My cat, Pea, was in kidney failure for the last 4 yrs of her life. Although I should have started much earlier (and would have if the vet had bothered to fully explain the necessity), I did administer subQ fluids here at home over the last 4-6 mos of her life. it made a HUGE improvement in her overall physical condition and quality of life. If your vet feels subQ fluids are necessary for your cat, please do not delay.

Although I am quite used to giving IM injections to my horses and less frequently subQ vaccinations to my dogs and cats, the idea of administering subQ fluids to Pea was quite daunting at first. Not only was Pea ancient, tiny, and frail, but she also had a lifelong history of DESPISING being handled and demonstrating her displeasure in painfully violent ways. I was afraid that we'd both end up in the hospital if I tried to give her subQs.

Much to my amazement, however, Pea accepted the procedure with very little fuss. After the first subQ treatment at the vet, I think she realized how much better it made her feel. Her objections here at home were minimal.

Have your vet (or the vet tech) teach you how to properly administer fluids subQ, and practice with him/her watching to correct your technique, if necessary. Do it several times under the vet's or tech's supervision until you feel reasonably comfortable. It is nerve-wracking at first, but you'll get the hang of it after a while.

Here are a few tips that helped me:

Warm the fluid bag in a sink of warm water before administration. Room temp fluids will give your cat a horrible chill and may cause considerable discomfort and struggling. Test the warmed fluid temp on your wrist as you would with a baby's bottle. It's better to err on the side of a little too cool rather than too warm.

I found it easiest to sit in the bathtub with Pea between my legs while Joe held the fluid bag above us. The confinement of the tub helped keep Pea quieter. Because Pea hated being handled or snuggled, I didn't pat or stroke her during the procedure. I just held her quietly. If your cat enjoys being stroked and/or cooed to, do that.

Most vets carry Monoject needles, but Terumo needles are known to be much sharper and less painful to insert (unfortunately, that also means they slide out easier if the cat moves around). You can order Terumo needles online if your vet doesn't carry them. Use the highest guage needle that will allow passage of the fluid.

Have you asked your vet about potassium supplementation? Potassium deficiency is common in CRF cats and causes hind end weakness. Anemia is another common problem in CRF cats and can be improved with iron supplementation. These are things to discuss with your vet.

Visit the website linked below for VAST amounts of INVALUABLE information on caring for CRF cats:

http://www.mindspring.com/~kerspin/

I also strongly recommend you join the Feline CRF Support Mailing List:

http://groups.yahoo.com/group/FelineCRF/

This is a large mailing list of over 800 members who are dealing with kidney disease in their cats. The information and support shared on this list is phenomenal. Some of the members, past and present, are working with renal veterinary specialists who provide treatment and management options the general veterinary practitioner may not even know about ... but you can find out about it through the list. It's a must if you're seeking information on kidney disease.

I know this is a difficult time for you, but your cat will maintain the highest possible quality and length of life due to your efforts. Don't let the frightening idea of subQs stop you from learning how to give themt. They are the single most vital management option for your cat.

I wish you all the best,

Laurie

My sister has a cat with advanced kidney disease who has been on IV treatment since the spring. My sis at first was terrified of having to do this, her cat can be a bit of a monster as well. But she found it to be a very straightforward procedure. My mom was catsitting in the summer and took the cat to the vet for the treatment since she didn't want to do it herself, and she said once she watched the vet do it that to her mind it looked relatively simple. One of my 16 year olds has kidney disease (diagnosed in April, he's on drug therapy) but so far he hasn't needed the IV treatment. He goes in for checkups about every 3 months to check his weight and blood levels. I am not looking forward to the day I have to give him IVs but I know the day is coming, just hope that it's a little bit away.

tess

Thank you both for the valuable info and encouragement and for the websites too, Laurie. Senorita goes to the vet monthly for blood testing, geriatric shot and fluids. She has been eating canned cat food designed for kidney failure, and she takes an appetite stimulant. She has been in a holding pattern as far as her blood levels goes, that is, until this week when the blood work showed progression of the kidney failure.

I think you are right about having the vet supervise me and my husband a couple of times before we go it alone.

Does the cat have to hold still during the administration of the fluids? How long does it take? I can imagine chasing a cat around the house holding up the fluid bag. Just joking, of course, but my imagination is definitely getting to me.

Why doesn't somebody start a business where they go to the houses of people whose pets need shots and fluid treatment? Sounds good to me. I've always been a needle-phobe, and sticking the cat is horrifying to me.

Yes, Senorita will need to stay as still as possible during subQ administration. Otherwise the needle will slip out, and you'll have to get a new needle to reinsert. It'll happen plenty of times, so have lots of extra needles on hand. That's why I sat in the tub with Pea between my legs. It kept her pretty still most of the time.

