Kidney failure- how bad is he suffering

My 14 (closer to 15) year old cat was diagnosed with a spine injury in January. It was making it hard to squat down to pee. He got some meds for the pain and was told he needs to lose weight. There is no way to fix it. He dropped from 17# to 13# in about 2 months.

We took Peanut back in and now know he also has kidney disease. He was just recently tested at about 20% kkidney function. We put a high sided tote we made into a litter box in the living room. He now will only pee on towels we put in front of the box. He won't go into the box.

He is so tired and drinks close to a quart of water a day. Part of me feels he is really suffering and hiding it the best he can. Part of me worries that it's just my frustration at having to wash a load of pee soaked towels each day.

I don't want to lose him too soon but I don't want to wait until he can't even walk over to the towels to pee. I feel like he's close to the end but my family thinks he's doing better than I do.

How do you know when your cat is suffering too much? They hide it so well. I want him around as long as possible but I don't want him to live in misery just so we can put off the inevitable for a few weeks or months.

@petcrazy76 -- i'm so sorry that your peanut is having these medical issues.

my snick is also 14 years old, will be 15 on august 1st. snick has chronic kidney disease too.

when cats are diagnosed with chronic kidney disease (CKD), they've already lost about 70% of their kidney function. but cats with CKD can and do many times live years longer, with treatment. one of the most important things with CKD cats is to give them subcutaneous (sub-q) fluids. these sub-q fluids help their kidneys by flushing out the toxins the kidneys normally would (but aren't able to as well, with their loss of functioning). a nice side effect of the sub-q's is that many/most cats have a good appetite right after being given the fluids. it's important to make sure a cat with CKD continues to eat well too.

i'm adding a link to an excellent website -- http://www.felinecrf.org/index.htm . this website is my (and many peoples whose cats have CKD) 'go to' website for info about pretty much everything related to feline chronic kidney disease. there's a whole lot of info there, so i'd suggest starting to read there, and just work your way through the info as you're able to absorb it.

is your peanut being given sub-q fluids? my snick has been given sub-q's (at home, by me) since she was diagnosed with 'the beginnings of kidney issues' about 4 years ago or longer. snick is currently at stage 2 CKD -- there are 4 stages. could you ask your vet what stage peanut's CKD is in?

i understand the stress and drain it can be at times to be a caregiver. it's not easy on us. but i also firmly believe in my snick's right to live as long a life as possible while she's continuing to have a good quality of life. so i'd look at your peanut's medical condition (also discussing with your vet, and treatments that may help) and his quality of life to make a decision about whether your boy is suffering too much.

re the urinating on towels. is the high sided tote litter box you made covered, does it have the lid on the top of it? if so, try taking the lid off of it. it might be that your peanut isn't comfortable using a covered litter box, or that his preference has changed -- that can happen with cats. you might try using an under the bed style plastic storage bin -- low sided, and without using the lid to it, as a litter box for your peanut. he may be having a hard time getting into and out of his current litter box, because of his spinal injury. if he's not wanting to use the litter box with cat litter in it, you might try placing a towel in it and see if he'll use the litter box that way. i'm thinking that once you've got your boy using the litter box with a towel in it, you could then try adding some cat litter under the towel, then gradually roll back the towel to expose the cat litter and see if you're able to help him become comfortable using cat litter once again. there's also a product called cat attract litter additive (http://www.preciouscat.com/cat-attract-litter-additive/) as well as cat attract cat litter (http://www.preciouscat.com/cat-attract/) that can help. and here's a link to Five Steps to Solving Litter Box Problems at the same website -- http://www.preciouscat.com/litter-box-solutions/ . another possibility might be that your peanut's spinal injury has caused some incontinence, or he's developed a UTI (urinary tract infection) -- cats with CKD can be prone to developing UTI's, especially if they're being given sub-q fluids (because their urine is so dilute). you might discuss those possibilities with your vet.

Thanks for the information. My cat is Stage 3. I got his blood values when he was diagnosed.

The vet recommended special food but as long as he's drinking so much she didn't want to start him on extra fluids right away. He was slightly dehydrated so I do need to watch that even though he drinks a ton.

