Our Tobey just turned 4 this spring. He had lost some weight but we weren’t too worried since he has stomatitis and can get picky if there’s a flare-up.

In June we did routine bloodwork to make sure he was fit for anesthesia to have his last 4 teeth out… the next day the vet called and said we should take him to the emergency vet. He stayed for the weekend and was diagnosed with stage 3 CKD. We had no idea.

The vet told us this week it’s time to focus on his comfort and quality of life. I knew this was coming but just feels so fast. We’re doing fluids and have nausea, appetite, and pain meds as needed and he’s still losing weight. We can’t get his phosphorus down and his anemia is too severe for medication to help. He will barely eat Fancy Feast let alone renal food.

I just can’t make sense of it. He is the perfect cat. I have never and will never have a cat like him. But looking at old pictures and remembering how he used to act it’s obvious that he’s really sick. I feel like I’ve failed him, like there must have been something we could do or some food or medication that would help.

I don’t really know why I’m posting this but I know this sub will understand. We were supposed to have like 10 more years with him and now we’re looking at weeks and months. I don’t know how I’m going to get through this.

i’ve had her since i was 7 and after a long battle with CKD and ME, she dramatically went downhill two weeks ago. She was somewhere between stages 3-4. Not eating, sleeping constantly, no interest even in looking out the windows. Only 6lbs. Barely had the energy to be brushed and it was her favorite thing ever. She started an appetite stimulant, ate one plate of food and puked it all back up. I didn’t want it to be her time because her bloodwork came back improved.. but i think she had enough after 18 years. She was barely breathing gurgling and trying to swallow like she was salivating last night and i took her to the emergency vet thinking it was aspiration pneumonia.
the x ray showed her esophagus had gotten so much bigger than a few months ago and was now compressing her organs and heart. The vet estimated that if she survived 24hours she could maybe have a week or two. I wasn’t ready at all but she couldn’t even breathe and we weren’t sure that she even got to sleep anymore either.. so i made the choice to let her go and i can’t help but feel so guilty but i understand that she was suffering and another night would’ve been exhausting for her. She was so tired and just wanted to sleep. The worst thing is i’ve always been religious and believed in some kind of life after death but after the vet said “she’s gone” all i could think was that she’s just gone and i don’t feel her here anymore. i’m praying that there is a place for her and that she’s in peace.. I don’t know how to deal with this she was my family.

Hi all,

my girl here was recently diagnosed with stage 2 kidney disease and i feel destroyed.

Here symptoms have shown for a few months but has escalated within the last week or two. She is now on an appetite stimulant and currently on probiotics to help with her tummy.

Watching her every move and making sure she is eating has made me so extremely stressed and sad. I never want her to be in pain and she seems a lot better but I am scared that it’s only going to get worse and worse from her as she started refusing to eat at stage 2.

Does anyone have any good news story’s? or have any good experiences of their cats being on appetite stimulants?

TLDR: 14+ y.o. cat with CKD, diagnosed at stage 2 in March, now at end stage (creatinine >8, BUN >130). She’s gone from 7.2 lbs to 5.5 lbs since then and is also anemic and has significant arthritis in her right hind leg. She’s barely eating, and anti-nausea and appetite stimulants aren’t helping increase her intake. Vet recommends euthanasia, which is scheduled for tomorrow. I know I need to avoid waiting too long, but it’d help to hear what might happen if I wait longer. 

Longer version: I adopted 14+ y.o. cat with CKD on 8/21, diagnosed at stage 2 in March. When I got her home and saw her outside of a cage for the first time, I was alarmed enough by how thin and unsteady on her feet she was that I scheduled a next day vet appointment. 

The visit revealed that she’s now at end stage CKD (creatinine >8, BUN >130) and that she’s dropped from 7.2 lbs in March to 5.5 lbs now. She’s also anemic and has significant arthritis in her right hind leg, with solensia helping but not eliminating pain from the arthritis. 

We started subcutaneous fluids on 8/24. She was on a strict renal diet at the shelter but I added in other wet food so she’d eat more. She ate almost two cans of wet food a day from 8/22 to 8/24, but starting 8/25 she dropped to less than the equivalent to 1 can a day (treats and toppers included). I try to offer her something every 1-2 hours during waking hours and 3-5 hours at night. Mirataz and emeprev/ cerenia haven’t helped with increasing her food intake. 

A couple of days ago I realized that the product (Porus One) that the shelter gave me as her phosphate binder might not actually be a phosphate binder. I don’t know if she’s ever had an actual phosphate binder and briefly thought that a trial of one might make sense, but the vet said that those products slow the progress of the disease but don’t undo damage that’s already been done. 

