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[quote=Anonymous]Hi, I have had great success keeping my cat alive and happy with kidney disease for the past year. (My cat is now 16 1/2. He began declining rapidly over last year's Thanksgiving holiday. I never dreamed he would make it to January. And here we are in November and he has been stable ever since his crisis last November!)

As others have said, the key to long-term management of kidney disease in cats is:

* subcutaneous fluids: 
We have been giving 150 ml nearly every day. After several months, the vet said we could try cutting back to alternate days, but I didn't want to risk it. This means that my cat pees a LOT because of all the extra fluid. But the extra fluids help to keep flushing toxins out of his system and keep him hydrated. With kidney disease, the cat loses the ability to make concentrated urine. So they become dehydrated very easily. That is why your cat was staying near your water supply. We also found it helpful to set up one of those pet water fountains; our cat seems to love drinking from it.

* nausea management and appetite stimulation:
     Pepcid: At first we used the expensive veterinarian-prescribed anti-nausea medicine, but when that first batch ran out, we switched to 1/4 tablet of Pepcid AC once a day. Now after a year, my cat has lost a bit of the weight he had regained, and he seems to be throwing up occasionally again, so the vet suggested we try increasing the 1/4 tablet Pepcid to twice a day.

appetite stimulant: We give a very tiny dose on alternate days (or sometimes every third day), because the vet explained that the pet needs time for it to clear out of his system. For some reason, it costs much more for 7.5 mg tablets than 15 mg tablet. The vet prescribed 1/4 of a 7.5 mg tablet per dose (once every 2 or 3 days), but instead, we found a much less expensive source for 15 mg tablets. That means we have to somehow cut them into 1/8 tablets! I have to get very clever with my pill cutter, and we end up sometimes with slightly larger or tinier bits.

My cat sometimes "cheeks" pills and later spits them out, but my neighbor is great with giving pills and I've learned from her. It helps to tuck the cat under my arm while he is sitting on a couch or even on the counter, and then stroke his chin with my other hand so he lifts his head way up to enjoy the stroking, and when he does that, he can't clench his teeth together, and also his throat is wide open and straight,  so while his mouth is straight up and he is relaxed, I suddenly press on the sides of his mouth so it opens, and then I toss the pill (or both pills if it's one of those days) back as far as I can to the back of his mouth, and I keep stroking his chin and wait for him to swallow. If he starts using his tongue a lot, I think he's moving a pill around, so I check inside his mouth and also between his teeth and cheeks to make sure he didn't hide it.

After Thanksgiving last year, my poor cat was so sick he could barely walk (staggering). His kidney function numbers were so bad the vet was amazed. (Like, a normal level is under 2 or something like that, and my cat's number was 13. The other measure was similarly awful. The vet surmised he had a kidney infection along with kidney disease. So he was put on antibiotics, too.) A couple of days of IV fluids while boarding at the vet barely helped at all. But what with that and anti-nausea meds and antibiotics and tempting wet food, at least he started eating again.

What really helped get his numbers down, though, was the consistent subcutaneous fluids given at home. The sky-high number was down to 6 within a few weeks, and in the 4 range a month after that, and entered the 3 range after some months, where it has remained.

I urge you not to write off your cat! Our cat has had an extra year of a very happy life and is still going strong. I have no idea how much time he has left, because he has a heart murmur too (being an old cat), and the extra fluids might make extra work for his heart, but at least for now, he is doing great; he's had the strength to leap up on the counter starting several weeks after we began treating his KD; his purrs and curiosity and love of the great outdoors let us know he is enjoying life. Last November he was clearly feeling miserable. But he rebounded quickly.

If you do start giving subcutaneous fluids, start out with stuff from the vet but then call around to local pharmacies and check online pet supply sources, because our vet's fluids were quite pricey compared to other sources we have found. But our local source went out of business and I'm paying about twice as much to get the fluids online. I'd love to know a good recommendation and price for the fluids, from anyone who has been through this. Thanks!

Good luck OP - hope your cat responds as well as ours did!

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