Semi Feral Cat. FIV and Renal Failure.

[Norachan]

Does anyone have any experience of dealing with renal failure in FIV cats?

Albert, in my banner below, is a 9 year old cat that came from a colony I TNR'd. He was neutered at around 8 or 9 months old, blood tested negative for FIV and FeLV then and was given his core vaccines.

Always been very healthy until last summer, when he had a gum infection that caused him to lose a bit of weight. He was treated with antibiotics, but didn't gain the weight back even though he was eating well. About a month ago I noticed blood in his urine. He was given antibiotics and anti-inflammatories, but blood tests showed he is in renal failure and is now FIV+

The FIV diagnosis is a bit of a mystery. He's always been a bit skittish and hard to handle, but was indoor/outdoor for the first year of his life and has been indoor/enclosure only for the past 8 years. As far as I know he's never had a fight with another cat that left any serious injuries. However his father, Gin Kun also in the banner below, was FIV + and Albert was living with another FIV+ feral rescue up until last year.

For the past month he has been on an oral prostacyclin https://www.toray.com/global/products/chemicals/chemicals005.html and Vetri DMG

He was eating well until last Friday. He threw up blood and mucus sometime over night on the 5th and stopped eating. I started syringe feeding him. The vet gave him Sub Q fluids and a couple of cans of Hill's Urgent Care. I'm able to get him to swallow about 3/4 to a whole can a day, as well as his meds and the supplement mixed with a liquid treat, but he won't eat on his own.

I understand that he probably doesn't have much longer to live. but I want to make him as comfortable as possible for as long as I can. I've lost one cat to FIV and another to renal failure in the last year. They both only lived for about a week after they stopped eating, but Albert seems much healthier than they were. He's still walking around, allowing me to pet him and enjoying snuggling with his sister and friends.

Should I just continue with the syringe feedings and hope he starts eating on his own? If anyone has been in a similar position I'd appreciate any insights.

 

[di and bob]

If he is tolerating the syringe feedings, continue. Try some lickable treats to see if you can get him to eat on his own. I use Delectable Lickables in the stew flavors to get them going after they quit eating. He just may start eating again. Try ANYTHING he really enjoys. Even if it isn't the best nutrition. Get some of that high calorie gel to see if that would help. You are doing all you can, and it sounds like he is still enjoying life. I'll keep you both in my thoughts and prayers.......

 

[FeebysOwner]

I don't have any experience per se, but have you considered trying baby food meat (Gerber Stage 2 or Beechnut) to see if that might jump start his eating on his own?

 

[mrsgreenjeens]

Has the vomiting stopped now? I've never had any of my kidney cats vomit like you described, so not sure what was causing that, but if it's stopped now, that's a good thing. Maybe he's still associating that with eating ? Or it could be a mouth issue again since that a common problem with FIV. I'm guessing the Vet checked out his mouth when you took him in for fluids on Friday?

I would definitely continue with the assist feeding as long as he's tolerating it. It's very possible he will start eating again on his own sooner than later. Are you giving him fluids at home too to make sure he's plenty hydrated? How bad are his kidneys and what meds are you giving him?

 

[NekoM]

I’m sorry your going through this. FIV is a tricky disease, there’s a few different ways it’s transmitted but generally lies dormant for years, and out of nowhere kicks in, so it’s hard to trace. FIV always triggers a secondary infection somewhere down the line and generally ends up in the kidneys. Cats hide it well and it’s almost impossible to detect until things get bad.
Theres no script on how it plays out. The SubQ fluids are the priority as they’ll push some of the harmful toxins out of his kidneys, keep him hydrated and help a little with his appetite. Follow his lead when it comes to eating, If you can get him to eat a tiny amount of food throughout the day it’ll metabolize better. Hydration is your best friend right now.

