Renal failure

Hello vets, I have acquired a stray cat about a weeks ago. She’s quite underweight but seems to have a decent appetite. Some urination outside of the litter box and sleeps quite a bit. She seems to have gained a bit of weight in the past week. Today we confirmed abscence of fiv, felv, uti, thyroid conditions. However there is a large mass on her kidney (evidentially seen when ultrasounding to get urine) and labs report “one of her kidneys is failing” She’s estimated to be about 10. I have her on renal diet now however the vet was unable to give me insight into progression other than it wasn’t going to get better. Im wondering if anyone can offer insight into so long as she continues to eat and drink if I can maintain a decent quality of life or if it would be kinder to start planning for euthanasia before she decompensates further. Thankful for any information you can give with such limited information

Hello and here is a huge hug.  It's a big thing when a cat is diagnosed with kidney issues and I can hear your frustration that your vet won't tell you a time.  But here's the thing - if your vet, who has examined the patient, ordered and checked all these tests, seen the lump, considered the differentials, is not a prepared to put a timescale on the rest of your cats' quality life, then a stranger on the Internet is in no position at all to do so.  I may have MRCVS after my name and over a decade of experience in small animal medicine, but I have far less information about your cat than your vet does.  What would you do if I said 'I think there are six weeks (that's an arbatary figure) left'  ?  Would you believe me?  Because you shouldn't.   Vets try to give you as accurate an estimation as possible and I trust that this is what your vet has done.   If they say that they don't know, it isn't because they are bad vets, but because that information is extremely difficult to pinpoint - uncertainty is the only known factor.   I have found that wider questions:  "if you had one hundred cats like this, would you expect any of them to be around in a year?" can get a more helpful response, because that way your vet isn't being asked to put a figure on one thing that they know that they can't predict.  more to come

Everyone has different ideas about the right time to put a cat to sleep.  There are some good articles in the blog - I will try to post them at the end.  It may be worth speaking to your family or a friend about it, or sitting down yourself and scoring your cat;  what score out of ten, where ten is her old self, would you give her for quality of life at the moment?  What score do you think is okay for an old cat?  At what score might you consider euthanasia?  Perhaps you could repeat the exercise every few days or plot it on a graph.  This can be useful because it will bring your attention to sudden declines - and may help you, in a few days / weeks / months, to gauge when the time is right.   I hear that she is doing well at the moment.  There are people who decide that they don't want to see a decline at all and ask for immediate euthanasia - which is valid if that is the right thing for them and their cat.  When I think of the people I have seen decline with illness, I don't think many of them would have asked for immediate euthanasia when they were still eating well and putting on weight, but that is for you as her owner to judge.  There is no right time;  it is important to do what is right for the two of you, and anyone else who is close. Wishing you all the best and here are some blogs:   here is Lucy on 'How do I know when my cats' pain isn't controlled any more' (if the link doesn't work, please search for the heading in the blog and it should come up) https://vethelpdirect.com/vetblog/2022/09/24/how-can-i-tell-when-my-cats-pain-isnt-controlled-anymore/ ...and me, on 'How do we know when it is time....' https://vethelpdirect.com/vetblog/2020/05/30/how-do-we-know-when-is-it-time-to-put-our-pet-to-sleep/

There are a couple of things that I am uncertain about from this case - can the lump be identified and would removal / identification of the affected kidney change anything?  Your vet or their pathologist may be able to answer that.  Wishing you all the best and please do let us know how you get on