Dear Most Esteemed and Knowledgeable Kitties:
Last year, one of my cats did from chronic renal failure at age 14. Because we were concerned about our other cat, Gizzy, we had the vet give him all the appropriate tests. All the results seemed good, and we were relieved. But then last week Gizzy wasn’t acting like himself and his breath smelled bad. We took him to the vet, who said he was fine — no fever, his chest sounded good, and he wasn’t dehydrated — and since all the tests came back good last year, he probably just had a stomach bug. Gizzy got worse that night, so we took him to an emergency clinic, where the vet told us the odor of his breath was evidence of kidney failure. We took him back to our own vet the next day; she conducted another set of blood tests and confirmed that he was in the very late stages of kidney failure. She said that Gizzy was so ill there was really nothing that could be done. When we asked the vet how Gizzy could have gotten so sick, so quickly, she said, “Well, one year is seven years to a cat.” We had Gizzy put to sleep because we didn’t want him to suffer — but we can’t understand how the disease could have come on so quickly. We feel they might have gotten the results wrong last year. Is this possible?
~ Dawn

Subcutaneous fluid therapy is a cornerstone in managing chronic renal failure in cats. Image courtesy of the Summer is a Verb blog
Siouxsie: First of all, Dawn, we’re so sorry for your loss. It’s especially hard when it’s so sudden and unexpected.
Thomas: Chronic renal failure (CRF) is a progressive and fatal disease, but when diagnosed early and managed with treatments like subcutaneous fluids, a cat with CRF can live comfortably for anywhere from one to three years after diagnosis.
Dahlia: The trouble is that cats don’t actually begin showing signs that they have kidney disease until they’ve lost at least 70% of their kidney function. By that time it’s too late to do much more than manage the illness.
Siouxsie: And when a cat presents in the late stages of kidney failure, as Gizzy did, there really is very little that can be done to prolong that cat’s life.
Thomas: Signs of early kidney disease are very subtle, and sometimes even lab tests won’t show anything extraordinary. Test results just slightly outside the normal range can be seen even in healthy cats and these are not generally viewed as alarming signs if the physical examination shows that the cat is otherwise in good shape.
Dahlia: One of the reasons vets recommend regular blood tests and urinalysis for older cats is that your vet might be able to see a trend of changes in your cat’s blood chemistry values that can indicate the early stages of diseases like CRF, hyperthyroidism, or other conditions sometimes seen in senior cats.
Siouxsie: But now to answer your question, Dawn: Can kidney failure really come on so suddenly? Could a cat really get that sick less than a year after receiving normal blood tests?
Thomas: The answer, from what we’ve been able to determine, is that it certainly is possible.
Dahlia: We haven’t found any sources that say that the progression from normal health to imminently fatal disease has to take any specific amount of time at all.
Siouxsie: The onset and progression of kidney disease seems to be determined by a combination of things from genetics to diet to environmental issues and stress. There’s really no way to know how this combination of risk factors will play out in any individual cat’s life.

This chart shows cat ages in terms of the human lifespan. Notice, too, that outdoor cats age a lot more quickly than indoor cats.
Thomas: Although cats do age faster than humans, most vets these days believe that after the first few years of life, one year in a cat’s life is the equivalent of about four years in a person’s life.
Dahlia: But that’s splitting hairs, really. The point is that because cats age faster than humans, regular vet exams are especially important for senior cats.
Siouxsie: Clearly you did all the right things by making sure Gizzy had the appropriate lab tests. Jeez, I’m 15 and even I haven’t had a full blood panel and urinalysis lately.
Thomas: Uh-oh! Mama heard you say that …
Siouxsie: *hisss* Drat! But Mama, I’m so healthy, even Doctor Jim said he wouldn’t believe I’m older than 8 if you hadn’t told him so!
Dahlia: Anyway, Dawn, there’s really no way to know if there was a mistake in interpreting Gizzy’s lab tests from a year ago. But we do want to reassure you that it is possible he was healthy a year ago and became that sick in such a short time.
Siouxsie: We know how hard this time is for you and your family, and we hope we’ve been able to set your mind at ease by at least telling you it’s possible … and by the same token, it’s quite possible (probable, in fact) that your vet did not make an error that cost your beloved Gizzy his life.
Thomas: Our blessings and purrs go out to you and your family, Dawn.
Dahlia: If any of you other readers have a cat with CRF, we highly recommend you visit the Feline CRF Information Center website. It’s a great resource for information on treatment and research, tips on how to give fluids and other home care, and a place for caretakers of CRF cats to find emotional support as they take this journey with their feline family members.
There si a difference between chronic renal failure (CRF) and acute renal failure (ARF). As was mentioned, signs of CRF first occur when the cat has lost 70-80% of kidney function. At that point, treatment is to give subQ fluids (100mL per day), and later add various medications to therapy if the subQ fluids alone isn’t enough to sustain the cat. I had a cat who lived 2 years past CRF diagnosis with merely subQ fluids. Yet I knew many other people (who belonged to my CRF list on Yahoo Groups) who had to give a cocktail of medications with the subQ.
