My cat has been diagnosed with 4th stage of chronic renal failure. Is the saline infusion worth it?

Question

My cat is 10 years old and he has been diagnosed with chronic renal failure. I feel so bad for not noticing until the last minute. He was supposed to stay at the hospital for a week and have the saline infusion done. I brought him home today (after the day worth saline infusion) so he can spend the night at home and go to the vet tomorrow morning. I was determined to get him to the hospital and do something about his conditions but I am not so sure of that decision anymore.

Since chronic renal failure is an incurable condition, I don't see the meaning of making him go through all the infusion and make him stay at the hospital where he feels confused and lonely. And on top of that, after the saline infusion today, he seems so weak and drugged. He can't walk properly, he is drooling and seems confused. The vet says it's because of the pills and although I trust the vet to help my cat, I don't want to put my cat through something he does not understand. Right now, I don't want to send him to the hospital anymore, but rather take care of him myself at home by giving him proper food and water.

I am scared for him and I don't know what the better decision could be. The last thing I want to do though is for him to feel confused or scared. If the pain he feels have little difference even with the saline infusion, I'd rather keep him home and give him the peace and comfort.

If any of you guys went through something like this with your cat or dog please give me some advice. Thank you.

Answer 1

Saline infusion is no medicine. It is "just" thinning down the blood, as if the cat drank water. In a case of kidney failure that is very important because not drinking enough can damage the kidneys even more. I assume that he got some painkiller as well as the saline and it was the painkiller that made him sluggish and weak.

If your cat was weak and confused because of drugs, he probably wasn't able to drink on his own. Due to his drooling he lost even more water. The saline substitutes the water he didn't drink.

If you take him home, there are some very hard descisions to make.

• If he's able to drink and eat on his own, you should add water to his regular food to increase the total amount of water he ingests. Please ask your vet for more instructions on how to best treat him at home. Be prepared to receive the answer that he won't survive at home. (I'm not a vet. I cannot possibly make any prognosis here.)
• If he refuses or is unable to drink on his own, he will die of thirst very soon (which in medical terms means kidney failure). In that case, are you willing to bring him back to the clinic or are you willing to end his suffering?

I'm very sorry and understand that you are in a tough situation right now.

Answer 2

Please don't feel bad for not noticing your cat's illness until now. Kidney disease generally has no symptoms until the very end.

Having said "don't feel bad", I know that's not much comfort. I had a cat die of kidney disease a few years ago, and I blamed myself completely. And the ironic thing is that I know full well that kidney disease is usually symptomless until the end, and there was nothing I could have done differently. But I still blamed myself. I still blame myself a little, to tell the truth.

I do have some advice which may be more useful. When you bring a very ill cat home from the vet, it's natural to panic and question the quality of that pet's life. I suggest you try to relax and give it a few days to see how the cat is doing before you decide the next step. I was once in that situation myself (different cat, different illness), and I was in shock when I brought the cat home. But he rallied, and we had another year and a half together with him in relatively good health, enjoying life.