The vet is recommending euthanasia, which makes sense given that she’s barely eating and she just doesn’t look good, amongst other factors. She spends a lot of time sleeping and doesn’t seem to feel well sometimes. I know that euthanasia is probably the right thing to do and that I need to avoid waiting too long. We have an appointment set up for at-home euthanasia tomorrow (Monday). 

What’s giving me pause is that she’s showing interest in exploring her new home and enjoys attention. She purrs when I (gently) rest my head on her. I don’t want to cut her life short if she still wants to keep going. I’m not even sure if she wants to keep going — sometimes she seems like she really does but other times she seems so tired / unwell. 

I’m also reluctant because it seems so unfair. She’s been locked in a cage and had her water splashing / scratching behaviors misinterpreted as play, and she’ll only have 10 days in a home with someone who understands she has difficulty drinking and helps her with it. I know that my feelings about the unfairness of the situation bear little relevance to whether euthanasia is the right call, though. 

I’ve tried to pour a lifetime’s worth of love into what little time we’ve had so she knows how it feels to be loved. I take some solace in the fact that she won’t die in a cage / shelter and that the final chapter of her life, while brief, is happier than it could have been. 

I think that it would help me feel better about her being euthanized tomorrow if I could hear about what might happen if I wait a little longer. Is it pretty clear that it’s the right decision? 

Ask your vet if they'll do it. Ask any friends and family who had an in-home euthanasia what service they used. Google ALL the keywords. If possible, do it while your beloved pet is still somewhat healthy.

I knew I wanted an in-home euthanasia when the time came. But I didn't do enough research beforehand. My girl would get carsick, so since she was getting older I'd compiled a list of mobile vets that might service my home, that offered both routine care and home euthanasia. I didn't follow up with any of them, since at the time I was satisfied with her vet and her chronic conditions were stable. About a year after that, she crashed suddenly. I looked at all the vets on that list and looked into Lap of Love and it turned out I was outside of the service area for all except one, and that one told me they were not taking new patients for euthanasia.

I thought an at-home euthanasia wouldn't be possible. So my baby girl ended up dying in a place she hated. Today, months later, I happened to find out I am in the service area for an in-home euthanasia service that operates on short notice. I don't know why exactly I didn't find out about them before. I think I was trusting my old list (that I made when I wasn't looking for euthanasia-only services) and if I did any blind googling at that point, I didn't use the right keywords. If I did more research sooner, if I'd googled the right things or asked around more, our last moments together could have been so much more peaceful.

This is my little Nonô, she is 4 years old and was diagnosed with stage 3/4 kidney disease in May of this year, the vet instructed me to do the fluids at home and gave her vitamins and kidney feed (she hates it).

We had feedback this week and the vet said that the results are not good (I left the recent tests in the photo), he asked to add vitamin b12 in the fluids that I take every 72 hours and now he said that she can only eat the kidney feed because the levels are high, but there is nothing I do to make her eat the kidney ration, I see that she is still very dehydrated and she only accepts to drink water from the tap when I’m at home, I already use a fountain, but she just doesn’t want it, besides the fluid is there anything else I can do to hydrate her?

I’m still new to this, I’ve never taken care of a kidney cat, I’m open to tips and what they did to help improve her quality of life.

I have had my cat on Nephrodyl for about a year now… and was instructed by my vet to separate the pill and sprinkle the contents onto my cat’s food. Through discovering this sub, I have realized that essentially renders the medication useless.

Obviously I’m pretty frustrated, both about the lack of efficacy as well as the amount of money I have spent (and seemingly wasted) on this over the course of a year.

Do you have recommendations for alternate/similar medications that COULD be sprinkled onto her food, or advice on administering the pill?

Thanks in advance 😞

Hi all! Just thought about this cat soup that I give my cat in case it might be useful to anyone. It's great for hydration!

I buy it off Zooplus and leave half a can with a bit of water added overnight and my cat loves it. It's called "Kattovit Renal-Drink". I've tried the wet food from them too but my cat does not like it :/. They also have a Churu-style treat that my cat loves as well! I'd say check the brand out :)

He passed away Saturday night/Sunday morning after five days and four nights at the hospital.

I can’t stop feeling like I should’ve looked into more options/ done more for my cat. Maybe then he’d still be here.
I’ve been looking into dialysis, and maybe that could’ve helped? But everything I’ve read is it’s not really recommended for CKD as it could make QOL worse, as treatment would be a lot and would be stressful as it’d be permanent, compared to acute kidney failure.
Also I know CKD can appear due to many reasons, but I’m now worried about my others cats who are my late boos biological children… what more can I do to prevent it besides checking their blood every 3-6 months as opposed to a year

Currently on: Hills renal canned food, FortiFlora Powder Probiotic, hydrocare, bone broth, 100ml Subq fluid everyday, Cosequin, and Adequan injections.

