Stage 4 kidney disease in a cat

Redo91

Hi all. Got the sickening news today that our 5 year old cat has stage 4 kidney disease. I’ll go into more detail below but before I lose people’s attention I just wanted to hear people’s experiences with cats with stage 4 kidney disease and if are there any positive stories as the prognosis seems fairly bleak. The vet said they were going to do a test on his urine to stage the disease but as there was no protein in his urine they wouldn’t get a result so they ran a type of blood test. They said his creatinine (not sure about spelling) suggested level 2 or 3 but to get the reading they had to add it to another value and it turns out he is just about stage 4. They said they will take him off the drip tomorrow and he can come home. They will do bloods on Monday again to see how he is responding but they think it could be a matter of days before his kidneys fail and best case scenario he could go 3/4 weeks without needing a drip. The vets are fantastic so not doubting them but just clutching for some positivity. Also if there are any important questions I should be asking tomorrow please let me know. Any help would so appreciated.

This is the long version of what happened in case there are any key details I’m leaving out:

First noticed he wasn’t himself on Thursday the 24th September. He then didn’t eat on the Friday or Saturday. I was very concerned by the Sunday so I brought him in to an after hours vets. He was tender near his hind legs so they thought he might have an injury there. They gave him anti inflammatories and pain relief and said if he wasn’t eating tomorrow to come back. He wasn’t so I came back the following evening. The vet put him on a drip and said he would hopefully be eating after 24/48 hours. He ate a tiny amount that evening but they expected him to be eating more so they ran bloods the following morning.

They said the bloods showed significant damage to the kidneys. His creatinine reading was so high the machine couldn’t read it. His urea was also high. I went in to see him the next day and he could only open one eye. They said they ran bloods the next day (Thursday) which was 48 hours after the first set of bloods. They said if he didn’t show improvement there wasn’t much they could do. To their amazement his creatinine had almost normalised and his urea had come down but was still high. They noticed his protein was low. They did a scan of his kidneys and intestines. They said the kidneys were small but the structure looked good. There was significant damage to his intestines which explained the low protein. He was passing very liquid diarrhoea with blood and intestinal lining. They started giving him paste to help build up his stomach and a drip to stop the diarrhoea.

They ran bloods again the following day (last Friday) which showed not much change. They had hoped to see his protein to go up as they were supplementing it. I went to see him that evening and he seemed brighter. He was eating very little at this stage even though they were giving him appetite stimulants. A different vet on call saw him on Saturday and was very concerned he wasn’t showing much improvement. He suggested euthanasia at that stage but I went to the clinic and spoke to a different vet and we agreed to see how he was on Monday. He seemed brighter than the day before. I went to see him Sunday and had shown even more improvement. He had eaten a significant amount of food (including nuts) even though he was no longer on the appetite stimulant and wasn’t passing blood or intestinal fluid in his diarrhoea.

His appetite was good also on Monday. They took bloods yesterday. His protein had now normalised (probably as he was no longer losing blood). They said his urea had come down very little. His creatinine had gone up slightly. At this stage he was on the drip for his kidneys over a week so they said they were not going to improve much more. As I mentioned above they wanted to stage the kidney disease (they anticipated he was around stage 3) and said he could come home once the diarrhoea had stopped (hoped by Friday).

They rang this morning to say they would do the blood test to stage the disease and the diarrhoea could take weeks to stop due to the damage to the intestines they would let him home even if it didn’t stop due to the cost and unfairness to him of keeping him in that long.

It was this afternoon that they rang with the diagnosis and bad prognosis.

Thanks if you persevered by reading this long. Just wondering is there any glimmer of positivity in the above? Is the fact he is borderline any help? His appetite is good at the minute.

Any advice would be much appreciated. Or if you have any questions please ask.

tk123

I lost a cat to it - was too late when he showed symptoms and similar to your poor cat. They kept him in on fluids and I took him home on a Saturday, made the appointment on the Monday as he was so miserable. I then lost my retriever at Christmas just gone. She was stage 2-3 when diagnosed and otherwise clinically fine. It was 6 months to the day of diagnosis to me letting her go.

It’s a tough one OP and I really feel for you. With Lucy I had made the decision to stop and not wait for her to get any worse but unfortunately she deteriorated as I had been warned - like galavanting around with a ball Christmas eve and just over night things changed. On one hand I think she helped cement the decision for me - I think if I had let her go on the morning of Christmas Eve I would have had some what-ifs. There was no doubt in my mind when we let her go that it was the right thing to do. She was still there if it makes sense - cuddling into me to the end.

Redo91

tk123 wrote: »

I lost a cat to it - was too late when he showed symptoms and similar to your poor cat. They kept him in on fluids and I took him home on a Saturday, made the appointment on the Monday as he was so miserable. I then lost my retriever at Christmas just gone. She was stage 2-3 when diagnosed and otherwise clinically fine. It was 6 months to the day of diagnosis to me letting her go.

It’s a tough one OP and I really feel for you. With Lucy I had made the decision to stop and not wait for her to get any worse but unfortunately she deteriorated as I had been warned - like galavanting around with a ball Christmas eve and just over night things changed. On one hand I think she helped cement the decision for me - I think if I had let her go on the morning of Christmas Eve I would have had some what-ifs. There was no doubt in my mind when we let her go that it was the right thing to do. She was still there if it makes sense - cuddling into me to the end.

God that’s really tough to lose two pets to it. I’m sorry to hear. Ya it’s a hard one to take. I came across a Facebook group (think it was recommended on here) that dealt with renal failure in pets. Some cats lived for a few years with it but not sure what sort of treatments they were on.

tk123

I found the FB groups upsetting and ended up muting them From what my vet said cats can cope for a lot longer with kidney disease but once it advances there’s just too much damage done. We did fluids at home for a good while so she was basically on dialysis and coped well but in the end she just deteriorated over night. The vet had warned me from day one it wasn’t normal for a dog with her blood levels to look and act so well and she could just suddenly go downhill like that.

Redo91

tk123 wrote: »

I found the FB groups upsetting and ended up muting them From what my vet said cats can cope for a lot longer with kidney disease but once it advances there’s just too much damage done. We did fluids at home for a good while so she was basically on dialysis and coped well but in the end she just deteriorated over night. The vet had warned me from day one it wasn’t normal for a dog with her blood levels to look and act so well and she could just suddenly go downhill like that.

Ya some of the posts on those groups give you hope but then you have to take them with a pinch of salt. Don’t want to give myself false hope either.

bb12

i had a dog diagnosed with kidney disease once. he had suddenly started losing a lot of weight. i did research online and took him off protein. used to cook him potatoes and pasta for dinner each night along with some butter and supplemented with fish oil. he put the weight all back on, was lively and doing good for about 4 months until he started losing weight again. i presumed it was the kidneys again so back to the vets for more bloods. his creatine levels had actually improved slightly which was surprising but he was diagnosed with lung cancer and that got him within days. still though i guess if you catch the kidney problems early enough there is hope of halting it but i know that;s difficult as in a lot of cases it's too late once they start showing symptoms.

Graces7

Heart with you .

I lost my dog and one of my oldest cats the same weekend a while ago, and it is a terrible thing. I was shell shocked.

My far- away family ORDERED me to go and find three more cats; not to replace them as that can never be, but to honour them

Enter Oliver, Selkie and Bella; street rescues.

It was a healing. Passing the loving on to those in such need of it.

Alun

So sorry to hear about your poor little cat, I lost a cat to kidney disease last year myself.

One thing though, kidney disease in cats is generally a chronic condition that older cats get and is purely down to the degeneration of the kidneys due to age and has no underlying cause. It usually comes on quite gradually.

It's less common in younger cats like yours, and if it comes on suddenly like that as an acute rather than chronic condition, it often has an underlying cause. Poisoning of some sort is a common one, and what you said about the bloody diarrhea and intestinal damage makes me suspicious. It doesn't have to have been something like that poison, it could be antifreeze, certain plants, even the pollen from lillies can cause it.

Redo91

bb12 wrote: »

i had a dog diagnosed with kidney disease once. he had suddenly started losing a lot of weight. i did research online and took him off protein. used to cook him potatoes and pasta for dinner each night along with some butter and supplemented with fish oil. he put the weight all back on, was lively and doing good for about 4 months until he started losing weight again. i presumed it was the kidneys again so back to the vets for more bloods. his creatine levels had actually improved slightly which was surprising but he was diagnosed with lung cancer and that got him within days. still though i guess if you catch the kidney problems early enough there is hope of halting it but i know that;s difficult as in a lot of cases it's too late once they start showing symptoms.

Amazing that his levels had gone down. If his could even stay as they were for a while I’d be happy.

Redo91

Graces7 wrote: »

Heart with you .

