My cat has just been diagnosed with chronic renal failure

It all started a week ago, my boyfriend had noticed she was bleeding when she was urinating. We took her to the vets for them to tell us she had an infection in her bladder, she has a lot of muscle waste age and not able to do the toilet the same. She also had an enema as she was very constipated. So anyway she seemed fine until yesterday I noticed she hadn't been for a number 2 since Sunday (9th feb) so I called the vets, they examined her to find out she want constipated. So they take a blood test from her, and called us when the results came in. She has chronic renal failure (CRF or CKD). Before we took her to the vets that day she was fine, going about her usual business, using her tray, eating etc, but once we got back from the vets and had been told the news she's not been using her tray ( forgetting where it is) we are having to pick her up and carry her to the tray, she's not eating(even when I try to feed her she turns her nose up at the food), she is sleeping a lot, doesn't seem to want my company. I've spoke to my boyfriend about possibly getting her put to sleep, but deep down I know I don't want to do it. Anyone have any clues on how long she has left and how to keep her comfortable. It's just so stressful seeing her like this

I'm sorry you have had this news. It really depends on how advanced it is and how she responds to treatment. There are some cats who only last a few months and others who have had it for like 6 years and are still doing pretty well.
Did the vet put her on IV fluids for a day or more? usually that is what is done at the start, to flush them out and rehydrate them, and sometimes can sort of jump start them,. then you can see how she responds. Plus the vet might have you giving something at home.

There are a couple good websites with information about it. I would start here http://www.felinecrf.org/ That is the intro page, just read through that part and especially check out the links in the section "Where to Start"
they also have a Yahoo Group http://pets.groups.yahoo.com/group/tanyas-crf-support/ where you can get lots of support and advice , and I'm sure there are some very knowledgeable people.

There is another site with almost the same URL felinecrf.com and that one is also good. I think the .org one is now more comprehensive. But both are worth checking out. I think that one has a Yahoo group too.

I don't know if she is yet at the stage where she would need subcutaneous ("Sub-Q" ) fluids, but that can be extremely helpful . It might sound hard to do at first but just about every cat caregiver can learn how to do it (There are videos and "how to" pages online) and cats seem to adapt very well. I think they learn that they feel so much better soon after they get the fluids.

There are lots of other things you can do too, depending what she needs. There is a whole section on that felinecrf.org site about treatments.
She might need some supplements to balance out minerals.
2.5 (or 5) mg of Pepcid AC , once or twice a day, helps if they get acid indigestion that upsets their stomach.
My friend's cat is on Fortekor, an ACE inhibitor that has made a big difference . It explains on that tanya's site about how it works for cats with CKD.
etc. etc. So there's various things that can help them feel better.
& both of those sites have tips on getting them to eat.

There are different schools of thought on diet. but one thing definite is a wet diet is helpful.
Then the traditional way was a protein restricted prescription diet. with protein lower than it would otherwise be legal. and that does sometimes help. but can also cause some other problems like anemia and muscle wasting. I think the canned is better than the dry though.

but in recent years many vets including at our cat-only clinic, are now thinking that rather than cutting the quantity of protein as much as it is in the prescription food like Hills k/d , it is better to concentrate on
* restricting the phosphorus ( which can partly be done by giving phosphorus binders, so that the phosphorus bypasses the kidneys) They think the reason the low protein diet showed improvement in some studies is more because it was also lower phosphorus.
* and focusing on the quality of the protein ( meaning easily digestible for a cat , like muscle meat from poultry or rabbit)
If this happened to a cat of mine again , I would probably go this route and feed like medium amount of protein not as low as in the prescription foods, but try to keep the phosphorus pretty low .
But what is REALLY important is keeping the cat eating SOMETHING.
Persuading Your Cat to Eat page http://www.felinecrf.org/persuading_cat_to_eat.htm

Hang in there. take a deep breath. You may be able to get her over this hump and have her feeling better for a while. And I knew of a cat who was diagnosed at age 16 and lived to 21.

Of course not all vets are equally experienced with treating this. you may need to be proactive and suggest things yourself, bring in copies of studies in vet journals etc,
or look around for a vet who does have a lot of experience treating cats with kidney disease. You could look via American Association of Feline Practitioners. or join that Yahoo Group and maybe someone on there can recommend a vet in your area, at least if you want to get a second opinion.

P.S. I messed up and mentioned a U.S. vet association, and I see you are in Scotland.
but the site I gave you the link for felinecrf.org is actually based in the UK. so there is info specifically for people in the UK .
and there may be people from Scotland in that Yahoo group who might be able to give you a recommendation if needed.

Take care.