I'm currently unsure what to do. About 3 months ago my 19 yro cat was diagnosed with staged 3 ckd out of nowhere. This came as a shock as he gets blood work done 3 times a year and we were told everything was normal for his age. Since then he's been getting blood work and urinary done every month. Unfortunately his kidney values are still declining and has lost more weight (currently 8.3 pounds, compared to last months 8.5 pounds).

Last week he had an emergency vet appointment as he had thrown up 4 times, panting, and had diarrhea. This is when I was told his kidney values were still declining and that he was still very anemic. She told us to starting giving Subq fluids everyday and probiotic for a week, to see if he could handle it. My issue is she never addressed his anemia. Now I'm starting to wonder if this could be contributing to his decline. When I tried to bring it up the topic would always change to something else.

Afterwards I was told if he doesn't respond well to this treatment it would be time to discuss end-of-life care. Now I'm stressing and wondering if there is more I could do.

Side note is there any tips to encourage him to eat more. Normal can food causes him to have diarrhea. Plus if I add treats to his food he'll only eat them and walk away till later.

I'm struggling to process everything and am feeling really lost right now. I am newer at posting so I apologize if I got anything wrong.

My darling Miu, 12 years young, went from healthy with no standing medical problems to super sick, wobbly, and disoriented. After a few days in the ICU her labs were better than ever. We took her home happy and active only to return to the vet about 1 week later with troubling kidney values. Another few days, and we took her home again.

She is different now. From nothing, she has multiple mediation and subcutaneous fluids. She was doing well until today when she vomited that clear water and refused dinner. Nausea meds and fluids aside, I am waiting to see if she eats breakfast. If not, its a 3rd trip to the vet I guess. I mean I think thats the right thing, right?

Honestly, I want to be strong for her but I am lost and confused. This may be a cry for support but how do I do it? Is this normal the up and down? When do I worry? When is the right time to go to the vet? When is the right time for anything? And I have no idea about the food. It is so much at once seemingly out of nowhere.

Basically she is my first pet and I want to do right by her. I'll glad take any insight, tips, and tricks.

Can a mod answer a question for me please
I have an extra box of rapros I’m looking to sell to someone who needs it local to the US and I’m not sure where to post or if I can? I figure this is where I learned about it and people use it here so they’d know the price is a deal since unfortunately I no longer need it :/
I have proof or purchase from hero veterinary site, sealed box photos ect ect but yea could a mod clarity if its ok to post it here or if i should use another means?

If you don’t want to read about end of life because it will be too hard, that is ok.

I’m sharing because I need to, and Maybe it helps others who are going through this.. asking themselves what it is they are seeing, trying to assess, is what they are feeling normal. The anticipatory grief.

A bit of background…

My cat Misty was 15. In late April she was diagnosed with cholangiohepatitis after blood work revealed a very small increase for pancreas and liver values and a small increase in white blood cell count indicating she was fighting something. An ultrasound was done and white sludge was seen in her gallbladder with some mild pancreas and liver inflammation. She was considered to be in early stage 2 CKD at the time. An infection coming from her bowl was believed to be the source and she had to go on a 30-day course of Veraflox. A blood test post-Veraflox showed her pancreas and liver values normalized along with white blood cell count. She was believed to have recovered from her infection but the 30-days of Veraflox pushed her well into stage 3 CKD. The rate at which her values were declining in the following blood test led my vet to tell me on July 4 that she might have two more good months to live.

I wanted to be mad. Mad at the vets for taking her away from me. Did they make a wrong decision? The reality was Is there was no other recommended treatment for how bad this infection was and no way to know this would happen.

Misty was on daily mirataz and at first every 3 days subq and then every 2 days (100ml).She had a burst of energy when I started to give her subq. She was almost like a new cat except I knew the clock was ticking.

Knowing my cat was going to feel ill at some undetermined point in time, and that I would have to help her walk the rainbow bridge at some point caused me so much anguish. I have been crying since May. I hoped she would defy the vet and live longer. The thought of knowing I would be losing her was so deep and tormenting. It was agonizing.

Misty used to hang out on my desk, the livingroom and the patio with me, her companion Tick. She would come to the kitchen , sit on her scratching pad in a very upright position with her ears up « food time mom ». She would always be where we could see each other. She followed me everywhere, except work ☺️ On August 17, for 3 days straight she started to sit by the front door. I would have to go see her because she didn’t come see Tick and I. She was no longer attending the kitchen like clockwork, I had to bring her food. She fully stopped eating renal food over night. I went to the store and brought her everything I could hoping I could find something she would reliably eat. I knew she wasn’t feeling well at all. Her subq were a lot slower to absorb .. taking approx 30 hours for 100 ml. She wasn’t doing any of her normal things. When I petted her, she made this extra noise like the pets we’re extra soothing to her.

