Feline Kidney Transplants Pose Ethical Questions

Arthur received his new kidney on May 15, 2014. Arthur is a flame pointed Siamese cat, traditional style.  He was diagnosed with chronic renal failure about a year ago. The operation took place at the University of Georgia Veterinary Teaching Hospital. It was the hospital’s second successful feline kidney transplant using adult stem cells which helps the patient’s body accept the new kidney. Adult stem cells seem to do a similar job as immune suppressing drugs such as cyclosporine.

Arthur the feline recipient of a new kidney

The lead surgeon in the operation, Dr Chad Schmiedt, says that he believes that UGA is the only veterinary facility using stem cells in feline kidney transplants. The use of stem cells in organ transplants decreases the risk of infection and lowers the risk of organ rejection. Also, the patient has an improved renal function a year after the surgery. For the scientifically minded these are “mesenchymal” stem cells.

The first cat to receive a kidney transplant using stem cells to improve the outcome is apparently doing well today. The surgery was performed in 2013.

Arthur had, in fact, been turned down for a kidney transplant by two other hospitals because of possible post-op complications due to concerns that Arthur wouldn’t accept the new kidney as he is unable to absorb as much immune suppressing drug as demanded by the operation.

Of course, all the focus is on the patient and the process.  I have rarely seen articles about feline kidney transplants. It must be a rare procedure because of both the expense and the success rate.  That said, we know that feline kidney disease is a major health problem especially in older cats so there are lots of opportunities to do kidney transplants.

I’d like to focus on the kidney donor. His name is Joey. We are told that he had been part of a research programme at the College of Veterinary Medicine.  I presume that means at Georgia University.  Well, I have negative thoughts about this; he was part of a research programme.  It appears to be a reference to animal testing, which as far as I’m concerned can never be justified. There are ethical issues surrounding animal testing and there are ethical questions involved in feline organ transplants.

Many people will think it is ridiculous to say this but Joey had no choice in the matter. He did not donate a kidney by choice. The operation to remove his kidney was imposed upon him and there is an element, in this double operation procedure, of experimentation. To me, it appears to be about veterinary surgeons at a university exploring the possibilities of organ transplantation amongst the cat population using stem cells to boost the chances of success. Are these experiments being carried out as a subtle form of animal testing as a precursor for human organ transplantation using stem cells as a means to reduce infection and improve the success rate?

I’m just asking the question because nobody has addressed the ethical issues as far as I can tell. A good point, however, is that the transplant programme at this hospital insists that the donor be adopted by the recipient cat’s family allowing both cats to live together as companions. Good – but it does beg the question whether they will get on. It doesn’t automatically follow that an individual cat will get along with another individual cat notwithstanding that he has saved his life.

For me, there are interesting ethical questions in feline kidney transplants.  Not only is there the question, as mentioned, of not being able to receive the donor’s consent, there’s also the question of whether the recipient cat’s owner should put their cat through such an arduous operation for what may be limited benefits. There may be an element of misplaced human desire going on here.  What I mean is that people do it for themselves or for the cat?

Also, of course, no one really knows how the recipient cat feels after the operation. The transplant may be a technical success and the patient may live for a year or more after the operation but how good was that year for the car? Would the recipient cat have requested a transplant? This is not only about the inability of getting consent from the donor cat; it is also about failing to obtain the consent of the recipient.  If we are honest this more about people than cats. This is where a cat owner truly has to be a cat guardian.However….

I am not against feline kidney transplants. Please don’t misunderstand the point of the post. There are real potential benefits. I just feel that scientist/veterinary surgeons need to ask so tough ethical questions. Are they doing all this to improve their status amongst their peers?

And should there not be a greater focus on eliminating the causes of feline kidney disease and urinary tract health problems which are arguably often caused by inappropriate commercial cat foods and lifestyles?

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Feline Kidney Transplants Pose Ethical Questions — 21 Comments

  1. Michael,just for knowledge. What would be the cost of this “Feline Kidney Transplant” ? Definitely beyond the budget of the average pet owner.Medical science has progressed by leaps and bounds in humans and seems that pets are also being researched for modern organ transplants.The cost factor would be very important as most cats, especially Persians suffer from chronic kidney failure.

    • Very good point Rudolph. I can’t see anyone but for the rich electing this surgery on behalf of their cat which tells me it is being done for research purposes and not for practical reasons. I should think the cost would be in the order of £5,000-£10,000 at a guess. It is two operations both of which are complicated and critical as I see it.

  2. I’m torn on this subject.

    I think it’s fantastic that a cat’s life can be saved with a transplant, especially if the cat is youngish and in otherwise good health to be able to withstand such a procedure.

    Ethically, it’s questionable. The donor cat isn’t able to consent; but, neither is the recipient.

