Saturday, June 9, 2007

Renal Failure in Cats

Chronic renal failure, also known as kidney failure, is one of the most common conditions affecting older cats. In fact one out of every five cats over fifteen years of age suffers from it. The disease is essentially characterized by a gradual decrease in the ability of kidneys to purify the blood and remove waste products from it. The disease usually has a slow insidious course and is usually irreversible unless a specific cause for the kidney failure is identified and treated (that often include tumors, infections and polycystic disease of the kidneys). In most cases though a cause is not identified and the usual course of the ailment is a slow terminal progression.

As the disease advances symptoms develop in cats that include loss of weight, energy and appetite, depression, altered thirst and urination, poor coat, elevated blood pressure and anemia. Diagnosis is usually reached after analysis of blood and urine along with clinical correlation. Initial treatment is then to correct the fluid and electrolyte balance in cats with administration of intravenous fluids. Blood and urine tests are then periodically done to monitor the course of disease.

Dietary control is of significance once the diagnosis has been reached:

The protein content of diet should be ideally low since most of the waste products that accumulate in blood after kidneys stop working are breakdown products of proteins. However this regulation has to be done with care - too little protein and the cat's health may worsen. Similarly phosphate content of the diet has to be regulated since lowering the phosphate content appears to protect kidneys from further damage. Since it may be difficult to accurately calculate the ideal amount of these nutrients in diet, I would recommend a commercial diet specially designed for the kidney ailment. Initially it may be mixed with the feline's favorite food to help the cat adjust to it. Another important element in treatment is adequate water intake. Cats with kidney failure frequently become dehydrated and there should always be an adequate water source available (water flavored with chicken or tuna often helps if the cat is not drinking). Similarly tinned or sachet food is preferable than dry food since cats generally get most of their water from their meals.

Other treatment measures include potassium supplementation (through tablets or powder), control of blood pressure (relatively straight forward in cats - through tablets) and correction of anemia by iron, and in advanced cases, hormonal supplementation.

Don't feel overwhelmed by all this info - the vet will be able to offer the exact dosage and treatment. If you find all this confusing and hard to undertake ~ there is one procedure that will most likely bring the cat's health to near normal if not totally normal ~ that is kidney transplantation. However that is not a simple undertaking. The procedure costs around $ 4500 to $ 8000 in my understanding and requires a lot of emotional commitment.

Regarding the question about euthanasia --- when I graduated I took a personal oath to never aid or abet euthanasia. I vowed to save everybody I treat - but sadly that has not been completely possible. Through my young career as a doctor for humans so far I've already seen many die - in front of me, literally in my arms - the old ones with cancer who are terminal with all hope lost and the young ones with trauma or the occasional gunshot, reaching the hospital when they are beyond help - and I've had to bear the loss of a kitten after she hunted and consumed a poisonous lizard and died soon thereafter - and I've learned one thing from all the hours of gloom ~ the timing of death is not for us to know or conjecture ~ Nature has its own ways and trust me - as I have learned through experience - there is nothing we can do about it. Each individual is different and is destined to a different fate. All we can offer is our best support. For pets though, there is a slight shade to the philosophy - they can't express themselves in our language. They can't show their pain nor their suffering in our terms. Cats are known to suppress lots of pain without obvious display. So we are their principal caregivers and decision makers. We have to make these difficult decisions for them and we have to live with these decisions for the rest of our lives.

If it helps: when I lost my cat I was younger - devastated and beyond consolation. I kept thinking of her and her memories and there could be no way forward for me - but soon afterwards I learned there is always a cat in need - an abandoned kitten who needs our help - a feral waiting for adoption or starvation - whose love we can share to move forward in our lives - every kitty cuter and more adorable than next ~ and it is only through this knowledge that I have relived ~ to be a proud owner of two new cats - learning to cope with loss and grief and growing to relish life when it is - and looking for new life when it is gone!

36 comments:

HRH Yao-Lin said...

That is fantastic post. I am sure Suz will find it really helpful and really comforting.

Chairman Mao said...

What an eksellent post. You sound like a kind and kompassionate kitty doctor. Thanks fur bein' one of our special beans on the blogosphere!

