I am going to lose my beloved Amato, my quiet, slow-moving, best friend. to kidney disease. It is advancing rapidly. I know all the things one can do to slow it, but he may be past the helping point. Any suggestions for making his remaining time good, and when will I know it is time to put him down?
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KIdney disease
- Thread starter seaturtle
- Start Date
I'm sorry you're losing your friend. The only advice I can offer is to make his last days as comfortable as possible. It's never going to be easy knowing when to say goodbye, but I believe you will know when he's ready to go. It's a matter of putting his comfort above yours - it's natural to want to hold on to them as long as we can, but if they're in pain then it's not really fair. I hope you still have a while yet with Amato. 
Sorry to hear this. It's not an easy scenario to be in. I have cared for a couple cats who had kidney disease, one when I didn't know very much and another after I had learned a lot more but who also had additional complications that cut her life short.
You'll probably want to look at this web site, if you haven't already: http://felinecrf.org/ It is full of useful info, perhaps a bit overwhelming but very good.
Cats diagnosed with chronic kidney disease (CKD) can live for years, though. I'm not sure what is the average, it depends upon how far along it is and every cat is different. Amato may or may not have additional complications that would affect his prognosis. If you already know the various things that can be done, you'll understand this: I know someone who gave their cat sub-q fluids for about 4 years. Not sure how much of an outlier that one is, but it is an example of how long some cats can live with this condition. They also often have some degree of digestive upset and meds can be used for that.
When do you let them go is always a troublesome question to me. I was struggling with it with Amber. I had this idea that she just needed to turn a corner with feeling better and we were syringe feeding her for a while. But she didn't give me a chance to make that choice and died on her own at home. I believe this was all down to an additional problem, congestive heart failure. Putting significant amounts of fluid into a cat to make her feel better and help the kidney function had a negative effect on her general well feeling in regards to the CHF. This type of heart function issue results in a buildup of fluid! So the balance wasn't there, and she didn't feel like eating or doing much. She seemed content much of the time but in hindsight I'm not sure she really needed those last few weeks....
Anyway, so that is one example. If Amato is not struggling with additional issues, he could conceivably bounce back fairly well just with fluid treatment and good nutrition. Who knows. If not, the fluid treatment may still have an effect for general well feeling, as in he'll feel better with it than without. You want him to be comfortable, not in pain, etc. Eating on his own can be a tricky one. Some might stop as soon as they have ongoing trouble getting a cat to eat, but sometimes that situation can be very temporary. There's no hard and fast rules here; you just have to evaluate month to month, week to week, day to day perhaps at some point. Using the litter box on his own might be a big one if it comes to that. Amber never stopped using the litter box, so I haven't experienced that, but certainly if he was soiling with no attempt to go to the litter box or something along those lines, I wouldn't find that to be a good quality of life.
Basically that's what you're evaluating, quality of life. If he still enjoys his favorite spots, still enjoys your company, isn't spending all his time hiding somewhere (which could be indicative of pain or other ill feeling), eats, uses litter box, I think you are premature. I don't believe he has to be super mobile on his own to still get some enjoyment. When some of those things start to fade though, then you may want to pay closer attention to what is left and make an evaluation. I still feel like with our earlier CKD cat, knowing what I know now, that we made that decision too soon and without having done enough for her. So it's a tricky thing to try to get this balance.
You'll probably want to look at this web site, if you haven't already: http://felinecrf.org/ It is full of useful info, perhaps a bit overwhelming but very good.
Cats diagnosed with chronic kidney disease (CKD) can live for years, though. I'm not sure what is the average, it depends upon how far along it is and every cat is different. Amato may or may not have additional complications that would affect his prognosis. If you already know the various things that can be done, you'll understand this: I know someone who gave their cat sub-q fluids for about 4 years. Not sure how much of an outlier that one is, but it is an example of how long some cats can live with this condition. They also often have some degree of digestive upset and meds can be used for that.
When do you let them go is always a troublesome question to me. I was struggling with it with Amber. I had this idea that she just needed to turn a corner with feeling better and we were syringe feeding her for a while. But she didn't give me a chance to make that choice and died on her own at home. I believe this was all down to an additional problem, congestive heart failure. Putting significant amounts of fluid into a cat to make her feel better and help the kidney function had a negative effect on her general well feeling in regards to the CHF. This type of heart function issue results in a buildup of fluid! So the balance wasn't there, and she didn't feel like eating or doing much. She seemed content much of the time but in hindsight I'm not sure she really needed those last few weeks....
Anyway, so that is one example. If Amato is not struggling with additional issues, he could conceivably bounce back fairly well just with fluid treatment and good nutrition. Who knows. If not, the fluid treatment may still have an effect for general well feeling, as in he'll feel better with it than without. You want him to be comfortable, not in pain, etc. Eating on his own can be a tricky one. Some might stop as soon as they have ongoing trouble getting a cat to eat, but sometimes that situation can be very temporary. There's no hard and fast rules here; you just have to evaluate month to month, week to week, day to day perhaps at some point. Using the litter box on his own might be a big one if it comes to that. Amber never stopped using the litter box, so I haven't experienced that, but certainly if he was soiling with no attempt to go to the litter box or something along those lines, I wouldn't find that to be a good quality of life.
Basically that's what you're evaluating, quality of life. If he still enjoys his favorite spots, still enjoys your company, isn't spending all his time hiding somewhere (which could be indicative of pain or other ill feeling), eats, uses litter box, I think you are premature. I don't believe he has to be super mobile on his own to still get some enjoyment. When some of those things start to fade though, then you may want to pay closer attention to what is left and make an evaluation. I still feel like with our earlier CKD cat, knowing what I know now, that we made that decision too soon and without having done enough for her. So it's a tricky thing to try to get this balance.
Is your cat on Sub Q fluids daily?
What things have you done or are you currently doing for Amato? I also have a kidney cat, and it's amazing what sub-q fluids will do! We got a little behind in our little one's fluids this week, and I honestly thought it was "the end" for her, then she got her fluids and she perked right up
That website 2bcat provided is my "go to" for most things kidney related. It has a world of information in it, including signs to look for towards to end, but also things to help their appetites, what might be causing them to get lethargic, constipation issues, etc, etc, etc.
As far as when to know it's time....my LAST kidney cat definitely let me know when he'd had enough. I would ask him often if he was ready to "leave me", and one day he looked me right in the eye and I could almost hear him say "yes"
BTW, our Vet said kidney disease by itself isn't normally painful. The main issue is the over acidic stomach, which can be combated by Pepcid A/C and/or keeping enough food in their stomachs. I feed my girl 5 or 6 small meals through the day, and keep treats under my pillow for 2 - 3 feedings during the night. She'll wake me up with kisses on my cheek, which is my signal to put a few (8 - 10) Temptations on the top sheet for her to nibble on. I just have to wake up enough to do that and keep the other cats away
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