The length of time it takes depends on the guage needle you use, how quickly you set the flow in the IV set, and the amount of fluid you give.

Just so you know, a CRF cat's blood levels tend to rise and fall. One of the most difficult things for a CRF caretaker to deal with is the fact that a cat who is on death's door one day can rally back to reasonable health the next. It makes it extremely difficult to decide when enough is enough and to consider euthanasia. We tend to keep holding out hope for one more rally.

Here are a few more things for you to consider in Senorita's care. First, it's much safer for her kidneys to eat small meals several times a day rather than one or two larger meals. Secondly, do everything you can to increase her water intake. Mix warm water into her canned food so she can lap it up as a gruel. Place water bowls all over the house. Consider purchasing a kitty fountain or leaving a faucet dripping (some cats love flowing water). I keep a goldfish in a two gallon, wide-mouth bowl on a cat accessible table from which my cats drink copious amounts of water.

You might ask your vet's techs if they could be hired to make a housecall to administer fluids. If you have a petsitting service in your town, they might employ a certified vet tech who could be hired. Ask at pet stores, breeders, trainers, and boarding kennels to see if anyone can recommend a certified vet tech. You might just be able to find one in your area who isn't currently employed at a vet's office and would be willing to help you out.

Good luck!

Laurie

One more important point - Keep an eye on Senorita's stool. CRF cats can't properly utilize the water they drink which is why they can drink huge amounts of water and still get dangerously dehydrated. Check Senorita's litterbox daily. If the stools are small, hard, and the color of red clay, she's probably constipated. Constipation is extremely painful for the cat and indicates dehydration. Constipation can also make her very ill and cause her to refuse food completely (and sometimes permanently). Her stool should be large, dark brown, and soft enough to pass easily.

If her stool indicates constipation, you should discuss the advisability of beginning subQ fluid treatments with your vet right away.

Laurie

Thanks, Laurie. You are a real encyclopedia when it comes to CRF. I'll watch the stools. The bath tub sounds like a very good idea. We feed her 3-4 times a day, and food is out all the time. We could ask the vet techs, but we should try to do it ourselves first, I think.

I am just trying to find out how many days I need to have the vets try to jumpstart my cats kidneys.She is 10 1/2 years old and has been at the vets for a day and a half now with IV fluids being administerred to try to restart her kidney funtions.They first told us they wanted to try this for a couple of days and see if it will work.However I have read that this process can take up to six days.I have 2 girls and a husband and we are struggling with the idea of having her put to sleep.(We experienced it 6 years ago with this cats sister,who had a tumor in her kidney)I just don't want to give up on her too soon but I don't no how aggressive we need to be with the restarting her kidneys.I was wondering if anyone can inform me of how long they went on with this first phase of CRF and what the outcome was.I Thank anyone who can help me,I have read up on this problem for the past day and a half so I understand it won't be easy if she does pull through but she is a valuable part of our family and I will do what it takes to make it right for her.

sharodell -- there is a great email support group for CRF kitties, you can subscribe right away and get lots of wonderful advice from people who have been right where you are.
http://pets.groups.yahoo.com/group/Feline-CRF-Support/

My cat has beginning CRF but we caught it early, and she has not had a crisis. I do know from reading on the Feline-CRF group that sometimes it takes 3-4 days (or more) of IV fluids. Your cat is relatively young, so can probably handle a more aggressive treatment, and likely has a good chance of bouncing back.

Please check out the group as soon as you can, everyone is very very supportive!

The therapy your cat will require will depend on her current status via blood test results. You should be requesting copies of all of her test results for your own records so that you can keep track of her progress and do your own research online at the CRF websites and mailing lists. Join the mailing list I linked in my earlier reply above. Also, spend lots of time reading through the information on the website linked below. Those resources will prove invaluable to you.

I wish all of you and your cats the best possible outcomes.

Laurie

Here is a link that might be useful: Tanya's CRF website

It has been a bit of a roller coaster with my kitty. She is only 3, so I think they are preplexed and are doing more tests than they would on an older kitty. Sadie was in the hospital for 4 days, then came home and they still have not stabilized her blood levels although we are on our way now in the right direction. If you are not comfortable with you Dr, SPEAK UP. Even if you switch to one in the same practice, it can make a big difference, and did for us.

the first one kept talking about putting her down, and I kept thinking she was going to die everyday. It was awful. The new one seems to think if we can get everything stabalized she will have a year or two. He switched one of her meds and she seems like her old self again.

