Kidney failure but good urine?

Hello I’m very confused and need some help! My lovely 3 year old Ragdoll boy has been diagnosed with between stage 2 and 3 (more towards 3) kidney failure via a blood test. I’m dumbfounded over how as he’s always had wet food with lots of water. He didn’t even seem that unwell, I only took him to the vets as he had sprayed a couple of times (he’s neutered) and his hunger was ravenous and he had some light coloured bowel movements. I have been beside myself with upset and worry not fully understanding what this means for him. The vet has just informed me however that his urine sample has come back ‘good’ with ‘nothing wrong’…Is anyone able to explain how this is possible if he has towards stage 3 kidney failure? Another question: he’s been prescribed semintra and I’ve ordered some Hills renal food for him. Will I be ok to give him other supplements at the same time as well, like Ipakitine? Thanks so much for any help.

Hello!  Not being your vet and not having seen these results, I wouldnt want to speculate.  However, clear communication is part of your vets job and if this isnt clear, then you need to see them again because this is an important thing to understand.   The questions to ask are: Does my cat have kidney failure or not? If so, what grade is it, why isnt treatment needed and should I be giving supplememts or not? If not, why was a diagnosis given and on what basis was it ruled out?  Should I be doing anything different now with my cat? I hope that this helps to make things clearer for you. Wishing you the best of luck  

Hi thank you for the response. I will get in touch with my vet again tomorrow and try and get more clear communication. When it comes down to it though am I right in thinking his urine wouldn’t be ‘good’ if he was truly at stage 3 kidney failure?

Hi- Im afraid it depends what they mean by 'Good' as I wasn't there and don't know the context.  A specific gravity between 1.035 and 1.060 is often considered normal for a cat that was well hydrated at the time of collecting the sample (International Renal Interest Society).   This is for your vet, Im afraid.

Hi- Im afraid it depends what they mean by 'Good' as I wasn't there and don't know the context.  A specific gravity between 1.035 and 1.060 is often considered normal for a cat that was well hydrated at the time of collecting the sample (International Renal Interest Society).   This is for your vet, Im afraid.

Please do let us know how you get on!

Thank you very much! I will get more info from the vet and update soon 😊

hello again! I just took my cat to another vet for a second opinion, and interestingly this vet said he doesn’t necessarily think it’s kidney failure. He said that after examining him he sees a quite healthy cat and that his elevated blood levels could be down to other issues. He said to put him on some urinary food (I’ve just put him on renal failure food but this vet said we shouldn’t jump to that conclusion) and that he doesn’t need the semintra he’s been prescribed yet as he needs more tests. So he said to monitor him, up his food intake and make sure he has plenty of water and then we should do more in-depth tests in a couple of months. I’m not really sure what to think now! Some background: my cat is a 3 year old Ragdoll, 4.8kg (he used to be 5.5 a year ago so has lost weight) and his appetite is RAVENOUS, he’s always desperately hungry so we’ve upped his food. I managed to get hold of his results from my previous vet, if anyone has any additional opinions I would really appreciate:

Hello!  From reading the first entry, I assumed that your vet had then tested the urine and found a higher SG than expected, making renal failure a less likely reason for the raised BUN and Urea.  It sounds as though your second vet has repeated these tests and now discounted renal failure as a cause (its always better not to be in renal failure).    So you're left with a three year old ragdoll, whose kidneys are normal (according to your vets), eating for his country but still losing weight (.7 of a kilo is significant).

Hi, thanks for the response- sorry I’ve worded it confusingly. The second vet hasn’t done any tests, only looked at the results I posted above which were from the 1st vet. This 1st vet did two urine tests within a couple of weeks of each other (hence the fact there’s two sets of urine results there) but not sure which came first. So the 2nd vet is advising further tests to these ones as he’s not sure they are evidence enough of renal failure. So I’m really confused!

Hi - we don't look at bloods on this site because they are really taken in context by your vet, whose job this is.  We cannot give second opinions.  However, from what you've written, I think both vets are now saying the same thing.  From what I understand from what you've said, the first vet saw the high urea and crea and initially thought 'kidneys' (as a lot of people would) - but then had an SG they were happy with and thought 'Oh!  maybe not kidneys after all!'  Then you went for a second opinion and your second vet (who had all the information straight off) went, 'not kidneys.'  Sometimes as more information comes through, the picture becomes clearer.    It would be unusual (although not unheard of) for a cat with kidney problems to present eating like a horse, so it sounds as if they want to look for other possible problems, which may include (I don't know - I'm not there) hyperthyroidism, for example, or diabetes (if glucose high), or occasionally liver disease or even cancer.  In your position, I would roll with it an let your vet - whichever you choose to go with, but we always advise sticking one where possible - do more tests to work out why your cat is eating a lot and losing weight.  They might also work out the cause of the high Urea and Crea, which can simply be dehydration or muscle breakdown etc.   Wishing you the best of luck in this interesting case.

Please do let us know how you get on.

Thank you so much for your help!! I will certainly get further tests done and update soon 😊

Hello again! An update. I took him to have full blood count, thyroid check, ultrasound and urinalysis by the 2nd vet practice I mentioned (who didn’t think it was kidney failure). Below are the results along with the email from the vet, who is of the opinion he doesn’t have kidney failure. Can anyone take a look and see if they agree? It’s been an emotional rollercoaster and I’m hoping she’s right and I don’t really have anything to worry about 🥺

wouldn’t let me attach this in above post so here is vet email: