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Chronic Renal Failure In A Cat

by ajerger - January 3, 2026 View Case Report

Hi there!
So I have a 17.5 yr old FS cat present on 12/19 for a second opinion with severe azotemia ( Creatinne 12, BUN >130, Phosp > 16, HCT 23%) severe dehydration, anorexic, dull mentation.
Western Dx: Chronic renal Failure Stage IV
TCM: Kidney Qi/Yin Deficiency/Cold
I ended up hospitalizing the patient for 1 week on IV fluids, Added Yi Guan Jian and Ba Wei Di Huang Wan after 2 days of hydration. The patient did remarkably well, was discharged after 1 week. Owner is still syringe feeding her at home.
Her Creatinine is down to 5.3, BUN and phosphorus are also coming down.
The problem is now her HCT, it has dropped to 16.7%. I don't know how to manage the HCT this low without using a conventional medication Erythropoietin, to help with the anemia. I know that Rehmannia should help, and she is on that as well, just not sure what else to choose?

Thank you so much!
~Allison

by naturevet

January 5, 2026

Hi Allison,

Nicely done with this cat being so severely azotemic and close to the brink! I still think you can expect improvements to continue on the Rehmannia and YGJ. I suspect that the HCT dropped further because of rehydration, given the improvements you've seen.

The bone marrow stimulating effect of the herbs takes about three weeks to start to kick in, since that is how long it takes erythrocytes to 'graduate' from bone marrow school upon introduction of a stimulant. That should mean that if you took a look at the CBC in another one to two weeks, you'd see the HCT starting to climb.

There would be no problem, though, in giving conventional bone marrow stimulants to help the cat out, if the owner is willing. As you increase the oxygen carrying capacity of the blood, the increased renal perfusion from the herbs should help the kidneys recover further. Hopefully, you'll see that and will see even more improvements in what is already an amazing case!

Steve

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