 

[Jcatbird]

My FIV cats experience stomach problems and the gum/dental and kidney issues all go together. The Fancy Feast broths and Petites were well tolerated. It seems to be dental pain to a great degree but tummy massages often bring up burps! It seems like that would be something minor but it really has brought relief. Pain meds help but balancing that with the kidney issues means you weigh which thing takes priority. With BJ I found that a little pain meds once in awhile meant he ate well and was really active again. I don’t know if you saw the posts about his kidney issues but the final renal failure came after he developed another issue, had to have dental surgery and he had already been weakened by heart worms earlier. Being careful about too much in the way of fluids is also a balancing act. I wanted BJ hydrated but not to overtax the kidneys. He did very well once the dental pain meds made it so he could eat better. He did throw up before that but stopped after I got him back on track again. Pain meds were only used here and there. Hoping that Albert improves!

 

[Norachan]

Thank you all for your input.

Has the vomiting stopped now? I've never had any of my kidney cats vomit like you described, so not sure what was causing that, but if it's stopped now, that's a good thing. Maybe he's still associating that with eating

Yes, he just threw up that one time, but that's what seems to have put him off his food. His favourite used to be steamed chicken breast, but I was hiding his original course of antibiotics in chicken so he won't touch that now.

I'm guessing the Vet checked out his mouth when you took him in for fluids on Friday?

Yes, the vet says his mouth is fine and his teeth are in good shape. He was drooling last summer from the mouth infection, which is how I noticed something was wrong.

Are you giving him fluids at home too to make sure he's plenty hydrated? How bad are his kidneys and what meds are you giving him

He's drinking tons of water by himself. I have large water bowls all over, inside and out. The vet said Stage 3 renal failure. The medication is a Japanese made one.

It's described as "an oral prostacyclin (PGI2) with beraprost sodium as its active ingredient"

He did very well once the dental pain meds made it so he could eat better. Pain meds were only used here and there.

Yes, I remember BJ's thread. Our vet was very cautious about prescribing pain medication, but gave Albert anti-inflammatories (injection and tablets) to reduce the swelling in his gums.

He's tolerating the syringe feedings remarkably well. I never imagined he would let me pick him up and hold him while I fed him. I used to have to go through all sorts of cunning ninja moves just to get the topical worming medication on the back of his neck. The fact that he's allowing me to handle him this much makes me think he's feeling very weak, or he's giving up on life.

I have managed to get a whole can of Hill's Urgent Care into him today though. Hopefully he's going to feel the benefits of all those calories and start eating on his own soon.

 

[Meowmee]

Does anyone have any experience of dealing with renal failure in FIV cats?

Albert, in my banner below, is a 9 year old cat that came from a colony I TNR'd. He was neutered at around 8 or 9 months old, blood tested negative for FIV and FeLV then and was given his core vaccines.

Always been very healthy until last summer, when he had a gum infection that caused him to lose a bit of weight. He was treated with antibiotics, but didn't gain the weight back even though he was eating well. About a month ago I noticed blood in his urine. He was given antibiotics and anti-inflammatories, but blood tests showed he is in renal failure and is now FIV+

The FIV diagnosis is a bit of a mystery. He's always been a bit skittish and hard to handle, but was indoor/outdoor for the first year of his life and has been indoor/enclosure only for the past 8 years. As far as I know he's never had a fight with another cat that left any serious injuries. However his father, Gin Kun also in the banner below, was FIV + and Albert was living with another FIV+ feral rescue up until last year.

For the past month he has been on an oral prostacyclin https://www.toray.com/global/products/chemicals/chemicals005.html and Vetri DMG

He was eating well until last Friday. He threw up blood and mucus sometime over night on the 5th and stopped eating. I started syringe feeding him. The vet gave him Sub Q fluids and a couple of cans of Hill's Urgent Care. I'm able to get him to swallow about 3/4 to a whole can a day, as well as his meds and the supplement mixed with a liquid treat, but he won't eat on his own.