We also brought her (just ysterday) to a Urologist at Animal Medical Center in the city. Again I think this was recommended because she is so young. She agreed with everything the Dr was doing and explained things in greater detail. I think he just wanted a second opinion. She did test for a few diseases that he hadn't and we will find out about those at the end of the week.

Not sure if this helps at all!

I'm glad this thread surfaced again. I joined the CRF group suggested by LaurieF above, and it was very, very helpful. Lots of moral support, suggestions and good information there. Sadly, our dear kitty died in September, but her time had come and the suffering was just too much. She was 17. We really miss her.

Boopadaboo, best wishes with Sadie. Could she have kidney failure at her tender age? I hope it's something which can be remedied and she will then have a long, healthy life.

Keep us posted.

Thanks socks. She does have it at such a young age. Breaks my heart!

Ohhh, too bad! Why do cats get CRF at such a young age!? It just doesn't seem right. Check in to the CRF group. It can be very helpful.

My Siamese is 14 yrs old, has probably been in early failure for a yr. She has regular checkups and wasn't in any crisis,until a month ago, when she grew lethargic, seems to shrivel up over night, and stop eating. Recognizing a possible crisis, I took her in and found out she had crashed from CRF. She was given 3 days of IV and gained back 1/2 lb from the lb she lost within weeks. Her creatine went from 5 to 3 and her BUN went from 80 to 50. Potassium tank was running on fumes, so she takes 1 and 1/2 pills per day. I give her mostly the gel, and for the last dose, half a pill.

She is on 100 mls of subqs every other day, or I can do 50 a day, since she is NOT a cat who will sit for this and I cannot get her to lay down. I am debating whether it is more torture for us both to do less daily or the full amt every other. She recognizes the room for this now and starts howling the minute I pick her up to get started. I use a 21 gauge Terumo needle with the Ultra Thin Wall, which takes a bit longer but does slide in easier. Of course, it slides out too when she wiggles around.

I warm the fluids, but it never seems warm enough when I test it, and I think she doesn't like that. Today, she howled and fought thru the entire 50 mls, but I did get it in. I am filling my sink with very hot water and letting the contents sit in it, but not the top..that hangs over. It seems to take forever to warm...how long should it take?

I hate doing this to Jasmyn and she is NOT doing any bonding or thanking me for this. She is mostly complaining and staring at me with this look, like how can you do this to me? Sigh...I am not afraid to stick her, but I do hate it so much. No matter what I tell her about being good for her, she just stares and runs away the minute she sees that bag.

PS....wanted to add that I am pretty calm during this, so she won't pick up my stress, but maybe she is anyway.

Jai4,

It sounds to me like you may be getting the fluids too warm for your cat. You shouldn't be using very hot water to warm the fluids. The water should not be any warmer than you can comfortably hold your hand in. The length of time it takes to warm the bag will depend on the amount of fluid in the bag; a full bag takes longer to warm than a mostly empty one. During warming, occasionally squeeze the bag to distribute the warmth throughout the fluid. This will speed the warming process and produce even warmth throughout the bag.

It is always best to err on the side of a little too cool rather than any too warm. Fluids that are too warm can damage your cat's tissues and cause her considerable discomfort. Always test the fluid temp by allowing some to flow over your wrist (just as you would test formula from a baby's bottle).

There's a great subQ fluid administration tutorial at the link below. Be sure to read both the tutorial and the reader comments below it to get all of the tips and tricks that make this procedure as easy as possible, both for you and your cat.

Laurie

Here is a link that might be useful: administering subQ fluids

Our cat Cleo is 20 years old now and is having kidney problems. She is not our first CRF cat. We were very sad and frustrated when we realized she was losing weight and we suspected kidney problems. We have 2 vets. One is a holistic vet and the other is a regular vet. I am posting on this list because we have been very successful in treating our Cleo's kidney problem. We are using chinese herbal medicine combined with Azodyl and Epakitin. She is actually gaining weight and has gone from needing to be on an IV to 1 sub Q per day and now 1 Sub Q every 4 days. Our vet is very suprised that her levels have gone to almost normal. She also eats CRF foods from Purina, Medical and Science Diet KD wet plus KD dry. Although sometime we even cheat and give her a teaspoon of meat every 3 days or so.

The chinese herbs we are using are:

Ba Wei Di Huang Wan
Useful for improve kidney performance, or profuse clear urine.

Wei Ling Tang
For appetite and kidney support

We make gelatin capsules (00) size. We fill the larger part of the capsule with Ba Wei Di Huang Wan powder and the smaller part of the capsule with Wei Ling Tang powder.

We give her 1 capsule per day of the chinese herbs and a capsule per day of Azodyl ( this is a probiotic bacteria that supposedly helps the body filter toxins in the blood)

We mix 1/2 scoop per day of Epakitin into her food. The scoop is provided with the Epakitin.

