Elderly cat with kidney issues and huge weight loss

[spydie]

Our 16 year old girl became quite unwell the last few days and it turns out she has kidney trouble. We don't have a formal diagnosis yet, bloods showed very elevated levels indicating kidney function is impaired and that she also has an infection. She had an ultrasound yesterday which showed nothing untoward and the vets also took a sterile urine sample which has been sent off to grow cultures from. She's at home and has some tablets along with special renal food, but just looking for any advice really.

She's painfully thin, but still eating which I'm hoping is a good sign. She's always been a petite cat, lost a lot of weight about 18 months and at thr same time her appetite increased dramatically but everything came back normal on bloods. She had actually been putting on weight during lockdown, as we were home every day she was getting lunch and it was only a week ago I said to my husband how much weight she had put on. She has lost all that weight though in less than a week, she is so thin and now weak too. I'm waiting to hear more from the vets, but other than giving her lots of small meals of the wet renal food throughout the day, has anyone been here with their cat and can suggest anything else we can provide to try and increase her calorie intake?

That is something to discuss with your vet. You can get convalescent, very high calorie and palatable food (Hills a/d), but I don't know how that would affect the kidney issue, if at all.

Thanks. I'm just looking for suggestions from people that have been here with their own cat so we can take ideas back to the vet and discuss, as mentioned we are still waiting to hear more and confirm what the diagnosis is. The renal diets all include lower amounts of high quality protein and I'm reading that these diets can cause weight loss which isn't going to help her much.

My cat became skeletal very quickly when she developed hyperthryroidism. She's had all the blood tests but somehow the vet had forgotten to do a thyroid one. It might be worth checking that they actually did one.
I had another cat with kidney disease and they do get very thin with it, she was on pills and a special diet for some years.
At the end when the disease had run it's course she became very dehydrated and confused so I'd look out for that too.

I can only speak from experience with my mums cat and it isn’t a happy story.

She was about 18 and became extremely thin and very hungry and thirsty.

Vet diagnosed kidney trouble and thyroid disfunction.
Was prescribed extremely expensive tablets which made no difference at all.

Any vet truly acting in the cats best interests would have put her to sleep imo but instead they insisted on continuing the tablets (that weren’t working) and putting the poor cat through 4 weekly blood tests (she had always been terrified of the carrier and the vet), she got worse and worse until she started attacking people for food and crying all day starving.

The poor thing had some sort of stroke/neurological event in the end, peed herself and lost control of her legs.
Vets still tried to convince my mum to pay out for more medication before agreeing to PTS

Thanks @madcatladyforever (great name!). I will certainly ask re the thyroid, I'd have thought so but who knows! Did you find your kidney cat managed to put weight back on? Will certainly look out for that, she's acting normally and seems ok in herself but I am keeping a very close eye on her.

Sorry to hear about your mum's cat @frostedviolets, not quite the same but I have been there with a horse that was clearly suffering and in chronic pain but looked great, vets wanted ££££ to investigate and it really was time to call it a day. I want to see what the diagnosis is and discuss options and go from there with the cat as whilst she is eating and behaving normally I do want to give her the chance to see if we can pull her back.

As mentioned before, would be good to rule out thyroid problems.

Having said the above, my boy went from being 6.85kg to 3.1kg. He was tested twice and kidney disease didn't show up. It was only when he started drinking a lot, that the results showed be had it. Some cats can live for a good amount of time with it, my boy only had two months from diagnosis. I do recommend small meals, towards the end I even found myself getting up at 5am as he showed signed of being nauseous at night. By all means try renal food, but many cats don't like it, so in the end it's more important to get food down them - wet is the way to go and you can add a little water to it. Also, leave water around the house and outside. She might not want it now, but as the disease progresses water moves through their kidneys quicker, they become very hydrated and thirsty.

Hopefully, you've got a good amount of time with her, but towards the end it was very hard to get anything in my boy, so be prepared to try different brands, chicken, fish and Webbox lickylix as a treat.

Do ask what is available medically to support her. If at any time you're not happy, do take her back, like I say they can get nausea, vet should be able to help with it.

My cat who was 8 and had severe heart disease, lost 500g in a week. I didn't realise how bad she looked until I picked her up after my holiday. Bloods showed kidney failure and I just knew it wasn't treatable on top of her heart disease. I looked at her one day and just knew it was time. The light in her eye had gone. She had a beautiful peaceful death. It was absolutely the right decision.

I think it will all depend on how she reacts to the tablets.
If she is eating bits and pieces of the renal food, that’s good. If she is not eating the renal food, then I would prioritise getting any food in her even if it is not the renal one.
Is she good with taking tablets?
If the tablets aren’t working and there is no other treatment, you may have to make a difficult decision, because untreatable kidney disease makes kitties feel very ill. Imagine being constantly nauseous and constantly thirsty, but even if you drink loads the thirst never goes away.
I do hope the tablets will work for her, fingers crossed.

Thanks @starfish4. I have read that the tests only show as positive once 60% or more kidney function has gone. Sorry to hear about your cat. Luckily she is eating the renal food, she's gone through 3 sachets today... and pleased to report she was up and asking to be fed like her normal self this evening. She us on some tablets, and poss antibiotics once the cultures come back. A little worried about the infection continuing untreated though until then good advice on the water bowls and early feeding, I left her with some food late last night and got up at 6 his morning to feed her.

Sorry to hear about your girl @Toddlerteaplease I'm certainly hoping we get a little more time with her and want to do all we can for her. Luckily she still looks to have her spark and vets have said she is strong and all other organs ate functioning normally, but we will take each day as it comes.

@BlueTreeBlue she is horrendous taking tablets, utterly vicious (otherwise she's the sweetest cat) but I've crushed them and added to her food and she's eating them that way.

Just adding to this....

Look up Tanya's ckd page.

This page specialises in cat kidney disease.

Ask for a copy of the bloods and just have a check against what they think it should be.

Lsoign weight quickly is not a great sign even for an older cat.

Is she drinking more than usual? I had two cats with ckd and managed then for 2 plus years before they passed away.

I gave them both daily injections into their necks of fluid. It's just under their skin so was easy to do.

Also a sign of not eating can be cystitis - also common in cats. Has she done her business outside the tray at all?

@celebgoss101 thanks for the insights, wow 2 years... I think we'd be lucky to get 2 months but maybe feeling pessimistic at the moment!

Yes she was drinking loads, all of a sudden she was climbing the fence into next doors garden to drink from their pond (They do have a cat fountain ) and started doing her business on the floor outside the tray instead of in it. Couple with the weight loss so booked her straight in to the vets first thing Monday.

She's definitely perked up tonight so hoping she's starting to feel a slight bit better...

Regarding Tanya's ckd page she is US based so her blood result values are in mg/dl where as U.K. ( and Europe) blood results are in umol/l. So please don't scare yourself with comparing U.K. creatinine results with her US values.
This page shows the international renal interest society's staging for Cats and Dogs and is the most widely used set of criteria for staging of renal disease in the veterinary world.

Good shout about Tanya's although I thought it had the UK ones on there too.

I would defo want a pee sample done.

Your cat is a little older, mine were 12ish but were also Persians who tend to not live as long.

The main things is to get her stable asap. I am surprised the vet hasn't given her antibiotics to start taking straight away as cystitis looks to be an obvious one. How long til the results come back?

Cats can go into "crash" where their levels to really high and they need an IV with fluids and antibiotics for 24 hours or so and then can calm.

Renal food is important but it's not very palatable and so making sure she eats is most vital so if she isn't eating that then try other foods.

Vets will differ on their experience on kidney disease and it's also up to you how much you do and you shouldn't feel bad either way. My two were easy (ish) to manage and didn't mind their injections too much, pills were always harder but pill pockets tended to work.

My vet said that even other vets at that practice would not have suggested fluids etc. It's far more normal in USA than in the UK.

Tanya's website can be massively overwhelming but it's also an amazing resource, even my vet read it as it does link to latest studies etc. The forums were also useful but massively intense. I was always putting quality of life first but some Americans will go to crazy lengths, but it helped and I became quite an expert at reading blood results etc.

Short term..

1. Offer small amounts of food constantly
2. Have lots of water bowls available , also a fountain if you have one. I used to also mix a bit of water into the food.
3. Chase up for results asap and post on here if you are unsure about anything feel free to PM or add to this thread.
4. Try puppy pads for peeing. If she doesn't feel well and just like in humans cystitis is really crappy for cats then she might prefer to pee on there.

Thanks for the links to Tanya's page, very useful and I've had a couple of late nights reading through it all!

I took her back to vets this morning as I didn't feel we were getting any answers (been chasing very day and asked for phone calls) and I don't want to prolong any suffering if there isn't much more we can do, but needed some answers first. Still no results back from her urine sample, but they have now given her a long lasting antibiotic so if she does have a UTI that will hopefully help.

They said her blood work puts her as a stage 2 going into stage 3, and that most cat's they see with her values are not eating and vomiting all the time. She is still eating and hasn't vomited at all since she started on the benefortin, and vets agreed she is very bright however she has lost 2llbs since Monday. She's had a subcutaneous injection of fluid as was slightly dehydrated, and I'm taking it on a day by day basis really.

My old girl, now sadly departed, was diagnosed with mammary cancer (for the 2nd time in her life) and kidney failure was found during the various tests she had. She was 15 at the time. We got an amazing 4 years of her afterwards, she passed away at 19. It was her kidneys that took her, we just couldn't keep them going any longer. When we realised she was becoming very frail we chatted to the vet on the phone and gave her one last night with us before calling it a day. She was hand fed tuna all night, we all camped in the living room with her so she wasn't alone and we took her to the vet in the morning. She slipped away peacefully but the vet still tells the tale of the oldest cat on their books living 4 years after a CKD diagnosis!

How is she now spydye?

Certainly stage 2 going into 3 should be managable but obviously depends how poorly she is now.

Glad they have her in an antibiotic.

My vets are pretty good but they have been better since I lost it with them a couple of years ago. My cat was in hospital with anorexia. She was really ill and I was very worried. They messed me about so much, not calling me back etc. Finally after being patient for a day I spoke to a vet who told me unfortunately my cat had kidney disease. Well that sent me over the edge, she had been diagnosed with that 2 years before and I knew all that. He had obviously glanced at her notes and shoved on the phone to me.

Finally after I cried a lot to the receptionist I spoke to a vet who read all my cats notes and could answer questions.

I followed up with the manager of the practice a couple of weeks later. I was polite but wanted to express where I felt things went wrong - mostly vets bring on and then off and then different night vets. Since then I've dealt with 1 main vet and if she isn't going to be about another vet is prepped to know I will ask questions and be knowledgable

Thanks for asking after her @celebgoss101, it's not good news. Been a rollercoaster few days, she really perked up sunday and I was cautiously optimistic that the antibiotics were helping. But then she barely ate yesterday and she's very weak. She's lost that spark in her eyes and I she is really struggling, I also don't think she can see properly.

We are taking her to the vets this evening to be put to sleep. She's been eating some roast chicken and ham today and I'm just trying to spend as much time with her as I can

I'm so sorry to hear that.

She has had a good innings but I'm sure that doesn't help right now.

I hope you managed to give her lots of cuddles and just know you were doing the kindest thing

Take care of yourself and don't feel guilty for being upset X