Just like Abby, Max still is not eating and hasn't in several days. It is virtually impossible to even get his pills in his mouth and he is drinking very little water. Yesterday and again today he threw up bile, which is a bad sign, and like Abby just lays on the couch. He is so thin, shakey and his back legs are weak. I have decided not to have him suffer through this terrible kidney disease anymore and he will be going to a better place, described in the poem "The Rainbow Bridge," to see his sister Bonnie. I will be taking him on Friday and like Laura, this is the most difficult decision anyone has to make. I call Max my little man, because my other 3 dogs are all girls. I will always remember him as a free spirit, so happy and hyper. I will remember his kisses and cuddling up to me on the couch at night, and his barking at people walking past the house and being so happy with himself when they passed by because he did such a great job scaring them off. He was with me for a wonderful 14 years, and I will wish him a safe journey, and I will miss him forever. Godspeed, my little man,until our journey comes full circle and our paths cross again.

I can't help much with the meds but can tell you I owned a miniature poodle that always had elevated alkphos (in the 600's) for years and one vet finally told me that it was just normal for my dog. He was diagnosed with Cushings in his final 2 years but I was never convinced the tests were accurate since my dog never had 'true' cushings symptoms. The symptoms he did have, and died from, were more indicative of a brain tumor. I wish you the best with your little gal.

Unable to tell at this point. UTI can decrease USG significantly; only way to tell if kidneys are OK is to clear UTI and recheck. I'd be concerned with pylenephritis, an infection of the kidneys, especially considering the fever, vomiting, and anorexia. A simple lower urinary tract infection doesn't cause these signs, but a kidney infection certainly could. Pylenephritis can be seen on ultrasound. Requires much longer antibiotic course than simple UTI (at least 8 weeks vs. 2 weeks). So it would be worth pursuing that possibility. We usually look at the physical exam to determine acute vs chronic renal failure. Animal in excellent body condition and only recently sick usually has acute renal failure. Animal in poor body condition usually has a chronic problem. Gray areas abound though, because if acute renal failure is severe, kidneys may not recover leading to chronic renal failure. Or an animal can be in chronic renal failure and get an major insult to the kidneys (dehydration especially) causing acute renal failure on top of it. The major difference is that acute renal failure is reversible with aggressive treatment (IV fluids, address the underlying injury if possible). Chronic renal failure is permanent. But the only way to tell is to address the renal failure aggressively for a few days and see what happens. If USG is still low after negative urine culture, then I'd look for causes such as renal disease, cushing's disease, liver failure, etc. Her kidneys are definitely working. Non-working kidneys produce isosthenuria, or a USG of 1.008-1.012. Anything above or below that range means there is kidney function. How much is anyone's guess, but with normal BUN and creatinine her kidneys are least 25% functional. Biggest thing is get the urine cultures, make sure the infection is cleared, then see what happens. Good luck.

JJ, Renal failure is extremely common in elderly cats (and often in not-so-elderly cats). Unfortunately, it is as variable a disease as are the number of cats who endure it. There really are no "norms" where renal failure is concerned. There are cats who live for years after diagnosis, and there are cats who fail very quickly. The only thing you can "expect" with renal failure is the inevitable end. It is a terminal diagnosis. As lf mentioned, many of the symptoms of CRF are manageable. The keys to management of CRF are education and vigilant caretaking. You have already been given the URL to one CRF website, but the website which I consider to be the "CRF Bible" is linked below. If you spend as much time as possible reading through these sites, you will learn a tremendous amount about this disease, its associated ailments, and its management. There is nothing more important you can do for your cat right now than to educate yourself about CRF. To answer your questions, at-home subQ fluid administration is a critically important skill to acquire and practice. Your vet can and should teach you how to do the fluid administration, and the websites offer pictorial tutorials to reinforce the procedure and offer helpful tips that your vet might not mention. You'll probably find it a bit nerve-wracking at first, but you'll get the hang of it, and your cat will become more and more cooperative as you become more proficient. It really is a life-saving procedure that provides considerable health benefits to the CRF cat with negligible (if any) discomfort. Perhaps the most difficult aspect of CRF is that a cat's condition can change from day to day, sometimes hour to hour. A cat who is critically ill one day may rally to relative health the next ... or not. We CRF caretakers tend to hold out for the next rally because it's so difficult to tell when a bad day will turn around or when it really does mark the end. If your cat does require hospitalization at some point, you will just need to trust your instincts and your knowledge of your own cat to help you decide whether to give him a chance to rally or to let him go. I, too, have a cat who is in the early stages of CRF with slightly elevated BUN and CREA values. He's my fourth CRF cat, and I know that he could become critical at any moment, or he could live in reasonable health for years. I've been down this road before, so I know what to watch for. I'll be having bloodwork run on him every 3 mos or more frequently if he becomes symptomatic. When his brother developed renal failure a year ago, I couldn't get his condition stabilized and was having to run bloodwork every couple of weeks to keep up with his changing blood values and symptoms. Unfortunately, I lost Bitsy just 3 mos after diagnosis. My first CRF cat, though, lived quite happily for 4 yrs after diagnosis. That's how variable this disease can be. I know you must be feeling overwhelmed right now, and you'll probably feel even moreso once you start reading the CRF websites. Don't let all the info make you crazy. I had to read the same info many, many times before it sank in and stuck. Just remember that the more you know about this disease, the better you'll be able to manage your boy and keep him comfortable and reasonably healthy for as long as possible. I wish you and your cat the best, Laurie Here is a link that might be useful: Tanya's CRF Information website