My cat has kidney failure and swollen kidneys. What treatment options?

Are IV fluids able to be performed? If they are I would recommend doing that over subcutaneous fluids. I would also talk to your veterinarian about starting an antacid with Mimi. When cats are in kidney failure they have a build up of acid in their stomach which make them not want to eat. Otherwise when cats are in kidney failure an aggressive treatment for at least 3 days and it is not helping, they typically at that point don't see any reversal in the kidney failure.

Hello, sorry to hear about Mimi. Based on those blood values, she has considerable renal disease. A creatinine of 8.6 likely requires hospitalization and medical support through injectable medications. Its unlikely that the oral formulations could take effect or that she will take them orally to help treat her. Most of the time, these patients require multiple medications to combat the kidney disease. In addition to the anti-nausea and appetite stimulant, they require antibiotics, IV fluids and other gastro-protectants. If the kidney disease continues to progress, they may even require dialysis. Ultimately, it sounds like the renal failure may be associated with her FIV, or that her FIV predisposed her to having a severe kidney infection. Your veterinarian may need to check her urine to look for any evidence of bacteria and potentially perform an abdominal ultrasound to asses her kidneys. Contact your veterinarian to speak about further diagnostics. Hope this helps and best of luck.

In chronic renal failure, the kidneys can become scarred or small in size, so the ultrasound supports that diagnosis. I am not sure what you mean by stain - this isn't a common term used in the US on ultrasounds. Changing the diet to a prescription renal food, increasing fluid intake by encouraging water consumption or administering subcutaneous fluids, using additional medications as the need arises, etc are ways to maintain or improve quality of life. Depending on the degree of kidney failure and Luci's response to treatments, she may have several more years of good life. But it is also possible that no amount of medical care could keep her comfortable and humane euthanasia may need to be considered sooner than later. Renal transplants are not commonly performed in the world. There is one University in the US that I am aware of performing them, but rarely. There is a large expense, risks of the immune suppressing drugs used, and the ethics of taking a kidney from another cat (that needs to be a perfect match) without them being able to give consent. Often the other cat will need to be adopted by the organ recipient.

Part of this decision should be based upon how Squeakers is doing clinically and how bad or not bad his values are. In general, if kidney disease is caught early on, it responds very well to treatment. Most of the time, treatment is simply a diet change to a kidney friendly, prescription diet. Pet’s where the disease is more advanced, may need to take a pill to decrease protein loss through the kidneys and they may need subcutaneous fluids on a daily or weekly basis. For cats with more advanced disease, they may need hospitalization and IV fluids to see if they will recover. Again it all depends on the blood values and how the pet is doing clinically. Most cats with kidney disease, if caught in time, will live an average of 2 to 3 years of quality life after diagnosis. This is variable though. Some pets progress quickly and others live longer than 3 years. You don’t know until you try. I hope this helps to guide your decision making. You can also find a fair amount of information about kidney disease on this website. Use the search feature. Please feel free to post any additional questions.

These lab results do not provide any "normal" values, which can differ based on the type of equipment used to run the sample, however I would agree that based on what I am used to as normal values Sabrina is in either renal failure or has very severe dehydration. Renal failure seems more likely given that she is also quite anemic (has low red blood cells), although her liver values do not look high to me. Typically renal failure is treated with aggressive intravenous fluid therapy, and with kidney values this high it seems unlikely that only getting fluids every 12 hours will make much of a difference. Also, with anemia such as she has, great care has to be taken not to give fluids too rapidly as to worsen the anemia. Persian cats are predisposed to a type of kidney disease known as polycystic kidney disease. This is easily diagnosed with ultrasound examination of the kidneys. Unfortunately, the prognosis is grim.

I think the fluid therapy will make her feel much better, and ideally kidneys blood test should be reassessed after 48 hours on aggressive fluid therapy. I know what you mean about cats and stress, but try to make her stay more comfortable by bringing in a home blanket and using feliway spray. They might give her some pain relief that will help her rest and be comfortable while there. I wish Luna all the best !

Unfortunately kidney disease in an older cat is generally a progressive disease. The treatments you are giving Mesi now are probably helping her feel better but the disease process is still continuing. Her kidneys will continue to shut down over time. I would recommend continuing the treatments for now if it is helping her feel better, eat, etc. You can also try to space out the treatments (like giving them every other day) instead of daily and see if that is still beneficial for Mesi. I hope this helps. Thanks for using Petco Pet Education Center, formerly Petcoach. Best of luck.