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Kidney disease in a cat.

Species: Cat
Breed: black and white mixe
Age: 8-11 years
First of all I am asking you because I am under extreme financial constraints right now and do not have enough money to take my cat to her regular vet. My cat was diagnosed with CRF about 6 months ago and was responding well to sub-q fluids which I have been administering at home. I just returned from about a month long work trip to find that she has lost a lot of weight. She also seems dehydrated when I do the skin test. She is still eating and drinking and somewhat active-though less than normal. She also seems to be loosing muscle. I called to ask my regular vet if I should increase her fluids to help her dehydration but she said she would not recommend anything until she gets another blood test -which here in New York is $300 total. So I am in a bind because I can not afford the test and do not have any idea what to do. I can't afford to continue the testing since Ive already spend a lot on this. I love my cat and would do anything for her so its a very difficult position to be in. Isn't CRF a degenerative disease, meaning she will never get better? What do you do when the disease progresses? Last time my vet recommend I hospitalize her which would have been about $2000 and completely out of my means. I feel I am in a very difficult place right now. So I guess my question is should I continue the fluids, or at this point in the disease are they harming her? Before I was giving 10ml every few days, and the past 5 days I have been giving her 10ml every day. Any advice you have would be greatly appreciated. Thank you so much

Online vet, Dr. Marie

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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Disclaimer: Although Dr. Marie is a qualified veterinarian, the information found on this site is not meant to replace the advice of your own veterinarian. and Dr. Marie do not accept any responsibility for any loss, damage, injury, death, or disease which may arise from reliance on information contained on this site. Do not use information found on this site for diagnosing or treating your pet. Anything you read here is for information only.

Customer reply:

Thank you so much for your reply. It has given me some things to think about, and I think that for now I will just continue the same dosage (which is 100ml- my mistake) since I think she is still doing pretty good compared to how she could be doing. If I can afford to take her to the vet later on for the tests again I will do that but Im just not sure what new information we are going to come up with since I know its just a matter of time before her kidneys shut down. This is my first pet of my own that I have had to go through this with and it is very difficult. Thank you for your help and kind words. It has made me feel a lot better and certain that Im doing all I can given my circumstances.

Online vet, Dr. Marie

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.

Customer reply:

Thank you, one more thing I forgot to ask or maybe wasn't entirely clear- can it actually harm her to give her fluids when she is in an advanced stage or is it typically when she stops eating that I should discontinue the fluids? It seems as though her body is still absorbing them okay but I worry about harming her with them if she cant absorb them

Online vet, 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.

Customer reply:

It does, thank you so much again. You have been more than helpful

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Dr. MarieDr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.

Is an online vet visit just as good as a trip to your veterinarian? No! But, many times, asking an online veterinarian a question can help save you money. While Dr. Marie can't officially diagnose your pet or prescribe medications, she can often advise you on whether a vet visit is necessary. You can also ask Dr. Marie for a second opinion on your pet's condition.