I hope none of you ever have to face this question: My cat is dying of kidney disease. I’ve done everything the vets have told me to do but she’s miserable. What else can I do to make her well?
The all-too common answer is the obvious: euthanasia. And while I'll never advocate this option without exploring every possible treatment option, make no mistake, kidney (renal) disease is a killer. It’s perhaps the single most common cause of death in cats over the age of ten. We don’t know how to prevent it or how to cure it—that is, unless you have $15,000 to $30,000 to spare.
Yet even if you had a bottomless bank account to your name, it might not be so simple to get a kidney transplant. Your cat has to be a good candidate. That means he has to be free of other diseases that might preclude surgical survival. She has to be young and vigorous enough to withstand the months of wait-time required. And then you’ve got to source a healthy kidney from a suitable donor kitty.
No, kidney transplants are not as easy as they might sound. Not that they sound like a breezy day on the beach to me, but many of my clients long only for the money to be able to make it happen. They think little of the realities inherent in bringing off this still-experimental vet school surgical technique.
Yes, kidney transplants in cats are still a tool of the future. We’ve still got a long way to go before even the hardiest sufferer might be well served for less than $10,000.
Even this week’s three year-old patient (in chronic renal failure for no good reason) is far from a candidate. This beautiful (and devastatingly sweet) Rex’s kidneys are shot. Her only hope is a lifetime of dialysis and all the care that comes with it (not available in our area)—or a transplant. Better luck next life. Maybe by then we’ll have the kind of medicine she deserves and her owners would kill for.
For now, even the luckiest kidney transplant kitties don’t have access to all they’d wish for. Their owners must often adopt a pesky youngling kidney donor as part of the package. Can you imagine? A whole new lease on life with a fresh new kidney and still you have to put up with a teenager clobbering you every time you turn the corner into the kitchen!
“There’s nothing easy about transplants,” I explain to my tearful client. Even if she had all the money in the world and she’d made it past all the health-check hurdles, I’d still beg her to think it through thoroughly. After all, being on the bleeding edge of a new treatment isn’t always all it’s cracked up to be.
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While I would do anything for my pets - there is only so much that I would *put* them through.
Kidney disease is one of those where the obvious option (for me, at least) is to make that animal as happy and comfy and pain free as long as possible - I just couldn't put them through a surgery like that.
Cindy February 22nd, 2008 12:46:00 AM
I have a dear kitty friend now with kidney failure and though I would give him my kidney if such a thing were possible, I could and would not put another cat through kidney removal... causing pain and potentially limiting the life span of that individual. I want my dear old friend to have a quality life
Then there's so much innovation in feline renal care that a person can do for their fluffy friend to give a quality life: Adozyl, special renal failure diets... and fluid therapy, also wonderful feline renal failure support groups and information on the web... and many vets are innovative and compassionate so that's a big help.
=^..^=
Rose February 22nd, 2008 02:15:00 AM
Let's not forget the ethical dilemma of submitting a perfectly healthy donor cat through a serious surgery for the sake of giving up one of his/her kidneys.
Also there is the issue that an owner would need to administer daily anti-rejection medicines for the rest of the cat's life. Although if one could afford the transplant in the first place, I suppose the cost of the cyclosporine would probably be a drop in the bucket.
That being said, I worked as a research tech for one of the vet transplant surgeons at one of the universities. There were plenty of success stories of some of the cats living 5+ years after their surgeries. At the time that I left the position, we were working on a protocol for *canine* kidney transplants.
Michelle Schwab February 22nd, 2008 08:13:00 AM
Xslf: I LOVE that!
