Kidney disease in a cat.

Dr. Marie replied:

I'm so sorry to hear that Willow is possibly not doing well. I feel for you in your financial position. Cases like this are difficult and often the solution as to what to do to help is not totally clear. I'll see if I can answer your questions and help you to make some decisions.

You are right that chronic renal failure is not something that cats recover from. Now, there are some cats that can have acute kidney disease (i.e. if they got into something toxic) and cats can make a full recovery from that. But, when we see a cat with chronic renal disease, then the goal is to keep doing what we can to help for as long as we can, but eventually the kidneys do eventually shut down.

One of the best things that I have found we can do is to administer subcutaneous fluids and it is excellent that you can do that at home.

Are you sure that you are giving 10mL and not 100mL? 10 mL is not very much at all. That is the equivalent of 2 tsp of fluid. 100mL would be just under half a cup.

Now I can't legally advise you on dosages without actually seeing Willow in person. I can tell you that I will generally give my cats with renal disease at least 100 mL of fluid at a time. I might do this daily or I could do it every few days.

Ultimately, the only way to know if things are getting worse is, like your vet says to do some blood tests. But, really you are in a tough position. If things are getting worse then there are only a few options:

1. Try some hospitalization with IV fluids and see if that gives her a boost for a while. But as you mentioned, that is expensive. And, there are no guarantees.

2. Keep doing what we are doing until she is obviously uncomfortable. (I'll write more on this in a minute.)

3. Euthanasia.

So the question everyone asks when dealing with a cat with declining kidney disease is when to consider euthanasia. Here are some criteria that I use when making that decision:

-How is the cat's appetite? If she is not eating much at all then this is a sign that she is really not feeling well.
-Do you feel that she is enjoying life?
-Is she moving around much? Cats that are not feeling well will tend to just stay in one position for most of the day. Often they will hide away from people.
-What is your gut saying? If you are feeling sorry for her most of the time then it may be time to say goodbye.

The biggest factor in all of what I have mentioned above is her appetite.

I hope that helps with your decision making. Please let me know if you have more questions.

Dr. Marie.


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Dr. Marie replied:

Ah, good. I am glad to hear it is 100mL and not 10mL. 10 would not be very helpful at all!!!

If you can afford the tests, it can help with decision making. But if hospitalization is out of the question (which I totally understand), then the tests are not going to make her better.

Keep an eye on Willow's appetite. You will likely know in your heart when the time is right to make the hard decision.

I hope she does well for as long as possible!

Dr. Marie.

Dr. Marie replied:

This is a tough question to answer. In theory, yes, it is possible to give too much sub-Q fluid. It is very unlikely that that would happen at 100mL per day.

If an animal had too much subcutaneous fluids they could eventually end up with some pulmonary edema which means that fluid could build up in the lungs. Generally, though, in giving subcutaneous fluids it is very difficult to give a large enough amount that would cause fluid to build up in the lungs.

If for some reason you are seeing a clear discharge from the nose this could be a sign that an animal is getting too much fluid. I can't say I have ever seen that happen as a result of SQ fluids.

If she stops eating, I would not see that as an indication to stop the fluids. In fact, if she stops eating then this means she is taking in even less moisture and nutrients and so the fluids would be helpful. But if she stops eating for long periods of a time then we need to start thinking about euthanasia.

I hope that helps make things more clear.

Dr. Marie.