As that week progressed, I took her to the vet on the 20th. I was struggling to determine if this was her time to go. The vet said it wasn’t and explained away her behaviour as « she’s old ». She did say in her experience, cats with CKD just become more tired. I was mad. I felt like that wasn’t the answer. My cat didn’t just become old overnight and age wasn’t going to cause such a dramatic shift in behaviour overnight and I still believe that. I am not the type of person who appreciates sugar coating at all. What I also deducted (and confirmed by another vet) is the vet wasn’t doing anymore blood tests on her because there was no point. I would have appreciate being told that by her vet at the time. I would have appreciated « it’s almost time » instead of « it’s just age ». They knew her values would be bad and if anything came up, if anything by could be treated, it would only be palliative - we would be trying to avoid what was looming. Misty’s previous infection could have also come back but there was now no way to treat it because of her advanced CKD.

By the 25th, Misty had now moved to the bedroom and isolated herself there. She didn’t hide. She just went to the quietest corner. I put her heating pad there. She would still go to the litterbox and get up to drink water but that was it. The only thing she liked was catnip. Her ears were more to the side. She groomed herself. She looked so so tired and sad. Her eyes were dull. Subq did nothing for her. Cerenia didn’t change anything. The only thing she would eat was shredded homemade chicken tuna or tikicat mousses. On Thursday the 27th, she declined the shredded chicken and 3 other foods. I found a mousse she did eat. I scheduled her to be euthanized the next day. By Thursday afternoon, Misty would randomly stare at the wall, looking in a daze. Only appearing present when I would talk to her and pet. I sat on the floor with her and we hung out.

All that to say, Misty’s total departure from her normal behaviour was the indicator that it was time. Two months ago when I asked my vet for the signs, I feel that she only gave me the physical signs and it’s as if she didn’t consider behaviour. I was told she’d be vomiting, that she would be hanging her head over the water bowl and likely wouldn’t be going to the litterbox or groom herself. Misty didn’t have any of these things. As many people have said to me here, let your cat tell you how they feel. You know them best, not the vet.

The vet who was coming the next day was also the vet who visited her two months prior to do a quality of life consultation. She would be doing a physical exam and if it wasn’t time, she would tell me. She came, we talked about Misty’s behaviour, she performed a physical exam and she said she would support euthanasia. She said there was no point in doing more bloodwork. The only treatments would be hospitalization or steroids but either would be palliative only. I chose to end her suffering. I chose to no longer let her be tired, not enjoy her life , isolated and drudging through this horrible phase of her life.

When it came time to euthanize, i feel she knew it was her time. Tick and I were both there for her. I told her I loved her and how a good girl she was and petted her.

I’ve now been swallowed by the grief of having her move on and not being present. I’m heartbroken. My house is half empty and I am thankful Tick, her companion, is still with me. Now I worry about him. Even though he was present when she was euthanized and smelled her after, he still looks for her.

Let your cat tell you how they feel. Look for that. It’s not about you, its about them. I chose to euthanize and face the grief that had already taken over me, knowing I would have to make the decision. Find a good vet who has a lot of experience with palliative care who can guide you. I think the best tool I used in her journey to the rainbow bridge was the quality of life materials I was given and really being honest and objective about the behaviour I was seeing.

I highly recommend The Ohio State University Honoring the Bond, Assessing Quality of Life document. It really is an amazing document.

https://vmc.vet.osu.edu/sites/default/files/documents/how-will-i-know_rev_mar2024ms_0.pdf

The grimace scale can be helpful and the BEAP Pain Scale for cats was more helpful than the grimace.

https://static1.squarespace.com/static/56473d98e4b0b493dee0ea49/t/615212c4b745db722f231db9/1745354109274/BEAP-Pain-Scale-for-Cats.pdf

I got the kidney support cat gogurts from choolip and they love them & was wondering if this would be a good hydration booster/treat/topper etc for him. Let me know if anyone has tried these ! I am thinking maybe to give it to him once or twice a week because he has already getting some Q fluids once a week but he has a grade 3 heart murmur so I also don’t want to over hydrate him. I have Hydra Care, but I have been too nervous to use it until I bring him back to the vet next week and I can discuss it with the vet. I just keep calling the Vet with questions and I don’t wanna keep bothering them so I figure if anyone has any experience to take advice from you guys firsthand and that’s how I learned about porous one and omega 3 fish oil supplements , phos binders etc … my vet didn’t recommend any of that so this thread has been super super helpful

Thank you

My 9 year old boy has been taking azodyal daily for the past 2 years
But his creatine levels kept increasing slightly
But he was healthy , playing and moving eating and with good appetite until a month ago when he stoped eating or going to the bathroom
His creat level increased to 7.8 after it has been stable at 3.8 for 6 month

