Cat has severe kidney failure - treatment options?

Yes! Cats really seem to enjoy especially in winter. I just take the whole bag and toss it into the bathroom sink with warm water. I have my whole bathroom rigged up as a kind of infusion center. Thank god it’s large not like my last bathroom which was too small for Barbie.

@CindyCRNA - I like your idea. I will have to try that…hopefully not anytime soon. :slightly_smiling_face:

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If I remember from working in the ER I think Vit B does burn a bit.

Hi Everyone,

Dewey (my sweet kitty) is doing OK. I have been giving him subQ fluids at home and that’s going fine. He perks up somewhat after getting the fluids and he’s more interested in eating after getting the fluids. Last night, he was acting almost like his old self. I know the kidney damage is still there. I’m just hoping the fluids can help him feel better for a while.

I have a few more questions for you guys.

How often do you give fluids and how much do you give? The vet tech told me 200 mL per day. Does that sound like too much? Everything I saw online was more along the lines of 100 mL (or possibly 125 or 150 mL) per day for an average sized cat.

Where do you get the fluid bags, the IV line, and the needles? I’m sure I can get them somewhere cheaper than the vet clinic. Chewy and were suggested. Anywhere else? Do those places require a prescription?

If I wanted to give him Pepcid tablets, how much should I give? He hasn’t been throwing up except for that one night before I took him to the vet. The vet gave me 4 tablets of Cerenia (16 mg each) but I want to try Pepcid first since it’s over the counter and I have heard some people had good results from it.

Thanks so much! :slightly_smiling_face:

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I’m a nurse so I have an endless supply at work. My moderate renal cat got 100ml 3 times a week.

This is a good question for your vet, but I do 2.5 mg once to twice daily. It seems to be tasteless, and you can add to wet food if they’re eating. It addresses an acidy stomach, which is definitely caused by high kidney values, and can cause nausea–but high kidney values can cause nausea separately from the acid production. Starting with pepcid is very reasonable, but don’t be afraid to add cerenia (or, better yet, zofran) if you don’t see him eating as well as you like. Mirtazipine is also a great addition once you have the nausea medicated.

My favorite pepcid is the generic regular strength from Walgreens. The pills are round, unlike the name brand (it’s hard to quarter the name brand) and the Walgreens version is liiiiittle pills–so you can drop the quartered piece into a bowl of wet food without crushing it, and it pretty much disappears. Super easy :slight_smile: Just make sure you’re buying the regular strength version of whatever you find, and not the extra strength. Pick up a pill splitter while you’re at it!

Glad he’s doing well with the fluids!! That’s great news!

Chewy did require a prescription–they will contact your vet to get it from them. I loved that they do auto ship, so I always had a supply.

200/daily was where we started when my kitty was very sick. I think we did that for about a month, then went to 200 3x a week. I always gave him a meal afterwards as his reward. I got the Hi-Tor Neo cat food from Chewy as it’s way less than prescription foods (they he hated) and didn’t need a prescription.

I gave the generic 10 mg pepcid cut into quarters–so 2.5 mg per day and they’re tiny cut up, so i just put them in his wet food and down they went.

1/4 pill of the Pepcid. I just get the Walmart generic. Needles - Big Dee’s, get the ones with the poly hub ( Big Dee’s (
They seem to be the cheapest. They do not require a prescription. Check your local medical supply store for line or ask a nurse friend if they can get you any that are being discarded. I used too get them when the nurses would open up a package to use on a patient and then didn’t. It can’t be used in the hospital after that but is fine for pets. Or you can buy from your vet but it can get pretty pricey. Either way get a long one or several short ones that can be strung together. Nothing worse than a short line. Mine is long enough to allow some movement but no running across the bathroom. As for fluids, check on line to see who is offering best deal. Sometimes that is Costco but you need to check your local store. I am going to need some fluids soon so if I find a deal I can get you some as well. Best to buy by the case.

My vet told me 100ml 2x a day. I hung a hook ( Spectrum 3.75 in. L Silver Steel Small Stratford Double Hook 1 pk - Ace Hardware making sure I had it in a stud and can hang full bags of fluids fairly high up the wall.

I am so glad to hear that your kitty is doing better. One question: did the vet tell you kitty had acute kidney failure or chronic kidney failure?

Shiloh - I believe my vet said “advanced kidney failure” or “severe kidney failure.” Something along those lines. It caught me off guard. I wasn’t surprised about it being kidney failure because Dewey has been drinking more water, but I thought it would be mild or moderate.

On my way home from work, I will stop at Walgreen’s and get some Pepcid. Is it OK to use the same IV line until the bag of fluids is empty? The bag is 1000 mL.The vet tech told me how often to change the needle but she didn’t say how often to change the IV line (and she only gave me one IV line). I have just been leaving the bag hooked up to the IV line.

That will depend on your vet and your kitty’s condition. I have given anywhere’s from 100 ml 3x a week to 300 ml twice a day! Most common for my cats was 100 ml once a day though. And I prefer to use the name brand Pepcid even if its more expensive, it crushes into a powder very easily, you can break it in half and then break it again if necessary. My vet recommends one quarter to one half of the tablet. Not all cats will eat it in their food so being able to crush it into powder and either add it to their food or mix it with enough water to give it in a syringe is helpful. Sometimes I add it to sardine oil as well.

