Q. My 13-year-old cat was recently diagnosed with chronic kidney failure. The day after Christmas I took him to the vet because he was so skinny, constantly drinking water and had no appetite. The vet recommended blood tests. The next day I received the horrible news. The vet had already given me Clavamox, an antibiotic to administer every 12 hours. He also gave fluids under the skin and a shot of dexamethasone. I brought him home, but he was listless, awake all night and walking very slowly to his water bowl and litterbox. I tried syringe-feeding a slurry of warm water with his food, but he ate very little. I keep him on a heating pad on a low setting, as well.
Because he was not responding well, I took him back to the vet to stay overnight on intravenous fluids, hoping this would help. I picked him up the next day after he was given an anti-inflammatory shot and penicillin in front of me. He is now doing worse. He cannot walk at all and makes strange moaning sounds and he still has the bad breath odor he had before the IV fluid treatment.
What could have happened to him after the 24 hour IV fluid treatment?
A: Although I can’t be certain without examining your cat or reviewing the bloodwork, I fear that your cat has end-stage kidney failure. It would have been ideal if your vet could have made the diagnosis at the time of the first visit and then hospitalized your cat immediately. Once the bloodwork revealed that the cat had severe kidney failure, you should have been told to bring the cat back immediately for hospitalization. I don’t know why your vet gave dexamethasone. I must say, it irks me when I hear of vets who routinely give sick cats an injection of steroids without thinking about whether it really is indicated.
The fact that you need to keep your cat on a heating pad suggests that he’s hypothermic. When the kidney toxin level becomes very elevated, a cat’s body temperature will drop. Also, when the kidney toxin level in the blood is extremely high, a cat will have very foul breath. This is the smell of uremia – literally “urine in the blood.” The fact that your cat is cold, cannot walk, has foul breath and is moaning tells me that he is very sick. He needs to be reassessed and then either hospitalized in a facility that has round-the-clock monitoring and care, or your cat may need to be put to sleep, depending on his condition and the severity of the renal failure. He needs medical attention quickly.