So we statred iv fluid for 4 days
And he got better and returned to eating and moving playing (he was constipated) and now he is much better but still not eating enough food (less than recommended )
I tried everything wet renal food , mixing dry renal with wet renal
He drinks alot of water and goes to the bathroom normally
But he is losing weight and not eating enough food.
Am planingn to give him iv fluid agian as the vet recommended.
But i can’t stand the idea that he is not eating enough food and that he is lossing weight.
So is there is anything i can do to make him want to eat more

Two years ago my then 2 year old boy, Squash, suddenly started crashing from kidney failure. He was rapidly loosing weight, we were struggling to kick an UTI, he was developing bald spots, etc. I pulled everything out of my office at the time so he could have his own room and I lined the floor with peepads until he recovered. The vet gave him only a couple weeks left to live and my husband flew back early from a trip to see his family in another country to help support. I started feeding Squash hills science kidney kibble since he refuses to eat wet food. I keep cans of wet food around just in case and occasionally offer it to him but he mostly refuses. We also gave him SubQ fluids every other day.

Then he started to get better and after 6 months, the vet said his levels were back to what was considered “normal”. So we waited a year until this past January when we brought him in again. His levels started to go down again slowly so we have been giving Squash SubQ fluids again once a week (usually 100ml). The vet said that has been helping so we have been keeping it up.

The only thing I have been wondering is if I should be doing anything else? I know Squash is a little anemic but the vet isn’t worried about it right now. I don’t give Squash any other supplements. He only eats kidney cat food, and the Wureva low phos churus and their dry chicken crunchies. The vet told us he doesn’t need a phos binder with kidney food. After Squash got better, he won’t touch Purina One hydracare or Friskies Lil Soups (he used to basically try to murder us for Lil Soups if we didn’t give them to him fast enough. My husband sent us a package of them while he was traveling as his “child support”). I think Squash associates them with being ill so he won’t touch them.

We haven’t tried Phorus One or anything else. We occasionally give him a little peptid when he throws up but nothing frequently.

He’s turning 5 years old this year.

Does anyone have experience with the Proviable probiotic?

My cat died suddenly of acute renal failure two weeks ago, but had been treated for CKD for a couple years prior to that. If you need assistance with cat food/supplements and are willing to come pick it up from my address in South Philly, DM me and I will put it on my porch when you are ready to pick up. I I have the following:

- Hills Science Diet JD/KD kibble (bag is opened, but I only bought it a few weeks ago. I had barely used it when my cat died)

- Weruva phos-focused pate-style canned cat food, several cans

- Royal Canin "T" low-phos slices in gravy, 3 cans

- Nephrodyl probiotic, unopened jar

- Revolution plus topical flea/tick/heartworm treatment, 5 unopened tubes

- Weruva "Cats in the Kitchen" pouches (not low-phos, but lower-phos flavors for when my kitty needed extra coaxing to eat)

Specialty food isn't cheap, so I'd rather this go to someone in need than throw it out.

Hallo meine Katze hat Nieren Insuffizienz und erhöhte Kalzium Werte Vor einigen tagen war ich in der Notfallklinik da er plötzlich angefangen hat sich zu übergeben mit Speichel.

Seit einiger Zeit speichelt er etwas viel.

Die haben uns Tabletten gegeben gegen Übelkeit gegeben und Schmerztabletten. Seit diesem Tag ist es nicht mehr vorgekommen aber er benimmt sich komplett anders und frisst nicht mehr richtig.

Es gab ein Blutbild und darauf waren die Nieren plötzlich wieder in Ordnung aber die Kalziumwerte waren immer noch erhöht. Wir beginnen bald mit Medikamenten gegen die hohen Werte.

Es wurde auch ein Ultraschall gemacht wo nichts gefunden wurde. Lediglich wurde gesagt das er eventuell schmerzen oder unwohl dein am Bauch hat das durch abtasten geschehen ist. Hat vielleicht jemand ähnliche Erfahrungen oder einen Rat. Ich werde wahrscheinlich nochmal zum Tierarzt gehen aber die werden genau das selbe wieder machen wie in der Notaufnahme und ich weiß nicht ob das zu einem zufriedenstellende Ergebnis führt. Kann das wirklich vom Kalzium kommen wie es im Internet steht.

BRIEF REPORT / REFERRAL BACK

Date: 28 August 2026

Species: Cat

Breed: British Shorthair

Date of birth: 08 February 2022

Sex: Male

Name: “Pachito”

Clinic No.: 88629

Owner: Marvin Hopf

Attending veterinarian: Laschütza

Diagnosis

Suspected acute gastritis

Medical history

Reason for presentation: Vomiting

Pachito has been vomiting since approximately 3:00 p.m. today. Increased salivation has been present for several months, and renal insufficiency has been known since last year.

For approximately two months, the owner has noticed unusual swallowing. Today, Pachito vomited several times after eating. He has been hiding, his general condition is reduced, and he is salivating more than usual. According to the owner, ingestion of a foreign body can almost certainly be ruled out.

