Chronic Renal Failure

September 22, 2009 5:01 PM

My cat has chronic renal failure. I need some advice.

I just got off the phone with the vet. His toxin levels have dropped enough they consider him "stable." Also, he ate without throwing up. He is going to spend another night at the vet with his IV, but she felt he didn't need to go back to intensive care. She'll call in the morning to give me an update, and then again in the afternoon with a final conclusion. She figures that we can bring him home tomorrow evening.

His prognosis is iffy, however. We will be switching him to a special food, and I'll be giving him fluids by an injection. If things stay stable he should live for weeks to months "and maybe beyond that." So we still have a bit of time with him.

I read up on Chronic Renal Failure. Among other things, it isn't so much painful as it's uncomfortable, mainly due to dehydration. We can use our judgment, but it seems possible that with proper care his quality of life should be okay right up to the end.

So things are going to be intense around the pet, but I'm going to see this through. I won't prolong anything, but I'm not going to cut anything short either. This is going to be a day to day thing for awhile.

But, the question: What are your experiences with older cats suffering from Chronic Renal Failure, or CFR?

posted by elwoodwiles to Pets & Animals (13 answers total)

You might find this thread from the Straight Dope Message Boards to be helpful. My own experience is with my parent's cat; she got another four months with the use of subcutaneous fluids before passing away at the age of 15.

My condolences for you and your companion.
posted by Johnny Assay at 5:11 PM on September 22, 2009

My cat lasted about 8 months after his diagnosis. I fed him low-protein kidney care cat food and gave him a daily IV. His quality of life was quite good up until the end. I had 8 months to prepare myself to do the compassionate thing and have him euthanized and to give him lots of love while he was here.
posted by xenophile at 5:23 PM on September 22, 2009

My cat has this. From the sound of it, it's much less severe with her than it is with your cat. So far, mine has no symptoms other than moderately elevated levels -- we got lucky and caught the renal failure early, during tests for a urinary tract infection.

At any rate, don't worry too much about the subcutaneous fluids. They seem a bit daunting at first, but they're not too bad. FelineCRF.com has excellent advice on how to do the injections. This site has photos of the equipment and of each step, which I found helpful.

My cat got used to the injections very quickly; she hardly seems to mind. It really helps to do it while the cat is eating, because then they're distracted, happy, and stationary for a couple minutes. I use a floor lamp as a sort of IV stand; I always feed her in the same spot, and give the fluids at around the same time. It's a good idea to stay there with your cat, pet him, and watch to make sure he doesn't take off and pull out the needle. I give 100ml per day, and it takes just a few minutes... usually she's still eating at the end. If you need to give more fluids, it might help to give him the food in stages, so he's still eating throughout. Or maybe you could give half in the morning and half before bed.

It's also important for them to drink as much as possible. One of those cat water fountains might help, or if your cat likes to drink from the running faucet, it might be kind to turn it on for him.

Hope this helps... I'm really sorry to hear it. I hope you get to have some time with him.
posted by vorfeed at 5:30 PM on September 22, 2009

oops, by that I meant "I always feed her in the same spot, and give the fluids at around the same time of day." The trick is to give the food, wait a minute or so until he's absorbed in eating, and then insert the needle for the fluids. If he's anything like mine, he'll be too busy eating to mind!
posted by vorfeed at 5:35 PM on September 22, 2009

One of my wife's cat's had renal failure, with the subcutaneous fluids he lived for another 3.5 years... the quality of life seemed to be ok.... Marcus was 12 at the time of the diagnosis.

Good for you for hanging in there with your friend... me and the 6 four foots around here will be thinking of you..

if you want more info, memail me and I'll have the boss answer...
posted by HuronBob at 5:41 PM on September 22, 2009

Here is a thread with a slightly different situation but also a sort of "what to do now?" question about someone with a cat who needed subcutaneous fluids.
posted by jessamyn at 5:56 PM on September 22, 2009

I posted this in the last CRF thread, please do explore the links, there is a TON of good information there. Also as I said in that last thread, if all your vet is offering you is diet and fluid therapy, you need to look around more, there are many more options than just those two for keeping your kitty comfortable for as long as possible (better quality AND quantity of life, and not terribly expensive). Your vet should be discussing blood pressure management (more or less always a problem with kidney failure), and meds like calcitriol with you, if not, your vet is many years behind the current therapy available for renal failure (and none of it is especially expensive).
posted by biscotti at 5:59 PM on September 22, 2009

