Worsening CRF, IV fluids?

Hi everyone,

I'm very sad, nervous and scared right now. I got Moritz's blood work results back today, and the numbers are significantly worse that in mid-September. His BUN is now 193 and his creatinine is at 12.3 (his BUN was previously 88 and creatinine was 4.4). The vet said that we could put him on IV fluids, but I'm just not sure if that's a good idea for him. The thought of him being without me and scared with a catheter hooked up to him just makes me so sad. There's no way of knowing exactly how/if he'd respond to IV fluids. I know these numbers are severe. I'm wondering if it isn't just best to keep him as comfortable as possible at home with me where he at least feels safe.

Moritz is the first cat I've had on my own, so I've never encountered a difficult situation like this before. I love him so much, and I'm having a hard time even imaging my life without him. But I don't want to make a decision for him based upon my needs.

I would appreciate your advice.

Thank you,
Elena

 

Did your vet say/mean IV or sub cutaneous fluids. Many of us do sub q at home. Check in a few other messages here to see Carl and Bob's answer where he linked to a video on administering fluids. The other fantastic resource is Tanya's site - its a yahoo group for kidney cats and is an absolute wealth of info. You might want to join that group as well for assistance.

 

If you are correct in your posting of a creat at 12.3 then sub-Q's at home won't do it. He would need IV fluids at the vets for at least 2 days.....max would be 3 days......to see if the creat comes down at all or enough to help then maintain him at home with sub-Q's. Usually 3 days at the most because it starts to affect his hematocrit and he could become anemic if he isn't already. Do you know what his HCT reading is and did the vet do a retic count if he is anemic to see if he is regenerative or non-regenerative? I'm sorry to say this but his numbers are really, really high and I don't know if there is any way to get them down enough to help him.

 

He is anemic, yes. It's quite severe at 15.5. I just don't know what to do. I'm so sad and nervous. If the IV fluids don't help/don't help enough, I don't want to put him through the stress, and I do believe that 2-3 days away from me/home would be very upsetting for him. I'm not sure that's fair for me to do.

 

Please read on Tanya's site..http://www.felinecrf.org/index.htm I'm so sorry his values are so high. They usually want to do a blood transfusion when the HCT gets down to 18% on sick cats but if he has non-regenerative anemia that isn't going to help. My BigGuy(GA) was up to 12 on his creat also and we did the IV fluids for 3 days but his HCT went down and all we accomplished was to get his creat down to 8. I then continued with fluids at home, plus phosphate binders, plus everything he needed including giving him Epogen for his anemia as he also became non-regenerative. Basically everything we did and all the monitoring and treatments just were too late. He had a great day his last day but then the seizures started. There really was nothing left to do......If he also has HCM, then the fluids can become a major concern. Not enough or too much........lots of monitoring with vet.

 

Thank you for your support.

He does have HCM. The vet said that because of the close monitoring, this wouldn't be too risky, but I'm not sure if that's true or not. His last ultrasound was in March 2012, so I'm also not entirely sure how it is today (if it's gotten worse). He's on medication for his heart.

My fear is putting him through stress since if the treatments won't be effective/effective enough (since I can't be sure if the IV fluids would help or not). I wish Moritz could tell me what he wanted. I'm trying to pay attention to his wishes/needs.

This is so hard, and I know you all can understand. My mom, who I'm living with at the moment, doesn't really understand, and that makes this even worse.

Thank you again.

 

It is always a hard decision of what to when they are sick like Moritz is. Sending purrs and prayers.

 

Elena, sending you many prayers for you and Moritz. So hard to know which way to go and what to do. BigGuy(GA) didn't have any heart problem and I was able to leave him for a few days on IV fluids but he was not that anemic and was not non-regenerative at the time. We did have some more time with him but was never able to get his creat done below 8 ever again. I also had an adopted one with only 1 kidney and I knew time was coming. He ended up with a creat over 12 something, left him for the weekend on IV fluids and it did nothing, he went up to over 14. I let him go peacefully.

 

Thank you, everyone, for your help. For the moment my gut is telling me to keep Moritz with me at home where he feels safe and loved and make him as comfortable as possible. Does this seem like the wrong decision? The vet said she doesn't really see a "right" or a "wrong" decision, but I already feel guilty by not exploring every avenue that could make him better. But again my concern is putting him through the stress of a vet stay when there's no guarantee treatment will help.

I had two cats growing up, but Moritz is the first animal I've had as an adult, and our bond is so strong, as I'm sure you all can understand. We've been through so much together. Maybe it's not good to start thinking about what it will be like when his time comes, but I can't help but think about that and feel so sad and scared. I can already feel an emptiness in anticipation of that time.

I'm trying to focus on the time we have left. And I know that no matter what, we'll always be together.

Thank you, again.
Elena

 

No, Elena, it is not wrong. He has so much against him and no way to bring those kidneys back and you know him.........