Thank you again,
That is fine, Maxine.
I was just trying to see if I could get a few more hints about what is specifically amiss in Angel's enlarged kidney. If there had been protein or white blood cells in her urine, then that could have been a hint of bladder or kidney infection which would be something treatable. And the reason I asked about an ultrasound is just because this would be a non-invasive way (since kitties will often not even need sedation to scan) for the vet to look inside the kidney and appreciate if the dilute urine is a side effect of Angel having been born with cysts in her kidney (which reduces the amount of natural functioning kidney tissue) or if there was something more sinister (like kidney stones, infection, or even kidney cancer).
Now if we assume that since her bloods were normal, we have this slightly enlarged kidney, and we know that her kidneys are not functioning quite as well as they should (since their job is to produce urine and we aren't seeing it properly concentrated), this means we can focus on the kidney and not those other conditions that can influence urine concentration indirectly (like those I mentioned before). In that case, if we were to try to determine which kidney based issue was bothering Angel, I would say that an ultrasound would be a good idea if possible to help you determine which of the above was playing a role and give you a real idea of her prognosis and how to manage this for her (since kidney stones can be removed, infections treated, and the other two managed). And just to note, in cases where we see cysts in kitty kidneys, we do find that they will struggling with kidney signs (starting with the dilute urine) but can be supported and treated to help maintain the best level of kidney function possible for them and kept comfortable for a good period of time.
That said, with funds being an issue, there is no reason why you cannot just treat the problem at hand with supportive care and monitor urine samples periodically to give you an idea on how she is doing and whether her kidney is deteriorating. To do this, we often will start by using diets that are low in protein, sodium, and phosphorus. Examples of these diets are Royal Canin Renal (here), Purina NF (here), and Hill's K/D (here). Now that said, as a kitten, we'd likely not want to restrict her diet as severely as we would with an elderly cat (the most common kitty to have compromised kidney function) since she is still growing. Therefore, I have included those links for you to compare to her current diet and would suggest potentially aiming for a diet that is somewhere in the middle of the two. That way, she will still get adequate nutrition for growth without over doing it with these kidney straining components.
Further to this, many vets won't start using any treatments in this early stage of kidney compromise. Still you may want to speak to them about what stage they'd consider starting treating her and her options. For example, we often use medications like ACE inhibitors (ie Fortekor) or treatment like the newly marketed Semintra to support kidney function.
Finally, since you noted financial concerns (which are understandable and we do have to be realistic and consider that Angel is likely to have an ongoing issue with this through her life), I did just want to mention that if you are on a pension then you would be eligible for aid via the RSPCA. They do have some hospitals based through the UK (ie London, Birmingham, Salford) that they will see animals directly at a subsidized cost. Still even if you are too far from an RSPCA hospital, then some branches(LINK) will still help subsidize the if you require them so that may be an option.
Furthermore, while it does depend on your tax credit status (whether you get housing or council tax benefits), you may be eligible for the PDSA. To find the PDSA nearest to you and check your eligibility, you can check HERE. If there is one near by, then care would only cost what you could afford to give. And just to note, in case you aren’t in the catchment area for PDSA, they will still help eligible folks with their Pet Aid Scheme (where they will put some money towards her care)
Finally, just in case you are local to London or Grimsby and in their catchment area, the Blue Cross (HERE) may be an option. Or for Londoners,the Celia Hammond Trust (HERE) also provides low cost veterinary care to animals via their two clinics.
Overall, urine dilution is a subtle and early hint that her kidneys are not quite functioning as they should. It would be ideal to have an ultrasound to tell you "why" she is struggling and how severe that may be as this will give an the best idea of her long term prognosis and what we may see develop with time. Still, even if that is not an option, the mainstay will be supporting her kidneys by reducing those dietary components that can strain them, monitor the kidney's function over time (with urine samples), and considering supportive medications when the kidneys do start to require more help. As I noted before, infection sounds to be less likely here (though we don't know whether stones, cysts, or tumors could be present) so most of our concerns will require management through her life instead of cure. That said, many cats live comfortable significant lives with reduced kidney function, so even with this terrible discovery for Angel, please remember that even if we don't have a cure we need to look at Angel to appreciate if she is truly suffering with this condition.
I hope this information is helpful.
If you need any additional information, do not hesitate to ask!
All the best,
Ps- Sorry for the wee delay in reply, as you can see I had quite a bit to say about wee Angel.
If you have any other questions, please ask me – I’ll be happy to respond. Please remember to rate my service once you have all the information you need. Thank you and hope to see you again soon! : )