# Cat Renal Failure - A Tale of Sickness & Recovery



## jacc1234 (Mar 20, 2010)

Hello, this is my first post here, im really glad I found this place. I recently have been though a serious ordeal with my 7 year old cat. Three weeks ago he started to vomit multiple times a day and would let out a horrible cry each time. He always had a sensitive stomach and would regularly regurgitate food right after eating but this was different. The vomit was foamy and sometimes was green with bile.

At first we thought it was hairballs but he seemed to be getting sicker and sicker. We finally took him to our regular vet who said it was nothing and not to worry about it. 18 hours later a 3AM we found him curled up in a corner barely breathing. His lungs were filled with fluid and he sounded like he was drowning. We rushed him to an emergency clinic and they were very grim. They gave him less then 50% chance of surviving. The vet on duty said they could try to save him but that it might be a good idea to put him down. We decided to give him a chance even though it was very expensive and his chances were not good.

After running a bunch of tests the next day they figured out he was in kidney failure and had heart disease because of it. The official diagnosis for any vet types was: renal failure and hypertrophic cardiomyopathy. They had to keep him there for a week of treatment. For half of hit he was in an oxygen chamber. Even with all of this his chances were still not good. 

Well, two weeks ago we were able to bring him home. His lungs had cleared up and his blood work showed that his kidneys were starting to function. When we good him home he was still in really bad shape. He could barely walk and was basically skin and bones. We had to force feed him, give him subcutaneous fluids(50Ml x2) and multiple medications(Norvasc, Furosemide & Potassium Gluconate).

Recovery was slow at first; he could barely stand and would have to stop walking and sit down every few feet. Its been two weeks since he has returned and he is doing amazing! I am so impressed with his will to live. He began eating regularly almost a week ago and looks almost like his old self.

We brought him back to the vet a few days ago for some blood work to check his kidney function. The results showed all of his levels were within normal range! Even the vets were surprised. We are still giving him his medications and fluids but have reduced the amount to 75Ml once daily. 

I am still a bit worried and I still have a few questions. I came here to tell my story and possibly get some advice from all of you. 

First off I am worried he is not peeing enough. We have cut his furosemide doses in half to 3.125mg twice daily. Currently he is "going" around 3-4 times in a 24h period. Does this sound ok?

Second, he is starting to eat much more like his normal self but is regurgitating after meals about once a day. He has always been prone to puking up kibble after eating but not normally this regularly. He still holds down most of his meals without issue though. Currently we are feeding him Science Diet Sensitive Systems because the vet did not seem too concerned about giving him a prescription K/D diet. We only found one food that basically stopped his vomiting, Wellness Core. The catch is that its a very high protein food and could have possibly been a factor that caused these issues in the first place. We switched both of our cats over to Wellness Core about 2 months before all of this happened. If anyone has any food advice I would appreciate it. He will not eat wet food ever so currently that's out but im open to suggestions. Also, can my "normal" cat safely eat the K/D food? Im just not sure how to prevent our other cat from eating his food.

If you have gotten to this point, I am impressed. Thank you for reading this long post and I look forward to hearing you stories or advice. Its been a rough month and I happy with all of the progress but am still worried sometimes. 

Thanks to everyone who reads this. I am really happy to join this community!


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## marie73 (Jul 12, 2006)

Welcome!

What an amazing story! I'm so glad you were able to bring him back to health. 

We do have people who can help you with your questions, but I think they're sleeping. Tomorrow you should get some good advice.

7 years old is too young to lose a cat. What's his name? Pictures?


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## jacc1234 (Mar 20, 2010)

Sorry I would also like to add that after getting my cat back from the vet he picked up a cold of some kind. Thankfully it is not in his lungs but he has been very stuffed up for a few days. They gave us some antibiotics which we have been giving him daily and it definitely getting better. He still has some snot in his nose but I think its finally on the way out. He has a history of URI's so this is a major worry especially with him in his weakened state. I don't know if this is relevant but I figured more info is always better then less. 

Also, I am really interested in feeding options. Any suggestions of food that would be of higher quality but sill low protein for his kidneys?


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## jacc1234 (Mar 20, 2010)

marie73 said:


> Welcome!
> 
> What an amazing story! I'm so glad you were able to bring him back to health.
> 
> ...


