My cat has stage 4 renal failure

By the way, the urine she passed today was yellow and not clear. 

Ihavethreecats said:

 
Thank you so much. 

Very disheartened because she didn't eat anything at all today. 

The IV is in 500 ml bottles, and I have started reusing it. The vet says that there is no point in giving iron because anyway, the kidney has stopped helping in the production of iron. 

I gave her a little Dupholac in the morning because she's constipated and I thought that might be the reason she isn't eating. But she still hasn't eaten anything much tonight. She stumbles a little now when she jumps and runs. Just a little though- now and then. She prefers to sit in our garden all day just quietly by herself, looking at the trees and the birds. It breaks my heart.

The vet said Miralax is good but it isn't available in our part of the world.

I'm just so sad and depressed. I don't know if she can continue much longer. 

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The thing with cats fighting off disease and illness is that they always seem to have a good day, then a bad day.  Don't get too depressed or sad, since between the advice that @mrsgreenjeens   has given you, and the stuff you have already done.  your cat Smoky does know this.  

At this point, I would buy any wet food and try if she will eat it, or give her her favourite foods.  warm them up a bit, and make a mash paste.  Even treats.

The reason iron is good to give is so that the red blood cells get infused to further carry out their repair procedures.  when a cat is anemic, it is too, low on the iron component of blood.  the B12 would give a boost of energy.

I know it sounds like the vet has already decided that the kidneys are shutting down., but if smoky, is alert, drinking and walking....I would not say that time has come yet.

Find the time for yourself, too, to get your mind off the illness, and just be with Smoky, and cherish the time.

You have done a lot.

Yes, with kidney cats, each day can be entirely different.  It's an up and down cycle, good and bad days.  Some days my little one will eat 4.5 ounces of food, other days only 1.5 ounces.  I just do the best I can and that's all I can do...same as we all do   and I do notice with Callie that when she does that thing that cats do when they shake themselves ( I say to rearrange their hair back in order ), she's always a little unsteady now.  Makes me sad .  But as Cat nap said, just enjoy the time you have with her, and you never know, things could definitely turn around.  This could just be a little blip in the road. 

And I think yellow urine is ok, just as long as it isn't DARK yellow.  If it gets to be that color, then it may be time for more hydration, after checking with the Vet.

Smoky was doing well the last two days- she ate more than usual and even went for a stroll around our compound. We were starting to feel hopeful, but then tonight she seems to be in a bad condition again. Her movements are very slow and deliberate and her eyes seem distant. She did not eat much. She sat for a while in a hunched position with paws beneath her before she fell asleep. When I tried to move her closer towards me, she hissed! She never ever hisses, so this must mean she is in pain. I cannot bear to see her this way! How do I know when it is time for me to tell the vet to euthanize? I do not want my baby to suffer.

Still giving her the sub-qs everyday- 100 ml daily. I do not know if it is working- her urine seems to be largely clear again, and she has taken to urinating in a specific place in the house where she normally would never urinate. So worried and upset    

They say when end stage comes around, her breath will smell foul and she will also have a strong body odour. She is depicting neither of these symptoms. But as I said, seems to be in pain.

Ihavethreecats said:

 
They say when end stage comes around, her breath will smell foul and she will also have a strong body odour. She is depicting neither of these symptoms. But as I said, seems to be in pain.

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When cats are in pain, they will usually withdraw, as in hide.  Is she doing that?  Be aware that kidney cats definitely have good and bad days.  My Vet told me that kidney disease was not really "painful", but perhaps "uncomfortable" might be more applicable.  Are you still giving her the antacids?  Is she throwing up froth at all, or throwing up period?  Is she maintaining her weight, or perhaps even gaining a little?  I think I  mentioned that some days my little one hardly eats anything at all, then other days she eats a LOT (for her).    Have you talked to the Vet about her urine being almost clear?  Does he want you to cut back on the fluids at all? 

I have no idea why Smokey may have hissed.  If anything, I would have thought maybe that would have happened when you went to give her the sub-q fluids.    My Sven would sometimes kind of moan, like "not again"   But he never fought us about it....I guess he was just resigned to the fact that we were bigger than him and we were going to win the fight.  Callie, on the other hand, I imagine will fight tooth and nail if she ever needs sub-qs, which I imagine WILL be needed sooner than later. 

