My cat, Titi, is 9 years old. Just over 2 years ago, the vet diagnosed him with Stage 3 CKD. He advised me to feed him renal dry food and give him Semintra once a day. Those two years went quite well. He even went from weighing roughly 8 lbs 13 oz to 15 lbs 7 oz. About a week ago, Titi stopped eating; his coat was dull and he had very bad breath. He was isolating himself. I took him back to the vet who told me he is now at Stage 4 (his creatinine, urea, and phosphate levels were higher than the machine could detect). He had large ulcers under his tongue. So, he has an AKI (acute kidney injury) on top of the chronic condition. The vet's prognosis was guarded, if not very pessimistic, and he talked about putting him to sleep. The vet said the AKI might be caused by kidney stones. He did an ultrasound where he saw large stones. He then referred us to a veterinary hospital. Titi had another ultrasound which showed that he has almost no left kidney left and that his right kidney is still quite large but with irregular borders. But that wasn't the main issue. The vet hospital advised trying a 48-hour stay to put Titi on an IV drip. The vet also gave him an injection of a steroid and a broad-spectrum antibiotic. After just under 48 hours (around 30 hours), the levels had come down but not enough. They are detectable by the machine but still very close to the maximum limits. The vet stopped the drip and explained that it wasn't right to keep pushing, and since he wasn't eating anymore, it was the end. He gave him a week at the absolute most to live. He could have fitted a feeding tube, but he didn't recommend it. So we decided to bring him back with us to be with him in his final days and give him some comfort. Titi is back home now. For the first three days, I still did two round trips a day to the vet for morphine and anti-sickness injections. I started feeding him (cat fish soups) and giving him water with a pipette (almost every hour) plus Semintra. The vet then suggested trying liquid renal food. Titi took it very well at first. After three days, he had regained some strength and even the vet was surprised. His prognosis went from a few days to a few weeks. So he decided to stop the morphine but keep the anti-sickness meds. This is the first morning without morphine, and I find Titi is really flat, and it's very difficult to feed him. He's drooling from the sides of his mouth. Plus, Titi is constantly going back and forth to the litter tray without necessarily doing a wee. No poo for at least three days. What should I do? Thank you so much for your replies.
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Hi everyone,
I lost my little one on Friday evening and it’s just so painful. He was my absolute world for 16 years. He had CKD... his creatinine and urea levels were climbing and just wouldn't come down. I tried everything for him (K/D food, glutamine); we went to the emergency vet several times and I consulted so many of them. I was in total denial, I really thought I could save him. But on Friday, he was on a morphine and glucose drip and had hypothermia. The vet said we’d try, as I wasn't ready to say goodbye... but that afternoon things went downhill; he was having seizures and couldn't even stand. I called the out-of-hours vet again that evening and the decision was down to me. I feel like I've killed him. I’m struggling with so much guilt, but seeing him in pain was heartbreaking. I would have given my life for him.
Go and have a read through this forum and the site on CKD (Chronic Kidney Disease). I don't think it’s active anymore, but you'll find some really valuable advice there.
I managed to keep my cat going for over 3 years using Azodyl capsules imported from the States; they contain bacteria that digest urea and take the pressure off the kidneys. I also used Ipakitine powder and special renal wet food (fish or chicken flavour). Azodyl must be kept refrigerated. The FASTEST way is via FedEx cold shipping from the US, delivered within 48 hours: https://www.thrivingpets.com/catalogsearch/result/?q=azodyl Lab page: https://www.vetoquinol.ca/fr/produits/azodyl-rein-chien-chat. It takes longer—about 10 days—via standard US postal service (and it's NOT refrigerated): https://www.ebay.fr/sch/i.html?_from=R40&_trksid=p2380057.m570.l1313&_nkw=azodyl&_sacat=0. Amazon doesn’t stock it anymore: https://www.amazon.com/Vetoquinol-425856-Azodyl-small-caps/dp/B007CHEQXQ. To give the capsules, I used to mix the powder with either some wet food or cat milk and then give it to him using a syringe. If I remember rightly (back in 2010), you need to give two doses a day—one in the morning and one at night. Do your best to help your little mate; he’d do the same for you without a second thought.
Hi there, could you tell us what stage of CKD your cat was at? I'm about to try and track down some Azodyl to make life easier for him, but I wanted to know if it's worth it! Please get back to me as soon as you can!
He’s putting up a real fight, the little lad. Maybe his time hasn’t come just yet after all. Cats are amazing; they have a real knack for catching us off guard, and this time it’s in the best possible way. I truly hope you get to spend many more happy days with him; make the most of your time together.