Thanks for the kind words. His name is Baebula and our other cat is Lilly, she is almost 4. I will try and get some pictures up tomorrow. He still looks a little rough with his shaved paws and chest from all of the different things he was hooked up to in the hospital . 

I really happy he is doing well but feel like im hyper vigilant after this mess so any little thing freaks me out now and I want to take him to the vet :?


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## marie73 (Jul 12, 2006)

I think it's normal to look at every little thing now and worry.

You're talking to the Queen of hypervigilence. I once almost rushed one of my cats to the vet, until I posted a question about it. Turns out she was just "chirping" at the birds outside. I thought she was having a seizure, I'd never seen the chirping before. Now I see them do it all the time.


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## laurief (Jun 22, 2008)

Kudos to you for stepping up and nursing your cat through his renal crisis. There are two categories of renal failure: acute renal failure (ARF) and chronic renal failure (CRF). From your description, it sounds like your cat experienced ARF (cats don't recover from CRF). ARF can be caused by anything that overwhelms or traumatizes the kidneys. Poisoning is one common cause. We live with so many toxins, both inside and outside of our homes, that poisoning occurs much more frequently than any of us would like to think. Regardless of the cause, the fact that your cat's kidney values are back in normal range is a great achievement and will hopefully signal long-term recovery and renal health for your cat.

As far as feeding your cat is concerned, high quality protein is essential for all cats, so K/D is NOT a good idea for either of your cats at this point. In fact, a protein restricted diet can seriously weaken a cat. Instead, choose foods with high quality protein and keep working on getting your cats converted to canned food (or switch to a raw or homemade diet). If your boy absolutely will not eat anything but kibble, choose a low-carb kibble like CORE or EVO.

Protein is not the enemy for cats in renal failure; phosphorus is. Problem is, meat is high in phosphorous, and meat is an essential protein source for cats. If your cat's phosphorus becomes elevated, you can add phosphorus binder to his meals to reduce phosphorus absorbtion. But again, that shouldn't be an issue as long as his kidneys remain healthy.

You did a fantastic job helping your boy recover. Just keep on top of his recovery by having his blood values checked every few months to make sure everything stays in normal range.

Laurie


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## jacc1234 (Mar 20, 2010)

I had my cats on Wellness Core and am a bit hesitant about high protein diets after this whole ordeal. There is no way to know what caused Baebula's kidney issues but we switched him to Core almost two months before everything happened. Also, the vets suggested a lower protein diet. 

I am interested in what you talked about and will look for more info. In the mean time, an dietary advice is welcome.


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## laurief (Jun 22, 2008)

You may find the following website extremely helpful and informative, although it is written relative to CRF patients, not recovered ARF patients. It has an entire section on nutrition for the feline renal patient.

http://www.felinecrf.org/which_foods.ht ... other_cats

Laurie


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## jacc1234 (Mar 20, 2010)

Nice. thanks a ton. I am hoping it ARF and not CRF but I always thought he was a big water drinker. I think I will be a bit more at easy next Monday when we get another round of blood work done to make sure his levels are all still normal. 

Im a bit worried today because he is not drinking or peeing as much. His energy levels and mood is great though so im trying to be positive. I think its probably because his is not being pumped full of so much fluids and taking a hefty dose of diuretics.


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## laurief (Jun 22, 2008)

jacc1234 said:


> Nice. thanks a ton. I am hoping it ARF and not CRF but I always thought he was a big water drinker.


Cats who eat kibble tend to drink more than cats who eat canned or homemade diets, because kibble is dehydrating. That may account for some or all of his increased thirst, though it's possible that he's been having renal problems for some time.

You should read the following pages on Tanya's site, as well, in case you haven't gone exploring and found them on your own already:

http://www.felinecrf.org/related_diseases.htm#HCM1
http://www.felinecrf.org/treatments.htm ... d_pressure



> Im a bit worried today because he is not drinking or peeing as much.


Cats who are receiving supplemental fluids generally don't drink much. Since their fluid requirements are being met by the subQ's, they simply aren't thirsty. He should be urinating plenty, though, esp. on the diuretic.



> His energy levels and mood is great though so im trying to be positive.


That's definitely encouraging. How is his appetite?

Laurie


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## jacc1234 (Mar 20, 2010)

His appetite is very good but he is only peeing like 3 times a day. His hydration is also good, his gums are slick and skin snaps back quickly. Activity is still good, he is getting feisty and wants to go outside. The only thing worrying me is the amount he is peeing. When we first got him back and he was on a high dose of the diuretics and fluids so he was going all the time. 