I understand that he probably doesn't have much longer to live. but I want to make him as comfortable as possible for as long as I can. I've lost one cat to FIV and another to renal failure in the last year. They both only lived for about a week after they stopped eating, but Albert seems much healthier than they were. He's still walking around, allowing me to pet him and enjoying snuggling with his sister and friends.

Should I just continue with the syringe feedings and hope he starts eating on his own? If anyone has been in a similar position I'd appreciate any insights.

yes my Wizard was fiv plus and had first ibd, then crf and then lymphoma. He had anemia too. But he lived a long time and was healthier than my others for quite a while. He always had a touchy tum though. It was not easy, fluids, meds etc. He was probably 21 when he left me, I miss him so much. He just ate normal food, dvm then said he needed the calories, by then I had mostly switched everyone to wet canned food and had tried home made food but he didn't like it and neither did Sybil. I didn't get the hang of it until Quinn came along and could not eat anything but homemade.

I have never heard of that. Wizard was on fluids, b12, epogen, prednisilone and chlorambucil.

 

[Jcatbird]

Allowing you to handle him could be weakness but I also have found that the ferals here seem to understand we are helping. The trust bond becomes stronger. With food going in, strength may return. Eating should become easier with the meds on board.

 

[mrsgreenjeens]

Did the Vet run more bloodwork last week to see if all his values (other than kidney) were ok? Just wondering since kidney cats can get out of whack in other areas too. Potassium, calcium, phosphorus, etc. And those can be addressed with meds and/or supplements. The prostacyclin is for high blood pressure. I'm just wondering if he might possibly have developed an ulcer or something since he vomited up blood. Perhaps since it was only once that isn't the case, but is still odd. Vitamin B could help with his appetite, and kidney cats are often low on that too.

I'd continue with the assist feeding as long as he's not putting up a fuss and is otherwise acting himself.

I'm thinking you are familiar with Tanya's site on kidney disease, but just in case, here is the link directly to the section on Stages and treatment: Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Which Treatments are Essential

 

[Norachan]

ferals here seem to understand we are helping

Yes, I hope he understands that. He'll come and rub against my legs when I'm opening cans for the rest of them, but won't eat anything I offer him. But it's like he's asking to be fed and knows the syringe feeding is helping.

Did the Vet run more bloodwork last week to see if all his values (other than kidney) were ok?

No, just weighed him, took his temp, checked his hydration and put him on a drip. I need to get him back to the vet next week and ask about other meds. I was given the Rapros because I assumed it would be difficult to pill him and that one is easy to hide in their food. But as long as he'll tolerate syringe feeding there might be something more suitable.

He's doing a little better today. He seems to have more energy and went out for a walk a few times.

 

[di and bob]

I feel so sorry for you, I know how worrisome it can be when one of your little ones is not doing OK. It seems to be all you can think of. I'll keep you both in my thoughts and prayers..........

 

[Jcatbird]

He went for walks? Taking his feedings? Yay!!!!!!! Nothing is better than a full tummy and a relaxing stroll with nature. All good! It sounds like he is content and more comfortable!

 

[Norachan]

Well, some good news and some bad news.

Good news: He ate by himself today! A packet of Sheba dry for breakfast and a pouch of chicken in jelly for lunch. I also gave him 25 ml of Senior Support tuna paste in between that because it's a good way to get his meds and a few extra calories into him.

Around 40 calories so far today!

Bad news: Blood in his pee again this morning. I was able to get a urine sample to show the vet. Mr Husband has taken a couple of hours off work this afternoon so he can take him for a 4 pm appointment.

I'll keep you updated.

 

[Norachan]

So, after another blood test and examination by the vet:

Kidney function no worse than it was. Continuing with the medication he is on.
Loads of bacteria in his urine. He has antibiotics and another medication. I know the Japanese word, it translates as hemostatic agent, if that makes sense.
In spite of my syringe feeding he has lost more weight.. His healthy weight is about 6.5 kilos. He was 4.3 kilos when we took him in because of his mouth infection in August, 3.4 kilos at the end of December, 3.2 kilos today. But I guess after 10 days of refusing to eat that's to be expected. At least his liver is OK.

