my cat has kidney damage, how will this effect him in the future?

Question
Ali,
With the diagnosis of kidney damage,what will be my  cat's chances of a full recovery?-how will his daily routine need to change to keep him from experiencing this again? I will have the full doctors report Friday. If there is extensive damage,will he live a painful life or would I need to make a decision that would free he from that?At this point his bladder is the size as a softball and are trying to reduce.It had all backed-up to his kidneys. I am worried and need to prepare myself either way, can you give me some insight on what to expect?

Answer
Val,

I'd like to start off this answer by telling you a bit about my most recent experience with a kitty who developed acute renal failure, how our vet treated her and what her life is like now slightly over 2 years later and I sincerely hope that I will help you to have a better understanding of what you can expect over the next while based on my personal experience.

In November of 2007 my eldest cat began showing signs that she wasn't feeling her best, she had started vomiting, but she was still eating, drinking and using her litter box so I decided to take a wait and see approach to see if her system would recover on its own. In the evening three days after MC began vomiting I had decided to book her in with our family veterinarian first thing next morning and while I was concerned I wasn't overly worried. That changed very quickly when I woke up at 2 am to the sound of my precious baby girl hissing which is nowhere near what she's usually like at home. I got up and crossed the room to check on MC and I immediately got my other half out of bed and let him know we had to go to the nearest emergency clinic right away. After paying the rather pricey up front fee at the 24 hour clinic we were ushered into an exam room where we had a tense wait before the veterinarian came to examine our girl. The physical exam yielded very little information beyond that MC was dehydrated so blood work and x-rays were recommended as a starting point. When the blood tests came back it was obvious what had been causing her symptoms - her kidneys were failing and the ER vet wasn't exactly optimistic, in fact she recommended euthanasia. After asking the vet if MC was in pain and being told that she wasn't we decided to take the x-ray, the blood test results and our little girl home until our vet's answering service would put us through to her at 6 am. As those few hours passed by I kept hoping that there was something our vet would be able to do for our baby girl and that we wouldn't have to say good-bye, after all, at that time she was only 8 going on 9 years old which isn't all that old for a healthy, well cared for indoor kitty.

When the answering service put our call through and we spoke with our veterinarian she asked that we meet her at the clinic ASAP to admit our girl to the hospital in an attempt to stabilize her kidney function. It broke my heart to watch my vet go into ER mode with my baby getting an IV line established and settling her into a hospital cage. I did my best to hold my emotions in check as I asked my vet what could possibly have caused MC's kidneys to fail so suddenly, after all, our entire family of fur kids had been out to the clinic for their annual physical only a month before and MC had been perfectly healthy at that point. Our vet felt that MC was the latest victim of the Menu Foods pet food recalls related to melamine tainted food in 2007, we honestly believed that we were feeding a safe food since our food hadn't yet made it to the recall list so we were shocked. Our vet recommended that MC's kidney values be retested 24 hours after her admission to hospital and as it happened her kidney function had deteriorated. MC was placed onto antibiotics and a special diet to let her kidneys function on cruise control and all we could do was hope and pray that she'd get better. Our vet is a holistic vet who uses homeopathy in her practice so she also began treating our girl with homeopathic remedies to alleviate her headache (toxins build up in the blood when the kidneys aren't functioning properly so our vet felt that MC probably had a headache) and encourage her kidneys to fight back. The good Doc's next recommendation was that our baby have her kidney function rechecked 48 hours later, we were so terrified that her kidney function had deteriorated and I made arrangements to go and visit our girl 24 hours before her next kidney function tests happened. I stayed with her for an hour and told her that we loved her and she could fight her way through this and come home to us. I force fed my girl since it was time for her feeding while I was there (she was hand reared from roughly a week old so she accepts syringe feeding better than some cats would). It was so hard to leave our girl and as I attempted to keep my tears at bay I told her how tough and strong she was and how much we were looking forward to having her come back home to us. 24 hours later I know I drove the veterinary staff insane, I called every few hours wondering if MC's blood tests had been done and what the results were. Unfortunately due to a few emergencies and unforeseen circumstances that often happen in veterinary practices it was the end of the day before MC's blood was drawn to test her renal function and we held our breath until we got the call. At first I thought it was bad news because the vet asked if I was sitting down and just as I was about to burst into tears the vet told us that MC's kidney function had returned to normal and she could be picked up the following morning. We couldn't have been happier and we were prepared to do whatever it took to restore our girl to full health.