Now we are giving him half as much of the diuretics and 75ml of fluids once daily. He is still drinking and the amount he does pee is a good size. Im just wondering if I need to get his blood work done earlier then next Monday. I guess I will give the vets a call tomorrow and see what they thing. 

I am feeding him Science Diet Sensitive Systems which seems OK. He has also has not vomited in the past few days which im happy about. 

Once again, thank you for the feedback and the suggestions of that CRF website. I have found some good info and advice.


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## laurief (Jun 22, 2008)

Don't worry. From your description, it sounds like his urine output is in keeping with his fluid intake and that he's doing very well. The vomiting he was experiencing before may very well have been caused by dehydration. Now that he's maintaining good hydration, hopefully the vomiting is a thing of the past.

Tanya's website is a godsend for the CRF caretaker community. Most of us consider it our "CRF Bible". I bet you'll find yourself going back to it over and over and over again. I know I do, and I've had it bookmarked for about a decade!

Laurie


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## jacc1234 (Mar 20, 2010)

Thanks for the encouragement, I really appreciate you comments. The vomiting, is really more regurgitation and has been an issue of Baebulas forever. It comes and goes and so far the only solution was feeding Wellness Core. I am going to call the vets tomorrow and see what they thing about feeding the Hills g/d which i guess is for cats with early renal issues. 

Thanks again.


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## jacc1234 (Mar 20, 2010)

Baebula is still doing well. His appetite is really good, he is eating all the time actually. He is still not peeing as much as I think he should but he seems good. He is starting to really fight when receiving his fluids. For two days in a row now he has tried to squirm away. Up to this point he would just sit there. As frustrating as this is im also happy because I think its a sign he is feeling better and we are still able to give him his fluids without too much trouble. Also, he has still not barfed! 

He has also stopped staying in our bedroom closet and instead has been hanging out on the back of our couch. 

I am still looking for feeding advice. He is a kibble junky and really wont eat anything else, not even treats. I am not going to make any dietary changes until he bulks up a bit and we some more tests results. Tanya's crf website likes Science Diet but there seems to be a strong dislike of them here. I have yet to decided if the dislike is justified or if they are just the pet food bogyman.


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## marie73 (Jul 12, 2006)

I'm so glad he seems to be doing better. The struggling is a good sign to me, too. And no barfing. And venturing out of the closet.


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## laurief (Jun 22, 2008)

Are you warming his fluids before administration? If not, you should be. Room temp fluids can badly chill a cat and make admin very uncomfortable for him. I warm Billy's fluid bag in a sink of hot water until the fluid inside the bag feels comfortable when I let a bit flow over my wrist (as you would check the temp of formula in a baby bottle). When warming the fluid bag, be careful to keep the connection of bag to line out of the water and dry.

Also, many of us CRF caretakers prefer to use Terumo Ultra Thin Wall needles. They are sharper than other brands (particularly Monoject which we often refer to as "kitty harpoons") and generally insert with less discomfort to the cat. I use 20 gauge Terumo UTW's. They have a fluid flow rate just about equivalent to a Monoject 18 ga., but they're thinner and more comfortable. You can buy Terumos here:

http://www.thrivingpets.com/index.php/t ... edles.html


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## jacc1234 (Mar 20, 2010)

Thanks for the tip, we have not been warming the fluid but will start to now. I will let everyone know how it goes. Also, we are using 20Ga Monoject needles but will purchase some Terumos shortly. We are both hoping that Baebula won't need fluids for a while depending on how his followup visit goes on Monday. If they do wan't us to keep administering them I am going to stock up on bags, Terumo UTW 20GA needles and lines. 

Baebula is still holding down his food and has not been in the closet all day! He is rotating between sleeping on the back of the couch and one of our living room chairs. His sniffle is almost gone and he is done with his antibiotics which means one less pill to give him each day. He has also put on some weight and no longer looks starved. His nose is dry and seems a bit irritated but im hoping that it will start to heal now that his cold is almost gone. His hydration seems good though so im puzzled why his nose is so dry. Historically I have always noticed his nose was not moist like our other cats so who knows. Does anyone know if we could put something like neosporin, Vaseline or moisturizer on it? I know that he will probably lick it off so it has to be safe to ingest. That makes me think that Vaseline would be the best bet. It might not even matter if he likes it of though.