Kittyhugs and purrs from MaoMao!

Suzanne said...

omer, thank you so much. i'm sorry i thought you were a kitty doctor, instead of a bean doctor. whoever you doctor, your compassionate heart is appreciated.

thank you thank you...it's good to have you here!

love
--suz
mama toni

Monica said...

Omer, that was very good information and specific to cats. Thank you for helping Suzanne out. You and Daisy could team up for some cat health conferences or something.

On another topic, Tracy and Denis (my people) are also in healthcare. Where do you work and live? We are all very curious because you seem to have some connection with a zoo as well.

The cat that came before us died of kidney failure so Tracy also knows what it is like to lose a kitty friend. I hope that Phoebe and I will live nice long lives like Suzanne has.

Caesar and Princess said...

We really enjoyed this.
Every life comes with that little bit of fine print... that we don't like to think about or read.
No one knows when the last day will be except God.

We did not know you were a Doc.
Cool.

We were just diagnosed with Kidney disease two weeks ago. we are 16

*~Princess

DaisyMae Maus said...

Thanks for doin' all of that research for my Cousin Suzanne. I'm sure that she (and efurryone else) appreciates the information!

A number of Feline Americans have had this insidious disease and a couple succumbed to it.

It is our hope that Suzanne lives for many more healthy years with the help of the tips that you've provided.

Your expertise is invaluable.
DMM

Miss Peach>(^,^) said...

Oh my how you have touched my furrry heart with your post about kidney problems Omer...
Like my sister Suz, I am also suffering from this right now, and Caesar & Princess. Mombean just takes life with me one day at a time...each a precious gift from above.
You have a kind and compassionate heart and I know Suz has been touched by your careing way. Your words about what happens after are so true, a new furry life waits its turn for love. This is how I came to my mom.
You are very brave to do the work of a bean doctor. You see so much and it must often break your heart when you are not able to help someone in need. This world can be a very hard cold place, discouraging many days. Sometimes there is a brightness that appears at the horizon...it is called, hope, love and compassion. I think if you look up the definition of those terms....it would say...See Omer
Luf Miss Peach with a clean washed face>(^,^)<

Lux said...

Thank you for posting this; it's very informative and you explained it all in a very understandable way.

Plus you seem nice. :)

Eric and Flynn said...

This is an excellent and informative post. Over the years I have had several cats eventually succumb to renal failure. They were all between the ages of 18 and 24, and it unfortunately seems that a cat's kidneys cannot remain effective if the cat has a long life. I once worked for a vet and was able to inject them to prolong their life.However the injections would initially be at 3 monthly intervals and would eventually need to be given twice weekly. When this happened, I knew my beloved pets would not be with me much longer.
We can only do so much for them in this way, but we can give them all our love for the good memories they will leave us with.

Parker said...

What a wonderful post. Thank you for educating us and for being so compassionate toward our lovely Suzanne and her Mommy!
Purrs!

Diamond said...

It is good to see all this useful information. Thank you for posting it.

Big Piney Woods Cats said...

Wonderful post. How nice of you to help and give all that information.

CalicoMom Toni

Daisy said...

Thanks for sharing this information with us. You must be very busy being a real bean doctor! My Mommie said that she lost one of her cats to renal failure many years ago.

Karen Jo said...

Thank you for such an informative post. I'm sure that the information has helped Suzanne and many other kitties. Your love and compassion really shine through.

Dragonheart said...

Omer, thank you for sharing your knowledge and experience with us.

You sound like a good doctor - very caring and compassionate!

Oscar the Puppy Cat said...

Wow! All I can say is, WOW! What a wonderful post. I've learned so much about many things on your site. This last post was very helpful for me as Oscar is getting up there in his years. Thank you!
Kim (Mommy to Oscar the Puppy Cat)

The Cat Realm said...

Thank you so much for this wonderful post! We were wondering what is wrong with Suzanne.
Our maid told us she lost a former employer to kidney disease which was very sad.
But he came back (reincarnated, she said) in the form of a wonderful kitten only a few weeks afterwards so that his companion didn't need to be alone.
We are sending all our best to Suzanne and her Mom.

claude said...