When we went to the vet hospital to pick our girl up our favorite technician let us in and brought MC into an empty exam room so that we could spend time with her until our vet came in that morning to officially discharge her from the hospital. When MC first came into the room I could tell she was feeling much better, she was her usual spunky self with plenty of attitude and the tech told us that our girl had swatted the thermometer out of her hand when she tried to take MC's vitals for the last time during this hospital visit. While we waited for the vet to come in the technician showed us how to administer injections of fluid under our girl's skin whenever she needed them, we already knew how to tell if our girl was dehydrated (a properly hydrated cat's skin will snap back into place instantly when you gently pinch the skin at the scruff of the neck, a dehydrated kitty's skin will take longer to slide back into place or remain pinched). We also paid our vet bill and purchased a bag of IV fluids, some needles, an IV line and MC's new prescription diet for kitties with kidney issues so that we'd be ready to take our girl home just as soon as the vet discharged her. We were relieved that our girl had sailed through this major crisis in her health and prepared to give her the daily home nursing care she would need for the remainder of her life according to the wisdoms of conventional veterinary medicine, but it did take some time for us to work out a way to help MC be more tolerant of things that had to happen for her to remain healthy.

As soon as MC came home from the hospital she immediately decided that she would not eat her prescription diet under any circumstances so we initially followed the recommendations of our vet's technicians and force fed her but it came to a point where MC started to run away from me whenever I approached her because she figured I'd either force food down her throat or poke her with a needle. It broke my heart to see my girl like that so when we went back to our vet a month after MC's discharge from the hospital I brought up my concerns with our veterinarian who said that under the circumstances it would be wise for our girl to eat the food our other cats were eating and watch her closely for any signs of deterioration. It didn't take long for us to realize that the way our veterinarian's tech had shown us to give MC her supplemental fluids just wasn't going to work for her. We tried setting MC on a counter top and administering fluids there, we tried settling her in a cozy chair for her fluids and these option simply didn't work so I did what I usually do when conventional approaches don't work out - I found a way for MC to get her fluids that worked for her. What worked for MC may not work for your kitty, but since we found that our girl shivered when we gave her fluids we began settling her in my lap on top of a heating pad set on low covered by a blanket and I cuddled her and talked to her the whole time she was receiving her fluids. MC still wasn't pleased about the fluids so she continued to run away from me whenever I had to give them to her so I decided that the best way to deal with that would be to give her some type of reward after each installment of fluids, since our girl is super finicky there weren't very many options - she wouldn't eat fresh roasted chicken breast, meat/broth baby foods, freshly cooked plain salmon or anything else that most cats would come running for in an instant...What she would eat was canned tuna so when we stumbled on that victory we kept copious amounts of tuna in our house at all times since we couldn't just give MC tuna and leave our other cats out partly because MC's small so she is sometimes picked on by one of our other resident cats and partly because the other cats weren't above stealing tuna from MC if we turned our back on her. For the price of half a can of tuna daily MC tolerated her fluids well, her feline "siblings" accepted her without bullying her and all was good in our world.

Once we figured out how to administer the fluids so that MC wasn't afraid or uncomfortable (the needles supplied by the vet were quite large and since MC was so sensitive that she would cry out when we used them for her fluids we actually went and purchased much smaller needles from our local medical supply warehouse even though it meant that giving MC her fluids took a bit longer). MC became so comfortable with receiving her fluids and so aware of her own body that she began asking us for her fluids when she felt rotten, oddly enough she was always quite dehydrated when she asked for the fluids...At our three month follow up appointment to check MC's kidney function our vet was glad to see that MC's kidney values were 100% normal and she told us to keep doing what we were doing. We had a few more follow up appointments to check MC's kidney function before it was time for our cats to have their annual physical and it just so happened that our girl was due to have her kidney values checked when she came in for her physical. Our vet told us that MC's kidneys felt great, she was well hydrated, her kidney values were 100% normal and then she surprised us by recommending that we begin slowly weaning MC off of her daily fluids to see if her kidneys had healed from the toxic insult of eating tainted food...Up until late fall 2008 I hadn't read or heard anything about the recommendations our vet was about to make as far as MC's treatment went, but we trusted her knowledge and over time we managed to wean our girl off of her fluids. I held my breath at our next follow up appointment because MC had been asking for us to give her fluids and I knew she'd generally been right up until this point, but MC's kidney values remained completely normal.

