Cat in hospital with creatinine > 14 and BUN > 120

Hi, first of all I wanted to thank everyone who posted here about their cats on IV fluids or had to make a call on whether to put them on fluids or do home therapy or let them go. All of it was really helpful over the last 2 days, especially on the first day when I got mixed signals at the regular vet and wasn't sure what to do. I wanted to share my experience in case it could help someone else down the line.

I went to the emergency vet thinking if anything I want to help Tiki feel better physically in his final days, and wasn't quiet expecting a maricle recovery. More background: Tiki's 16.5, his values when tested at regular vet and later again at emergency vet, was creatinine > 14 and BUN > 120. Despite the numbers, a major reason why I did choose to go to the ER was because Tiki was still eating treats and actively walking around, and seemed overall bright despite going to loafing position after some socialization. I could not in good conscience put him down without trying.

He's been at the ICU for 36 hours, the emergency vet has since tested him 4 times, including this morning, and while he seemed perky when I visited him yesterday afternoon and ate his favorite freeze dried chicken treats I brought for him from home, and a couple of kibbles (which he wasn't eating 3-4 days ago), his values stayed in the same ballpark.

He's was severely anaemic with RBC at 4.85, hematocrit at 15.6, and hemoglobin at 6.3 at the regular vet's. The emergency vet initially held off on a blood transfusion as they tested it was 21, they said the lower numbers when they first tested and at the regular vet's also probably due to his blood clotting alt, and did tell me the IV fluids likely would drop his hematocrit numbers further, and he may need the transfusion. His numbers did drop to 14 after being on IV for over 24 hours so he's now getting a transfusion on day 2.

I was very worried about the ER experience since all of the emergency vets around my area had a lot of negative reivews. However, the first emergency vet I spoke to was fortunately an attending with years of experience, and excellent bedside manners, and super patient. Based on the labs, she suspect what brought on what appears to be acute on chronic (ACKD, see Acute Kidney Injury on Tanya's site at felinecrf.org) is cancer, and even with IV treatment it's hard to say how long he will last. This explained why his last labs in Jan was so stellar - back to stage 2 CKD at creatinine at 2.1 according to his regular vet, after being on Sub Q fluids for 4 months, and why the Acute Kidney Injury came on quickly. This diagnosis alone did give me a lot of peace, knowing I did not let Tiki down when he was clearly was still fighting for his life, and that we both did what we could.

I'm going to visit again later to comfort Tiki that I'm still here for him, feed him some treats if he would take it and see how the blood transfusion went.