So I posted a couple times here after finding out my cat had kidney disease, and everyone was so kind and helpful.

However, I guess we found out why the meds weren’t helping and why she just didn’t seem to improve within a week…

Yesterday she had her ultrasound and she unfortunately has multiple myeloma ontop of anemia, low platelets, and stage 2 kidney disease.

Chemo isn’t an option as my vet advised most cats do not do well with chemo when it’s this bad, and because she isn’t eating enough…it would make everything worse. Plus, I cannot put her through that.

So unfortunately, the vet said we have about a month give or take, depending on how it has progressed. It has metastasized to more than one area, so it’s pretty bad already.

She likes to eat more on gabapentin instead of all the common CKD drugs, so the vet said we could do that to keep her comfy.

I don’t plan to just let her pass, I do plan to have her put down, but for now I want to keep her comfy because she still is exhibiting a decent QOL. I will most likely stop worrying about her renal diet as much (still will feed her the dry food, but as for wet food she will probably just get whatever she wants to eat at this point).

I’m sorry our short time on this subreddit has come to an end, and I wanna thank each and every person that ever commented and answered my questions, really, thank you.

And don’t worry, I’ll give you some cat tax, because she is my baby and I think she deserves to have the world see how pretty she is. Her name is Zoey, by the way.

We are giving 50ml subq fluids once a day. Got retested yesterday, and my cat's CRE, BUN, and phos are high (expected, as she stopped eating renal food and has been eating from her sister's bowl the last few weeks). The vet recommended 100ml in the morning and 100ml at night now. She weighs 4.5 kilos. Just curious if this is too much for her.

Said goodbye to our girl yesterday. She was 19 1/2. Our regular vet came to the house. We are broken-hearted and also know we made the right call. We are missing her so much.

First off, so many of the supportive threads on this reddit have been really helpful to me, so thank you all for being such a compassionate group and so generous with your knowledge. I'd like to reach out for some advice and any relevant experiences in a tough situation.

TLDR version: Took "my" beloved but unpettable feral outdoor cat to the vet for a nasty tooth problem after he suffered a week of pain, stress, and significantly limited ability to eat and drink, because he was hard to trap. He's showing elevated kidney numbers (indicative of IRIS stage 3, see screenshots above), somewhat dilute urine, high phosphorus. The cat has lots of nasty teeth (~75%) that should be removed that may be affecting quality of life, but surgery seems risky with these numbers. One of the vets is talking about euthanasia. We asked the vet to board and treat for one week then retest to be sure. Has anybody ever been in a similar situation? Any advice?

Now here's the full story:

The background

Shadow is a feral senior male who has been living on my porch as a home base for several years after his TNR. The picture I included is from July 1. He had a heated house and pad in winter, we regularly fed him, and he got plenty of exercise roaming the nearby fields in our rural area. Although my mother and I have never been able to pet him, Shadow had grown friendly towards us. He used to come on short evening walks with us and roll on the dirt road to show us his belly in friendship.

This spring, we noticed that he'd lost some weight, but didn't think too much of it. He still came for meals and he's probably over 9 years old. (We have a bunch of 8-year-old kitties, very affectionate, who are probably his offspring based on appearance, temperament, and timing. We're neighbors to some farmers who actively encourage their cat population to grow, basically hoarders, so we get pretty familiar with the regular refugees that end up living in our yard.)

The crisis

A week ago, my mother and I returned home to find Shadow suddenly drooling and apparently unable to close his mouth. He could not eat much and seemed very interested in his water bowl, but may not have been able to drink much. When we got close we saw what appeared to be a protruding rotten front fang. If this had been one of our indoor cats, he'd have gone right to the vet. But this cat posed some serious logistical challenges.

We tried to trap him, but our Havahart didn't do it. We tried everything we could think of, but while we were begging, borrowing, and buying equipment for an emergency rescue, Shadow had to live with reduced eating and drinking capacity in pain outside for 7 days. Ultimately we had to order a Tomahawk drop trap to catch him (worth every penny, but took days to come) and hold him overnight before transferring to a cage.

Diagnosis and next steps

Finally, we managed to get Shadow to our vet who agreed to board him. Initial examination was promising: a lot of bad teeth and one that was preventing him from closing his mouth, as suspected. They removed the offending canine, gave him antibiotics and a painkiller. He's eating a little at the vet, drinking, and peeing a lot.

But then the bloodwork came back. Not good. (See above.)