Now, nearly two and a half years after our girl began showing signs of renal failure her blood work continues to come back right in the mid-normal range, she eats a combination of a high quality canned food and a homemade raw diet that's properly supplemented and balanced for the unique nutritional needs of feline companions and she's 100% healthy and happy. Conventional medicine hasn't got any explanation for MC's recovery and since our girl's condition didn't improve until our vet began treating her with homeopathy I must admit that I credit MC's survival to the use of homeopathy by our knowledgeable, skilled and well trained veterinarian. We still can't thank our amazing veterinarian nearly enough for saving our precious little girl. In hindsight with MC's history of having medical issues that are relatively serious from time to time it seems fitting that she managed to pull through the toxic insult on her kidneys caused by eating tainted food that led to renal failure - her recovery is a miracle, especially when you consider that Menu Foods produced melamine tainted pet food that cost thousands if not tens of thousands of pets their lives and left behind just as many grieving pet parents.

In 2009 MC's son began acting a little off after having some routine dental work done. Our veterinarian couldn't see anything wrong with our little man when she examined him, however we weren't willing to take any chances, especially in light of MC's near fatal bout with renal failure so we insisted on blood tests to alleviate our concerns about his health. As it turned out his bloodwork showed that he was dehydrated and his kidney values were a little high. At first I was very frightened, I wondered if we'd lose our boy to renal failure partly since he's much less tolerant than MC and more easily stressed (we call him our little chicken since he tends to disappear when guests come to our home or he hears anything that might be remotely dangerous to him, in his opinion of course). Our vet assured us that the blood tests hadn't shown quite that level of renal failure that MC had when she was admitted to hospital during the Menu Food pet food recalls. Our little man was admitted to hospital and placed on IV fluids to see if rehydrating him helped to return his kidney values to normal. His kidney values were a bit wonky for a few days and when our vet's practice partner called us with the results of Sooner's kidney values which were still slightly above normal. During the course of our conversation we learned about a new treatment that's been developed to treat kidney failure in people. Apparently there's a probiotic that's been developed to treat humans with renal failure living in areas where dialysis is not an option (third world countries, areas without dialysis facilities, etc) which works quite well. From what I understand it's a fairly new treatment that can certainly be tried as a treatment for cats with kidney failure. Luckily our boy's kidney values returned to normal once he came home, finished his course of antibiotics and had a chance to recover from the stress of being in a busy veterinary hospital, coping with the noise and activity and being handled by a variety of people he wasn't familiar with. Our little man is definitely a homebody who is most comfortable being cared for at home by people he's comfortable and familiar with.

One of the first questions that I asked of our veterinarian when MC was hospitalized in the hopes of stabilizing her kidney function was if our girl was in any pain. Our vet told us that in all likelihood she probably had a bit of a headache and felt fairly run down due to the toxins that had accumulated in her blood as a result of the kidneys not functioning normally to filter waste and toxins that normally leave the body when the cat urinates. Your situation is different in that your kitty's renal issues developed because he wasn't able to empty his bladder. I suspect that your vet's prognosis for this kitty is going to depend heavily on how quickly his bladder is emptied and whether his kidneys are able to recover after the toxic insult of having urine containing harmful wastes washing back into them. At this point since your kitty hasn't been able to empty his bladder completely I would imagine that he's pretty uncomfortable, if he was my little guy my first priority would be to have the veterinarian and his/her staff empty this kitty's bladder via catheterization and flushing his bladder with sterile saline to remove anything that has the potential to prevent his bladder from emptying. I would assume that your vet has already catheterized your kitty to help alleviate his pain, if not it's certainly something that should be discussed with your vet since it would significantly increase your cat's level of comfort. Your kitty will have to be sedated for a short period of time while the catheter is placed, his bladder is flushed, the urine is removed and any crystals/stones are removed to prevent further blockages from happening. The kitty will most likely have to have the catheter in place until his condition completely stabilizes which means that when you visit him he will likely be a very unhappy looking kitty wearing an Elizabethan collar (essentially a big plastic cone that prevents your kitty from reaching his back end and removing his catheter). I don't really know for certain how much your kitty's kidneys are likely to recover given that his bladder hasn't yet been fully emptied (I would recommend asking why this hasn't been done since he's probably in quite a serious amount of discomfort