ARF, on the other hand, is exactly that–acute. The onset is FAST. The onset is how you described. Normally ARF has a more specific “cause”–like an outdoor cat injesting antifreeze, or something like that. From what you describe it sounds like Gizzy had ARF.
I am very sorry for your loss. I am sure Gizzy is frolicking with my CRF kitty, Jowls, across the Rainbow Bridge.
~Melissa
Seems like Melissa’s comment is correct. I had a calico (Patches) that I rescued who was in kidney failure for a while. The tests were okay but the doctor me her Bunn level was a little high and that probably was a sign she would be in kidney failure. That was approximately two years before she died. Your kitty’s came on very fast. At least he did not suffer for many months and years which is difficult to watch. With the fluids my Patches lived only three extra months but they were wonderful. Her last two days were really bad. It is never easy either way. I’m sure they are all happier and healthier now and rest assurred, you did the best you could.
hello, now I know what your cat has is he old? if so it is probably his teath rotting because of old age if he is not old please email me and I will try and find out thanks : )
Three of my cats were diagnosed with chronic renal failure 2 years ago. I was so upset! But, two years later they are still going strong. DO not give up on your cats with CRF… there are steps you can take to help them live a long life. I have them on a high quality diet of wellness wet food (dry food is not good for cats with renal problems), raw food (you buy this at a pet store…do not just give raw meat) and I have them on RenAvast. You can order at http://www.renavast.com. My cats are 15, 15 and 14!!
I just read about the kidney failure, ironically my 17 year old cat, I just got 2 months ago (Oct. 2011) has just been diagnosed with possible cancer of the left kidney. You have an interesting read. I will definitely check out the web site related to renal failure.
I had two cats who grew up together. One 15 years, one 16 yrs. Toby, my 16 yr. old dedicated friend, knew his time was coming. He had arthritis, was declining, and we had “talks” about the day he would have to leave. We were ok and in the difficult space between “knowing” and “deciding”. When is it time to help him? We made him one spot, cozy, to return to after eating etc. My younger cat had her own problems, hyperthyroidism, but seemed in great shape. While watching Toby decline, one day the younger, her name was Chicken….one day she just looked at her water and fell over. Rushed to the ER…..she was in kidney failure. I had no idea, as Toby “appeared” to be reaching his old age first. It was her time, I was shocked. Within days Toby declined fast. He knew she left. He left a few days later. My point is, though there are “tests” and exams, sometimes they cannot look at you and say “Mom, I don’t feel well” …… it hit my younger cat in days. There were no underlying signs….except, tiredness? Sometimes we try our very best, and things still go wrong. I have never had a connection like I had with them. It was in the soul. My best friends both went at the same time. I guess I find solice in knowing they are together? But, we have Furgis. A silly, dominant 6 yr old neutered male….who is adapting also. We are healing together, and are forming a bond. It just may be deeper than I thought soon, as I have never had only one cat to lavish every bit of attention on. Its his time to blossom. Get blood work, regular check ups, but sometimes they hide an illness, until its impossible. As long as all our actions are based on the well being of the animal….not ourselves…..we will do the right things. Cats are mysterious….but also for those who have lost their family members….find comfort in knowing they do not look at the end the same as we do. We humans grow up with a sort of fear of dying…..cats do not have that fear. They are not afraid, which makes it clear why they seem to handle their illnesses emotionally better than we do. Lol.
My little kitty was 17 when she passed from CRF. I think if my vet that I had at the time could have recognized her symptoms. Now that I look back they were very apparent but at that time I knew nothing of CRF. He definitely did not pick up on what was happening to her. It wasn’t until I moved that a vet was able to diagnose her but she was already critical. I had her on intravenous twice a month and on subcutaneous water daily. This allowed her to live comfortably 3 additional months after diagnosis.
Her final day was difficult and she passed in my arms on Valentine’s Day. I still miss her.
About 7 months ago I found and rescued a 6 weeks old kitten who is getting all my attention. I love her a lot but my heart still aches for my little one. I kind of think she sent this little one to me to help fill my life because she knew how much i loved her.
I love dogs even if their small or big. I ts really hard to have a dog, you have to walk them and feed them and even more but they will always be your best friend
I’m so sorry for your loss.
My cat died from CRF when he was 12 years old. He was was diagnosed in 2008 after an emergency visit to the vet (though at that point he had acute renal failure) and lived four more years with sub-q fluids and a special diet.
Though his disease developed slowly over the years, unfortunately, like Dahlia said, his symptoms weren’t really indicative or specific to renal disease until he had lost more than half of his kidney function and he could never fully recover from that. I’m just happy for those extra four years we had together thanks to an amazing vet, and I know he enjoyed them and was a happy kitty. :)