Dr. Patty Khuly February 22nd, 2008 08:50:00 AM
I have a cat in my life, though he is not mine (I cat sit him). He's an amazing cat and the center of the universe for my 2 friends. The cat is 18 and seems to have slowed down just in the last 12 months. First it started with thyroid disease (about 2 years ago). This last year has been a constant UTI / Clavamox rotation and now....kidney failure. The guys have to administer subcutaneous fluids every other morning, their own little hospital! It seems like a lot, and I wonder if they are clinging to the last little bit of hope, postponing the inevitable. But then I see the kitty, and he's completely 'normal' and happy (albeit old). He acts like his usual self, just sleeps a lot more.
It's so, so hard to tell in this situation when the 'right time' will be. I suspect Spike will let them know. I had hoped he would live forever.....
Creature of Habit February 22nd, 2008 09:08:00 AM
To me the donor is a huge issue. If they 'have to' a dopt a 'donor' will some not care for it in the same way as if they really wanted to adopt another cat? Given that most cats have kidney issues what are the implications for the livespan and geriatric health of the donor cat? Has anyone studied this?
emily February 22nd, 2008 09:42:00 AM
Dr. Patty-
When I was a teenager, my parent's 2-year-old cat was diagnosed with complete renal failure--his kidneys suddenly stopped working for no obvious reason. We considered a kidney transplant--we had also adopted his full brother, who was perfectly healthy--but we decided to go with dialysis instead. For the next 6 years, Tuna got 100 ml of fluid subq six days a week--I don't think he ever actually enjoyed it, but he was very well-behaved and looked like the picture of health. He died suddenly (probably a heart attack) at 8, but his life until then was a normal, happy one. If your client is willing to put in the time, she could keep her cat going for a good long while.
Sarah February 22nd, 2008 09:01:00 PM
Sarah: It always depends on the severity of the damage to the organs. Subcutaneous fluid therapy is a mainstay of my renal failure treatment as long as some kidney function still exists, but it's different from the dialysis I referred to in this post. Renal dialysis is a specialized, in-hospital procedure almost identical to the one we use for humans whose kidneys have failed. They must be brought in to a specialty center (the machine is very expensive) and attached to it through catheters placed in the cat's blood vessels. It cleanses the blood of the toxins the kidneys can no longer eliminate.
btw, I wish more owners would have your family's dedication to your kitty's life. Six years of SQ fluids is a feat!
Dr. Patty Khuly February 23rd, 2008 07:57:00 AM
Just to add to the sub-q thing: perhaps it's a feat, but as my photos above show, it's well worth the effort.
Sure, Zora isn't a huge fan of her daily sub-q (or her daily medication), but once she has that needle in her, she calms down and is content with her treat.
And the great quality of life the sub-q has given her is well worth the few minutes of discomfort a day while giving the sub-q.
Xslf February 23rd, 2008 01:03:00 PM
My cat Aldo had a kidney transplant last July at the Universery of Madison in WI. It costs approximately $17,000. I love my cat more than a stupid new car, so why not spend my money on the being that makes me happy. Aldo was 7 years old and I hope will have another 7 years at least. All I know is he's comfortable, doesn't need sub Q fluids anymore, and is really doing well. Keeping him on anti-rejection medication is not difficult.
This procedure is not as "experimental" as this article suggests. Transplants have been going on for a long time now, all around the country. And it isn't difficult to find a donor. Mine came from a research facility in upstate NY. But other transplant centers use strays from various shelter. The good thing is, you get to save two cat's lives because you must adopt the donor cat. All the donor cats I've heard about have made wonderful pets. My donor cat, Geno is hysterically funny, sweet, trusting, and BIG. I love him very much now.
If anyone is interested in more complete information on adoption should visit the Feline Kidney Transplant Website. The folks on this site are wonderful and will answer any questions you might have. They even have a "support group" for people who have taken this step for their cats.
Dyann April 22nd, 2008 07:42:00 PM
I took my 3 year old cat in to be spayed today and they found cysts in her kidney and it was also attached to the ovary and they then told me they had to remove that kidney. It is costing me a fortune but I found this cat on the side of a road with pneumonia and conjunctivitis at 4 weeks of age I bottle fed her and she is part of the family. However no one can seem to tell me how long a cat will live with 1 kidney. Does anyone know?