    Overall, I lean toward thinking that it’s acceptable only because no cat can consent to any surgery or procedure, even nail clipping. But, they’re done.
    The responsibility to consent rests on the caretaker, just as it does a parent with an underage child.

  3. I’m worried that if kidney transplants for cats become common and affordable, that unwanted cats will be exploited by being made to be donors.
    What if some unscrupulous vet decided to ‘adopt’ cats from Rescue Shelters, in order to use them as donors.
    It’s a horrible thing to think but in America especially we know there are vets who declaw cats without a thought for the feelings of the cat.
    Also who knows if a cat would want to go through such major surgery just for the sake of living a bit longer, cats need quality of life, not just quantity.
    I’m against keeping animals alive when their time has obviously come, heart breaking as it is, it’s the one kind thing we can do for them that we can’t do for human loved ones.

  4. . . .Cats need quality of life, not just quantity….I’m against keeping animals alive when their time has obviously come….

    Top o’ th’ mornin’ to you, pal Ruthie! (A beautiful noon-hour from this end, but nearing sundown at yours.)

    Anyhow, I’m with you on this. For it’s true – neither the donor nor the recipient has a word to say as to consent.

    I’ve never especially understood the point of human transplants, although – apparently – a recipient can live for ten years and more if they pop anti-rejection pills every day. It has long been my impression that heart- and kidney-transplant recipients lived for only a couple of years, but I am mistaken.

    Question is, though, Ruth, would you do it to a cat? You don’t sound as if you would, even if you were rich as Croesus. For it’s true: there are terrible ethical issues. Giving some thought to dietary preventions throughout the life of the cat is a more humane alternative – assuming renal failure is diet-related. Which it likely is to a large extent.

    And yet – and yet – why must life always be cluttered with ‘yet’s’ and ‘but’s’ and ‘however’s?’

    The poignancy is that your fur-child – unless he dies on his own – has no part in deciding how long you allow him to live.

    Ethel lay cradled in my arms during the final few minutes of her life. And all the while she was being her dearest, quintessential little Ethel: innocent, calm, purring away, pumping my wrists with her plump poly-paws, alert, at peace and serenely happy to be held by her mom. Throughout her life, she’d had this not-a-care-in-the-world-happy, faraway gaze when she knew she was cherished.

    Should I have taken her home and ‘kept trying?’

    She’d eaten five small snacks the day before, because she’d just tried a new kind of appetite pill. And as directed, I gave her another half pill that night. But when I checked her the following morning, her saucer of food with its different flavors sat untouched, and she lay hidden under her chair.

    How in the name of decency could I have given her still another appetite pill that morning, when she had stopped eating despite the pill she’d had the night before? Was I wrong to imagine she was miserable when she lay under her chair? Yes – she walked into the living room within a few minutes, but sat in one spot, hunched on the floor.

    What to do? God…what to DO? Finally, I realized I couldn’t put her through any more of this.

    She lay in my arms happily purring as we waited for the vet. When he came through the door we talked for a few minutes. At last, streaming tears, I handed her to him. He too was tearing up and half turned away. ‘I hate this part of my job,’ he said. Two minutes later, he brought her back in. Her joy was gone. She was staring unfocused, bewildered and bedraggled. I reached out for her, and sat down as she collapsed in my lap. Seconds later, her beautiful head lolled to the side and dangled across my forearm, as if her neck had been crushed in a vise.

    Her lifelong endearing trust in me, her happiness and perennial sweetness lay in ruins from the poison in her veins.

    She had no choice. She had no voice. She never suspected what it was I had done to her: that everything she was would be ashes within an hour or two. I killed her at 11:00 a.m., and the crematory van took her away at noon.

    Is this not an enormity? Or is it something else? Something fine and noble?

    During those minutes that I still held her, she lay in my arms as she had for eight years during her daily pettings. But this time she didn’t feel the caresses. She lay without moving, torn from life into darkness because I had willed it. Nothing was left of my little girl. It was as if I had ground a once living, exquisite flower under my heel.

    They have no say. All they have is love for us. All they have is trust.

    • Cats need quality of life, not just quantity

      This is what guides me to and if a elderly cat with chronic kidney disease has to go through a kidney transplant with all the incumbent post-op problems and human caretaking needs I feel it is wrong.

      • I agree with that too Sylvia no use keeping a cat alive just to keep the human happy. We thought of that with Cassy but just couldn’t when she was in too much pain.

    • A beautiful noon-hour from this end, but nearing sundown at yours.

      Correct but today is the longest day of the year in the UK. It is still quite light at 9 pm! I’m am tempted to go outside and work on the website in the garden.