As to knowing when the time comes...they always say you will just know.  I always told Sven, from the day we learned he was sick, that all he had to do was let me know when he was ready to go, and I would let him go.  I can't tell you how many times I asked him if he was ready, because he wouldn't eat and acted so, so out of it, and every time I asked him, he would jump right up and start eating .  The last time I asked him, he looked me right in the eye and started purring, a really loud purr.   And I knew he understood exactly what I was asking, and he answered me.  And I kept my promise   (that was 3 years after he got sick, almost to the day, and THAT was just a little over two years ago)

BTW, WHY can't you post pictures of Smokey?  Have you tried lately?  I think you need to have a certain number of posts under your belt before you can, but maybe you have reached them.  I would love to see pictures of her! 

Ihavethreecats said:

 
Smoky was doing well the last two days- she ate more than usual and even went for a stroll around our compound. We were starting to feel hopeful, but then tonight she seems to be in a bad condition again. Her movements are very slow and deliberate and her eyes seem distant. She did not eat much. She sat for a while in a hunched position with paws beneath her before she fell asleep. When I tried to move her closer towards me, she hissed! She never ever hisses, so this must mean she is in pain. I cannot bear to see her this way! How do I know when it is time for me to tell the vet to euthanize? I do not want my baby to suffer.

Still giving her the sub-qs everyday- 100 ml daily. I do not know if it is working- her urine seems to be largely clear again, and she has taken to urinating in a specific place in the house where she normally would never urinate. So worried and upset    

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Ihavethreecats said:

 
They say when end stage comes around, her breath will smell foul and she will also have a strong body odour. She is depicting neither of these symptoms. But as I said, seems to be in pain.

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@Ihavethreecats    I really do not know what to say.  My vet told me that it was time when my cat  Sparky, stopped eating.  He never mentioned the bad breah, which Sparky did have, but no body odour.  My cat was 2yrs 3mts but suffering from complications relating to him having  a felv+ and fiv+ status.  Here in canada they did not have any experimental drugs like they have in the U.S.  (maybe they will, someday)

For your Smoky, you asked before that you wished you could post a photo.  I don't see why not.  I don't know if you have to have over 20 posts but if you do not have enough, just go over to my thread about music, and post as many times as you want.  The thread is about songs you like, and you don't have to have videos or stuff. Just titles are fine.http://www.thecatsite.com/t/275152/songs-that-make-you-happy

Don't worry about the dumb title.....it was just that I wanted happy songs so I would not just be listening to sad songs.  

You can also go to the "caption this photo" thread and write whatever you want.  I go there often because humor helps me cope.

As for posting a photo. the "how to section" is here"  : http://www.thecatsite.com/a/how-to-add-an-image-to-your-forum-post

mrsgreenjeens said:

 

Ihavethreecats said:

 
They say when end stage comes around, her breath will smell foul and she will also have a strong body odour. She is depicting neither of these symptoms. But as I said, seems to be in pain.

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When cats are in pain, they will usually withdraw, as in hide.  Is she doing that?  Be aware that kidney cats definitely have good and bad days.  My Vet told me that kidney disease was not really "painful", but perhaps "uncomfortable" might be more applicable.  Are you still giving her the antacids?  Is she throwing up froth at all, or throwing up period?  Is she maintaining her weight, or perhaps even gaining a little?   I think I  mentioned that some days my little one hardly eats anything at all, then other days she eats a LOT (for her).     Have you talked to the Vet about her urine being almost clear?  Does he want you to cut back on the fluids at all? 

I have no idea why Smokey may have hissed.  If anything, I would have thought maybe that would have happened when you went to give her the sub-q fluids. 

  My Sven would sometimes kind of moan, like "not again"

  But he never fought us about it....I guess he was just resigned to the fact that we were bigger than him and we were going to win the fight.  Callie, on the other hand, I imagine will fight tooth and nail if she ever needs sub-qs, which I imagine WILL be needed sooner than later. 

As to knowing when the time comes...they always say you will just know.  I always told Sven, from the day we learned he was sick, that all he had to do was let me know when he was ready to go, and I would let him go.  I can't tell you how many times I asked him if he was ready, because he wouldn't eat and acted so, so out of it, and every time I asked him, he would jump right up and start eating

.  The last time I asked him, he looked me right in the eye and started purring, a really loud purr.   And I knew he understood exactly what I was asking, and he answered me.  And I kept my promise

  (that was 3 years after he got sick, almost to the day, and THAT was just a little over two years ago)

BTW, WHY can't you post pictures of Smokey?  Have you tried lately?  I think you need to have a certain number of posts under your belt before you can, but maybe you have reached them.  I would love to see pictures of her! 

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Wow, @mrsgreenjeens  ...You are such an amazing person.  And all your cats are lucky to have you.  So Sven is now looking down and smiling.....or just purring because his story helped someone else.  Thanks for all you do. and your detailed posts.