I managed to keep my cat going for over 3 years with Azodyl capsules that I had to order from the States; they are bacteria that break down urea and ease the strain on the kidneys. I also used Ipakitine powder and special renal wet food (fish or chicken flavour). Azodyl is a medication that must be kept refrigerated: the fastest way is via chilled FedEx shipping from the USA, which arrives within 48 hours: https://www.thrivingpets.com/catalogsearch/result/?q=azodyl. Lab page: https://www.vetoquinol.ca/fr/produits/azodyl-rein-chien-chat. A slower method is about 10 days via standard USPS (and it won't be refrigerated): https://www.ebay.fr/sch/i.html?_from=R40&_trksid=p2380057.m570.l1313&_nkw=azodyl&_sacat=0. Amazon is out of stock: https://www.amazon.com/Vetoquinol-425856-Azodyl-small-caps/dp/B007CHEQXQ. To give him the capsules, I’d mix the powder into some wet food or with some cat milk and give it to him using a syringe. If I remember rightly (this was back in 2010), you give 2 doses a day—one in the morning and one in the evening. Do your best to help your little mate; he’d do the same for you in a heartbeat.
Hello,
I’ve never heard of this treatment. How did you find out about it if it’s only available in the US? Was your cat in the end stages?
I’m not expecting to extend his life by years, but I’m open to anything that might help him.
Hi everyone,
I’m not one for prolonging things unnecessarily either. Last night, I’d made my decision, and it was so, so difficult. At about 11pm, Titi got up from his bed (which he hadn’t done all day), jumped onto my lap and gave me loads of cuddles. It lasted all night; he kept ‘pestering’ me for cuddles and purring away. I have to tell you, the decision I’d made with such a heavy heart last night just didn’t feel possible to go through with anymore.
On top of that, he couldn’t stand my other cat lately, but now they’re inseparable again and they won’t stop grooming and snuggling each other.
I know my Titi inside out, and I can see he’s hanging in there, even if he’s obviously not at his best. Yesterday, he was definitely exhausted and likely feeling the comedown from stopping the morphine. Since this morning, he’s much more responsive—he’s using the litter tray, drinking on his own and eating a little bit from a syringe.
Honestly, I don’t think his time has come just yet, but I promise I won’t let him suffer just for my sake; I love him far too much for that—he’s like a child to me. But I can’t make that call without trying for him first; I feel I owe him that.
I went back to see my vet this morning and he agrees, even though he is usually someone who suggests euthanasia quite quickly, especially in terminal cases.
Tomorrow, I’m seeing another vet who specialises in herbal medicine; she might have some options to keep Titi comfortable and support him gently through to the end. If she tells me there’s nothing more we can do, I’ll stop everything.
I won’t put him through another stay at the vet’s, because that really would be going too far, and Titi just can’t stand being away.
Anyway, thank you all for your messages and support. I’ll keep you posted.
There are some really good medications available; I managed to keep two of mine going on a combination of benazepril and Rubenal for over seven years. But once a cat reaches the end of the road, regardless of the meds, if their kidneys have failed, it’s either a case of helping them pass away peacefully or keeping them going for a few more days in absolute agony.
Like @Kalou, I’m against over-treatment. I did it once with one of my cats with CKD and I regret it deeply—force-feeding him, putting him on a drip, and leaving him at the vet’s only to end up back at square one. As soon as we got him home, he’d go downhill again. I thought I was doing what was best, but sometimes trying to do too much can actually do more harm than good.
Thanks again for your reply; it’s certainly hard to read, but it helps. I just can’t bring myself to accept it because this cat is pretty much my whole life. I already know what the vet would do, but I wanted to cling to the slightest bit of hope. I think I’ll go back to see him tomorrow and take the time to talk it through with him.
Hi Calicou,
I agree with what’s been said. We’ve all been through this at one point or another with our cats, and it’s true that sometimes you have to hold on.
But not with end-stage CKD! Why would you want him to ‘go all the way to the end’? The end of what exactly?
You love him, but you need to love him for his sake, not your own.
Don’t let him suffer unnecessarily.
Animals have that one mercy: the fact that their owners have the ability to end their suffering.
If you love him, let him go.
Liza
I managed to keep my cat going for more than 3 years with Azodyl capsules imported from the US; they contain bacteria that digest urea and take the pressure off the kidneys. I also used Ipakitine powder and special renal wet food, either fish or chicken flavour.
Azodyl must be kept in the fridge:
The FASTEST way is via FedEx refrigerated delivery from the US within 48 hours:
