Acute kidney injury - am I wrong to hope?

[lucymc11]

Hi everyone, my baby girl, a 11.5 year old domestic longhair was taken into vet hospital on Thursday as she had stopped eating, walking and just seemed so under the weather.

I had taken her to the vets on Tuesday as she'd stopped eating (still walking) and the vet told me she was in pain due to her arthritis and prescribed Gabapentin. I gave her the Gabapentin Tues eve and Weds morning and she deteriorated. I called the vet on Weds to ask for advice and they told me it was probably a reaction to the Gabapentin and to stop it ASAP. On Thurs she was so poorly I took her in as an emergency appointment.

She was diagnosed with acute kidney injury (cause unknown at the moment - urinanalysis results pending). After 48 hours on fluids kidney markers in the bloods have come down but they're still too high. An ultrasound has shown no structural damage to the kidneys. We're going to continue her fluids for another 48 hours and check her bloods again.

The vets are giving a very guarded prognosis but I'm really struggling with the uncertainty of her recovery. They're telling me everything is moving in the right direction but she's by no means out of the woods yet.

This has absolutely broken me, so much more than I thought it would. I knew how much I loved her but always thought I'd be strong when she got ill and think about the lovely life she's had. I guess the reason for this post is to see if I should prepare for the worst? Is it very unlikely she'll make a full recovery? Is it cruel to keep putting her through this treatment and keeping her at the vets?

The prognosis is guarded but there is a chance she could improve, I would be guided by your vets and carry on .
Have seen cats come back from terrible renal levels, but it is very dependent on the underlying cause of the damage.
I really hope you get a positive outcome xx

Thank you so much @karmalama for your reply.

They took her urine sample on Thursday to identify the cause but results have been delayed from the lab. Does this delay prevent the efficiency of her treatment in any way?

She's an indoor cat and I can't for the life of me think what she could have ingested. She only eats the finest tinned tuna steaks and v v expensive biscuits, she just isn't the kind of cat to lick/ingest random things. Her white blood cell count is low so they've said an infection is possible but not likely.

She was taking loxicom for the past month or so for her arthritis and I've now read things online that say this can cause AKI but seems to be conflicting views.

Never felt sadness and guilt like it. 😢

My boy has renal failure (CKD), so I've spent an awful long time researching this subject recently! As far as I can tell if the cause is a sudden injury, poisoning, infection or anything like that (AKD), there is a fair chance of recovery as long as it's treated as soon as possible and aggressively. The treatment can depend on the cause e.g. antibiotics if it's caused by infection, but in all cases the fluids are critical.

Don't panic YET, it can take days for the fluids to get the urine levels back to normal. I would say prepare for the worst & hope for the best, early days yet! The prognosis is near enough always "guarded" as the cause and the individual cat mean there are too many variables to know.

Have a hand hold from me, and a paw hold from my CKD Boycat.

X-post with your latest.

I spent ages agonising over whether I could have prevented it in Boycat, like yours he is an indoor only cat and I eventually came to realise that there was absolutely nothing different I could have done but it was hard to let go of guilt.

Due to my project management background & my ADHD, I tend to research everything to death and looked into potential dangers to cats in the house before I got mine - it's terrifying all the things that can harm them!

Thank you @Allergictoironing appreciate it! Lots of love and best wishes to your boy. ❤️

I had a girl cat with CKD and she had 2 years after her first crash when she was first diagnosed. If it's AKI then the prognosis is pretty good if you can tackle it aggressively - treat the cat, not the numbers, and it does take a while for those scary numbers to come down.

Thinking of you and your fluffy one!

I'd still hope. The Gabapentin will have made it far worse, however the concern would be what caused her to stop eating before the Gabapentin.

Neither Gabapentin or Loxicom are good for kidneys, and she may have a pretty miserable life without either.

Thank you @AnnaMagnani for replying. Yes she went downhill so quickly after taking the gabapentin so you've confirmed what I thought.

I'm extremely grateful for the care the vets have given her since she they found her AKI, but I do feel slightly angry that it was missed when I brought her in on Tuesday. I can only assume she had suffered the kidney injury at this point as she wasn't eating, was drinking more and just generally out of sorts. The vet we saw on Tuesday was quite dismissive and said basically said "it's difficult to say what's wrong with her so let's just assume it's the arthritis".

Is it unreasonable of me to feel like this? I don't think for one minute the vet deliberately missed it but I just wonder if she should have had a blood test on Tuesday and whether this would have made any difference.