BTW, when I said they are usually put on IV fluids at the start , it depends how ill they are when diagnosed. Sometimes the cat is not really in crisis mode but just they just happen to find somewhat elevated numbers in a routine test. But it sounded like your cat was in bad enough shape that at least in the US the normal course would probably be to start by putting her on an IV drip for at least 24 hours but more often it's better to keep them on the IV a few days.
This page tells more about that http://www.felinecrf.org/is_there_any_hope.htm

My old guy was 13 years old when he was diagnosed with CRF, and he lived for another 3 years.  We had our ups and downs with it, and toward the end we were doing Sub-q fluids frequently, but for the most part, life went on as usual.   He did take lots of Pepcid AC for his over acidic stomach (a side effect of CRF), so our biggest hurdle was figuring out how to get him to "take his pills" .  But over the years we learned all kinds of tricks.

You will too! 

Oh, our guy was chronically constipated also, so we gave him Miralax (probably called something different in Scotland) twice a day, everyday, just mixed with a little water, then mixed with a tiny bit of food.  It's tasteless and stays liquid so it's easy to administer, AND, it works! 

So, there is hope that your baby can still live a long, happy life.  She may just not be herself right now because of the Vet visit and being poked and prodded, plus having the UTI and getting the enema, poor thing.  You wouldn't feel very good either, I'm guessing . 

My 13 year old cat was diagnosed back in November. She was nearly dead, she was completely limp and had been throwing up all food for days. The vet was closed all weekend. The night before her appointment I thought she was going to die. She was still with us in the morning, I was able to just scoop her up and put her in the carrier, something she never let me do. We did a blood test. When we got home she was suddenly a little better. We got her to eat some food- her favorite Meow Mix wet. We heard from the vet days later who told me she had CRF and needed to be on an IV for two days which would be $300+ and we would need to redo bloodwork for $130ish dollars. I'm a college student. I just lost my job at the time. I told her I couldn't afford it. Plus, Lulu was doing better! She didn't want to hear it. I told her I would wait and see how Lulu does, she HATE the vet and making her stay there for two days and nights would kill her if the CRF didn't first. She gets so stressed... plus they don't have anyone there at night, nor do they even have a vet there for most of the business hours! No one would be monitoring her, the vet is 40 minutes away... no. Well the vet got an attitude and told me that if I didn't get the IV she would give her "two days" to live. With an IV she could have "two weeks to a month".

I said no. I asked if they could do a sub-q instead. No. The bloodtest also came with a urinalysis. I gave them the sample, didn't hear back for two weeks. I emailed them asking for the results. I get this horrible passive aggressive message on my home answering machine a week later saying "WE HAVE BEEN TRYING TO REACH YOU! We have called your ccellphone MULTIPLE times" they don't have my cell number, plus I had no missed called "YOUR INBOX IS FULL BLAHBLAH RANT RANT THE VET STILL WANTS LULU ON AN IV! SHE'S VERY SICK! SHE NEEDS AN IV! SHE ALREADY DISCUSSED IT WITH YOU!" -click-. I'm done with them. I'm currently shopping for a new vet. I have never had such a horrible experience. Oh- PLUS the reason she crashed! She has had it for over a year! We took her in last Jan because she was walking on her hocks. They insisted it was just arthritis and nothing to worry about- put her on STEROIDS. That's when she started losing weight and throwing up a lot. It didn't get extremely bad until Nov. though because she crashed then. The vet did nothing for us though. It's a miracle that she is doing so well.

But back to Lulu. It has now been three months. She is back to normal. She is peeing a lot, but she hasn't thrown up her food since I took her to the vet. We put her on an all-wet diet and give her "cat sip" as well.  She always balded due to allergies, well her coat is amazing now. Her energy level is higher than my one and two year old cats. She's doing really great. The vet said she would be dead in two days, well so far it's three months and she's doing great. She went from near-death to acting like a kitten again. 

It DID take a while for her to eat normal again. For a few weeks she was impossible. She would only eat one type of food one day, then the next she would hate that kind. We had so many open cat foods it was insane. Now she eats anything again. She would also eat very little, turning her nose up at everything. Now she eats the daily recommending amount. Her weight is up again too, she had lost two pounds. I think there is hope for your kitty. I would wait a few days or a week and see if she improves. You're in the same place I was with Lulu. 

Well my cat seems to have perked up a little, she is eating small amounts as to eating nothing for 3 days, but she won't leave our bedroom. She'll only leave to get a drink and use the tray. We've had to bring everything to her, otherwise she would randomly wee in the room or not eat. We are going to keep a close eye on her. It's such a horrible thing to be told, I couldn't look at her without crying.

