A 6 year-old, spayed female, domestic shorthair cat was admitted for evaluation of a pathologic fracture of the right calcaneus associated with a soft-tissue mass. The patient became anuric and inappetant 2 days following a right pelvic limb amputation. Complete blood count and serum biochemical analysis revealed anemia, severe azotemia and metabolic acidosis. Acute oliguric renal failure was diagnosed and intravenous fluid and diuretic therapy were initiated. The azotemia, electrolyte imbalances, and acidosis were refractory to 6 days of intensive medical management. The patient was transferred to a facility with hemodialysis. Hemodialysis therapy was successful in reducing the metabolic abnormalities, and the patient was discharged. One month later, the patient presented for evaluation of heart failure and presumptive aortic thromboembolism. The patient died in hospital despite aggressive medical treatment. Current therapies in the management of acute renal failure in the cat will be discussed, including intravenous fluid and diuretic therapy, peritoneal dialysis, hemodialysis, and renal transplantation.