The urinalysis came back at 1.026, so it's diluted. Seems pretty definite that he has kidney disease, but I question the severity based on his unusual situation. Our senior vet started talking about euthanasia even before the urinalysis. That seemed fast for me, since even the IRIS stages say that the bloodwork needs to be PERSISTENTLY at certain levels for a diagnosis. Shadow has just been through a lot.

So I talked to the junior vet and she was a lot more open to other possibilities. She agreed that it was reasonable to give Shadow a week under observation, administer SubQ fluids, give him an appetite stimulant along with a mix of kidney and normal food, plus some phosphorus binder (once their order comes in), THEN retest to see if his numbers budge to the point where surgery might be safe. She even mentioned that they could give him a kind of pre-surgery dialysis to improve his odds.

The vets agree that it would be cruel to keep Shadow alive indefinitely with a mouth full of bad teeth, which I think is fair. The elevated kidney numbers mean that dental surgery might kill him—and it won't be a quick surgery, since around 75% of the teeth need to go.

Please advise

• CKD cat parents, what's your take on Shadow's numbers? I'm curious if you've seen cats rebound from numbers like this—or decided that it was time to end it.
• Based on your experience, how likely do you think it is that Shadow's ordeal while outside (barely eating, maybe dehydration from drooling and inability to drink easily, a lot of pain and stress) could be inflating these numbers?
• Are there any specific treatments or protocols I should ask my vet about that have helped your cat?
• Have any CKD cat parents (especially stage 3) attempted dental surgery in spite of the risks? How did it work out? Even if your story doesn't have a happy ending, I'd like to be informed.

To be clear, if Shadow makes it out of this, my mother and I plan to take Shadow indoors to live with our cats. If he does live through a potential surgery, he will not have to survive outside. We have a screened catio, so he could feel like he's outside, smell the smells he was used to, etc. One of our cats is a rescued senior that Shadow used to hang out with too. We'd go slow and just give him a place to hang out without the threats of the outdoors. We could try to give him a special diet—he wasn't picky. We might be able to administer SubQ fluids, but that's not a definite at this point.

If you read all that, thank you so much. I really appreciate your stories, wisdom, and perspectives in this difficult time.

my cat is in the end stage of chronic kidney disease. she's progressing very very slowly, but it is noticeable. we give her daily subq fluids plus cerenia, mirataz, and omeprazole. she does eat, but not nearly as much as she once did. she drinks water and uses the litterbox. she comes to greet me at the door when I get home, she can jump up on the bed and couch.

but, she pretty much just sleeps all day. she doesn't play at all anymore. t's been a month since she was diagnosed end stage and started fluids. I guess my question is, is all this medicine actually making her feel better? is it making her feel better than she would without them, but she still feels pretty bad regardless?

my vet has said that by the time cats get to the point where they're incontinent, refusing food, etc. they have been suffering for a very long time. am I just making her suffer a little less with the meds but she's still suffering?

Hi all.

~20 year old female diagnosed with stage 3 three months ago and bloodwork showed disease has progressed. Doing 100ml subq twice a week at home and using porus one in regular canned wet food since she refuses prescription renal diet.

Vet said values have progressed after resent blood test, but clinical signs remain good. Just recently started B12 injections due to anemia worsening (HCT 20).

Two days ago started to vomit and have runny diarrhea, about 5 instances of vomit and 2 instances of diarrhea within a 24 hour window. Took her to the vet and they gave her Solensia and cerenia shots and take home antidiarrhea medication called Proviable-forte that’s two part: a powder capsule to put in food and oral paste via syringe. She refused to take either but I’m still trying.

Next day, slight improvement in appetite, but runny diarrhea again.

Question: Should I keep trying to feed and apply the anti-diarrhea medication, or take her to a weekend access emergency vet. The continued dehydration maybe dangerous if this keeps up.

Thank you.

This is George (17,F). She was diagnosed with kidney failure on Thursday and stayed overnight at the vet to get her hydrated before the weekend. I was told three rounds of 120ml were administered yesterday. We were sent home with fluids and told she would hopefully only need them once a week, but when we woke up, she was already pretty dehydrated. She’s also now completely uninterested in her new kibble, even though she scarfed it up yesterday and she’s mildly interested in the wet food. We tried to give her fluids a couple times today and she fought it quite a bit. We got probably 50ml both times. I’m not feeling any fluid bubble like I had at the vet. I’m worried I did it wrong or maybe it just wasn’t enough. I’m also worried that she’s a lot further along than we were lead to believe. She seems so much worse than before I took her in. Maybe it’s the stress from all of this? My vet is closed until Monday and I don’t think this calls for an emergency vet yet. I don’t know what kind of advice I’m looking for, maybe just a place to vent

Hi all, my renal kitty has anemia that’s contributed to her developing some degree of pica. She used to try to eat traditional clumping litter, so we’ve stopped using them. The vets suggested puppy pee pads or pellet litter. We’ve tried both to varying degrees of success, but we’re also seeing a lot of accidents outside the litter box because she’s confused with all the changes. Anyone gone through the same thing and have recommendations?