Ohh the vet didn't say anything about sub q fluids, she did mention about the food specially for cats with kidney problems, but she said the disease has progressed too much that it probably wouldn't do anything. For the constipation she gave us lactulos to give her 3 times a day, that seems to be doing the job x

So, did the Vet call you afterwards with the results of the blood test or did you get the results while still there?  What did they advise you to do...just do nothing except maybe change her food, but it probably won't do any good .   Here is a website you really need to get acquainted with:  http://www.felinecrf.org/index.htm

This has pretty much every thing you need to know about CRF. 

But the first thing I think you need to do is get a new Vet!  This one sounds to me as if he doesn't care, IMHO.

I totally agree with mrs green jeans. Please do look at that site she linked and that I linked earlier, and read the intro parts about How Bad is it? and Is there any hope? There are cats who have been in very bad shape when diagnosed and then done much better. If this vet did not suggest IV or Sucutaneous fluids it sounds like she either is not aware of current practices, or doesn't really care. You might need to find a new vet. Even 20 years ago my vet gave me more options

Welcome to TCS, louise220489!

I have to tell you, based on what your Vet has said and done so far, I'm not impressed with her....at all.
 

I will also tell you that her response to your cat's illness is very typical of most "Vets" in the UK...and I will qualify that as follows: I am involved online with a group of people from all over the globe who are there for one reason only, to share the best information and advice about their kitties who have kidney disease to keep them healthy for as long as possible.  Most, if not all of the first postings of people from the UK involve stories of Vets who know nothing about what can be done, tell clients that euthanasia is the only option, refuse to allow clients to treat the cat at home (e.g. sub-q fluids), object to clients educating themselves via the Internet...and on and on. So, nothing new in your Vet's approach - par for the course over there, sadly.

Now, there are some Vets on your 'side of the pond' who ARE educated and with-the-times and willing to work with clients towards keeping their cats as healthy as possible. The person who runs the online group is herself from the UK and maintains a current list of such competent Veterinarians. There are group members from Scotland as well.

My advice is only what I would do myself - if I were in your shoes.

I would join that group, tell my story and get some advice - as well, once a member, you can request access to that list of Vets.

I will tell you that the group is very large, that the online "look" of it is different from a forum like this (it uses email messages instead of threads) so it takes a little getting-used-to. I would suggest getting yourself a Yahoo email addy before joining up - it will be simpler and less confusing for you if you do.

If you want to read more about the group, it's all here http://www.felinecrf.org/tanyas_support_group.htm

If you decide to join, there's a link on that same page, or, just go here http://pets.groups.yahoo.com/group/tanyas-crf-support/

BTW, one doesn't need to use the "prescription" kidney foods....the key is to use foods which are low in one chemical: phosphorous. There is a list of such foods - I don't want to overload you, so post back if you want more info.

In your first post, you wrote:

Anyone have any clues on how long she has left and how to keep her comfortable

Click to expand...

Nobody - including that Vet of yours - can predict lifespans. There are ways of telling how extensive is the kidney disease - you can ask this Vet for certain test results, post them for the group to see and get some feedback from very experienced people.

About keeping her comfortable: when the kidneys are working sufficiently well, everything is balanced. When there isn't sufficient working kidney, that balance is thrown out of wack. However, people are able to put balance back into things...it sometimes gets complicated, and that's where the group can and does help.

Why don't you take it for a "test drive"? You could just join up and read the other back-and-forths among members and judge it for yourself.

Louise, White Shadow has some great advice, and gave you a link to the same group I mentioned. It does seem like for some reason a lot of UK vets are either not up to date with current recommendations for treating feline kidney disease, or else just have an attitude of 'It's not worth bothering'. But there ARE other UK vets who are much better informed and willing to work with the owner to help the cat make the best use of their remaining kidney function. And I am sure there are also people in the group who have been able to change their vet's outlook about treating cats with kidney disease. Yes it's a terminal illness. but there is a great variation in how long they may have. If treated some cats have had quite a few more years. I can't promise what would happen with your kitty, but I just want to make sure you know about the options. >>>>>>>>>>>>>>>>>>> People on that group who are from the UK can also advise you about commercial tinned foods low in phosphorus. ......... In any case, it can't hurt to try. It is a busy group so I would sign up for a Yahoo account, and then read and post from the group's page on Yahoo Groups site, instead of having messages come into your e-mail box. .........................Re subcutaneous fluids : It's sort of like low tech dialysis. It's a way of getting more fluid into them than they could get from drinking , to help keep them hydrated and flush out the toxins that build up because the kidneys aren't working well enough. so that the cat feels better. it can help with nausea, constipation, all sorts of symptoms. Once the disease has progressed to a certain point, the fluids can be extremely helpful. ....................................I'm glad the constipation is better !

Not sure if anyone mentioned that the blood in the urine is a sign of a UTI which could really be throwing off her kidney numbers. If that is what it is, once that gets treated with antibiotics her numbers could actually be much better than they look.