Feline kidney transplants and the bleeding edge trade-off

I hope none of you ever have to face this question: 

"My cat is dying of kidney disease. I’ve done everything the vets have told me to do but she’s miserable. What else can I do to make her well?"

Once we've tried everything else in our arsenal, the all-too common answer is the obvious one: euthanasia. And while I'll never advocate this option without first exploring every possible treatment option, make no mistake, kidney (renal) disease is a killer. It’s perhaps the single most common cause of death in cats over the age of ten. We don’t know how to prevent it or how to cure it — that is, unless you have $15,000 to $30,000 to spare.

Yet even if you had a bottomless bank account to your name, it might not be so simple to get a kidney transplant. Your cat has to be a good candidate. That means he has to be free of other diseases that might preclude surgical survival. She has to be young and vigorous enough to withstand the months of wait-time required. And then you’ve got to source a healthy kidney from a suitable donor cat.

No, kidney transplants are not as easy as they might sound. Not that they sound like a breezy day on the beach to me, but many of my clients long only for the money to be able to make it happen. They think little of the realities inherent in bringing off this still-experimental vet school surgical technique.

Kidney transplants in cats are still a tool of the future. We’ve a long way to go before even the hardiest sufferer might be well served for less than $10,000.

Even this week’s three year-old patient (in chronic renal failure for no good reason) is far from an ideal candidate. This beautiful (and devastatingly sweet) Rex’s kidneys are shot. Her only hope is a lifetime of dialysis and all the care that comes with it (not available in our area) — or a transplant. Better luck next life. Maybe by then we’ll have the kind of medicine that she deserves and that her owners could actually afford.

For now, even the luckiest kidney transplant kitties don’t have access to all they’d wish for. Their owners must often adopt a pesky youngling kidney donor as part of the package. Can you imagine? A whole new lease on life with a fresh new kidney and still you have to put up with a teenager clobbering you every time you turn the corner into the kitchen!?

"There’s nothing easy about transplants," I explain to the tearful client who asked the tough question that began this discussion. I tell her that even if she had all the money in the world and she’d made it past all the health-check hurdles, I’d still beg her to think it through thoroughly. After all, being on the bleeding edge of a new treatment isn’t always all it’s cracked up to be.

Dr. Patty Khuly

is a small animal veterinarian in Miami, Florida where she practices medicine at Sunset Animal Clinic. She is a graduate of Wellesley College, the University of Pennsylvania School of Veterinary Medicine and The Wharton School of Business.