Thanks again.


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## laurief (Jun 22, 2008)

jacc1234 said:


> Thanks for the tip, we have not been warming the fluid but will start to now.


When I was first taught to administer subQ fluids many years ago with my first CRF cat, my vet neglected to tell me to warm the fluids, and it made my poor cat miserable. She would tremble and struggle during the admin. It wasn't until I asked one of the vet techs about her trembling that the tech told me to warm the fluids. DUH! As soon as I started warming the fluids for her, Pea quit trembling and struggling.

I have since learned from another vet that room temp fluids are often given to cats with high fevers to help bring the fevers down, since they are so cooling. So now the only time I use room temp fluids is when I'm trying to bring down a fever.

Different cats do seem to have different fluid temp preferences, though. On the CRF support mailing list, there are members who will occasionally report that their cats are more cooperative with room temp fluids than with warmed fluids, but those are the exceptions. Most prefer warmed fluids. When in doubt, though, you should always err on the side of a little too cool rather than any too warm. Just remember to always check fluid temp on your wrist first.

BTW, do NOT warm fluid bags in the microwave. That can easily get the fluids too warm and will also warm them unevenly. Use a sink or large bowl filled with hot water, instead.



> If they do wan't us to keep administering them I am going to stock up on bags, Terumo UTW 20GA needles and lines.


These are very good supplies to keep on hand even if you aren't using them regularly. BTW, you can generally buy fluids MUCH cheaper by the case from Target Pharmacy or one of the other pharmacy chains than from your vet. All you need is a prescription from your vet.



> Baebula is still holding down his food and has not been in the closet all day!


That's TERRIFIC news! He's obviously feeling much better!



> He has also put on some weight and no longer looks starved.


More great news.



> Does anyone know if we could put something like neosporin, Vaseline or moisturizer on it?


Rubbing on a tiny bit of Vaseline won't hurt, but make sure not to use enough to get into or cover his nasal openings. You sure don't want to accidentally suffocate the poor guy. Vaseline is often used in lieu of hairball remedy, so it's safe to ingest in small, infrequent amounts.

Laurie


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## jacc1234 (Mar 20, 2010)

I warmed the fluids today and things seemed to go more smoothly. I filled a large bowl with hot water and left the bag in it for 15 minutes. I made sure the bottom part was kept out of the water and dry by hanging it over the edge. The bag felt nice and warm but the fluids still felt a bit cool on the wrist.


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## laurief (Jun 22, 2008)

You can stick most of the line in the hot water, too. Just make sure you keep the connections of line to bag and line to needle out of the water.

The fluid should feel warm on your wrist, but not uncomfortably so. Remember that a cat's normal body temp is several degrees warmer than our own. You can experiment with fluid temp to see where it is most comfortable for your cat during admin. Just don't ever admin it warmer than is comfortable on your own wrist.

Laurie


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## jacc1234 (Mar 20, 2010)

So far so good with the warm fluids. He was very good the last few days but today got really pi$sed off. He was actually growling at us when we moved him into the back room for his fluids. We seem to have better luck when we bring the fluids to him when he is sitting in his chair. Its just tougher to gauge the correct amount when we hold the bag instead of having it hanging. 

He did puke yesterday after eating but im not really worried about it because its pretty much the status quo. His hydration is still good but his nose is still dry . I have not put anything on his nose but I am running a humidifier next to the chair he sleeps on. Hopefully this will help keep his nasal passage more moist. I am looking forward the vet on Monday. It will be nice to get an update on his progress and we might even get to stop giving him fluids.

Edit: The censors on this site are funny. I guess I really "urinated off" my cat today!


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## marie73 (Jul 12, 2006)

I hope he continues to get better and that it's good news on Monday.


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## jacc1234 (Mar 20, 2010)

After reading another post I noticed that Baebula has a bit of dandruff im not sure what this means or if its serious but I thought I should mention it. So anyone have feedback or advice?


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## tanyuh (Jun 7, 2003)

I'm sorry, but I don't have anything to contribute.. I just wanted to say that wow, this is an amazing story and very encouraging! I'm so glad that your cat is on the mend, you've done an incredible job taking care of him. I hope, too, that he gets a great checkup on Monday! Also hoping for some pictures!


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