I just lost my Himalayan on Nov 2006 -- now my 15-year old tuxedo kitty has just been diagnosed with kidney failure.
I don't know how to do this.

Little Girl's last days were a nightmare of needles, pain and fright for her. Her last night was spent alone in a vet hosptial. I will not do this to my Smooshy. Right now, she won't eat very much, is thin and experience some stomach problems -- hear her making what sounds like mild regurgitating sounds, swallows, etc. But otherwise, she's okay.

What do I do?!
I can't bring her to be put down right now -- she's not THAT sick yet -- I can't make that decision. I DON"T WANT TO MAKE THAT DECISION AGAIN. Felt like I "played God" when I had LG put down.

A part of me can hardly bear to look at Smoosh -- another part of me wants to quit my job and stay with her every second of the time I left with her.

They say "You'll know" when it's time to make that decision.
But I don't.
Is she miserable now?
Does she want to live?
Should I take her for second opinions, subject her to IV treatment/hospitalization etc do all I can to prolong her life?
Do I let her just slowly decline here?

Anyone been thru this before?
I just don't know what to do.

Kim,

Stay calm, it's not the end of the road, my Denis had renal failure yet managed to carry on for quite a while with the aid of medication, in fact apart from the daily tablet you would have thought there was nothing wrong with him.

Kidney disease can be managed quite successfully either through the conventional route or by other routes.

Has you had any blood work done yet? Once that has been done you can then start treatment to bring the levels down depending which areas need addressing. Unless she is seriously dehydrated you shouldn't need to do IV treatment. What has your vet said to you?

As I have said cats can go on a lead a normally life for a long time despite renal failure, the kidneys will never fully function normally without help but it is manageable and treatable. She will require regular check ups to check blood levels or wee tests, Denis would have a check up every 3 months just to make sure his blood levels were stable.

A lot of our feline friends here have had renal failure so I'm sure their Mums and Dads will also be able to give you a lot of advice and help to.

I'm sure once the levels start to respond she will start to eat a bit more and her stomach will settle down.

Anyway without knowing exactly what you vet has said I can't really offer any specific advice but renal failure does not mean that you have to think of letting her go.

My thoughts are with you.

Kim you are blessed to have EM's advice and it is very wise. Take all this one day at a time and don't panic. I am reassured with EM's advice that you have quality time left with your cat. I euthanized two and have so many more regrets for the cat that I euthanized too early than the one who suffered longer physically. My first cat was ready to go and at the vet's he reached for and touched my hand and seemed to be telling me don't worry, it's okay, I'm ready. My second cat was crying that he didn't want to go and I will always feel like I betrayed him. I posted (3hrs ago on topic Rollercoaster)info about an article that discusses euthanasia and that was the best article I ever found-it was proposed by furkidlets mom, who has been wonderful for all of us here

http://www.katberard.com/com_faq.htm

KimL

Oh I'm so sorry this is happening to you. E.M. gave great advise. I don't know what I can add, just want to let you know I'm thinking of you and your Smoosh.

Do try to remain calm, you do know, you will know, you can do it. Just love him while you have him as much as possible.

Love

We lost Misty to cancer a few weeks before Christmas. He had kidney failure for four years. We managed it with fluids at home for this entire time. He did great and seemed to enjoy life until this past fall. So there is hope.

Our vet also put him on Benzapril, which slows the progression of kidney failure...you may want to look into that.

Believe me, after some home fluids and potassium supplements, Little Girl may perk up.

Find a vet willing to give it a try. Misty only needed his twice a week, so his quality of life seemed great.......

Hope this helps....Misty's Mama

E.M. is right...don't panic, at least not yet! Nissa lived 6.5 years with kidney disease and it only became true "failure", technically, in the last 2 years, and even then, she still had plenty of spunk in her up until her blood pressure rose suddenly (one of my regrets...we SHOULD have been having that checked every once in awhile) in the last 6 months of her life. Many kidney cats get regular sub-cu. fluids at home, either done by yourself or by a vet tech who can come in and do them for you (for a fee, of course). For us, we didn't even have to do many, but this depends on many individual factors. Some cats are fine with them, others hate it, so you'd have to try and see. (this is different from an IV line at the vet's)

