Kidney Disease in Cats when To Euthanize? Mild to moderate kidney disease is common in older cats. It’s rarely an emergency unless your cat is lethargic and has other problems. But it can be progressive, so you will need to monitor him carefully for the next few years.
Although most cats with CKD are older, many are middle-aged or even younger. It’s usually diagnosed around age 10-12 but might occur as early as 5-6 years old, especially if your cat was found to have high blood pressure when he had his annual checkup – Hypertension can damage the kidneys over time.
As long as the kidneys are still functioning at a low level, you can control secondary conditions before they become life-threatening. Treatments are limited though; treatments include a low protein diet, a prescription diet such as Hill’s k/d, Vetmedin (Pimobendan) if your cat has heart disease, and medications to control the side effects of CKD.
If kidney function declines below 15%, you can expect your cat to become lethargic – he will sleep more and show less interest in playing or going outdoors. Most cats don’t appear ill until they’re down to around 5% kidney function – so continuing to monitor them at home may be worthwhile.
If necessary at this point we would aim for palliative care only; we would not try aggressive treatments such as dialysis or a transplant because it is likely that at this stage there is brain damage too which might mean that euthanasia would be the kinder option. If your cat is at this stage, you will need to decide whether euthanasia or continued supportive care (without dialysis) is best for him.
The progression of kidney failure varies between different cats; some deteriorate rapidly whereas others continue to eat and show some interest in life until the very last stages. As CKD progresses, fluid buildup can cause discomfort so your cat may require medication for pain relief. Your vet may also prescribe diuretics to help control fluid build-up – but these can lose their effect as more damage is done to the kidneys, so they’re usually only used for a short period. Fluid can sometimes be removed with frequent subcutaneous fluids given daily or every other day, but this is also limited in its effectiveness.
If your cat is losing weight or seems very lethargic, you should take him to the vet for an examination. It may be that he has only a temporary illness – but it could also be signs of kidney failure. When in doubt check with your vet.
I agree with most of what I’ve heard about caring for cats with kidney problems– until they get to the 5% stage of kidney function left. After all, if your cat’s not interested in playing or going outside, then at that point you don’t have much to lose by euthanizing.
I certainly would never put my cats through dialysis or transplant; I agree with others who’ve stated that the stress will only make matters worse for your cat– and if his kidneys are damaged enough for him to need dialysis, there’s probably sufficient damage to his brain (by now) to make euthanasia a better option.
However, I do not believe it is kinder to euthanize when the cat has 5% kidney function left. As long as your cat can still get around and eat and drink (and pee on his own), he should stay with you until he gets very sick and starts problems with one of these functions– or until his kidneys have deteriorated so much that he can no longer eat, drink, or pee on his own.
I’m familiar with the experiences of many people on dialysis for humans. Unless your cat’s kidneys are very severely damaged (to the point where he can’t live without dialysis), I don’t believe that dialysis is good for him– it will stress him out tremendously while prolonging his life but not giving it back to him. Dialysis still takes a lot of the cats’ energy and mental alertness even if they survive this often traumatic treatment; there are plenty of stories of dialysis-treated humans who say their “quality of life” wasn’t worth living afterward.
So, in my opinion, dialysis is only avoiding the inevitable when the cat is still eating and drinking well. Once you can see your beloved pet slipping away, it’s time to let him go– not prolong his life with dialysis in hopes he might recover some of his vigors in six months or a year.
Euthanasia by injection is quick and painless for both you and your cat; I believe it’s kinder than letting your cats die slowly on dialysis (unless their kidneys are very severely damaged). Cats who are 5% kidney function probably won’t live much longer anyway; but they will suffer considerably if given dialysis, so why put them through that? When these cats develop problems like diarrhea or vomiting, they generally don’t last more than a few days before that complication kills them. I’m sure it would be very hard for you to see your cat suffer like this– and it’s not necessary, considering how humane euthanasia is.
I know it’s a decision no one wants to make; but if you can still see some quality of life for your cats– even if he isn’t the frisky little guy he used to be– then let him stay with you until his condition gets more severe and stressful. If your cat can get up and walk around on his own, eat and drink (and pee), then just keep him happy until he comes down with an illness that makes him uncomfortable or he stops eating or drinking entirely.
It may only be a matter of days at this point; but if you let him suffer through dialysis, it may be weeks before he dies. I believe it’s more humane to just let him go when his condition starts to decline– not prolong the inevitable.
The convenience of euthanasia by injection is that you don’t have to watch your cat slowly decline– which would be emotionally draining for both of you. The process only takes a few minutes and your cat slips away peacefully, which is far less stressful than letting your cats endure dialysis or transplant.