My cat Willow had CRF for the last 4 of her 23 - yes 23 - years. She was also diabetic and got insulin twice a day for 8 years. She did get subQ fluids occasionally, and then every few days at the end. I have to say she was a trooper and an easy cat as I had no problem with fluids or giving insulin. Caring for a cat with an illness like this is a big commitment, and can be difficult and challenging at times. I have friends and a sister who also had cats in CRF. It really is different with every cat, and when they have a bad time you just know they don't feel good and it is hard because you want to make them feel better. If you have a good vet who supports your home care it's a lot easier. Once you get the right food - which can make a huge difference, and one you get a little better at "reading" your cat, it gets easier. There are support forums and lots of other resources on the internet, and many people who have been through this are happy to help or give advice. Good Luck!
posted by pinkbungalow at 6:16 PM on September 22, 2009

oops - also wanted to suggest stick to canned food even though they make dry. mix a little water in every time you feed so the kitty takes in as much normally - this *might* help a little with how much fluid s/he needs. Be careful about not overdoing fluids my kitty also had congestive heart issues at the end and we needed to watch fluid build up carefully.
posted by pinkbungalow at 6:19 PM on September 22, 2009

One of my cats had this and was diagnosed when he was about 10. Our vet predicted that he would live about 6 months with good quality of life if we went the subQ route, with treatments at home about twice per week. He was also on blood pressure medication and vet-prescribed food. He ended up living about 14 months, with excellent quality of life until the last week or so. Giving him the fluid treatments was nervewracking the first time--but became much easier very quickly. The treatments never seemed to cause him any pain at all, and once you get your routine down they go very quickly.
At the end, I knew the time had come to do what I knew was right, and I know that I appreciated every extra QUALITY day that I was able to share with my cat. If you truly love your pet, you'll be able to make the right decisions throughout this process.
posted by bookmammal at 6:50 PM on September 22, 2009

I think a certain amount of your answer will depend on how comfortable your cat is tolerating the fluid injections. One of our cats was in this condition for quite a while, and near the end he really just didn't want to put up with the process - as weak as he generally was by that point, he'd start to put up a fight over that. But we did this for several years, so overall it worked out very well.

I'll second vorfeed's suggestion of the cat water fountain, too.
posted by me & my monkey at 6:56 PM on September 22, 2009

elwoodwiles, you're in good company here. MeFites seem to know quite a bit about CRF kitties.

The question Jessamyn linked to above was my question. AJ, 14 years old, was getting 150ml daily for her kidney issue. I say "was" because she saw her doctor today and we're decreasing the fluids to every other day (yay! For AJ, it seems that her kidneys might come back from their initial damage, which is why her doctor has taken the "let's wait and see" approach).

For giving the fluids, I highly recommend warming the fluids first. AJ tolerated cold fluids but would whine a little; once I started warming them, I noticed two things: one, the fluids flowed faster (maybe that was all in my head but whatever); two, AJ didn't whine and chilled with me. Poking the needle in fast is preferable to going slow. I feed AJ a can of wet food after we're done with her fluids. This seems to work well; she knows if she puts up with the process, food comes right after. Also, I keep the other cat out of the room while we're doing it; otherwise, he interferes and upsets AJ. If she squirms too much, the needle slips out and we have to do it again. (That she lets me stick her with a needle at all amazes me; she won't even let me give her a pill or liquid antibiotics).

While AJ was first going through this, she was peeing on my bed, peeing on the bathroom floor and demanding water from the bathtub tap. I fixed all of that by accommodating her with extra litterboxes in various rooms and by getting a water fountain for her. She no longer pees on my bed or the floor; she drinks lots of water from the fountain (a Drinkwell). I've read one or two websites that claim CRF cats need more litterboxes so that they are always close to one - the additional fluids makes it tough for them to get to a box in time.

With AJ, I've noticed that the fluids definitely make her feel better; she has the younger, heavier male cat in the house afraid of her now (when she was sick, he took advantage of her inability to defend her place in the household hierarchy). Her quality of life is definitely back to 'normal' - she initiates play with me and will play alone by chasing her tail or running after flies.

I feed both cats the same diet: they have dry food available 24/7 and wet food once a day. Both foods are Wellness brand products, which are formulated for feline kidney health.

As you go through this, if you want to chat, send me a MeMail.
posted by LOLAttorney2009 at 7:36 PM on September 22, 2009

I never thought I could poke a needle into my cat and give him fluids, but it was easy. You have to poke the needle in confidently, and I warmed the fluids with a heating pad, but eventually my cat seemed to actually enjoy the process--maybe because it meant he got attention and petting too.

Pierre lived a good life for another three months, though there were days were he obviously didn't feel well. After that it was also obvious that it was time, and I had our vet come and euthanize him at home. I was really glad to have the time to spend with a surprisingly energetic Pierre and the time to prepare emotionally for his being gone.
posted by jjwiseman at 12:29 AM on September 23, 2009