It does sound like your vets are likely using the IRIS (International Renal Interest Society) guidelines for assessing the stage of kidney disease, which most vets here in the US also do.Chronic Renal Failure tho it's in such early stages that there are no visible signs of anything being wrong but his creatinine levels are high enough to suggest the issue... Creatinine is 182 actually
Urea is 6.5...They are strongly against sub q or whatever fluids for treating kidney disease in Macedonia.
But even IRIS suggests that at the higher end of Stage 3 there might be a need for sub-Q fluids to help with dehydration that will occur as the kidneys continue to worsen in terms of function. The point of sub-Q fluids is when a cat can no longer drink enough to keep up with what is required to enable their kidneys to process waste correctly. I think of it as the kidneys trying to process 'sludge' (dehydrated blood) which put additional pressure on them to do so. But, more technically put - dehydration can cause toxin levels in the blood to rise and reduce blood flow through the kidneys, which in turn causes the kidneys to 'overwork' resulting in further deterioration.
I am not suggesting anything but rather curious if you know why your vets are so opposed to sub-Q fluids. Is it that they are opposed now at the Stage your cat is in (which would make sense), or are they opposed even in the higher stages?
There is also some dialog on when introducing renal food is most appropriate, however, I believe IRIS does denote Stage 2. There are other medical data that suggests it may be applicable at the later stages because renal foods are generally comprised to reduce the amount of protein as that can wear on the kidneys as well. However, it also has been known to attribute to muscle mass loss, escalating a process that occurs in aging cats with or without kidney disease. Just wonder how that applies to your cat who I think is still young yet at 7yo. (For perspective, I have an 18+yo cat with kidney disease in Stage 2-3.)
Lastly, I am also curious about the phosphorus level of your cat - I see you are giving him RenalVet, which I believe is a phosphorus binder.
Have you ever looked at this website? You might find it interesting if you are into becoming knowledgeable about all the nuances of kidney disease. Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Everything You Need to Know to Help Your Cat (felinecrf.org)
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