I lost my dog and one of my oldest cats the same weekend a while ago, and it is a terrible thing. I was shell shocked.

My far- away family ORDERED me to go and find three more cats; not to replace them as that can never be, but to honour them

Enter Oliver, Selkie and Bella; street rescues.

It was a healing. Passing the loving on to those in such need of it.

Oh Jesus in the same weekend?! That’s awful. Ya that’s a good idea. My cat is a rescue cat too. Awful to think what people do to them.

Redo91

Alun wrote: »

So sorry to hear about your poor little cat, I lost a cat to kidney disease last year myself.

One thing though, kidney disease in cats is generally a chronic condition that older cats get and is purely down to the degeneration of the kidneys due to age and has no underlying cause. It usually comes on quite gradually.

It's less common in younger cats like yours, and if it comes on suddenly like that as an acute rather than chronic condition, it often has an underlying cause. Poisoning of some sort is a common one, and what you said about the bloody diarrhea and intestinal damage makes me suspicious. It doesn't have to have been something like that poison, it could be antifreeze, certain plants, even the pollen from lillies can cause it.

Sorry to hear about your cat. Ya they are fairly confident it was poisoning based on his age and the fact it came on so quick. Wish we could know what he ate but I know it’s impossible to determine.

Graces7

Redo91 wrote: »

Oh Jesus in the same weekend?! That’s awful. Ya that’s a good idea. My cat is a rescue cat too. Awful to think what people do to them.

Yep; my neighbours dug a grave for my dog then I found Beata at death's door the same day. So I opened the grave.

My family had the right idea. These are youngsters and utterly devoted.

Just hang on in there with yours. With you in heart as all here are.

Mollyb60

My cat was diagnosed with KD in May there. We noticed her back legs starting to give out when she was walking so we took her into the vet who said her creatinine and urea levels were off the charts too. They kept her in for a few days to rehydrate her and get the levels down which thankfully worked.

Oddly enough the vet has never actually told us what stage she's at but he said 2/3's of her liver function is gone. I'm assuming she's stage 2 or 3. She's now on a little tablet to increase blood flow to the kidneys and we're taking her in for booster shots and appetite enhancers every 6 weeks. She's doing well and eating well so we're happy enough. It was a devastating diagnosis for us though because the rescue center told us she was 5 when we got her. Our vet actually thinks she's 5 years older than that so therefore the diagnosis is less shocking as she's actually an elderly cat. He's told us to watch her eating closely and if she goes off her food that's a major sign of things going downhill so she's watched like a hawk now at meal times.

I'm so sorry that this has happened to your little kitty. Fingers crossed it works out ok for him.

Redo91

Mollyb60 wrote: »

My cat was diagnosed with KD in May there. We noticed her back legs starting to give out when she was walking so we took her into the vet who said her creatinine and urea levels were off the charts too. They kept her in for a few days to rehydrate her and get the levels down which thankfully worked.

Oddly enough the vet has never actually told us what stage she's at but he said 2/3's of her liver function is gone. I'm assuming she's stage 2 or 3. She's now on a little tablet to increase blood flow to the kidneys and we're taking her in for booster shots and appetite enhancers every 6 weeks. She's doing well and eating well so we're happy enough. It was a devastating diagnosis for us though because the rescue center told us she was 5 when we got her. Our vet actually thinks she's 5 years older than that so therefore the diagnosis is less shocking as she's actually an elderly cat. He's told us to watch her eating closely and if she goes off her food that's a major sign of things going downhill so she's watched like a hawk now at meal times.

I'm so sorry that this has happened to your little kitty. Fingers crossed it works out ok for him.

That’s great that she is responding well. Do you know did her creatinine and urea levels normalise after the drip or just come down? Ya I’m going to have to keep an eye on his eating. He’s home now on special kidney friendly food (low in phosphorous). He’s drinking plenty and grooming which is a good sign I guess. Eating well too. I realise this can all change very quickly though.

Alun

Not to put a damper on things, but IMO creatinine and urea levels can sometimes drop significantly after a drip or "backpack" rehydration but jump back up soon afterwards. That's for chronic KD anyway. Maybe in cases of acute KD, once the cause of it is treated the kidneys might recover a bit, or at least stabilize, I don't know.

On that subject, did the vet do anything at the time to attempt to counteract the effects of whatever poison it was? I'm thinking something to make him vomit and give him activated charcoal? You have to do that pretty quickly after ingesting it to stand a chance of making much difference though.

By the way, drinking is good, but depending on how much "plenty" is, it could also be a warning sign.

tk123

Alun wrote: »

Not to put a damper on things, but IMO creatinine and urea levels can sometimes drop significantly after a drip or "backpack" rehydration but jump back up soon afterwards. That's for chronic KD anyway. Maybe in cases of acute KD, once the cause of it is treated the kidneys might recover a bit, or at least stabilize, I don't know.

We had them drop once for Lucy. They gradually climbed each test after that. For her the fluids managed her symptoms quite well. I'll never forget that **gulp**:eek: feeling when the nurse was showing me how to do it and walked in with the bag on the stand and me putting the needle in the first time etc etc.

Mollyb60

Redo91 wrote: »

That’s great that she is responding well. Do you know did her creatinine and urea levels normalise after the drip or just come down? Ya I’m going to have to keep an eye on his eating. He’s home now on special kidney friendly food (low in phosphorous). He’s drinking plenty and grooming which is a good sign I guess. Eating well too. I realise this can all change very quickly though.

Yeah it was the IV fluids that got the levels to drop originally. We brought her back for a check up 2 weeks later and they had gone back up which is why she was put on the medication. They have reduced on their own since we've got her on the tablet.

Alun wrote: »

Not to put a damper on things, but IMO creatinine and urea levels can sometimes drop significantly after a drip or "backpack" rehydration but jump back up soon afterwards. That's for chronic KD anyway. Maybe in cases of acute KD, once the cause of it is treated the kidneys might recover a bit, or at least stabilize, I don't know.

By the way, drinking is good, but depending on how much "plenty" is, it could also be a warning sign.

This is exactly what happened with our cat so the vet knew then it was chronic KD rather than acute and needed management. How much water she drank was the first question the vet asked us when we presented with her. Our answer was that she was always a thirsty cat and had been since we first got her so it was nothing out of the ordinary for us. But it's usually the strongest indicator that something's wrong with the kidneys.

Redo91

Alun wrote: »

Not to put a damper on things, but IMO creatinine and urea levels can sometimes drop significantly after a drip or "backpack" rehydration but jump back up soon afterwards. That's for chronic KD anyway. Maybe in cases of acute KD, once the cause of it is treated the kidneys might recover a bit, or at least stabilize, I don't know.

On that subject, did the vet do anything at the time to attempt to counteract the effects of whatever poison it was? I'm thinking something to make him vomit and give him activated charcoal? You have to do that pretty quickly after ingesting it to stand a chance of making much difference though.

By the way, drinking is good, but depending on how much "plenty" is, it could also be a warning sign.

Ya that’s the fear alright. Not sure. They had him in so many different things so was hard to keep track. Initially they narrowed the three causes down to poisoning, feline aids or feline leukaemia. Based on how he responded to his treatment they could narrow it down to poisoning.

Ya he’s not gulping it down but drinking a decent bit. But a few times I’ve tried to push the bowl towards him and he hasn’t gone near it. He’s eating lots of the kidney care nuts. The punches he seems to lick the jelly off and then eat the chunks later.

Redo91

Mollyb60 wrote: »

Yeah it was the IV fluids that got the levels to drop originally. We brought her back for a check up 2 weeks later and they had gone back up which is why she was put on the medication. They have reduced on their own since we've got her on the tablet.

Do you mind me asking what medication reduced her levels?

Mollyb60

It's called Benazecare 5mg. We're giving her half a tablet a day.

Redo91

Mollyb60 wrote: »

It's called Benazecare 5mg. We're giving her half a tablet a day.

Thanks very much. Much appreciated.

Graces7

When I lost my lovely Pandora, it was heading for 30 years ago and the only vet advice was not to give her protein, eg boil rice with liver then remove the liver. Then they said let her eat what she wants. We all knew she was failing

I n those days ... "dolpol"; ie drink a lot, pee a lot.

Stay strong. With you in heart and prayer .

Redo91

Mollyb60 wrote: »

It's called Benazecare 5mg. We're giving her half a tablet a day.

Mentioned this to the vet but they said as my cat is not losing any protein through his urine this medication would serve no purpose.

Mollyb60

Redo91 wrote: »

Mentioned this to the vet but they said as my cat is not losing any protein through his urine this medication would serve no purpose.

Ah well, worth a check anyway. Fingers crossed you can get a treatment to help him out.