Dear Omer,
First, thank you for helping me better understand this disease. My Claudie is in the last stages. My Vet says I'll know when it is time to let go---but I don't. All I know is I am so sad. It is so very hard. I'm crying through this note.
Much love to all Moms and Dads in pain.

Bev

sbuffa said...

My kitty was diagnosed yesterday with advanced renal disease. I can not seem to stop crying. She turned 17 on July 20th. She is my heart.....I feel like such a terrible mom....I can not believe that I didn't notice the signs earlier. It bothers me so much that my heart pains thinking about it. She has an appetite, drinks a lot of water, paces, walks very slowly and has lost some of her vision. Her blood pressure is 230 and the doctor gave her some tablets to control that...but she refuses to take them. I am waiting for the liquid form to arrive in the mail. I asked the doctor how much longer does she have to live and he only told me she doesn't appear to be in pain. I do not want her to suffer, but also do not want to put her to sleep. I can not sleep or stop thinking about this. It is comforting to know that I am not alone with this problem.

Anonymous said...

Thank you for the wonderful compassionate words of wisdom. My 16 yr old cat was diagnosed with Renal failure last week, one vet suggested Euthanasia which I am having a hard time in making that decision. I am an I.C.U. R.N..yet I find myself in denial with my cat, it was great to read your gentle words of compassion. My cat is still here but for how long no one knows..I just don't want her to suffer. So I am unsure of what to do.

Anonymous said...

You are going thru the exact same thing as I am, my cat is 16 and was diagnosed with advanced, acute renal failure. He seemed so healthy and this came on so quickly. It is difficult to know what to do as I have been told to have him euthanised but I just can't agree with that at this time. i am hoping someone out there such as a vet can offer words of wisdom, can the cat survivie for a few months, what other treatment is available. They did I.V therapy for 3 days and then said it made no difference in the lab values...any words of wisdom???

Ailurophile said...

@ Anonymous

It depends upon the stage of renal failure and the particular health condition of each kitty. Still there are treatment alternatives available even in advanced stages of the disease, include kidney transplant - an expensive but curative option. For more visit felinecrf.com

Sorry for my belated reply.

Anonymous said...

as my cat is dying on my lap from renal failure as I type this..I googled and this message/blog came up which made me a little less sad. Animals are sometimes better than any other human friend you can have.

Anonymous said...

:-)

Anonymous said...

My 16 year old cat was diagnosed with chronic renal failure about a or so ago. We were giving him fluids twice a week and now once a day. The vet told me I'd know when it was time to let go too, but I'm not sure. I can't make him stay and suffer, but how do I take him to be put to sleep? I don't know that I can sit here and watch him get worse before letting him go though. I just wish he could tell me when it's time.
~Heather

Anonymous said...

^ a month or so ago, sorry.

Anonymous said...

I have just lost a cat to renal failure. She was 20 and diagnosed eight months ago. I can tell you that what extended her life and quality of life - along with her own will to live - was administration at home of Sub-Q fluids. For the past month it has been daily administration. Also found that in last few weeks the only food she would eat was A.D or MedCal high protein. less than ideal for her, but high taste appeal and she needed the calories. She enjoyed a lovely final summer and fall. When her last day came it was clear that euthanasia was the right option. Her battle had been heroic, she deserved the peaceful closure that only the vet could give her.

Anonymous said...

God Bless all the cats out there!! I lost my cat in November. He was such a joy, I miss him dearly. You are all very compassionate. I can relate to all of you.

Anonymous said...

I am in the same boat. I'm trying to keep my little guy alive despite the cost. He needs an ultrasound now. You can donate at

http://www.giveforward.com/mariosultrasound

even if it's a couple bucks, it will help
thanks
mario

Anonymous said...

I am sitting here today waiting to take my 19 yo named Tiger to the vet today. He has gone down so much in the past few days and I am sure I will have to make a decision today....I am so dreading the invetiable.....I will miss you Tiger...one of the best darns cats anyone could ever hope for.

Greta said...

What a wonderful compassionate article. Thank you so much for posting this. I lost my beautiful black cat, Bruno to CRF just after his third birthday which was at Halloween 2010. I hope that one day there is a cure for this terrible affliction. Bruno was a rescue cat who had been ill treated by his previous owners and had actually been taken by them to be put to sleep at only 8 months old. The vet phoned the animal charity to come and take him and he came home with us shortly after and we had him for just over two fantastic and joy filled years. From him taking ill, he only lasted 3 weeks to the day. Everything was tried, drug and holistic therapies, faith healing, Reiki, (the lot) but in the end nothing could be done. I miss him every day and now one of the other cats Charlene who is very old (about 18) has it as well but it is being controlled with Benazecare. She has gone partially blind due to high blood pressure, (also thankfully under control) and has regular vet checks. As I write this, I am thinking of Tiger from the previous post. I hope something could be done to help him survive. God bless and keep safe all our precious companions and give comfort and strength to all their carers. Also bless all of our departed angels. I pray that a cure for CRF be found soon. With love to you all..........Greta xx

Anonymous said...

My precious Platinum Tonkinese Sasha was just diagnosed with CRF this past Friday. I left her overnight with the encouragement of my vet that hopefully after being on fluids overnight her symptoms would improve. I was told that with the proper treatment Sasha could possibly live another year or more. Being the kitty lover that I have always been and not wanting to let Sasha go without a fight, I agreed that I would do whatever necessary to give Sasha as much more time as I could. Regretfully I made the wrong choice. I brought Sasha home Saturday with the hope that her symptoms would inprove with proper care and treatment, however she had a severe seizure late Saturday night and I knew that I had to let her go. I am 45 years old and have never in my life experienced seeing an animal have a seizure, it tore my heart out. It killed me to have to let her go but I knew in my heart that I was doing the right thing by letting her go. As so many of you have mentioned, I loved her too much to watch her suffer any longer. If I had known on Friday how severe her CRF actually was, and that I would be bringing her home and dealing with the possibility of her having such violent seizures, I would have made the choice to let her go that very day. Sasha was 17 years old, I was blessed to be able to have her in my life for 15 beautiful years of those 17. For those of you who have kitties that have been diagnosed with CRF or for those of you who may one day be faced with caring for a kitty with CRF, I pray that you have a much better experience and that you have the joy of enjoying a little more time with your kitty than what I had with my precious Sasha. XOXO Kim

Anonymous said...

I have just lost my beautiful18 year old cat Melody today . She was a hypothyroid cat and was diagnosed with serious renal failure. Your article has given me a sense of peace,Thank you.

Anonymous said...

My cat was diagnosed yesterday. I was told it was pretty bad. I havent stopped crying since then. He shows signs of improvement, but I know they are fleating. I have had him for 16 years and having a hard time deciding what to do. I will go in for fluids Friday and see how he does this weekend. I figure he should at least enjoy his last weekend in the sun. I will be a mess on Monday.

Ward Johnson said...

I had a Tonkinese seal point for nearly 15 years who was taken by CRF. I took him to the vet and they administered dialysis but it didn't help. His fur was always damp and moist. I would hold him close to me and he would purr then, assuring me that he acknowledged my love and care. Finally it was time to put him down. I left the shelter after they gave him one injection and cried harder than I ever cried at a human funeral. A year or two later, I obtained a Tonkinese Champagne Mink, another male. He and I are not as close as the first one was. But he has tried. God bless his little heart. Because I see his weakening body, his wet furr, his questioning looks of why me daddy? I hold him close and in my lap. He lies there almost motionless. He'll give me that look of what did I do? He would never bed down with me until recently. Almost as to say,"I am afraid daddy." I hold him close and treads upon my hands. He yowels real loud lately. Almost like a child in pain and it just kills me inside to hear this yowel. I don't know about putting him through dialysis like the first one. Nor do I care to euthanize him as I did the first one. I think I will hold on until the last moment by his side as his soul mate and human daddy until the good Lord calls him home. It's so sad to experience the passing of a great friend and pet like one of these Tonkinese felines truly are. They are everything you read about. Almost like the star of the movie years ago called, "That Darn Cat." His name is Quixote, like Don Quixote, the lover. I will love him forever and ever.

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