Q: Can my 17-year-old cat with probable kidney failure really be treated? My vet said to bring her in, but I have been down this road with my other geriatric cat. Can’t I do something besides bring her in, most likely, to die in his office? Can the traditional practice of veterinary medicine provide palliative care in for this kind of situation to make it easier for my cat and me?
A: Chronic renal failure (CRF) commonly causes illness in cats, especially in older cats. While it may be difficult or impossible to improve kidney function in cats with chronic renal failure, you can delay the progression of renal failure, improve the cat’s quality of life and extend a cat’s survival time through a variety of diet and drug interventions.
Bring your cat to the vet and at least do bloodwork, to assess the severity of the kidney disease to see if your cat requires hospitalization. Cats that are acutely ill with CRF require hospitalization, intravenous fluids and other supportive measures. I can’t tell from your letter how sick your cat is, so I cannot predict if your cat will respond to treatment. Hospitalization and intravenous fluids may improve the cat’s condition, but it does not return it to normal.
If you cat’s condition improves and she is sent home, feed her a prescription diet designed for cats with CRF. It is proven that cats with CRF that eat these diets do better and live longer. If your cat has mild or moderate kidney failure, it may not need hospitalization, and may be managed at home. You can perform many treatments at home to make a cat with CRF more comfortable. For example, nausea is common in cats with CRF, contributing to the poor appetite and vomiting. Antacids like famotidine (Pepcid) have proven beneficial in some cats with CRF.
Some cats with CRF will develop low levels of potassium in their blood. This can accelerate the progression of the CRF. Potassium supplements can correct this problem. Twenty percent of cats with CRF have high blood pressure. This, too, can accelerate the CRF as well as damage the eyes, heart and nervous system. Give cats with CRF and high blood pressure medication to control it. Some cats with CRF lose too much protein in their urine. These cats tend to have shorter survival times. Fortunately, you can correct this with proper medication.
Cats with CRF tend to develop anemia over time. You can treat severe anemia with injections of a hormone that causes the bone marrow to release more red blood cells.
As the kidneys continue to fail, the blood phosphorus level may begin to rise. Elevated phosphorus levels can be detrimental to the kidneys. For cats with high phosphorus levels, mix a phosphate binder into the food. These supplements bind the phosphorus in the food to prevent the cat from absorbing it.
Encourage cats with CRF to drink as much water as possible. Do this by feeding canned food, adding water or broth to the food and using fountain-type water bowls. Give cats with inadequate water intake fluids subcutaneously (under the skin) at home. Although this sounds daunting, cat owners can quickly master this skill, once shown the proper technique.
Many advances have been achieved regarding the treatment of chronic renal failure. Although CRF is not curable, cats can live for many years after diagnosis if treated appropriately.