Expert: Jessica - 11/4/2010

Question
Hi Jessica, I seen you posted a question back in May about
your 18 y/o cat with end stage renal failure. I am in the
same exact dilemma as you were, and I was wondering what you
did. My vet is quoting me $600 for 3 days hospitalization
for IV fluids. Her creatine level was 10.6, she is severely
dehydrated. The vet brought up euthanasia, but I cannot bear
to let her go yet. I also cannot afford $600 treatment
either. I brought her home for now and I am giving her Sub-q
fluids. I just want to know what you decided to do and how
it turned out for you.
Thankyou, Tara

Answer
Hi Tara,

I'm very sorry to hear about your poor kitty.  It's so hard when our cats are diagnosed with something we're unable to cure.  No matter how many times I find myself in that position, and it is always heart-wrenching.

One thing I have learned about kidney disease, though, is that it's merciless.  I have found this is a disease that's better to help a kitty pass in peace through than to put up a struggle through.  The cats are just so sick for so long.  

I certainly understand that you aren't ready to let your kitty go, yet, and you can continue with the sub-q fluids at home until you feel a little more sure that her condition is or is not going to improve.  You may also want to talk to your vet about some medications to help her feel better, if none have been sent home.  These might include Pepcid or Tagamet to help her belly (kidney patients often have excess stomach acid or ulcers), Cerenia to reduce nausea, and injectable B-12 to be given into her sub-q line, usually once a week, to encourage red blood cell production.  Some vets also recommend medications like benazepril to reduce the loss of protein in the urine, and adding a phosphate binder like Alternagel to meals, to prevent the kitty from absorbing harmful phosphorus from her food.  An appetite stimulant such as mirtazapine might also be beneficial.  

If she shows no improvement within a few days, however, I would encourage you to think further about making a final choice for her.  It's such a difficult decision, but it truly is the kindest thing we can do for a kitty facing a disease as tough as end-stage renal failure.

I hope she improves.

Best of luck,
Jessica