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Early Stage Kidney Failure in Cat

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luckypenny
February 23rd, 2009, 11:04 PM
That's absolutely fantastic news Growler :highfive: :2huggers: !

growler~GateKeeper
February 23rd, 2009, 11:10 PM
Thanks LP :D It is wonderful :D her vet is also very pleased :D

Sylvie
February 24th, 2009, 03:02 AM
This is the best news I have heard in a long time :grouphug:

growler~GateKeeper
February 24th, 2009, 10:09 PM
Thanks Sylvie :D

14+kitties
February 24th, 2009, 10:18 PM
growler - you must be soooo happy with those test results!! Just goes to show what perceverance and lots and lots of love can do!! Great job!! :highfive:

growler~GateKeeper
February 24th, 2009, 11:30 PM
I am so so very happy about those results Thanks Gerri :D

growler~GateKeeper
February 26th, 2009, 12:48 AM
Mad Catter I just wanted to point out a correction in the amount of food Duffy is eating:

Duffy is eating roughly about 100g ground raw per day sometimes upto 125g especially if its Turkey her current fave. The Natural Instincts ground raw comes in a 250g chubb so I partially thaw & cut in half then store in Ziploc Single Serve freezer containers.

growler~GateKeeper
February 26th, 2009, 01:00 AM
I posted this in another thread & thought I'd also put it in here:

There are 4 stages of renal failure according to The International Renal Interest Society (IRIS)

Stage 1 pre-failure: Creatinine below 140; approx loss of kidney function 0-33%; labeled as non-azotaemic (at this stage kidney problems would be suspected only if an anatomical or functional abnormality had been detected - felinecrf.org)

Stage 2 mild failure: Creatinine between 140 and 250; approx loss of kidney function 66-75%; labeled as mildly azotaemic

Stage 3 moderate failure: Creatinine between 250 and 450; approx loss of kidney function 75-90%; labeled as azotaemic

Stage 4 severe failure: Creatinine over 450; approx loss of kidney function over 90%; labeled as azotaemic

If the vet ever uses the term "End Stage Renal Disease" ask them to clarify exactly what they mean.

From http://www.felinecrf.org/how_bad_is_it.htm#ESRD

This expression literally means that the cat's kidneys are at the point of failure and there is no longer anything that can be done. Some vets use it in this sense, referring to a cat who is rapidly becoming unable to deal with the CRF, ceasing to respond to treatments and likely to die very soon.

However, other vets use it to mean any cat with numbers in the range of Stage 2 or 3, which does not necessarily mean that death is a couple of days away.

....if he/she merely means that your cat has high numbers, consider treating the cat; the numbers may come down with treatment, and even if they don't, your cat might be able to handle high numbers. Even if your vet thinks death is imminent, it may be worth treating your cat regardless to see how he or she responds; cats are real fighters and can often pull through. Obviously though, you don't want your cat to be in pain when it is a hopeless situation.

I also want to point out that the values can fluctuate between the stages for example 06 Aug 2008 Duffy's creatinine was 322 = Stage 3, two weeks later she was retested 20 Aug 2008 Duffy's creatinine was 218 = Stage 2

brewerk
February 27th, 2009, 01:19 PM
I just wanted to post in here.... I'm a new user to this site, but I just wanted to extend a huge THANK YOU to Growler for this thread.

Long story short, our 18 year old kitty and our 13 year old schnauzer passed within three days of one another at the end of 2008. At this time, my wife and I have our remaining two kitties (10 yrs & 4yrs) and a 6 month old Catahoula puppy.

When our older pets passed, our 4 yr old kitty got very sick. She stopped eating, was in the litter box every five minutes, etc. Took her to the vet and she had a horrible UTI and her kidneys were functioning at about 25%. (Some backstory - she lost an eye to infection when she was a kitten. Found in very poor conditions before my wife adopted her.) At any rate, the vet gave us antibiotics for 30 days and told us to get her on a low protein kidney diet. As you can imagine, that did not work. I think they gave us Hill's K/D. She wouldn't touch it. She progressed even worse and needed subq fluids every few days.

After reading this thread and learning what cats with kidney issues really need, we decided to try something different. We FINALLY got her to eat cooked chicken breast and some chicken liver. From there, we transitioned her to canned regular Friskies, and now she's eating canned Wellness Chicken Formula and she is doing FANTASTIC. She's gained almost a pound back (she was down from 10lbs to almost 7lbs). We finally have a happy kitty again. She comes out from under the bed, purrs and dances around the room begging for food.

So, I guess I just wanted to say thank you. I'm so glad I found this thread and I have learned SO MUCH. I know ultimately a raw diet would be best, but she's so picky, we don't think she will touch it. So we'll continue with the high quality / low phosphorus food for now, maybe try the raw in the future, if necessary.

Right now we are just so happy she's eating and happy. So thanks again...

chico2
February 27th, 2009, 03:52 PM
brewerk,how nice of you and how wonderful that your kitty is doing good.:thumbs up
Our Growler is always very helpful and knowledgeable,I am sure she'll appreciate your praise very much.:thumbs up

growler~GateKeeper
February 27th, 2009, 11:17 PM
brewerk First let me say I'm sorry for the loss of two of your family members especially so close together :candle: :candle: they are reunited at the Rainbow Bridge (http://www.indigo.org/rainbowbridge_ver2.html) :grouphug:

Your welcome, I'm so very glad our experience has helped you & yours :grouphug: it's always wonderful to hear how a kidney cat/dog has bounced back & is doing great :D

TeriM
February 28th, 2009, 12:25 AM
Growler, I just wanted to add my congrats and express how wonderful I think this thread is. If I ever have to deal with this situation I know the first place I will be looking for info :thumbs up.

growler~GateKeeper
February 28th, 2009, 12:27 AM
Thanks Teri :)

Love4himies
February 28th, 2009, 07:28 AM
brewerk I am sorry to hear about the loss of two of your loved ones :grouphug: and am so glad to hear your current babies are now eating a healthy diet :thumbs up.


I too had a kitty that was not doing well (Puddles, who was eating crap kibble) and with the wonderful help of Growler (and Sugarcatmom) I was able to transition her to Wellness and now eats part raw. It made the WORLD of difference in her and her bloodwork is much better. I think they extended the life of Puddles by years and will be eternally grateful to them.

growler~GateKeeper
February 28th, 2009, 11:50 PM
L4H The fact that Puddles is doing so well is all the thanks I need :D :grouphug:

Did I ever tell you that one of Duffy's nicknames is Puddle? Has been ever since she was a wee kitten & she responds to it too :D

Helene4
March 1st, 2009, 08:48 AM
Growler, this thread is inspiring! Duffy, keep up the good work!:thumbs up

mikischo
May 3rd, 2009, 02:09 AM
Growler, thanks for your very informative thread. I am happy to hear that Duffy is doing so well.:thumbs up

I have an 18 year old cat named Mickey. He was diagnosed with early CRF in mid 2007. In early March it escalated very suddenly to Stage 4 with his creatinine numbers since then varying between 369 (4.17 U.S.) and 592 (6.70U.S.). Prior to that his readings were in the 200's and on January 21st they were still at 283 (3.20 U.S.). Needless to say we have had a very rough ride these last couple of months. I know what people mean when they call it being on a roller coaster.

It was this very thread that kept bringing me back to Pets.ca. Frequently, when I googled something related to CRF it would lead me to this site and usually to one of your posts. In the last couple of weeks since I joined this forum, I have read your thread from beginning to end. I plan on starting my own thread, possibly before the weekend is over, with more details on what has been happening with Mickey. I have a lot of questions still, and look forward to hearing more from people such as you, sugarcatmom and others who have knowledge of, or are going through or have gone through similar situations.

There are so many controversial issues related to CRF. My vet pushes the prescription low protein diets. I also disagree with her on the type of fluids to use (I am presently giving Mickey sub q fluids twice a day). She insists that 9% sodium chloride fluids are best for CRF cats (she is concerned about potassium getting too high) and I feel, from what I have read, that lactated ringer's is better and it seems that most people with cats with CRF use lactated ringer's. We have now compromised on this and Mickey is on lactated ringer's 2/3rds of the time and sodium chloride 1/3rd of the time. His potassium levels are currently just above the mid range of normal and have never been higher than that.

I realize that this disease will win in the end but I am still hopeful that he will stabilize and have at least a few more months of reasonably good quality time ahead.

Once again, thanks for this very informative and inspirational thread.

growler~GateKeeper
May 3rd, 2009, 03:51 AM
Hi mikischo I'm sorry to hear Mickey has had a rough go lately :grouphug:

I'm glad this thread has helped you & I hope it will continue to do so. Any questions you have I will gladly answer & try to help find some solution for you & Mickey.

Since you've read the thread I guess you can tell I don't follow the low protein theory being that Duffy is raw fed :D.

About the type of fluids: {Duffy gets LRS (Lactacted Ringers Solution) every other day}

Sodium Chloride aka Saline Solution is often used with cats that have high calcium levels, and because it contains no potassium - which some cats do need added - it's good for cats with high blood potassium levels. However it can be too acidic for some & it may sting when injected which makes the process uncomfortable for the cat. Because of the level of sodium & chloride it may not be good for a cat that has either liver problems or high blood pressure.

LRS contains lactate which when metabolized by the liver into bicarbonate it acts like a buffer to help control metabolic acidosis & it doesn't sting :D. It does contain sodium chloride but also potassium, and calcium.

Are you getting your fluids, lines & needles from the vet? You can purchase these from any pharmacy usually much cheaper. I purchase from a medical supply company locally. What needles are you using? I and many other CRF parents prefer the Terumo Ultra Thin Wall 20 gauge, the flow rate is about the same as the 18g regular ones from the vet but the actual poke is hardly felt due to the thinner walls & sharper beveled edge & tip.

I wish you & Mickey many many more good months :goodvibes: :goodvibes: :grouphug:

brewerk
May 5th, 2009, 05:50 PM
Just wanted to come by and update.... I posted in February about our 4 year old kitty Cinders and her early stage kidney failure diagnosis. For the last month and a half, she is doing GREAT! We have an appointment to get bloodwork later in the month and I can't wait to see the results. I probably don't even have to see them, she's clearly so much improved from January.

She is exclusively eating the Wellness Turkey, Chicken & Chicken/Beef varieties (and a bit of cooked chicken twice a day) and is already up to 8.5lbs. Anyway, just wanted to let you know. I think the vet gave her only a few months left, but I just don't see that even being a possibility at this point. We've NEVER seen her behave this way... begging for food, hallway stair racing at night, and giving the puppy a run for her money!

Thanks again for all the info, growler. If we had listened to our vet, she probably wouldn't be here today!

hazelrunpack
May 5th, 2009, 08:46 PM
What a great update, brewerk! :goodvibes: :grouphug:

growler~GateKeeper
May 6th, 2009, 12:40 AM
brewerk sounds like things are going great :highfive:

Many many :goodvibes: :fingerscr for the coming test results

mikischo
May 6th, 2009, 01:01 AM
Growler, sorry for not replying sooner.

Since you've read the thread I guess you can tell I don't follow the low protein theory being that Duffy is raw fed .

I have never tried raw feeding although I have considered it. It always seemed so complicated, for one thing and I guess I wasn't sure if it was the way to go. I have given Mickey small pieces of raw chicken or steak from time to time over the past couple of years (for a treat), when we were cooking it for ourselves and he actually loved it, especially the chicken (he much prefers the raw to the cooked). He would likely have been fairly easy to convert to raw feeding, but since his last crisis that brought his numbers up so high, it has been a challenge just to make sure he eats enough of anything,:wall: so this is not the time to try to make any drastic food changes.

An interesting thing is, back in late January when I took him in to be treated for constipation and dehydration, his creatinine on admittance was 282 (reference range 71 - 212). At that time I let the vet convince me to try him on their prescription low-protein diets. He turned up his nose at every one of them except Medi-Cal reduced protein. He actually liked that one and ate it with gusto for the next several weeks until he went into crisis on March 8 with another bout of constipation and dehydration. This time his creatinine on admittance was 489 and, even after being on 5 days of IV fluids followed by sub q's at home, has been bouncing between 369 and 592 ever since. I can't say I would go so far as to blame the low protein diet for his sudden and rapid decline in health, but it does seem like a strange coincidence that he went downhill so rapidly after changing his diet.

Right now he is still eating some Medi-Cal because it is one of the few things I can get him to eat. I am also now giving him Wellness beef and chicken formula and he has been eating a bit of that every day lately. Trying to slowly move him to eating more of it and less of the Medi-Cal. I also have been giving him lightly boiled chicken thighs and sometimes I give him a little of it raw as well. Between those three things he manages to eat enough to sustain himself. When I first brought him home from the hospital it was a struggle to get him to eat anything at all. Even now I have to take the food to him to make sure he eats enough each day.

Thanks for the info on the comparisons between the LRS and sodium chloride solutions. It helped to reinforce that I am on the right track by working out the 3 to 1 LRS and sodium chloride compromise with the vet. Mickey's calcium levels were 2.45 (reference range 1.95 to 2.83) when they were last tested so still well within normal as well as the potassium being still at a safe level. If we can keep things going (am taking things one day at a time right now:pray:) I plan on getting a full blood chemistry done again in about 2 weeks (will then be 5 weeks since the last one) so that will determine where we go from there.

Are you getting your fluids, lines & needles from the vet? You can purchase these from any pharmacy usually much cheaper. I purchase from a medical supply company locally. What needles are you using? I and many other CRF parents prefer the Terumo Ultra Thin Wall 20 gauge, the flow rate is about the same as the 18g regular ones from the vet but the actual poke is hardly felt due to the thinner walls & sharper beveled edge & tip.

My vet charges $19 per bag of fluids. I had started looking for other sources. After reading your post I decided to check around in earnest and found I can get them from Stevens Home Medical Supplies Store for $4.15 a bag. Wow, what a difference. I can also get the needles and lines from them. They have warehouse locations in several cities and they will also ship, although I don't know what the shipping charges would be (I can pick them up here myself). Here is the link in case someone else might find it useful:

http://www.stevens.ca/generic.htm?ECINFO=LOCATIONS.

I started out using the Terumo Thin Wall (not Ultra) 18 gauge which is what the vets here use in their practice. I did recently switch to the 20 gauge Terumo Ultra Thin Wall which the vet also carries and you are right - Mickey doesn't even seem to feel the poke. I will now be buying these much more cheaply from Stevens.

I am now giving Mick lactulose regularly as needed to prevent constipation (with his high numbers another episode would likely pull him over the edge). I am also giving him probiotics (acidophilus from the health food store) once or twice a day as well as B complex and B12. I find the Holistic route you have taken quite interesting and it seems to be working very well for Duffy. If we can pull out of this recent crisis and stabilize things a bit :fingerscr (consistent creatinine levels in the high 300's or even low 400's would make me very happy at this point) I might consider looking into that myself. My regular vet, like most, is very "by the book" in treating renal failure. She has a 17 year old cat who is in early CRF and she has her on the prescription renal diet, so she really believes in it.

I still plan on starting my own thread (didn't get it started last weekend). Mickey has so many issues going on right now and I have so many questions that I really need to get my own thread going.

Thanks again for your response and for sending the :goodvibes::goodvibes: our way.

growler~GateKeeper
May 6th, 2009, 02:33 AM
I can't say I would go so far as to blame the low protein diet for his sudden and rapid decline in health, but it does seem like a strange coincidence that he went downhill so rapidly after changing his diet.

Muscle wasting can and does make a large impact on the blood creatinine levels as cre is a by product of muscle. If he hasn't been eating enough or enough protein to keep up the strength in the muscles it could make an impact in 2 months time. Dehydration can also play a role here.

When I first brought him home from the hospital it was a struggle to get him to eat anything at all. Even now I have to take the food to him to make sure he eats enough each day.

Have you had a look at this page: http://www.felinecrf.org/persuading_cat_to_eat.htm

My vet charges $19 per bag of fluids. I had started looking for other sources. After reading your post I decided to check around in earnest and found I can get them from Stevens Home Medical Supplies Store for $4.15 a bag. Wow, what a difference. I can also get the needles and lines from them. They have warehouse locations in several cities and they will also ship, although I don't know what the shipping charges would be (I can pick them up here myself). Here is the link in case someone else might find it useful:

http://www.stevens.ca/generic.htm?ECINFO=LOCATIONS.

I started out using the Terumo Thin Wall (not Ultra) 18 gauge which is what the vets here use in their practice. I did recently switch to the 20 gauge Terumo Ultra Thin Wall which the vet also carries and you are right - Mickey doesn't even seem to feel the poke. I will now be buying these much more cheaply from Stevens.


