Cat with end-stage renal failure: tips to support him until the end

With my experience as a veterinarian I have assisted many cats suffering from end-stage renal failure. This disease, although devastating, still allows you to provide quality time to your partner if you know what to do. I remember in particular a 17-year-old Persian, Figaro, whose lover managed to maintain an acceptable quality of life for more than two months after the terminal diagnosis. Here are my tips to help you get through this difficult time with your feline. 🐱

Quick summary:

End-stage renal disease in cats requires specific care to maintain an acceptable quality of life.

• Recognition of symptoms : excessive thirst, loss of appetite, weight loss, uremic halitosis and discolored gums.
• Essential palliative care : hydration through fluid therapy, specific renal diet and adapted medicines under veterinary supervision.
• Everyday convenience : welcoming space, multiple water points and constant emotional support.
• Decision on euthanasia : to be considered when evaluating the animal’s suffering and quality of life.

Understanding end-stage renal disease in cats

End-stage renal disease represents the final stage of chronic kidney disease. At this point, your cat’s kidneys can no longer perform their essential functions filtration of toxins and elimination of waste. This failure leads to a buildup of toxic substances in the blood, causing what is called “uremic syndrome.”

Clinical signs of a terminally ill cat include:

• Excessive thirst (polydipsia) and large amounts of urine (polyuria)
• Loss of appetite leading to complete anorexia
• Significant weight loss and general weakness
• Characteristic bad breath (uremic halitosis) 😷
• Mouth ulcerations and frequent vomiting

Last year I treated a domestic cat whose blood tests showed alarming levels of urea and creatinine. The owners were distraught over his suffering. I had to explain to them that the symptoms would worsen with the possible onset of tremors, convulsions and a comatose state.

It is essential to recognize the signs of pain in your pet. A cat with end-stage renal failure may present tremors, restlessness or, conversely, excessive prostration. His breathing often becomes shallow (about 10 breaths per minute compared to 22 normally) and his heart rate may slow significantly.

The observation of gums that become discolored (turn gray or white) it is also a worrying sign. Keep in mind that other serious feline diseases, such as lymphoma in cats treated with cortisone, may present with similar symptoms, making an accurate diagnosis important.

Daily care and support options

When faced with end-stage renal failure, there are several palliative care options to improve your cat’s comfort. 💉 Hydration remains essential: intravenous fluid therapy in the clinic is the most effective, but administration of subcutaneous fluids at home can be considered after adequate training.

For food, choose:

1. A specific food for the kidneys (low in phosphorus)
2. Wet foods to promote hydration
3. Meals divided into small quantities
4. Appetite stimulants if necessary

Drug treatments may include appropriate antacids, antiemetics, and pain relievers. Never give medications without veterinary advicesome of which can worsen kidney damage.

For everyday comfort, create a cozy and easily accessible space for your cat. Move his water and food bowls closer to his resting place. Increase the number of water points in your home to encourage him to drink. If your cat has become incontinent, use mattress pads or blankets to protect his bed.

Emotional support is equally important. Stay calm and reassure her, speak softly to your partner. Cats at the end of their lives sometimes seek closeness, sometimes isolate themselves: respect their choices while remaining available. 🤗 If you observe signs of intense suffering, such as in cases of animal poisoning, contact your veterinarian immediately.

Making the decision about euthanasia

The issue of euthanasia is undoubtedly the most delicate. This decision must be made considering above all your pet’s quality of life and level of suffering. Euthanasia becomes an option to consider when your cat:

He has not eaten anything for several days, can no longer move, shows signs of pain despite treatments or when his quality of life is significantly reduced. To objectively assess this quality of life, observe his mobility, his appetite, his interactions with you, and his overall comfort.

Euthanasia is a medical procedure that generally takes place in two phases: a first injection of a sedative to put the animal to sleep, then a second injection to stop the heart. You can choose to be present or not during the procedure, depending on what you feel is most appropriate for you and your cat.

In some cases, euthanasia can be performed at home, which is often less stressful for the cat. Don’t hesitate to discuss this with your vet.

The grieving that follows is a personal process that varies from person to person. Give yourself the time you need and don’t hesitate to share your pain. Remember that animals with unusual behaviors such as a standing hen with its eyes closed also require our attention, but the relationship with a long-standing companion cat creates an especially strong bond.

The loss of a cat is always painful, but offering yourself the opportunity to accompany it with dignity until the end is a final testimony of love. 💔 Take the time you need before considering adopting a new animal.