18 year old cat with CRF

Question
I have an 18 year old cat with CRF. She is on sub q fluids daily. As of last 2 days she is resisting eating the RX food so the vet has said to feed her anything she will eat.

I worry about her numbers going up but can't see "starvation" as an option.

Am I being horrible if I feed her what she wants instead of letting her
not eat the RX food? I am afraid because then I will blame myself if her numbers go up. Her BUN and Creatinine and Phosphorus levels when I say numbers.

I fear I am contributing to her death if I let her eat what she wants and yet then I ask myself is letting her starve a better option.

Please help me. This may seem like a simple question to you but to me this is a very hard question as despite the fact I have my beloved cat, I have never faced this before and have zero experience with trying to figure a question like this out.

Thank you for your opinion,
Sue
ps I just don't want to be the reason she dies if her numbers go up if I feed her what she will eat. On the other hand, how can I in good conscience watch her starve and not eat? Please advise as to your opinion. I am so confused. I love her.

Answer
Hi Sue,
I totally get what you're feeling here. I went through it with my own 19 yr old cat, Floyd. Let me tell you what I discovered.

In the end, it doesn't matter what we do. The numbers WILL go up despite our best efforts, our diligence with fluids, our love and our tears.

I found out that the fluids do NOT help with the kidneys at all. All they do is provide the fluids the body needs to be comfortable. I use to believe (and being a Vet Tech, I studied this as well!) that the fluids we gave, whether sub q or IV, would clean our the kidneys and take the load off of them- thereby helping them last longer.
I found out that this is simply not true. To be perfectly honest (as I had to be brutally so with myself) is that we are simply making our beloved cat comfortable while they wait for us to be strong enough or overwhelmed enough to say goodbye and let them go, or they die on their own overnight while we restlessly sleep.
The fluids do nothing to extend their time with us. Well, maybe a little. To be fair. But only because we are replacing what the kidneys can no longer do.

Which brings us to the food. At 18 and on fluids, we both know she isn't going to be around long. Let her eat what she wants, as long as she is eating, she is telling you that she isn't ready to go. I don't think that her diet will make her numbers go up that much in a short time. Remember that kidney disease isn't normally detected until 80% of all kidney function is gone. That takes years to happen. It's a sad fact that we cannot see it coming. The only thing you can do is feed a food that is kidney friendly from the start.

My Floyd lived to be 19 because he was raised on Science Diet and then I switched him to K/D from Hills Prescription Diets when he was 10. So nine years on K/D probably prolonged his life. K/D is the Kidney Diet that Hills makes for CRF. I don't know what kind of RX food you are feeding her but you can try to enhance it with warm chicken broth, mix in some of her old food with it etc. Floyd ate the dry food, (all my cats did and lived past 14 but he was the King of Cats so he went the stretch to 19 yrs , 1 month) and he loved it. They all loved it. Crouton, who also ate K/D until I Floyd died ate Science Diet Senior after that. She made it to 15.

Your cat is a Star as well making it to 18. The vets at seminars used to tell me to let them know my secrets as they stopped measuring health issues in cats at the age of 16. Maybe they have changed that now but I doubt it.

So give her what she wants to eat, spice up the diet food more with chicken broth, and mix in some old food with it. That's all you can do Sue, and hope for the best. When she stops eating everything, no matter what it is, and gives you a look you will never forget, then she is saying, "I'm ready."
All we can do then is grant them that gift and grieve. But let your grief be swirled with the thought that you gave her an epic life and that she is happy and out of the misery that CRF brings.

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I'm sorry but I did not make any assumptions about your cat. I have 42 years of experience dealing with this. I have been through it too! I have read the same articles as you have but the newest ones contradict the older ones. I asked three different vets here and got the same answer. The AVMA states the same information. I have studied this deeply because of what I went through with my two cats. It's a terrible disease and it's hard on everyone.  

Ask your own vet. Ask for an honest opinion, not just one that they want you to hear. I am sorry that you think what I told you was impolite, but I am not going to lie to you. I am sorry that my years and years of experience, not to mention personal experience with my own cats is not enough. I wanted you to know that what you are doing is great but that changing her food isn't going to mess it up because the bottom line is that she is very, very sick.

I would be sad but glad to know these things and take them to heart and enjoy her if I WAS being told this. I would let her eat and worry less. I would give anything to have Floyd back - I would do so many things different for him and myself.  

If the truth about her situation offends you, I apologize for that. I hope that you can see that all I was trying to do was let you know that you are doing the VERY BEST for her in every regard, and that I know what it feels like, the worries, etc. BECAUSE I too, have experienced it. Enjoy her, feed her and love her.
Forgive me.