I think the pain is making him not use the litterboxes. He used to start in the box and then walk out. Now he just stopped going in. He has an under the bed tote, a high sided tote with a door cut in the side and 3 other regular litterboxes to choose from. He poops in the box but wont pee in one. I think he avoids them because he associates them with pain.

Is he still on pain meds?

Cats with Kidney Disease should not really be in pain, unless they are having stomach ulcers, that time of thing.  But their kidneys should not be causing pain, so my Vet says.  .  Is the pain caused from the spinal injury?  I'm not sure I understand how he can urinate on towels and that not hurt, but not urinate in the box because that hurts?  Also, I would think pooping would hurt worse, as that involve pushing and arching of the back, etc.  BUT, if he is in pain from the injury, then he should be in meds to control it. 

I totally agree with everything MickNNick said, particularly about how to get him to use the box again.  Have you tried Cat Attract litter.  That's supposed to actually attract them to the box.  But I DO think the type of box may be an issue, IF it's his spinal injury that's part of the problem.  You could even use a cookie sheet or jelly roll pan that he just needs to basically walk into.  He'll get litter everywhere if he tries to cover up his "leavings", but better than having to wash icky towels everyday.  Also, are you washing those towels in enzymatic cleaners, or not?  If not, then they are just drawing him right back to that spot, as even washing in the washing machine with HOT soapy water will not get the smell out to a cat   If none of these things work, including pain meds, then I would really suspect he has a UTI, which IS pretty common in kidney cats. 

I don't know, but if he's drinking lots of water and still a little dehyrated, seems to be that he still might need sub-q fluids.  Honestly, they DO make them feel SO much better.  I also have a kidney cat who will be 16 in January.  She is my 3rd kidney cat , so I know of what I speak .    On on that topic, there must be some underlying reason why he is so tired.  Perhaps he's low on potassium, or Vit B.  Kidney cats often get anemic,or even get high blood pressure  Were all these things checked?  

BUT, if he is not withdrawing from the family, then I would say he's not ready to go.   Cats who are in a lot of pain will usually completely withdraw from the family.  If you are truly worried about his quality of life, here is a scale you can use to try to judge where he is:  http://www.veterinarypracticenews.com/November-2009/Quality-Of-Life-Scale/

It is good that you don't want him to suffer.  I'm the same way.  My last kidney cat was my soul cat, and I told him when he was ready, I would let him go.  After three years, one night he looked at me and flat out told me he was done .  the next morning we called our Vet and took him down.  Even our Vet cried, but she said she barely touched him with the needle and he was gone...that's how ready he was .  But up until that night, whenever I asked him if he wanted to leave me, he would always do something that indicated he wasn't ready to leave yet. 

petcrazy76 said:

The vet recommended special food but as long as he's drinking so much she didn't want to start him on extra fluids right away. He was slightly dehydrated so I do need to watch that even though he drinks a ton.
 

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I don't know, it seems to me that if he's drinking a ton and still dehydrated, he could benefit from fluids. When my kidney cat reached that point, my vet started her on sub-q fluids, and it really made her feel SO much better. She just hadn't been able to stay hydrated no matter how much water she drank. I think they need the electrolytes in the fluids, not just plain water. Plus, when she feels better, she eats better, and that helps keep her from getting so dehydrated and poorly again.

Peanut had a complete blood workup when he was last at the vet. Nothing concerned the vet except the tests related to kidney function. She said some cats feel better on the special kidney food so we've been finding one he likes. Now we're in the process of switching him off the old food.

Im supposed to let my vet know how he is doing on the new food. Maybe she was waiting for that before she tried the extra fluids. Im not sure. His skin bounces back pretty quickly so he doesnt seem very dehydrated at this point.

All I read on kidney problems listed lethargy and weakness as symptoms. I thought that part was normal.

He is not currently on pain meds. He finished and was doing ok for awhile. Im not sure why he's not using the box. Sometimes he starts in the box and walks out while he is going. The only reason we put the towel down in the first place is because he'd walk out or stand up with his butt toward the door we cut in the tote. His back pain may be causing his litterbox problems. Peanut has always let us know he's unhappy by peeing on things so its hard to know when he's sick and when he's upset.

I will talk to the vet about meds and fluids.