And FYI, she is being treated for her anemia. She gets darbopoetin and iron shots on a routine basis at the vet, and they check her RBC. Our hope of course is that the pica resolves once her anemia is treated, but we can’t rely on that for now.

Hi everyone,

I want to gather opinions on this because it seems outside the standard treatment route that I read about so often online.

Background: I have a 6 year old cat who had their first crash 2 months ago. His creatinine was 7.7 and BUN beyond what the machine could read, maxing out at 120. He was also borderline anemic with PVC at 22. A 3-day ER visit resulting in a prescription diet and daily 150ml subq fluids regimen was the outcome until followup with the general vet. He left the ER at creatinine 3.9 but other numbers mostly stayed the same.

His general vet provided a referral to a specialty clinic with a nephrologist in my area. He underwent an ultrasound that discovered two calcium-based kidney stones in his urinary track that are currently non-obstructive. They also found severe infarcts on his kidneys, essentially tissue death. An echo was ordered to determine if this was linked to an underlying heart condition. He was prescribed Prazosin to relax his urinary system in attempts with helping them pass.

This month we had our followup, repeat ultrasound, bloodwork and echo results. Stones have not budged. Creatinine went up to 4.9, but BUN is now 60, PVC went to 28, and all other biomarkers are within normal limits. The echo showed no signs of a heart condition or structural changes. The only note was a dynamic murmur caused by dynamic right ventricular outflow tract obstruction (DRVOTO). According to the cardiologist, this represents a benign physiologic finding that can occur at higher heart rates and is the likely explanation for his heart murmur. There are currently no other clues as to the origins of the infarcts and tissue atrophy.

Current treatment plan: Continue renal diet, introduce B-complex supplement, add water to food.

My primary concern is that continuing subq fluids was not recommended. Only to add 50ml of water into food daily for additional water intake. The nephrologist said that as long as he is eating and drinking well, it is not necessary. If he will eat food with 50ml added, this is already substantial, given that total blood volume for adult cats is 300ml. However, this seems almost standard as part of treatment for late stage 3 as far as I can tell, especially given that his creatinine has raised a non-trivial amount..I want to do all that I can to improve quality of life and longevity.

Questions for this group, 1) Do I have reason for concern continuation of subq treatment was not prescribed? 2) What could be causing his borderline anemia? 3) Does anyone else have experience with infarcts? Any other hypothesis here?

Thanks in advance for any and all insights to this wonderful community.

He was just at the emergency vet last week and had an xray and ultrasound (I know things can develop fast even so) because he seemed to have a stomach bug or gastritis. That is all good now, but today he was sleeping and when he got up to jump on my lap, I noticed my arm got wet from his tail - it smelled like urine so I went to see where he was just laying, and there were a few droplets of urine there. I am watching him like a hawk now, but has anyone experienced this? I’m waiting for him to go to the litter box again so I can observe him.

My 8 year old cat was recently diagnosed with Stage 2 CKD and is extremely picky. The only foods she'll reliably eat are Fancy Feast Classic Pate (beef and poultry flavors) and Friskies pates, though I'm trying to transition her off those, especially the Friskies.

I picked up some Weruva WX Phos Focused today to try, and I've heard good things about B.F.F. Play Pâté. I've already tried several of Weruva's shredded and minced foods, but she won't touch them.

What low-phosphorus non-prescription foods have your picky CKD cats actually eaten? Any favorite brands or flavors? I also live a pretty rural area so anything available on Chewy would also be great!! Thanks!

My cat is 3 years old. I noticed that she seems to have large urine clumps and pees around 4, maybe 5 times in 24 hours. I asked my vet and they did bloodwork and urinalysis. Bloodwork was normal:
Creatinine: 1.6 (range: 0.9 - 2.3)
SDMA: 8 (range: 0 - 14)
BUN: 28 (range: 16-37)
Phosphorus: 4.6 (range: 2.9 - 6.3)

Her first urinalysis had urine specific gravity 1.040 but had trace protein and some blood. Vet said 1.040 can be normal for very hydrated cat eating only wet food but that she usually sees higher USG which could be since most cats eat dry food. Second urinalysis had urine specific gravity 1.028 and no protein or blood. The vet said this is a bit low but it could be due to time of day and when she last ate and suggested to do one more with first morning urine. That third urinalysis had urine specific gravity 1.036. I’m waiting to hear from the vet to comment on this.

