boxes). I then stopped force feeding her although the vet said I could continue. She became more relaxed but hid under my bed and refused to take any food. The vet saw her once more and we arranged a date for euthanasia. Her last few days were spent under my bed. At least she died at the vet peacefully.

In the second case, Lilly's kidney defect was discovered early. As a young cat she was always drinking water so we had her tested. No idea about stages but it took quite a few years before she had phases of vomitting and refusing to eat. Blood analyses showed that things were getting worse, but vets were always optimistic that it wasn't the end just yet. In fact one vet wanted to thoroughly re-examine the few teeth she still had. I told the vet to get her suitably fit before he sedated her yet again. In spite of medication, her general condition did not improve. She would eat small amounts, was sometimes very friendly settling on anybody's lap but othertimes she would disappear into the cellar and I would sit with her there. Unfortunately, it was late one Sunday night when I knew she was suffering badly. I found her lying in the litter box unable to move her back legs. The all-night vet clinics are more than an hour's drive away, and I do not drive at night. I decided to phone the local vet first thing on Monday morning and to spend the night with her. I put her back in her basket and tried to keep her warm. She was dreadfully nervous and couldn't settle down. She died at about midnight after suffering 2 or 3 violent seizures causing her to scream. I certainly don't want any of my cats to have to go through such a painful and scary death. Although no-one likes to have a cat euthanised, I am relieved that, apart from Lilly, all my other very senior cats and terminally sick foster cats and kittens, could be quickly put out of their misery.

I wish you and Rascal some good times together and, when the time comes, a peaceful parting.

Thank you for sharing your experience with me. It was really helpful to read your response and I appreciate it.

 

[kpc1024]

Also, if you want some excellent information, go to this site...it was my savior when researching this disease.
Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Everything You Need to Know to Help Your Cat

Thanks!

 

[Jem]

Did you have any problems with food pickiness? It is so hard to get him to eat, he appears excited to see food and then I put the food in front of him and he walks away.

What the vet (and Tanya's website) explained to me was that when the toxins build up in the body because the kidneys can't filter anymore, it causes kitty to feel nauseous, so they won't eat...or have reduced appetite.
They will also attribute their sick feeling to the food, especially if fed the same thing every time. So what I did was get multiple different foods and served him a different one every meal so he didn't lose interest in his food if he happened to feel nauseous at the time and linked it to the food.
That's probably what's happening to your kitty, you put down the food but he feels sick...even though he's hungry...smells the food...thinks to himself.......and walks away.
That's one of the big pluses to the sub-Q fluids. It's acts like dialyses for the kitty helping to flush the kidneys with enhanced hydration. It was the best thing we did during the whole thing that kept him eating.
My boy was also prone to gum/tooth abscesses, so that was also a factor in his sometimes poor eating habits, but I could often tell if it was an infection because his breath would start to smell bad.

 

[Jem]

I also wanted to add, that no matter how much you manage to get him to drink or consume with his food...when it comes to the end stages of CKD, a kitty just can't drink enough to flush the kidneys the way they need.

 

[kpc1024]

I also wanted to add, that no matter how much you manage to get him to drink or consume with his food...when it comes to the end stages of CKD, a kitty just can't drink enough to flush the kidneys the way they need.

Thank you for the info. I starrted the subq fluids. he still wont eat, even with antinausea meds. i switch his food up, and for some he looks super interested but then starts licking his lips and turns away. I also give him an appetite stimulant. I am so annoyed that i cant fix this and might do him in.

 

[Jem]

I starrted the subq fluids. he still wont eat, even with antinausea meds.

How long has it been? The lip licking means he's still nauseous and/or the smell of the food is turning his stomach. It can take several days for his system to flush and the nausea to diminish. You mention switching his food but have you tried a food he's never had before? If not see if that will work. You could also change up the smell by adding some fortiflora (a probiotic you can get from the vet) or even a sprinkle of parmesan cheese. Or mix in some tuna or tuna water from the can. Anything that smells different from what he's been used to.
I hope something works...

 

[John Perram]

Thank you for the info. I starrted the subq fluids. he still wont eat, even with antinausea meds. i switch his food up, and for some he looks super interested but then starts licking his lips and turns away. I also give him an appetite stimulant. I am so annoyed that i cant fix this and might do him in.

I have the same problem. I boiled up chicken breast and my cat ate that. I also got stage 2 meat baby food with
Virbac Rebound Recuperation Formula for Cats I mixed the 2 and she loved that.

 

[Kritter]

Thank you for sharing your experience with me. It was really helpful to read your response and I appreciate it.

 

[kpc1024]

How long has it been? The lip licking means he's still nauseous and/or the smell of the food is turning his stomach. It can take several days for his system to flush and the nausea to diminish. You mention switching his food but have you tried a food he's never had before? If not see if that will work. You could also change up the smell by adding some fortiflora (a probiotic you can get from the vet) or even a sprinkle of parmesan cheese. Or mix in some tuna or tuna water from the can. Anything that smells different from what he's been used to.
I hope something works...

He started eating again. He driving me crazy. I think ti is nearing the end and then he perks up and starts eating. Such ups and downs. More ups, though. The Cernia seems to help. I give him a little more than I did previously and I guess it is working