Hello I am Dr. Joey. Thanks for trusting me to help you and your pet today. I am a licensed veterinarian with over 16 years of experience. I look forward to working with you.
I am so sorry you are going through this with Renny. The not eating is a complex issue and it might be associated with the finding of mild kidney insufficnecy. Great job trying to tempt her with everything you can. I have a few notes that might help you work through things.
First, why is she on Clavamox? Did her urinalysis indicate she has a UTI in addition to renal insufficiency? If so, then this is certainly a great antibiotic BUT it causes profound nausea in many cats. So, one factor to consider is if she has persistent nausea because of the medication. If she was my patient I would recommend skip the next 2 doses. Not a huge deal, even if she has a UTI. If her appetite improves then we found the culprit and on Monday you can contact her vet and get a different antibiotic.
Second, were her Phosphorus/Calcium levels normal? If not tested then this is a must because if the phosphorous is elevated then this leads to a profound level of nausea and needs to be addressed. There is special medication for this.
Third, was her blood pressur normal? I am assuming so. If not, then this also needs to be measured and addressed.
Fourth, why wasn't she hospitalized with intravenous fluids in-hospital? This is the absolute best for treatment (or at least to get a cat who has not been eating for a long period a boost) and unfortunately at this point for her I must recommend you strongly consider taking her in on emergency to have this done for the next 24-48 hours. Then she can receive medication IV. Never discount the ability of IV fluids to help miraculously to make a cat feel so much better in these situations. Subcutaneous fluids,which is probably what you are doing at home, are very helpful AFTER a cat has been properly stabilized with IV fluids. Big difference. However, if you do not want to take her to be hospitalized now, then our only option is to work with what you are trying at home, which is to continue subcutaneous fluids every 12 to 24 hours, depending on what your vet recommended.
So, for anti nausea, the Cerenia is good, but this is not a long-term medication. I find a huge part of the nausea in cats with kidney issues is uremic gastritis. This is often best contended long-term with a combination of an H2 blocker such as famotidine (10mg and 1/2 tab once daily...I see you are doing twice but once daily is usually a standard for cats; or get compounded professionally to a transdermal medication you rub on the inside of her ear once daily) AND some cat also need a medication like sucralfate for a short term to help soothe the system and coat any gastric ulcerations that might have developed.
As an overall side note, her kidney values are not very elevated (in fact, they are only just barely out of the normal range; I see sick cats with creatinine of 5 or more and BUN of 100 or more). So, that is why I started this with the preface that her nausea might be associated with the kidney disease. There may be something else going on, and this finding of some mild (and it is mild) renal insufficiency may only indicate a normal age-related change that is not the primary culprit. If she was my patient I would advocate two things overall to consider right now: 1)hospitalize her with intravenous fluid therapy for 24-48 hours to get her hydrated and support her recovery, and 2)Do some further looking which at this point involves imaging (radiographs/xrays and/or ultrasound) which is mostly a cancer screening, check her blood pressure if not done, and I am not sure how extensive her lab work testing was but must include a complete blood count, chemistry profile with electrolytes, thyroid screening, pancreatitis screen (PLI) and urine check to get a complete picture.
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