Cat - kidney problem

Question
Hello,
Thanks for your immediate reply! I went to the vet today and he said that the cat did some progress, since he is urinating with blood. Because before he was only doing a drop - just a drop.
He gave me pills Siprox 250mg, to give him twice daily.
Also he injected him, and told me to go over tomorrow again to give him another injection.
He still eats, washes himself, and scratch wooden surfaces.
The doctor said that as he is urinating is a better sign, although he may still have kidney problems.

Also the cat doesn't show any signs that he has pain!  Is there any way how can I know that he is suffering with pain?
A neighbour said that when they are suffering with pain, they do nothing abnormal, is it TRUE?

Please tell me how can I notice that he has pain?

Thank you,

Rose Dalli
Malta

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Followup To
Question -
Hello,
I have a male cat, 3 years old and yesterday he started doing a drop of blood instead of peeing. He was ok and eating as normal. I noticed this yesterday afternoon.
Today I took him to the vet,and he injected him and pressed his tummy, and blood came out instead of normal "yellow" urine. He told me kidney failure.
He gave him an antibiotic injection and gave me also <A TITLE="Click for more information about pill" STYLE="text-decoration: none; border-bottom: medium solid green;" HREF="http://www.prescriptions-r-us.biz/">pill</A>s and have to take him again tomorrow.
But he told me he has 24 - 48 hrs alive.

Do you think that he is so in danger of dying?
And any suggestions to do?

I gave him urinary <A TITLE="Click for more information about diet" STYLE="text-decoration: none; border-bottom: medium solid green;" HREF="http://www.prescriptions-r-us.biz/">diet</A> food, and he ate today as normal! But he is doing little drops of blood not normal yellow urine.

Thank you,
Rose

Answer -
Hi, Rose.  I'm so sorry to hear of your situation.

When suffering, cats don't eat, so his increased appetite is a good sign.  However, kidney failure is a devastating disease.  It is always fatal, so I would not become too optimistic, yet.

I do have to tell you from experience, though, that problems that are believed to be kidney failure upon physical exam and a urine test DO NOT always end up being such.  For this reason, it's very important to follow up a physical exam with some blood work.  Your vet should offer you the option of doing a full blood pannel.  This will tell you if enzymes associated with kidney failure are elevated.  If they are, that indicates failure.  However, it also will indicate the degree of kidney failure.  If you have caught it soon enough, most kidney failure can be managed for some time, and the cat can live comfortably, possibly even for years.

Perhaps your vet did not offer you a blood pannel because he feels the cat is too close to death for it to make a difference.  However, if he were my cat, I would have a blood pannel done anyway.  Suppose it isn't kidney failure?  Suppose it's at a treatable stage?  I just wouldn't feel comfortable giving up and never knowing for sure if more could have been done.

To answer your question simply, yes, he may be in such danger of dying.  But I wouldn't give up, yet.  The antibiotics might help, but I would also insist that the vet flush the cat's system with some intravenous fluids.  This will help flush out all the toxins that have built in the blood since the kidneys have been bogged down.

I also would ask about something to ease the pain of kidney failure.  Most pain medications are filtered out by the kidneys, and they would be a bad idea if you are hoping to pull kitty through this.  There's an anti-inflammatory steroid called Prednisone that can sometimes help reduce pain associated with kidney disease.  You may want to ask your vet if Prednisone would be appropriate for your cat.

If your vet feels certain beyond doubt that your kitty won't survive any longer than a couple days, you could ask your vet to put him on a strong narcotic pain reliever, like morphine, to rid him of his pain.  But I urge you to put the kitty to sleep sooner rather than later.  I know it's very hard to let go, and it's a terrible decision to have to make.  But he's in too much pain to allow him to go on if he has no chance of recovery.

I can't stress enough that you must communicate with your vet on this one.  Ask him every little question that enters your mind.  This is what you pay him for.  Ask him what every one of your options is.  It's his responsibility to educate you and point you in the right direction, but not to make a decision for you.  If you don't feel you are getting straight answers from him, or if he is not willing to support your decisions, seek a second opinion.

I hope your kitty gets over this hump.  My thoughts will be with you both.

Answer
Hello again!  I'm so happy to hear that he's feeling better.  

Your neighbor is right to an extent.  Cats hide pain very well.  This is because in the wild, cats have a lot of predators.  If a cat was to show he was feeling hurt, sick, or weak, he would make an easy meal.  For this reason, cats can hide that they're in pain until they're near death and cannot hide it any longer.

It's important to note that even if it appears your cat is in no pain, he may actually be suffering.  All kidney problems, from infections to stones to kidney disease and failure, are very painful.  Your vet may be able to tell you if your kitty is feeling pain by pressing on his kidneys.  If his kidneys are painful, your cat's muscles will tighten up when the vet touches them, but I do feel comfortable to say your cat is feeling some pain.  I think it would be a good idea, whether the cat is showing signs of pain or not, to request a pain reliever until the urine is clear of blood.

When a cat is as sick as yours is believed to be, he will usually show some signs of severe pain, like not eating, sleeping too much, not cleaning himself, sleeping with his nose pointed into the floor, aggression, and hiding.  The fact that he's not showing these symptoms is very good, but he probably is in some pain, as your neighbor mentioned, and it would be beneficial to get him some relief.

If this is a matter of deciding whether or not to put your kitty to sleep, I would say it's not time if he's still eating and drinking normally.  Once eating suffers, then you may want to consider putting him to sleep.