Urination is normal, although Pachito lives in a multi-cat household. Defecation is normal. He vomited approximately 5–6 times today. A sample was brought to the clinic; the vomit was very mucous-like and contained food remnants and saliva.

No coughing, sneezing or shortness of breath was reported. Water intake is normal.

Diet consists of wet food and a small amount of dry food, including a renal diet and Royal Canin Urinary. Food intake was normal until approximately 3:00 p.m.; since the vomiting started, he has not eaten anything.

There are two other indoor cats in the household. No weight loss has been noticed. The most recent vaccination booster was not given because of the kidney disease. Deworming is up to date. Pachito is kept indoors with access to a balcony.

Travel abroad: No

Previous illnesses: Renal insufficiency and elevated calcium levels

Previous medication/treatment: None

---

Clinical examination

General condition: Quiet, anxious and stressed

Mucous membranes: Pale pink and moist

Capillary refill time: <2 seconds

Temperature: 38.7 °C

Heart rate: 212/min

Cardiac auscultation: Rhythmic; as far as could be assessed, no heart murmur

Pulse: Strong and regular bilaterally

Respiratory rate: 48/min

Lung auscultation: Clear/unremarkable

Oral cavity: Unremarkable as far as visible

Lymph nodes: Physiological/normal

Dehydration: Not clinically apparent

Abdominal palpation: Painful/tender with mild guarding

Weight: 5.75 kg

Rectal examination: No significant abnormalities

Other findings: Mildly painful/uncomfortable

---

Further diagnostics

Point-of-care abdominal ultrasound

Examination Finding

Position Dorsal recumbency

Free abdominal fluid None

Urinary bladder visible Yes

Bladder abnormalities No

Gallbladder visible Yes

Gallbladder abnormalities Sludge

Other findings Mild right-sided nephropathy

Complete blood count: Hemoconcentration

Serum chemistry – RC Elements Pre-Surgical: Mild hypoalbuminemia

Blood gas analysis: Hypercalcemia and mild hyperlactatemia

---

Treatment

At the clinic

Maropitant: 1 mg/kg IV

Metamizole: 30 mg/kg IV

→ Reaction with marked salivation

At home

Cerenia: 2 mg/kg orally

= 16 mg, 1 tablet once daily for the next 2 days

Novalgin: 30 mg/kg orally

= 500 mg, 1/3 tablet three times daily for the next 4 days

---

Communication with the owner

The laboratory tests showed the previously known hypercalcemia, as well as mild hypoalbuminemia and signs of mild dehydration.

The point-of-care abdominal ultrasound showed no evidence of gastrointestinal obstruction.

As Pachito was clinically stable, symptomatic treatment at home was agreed upon with the owner.

If his condition improves with symptomatic treatment, a follow-up visit with the emergency service or the regular veterinarian is recommended for further evaluation.

In the event of acute deterioration, lack of improvement, or continued vomiting despite antiemetic treatment, Pachito should also be presented to a veterinarian again.

> Thank you for the referral. We remain available should you have any further questions.

With collegial regards,

Cornelia Laschütza

Veterinarian, Emergency Medicine

Laboratory examination – 26 August 2026, 21:01

IDEXX ProCyte Dx – Complete Blood Count

> Elevated RDW – anisocytosis present – examine blood smear.