Obviously you know your kitty better than anyone else does, after all, you live with him 24/7. Only you know for sure if he'd be likely to tolerate fluid therapy, daily medications, a special diet or any of the other treatments that might be useful to help him recover his kidney function. My recommendation at this point would be to see if you can find a homeopathic veterinarian or a holistic vet trained in the use of homeopathy in or around your area since I believe that a holistic approach that combines conventional therapies like fluids and a change in diet with "alternative" therapies like homeopathy, massage, veterinary chiropractic care as well as a whole host of other potential treatments. I must admit that after speaking with our vet about the conventional wisdom of prescribing a low protein diet to cats with renal failure and asking her countless questions to satisfy all of my many many questions and concerns I've learned something very important. While many conventional veterinarians believe that a low protein diet is the only way to ensure that a cat's kidneys aren't stressed once they've been diagnosed with renal failure of any type there are actually two schools of thought on this issue, the first and most commonly recommended by conventional vets is to reduce the amount of protein in a cat's diets as a means of ensuring that the cat's kidneys aren't overworked. The second school of thought where cats with renal failure and the amount of protein in their diet is concerned is that it's not about the quantity of protein in a cat's diet, but rather the quality of the protein that the cat's diet contains.

Based on my conversations with our family vet I don't necessarily believe that it's wise to put kitty on a low protein diet for the remainder of his life which is in all likelihood what your vet will recommend. Before MC nearly lost her life to acute renal failure caused by the toxic insult to her kidneys related to eating melamine tainted food in 2007 I truly believed that I was doing what was right for my cats by paying the extra money for premium and super premium cat foods recommended by most veterinarians, however when I took it upon myself to research the unique nutritional needs of cats I realized just how wrong I'd been to blindly follow recommendations without taking the time to learn more about proper feline nutrition and the pet food industry as a whole. As pet parents most of us believe that veterinarians must know more about what constitutes proper nutrition for our pets, after all, they went to school to learn about animals and nutrition is a fairly basic part of how we care for our pets on a daily basis. Unfortunately the reality is that veterinarians spend much less time learning about the nutritional needs of our pets than they do learning anatomy, surgery and treating a wide variety of illnesses and injuries in many different species of animals. Unfortunately nutrition isn't a part of veterinary medicine that is covered extensively, in fact veterinarians learn more about nutrition from pet food manufacturers than they do during their years in school. I was appalled when I learned this for a few specific reasons:

1) Isn't the concept of pet food manufacturers educating veterinarians about the nutritional needs of our pets and other animal companions somewhat like allowing a cat to guard a chicken coop (aka a dangerous and foolhardy choice)?

2) What regulations are in place to stop pet food manufacturers from simply formulating their products as they see fit with cheap, low quality ingredients, unnecessary fillers and chemical preservatives and telling veterinarians that their diet is ideal?

And finally,

3) Given that some pet food manufacturers actually pay veterinarians to recommend their particular brands of pet food are all veterinarians ethical enough to act in the best interests of their animal patients rather than simply recommending a specific brand simply because it benefits them financially?

In the experiences I've had throughout the years when it came to dealing with different veterinarians (during the times I was trying to find the best possible vet for my pets as well as a vet who was approachable enough to ask questions of and get honest answers from) I noticed that virtually every veterinarian recommended one or more specific brands of pet food. Without fail most veterinarians will recommend a brand of pet food to their clients so I have to admit that I found the fact that our veterinarian didn't make specific recommendations when it came to what our pets should be eating kind of refreshing. It was nice not to have a vet who made us feel guilty for not feeding our cats specific brands of food, although I must admit that I generally followed the advice given by previous veterinarians when it came to what we fed our cats. Up until our baby girl had nearly lost her life during the Menu Foods pet food recalls we paid for premium and super premium pet foods and we felt confident that we were paying for our cats to eat high quality food, we never suspected just how wrong we were about the pet food industry and the quality of most commercially produced pet foods on the market today. I must admit that I was surprised when we asked our vet which brand of food she felt we should be feeding and she didn't make recommendations as to which specific pet foods would provide the best possible nutrition for our cats. What most people don't realize is that pet food manufacturers often pay veterinarians a stipend for recommending specific brands of food or provide their specific brand of pet food to the clinics for free or at a fairly low cost and these veterinarians are then free to sell their stock at whatever price they want to in order to make a tidy profit.