Amazing the difference eh? :rolleyes: :D

Sounds good :D I'm paying $5.15/bag with a different local company Pacific Health Care (http://orderteck.com/cgi-bin/phsupply). PCH ships also, their cost is just under $6 for either same or next day courier delivery from the next city over. :D

I am now giving Mick lactulose regularly as needed to prevent constipation

Are you adding a teaspoon or 2 of extra water in Mickey's food? I found that helped when Duffy was eating canned.

Have you tried Salmon oil? Duffy is getting a pump of Grizzly Salmon oil (http://www.grizzlypetproducts.com/salmon_oil/salmon_oil.html) twice a day, it's been wonderful for her.

How much fluids are you giving? How much in total per day? Has your vet mentioned a change to the schedule/volume to help combat the dehydration & constipation?

mikischo
May 15th, 2009, 11:30 PM
We have had some ups and downs in the past 10 days since my last post. I made several attempts to reply to your post but somehow couldn't get my thoughts together to finish it so here goes again.

Muscle wasting can and does make a large impact on the blood creatinine levels as cre is a by product of muscle. If he hasn't been eating enough or enough protein to keep up the strength in the muscles it could make an impact in 2 months time. Dehydration can also play a role here.

Mickey is definitely showing signs of muscle wasting in the hind end and legs, walks more slowly since becoming so ill in March and often limps quite noticeably and is otherwise showing signs of weakness (has increasing difficulty going up and down stairs). He has had arthritis for the past 3 years or so; therefore it is hard to know what problems are attributable to a worsening of the arthritis and what are related to the CRF and anemia (his PCV was only 18% when his last blood work was done four and a half weeks ago but up from 17% two weeks prior. The anemia is a major concern).

Have you had a look at this page: http://www.felinecrf.org/persuading_cat_to_eat.htm

That is an excellent website and everyone who has a CRF cat would benefit greatly from reading it. Thanks for pointing it out. I had come across it previously and have used several of the suggestions over the past couple of months. I have done some syringe feeding of Hill's AD when his appetite was at its worst and he was turning away from everything I offered him. I raised his water dish a couple of years ago because I thought it might be easier for him to drink with his arthritis. I now keep his food dishes raised as well. I also offer him food frequently when I am at home because he eats very little at one time. His taste changes frequently so I have a small variety of things to offer him (if he turns up his nose at one thing he may accept another at any given time). Lots of food gets wasted this way but what can you do?:shrug: I took him to the vet yesterday and the good news is that he weighs the same as he did 4 weeks ago. I was pleasantly surprised as I fully expected some substantial weight loss because of his eating issues. Guess these frequent feedings are working.:D

Are you adding a teaspoon or 2 of extra water in Mickey's food? I found that helped when Duffy was eating canned.?

I usually add some water but have to be careful with this because he is so finicky. Sometimes he prefers it watered down more, sometimes less, sometimes not at all.

Have you tried Salmon oil? Duffy is getting a pump of Grizzly Salmon oil (http://www.grizzlypetproducts.com/salmon_oil/salmon_oil.html) twice a day, it's been wonderful for her.

I do have a product from the vet called Aller-G-3 which has much the same ingredients except it doesn't specify what kind of fish the oil comes from. Am having trouble giving it to him regularly though because he is so finicky and sometimes it gets wasted along with the food if he turns up his nose at it. Is there any other way to give it to him besides in his food? How do you give the oil to Duffy?

How much fluids are you giving? How much in total per day? Has your vet mentioned a change to the schedule/volume to help combat the dehydration & constipation?

Mickey is getting a lot of fluids already (so much it is scary). He is currently taking 100 to 150 ml twice a day (200 to 300 ml per day). Back in March when he first came off the IV fluids he was taking up to 400 ml per day for a while. I would feel more comfortable if I could taper it down further than what he is currently getting but right now he seems to need it. He is a big cat. For years he weighed about 19 lbs (wasn't all muscle:laughing:) He was 13.25 lbs. when he was at his worst after his crisis in March and is now holding at 14.75 lbs for the past 4 weeks. We are still having trouble with the constipation. Last Sunday he was straining so hard that he vomited twice but managed to get a reasonable amount out and a little more the next morning. Had the same problem on Wednesday (straining followed by vomiting but at least still managing to get a fair amount out). I took him to the vet yesterday because of these issues and my concerns about the continued weakness. We are going to wait a couple more weeks before doing more blood work so all he got yesterday was an enema:yuck: to completely clean him out. I need to find better ways to help regulate the bowel movements without increasing the fluids. Lactulose is proven to be quite safe for cats to take long term and I am going to give him about 2 cc's twice a day whether he goes or not and up it to at least 3 cc twice a day on the days he doesn't have a movement. I have also bought a jar of Heinz Organics Butternut Squash like you recommended in one of your posts so we'll see if that helps too. He loves the taste of it.

So at the moment my biggest concerns are the constipation and his continued weakness. As I'm sure you know, unregenerative anemia can be very serious and Epogen treatments would be very scary to have to put him through (chances of developing antibodies). Since his PCV went up slightly over a two week period I am still hopeful that we can somehow get the numbers to a safer level without having to resort to that. I have now also started giving him benazepril (Fortekor) (started with a low dose of 1.25 mg per day). He did have protein in his urine when it was tested before. Maybe that will also help with the muscle wasting and weakness:fingerscr.

Thanks again for your suggestions and support.

PS: I noticed Duffy celebrated her 18th birthday a few days back. Sorry I missed it at the time. Congratulations to Duffy:highfive:and to her devoted owner!!!:thumbs up Mickey and I wish her continuing good health and many more birthdays.:goodvibes::goodvibes::goodvibes:

growler~GateKeeper
May 16th, 2009, 01:18 AM
Mickey is definitely showing signs of muscle wasting in the hind end and legs, walks more slowly since becoming so ill in March and often limps quite noticeably and is otherwise showing signs of weakness (has increasing difficulty going up and down stairs). He has had arthritis for the past 3 years or so; therefore it is hard to know what problems are attributable to a worsening of the arthritis and what are related to the CRF and anemia (his PCV was only 18% when his last blood work was done four and a half weeks ago but up from 17% two weeks prior. The anemia is a major concern).

Unfortunately the arthritis does make the determination of which is causing it more difficult. :sad: Will Mickey allow you to give small gentle massages to his back legs & hip areas? Helps to loosen the tension in the muscles and increase blood flow to the area, the gentle movement also helps arthritic joints - I used massage therapy on my :rip: :dog: who had arthritis in his hips & spine he showed definate improvement after the massages.

Lots of food gets wasted this way but what can you do?:shrug: I took him to the vet yesterday and the good news is that he weighs the same as he did 4 weeks ago. I was pleasantly surprised as I fully expected some substantial weight loss because of his eating issues. Guess these frequent feedings are working.:D

You can freeze the rest of the can of food for the next time you feed that particular one. Empty the food into something like Ziploc freezable single serve containers. A while ago I asked the customer service department at Wellness if freezing their food changes the taste/nutrients etc and they said no it's fine to freeze it.

Excellent news on the weight holding steady :highfive:

I do have a product from the vet called Aller-G-3 which has much the same ingredients except it doesn't specify what kind of fish the oil comes from. Am having trouble giving it to him regularly though because he is so finicky and sometimes it gets wasted along with the food if he turns up his nose at it. Is there any other way to give it to him besides in his food? How do you give the oil to Duffy?

Picky eaters :rolleyes: :D Duffy gets the salmon oil mixed into her raw food, she quite likes it. The salmon oil capsules I'm now of are quite large - more the size to give to a large dog, but there is another alternative, another member Sugarcatmom recommends using Slippery Elm Bark, you can try that:

[QUOTE]originally posted by Sugarcatmom
If you can find some slippery elm bark powder (from a health food store), mixing just 1/8 to 1/4 of a tsp in with some canned food a couple times a day can help with constipation, and it's a very safe supplement. Make sure any other meds are given about an hour apart from the SEB as it can interfere with their absorption.

Mickey is getting a lot of fluids already (so much it is scary). He is currently taking 100 to 150 ml twice a day (200 to 300 ml per day). Back in March when he first came off the IV fluids he was taking up to 400 ml per day for a while. I would feel more comfortable if I could taper it down further than what he is currently getting but right now he seems to need it. He is a big cat. For years he weighed about 19 lbs (wasn't all muscle:laughing:) He was 13.25 lbs. when he was at his worst after his crisis in March and is now holding at 14.75 lbs for the past 4 weeks. We are still having trouble with the constipation. Last Sunday he was straining so hard that he vomited twice but managed to get a reasonable amount out and a little more the next morning. Had the same problem on Wednesday (straining followed by vomiting but at least still managing to get a fair amount out). I took him to the vet yesterday because of these issues and my concerns about the continued weakness. We are going to wait a couple more weeks before doing more blood work so all he got yesterday was an enema:yuck: to completely clean him out. I need to find better ways to help regulate the bowel movements without increasing the fluids. Lactulose is proven to be quite safe for cats to take long term and I am going to give him about 2 cc's twice a day whether he goes or not and up it to at least 3 cc twice a day on the days he doesn't have a movement. I have also bought a jar of Heinz Organics Butternut Squash like you recommended in one of your posts so we'll see if that helps too. He loves the taste of it.

So at the moment my biggest concerns are the constipation and his continued weakness. As I'm sure you know, unregenerative anemia can be very serious and Epogen treatments would be very scary to have to put him through (chances of developing antibodies). Since his PCV went up slightly over a two week period I am still hopeful that we can somehow get the numbers to a safer level without having to resort to that. I have now also started giving him benazepril (Fortekor) (started with a low dose of 1.25 mg per day). He did have protein in his urine when it was tested before. Maybe that will also help with the muscle wasting and weakness:fingerscr.

Thanks again for your suggestions and support.

PS: I noticed Duffy celebrated her 18th birthday a few days back. Sorry I missed it at the time. Congratulations to Duffy:highfive:and to her devoted owner!!!:thumbs up Mickey and I wish her continuing good health and many more birthdays.:goodvibes::goodvibes::goodvibes:

If Mickey is still having constipation issues you probably won't be able to lower the fluids right now, plus a majority of the determination of the volume of fluids needed is based on his blood test results. Try the butternut squash, and/or slippery elm bark see how that works. I found it best to freeze the amount of BNSquash needed per serving in ice cube trays then dump it into a freezer bag, that way it won't go bad in the fridge before you finish the jar :D

Will Mickey eat raw chicken? The next time you are cooking chicken, save a small (thumbnail or so) piece of raw meat no bone, & see if he'll eat it. If he does you can add a couple of small pieces of raw meat to his daily feedings (no more than 5-10% of his daily food intake because meat alone is not properly balanced) to provide extra nutrition & improve muscle mass.

Thank you for the birthday wishes for my grrl :D

PMFan
May 23rd, 2009, 10:59 AM
hello. i'm new here.

thanks for all the great information in this thread !

i'd be interested in seeing what combinations of foods, meds, etc members here are using/have used successfully. is this the thread for that or is there another?

one issue not addressed here (that i could see) is sodium content in the commericially available high quality canned cat food.

since the script varities have lower sodium content, should i also aim for lower sodium when selecting the no grain/non-script brands? if so, what % or DM numbers should I look for ?

here are details on my 15+yo cat, rachel, diagnosed May 4, 2009.

BEHAVIOR
- drinking pretty well, i've not measured qty as i have another cat
- using the litter box
- goes pee/poo outside also, from what i've seen her pee is very clear
- appears to be well hydrated based on the skin grab/release test
- playful at times
- sleeps quite a bit
- we recently have a stray moved in and she shows territorial aggression toward her. so she still has quite a bit of spunk.

DIET THEN
- previous to now
-- CANNED friskies and 9lives (now transitioning to high quality canned)
-- various dry foods - friskies, goodlife recipe (have not stopped this yet)
-- occassionaly enjoys raw/cooked chicken, cooked hamburger/steak
- treats - various

DIET NOW
- started this week feeding NV chicken mixed w/ small amt of Purina NF (to lower phos levels). after reading here, should i stopt the Purina NF?
- will try EVO venison since is lower at 146 mg phos per 100 kcal according to analysis chart
- 1 TBP/day of 2% plain fage yogurt for the good bateria
- i want to start giving probiotic and digestive enzymes - any good brands out there?
- raw/cooked chicken
- treats - various

TREATMENTS for CRF
- diet only
- conventional vet mentioned sub'q's at home at some point, has not metioned anything else, but i've not discussed CRF progression w/ him.

URINALISYS
- none done nor suggested by vet. will have them perform at followup for bloodwork.

BLOOD WORK
last 3
Oct 08 / Feb 09 / May 09 (ref range)
*indicated bold on results meaning outside normal range

CK 207/127/1033* (64-440) = this one skyrocketed=vet said prob indicates kidney damage? her potassium was high in feb which i've read can cause heart damage.

BUN 38*/38*/47* (15-34)

Creatinine 1.7/2.8*/2.7* (.8-2.3)

Phosphorus 4.9/4.2/3.9 (3.0-7.0) trending down ?

Potassium 4.3/5.8*/5.0 (3.9-5.3)

Calcium (CA) 10/9.9/9.7 (8.2-11.8)

TCO2 21/24/19 (13-25)

T4: 11.4* Oct 08 /less than 0.4* Feb 09 (0.5-5.8) (t-131 iodine treatment given in Jan 09). possibly hypothyroid? will have vet recheck blood work and T4 levels soon.

BP: taken in Dec before t-131 and ok. not taken since, will request in June

WEIGHT: was always ~10#. was down to ~7# (hyperthyroidism), after iodine trtmnt in Jan 09, is now ~9.5#

Catzig
May 23rd, 2009, 09:04 PM
We lost our beloved Siamese, Oscar, in August 2006 to CRF. During Oscar's journey with CRF, I found this site very useful ... http://www.felinecrf.com/manag0.htm (I think it may even have been mentioned in a previous post?) I referred to it often, especially when we were about to start giving sub-Q fluids at home.

Good luck Growler! :fingerscr

growler~GateKeeper
May 24th, 2009, 03:28 AM
hello. i'm new here.

thanks for all the great information in this thread !

i'd be interested in seeing what combinations of foods, meds, etc members here are using/have used successfully. is this the thread for that or is there another?

Hi PMFan welcome to the board :) and the CRF club :rolleyes: :D

It appears of all the members currently dealing with Feline CRF, I have been dealing with it longer than others, most are recently diagnosed & some have started their own threads, but anyone/everyone is welcome to post here :)

If you missed the thread summary it's here (http://www.pets.ca/forum/showpost.php?p=748618&postcount=220)

As for what food/supplements I am using see Duffy's schedule here: http://www.pets.ca/forum/showpost.php?p=749582&postcount=229


one issue not addressed here (that i could see) is sodium content in the commericially available high quality canned cat food.

since the script varities have lower sodium content, should i also aim for lower sodium when selecting the no grain/non-script brands? if so, what % or DM numbers should I look for ?

Sodium hasn't been an issue for my grrl Duffy or as yet brought up by other members, one cannot completely cut out sodium as it is still an essential electrolyte however, as with people, high levels can lead to hypertension aka high blood pressure so balance is important.

The AAFCO Nutrient Profiles for canned foods have sodium content necessary for growth & development as 0.2% DM, the prescription canned foods range from 0.16 - 0.56 % DM. The Wellness canned varieties all have a DM sodium content of between 0.2 - 0.93% with most under 0.5%.

If you are reducing the sodium content of the canned food you are feeding it should be done gradually to allow the kidneys time to adjust

here are details on my 15+yo cat, rachel, diagnosed May 4, 2009.

BEHAVIOR
- drinking pretty well, i've not measured qty as i have another cat
- using the litter box
- goes pee/poo outside also, from what i've seen her pee is very clear
- appears to be well hydrated based on the skin grab/release test
- playful at times
- sleeps quite a bit
- we recently have a stray moved in and she shows territorial aggression toward her. so she still has quite a bit of spunk.

DIET THEN
- previous to now
-- CANNED friskies and 9lives (now transitioning to high quality canned)
-- various dry foods - friskies, goodlife recipe (have not stopped this yet)
-- occassionaly enjoys raw/cooked chicken, cooked hamburger/steak
- treats - various

DIET NOW
- started this week feeding NV chicken mixed w/ small amt of Purina NF (to lower phos levels). after reading here, should i stopt the Purina NF?
- will try EVO venison since is lower at 146 mg phos per 100 kcal according to analysis chart
- 1 TBP/day of 2% plain fage yogurt for the good bateria
- i want to start giving probiotic and digestive enzymes - any good brands out there?
- raw/cooked chicken
- treats - various

TREATMENTS for CRF
- diet only
- conventional vet mentioned sub'q's at home at some point, has not metioned anything else, but i've not discussed CRF progression w/ him.

URINALISYS
- none done nor suggested by vet. will have them perform at followup for bloodwork.

BLOOD WORK
last 3
Oct 08 / Feb 09 / May 09 (ref range)
*indicated bold on results meaning outside normal range

CK 207/127/1033* (64-440) = this one skyrocketed=vet said prob indicates kidney damage? her potassium was high in feb which i've read can cause heart damage.

BUN 38*/38*/47* (15-34)

Creatinine 1.7/2.8*/2.7* (.8-2.3)

Phosphorus 4.9/4.2/3.9 (3.0-7.0) trending down ?

Potassium 4.3/5.8*/5.0 (3.9-5.3)

Calcium (CA) 10/9.9/9.7 (8.2-11.8)

TCO2 21/24/19 (13-25)

T4: 11.4* Oct 08 /less than 0.4* Feb 09 (0.5-5.8) (t-131 iodine treatment given in Jan 09). possibly hypothyroid? will have vet recheck blood work and T4 levels soon.

BP: taken in Dec before t-131 and ok. not taken since, will request in June

WEIGHT: was always ~10#. was down to ~7# (hyperthyroidism), after iodine trtmnt in Jan 09, is now ~9.5#

If you can get both your cats off dry food altogether that would be best some tips here for Transitioning Dry Food Addicts to Canned Food (http://www.catinfo.org/#Transitioning_Dry_Food_Addicts_to_Canned_Food_)

The probiotic I give is PB8 (http://www.nutritionnow.com/PB8.htm) 1 capsule twice a day, another member Sugarcatmom likes Natural Factor's Ultimate Multi (http://www.nutrawayscanada.com/Ultimate-Multi-Probiotic_p_17-218.html)

A urinalysis should be done with every 3 month kidney blood test, the Urine Specific Gravity is an important factor especially before starting fluid therapy.

For the bloodwork:

The high CK level is often a muscle enzyme release reponse to stress see the post here I just wrote for another member: http://www.pets.ca/forum/showthread.php?p=782334#post782334

Everything else looks alright for a recent diagnosis, nothing alarming but I would keep an eye on the calcium : phosphorus ratio ideally it should be around 2:1 basically meaning for a good balance between the two the calcium should be around double the phosphorus level but with both still in their respective normal ranges.

As for the HyperThyroidism, I've been through that & also went with the Iodine therapy, it is not unusual for the T4 to be hypo for several months after 131 treatment - Duffy took close to a year before her level came back up to normal range. There is a HyperT thread here (http://www.pets.ca/forum/showthread.php?t=60971) if you wish to go more into that :)

Great news on Rachel gaining some weight back :thumbs up

We lost our beloved Siamese, Oscar, in August 2006 to CRF. During Oscar's journey with CRF, I found this site very useful ... http://www.felinecrf.com/manag0.htm (I think it may even have been mentioned in a previous post?) I referred to it often, especially when we were about to start giving sub-Q fluids at home.

Good luck Growler! :fingerscr

Sorry to hear about Oscar :grouphug:
Thanks Catzig :) Duffy & I have been dealing with CRF for the past 2 years and still going strong :D

Duffy has her 3 month recheck tomorrow - will keep ya'll updated :goodvibes:

mikischo
May 25th, 2009, 09:40 PM
Mickey has lost the battle against CRF due to complications from heart disease. In the last several days he was having increasing trouble walking and by Wednesday he could no longer jump on his favorite pieces of furniture (sofa and loveseat). This continued to deteriorate. Each step become a terrible struggle for him. Finally he could walk two to three steps with great effort and then stumble and fall. Weakness was in all legs but greatest in his front legs. I had previously planned on getting blood work done in a couple more weeks but moved the appointment to Saturday. I had hoped the bloodwork would help solve the mystery and help us to find a solution. By Saturday it was an extreme effort to just make it to his litter box but try he did. Amazingly he was still eating through all of this. The bloodwork showed his kidney numbers still were high but no worse than before other than the phosphorus (now 3.03) and phosphorus binders were prescribed. The high phosphorus should not have contributed to such extreme weakness and uncoordination. Potassium was very good (over the midrange of normal). His PCV had actually improved rising from 18% to 21.6% so that should not have been contributing to this terrible weakness. There was nothing in the bloodwork that could explain what was happening to him. The vet then did an xray and found his heart to be enlarged. There was no indication of fluid on the lungs on Saturday. Otherwise no other abnormalities could be detected on the xray. In the past there was nothing to cause them to suspect heart problems. He was scheduled to go to another vet hospital to get an ultrasound on Monday. Sunday, he was almost unable to move at all and then started with open mouth breathing that was indicative of congestive heart failure. When I got him into emergency, there was now fluid on his lungs and his poor heart was stopping and starting even after being put on oxygen. He was barely conscious. I was told the prognosis was not good considering the condition of his heart and they might not be able to pull him out of this. If they somehow did, it would be very difficult, considering his high need for fluids for the CRF, to try to balance things to do what was best for both the kidneys and the heart. In any case his remaining time would have been very short. Watching my poor boy lying there almost lifeless struggling for each breath, I knew there was only one thing left to do for him. My heart is aching and I will miss him so much.

Thank you so much for your help and support! Mickey had too many complicating factors working against him and sometimes things are just not meant to be.

IF ANYONE WISHES TO EXPRESS THEIR CONDOLENCES PLEASE DO SO ON THE FOLLOWING THREAD THAT I STARTED IN MEMORY OF HIM.