You'd do well to read through all or most of this site:
Tanya's UK Feline Chronic Kidney Failure Pages It's chock-full of info. If you prefer the more natural methods, as we did, there's even a separate section on some of those....although there are many more tricks of the trade that aren't listed there. There's also a Yahoo group which I found through Tanya's site somewhere, for those interested in natural stuff, though I didn't get a chance to use it much by the time I found it. And of course, a holistic vet helps, too, as diet considerations are all-important to managing disease of ANY sort. I don't (and neither did our 2 vets) believe in only using those commercial low-protein canned foods, as it's well known cats end up starving to death on them. We used MediCal (called something else in the US, but same company, same formula) as part of her diet only - it's a reduced protein diet, but not as low as most others, and they don't use the scrapings off the slaughterhouse floor for 'meat', as most others do. We also used both some homemade raw food diet, plus adding anywhere from 10-25% organic cream of white or brown rice to Nissa's high-quality (Wellness and others) canned food, and restricted her to only up to a Tbsp. of higher-quality (Wellness) dry food/day. I also finger-fed whenever necessary, as keeping up the weight is all-important.

For the stomach upset (probably acidosis; Nissa had acid reflux, too, in bouts, here and there), you can't beat Slippery Elm Bark Powder (also on Tanya's site), 'cooked' with pure water and dosed appropriately. It coats the mucous membranes throughout the body, so soothes things. (also good for diarrhea) It doesn't taste terrible, either, so is accepted quite nicely.

We also used many supplements, as per her docs intructions, and sometimes some western herbal preps. as well as trying some TCM herbs, which she didn't seem to take too well to. And of course, her mainstay - homeopathics. Accupuncture can also work 'magic' on kidney cats, but Nissa wasn't a "good candidate" for that, so we never tried it. Her daily Reiki treatments, both hands-on and distance also really made a big difference - Nissa LOVED energy healing (and many cats do)! I also tried a few other types through the years, as it seemed warranted to do so. There are really a plethora of methods to try with kidney disease, but you have to read, research, decide and see what's available where you are. The single most helpful thing for us was having holistic vets, as there is SO much more available than just allopathic management, though both may be needed at the same time. But you can't do all this on your own and need qualified help. We also used some colour therapy, crystals, flower essences, accupressure from me at home, and a few other things here and there, to see which ones made a difference. And there were STILL other things I'd never tried....and now wish I had...just in case. But one can't try everything, I suppose, so I'm mainly content that I did all that I did, at least.

It sounds and feels overwhelming, I know, and sometimes it was, but she was worth every second of effort to me and I only regret what I DIDN'T do, or try. There was also another article I'd posted on Quality of Life issues (in the Resources section, I believe), which is also worth reading, as it gave some pretty good things to look for to know 'when'. But for me, while I gauged such things all the time, I wasn't prepared to give up until it was OBVIOUS that she needed help to go. And I also know of plenty of cats who were helped through kidney "crashes" to go on and live a few more years or quality life, too, so even a "crash" isn't necessarily a death sentence. Luckily for us, this never happened. Nissa only crashed when it was her real time, and it was pretty sudden and acute. I never give up until there's NOTHING left that the docs and I know of that will help. We were probably less than a day away from her going on her own when we were able to get her help (at home), and this is how I personally think it should most often be, as this is also a matter of the soul being ready, in my opinion anyway. It helps them to cross most easily when their minds and bodies are truly ready, and their 'recovery' on the Other Side is faster that way. (google Elizabeth Severino's website for an article on the 'stages' the animals themselves taught her about dying and euthanasia) But we DID have remedies (and even drugs, tho we didn't end up using those) to address pain issues near the end, as that's all-important, too. Btw, Nissa was 13 when first diagnosed, and lived to be 19 yrs, 7 months, with all but the last 3 days being of high to okay quality of life. Many people can't even lay claim to that, when diseased, so I think we did pretty darn good.

Oh, and I meant to mention too, that kidney disease is quite a common thing for animals who are grieving to get. (the emotion associated with problems with the kidneys is fear, and grief can bring fears up, so it makes perfect sense) Nissa's came on mere weeks after we lost her brother, Sabin. This is also why I'd highly recommend finding a homeopathic vet, who can prescribe remedies that address both grief, fear AND the total 'picture' of the individual (known as "const*itutional" prescribing), as well as the physical manifestations of the disease patterns that THAT individual expresses as symptoms. Both of our vets practised homeopathy (and other things) and were both trained as "classic" homeopaths (those who believe in usually only ONE remedy at a time, and not combinations of remedies, tho there are sometimes exceptions, such as during or after surgery).