Prior to us deciding to remain with our current veterinarian I had previously asked a variety of veterinarians about the possibility of making my cats their own food right in my kitchen and I must admit that I got a variety of negative reactions from vets ranging from absolute horror that I would suggest such a thing since homemade diets weren't properly balanced for our pets to having a vet suggest that making my cats their own food could potentially be fatal for them since a homemade diet lacked the nutrients, vitamins, minerals and other ingredients our cats would need in order to remain healthy. After the Menu Foods pet food recalls I was no longer a part of a small minority of people who wanted to know more about feeding their pets a well balanced, nutritious diet made right at home, many pet parents were shocked and angry that the pet food industry apparently hadn't noticed that they were producing poisoned food that unsuspecting pet parents were feeding their beloved pets. I decided to do some research about homemade diets for cats since I was aware of a few basic things including the fact that cats are obligate carnivores and they need to eat a diet that's meat based in order to be healthy and the obvious but often overlooked fact that when cats catch their prey they don't rush home to get vitamin supplements or build a campfire to roast their rodent, small mammal or bird to perfection. When I asked our veterinarian about feeding our cats a homemade diet to my absolute surprise and delight she pointed me in the direction of a couple of websites containing important information about feline nutrition as well as recipes for well balanced homemade raw diets for our feline friends. Our vet even let us know that we might have a difficult time introducing the new diet to our cats since they'd grown up eating kibble and canned food, but that if we were patient we'd eventually get our guys onto a healthy home prepared diet. Another useful thing to be aware of when it comes to cats and their nutritional needs is the fact that cats aren't as healthy on kibble diets partially because they can suffer from dehydration chronically which eventually takes a toll on their kidney function. Unlike other mammals cats evolved from the deserts of Egypt and as a result they don't have a strong drive to drink water in order to rehydrate themselves, this is why it's crucial that cats obtain the vast majority of the water they need on a daily basis from their food - canned and home prepared diets are a far better choice, don't be afraid to add a little water to your cat's meals as it will help him to be better hydrated so he'll be less likely to develop serious health issues later in life.

The websites that I'd recommend you consider checking out are listed below:

1) www.catinfo.org

This website was created by a veterinarian who is fairly down to earth and I must admit that she offers information about feline nutrition that just makes sense. This is also the website that our veterinarian recommended we check out when we asked her about making our cats a homemade diet. Dr. Pierson helps to explain what cats actually need in their diet to be as healthy as possible, she also includes a recipe for a homemade raw cat diet and pointers for introducing the diet to even the most finicky cat, she also offers basic advice when it comes to what form of cat food is best for cats and why and Dr. Pierson also provides a list of high quality commercially produced canned cat foods that you can feed instead of your kitty's current diet or as a stepping stone towards introducing her raw cat food recipe.

2) www.catnutrition.org

Dr. Pierson's site makes reference to this website multiple times and I have to admit that I was impressed by the extensive information about homemade diets on this site. In my opinion between the recipe for homemade raw cat food (which is large enough to work for a multiple cat household) and the education you'll receive about what the nutritional needs of our feline companions are this site is well worth the read.

3) www.felinespride.com

On the catnutrition.org website the site's author makes reference to this company and if I remember correctly there are links to this site on her website. Feline's Pride provides a great alternative for pet parents who would rather purchase a well balanced raw diet than make it in their own kitchen. This company has a great selection of different flavors and quantities of their raw cat food and they will ship frozen throughout the US and into some parts of Canada. Feline's Pride guarantees that your kitty's raw food will arrive at your doorstep mostly frozen provided of course that you are there to sign for the shipment when the courier comes. I have yet to read through all of the testimonials on their website but I have to admit that what I have read is incredibly positive.

4) http://www.halopets.com/pet-education/pet-articles/pet_food_what_you_need_to_kno...

This article helps to debunk some of the myths about the ingredients in most commercially produced pet foods. It's a fairly long article, but I really recommend reading it in its entirety since the information in the article is quite accurate. I realize that most pet parents will be disturbed by the information in this article, but I think it's important for every pet guardian to have all of the information they need in order to make the best and most informed decisions about caring for their pet that they can. While I'm sure that many pet food manufacturers aren't happy that this article was written and some veterinarians claim that the information is biased or false I believe that the article provides an honest look at the pet food industry. I would caution you against reading this article at mealtimes or shortly after you've eaten if you've got a sensitive tummy since some of the content in the article is at best disturbing and at worst absolutely disgusting. This article is very successful at pointing out the shortfalls in terms of the regulations in place to protect our animal companions from potentially dangerous ingredients that are routinely added to pet foods. I'm sure that you'll be just as shocked as I was when I first read this article because it sounds to me like you want nothing but the best for your little guy.