    • All in all, I’m still leaning a little on the positive side of feline transplants with conditions. I’m not too opposed to transplanting a cat that is on the younger side and in good enough condition to withstand it all. Would we deprive our blind cat of a transplant that could restore sight or refuse a blood tranfusion?

      As guardians, we can be faced with all sorts of ethical or unethical situations. I still struggle with euthanasia and whether I have the right to demand that a life be taken. My cats can’t express how they feel about my playing god. But, what I do know, is that the will to live is very strong with humans. I can only assume that it is the same with cats.

    • OMG Sylvia, so very sad and such a horrible dilemma but you knew then and know now that really you had no choice, quality of life was gone, you did what you could for her in life and finally in death. It is horrendous, it kills a part of you to do it but it’s the last loving thing you can do for them.

  5. Yea i would say it be very expensive i think you’d have some sort of pet insurance. The only thing Id worry even after you payed that sort of money out is there any guarantee it will work and would it prolong your animals life?

  6. I’m going to say no, I don’t believe that kidney transplants between cats are a good thing. Firstly because there has to be a healthy donor cat who is then robbed of a kidney because obviously the cat has no choice in the matter. His health is then compromised for the rest of his life and there is no guarantee that the transplant will be a success anyway, and if it is then for how long? And I can’t bear to think how many cats have been “part of the research programme” (lab cats)so far and who have lost their lives as well as their kidneys as this procedure was perfected for the few who can afford it to keep their chosen cat alive a little while longer. What makes some cats more important and precious than others? Having someone to love and care for them that’s what. I’m also worried because I have seen, read, heard before that the procedure of live kidney donation in humans is far more painful for the donor that for the recipient and these feline donors, even though the recipients family is forced to give them a home could have pain for a long time after the op but maybe not be held in such regard as the cat who was worthy of being given another cat’s kidney. It all seems wrong to me. I, like Ruth, worry that unwanted cats will be exploited, if in years to come this procedure becomes more common what’s to stop unscrupulous vets acquiring a few donor cats by a backdoor method and offering the procedure without the requirement for the disposable donor cat to be accepted too. We know there are unscrupulous vets who will harm cats for money, this is another way for it to be done.
    My precious cat Felix died of kidney failure on 1st June 1997, it broke my heart, I loved him so much that I wanted to die as well, but he was ready to go, it was maybe not quite his time to go, he might have lingered another 24 hours having fits and feeling terribly ill but it was in my power to spare him that, it was my duty, it’s what we do because we love them.

    • Good point Babz. To me it is trying to transfer the concept of human organ transplants to cats and I don’t believe it works for the reasons you state. Cats hide pain as we know. How are we going to be sure both cats – donor and donee – are pain free and will the caretakers do their job looking after them with drugs – I suppose for the rest of their lives. To many unknowns for me.

  7. Hi,Barbara –

    I was crying yesterday when I wrote about my girl, and thank you for having the heart to have known that.

    As usual, my thoughts are non-linear. The subject of the post was kidney transplants, but I bent that into our fur-kids’ pitiful lack of choice, the power we have over their lives: how long they may live, and when they must die. And it’s all done in the name of love.

    But the subject revived what I’d been reading for several weeks. And everything I read, both books ad websites, drove home the same point: psychopathy is the absence of feeling. It isn’t necessarily cruel. A few years ago, a psychopath in England, if I recall a website I read several weeks back, committed multiple murders without a trace of dislike for his victims. He did it, he said, because he was bored – and according to theory, psychopaths suffer overwhelming boredom. Moreover – again, according to theory – psychopathy is a ‘sliding scale.’ We’re all ‘that way,’ to some degree.

    Which may be true, though I also think rhino-hide indifference (the word is ‘oblivion’) is partly economic. Unless a person is Mother Teresa, how can he bear to feel, without surcease, the suffering of others? Our monetary funds are finite, and so are our emotions, unless we are saints. Or am I wrong?

    Although it is dated, I’ve been reading The Territorial Imperative (title underlined), by Robert Ardrey, who wrote extensively in the 1960s.

    (As an aside, Elaine Morgan, a jolly, delightful woman and a wonderful writer, died last year in her hometown in Wales. While she too, in common with Ardrey, never studied it academically, she had it in for both Desmond Morris and Ardrey because of their macho approach to anthropology. Her books, like theirs, are exhaustively researched. They’re also engagingly written and filled with dry humor at the expense of these two guys, whom she targeted for decades.)

    As for Ardrey, his prose is poetic: dense and rich as Victorian fruitcake soaked in brandy. His style is pure pleasure, whether or not you follow his reasoning on every page.

    Be that as it may, he describes what he sees as a gruesome trait in human nature.

