kidney failure

Question
My 4yr old cat has just been diagnosed with kidney failure.  His BUN is 211, CRT is 23.  I've been giving him SQ fluids for 5 days now and he doesn't seem to be getting better.  Is there any hope?   I'm considering Euthanasia today, but should I wait and have his BUN and CRT rechecked?   I just want to know if I'm doing the right thing.   
Also, we don't know what has caused this in such a young cat.  He's and indoor cat.

Answer
Hi Denise.  You are right...a 4 year old cat should not be in renal failure.  Are you sure that he's urinating?  He may have a urinary tract blockage (blocked by crystals in the urine), which is very common in male cats.  To unblock him, your veterinarian will need to insert a urinary catheter for 48 hours to drain the trapped urine and the crystals that are unable to pass naturally.  This is the main ailment I would have to assume as a possibility in a young cat in renal failure.  I would call your veterinarian immediately to discuss this as a possibility and for a urinarlysis which will detect any crystals that may be formed in the bladder. If this is the case, soon after your cat is unblocked, he will be better.  His BUN and Creatinine levels will be at the normal level.  But the unblocking must be done asap.  
If this is not a urinary tract blockage, the other  possibilities are that he ate something toxic and his organs are shutting down from the toxicity, or that he was born with a birth defect that has severely caused damages to his kidneys, or that he has a severe urinary tract infection/bladder infection/kidney infection.  I can tell you that the highest creatinine level I have ever seen was 16.8...it was my siamese cat who was in renal failure and he was not improving so I had to euthanize him.  I have never seen 23 as a level.  That is unbelievably high.  Generally with renal problems, the system goes like this:  IV Fluids for 72 hour straight and then another renal count test.  If the BUN and Creatinine levels are not improved by this time, they will never improve.  A creatinine level that is 10 or over is considered very severe and untreatable.  If your cat has a urinary tract blockage, this will clear up.  If not, I'm afraid that there is no chance of improvement with a creatinine level this elevated.  I wish I could tell you something else...unfortunately, these values are unbelievably high and, if not blocked, they are most likely going to continue to elevate.  If your cat is urinating well, and your do decide to euthanize, I would definitely suggest checking his levels again for a peace of mind.  I'm so sorry you are going through this difficult time right before the holidays.  I know what it's like to be faced with a decision like this, and I can tell you that whatever you feel is best, will be best for your baby.  Please feel free to write me anytime.  I understand what you are going through and I'm here for you if you need anything.  If you do choose to euthanize, but have never been through this experience before, please feel free to ask me any questions about it.  I want to put your mind at ease and will be happy to answer any questions that may be itching at you.  
Please take care and know that I'm thinking of you and your boy.
Hugs!
Hilary