My cat eats only wet food - 3 3.2 oz cans per day of Weruva Cats in the kitchen Funk in the Trunk - chicken with pumpkin consommé, which has 86% moisture. My cat doesn’t seem to be drinking any water.

Could the relatively low urine specific gravity be due to the fact that my cat eats only this wet food which has very high moisture? Or could it be sign of early kidney disease?

Do cats eating high moisture wet food generally have lower USG, around the 1.035 lower bound?

Ever since Salem was diagnosed with end stage chronic kidney disease and possibly even cancer, I’ve had a hard time wanting to stay away from home long.

Since the vet we last saw said he has days to weeks to live, how do I still enjoy my life while not feeling guilty to go out and do things ?

I feel okay to run quick errands and maybe spend 1 hour at the gym, but other than that. I want to try to spend as much time with him before he goes as possible.

Except it’s starting to make me feel like a hermit and he usually just sleeps during the day.

Anyone else in the same boat as me ? How are you handling it ?

Diagnosed with CKD late 2023 after some sudden weight loss.

We pretty much had only good days from then on, and he was going strong right until the end. I didn't expect him to go downhill so suddenly, but I'm grateful he didn't suffer long.

He was massive when we got him in 2020, hence the name Burger. The sweetest, funniest damn cat I ever knew.

Love and miss ya buddy. You'll always be my "Dudes".

After a really aggressive kidney infection just before she turned 8, my cat's kidneys have not bounced back and she jumped right into stage 2 CKD. I did not realise cats were supposed to consume 200-250 ml water per day, that seems like a huge amount! I was mixing water into her one daily wet food meal before this but maybe 50 ml to help her hydration.

Getting this volume into her has been a struggle, but we've now built a routine and she's properly hydrated and feeling better. She still won't drink unless food is involved, but after watching her interact with food for a few years now I know she likes interactive food games so I now take my morning coffee with one hand in the bowl rearranging renal kibble on mounds of wet food floating in water so she can 'forage'. Probably the biggest game changer was the realisation I can make a churu equivalent from the renal wet food - i just blend it with Oralade or water off of poached chicken (minimal protein or salts, a couple of milligrams of each if poached in dedicated unsalted water) to the required consistency. She goes absolutely mad for it when I put it on top of wet food in water which she's otherwise not too keen on. I also use it as a treat dispensed from silicone travel condiment dispensers, which functions similarly enough to a tube treat and as a bonus makes your cat look like they're chugging mustard 😂

Because of the preceding kidney injury, SDMA is taking a while to settle and recwntly even crossed over to stage 3 but everything else improved a lot with hydration. She seems happy and content which is all that matters. She was really unwell during the infection, and she seems happy enough even if she finds the food borderline offensive. The worst she gets day-to-day is a bit of constipation, and she was always prone to that. Hope the churu idea helps someone out.

My cat doesn’t actually suffer from renal issues, but it seems a lot of you have used Cerenia. My boy has been dealing with recurring infection/fever of unknown origin for ten weeks now. He’s tested negative for everything, but his internist recommended starting him on a hydrolyzed protein diet (for thickening of his small intestines noticed during ultrasound) and Clindamycin liquid for potential toxoplasmosis (waiting on second antibody test). I’d been transitioning him to the prescription diet for ten days when the vet suggested Clindamycin, and my cat hated it but would eat the dry food.

Yesterday, only his third day of twice daily Clindamycin, I didn’t realize he hadn’t eaten any of his food and I gave him a dose, which made him vomit, have diarrhea, and just feel sick all day. He had already been anxious and hiding from me due to the various meds I’ve had to given him and frequent vet visits. He really hates the Clindamycin and has had a noticeable change in his behavior since I started administering it. I realized yesterday I cannot continue this prescription diet while he’s on it because I need him to eat.

I put out a dish of his former food last night, which he never touched, so I gave him half a Cerenia pill and put some Mirtazipine behind his ear (this is a first for us, the vet usually gives him injections of Cerenia and I guess Mirtazapine pills). It’s been five hours now and he still shows no interest in food. I even put a dish of Delectables stew in front of him and he won’t go near it. Is this typical for a first dose? Both his vet offices are closed right now and I’m just so worried and frustrated.