@Ihavethreecats    I think you will know, too, since that decision is so difficult.  Smoky will let you know.  

The tabby in the background is Smoky in 2012. The black one in front is her kitten Beelzee.

People who see her now, after she fell sick, say that her colour seems to have changed. Is this usual? She has lost weight and was 2.5 kg when i took her to the vet ( at the time of diagnosis). Since then, i think that she has put on a little more weight ( not too much ) but her coat is not as shiny as it used to be. She prefers to remain outdoors in the daytime and comes in at night to get her subq fluids. 
This is a photo that i clicked of Smoky just 10 minutes ago. Today she had about 80 grams of wet food. ( tuna and ocean fish) . I have to coax her into eating and she prefers to lick the food off my hand.I haven't taken her to the vet after that first visit as he had not been too keen on giving her food or sq fluids and was talking about letting her go....

I am trying to contact my specialist vet who was advising me on what to do, but am not able to get through to him. Smoky is passing clear urine and prefers to do it on a newspaper rather than go down to her litter box. She seemed to be in pain last night but is okay today. When i run my fingers over her tummy( the side )  i feel something hard( like a little lime) . Could it be due to the fluids or is it due to constipation? Guess i will have to take her to the vet sometime. He is not going to be happy about my having treated the cat against his instructions!! Furthermore, i have to leave town for a week on urgent work and there is no one to look after Smoky. The last alternative would be to leave her at the vet's where the care may not be good and the conditions are not hygienic. Preferably, it would be ideal to leave her at home where she is the happiest and get someone to come and feed her. But unfortunately, no one is brave enough to give her her medicines , let alone poke her skin to give her her fluids!! One more week to go to find some solution. Does anyone have any suggestions? Is it okay if she foregoes her medicines and sq fluids for a week? I pray and hope that the specialist vet returns my calls or messages sometime soon. In the meantime, i think i will brave the wrath of the local vet and take her there for an examination... Pray for her please. She is an integral part of our family and i just can't bear the thought of losing her, Thank you Mrs. Greenjeens for all your support and also Catnap for sending me the site to post her photos. But i think i have managed to learn to post it here and you should be able to see her for yourself... Once again, thank you 

I wish I could answer your other questions with specifics,  but I just would not know.  If it were me, I would take her to the vet before your trip, just to check out that hard spot.  But if you feel your vet is going to pressure you, then tell him straight out how you feel about the timing, and how you want to proceed.  Right now, you are facing the most difficult decisions.....as to how her quality of life is. 

If you place her litter box closer, will she use it then?

I had food dishes, water bowl on one side of cat bed , about 4 feet away, and litter box was in other corner of room.  All moved to living room,  where we'd be together,  but sometimes Sparky would just want to be in basement where it was cooler and quiet. His illness was different and he went downhill fast.

Smoky eating is a good sign.  And if she is pooping, then even better.

She looks alert in the second photo, since she turns her head.  What a fluff ball. 

Sending you my prayers for Smoky, and all your family.

Yay    you got pictures up!  She still looks pretty good to me , if not a little grumpy in that last picture 

Now to business      If she is outside most of the day, then you probably cannot monitor whether or not she is constipated, so what you are feeling could very well be hard stool...it's just hard to know.   And IF she is constipated, that could even be why she is not using her litter box!  I don't know whether or not you have read this particular part of the website on feline crf, but this page is pretty detailed on the constipation issue and is VERY informative as to what you can do to help out:  http://www.felinecrf.org/constipation.htm

Now, as to that week you are going to be away on business.  Is that a full 7 days, or a 5 working days?  Sometimes we would skip several weeks or even months at a time with Sven and not give him any sub-q fluids!   He really didn't like them, and we believe in quality of life versus quantity, so we would give him a break  to see if it made a huge difference.  It wasn't until he was really throwing up froth almost daily that we started doing it on a routine basis (every other day) because the Vet said it would help clear out the toxins and help stop that froth stuff, along with giving him pepcid a/c.   So,  I'm thinking she would probably be better off (less stress) if she were to stay in a familiar environment and not get her sub-q fluids for the time you are gone.  (your local Vet may not give her fluids anyway, right?)   Maybe whoever is feeding her can just add water to her food to make sure she gets a little more fluid intake?   How are you giving her her meds right now?  Could they be crushed and added to her food or are they too bitter? 

Here is an article on tips to get your cat to drink more, just in case:  http://www.thecatsite.com/a/tips-to-increase-your-cat-s-water-intake