My senior cat has kidney failure. Should I rehydrate despite stress?

Poor girl. There is a natural anti-anxiety medication that you can try first before resorting to stronger anxiety medication from your vet. The product is called Zylkene and is available on Amazon.com. Ask your vet if this is appropriate for your pet Sabre to try to reduce her anxiety so that she can continue receiving her much needed treatment for kidney failure. I would also encourage you , if you have not done so already, to keep her on her kidney prescription diet, which is the mainstay treatment for pets with kidney failure. Best of luck with your pet Sabre and I hope that she can relax soon and take her treatments with less anxiety. Take care!

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.

Hello, I am sorry I misunderstood your question earlier. I hope this response helps you. In order to stage renal failure, we need to know the urine specific gravity, blood pressure, and urine protein to creatinine ratio. Based on the values you provided, she has chronic kidney disease but I cannot stage it without further information. If the free T4 was elevated that is consistent with hyperthyroidism which often masks underlying kidney disease. Therefore, her kidney disease could be worse than we suspect based on the info you provided above. Realistically, she has two diseases and fortunately both are treatable. Ultimately, the prognosis depends on response to therapy. It is not uncommon for some patients to do well for a few years with appropriate therapy and kidney diet. Prior to treating her hyperthyroidism, her kidney disease should be treated (at home) with subcutaneous fluid therapy, antibiotics to cover for an underlying kidney infection, and vitamin B12 supplementation. After she feels better and begins eating consistently, discuss treatment for hyperthyroidism.

I think IV fluids and supportive care are a reasonable place to start. If your veterinarian is suspicious of acute kidney injury then Mimi could regain kidney function with aggressive supportive care, but some cats will worsen despite treatment. If your veterinarian is suspicious of chronic kidney disease then her kidney function may not improve but often cats can be managed with medication and diet changes with a good quality of life for months to years. The acute vs. chronic designation is usually based on the history and overall exam findings. I think an ultrasound and urinalysis are good next steps - you may also want to ask about culturing the urine (although she may currently be getting antibiotics which could change the results, I can’t quite read a couple of the injectable medications). A blood pressure might also be helpful, and checking phosphorous, calcium and electrolytes in a blood panel could help. The only lab finding that is a little odd is the increase in lymphocytes, although sometimes the machine will not differentiate between cell types well and this may not be significant. Good luck to Mimi!

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.

I forgot to mention that they will also require a urinalysis in addition to the blood test in order to confirm kidney malfunction exists, before proceeding with the recommended treatments that you mentioned.

225ml is not a problem. A daily maintenance fluid for a cat would be 60 ml/kg. Your kitty weighs 12 lbs, which is about 5.5kg. So her daily maintenance would be 330ml. She actually may feel very good now, which is why she is using her scratching post and obviously is not nauseous but hungry. The extra fluid is likely flushing out toxins. So, no , you do not have to worry. Since you are giving the fluids under the skin, she will only pull in what she needs over time. Good luck with your kitty!