Her recovery has been remarkable. We really want to share this information in the hope that someone else may be able to help their pet. We don't know how long she will survive like this but the initial results are very promising. Her quality of life is excellent, and we couldn't have done it without the holistic vet and our regular vet's treatments both combined.

Do you have a gas oven? If so, the ambient temp in the OFF position is pretty close to a cat's body temp...~100F. Instead of warming the bag in water, I would put it in an UNHEATED oven for 1/2 hour. (Of course, this will not work in an electric or micro-wave...never even think of putting the bag into a heated oven.)

I've had two CRF cats over the years...both took to fluids really well. I'm praying my current cat will never need sub-q's because she's a wriggler.

We have been doing the fluids twice a day for our cat for the last few weeks. Administering it isn't a problem, but the cost is $30 for the 2 bags per week. I found out recently that you can get a dozen of the exact same bags at costco pharmacy (with a written prescription from the vet) for $24.89!!!! HOW CAN THE VET CHARGE THAT MUCH MORE????!!! Now I'm wondering what everyone else has been paying.

I buy LRS by the case from Target pharmacy for around $25 with a script from my vet. I buy needles and IV sets online. 20 ga UTW Terumo needles are about $7/100, and IV sets are $2.85 each.

SubQ fluids are pretty cheap when you know where to buy the supplies.

Laurie

How old is your cat?

What brand of food did you feed? Most foods are filled with cheap grains and fillers, grains probably stressed the kidneys over the years and overtime lead to this. Cats are 100% carnivores, the only time they eat plants is to soothe their digestive tracts. Grass,catnip ect.

Vets in gen know a lot about how to treat these kinds of issues but sadly because of mass capitalism, ( if you think purely in a $ view point- this makes perfect sense to the makers of the food) The foods they preach to be good are crap ( S/D science diet, and (Iams - a brand that does animal testing BTW). actually cause many of the issues they do services for. Use the prescription food only when you MUST and then switch to raw or grain free canned.
Pre made raw
Natures variety
Bravo
Primal

canned/dry
Innova EVO
Instincts
wellness grain free,and wellness core
ziwi peak

Orijen- a dry

Raw is NOT an advisable diet for a CRF cat for several reasons. First, raw meat is high in both protein and phosphorous, both of which can be exceptionally difficult for compromised kidneys to handle. Second, CRF cats are immuno-compromised, so they are not as able to handle the sort of foodborne bacteria in raw meat that healthy cats can generally handle without much trouble.

Laurie

It can prevent something like this from happening though, note I DID say perscription diets are needed IF its gotten that bad. By the time its happened, cat is used to bad diet and it is difficult to change.

runsnwalken, have you ever taken care of an elderly cat? I certainly agree that diet can have a tremendous effect on both the short and long term health of any living body, but you seem to cling to a notion that diet can render a body immortal. It can't. At some point, all living bodies give out, regardless of what that body has consumed over its lifetime. Maybe the kidneys go first. Maybe the heart goes first. Maybe any one or combination of a thousand other things fail simultaneously. But SOMETHING is going to end the body's life, and not all physiological failures can be logically or factually attributed to poor diet.

Some day your own cats' bodies will start to fail. At that time, I hope you can accept the reality of bodies getting old and your ultimate inability to do anything to stop that process.

Laurie

I can't get over how things have changed since my 18 1/2 yo Mr Kitty died of kidney failure 35 years ago. Back then, there was not much we could do other then put him on a special diet. The vet recommend we give him some prescription diet in cans plus rice to eat. Mr Kitty was not happy. We live out in the country and at that time there were no specialists in cat care. Our vet treated farm animals. They did their best and loved their patients. We found Mr Kitty dead one morning. I am so glad that there are so many new and better things now in veterinary medicine and there is so much information available on the internet. We are loved by three cats now and feel lucky that there is so much information available to keep them healthy.

Lisa, my vet charges $28/liter of LRS. I generally like my vet practice, but that is just highway robbery IMO. I also get supplies elsewhere (at a local pharmacy), but since my original vet left the practice to stay home with her baby, I've noticed the remaining vets don't advertise freely that they will write an outside RX. That's the only thing that bothers me about my vet...

Its true they fail, Laurie, I know this, no diet makes pet immortal. I'm not making raw diets to be the fountain of enturnal youth.

everyone dies.

but diet/lifestyle does play a major role, on animal X, there's this show about strange drinking water called"Fountain of youth" because cattle in this outback farm who drank it lived MUCH longer then cows of other places. they had their last calves at 17! (like a woman having a baby in her 70's) and lived into their 20's and up. They died- but not normally- as far as age goes.