There is also this site, tho not as comprehensive as Tanya's:
Emma's Top 13 Weapons for CRF

Just another little piece of information, when you first look at all the medication and treatment possible for CRF it can all seem a little daunting, and will stress that not all of the treatments will be required, it all depends on what each individual patient requires to keep the kidneys functioning at their possible best.

Try not to be alarmed about the thought of home administering of sub-cu. fluids, you may find that in your individual cir%%stances that this is not needed, it all depends on whether they are drinking enough fluids naturally to flush out the kidneys or not. I cannot say whether you will need to do this or not, but don't take this to be blanket treatment for CRF. In fact we never had to do this with Denis, the only time he had IV treatment was at the very end when the kidneys failed completely.

I would also like to mention trying rehydration as an option ie electrolyte sachets as they can respond very well with these, and indeed after a brief spell of taking the electrolytes this can be enough to readdress the dehydration situation without any further treatment. But again, its all down to how the individual is.

Diet is hugely important factor in maintaining kidney quality and your vet will be able to advise you on this. No more treats I'm afraid.

It is possible that they could go on to develop hypertension, this does seem to go hand in hand with CRF (high blood pressure) at a later stage so this will have to me monitored at regular check ups but again this is easily treatable. But having said that, this may be a lot longer down the line or even not at all.

Potassium may be needed to keep these levels in check.

Unfortunately CRF is quite common in cats the older they get and some cats will need more care than others to manage the situation but even though it sounds as if it is fatal, it isn't, cats adapt well and go on to continue to live full and active lives despite impaired kidney function.

There is plenty of hope and plenty of things to try in order to get the condition under control, this is just the beginning and not the end. There is plenty of life left in Smoochy yet.

It is a big subject but with the advice of a good vet, help is at hand.

I hope some of this advice has helped ease you mind and allay some of your initial fears.

Take care.

E.M

E.M. is right. All the many things listed don't always apply to every cat; most didn't for Nissa. She was on potassium powder (veterinary), and to naturally increase her electrolytes, I added (organic) brown rice water to her wet food with each meal. (easy to make: 1 part org. uncooked brown rice to 5 parts purified water; let soak for 5-7 hrs. then strain off rice; pour into icecube trays and freeze; thaw one cube for use, keep refridgerated, and discard after 3 days if not used up) It worked VERY well for her, and may have been a factor in not having to give sub-cu. fluids very often. Even if not used, adding a bit of purified water to the food helps to add more fluids to their body as well, as kidney cats can't really drink enough water to make up for large losses of fluid, IF their condition is too far advanced, so it's good insurance. It also is a good idea to warm their wet food to at least room temp. over water on the stove (do NOT use the microwave if you can help it) and to provide warmth wherever possible as kidney cats tend towards chilliness. (Nissa had some heated gel pillows, the ones you use for aches and pains, which she loved)

Blood pressure is checked by a small animal blood pressure cuff and sensor that is usually taped to their 'arm'. We got lucky and had a surgical vet tech who was so good at it that she only used the tape if an animal was actually in surgery, which was good as it was the tape, not the cuff, that Nissa hated (seeing as it hurt to pull the tape off her fur, as one would expect). Her BP didn't skyrocket until her last 6 months...but if we'd caught it earlier, it wouldn't have done the damage it did, so it IS expedient to have this checked if their kidney function has decreased to a larger degree. She was showing some symptoms of hypertension, but neither of her docs put 2 and 2 together, and unfortunately, I didn't KNOW what the symptoms were (because I'd avoided reading that part in Tanya's site), so this was ALL of our fault that this happened to my girl. (I also didn't even know our local vet had gotten a blood pressure monitor herself since we'd last discussed it, as not all vets have them yet)

But yes, E.M. IS right - it's usually not an acute condition, but a chronic one that can be successfully managed for some time, so with some basic effort on your part, Smoochy may very likely have a long time with you still. I know I was panicked at first, too, but becoming aware of what to look for is also wise, so you'll be more prepared in case certain symptoms show up later. But there's also no substi*tute for remaining hopeful and positive about Smoochy's condition, as that can help almost as much as any health measures you take. Nissa proved to me this was true, God bless her.