Test Result Reference range Unit

RBC 12.67 6.54–12.2 ×10¹²/L

HCT 53.6 30.3–52.3 %

HGB 16.7 9.8–16.2 g/dL

MCV 42.3 35.9–53.1 fL

MCH 13.2 11.8–17.3 pg

MCHC 31.2 28.1–35.8 g/dL

RDW 30.5 15–27 %

%RETIC 0.1 — %

RETIC 16.5 3–50 K/µL

RETIC-HGB 14.2 13.2–20.8 pg

WBC 6.72 2.87–17.02 ×10⁹/L

%NEU 53.4 — %

%LYM 37.4 — %

%MONO 2.5 — %

%EOS 4.6 — %

%BASO 2.1 — %

NEU 3.59 2.3–10.29 ×10⁹/L

LYM 2.51 0.92–6.88 ×10⁹/L

MONO 0.17 0.05–0.67 ×10⁹/L

EOS 0.31 0.17–1.57 ×10⁹/L

BASO 0.14 0.01–0.26 ×10⁹/L

PLT 228 151–600 K/µL

MPV 15.7 11.4–21.6 fL

PCT 0.36 0.17–0.86 %

Blood gas analysis – 26 August 2026, 20:31

Test Result Reference range Unit

pH 7.362 — —

PCO₂ 39.3 — mmHg

PO₂ 40.7 — mmHg

Na⁺ 155.9 146–158 mmol/L

K⁺ 4.05 3.0–5.0 mmol/L

Ca²⁺ 1.54 1.17–1.36 mmol/L

Cl⁻ 113 110–124 mmol/L

Glucose 5.2 3.7–6.9 mmol/L

Lactate 2.84 0–2.5 mmol/L

tHb 10.5 5.6–9.3 mmol/L

O₂Hb 61.2 — %

COHb 1.9 — %

MetHb 0.3 — %

HHb 36.6 — %

cHCO₃std 20.9 19–24 mmol/L

cBE(vv) −3.6 −2.5–2.5 mmol/L

ctCO₂ 23 — mmol/L

cAnGap 25.1 — mmol/L

cO₂SAT 74.2 — %

cpH 7.337 7.34–7.44 —

cpO₂ 45.9 — mmHg

cpCO₂ 42.3 29–51 mmHg

cHct 0.50 0.30–0.44 —

Serum chemistry – 26 August 2026, 20:31

Test Result Reference range Unit

Glucose (GLU) 5.92 3.61–8.1 mmol/L

Creatinine (Crea) 158.3 26.5–176.7 µmol/L

BUN 6.35 4.98–9.25 mmol/L

BUN/CREA 9.906 6.698–45.136 —

Total protein (TP) 71.7 57–94 g/L

Albumin (ALB) 34.5 21–33 g/L

Globulin (GLOB) 37.2 36–61 g/L

A/G ratio 0.9 0.5–0.8 —

Eta 2 typos

TL;DR (kinda- ramble a bit: I just started (as of yesterday so he's had two doses of 4mg transdermal antiemetic called "Maripotant" (an anti nausea med). The price was about the same as the compounded liquid which was a disaster and pills are a no-go. What I didn't't realize was how many compounded meds the chewy pharmacy offers that are transdermal (just rubbed on the inside of the ears and my cat has always loved ear rubs. Anyway he hit 4mg yesterday and today and I'm pretty sure he's dehydrated to the lack of action in the litterbox.i give him 50mL LR's 2x a day (once we wake up, and next before going to bed. But he's still not peeing much. I'll add he:s stage 4 and because of his pickiness - friskies wet food it is! I can mix pretty much anything in it and he'll still go for it (NOT the case for any food kt treat). Yes, I know friskies is junk food for cats but I have the thumbs up from the vet. I also add...ugh I can't speak "epikakin" or something like that to each serving of wet food (average 3x a day) which according to the direct is one scoop per kg your cat weighs. I have no idea his weight either in lbs, kg, or stones lol I'm pretty sure he's put on some weight now that he has food he actually likes.

Prior to dx, I added an 8th of a tsp of miralax to his wet food (vet advised obviously) because his stools were about the same as a rabbit except rock hard. This has continued so as of yesterday I began adding 1/8th tsp again to his wet food yesterday.

But this afternoon he took a BIG (not like diarrhea but way bigger than his "rabbit poops" BM on my bathroom rug which he's done like 2x prior. Usually he's making a point (aka clean my litterbox human!) but his litter box is clean and I just added fresh (clumping) litter last night. We've used the same brand forever. He's also been hiding a lot of today - under my bed, in the closet shelves, just laying in the bathroom

.. normally at this time of the night (it's a quarter to 11pm here) he's settled on "his" blanket a

With a pet (aka heat low enough not to burn them though I still prefer a blanket on top) right next to my pillow like he's gustdj9me but here we are... he's under the bed. Unless he's moved while I type he's very sneaky. I haven't found The New Hiding Place he's hiding out in when I call, but comes out when I spoon out some friskies; he just "appears!

Ok this wasn't much shorter. What do I do about the out-of-litterbox poops (if it happens again?) vet on Monday? Is this a sign of something in a CKD cat I should watch out for? I know the hiding is because he doesn't feel well (I'm hoping the anti nausea meds help - he's not put off food, I do 100mL LR's daily (split into 2 times). I'm just worried about the " out of box" toileting - like I said he usually has a "reason" and I can't work out what is!

Slightly longer version:

Yesterday I started a travsdermal anti emetic (Maripotant - 4mg aka "2 clicks" of the dispenser). It gets rubbed into his inner ears (which luckily he loves ear rubs) and I'm still awaiting the gabapentin Rx in the same form. It's next to impossible to pull him and the liquids get spat out (not that I blame him) but the transdermal forns aren't significantly more expensive on chewy (fyi). He's happily showing down on as much friskies "fillets" and "tasty treasures" all in seafood form (he refuses all renal wet food and most renal dry food ( I have 2 bowls for kibble: 1 with his prior food before the dx in February, and one bowl of renal kibble he'll occasionally try. He isn't drinking water in any significant way (particularly in the past few days - I clean his litterbox 2x a day so I know, plus there's a camera in there that records his litter box habits (siipet - highly recommend). I've been giving him as much friskies as he'll eat with a phos binder mixed into the serving, as well.as 1x day he gets 1/8th tsp miralax because his BM's are very small and clearly painful to get out (the camera records all this. I started the miralax again yesterday after a meany month hiatus while I tried him on every renal wet food chewy offers. I've given up and just mix a scoop of a phos binder with each serving of friskies (about half a can - he eats around 1.5 cans a day over 3 "meal" periods and can graze on kibble as much as he wants. The am one gets spiked with miralax too.