    Specifically, a group of people (a clan, a society, a nation)is gung-ho in its solidarity and reciprocal ‘caring’ so long as they have a foe against whom to aim their aggression (which is inborn, according to Freud, and a bunch of anthropologists). But when the ‘enemy’ is ousted or otherwise defeated, the group’s aggression loses its outlet. At that precise juncture, it splinters into factions that turn on each other hammer & tongs. True? Witness Egypt and Libya and the Syrians: the ‘good-guy’ rebels are whacking away full-tilt at their former comrades-in-arms even, sometimes – as in Syria – where the villains are still enthroned.

    Question is, how can a person not
    shut down sooner or later? How can he find the resilience to feel the never-ending energy of human aggression and the suffering it produces? Or the suffering caused by disease and natural disaster? Eventually, how can he not need to tune out the deaths from ebola, AIDS, starvation, torture, snipings, car-bombings, ad infin.?

    Isn’t it the same with milder degrees of human sadness? Do you burst into tears when you read the obituaries? Do you sit sobbing at your desk? Do M.D.s collapse in sorrow over their dying patients? (And they all pop their clogs.) My vet wiped his eyes with the back of his hand when I said goodbye to my little girl. Was he putting on an act? I don’t know. They might have been crocodile tears shed to endear himself to the client. Yet I think they were real to some extent, though vets are accustomed to giving the needle to animals every day.

    The opposite end of the spectrum? When I was breaking down over my boy – and I’m sorry I lack the stoicism of someone like, say, the late Jackie Kennedy in the presence of death – my other vet, in an edgy tone of voice, briskly gave me to understand that she’d ‘put down’ 1,500 cats over the years. So what was my problem? Did I doubt her competence?

    Michael wept over his old lady when she passed on. But she was his daughter and he was her dad. And I could read about her and look at her photo and not shed a tear. I can read about all the cats you and Ruthie have lost over the years, and not cry. On a cognitive level, I understand what other parents have gone through. But I don’t feel it. I can understand how Marc must have felt when he held Red in his lap and cried over him. But I feel nothing of what he felt. Nevertheless, would I feign the emotion? For their sake, of course. I’m not that thick. I certainly couldn’t let it drop in nonchalant silence, or chat away about something else. What’s more, would I feel what you felt if I were in England and saw you in tears? Yes. I’d cry over Poppy – even now, years after her death, if I saw you and Ruth sobbing away. And I also had tears in my eyes when I looked at that photo Ruthie e-mailed last week: to see the beautiful handiwork and craftsmanship. But no more of that, or I’ll break down again. . . and can only imagine what you have gone through.

    To read, though, about tragedy or to hear it on the radio? No. After a while, I tune it out. And this is what the scientists label psychopathic non-feeling. But isn’t it also emotional economics? Self-preservation?

    For all its good and happy news once in a while, it seems one has to forget a fair number of posts on this website. Yet many of its regulars have what it takes to immerse themselves in surfeits of misery and do everything they can, to their extraordinary limits, to alleviate the pain. Could I do what they do? No. I’d fold. The most I can do is donate whatever I can afford to animal rights (it’s the elephants now), or care for stray cats I’ve fed and ‘vetted’ over the years.

    Anyhow, as I usually do, I strayed from the subject: I veered off from kidney transplants to the overwhelming – but rightful? – power we have to deny the least choice to our children. With neither the strength nor the knowledge to resist, they can only follow their parent in gentle affection. And there you have the hell-fires of pathos, the source of all our tears – our torrents of tears: our children’s unblemished innocence, their unknowing trust in us to the end, never to glean that we mean to kill them, beloved as they are. Is there nothing wrong in this? But what are the choices? When he loves his child, a parent will chose the act that ends pain.

    As for your comments on kidney transplants, I wish I had your fluency in describing your opposition to transplants. I had no idea the donor suffered. I thought the procedure was only mildly painful from that end – though risky, it goes without saying, with only one organ to do the work of two.

    As to the other point you made, you’re on target again. As surely as the sun sets in the west, the procedure is guaranteed to devolve into still another lucrative scheme. And, as you say, who knows what the donor and recipient are feeling (assuming the donor is still alive, which he likely is not. When the money comes rolling in, the declawing vets will be ripping kidneys left and right). What’s more, can you give the poor cat the drugs he’ll need to take every day to slow the rejection? I also abhor chemotherapy for any animal. That’s nothing but cruel. It’s all for the people – not for their suffering children.

    Hastily written and poorly thought through.

    Don’t work too hard, and pet the Boyz! xx

    • It was the hardest thing ever in my life to do. She was such a special girl still miss her like crazy. I know it was the right thing to do, and I wouldn’t want to prolong her life as its just cruel to do that. I know at least shes at peace and happily playing with her sister from above. Jasmin has helped me move on with my grief but ill always remember her special love. Its only been 5 months but feels like eternity.

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