British Shorthair Kidney Issue - Help!

[Onemoretimeround]

This is Eric (right) with his best friend Geoffrey. He’s a 5-year-old British Shorthair, very much a homebody and incredibly loved.

Eric has had a tough week and we’re looking for advice or shared experiences.
He’s been diagnosed with a severely distended ureter and a very small, likely damaged (possibly non-functioning) left kidney. His creatinine levels were 232, then dropped to 170 after a hospital stay, but this may just be from hydration. He also has E. coli and another bacterial infection, so we’ve just switched to a stronger antibiotic. He’s on a muscle relaxant too.

The infection might be contributing to the blockage, but the vet suspects long-standing narrowing or scarring. No definite stone was seen, but it can’t be ruled out.

At the Royal Veterinary Centre, the vet explained that this isn’t a clear-cut case. She outlined the pros and cons of subcutaneous ureteral bypass (SUB) surgery versus ongoing medical management.

We’ve chosen to try medical management for now, as the surgery:
– is invasive and carries risks
– needs long-term maintenance (regular flushing under sedation)
– may not help if the kidney is already too damaged
– comes with ongoing cost and insurance implications

Eric is not currently in pain, and before this, we wouldn’t have known anything was wrong. However, the vet said we could be in the same position in a week when he has his follow-up scan.

Has anyone had a cat in a similar situation?

– Did you choose SUB surgery, and how did it go long-term?
– If not, how did your cat manage on medical treatment?
– What factors helped you decide?

Any advice or experiences would mean a lot to us right now.

Hello @Onemoretimeround I have no direct experience with SUB but looked after my boy Elton who had late stage CKD for over a year. The non surgical treatment is primarily diet led although you can also get supplements such as Porus One which helps support the kidneys. The main challenge with the diet food is finding one that the cat will accept. We eventually settled on a dry renal food that he would eat but wet food would have been better. If your boy ( who is beautiful by the way) won't tolerate any kidney diet options then you can add a phosphate binder to ordinary food which will help a bit. Eventually Eric may need SubQ injections to help flush out his kidneys. These can be administered at home and can really help prolong life ( like dialysis for humans) but unfortunately Elton wouldn't tolerate them. I can thoroughly recommend a site called Tanya CKD which has everything you need to know about supporting cats with kidney disease - I wish you and Eric well.