Need closure regarding the death of my CKD cat

Sorry for the long winded post but my 17 year old beautiful boy Bubs was recently put to sleep and I’m absolutely devastated, but even more so after reading more info on CKD and wondering if I trusted the vet too much rather than doing more research. Last Wednesday I took him in to be checked out as he had lost a fair bit of weight (I feel awful for not taking him sooner) and had been hiding away for a couple of days. He wasn’t hiding constantly, just while my toddler was around he would sit by the heater in the corner of my bedroom and only come out and sleep with me on the couch at night. He was still eating a decent amount and drinking a lot. Vet suspected CKD and after bloods were done he diagnosed him with stage 3 CKD. He didn’t tell me any numbers or anything. Just explained he had lost 90 percent of kidney function. He prescribed a special diet to try and also Telmisartan (Semintra) oral dose once a day to slow the disease. I picked up the food and medication up the following day and Bubs loved the new biscuits and was his usual (albeit slightly off as he had been) self. That night (Thursday) I gave him his first dose of Semintra, and the following morning (Friday) I noticed he hadn’t touched his biscuits or his water that night. Later that morning my partner called me at work to say Bubs had vomited foamy liquid and still wasn’t eating. I called the vet and he said don’t give any more Semintra, just monitor him and bring him in on Saturday morning if he vomits again. He didn’t vomit again that day or night and he ate a tiny amount of biscuits and took a little water. I called the vet Saturday still concerned over Bubs food and water intake and told him he also seemed a bit confused and out of it. The vet said don’t worry about the food right now and monitor him over the weekend and call him back Monday. He got no better over the next 24 hours and I now see I should have taken him to an afterhours vet but I trusted my vet thinking if he was worried he would’ve advised on what to do. Plus from what I read the diagnosis of stage 3 wouldn’t mean he would suddenly be on death’s door. On Monday I took him in and the vet said he’s suffering and recommended euthanasia. I asked how could he progress that fast and he said we must’ve caught it at the tail end of stage 3 and thought there were other things going on due to age and it was kindest to euthanize. I was in shock and begged him for other options and he said I could take him home that night (hesitantly) and he would give sub fluids to make him more comfortable and then euthanise the following day. He then very hesitantly said I could take him to afterhours for IV fluids which “MIGHT” make him feel better for a day or two but that’s it. He wasn’t optimistic at all. This vet has been treating both my cats for years and has always been great and I trusted him. But I refused to believe he could be at the end so soon so I immediately took him to the afterhours clinic then and they started him on the fluids overnight. As they close at 7am I was to pick him up the following day. When I picked him up they had diagnosed him as end stage renal failure (though they hadn’t done bloods). I asked what to do, whether to continue fluids at my vet that day. The vet who handed him over kind of grimaced and said I could try but he was unlikely to improve. He said he hadn’t urinated so it wasn’t a good outlook. I tried to ask more questions but he kind of rushed me out the door. When we got home Bubs seemed lethargic and unwell, he wasn’t himself at all and wouldn’t do anything but hide in the corner of our bedroom so I believed the vets and decided I couldn’t bear for him to suffer and get worse. I cuddled him and reassured him that day and then took him to be put to sleep later that day. The vet said it was unlikely I would’ve got more than a few days after fluids and said even then it might not have worked. I feel that I have killed my cat prematurely and wasn’t acting rationally. I trusted the vets knew best but I don’t understand how he went downhill so fast. Could it have just been a crash and he would have bounced back? Did the medication harm him? I read a study afterwards saying Semintra can actually make kidney function worse and cause an acute episode sometimes. I can’t find any other info on a cat being diagnosed with stage 3 CKD then euthanasia being recommended 5 days later. Does this happen?

Hello - first, I'm sorry to hear that you lost your cat.  It's rubbish, whenever and however it happens - very few owners feel unequivocally convinced that they did the right thing all the way through the process.   I don't know if you are aware of the stages of greif, but after the 'shock' there is often a 'bargaining' phase, where you brain tries to say 'if only we'd tried that -' or 'the diagnosis might have been wrong' or 'it shouldn't have happened because-' or 'if only Aunt Mavis hadn't said she thought it was time, I might never have -' or whatever it is, in your personal case. Your brain doesn't want it to have happened.  This stage of greif is very well documented and is part of a healthy process.  I'm glad that you are here trying to understand what happened because it shows that you are trying to resolve the confusion around your pain.

I don't know whether you've heard of a charity called The Ralph Site, but this is their specialist area, so when I've finished spouting here, definitely look them up too!

It sounds as though two separate vets reccommended euthanasia in your Bubs' case so, from what I have read, I have no doubt that it was the right thing.  I agree that your / your vets' hypothesis of having caught it at a rapid decline at the end of stage three, could have been correct.  I suppose it is tied in with what caused it and also how long your cat had been happily 'masking' signs.   Sometimes kidney disease is accelerated by various factors too, such as another illness affecting the blood pressure; sometimes the signs progress quickly.

My advice from here would be to contact the Ralph Site, and / or even to have another word with your vet.  It's stressful when your cat is struggling and perfectly understandable to feel afterwards that you would like more information.  Sometimes, kidney failure is much more acute (rapid) than others and there can be a long of factors contributing to this.  Hopefully, your vet should have a good understanding by now, of what happened in this case.  Keep asking questions.  Wishing you all the best.

Hi, Bubba's mum,( you are still his mum x)  please contact me concerning semintra, after searching for over 6 month for ingredients  in semintra  I finally have it and all the evidence to prove its lethal I need to send you links to scientific research,  my baba just about still here but I did not give dose was told, shes a mess , skin & bone, semintra has substances in that dissolves organ &  skin  tissue and corrodes metals. This is most likely why the lethal ingredients  are not stated on data sheet, SODIUM HYDROXIDE, HYDROLIC ACID, BENZALKONUIM CHLORIDE, HYDROXYETHYL CELLULOSE,  MALITIOL,  NO WONDER CATS ARE DYING FROM ALL OF THESE DEADLY LETHAL INGREDIENTS,  cats died on clinical trials wtf are they doing allowing it as medication when it highly  toxic worse than bleach. Contact me PLEASE, I have evidence,  ( dennyd402@gmail.com or messanger & Fb,  Babatige denn) ) we need to fight this company and save animals lives, They are killing animals with so called medication, sorry about your baby boy my heart sank reading your post. im now fighting for my baby girls life. THE VETS ON THIS SITE YOU NEED TO KNOW ABOUT THIS AS YOU ARE ALSO LIABLE FOR PRESCRIBING THIS EXTORTIONATE PRICED HIGHLY TOXIC LETHAL POISION CONTACT ME I WILL SEND YOU EVIDENCE AND I BEG YOU DO NOT SELL IT AS YOU ARE KILLING ANIMALS BY PRESCRIBING THIS. IF ANY VET CAN PROVE ME WRONG ID LOVE TO HEAR FROM YOU AS I HAVE EVIDENCE FROM  THE COMPANY!  AS I BET EVEN YOU DID NOT  KNOW UNTIL I STATED  ABOVE, THE SECRET INGREDIENTS  KILLING OUR ANIMALS AS IT IS NOT STATED ON DATA SHEET THAT IS AGAINST THE LAW. I & NO DOUBT BUBBAS MUM WILL CLOSE  THIS COMPANY & GET JUSTICE FOR OUR FURBABYS.