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Why does my cat have a sour smell off and on?

Hi I have a tabby who is 18 years old. He had lost a lot of weight over a couple of years. I took him to the vet and they did a wellness check and blood tests and discovered thyroid issues for which they put him fonfelimazole 2.5 mg 2x per day. They also found he had kidney issues and is on rental food for that. Anyway he has been doing well with the vets care but now I notice that off and on he smells like sour food. It is a very strong odor and it is not his breath. He is also displaying behavioural issues such as constant meowing or jumping on things as well as twisting pictures on the wall. He seems to want my constant attention and when he doesn't get it he goes looking for new things to do such as jumping up on the buffet on top of my grandmas China. He will just hop up there and look at me almost as if to say, "Haha what you going to do about this one?" I am concerned because I love him so much.
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