Shannon September 29th, 2008 07:48:00 PM
To Shannon: a cat with one good kidney can live for many, many years. We expect Jack, our donor cat, to be with us a decade down the road (yes, that's been studied). I think the question is whether the cysts are likely to invade the other kidney. I don't know the answer to that. Might be time for a referral to an internist?
To anyone considering a kidney transplant: Actually kidney transplants are no longer considered experimental. They are expensive. And they do require an extraordinary commitment on the part of the humans in the family. The anti-rejection meds must be given every 12 hours. And because the cat is immunosuppressed diabetes and infection are always dangers lurking on the horizon. And the cat must be regularly tested to see what the level of cyclosporine is in his blood.
Our cat Gordy was transplanted at the University of Pennsylvania in September 2007. It's been a roller coaster, I won't deny that, but I'd do it again in a minute. He was only 8 years old at the time and had been diagnosed at 6 months old.
Our donor cat came from the SPCA in a small city in PA via the Penn donor colony. In September 2007 that SPCA's web site had a huge desperate message on their front page, begging for help with the over 600 cats they were trying to help (that has to be more cats than a small city like that can absorb in years of adoptions). Our Jack is a wonderful boy but he's black, was unneutered and has some minor litter box issues so he had no hope in that setting. I am firmly convinced we saved his life. Since I don't expect to live long enough to see a no kill nation, unfortunately, I think we are decades and decades away from ethical issues with respect to donor cats. In today's world, a transplant results in the saving of two lives. Here in Baltimore, for example, the city shelters euthanizes well over half the cats it picks up (and that's a dramatic improvement over a decade ago). I'm sure any one of those cats would give up a kidney for the chance at a cushy home for life.
Maryanne
Maryanne February 3rd, 2009 04:22:16 PM
There is a lot we can do to prevent kidney disease in cats. I have a 12 year old cat that developed kidney disease two years ago. I have done much research and reading on this subject. How I wish I'd known a few simple things years ago! It is crucial that pet owners realize that dry commercial pet foods do not support healthy body function of cats (or dogs), but rather set them up for diseases. It usually begins in cats 3 to 4 years of age with urinary infections and stones. Cats are designed very specifically to eat mice, birds etc. If you responsibly keep your cat indoors you must feed them foods as close as possible to their natural diet. Cats are not designed to drink water and even if you see them at the bowl, if you are feeding dry food they will stay about 50 % dehydrated. Over time they cannot handle the urine being so concentrated and their kidneys begin damage. It is a huge improvement to feed your cat canned foods, but even better to do raw. This is very simple now with powders available (Feline Future) and ground meat from your grocery store. Even poor quality cooked canned foods are a tremendous help to avert kidney trouble. The other issue I have found is a bit more difficult to avoid, but hopefully less of an issue. Studies are showing a significant link between feline distemper vaccines and kidney didease (because of the way the vac is developed). Most kittens have already received this vaccine before the owner has aquired them. A possible help is to administer an immune builder before the cat receives the vaccine (like Transfer Factor etc).
The money factor that ties Veterinary Schools and mainstream market pet foods to financial profit rather than preventative health is formidable. There are, however, many kind and wise professionals in these fields trying to make a difference. We must, with our own personal health as well as our pets, think for ourselves and hope that 20 years from now people will be picking up their prepared cat/dog food at their local grocery store in the meat/frozen food departments.
The last very important help is a probiotic called Azodyl. My holistic vet started my cat on it a year and a half ago. It is a specific probiotic that helps the cats body to metabolize proteins to avoid the toxic buildup present with kidney disease. Our local traditional vets prescribe it as well. It is an absolute life saver. It is available through Entirely Pets online at a reduced price from what you usually pay at the vets office.. This info will help. Please check it out
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