Young kitty has Acute Kidney Failuere--- does he have a chance??

Where to Start
This site is extremely comprehensive, as you can see from the number of links in the sidebar on the left. But don't panic, you won't need to learn about every single aspect.

Most people who arrive here for the first time have two overwhelming concerns:

• 
  they want to know how severe their cat's case is.
• 
  they want to know how best to help their cat, and quickly.

I therefore recommend that you read these pages first:

• 
  How Bad Is It? - discusses the various stages of CKD in cats.
• 
  Is There Any Hope?: discusses the various scenarios you may face.
• 
  Key Issues - the crucial issues to focus on in order to best help your cat. Don't worry, it is highly unlikely that you will need to deal with all of them at once.

These pages will get you started quickly so you can hit the ground running. Then, later on, you can gradually get up to speed on CKD in more detail. The Site Overview - Finding What You Need page provides a brief summary of the contents of each page, so if you're not sure where to find something, check here, or just check the sidebar on the left.

Homepage

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White Shadow said:

Hi aireyell and welcome to the forum !

With the right treatment - at the 'hands' of a competent feline Veterinarian - there's usually a high probability that a young cat will recover from an episode like this.

One certainty is that it will take time...and, many "ordinary" Veterinarians do not allow sufficient time before making pronouncements. My sense is that 2-3 days of IV treatment will probably not be enough.

There's one thing that I just do not understand....that's the "pain meds" part. Unless there's been some other injury, acute kidney failure is not painful and so, there is no need for pain meds (which makes me wonder what these Vets are thinking - or, more properly how familiar they are with feline kidney failure). I'm also concerned about exactly which pain med is being given....some of these are toxic to the kidneys, others need to be excreted by the kidneys.....so, either way, a major concern.


I hope you are a reader, because you'll need to educate yourself about how all this works. There is a website, considered by many people to be the "oracle" of all things kidney cats, that I'll direct you to - it's written in plain language but rock-solid in science.

There are two parts to go through first, then a third to give you a sense of the most important ongoing issues - here's a snippet from the homepage with the three links embedded:

The woman who owns that site also hosts a specialized online community which you can join and where you'll get expert advice and help 24/7 - the group's homepage is here: Tanya's Feline Chronic Kidney Disease Support Group

Hope that helps !

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aireyell said:

As far as the pain meds, he's on buprenorphine. I actually just called the vet now to ask about it and she said that he would be generally uncomfortable without it and that it's safe for him. She's not specialized, however. Wow, I really hope he's safe taking it now.

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White Shadow said:

In case you have not found the pain meds section of Tanya's site, here's the coverage of buprenorrphine: http://felinecrf.org/treatments_antibiotics_painkillers.htm#buprenorphine

It's cleared from the body by the liver - so, no extra load on the kidneys nor no buildup in the body if kidneys not fully functioning, so in that respect, she's right about it being safe (if liver function is fine). There is one caution in there for future reference (an appetite stimulant).

There is one side effect of buprenorphine that would be a concern to me, though - it's not mentioned in Tanya's coverage, but is in Plumb's Veterinary Drug Handbook and is frequently reported by cat 'owners' (and here on TCS). It "may cause urine retention" (Plumb's ref).....now, that's something definitely unwanted when "flushing" a toxin is the entire focus of treatment !  (I've seen this in my own cats given Bup...now, the effect in them didn't appear to last longer than about a day, after which urination appeared to return to normal....) I think I'd have it stopped ** and this particular concern discussed with the specialist before it might be re-started. "Generally uncomfortable" doesn't seem to me to be a reason to administer an opiod drug "thirty times more potent than morphine" (Tanya's ref). Helen (who authors the Tanya site) describes the "feeling" of experiencing kidney failure as that of having a "hangover"....well, I suppose that's "uncomfortable", but, personally, I wouldn't risk slowing/reducing the detoxification process to address that.

(Bup can also cause constipation ("difficulty voiding" - Plumb's) and that's been reported here on TCS, though I haven't seen it with my cats. If he isn't producing stool, Bup may be the reason. Now, constipation would certainly contribute to 'general discomfort'.....as an aside, he should be eating wet foods only.)

** I don't know how comfortable you are with an issue like this with the Vet - most of us are 'naturally' intimidated in these situations because, of course, of the 'layperson' is lower on the education/training and perceived knowledge base gradients. For many people it's a learned ability - I have no problem specifying what I want/don't want done, but it's taken time and practice. At the same time, you're paying for the treatment, so you have every right to specify what's to bee done and what's not. Perhaps, in this case, it might 'ease' things to say, "Well, let's take him off the Bup and closely monitor for any reaction/changes..."

I suppose, at the very least, I'd want to share my concern - or, have it shared - with this specialist who's about to become involved.

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