Ate another pouch of chicken in jelly on his own and had another 25 ml of Hill's Urgent Care by syringe.

I guess I'm just going to have to keep cramming as much food into him as I can.

 

[Antonio65]

Does anyone have any experience of dealing with renal failure in FIV cats?
[...]
Should I just continue with the syringe feedings and hope he starts eating on his own? If anyone has been in a similar position I'd appreciate any insights.

My Lola, in my avatar, had a renal failure. She was diagnosed when she was a little younger than 6 years, and she was treated accordingly for the rest of her life (she went to the Bridge at the age of 16 years and 10 months), with a proper diet, subQ fluids, pills (Fortekor), vitamin supplements and probiotics.
At the age of 16 we had the surprise, she tested positive to a FIV test upon entering a clinic for a surgery. She tested negative at the moment of spaying (7 months of age), and we were convinced she was negative.
She was an indoor only cat, apart her first year of life when she was allowed out a few hours a day. She was quiet and kind to anyone, so why she became FIV+ is quite a mystery, even if we have the idea that she was involved in an aggression from another cat when she was very young and she came home with a wound on her thigh, the nature of which we never found out for sure.

Anyway, she didn't reach the point when she lost her appetite, or would throw up, due to her CKD, but she had to be syringe-fed for several weeks due to an oral carcinoma, and the vets followed two methods. The first was a PEG tube, the second was an E-tube.
So, I wonder if you can resort to this to have your Albert eat the right amount of food with the least stress for him

 

[Jcatbird]

More yummy food Albert!
BJ did not start back eating again and the decline never improved so , I’m spite of some blood seem, Albert is doing so much better! Of course BJ had so many other health issues before that and we had no idea of his age. The heart worms took quite a toll on him but he still got in some amazing years. Albert eating on his own is wonderful! I’m thinking that once the bacteria is hit with the antibiotics things will be much better.

 

[mrsgreenjeens]

Yes, that urine infection could be causing his appetite issues and general malaise. But I'm wondering about that hemostatic agent. That is something normally used to stop bleeding, so do they think possibly he has a bleeding ulcer or something? I wouldn't think that would be what would be prescribed for an ulcer, so probably not. Did they say why they were prescribing it?

But the good news is that his kidney disease hasn't advanced and his liver is still ok. One step at a time .

 

[Norachan]

But I'm wondering about that hemostatic agent.

Maybe I haven't translated it properly. The Japanese is 止血剤. Literally Stop Blood Formula. It's been prescribed to one of my other cats when she had a mouth infection that was making her gums bleed. It's usually given along with an antibiotic.

Albert's mouth is fine now, so I guess it was prescribed because of the high quantities of blood in his urine. What do you think, is there a better word than hemostatic that makes more sense?　

 

[Norachan]

At the age of 16 we had the surprise, she tested positive to a FIV test upon entering a clinic for a surgery. She tested negative at the moment of spaying (7 months of age), and we were convinced she was negative.
She was an indoor only cat, apart her first year of life when she was allowed out a few hours a day. She was quiet and kind to anyone, so why she became FIV+ is quite a mystery, even if we have the idea that she was involved in an aggression from another cat when she was very young and she came home with a wound on her thigh, the nature of which we never found out for sure.

It's reassuring to hear she lived so long as an FIV cat with kidney problems as well. Did she have to stay at the vets while the feeding tube was in place?

This time last week I was convinced that Albert only had a short time left to live, but the syringe feeding has really turned him around. He's been asking for food every few hours today. I'm so happy that he's got his appetite back again. I syringe fed him some wet treats with his medication mixed in, but apart from that he's been able to eat normally.

Thanks for your support everyone!