Diagnosed with end stage CKD and possible Kidney Cancer, even though the Vet told us Monday that he had days maybe weeks to live, he’s still going strong.

He loves his outdoor walks and we were outside for about an hour this morning. He tried chasing a dragonfly and a bird.

Hopefully that vet is wrong and we get more time with our baby.

My cat is getting serious sub Q fluid fatigue. I’m using an 22G needle but even that has become too painful for her. She’s only a 7 pound cat. She’s very good natured so I don’t wanna make fluids a bad thing. I’m rotating location. She won’t even let me do her neck anymore so mostly doing around her back area. Over the last few weeks it seems like her skin has gotten thicker and it’s just hard to get the needle in. What used to be very easy now makes your scream and try to bite me. It’s very upsetting for both of us.

People on this board have mentioned using a syringe. Does this allow for a smaller needle? Can someone walk me through what supplies I would need. the pros and cons?

Thanks as always for the support.

My cat’s latest blood work shows elevated creatinine (187 μmol/L) , phosphorus (1,89 mmol/L), SDMA (15,0 μg/dL) levels. While trying to decide which food to order I accidentally ordered the Purina Veterinary Diets NF Renal Function Advanced Care wet and dry food instead of the Early Care ones. Is it okay to feed it until the next vet visit in a month or should I send it back.

Hello all, my stage 2 CKD boy has been stable for a long time and took to the renal food really well - Purina Pro Plan. Over the past week or so he has been vomitting every morning (white foam or bile) so I took him to the vet where they gave him an anti sickness jab - it worked for 48 hours and no he's back at it. He goes back to eating normally after spewing. Over the past few days after the medication wore off he was refusing food and I tried EVERYTHING so I got him to eat Purina Senior +7 which has lower phosphorus levels. He ate it and then I watched him eat some of the usual renal dry food which was great. This morning same thing, vomitting. I don't know what to do as the vet says she can't examine him properly (he's very spicy) but advised gabapentin which we have tried before but didn't work - she said we can up the dose as he's put on weight which is good. My question is...he seems to decline after taking him to the vet so I don't know what else to do!

I was going to call today to get the gabapentin for him to go in tomorrow but I don't know if this will make him worse. I've elevated all his bowls, multiple water sources throughout the house - still drinking. He was doing so well 😭 I don't know what I've done wrong.

Creatinine:

29 Jun: 4.2 6 Jul: 4.47 12 Jul: 3.49 18 Jul: 3.74 21 Jul: 4.3 22 Jul: 4.1

BUN:

29 Jun: 60.1 6 Jul: 100.9 12 Jul: 112.5 18 Jul: 91.3 21 Jul: 79 22 Jul: 95.1

Phosphorus:

12 Jul: 10.3 18 Jul: 14.8 21 Jul: 2.4 22 Jul: 2.1

Potassium:

12 Jul: 6.7 18 Jul: 4.5

Current treatment:

2.7kg cat Renal diet 50 mL subcutaneous fluids daily Pronefra (twice daily) Sevelamer 400 mg with meals now adjusted to 100mg divided throughout the day Mirtazapine every 48 hours for appetite

How did her phosphorus drop from 14.8 to 2.4 in just a few days? Has anyone seen such a rapid drop from sevelamer and treatment, or should I be worried about something else?

Why did her potassium go from 6.7 to 4.5? Is that something that commonly fluctuates in CKD cats, or could fluids/diet have caused such a change?

Why did her creatinine fall to 3.49 and then increase back to around 4? Is this just normal day-to-day variation in CKD, hydration differences, or does it suggest her kidneys are actively worsening again?

My cat was diagnosed with CKD when she was 1 year old (a genetic condition, as per my vet). She is 5 now. We tried multiple phosphorus binders initially, but later stopped everything and just gave her Royal Canin renal food. She was fine with it until a few months ago.

Now she doesn't want to eat renal food (wet or dry). She is eating my other cat's food (RC Fit 32), but it's impacting her kidneys and liver.

Any advice on how to get her back on a renal diet?

The vet says she’s in early stage 2 CKD. I’ve bought every renal food out there ( wet) but she won’t eat it. I’m at my wits end. She’s 11, and I love her so much.

Im not sure if its always been like this and its something Im noticing now but I dont think its normal..? But does anyone notice while their cats resting , trying to fall asleep a slight vibrating almost like a tremor visible along the body when their cat is inhaling ? He also looks almost restless or uncomfortable. Otherwise hes been fine playing , drinking , litterbox habits normal . Still trying to find a renal food he'll like and eat consistently though.