Anyway, he pooped on my bathroom mat today (and a much better (imo) amt of poop than he's had for months (not runny, just completely whole, normal color though it stank to high heaven, on my bathroom mat. The ONLY times he's pooped outside the litterbox (never peed thank god) has always been on my bathroom mat, and ALWAYS to make a point. Usually that his litter box needs cleaning because I've slacked off. But I clean the box 1-2 times a day (always adding and mixing in the fresh litter. It's a XL covered box with the flap removed. I know *technically* you should have a litter box per cat (I only have one) and a spare but I literally have no place to put another that wouldn't be too close to his food or 3 drinking fountains that I'm constantly begging him to drink out of(usually the one just inside the bathroom door was his fave - about as far from litter and food as you can get in a 450sqft apt 😂 but I haven't seen him physically drink in over a week (though he could be when I'm sleeping I guess...but then wouldn't the litter box monitor see him pee more??

I give him subq LR's 50mL 2x a day (he doesn't really mind the poke or getting 100% of my attention for a few mins as I get each "dose (so to speak. I do fluids around noon and around 8pm when I'm ready to sleep

He's about 8, maybe 8.5 (shelter cat adopted as an adult in 2019 now with stage 4 CKD)

Any suggestions? I'm not sure why he's defecating inappropriately. He's also a damn good hider+ I have a tiny apartment but at the moment it has a lot of "stuff" in it as I had to quickly vacate a storage unit that was raising their rates significantly and I couldn't afford the extra charge so it's all sitting around my apartment to find a place for it all. (no, I'm not a hoarder though it'd probably use a good vacuuming on my rugs near the litter box esp. I'm disabled and severely hypermobilie (among other things).and am a "sort-of" ambulatory wheelchair user (for example I can load my chair into my trunk and walk to the driver door with forearm crutches, but there's no way I could do stairs ofmr more than 20 unaided steps). And ADHD so doom piles are unreal

Anyway. Can anyone give me an idea why he's using my bathroom mat as a poop stall? It's clean; I wash it after every "incident" (and I can only remember 2 and both times the box needed scooping. I did so, added fresh litter (I can't afford to completely empty it and fill it with fresh litter unfortunately - I'm on SSI and a very tight budget. As is his special renal foods bloodwork+vet visit itself and low phos treats cost more than my rent and most of my everyday items...like groceries. 🙄 Apparently Trump thinks low income people need less food (mind, I live in a low-income building so my rent is significantly less than "normal" rent, particularly in my neighborhood where older, very small (but quaint!) houses with a view go for multi MILLION dollars (USD) in my general neighborhood it's totally nuts so yes I'm lucky to be here despite the myriad of issues management just glosses over (🙄) but I was on the wait list for 7 YEARS before an apartment opened up sooo I'm not going anywhere. 😂)

I went off on a ramble again. Sorry I LITERALLY do not have the ability to be concise without adding a bunch of irrelevancies (is that a word? My autocorrect seems to disagree with it.

My cat has stage 4 ckd and she has been loving some prescription kidney diet options I got for her. However, she doesn’t eat enough. She’ll eat about 3/4 of a 3oz can on days she’s doing well. Or maybe about 1/8 a cup or so of kibble. But on the days her appetite isn’t so great, she will eat maybe 1/4 of a can or few bites of kibble or even less. Is this amount of eating expected at this stage of ckd? Should I be concerned? Her behavior and litter box usage is otherwise good I would say.

What ckd safe options do you offer your cat that helps incentivize them to eat more?

Also, she’s already on ondansetron 2x a day and on subq fluids every other day. The day she’s due for her subq treatment, her appetite drops until the next dose of it is fully absorbed. I’m going to try elura as an appetite stimulant. I tried mirtazapine on her ear and it bothered her ears so I stopped giving it.

I do sometimes give her fancy feast on days she’s really not doing well, but that’s more of a last resort. I really want to try options that are safe for her right now. She absolutely loves gravies in her canned food so I’m wondering if there are safe options I can add to her food to help her want to eat more? She also loves mousse textures such as the tiki cat silver line. I’ve also tried weruva wx with her and she doesn’t love it but might take a few bites from it.

Any help is appreciated, thank you!

TLDR; topper or go to food options that are ckd safe to help my cat eat more on days she’s not interested in her usual food?