Veterinarians who have a general practice are jacks of all trades literally speaking, they must be able to perform routine health exams, counsel pet parents about providing the best preventative care for their animal companions (usually a variety of species) but they must also be dentists, x-ray technicians, pediatricians, behaviorists, ER doctors, anesthesiologists, surgeons, obstetricians, oncologists, etc, etc... While I believe that conventional medicine has many wonderful things to offer our pets in terms of helping them to live longer, healthier lives free of suffering I also believe that many pet parents are easily pushed into making decisions about their pet's overall health without having all of the information that they truly need in order to make the best possible informed decisions about their pet's care at least some of the time. I've seen this scenario play out repeatedly in various veterinary practices I have taken my pets to while I was searching for our dream veterinarian who we're so thankful to have at this point. For instance many vets insist upon vaccinating our pets annually or in some cases even more frequently while new research over the last several years has been proving that vaccines given too often can actually cause or contribute to a variety of serious health problems ranging from certain types of cancer, allergies, auto-immune conditions and renal failure to name but a few. Luckily our vet is less concerned about the practice bank account than she is about our pets' long term health so she provided that information to us immediately when credible studies began showing that overuse of vaccines could potentially cause our beloved pets serious problems later in life so since that point we've only vaccinated minimally since our guys are fairly low risk when it comes to contracting contagious diseases that are preventable by the use of vaccines.

In my experience very few pet parents are aware of the incredible shift over the last few years towards either combining conventional treatments with alternative therapies ranging from homeopathy, herbal medicine, veterinary chiropractic care and massage (there are so many options that it's just not possible for me to list all of them here) or turning completely to alternative medicine when conventional medicine fails their pet. Personally my experience has been that for serious issues such as your kitty has a combination of conventional and alternative therapies is probably best, however I have heard stories on different pet related tv shows such as Natural Companions on The Pet Network where pet parents chose to walk away from conventional medicine after it failed their pet and rely solely on alternative therapies that have saved the lives of their animal companions (one such case that aired recently on Natural Companions here in Canada was a case of a kitty with kidney failure who recovered as a result of veterinary chiropractic care).

To be honest, I'm probably biased when it comes to alternative therapies but I truly believe that homeopathy is a great option for treating a variety of medical and behavioral issues in cats. I've seen amazing things happen when conventional medicine wasn't helping my cats to improve and our vet administered homeopathic remedies, in fact I believe that if it hadn't been for my vet's use of homeopathy in 2007 I would have lost my precious girl MC (which by the way is short for Miracle Cat since she beat the odds and survived being hand reared at roughly a week old...she's lived up to her name on multiple occasions since and I don't know what I'd do without her!) I believe that homeopathic remedies administered by a homeopathic veterinarian or a holistic vet trained and experienced in the use of homeopathy would be a good addition to your kitty's care starting ASAP. Obviously conventional medicine is going to have to help your kitty by catheterizing him, emptying his bladder and alleviating the blockages in his urinary tract, but I think he stands the best chance of full recovery if he's treated with homeopathic remedies in addition to his conventional treatments. In the event that you're unable to find a holistic vet trained in homeopathy or a homeopathic vet in your area it might be well worth your while to check out the Ask A Vet portion of this site, Dr. Christine Chambreau is a homeopathic vet and she's been absolutely fantastic when I've referred previous questioners to her for help. From what I understand Dr. Chambreau is willing to do phone and email consults for a specified fee, but you'll have to discuss that with her if you're interested.

I would also like to forewarn you, sometimes vets who practice only conventional medicine tend not to be very receptive when holistic or alternative approaches are suggested by their human clients, don't be discouraged. You know your kitty best and you know what he's likely to tolerate. Typically cats do best in a low stress environment that's quiet when they're recovering from any serious illness, obviously a busy animal hospital may not fit the bill especially if your kitty tends to be the nervous, high strung type. It's quite possible that when your veterinarian discusses your kitty's condition, treatment options, the probability that those treatments will be successful and finally your kitty's longer term prognosis with you that s/he won't be very optimistic. When MC developed renal failure in 2007 during the Menu Foods pet food recalls the 24-hour emergency vet clinic recommended that we euthanize her. Thankfully we were familiar with our vet's holistic approach and we decided that it wasn't in MC's best interests to euthanize her without at least giving her a chance to recover under our veterinarian's care. Your kitty's condition is slightly different from MC's in that he hasn't been able to empty his bladder and that's caused him significant pain for awhile now. Where the two situations are similar is the fact that both kitties were diagnosed with renal failure after a toxic insult to their kidneys (in MC's case melamine, in your kitty's case the toxins normally excreted from his body through his urine have backed up into his kidneys as a result of him not being able to empty his bladder).