I’m glad Dewey seems to be doing well. doesn’t require a prescription for the needles or IV lines. I got fluid bags from my vet but I know others got a rx and used a pharmacy. It was just as easy for me to get a months supply from my vet.

I think I started off doing 100 ml once a day but when the kidney failure got worse, we moved up to 100 ml twice a day. 200 sounds high to me at one time, but if he’s feeling better it’s obviously helping him. You could call your vet and double check to make sure that’s accurate.

Pepcid dosage is weight dependant. I’d call the vet and see how much to give. I think I gave Thomas 1/4 of a 10mg tablet, but it’s been so long ago I don’t know if that’s correct.

I’m so glad he’s feeling better! That’s awesome news! Thomas got 2 or 3 good years with fluids so it’s great he’s doing good. :slight_smile:

Oh, and I changed my line with each bag. I stockpiled lines and needles so I always plenty on hand.

Yes use a new line with every bag and a new needle every time you give fluids. If the needle hits the floor or touches any surface I replace it with a new one too.

After you remove the needle, pinch the hole together for a few seconds so that you don’t get any fluid leakage. That’s especially helpful when you are giving so much at once. With cats that are easy to treat, if I am giving more than 100 ml, I will split the dosage into two areas of their body. If you have too much fluid in one spot it can also leak out of the needle hole. Another advantage to using small needles.

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I have just skimmed this but did you see the bloodwork results?

You can use the line over and over again. You are right - it’s the needles that need to be changed.

I’m sorry to hear kitty is in advanced renal failure. Acute (by my understanding, please correct me if I am wrong) can be fixed. Chronic/advanced/etc not so much. Kitty can live quite some time after a diagnosis like that. I had one cat that after a bout of acute in which she lost a kidney (it atrophied) she was dx with CRF and I was able to help her live another two years. It was the cancer and liver failure that got her in the end. Glad to hear he is doing well so far!

Yep. Definitely don’t remove the line unless you’re swapping out another sterile line right then. Once you open the bag, it needs a line on it.

I generally did half the bag, then swap line, then the rest of the bag. But one line per bag isn’t bad. Don’t take the line from bag to bag.

And always best to swap needles on the line when you finish, rather than when you start–don’t leave a dirty needle on the line. Toss your dirty needle after you run fluids, get it ready for the next time.

I lost a kitty to Kidney failure about 10 years ago. I took him in because of vomiting, lethargy and lack of appetite. His kidney values were off the charts.

I made the decision to put him to sleep. He was happy at the vet’s - purring and socializing with the vet and vet tech - I actually had to push for more diagnostics (bloodwork) because they said he was presenting so well and I kept saying he was just not himself. One thing my vet said that stuck with me was this: they are super stoic. They said they could send me home Sub-Q Fluids, but as stoic as they are, by the time they show symptoms of the issue it’s pretty bad, and just a very short-term Band Aid in this case.
I wanted him to go before it got really bad, rather than dragging it out. Cats, I think, more than dogs hide what’s going on. Just my two cents.


I have a copy of the bloodwork at home. I got a copy in case I need to take him to an emergency clinic or call the place that does at-home euthanasia. The only number that I have with me right now is one of the kidney numbers. The vet told me that the normal range is 14-36. Dewey’s was 113. That doesn’t sound good at all. Could the fluids help that number go down somewhat?

When the time comes, I will have him put to sleep at home. He is always horrified to go to the vet. When I took him to get IV fluids, he didn’t pee at the clinic all day. He peed in the crate on the drive home. I’m sure he didn’t pee at the clinic because he didn’t feel comfortable doing it there.

It can be helpful to compare bloodwork to the IRIS staging guidelines. Here’s the PDF about that:

The one normal range and high value the vet mentioned isn’t really fitting into the BUN and creatinine ranges, though…and a SDMA of 113 would be really whoppingly high :frowning:

Yeah, fluids can make a difference on the bloodwork (as can the antibiotics, if there was an active infection.) Has the vet mentioned rechecking the labwork in the next few week-ish?

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My vet used to tell me to treat the cat not the numbers. I’m not talking the quantity of fluids of but quality of life.

In other words, try to give it a little while with the fluids, see how he does and how his numbers look on the recheck blood work. In the meantime, if he’s feeling better on the fluids, eating, peeing/pooping and doing his normal stuff, try not to worry about them.

It’s easier said than done but I’ve learned that how they act and feel is way more important than blood work and tests.

None of mine are good travelers or vet goers either. We do have two mobile vet practices here but my work schedule has made getting appointments with them almost impossible for now.

Eta -

I found this website so helpful. Two of mine now have the early stages of kidney disease and I’m revisiting it often.

Totally agree that this website is a great resource. The forum is…not so great, especially if you’re more worried about quality of life over quantity of life :frowning:

I never did the forum - sounds like it was probably for the best.