Based on the information that you've provided in this follow up question, it doesn't sound as though your kitty's received the treatment needed to fully empty his bladder and flush any obstructions out of his urinary tract - normally the conventional treatment with a kitty who has a bladder obstruction such as your kitty does would be to anesthetize him so he doesn't experience the pain of being catheterized and having the blockages flushed out of his urinary tract via flushing that catheter with sterile saline. It's certainly well within your rights as your kitty's human guardian to ask what treatments he has received up to this point. If removing the obstruction either via a catheter or surgery hasn't been attempted or recommended then I think it's well worth asking why this hasn't been done because the longer your kitty isn't able to pass urine the longer the toxins normally flushed out of his system by urinating which would mean that more damage would be done to your little guy's kidneys. It wouldn't surprise me if your kitty is on IV fluids, pain medication, antibiotics and a special prescription diet at this point, which would be fairly standard for any kitty in this situation based on my current level of knowledge at this point. If you aren't comfortable asking your vet questions or you aren't satisfied with the answers you get when you do ask questions about your kitty's treatments up to this point and what the treatment plan is for him over the next while then it may very well be time for you to consider taking your kitty to another veterinarian for assessment and treatment or at least getting the results of any tests that have been performed including x-rays and consulting another vet.

I also think it's important to recognize that you know your kitty best and only you can make life or death decisions for him. For some cats the clinic environment is just too much for them to handle - the noise, constant movement of staff around their hospital cage, diagnostic tests, being handled by vet staff and receiving medications or other treatments prove to be extremely stressful to the point where they completely shut down and give up on life. In a situation like that you may want to consider what is in the best interests of your kitty over the next few days, weeks and months. For some cats although they find the environment of a busy veterinary hospital and all that entails difficult they seem to respond better to the stress. Be sure to ask your veterinarian and any staff who have been caring for your kitty regularly about his overall attitude, comfort levels and basic functions necessary for life. You may be able to increase your kitty's comfort levels by bringing him a taste of home. A relatively simple way to help your kitty out and decrease his stress levels somewhat is to bring something from home that can be used as bedding for his hospital cage - small blankets, bath towels, sweaters or other items that you've worn or slept with are all good choices. Visiting your kitty as frequently as your vet and time schedule permits is also another great way to help your kitty be more comfortable in the hospital, however you'll have to check with your veterinarian to see what clinic policies are regarding pet parents visiting their animal companions. Check with vet staff to find out if your kitty is being allowed to eat, if so maybe bringing in small amounts of his favorite food or special treats might help your kitty be happier while he's in the hospital. Good food choices for most cats include plain meat/broth baby food (no spices, garlic, onions or salt if at all possible), plain yogurt (it will help prevent diarrea or at least reduce the severity if your kitty is on antibiotics because it contains beneficial bacteria that are normally found in a healthy digestive tract, they often get killed off by antibiotics since these drugs don't discriminate between good and bad bacteria), a small amount of plain cooked beef, lamb or poultry is often well received and a high quality canned cat food is also a good choice. If your kitty isn't eating but your vet wants to get him eating sometimes the best way to make that happen when a cat is stressed is to wow their tastebuds and have their favorite human offer the food in a quiet corner of the clinic away from the majority of activity and noise if at all possible. If your kitty seems to be coping well with his hospital stay, his bladder has been successfully emptied either via a catheter or surgery (whatever the vet deems necessary) and he seems relatively alert and responsive then it's quite possible that with some time in the hospital on IV fluids and other prescribed treatments the vet deems necessary then he very well might begin to improve if he's given some time. If your kitty seems distressed, depressed or unresponsive then it truly is in your best interests to be honest with yourself when it comes to what needs to happen in the best interests of your kitty. Obviously hospitalized cats can seem quite stressed, depressed, unresponsive and generally unhappy just as a result of the stressful environment, if your kitty's behavior doesn't seem normal compared to what you're used to seeing then it's well worth asking the vet staff if you can spend some time with your kitty in a quiet room at the veterinary hospital and assess how he's coping when you've had a chance to spend some quiet time together. It's important to ask vet staff who have been handling and treating your kitty routinely since he's been hospitalized how he's been doing in terms of basic things like grooming himself, his overall attitude and how he responds to routine handling by the veterinarians and the clinic staff? Does your kitty respond as he normally would to your presence, affection, voice, etc?

In the event that the worse case scenario happens and your kitty's renal function has sustained permanent damage then you have to take some time to seriously consider whether or not you're willing to provide the nursing care that he needs at home once the veterinary team is able to stabilize this kitty's condition enough for him to come home. Are you truly up to injecting supplementary fluids as often as necessary, assessing whether your kitty is urinating, defecating, eating, drinking and behaving normally? I know that it might sound strange to you, but in my experience pets will tell you when it's time for them to move on from this life to wait for us at the Rainbow Bridge. When it comes down to it you'll know deep down in your heart when it's time to humanely end your kitty's life if that becomes necessary in this situation. This is a decision that any person who shares their life with any animal companion dreads having to make and it's incredibly difficult to make the decision to end the life of a beloved family member who is terminally ill or suffering severe pain that the veterinarian isn't able to treat only to bring on your own suffering. Since there is a possibility that you may be faced with that decision within the next while I also felt that it was important for you to know that I'm certainly willing to offer an empathetic ear should you need support from someone who actually understands what it's like to lose a pet (rather than those who will say It's just a cat... along with other similar comments that can bite deeply for those of us who consider our pets family or close friends). This decision shouldn't come down purely to finances, and if the financial cost of veterinary care is an issue I'd be more than happy to provide you with the names of different organizations that may be willing to help offset the cost of your kitty's medical care or loan you the money to pay for his care - I keep a binder full of such resources just for situations where pet parents are having difficulty paying for the medical care their kitty needs. If you're in need of this information all that I ask is that you provide me with the general area you're writing from, this will help to save you time by ensuring you don't have to work through pages and pages of resources that aren't available in your area and knowing your general location also helps me to save time because I can simply provide you with just the information you need which will allow me to help other pet parents in need.

In the event that your kitty's health has deteriorated to the point where you end up facing the decision to end his pain I've taken the liberty of including a few pieces of writing that I've found helpful during the times that I've lost cherished animal companions. I truly hope you don't have to make such decisions any time soon, but there's a chance you may have to. Hopefully these pieces of writing will offer some much needed comfort if the worst should happen over the next little while.

The Rainbow Bridge

Just this side of heaven is a place called Rainbow Bridge.

When an animal dies that has been especially close to someone here, that pet goes to Rainbow Bridge.
There are meadows and hills for all of our special friends so they can run and play together.
There is plenty of food, water and sunshine, and our friends are warm and comfortable.

All the animals who had been ill and old are restored to health and vigor; those who were hurt or maimed are made whole and strong again, just as we remember them in our dreams of days and times gone by.
The animals are happy and content, except for one small thing; they each miss someone very special to them, who had to be left behind.

They all run and play together, but the day comes when one suddenly stops and looks into the distance. His bright eyes are intent; His eager body quivers. Suddenly he begins to run from the group, flying over the green grass, his legs carrying him faster and faster.

You have been spotted, and when you and your special friend finally meet, you cling together in joyous reunion, never to be parted again. The happy kisses rain upon your face; your hands again caress the beloved head, and you look once more into the trusting eyes of your pet, so long gone from your life but never absent from your heart.

Then you cross Rainbow Bridge together....

Author unknown...

May your whiskers be ruffled by only pleasant breezes,
May your bowls be filled with tuna and sweet cream,
May your dreams be blessed with legions of mice,
And most of all,
May you forever purr in peace.
Amen

Fragile Circle

"We who choose to surround ourselves with lives even more temporary than our own, live within a fragile circle, easily and often breached. Unable to accept its awful gaps, we still would live no other way. We cherish memory as the only certain immortality, never fully understanding the necessary plan."

Irving Townsend

There is also an incredible video to help pet parents mourn the loss of their beloved companions, it's called Til Then. I should forewarn you that you'll want to have a full box of Kleenex available if you watch this because it's a tear jerker. You have a right to mourn your much loved pet if it's his time to cross over to the Rainbow Bridge and don't let anyone tell you that losing him is any less significant than losing any other family member or close friend because it isn't - love is love regardless of whether those who share the relationship are of the same species or a different one. I'm certainly willing to offer a supportive ear if you need it over the next while, it sounds like you're in for a tough time whether your kitty makes it through this health crisis or it's his time to pass on. If you have any further cat related questions or concerns I'd be more than happy to help you out to the best of my ability. I wish you and your kitty luck over the next while, you'll both be in my thoughts and prayers.