[URL="http://www.pets.ca/forum/showthread.php?t=62994"]R.I.P. sweet Mickey (http://www.pets.ca/forum/showthread.php?t=62994)

growler~GateKeeper
May 26th, 2009, 01:06 AM
mikischo again I'm very sorry about Mickey :candle: :grouphug:

growler~GateKeeper
May 26th, 2009, 02:04 AM
I got the results from Duffy's Sunday appointment, a comparison to the previous test:

Test....................reference..........Feb.... .........May
UreaNitrogen/BUN..(5.0-12.0)........H..15.........H..16.1 mmol/L
Creatinine............(71-203)..........H.216.........H..254 umol/L
Calcium (Ca).......(2.00-2.90)...........2.42...........2.57 mmol/L
Phosphorus..........(1.00-2.40)..........1.45...........1.43 mmol/L
Anion Gap............(12-26)................25.8.......H..28.8
Specific Gravity....(1.015-1.060)......1.014.........1.020

Overall not too bad :) I'm quite happy the BUN only went up by 1.1mmol/L, the rise in creatinine is not too bad considering past jumps/highs, of course it would've been better had it not risen :rolleyes: CA & Phos around the same as before, these have always been within normal for Duffy. Anion Gap basically equals (sodium + potassium) Ė (chloride + bicarbonate), if the Anion gap increases it may indicate metabolic acidosis, though there can be other reasons for metabolic acidosis not just the anion gap. Some slightly technical info on Acid-Base, Electrolytes, and Renal Failure (http://66.102.1.104/scholar?hl=en&lr=&q=cache:7TYOzVWsUpAJ:www.vetshow.com/download/purina/polzin.pdf). I have noticed some minor lip licking & occasionally needing to be bribed to eat - though that could just be cuz I have her fave cereal on hand & she wants some :rolleyes::D A bit of a surprise given that Duffy gets regular fluids, but nice to see a slightly higher concentration in the urine :D

As always the values do fluctuate, so there may be some ups and downs with some while others remain fairly consistant.

Duffy was given a different dose/schedule of a remedy we've used before so that was given Sunday night & Monday morning. Plus we added a new remedy for cleansing the toxins from the kidneys, that is given daily for a month.

I haven't yet had a chance to speak w/the vet about what he thinks of the results, there were a couple of other values either slightly high(H) or low(L) Calc osmolity H, albumin H, lymphocytes L, platelets L, none of the changes were very high/low or significantly different from the last test.

Overall I'm happy with the results :D

Love4himies
May 26th, 2009, 06:51 AM
Oh Growler, I am so happy that Duffy is doing so well. You are such a terrific mom, she is so lucky to have you :grouphug:

hazelrunpack
May 26th, 2009, 08:58 AM
That's great that she's concentrating her urine better despite the sub-q's :thumbs up

Good job, Duffy! :highfive: (And great job, Mom! :thumbs up :D)

mikischo
May 27th, 2009, 06:40 PM
Glad to see Duffy's great test results. I found the increase in urine specific gravity to be quite surprising.:thumbs up

growler~GateKeeper
June 7th, 2009, 08:45 PM
I will preface this post by saying Duffy is fine now & back home. :cat:

We had a scarey crisis here over the last couple of days, all started Thursday at 5 am with straining to poop from the inability to pass fairly normal looking/feeling poop plus some granule bits of poop and diarreah, combined with vomiting and open mouth panting. This all resulted in a trip to the conventional vets cuz they were open (plus closer), Duffy was manually evacuated of normal size & consistancy poop and diarreah. She was taken into the back briefly for xrays which did not reveal any blockages, nor any definative reason for her other symptoms of elevated breathing and heart rate, though her temperature was fine, and she was shaky on her back legs when straining.

I left there at 10am since I had to go into to work that day & could not stay home to monitor her, she spent the day in hosp for monitoring and by 1:30 when I called to check on her she was still the same as earlier, with the addition of drooling and laying in the litterbox :sad:

The hosp ran some in-house blood work which showed out of normal values:
- elevated pCO2 partial pressure carbon dioxide
- decreased tCO2 total carbon dioxide
- decreased K potassium
- normal BUN/Urea :confused:
- slightly elevated Creatinine but lower than the test run 2 weeks ago :confused:
- elevated AST aspartate aminotransferase a liver enzyme that rises relatively easily and is not as important in liver evaluation as ALP elevations but a substantial increase may also warrant follow up liver testing
- decreased ALKP alkaline phosphatase - liver and bone disease are the most common causes for increased values in cats but nothing I've found so far defines why it would be lower except the kidneys rapidly excrete any excess

At this point she stiil wasn't feeling any better, hadn't eaten the Wellness I had my mum bring out for her, was still straining and they were unable to get a urine sample for testing. The Dr was concerned about liver damage & wanted her on IV fluids LRS with KCl Potassium Chloride added plus meds & to stay in hosp overnight however they did not have anyone staying, just someone who came in periodically for treatments. I of course wanted 24 hr monitoring so we arranged for me to transfer Duffy to the Animal Emergency Clinic. At this point she was still feeling sickly but looked so much better than when I saw her in the morning and no more drooling. When we got there she was reassesed, had blood drawn again & this time sent out the the lab for an accurate comparison to the tests taken 2 weeks ago, her BP checked 120 nomal, more xrays taken, hooked back up to the IV & kept overnight. The ER vet was not too concerned about the liver enzyme that was elevated since that one AST does not generally indicated liver disease in small animals, she was more concerned about the possibility of pancreatitis. I did get to go visit with her in the back for a bit and to say goodnight. They asked what I wanted them to feed her since I didn't have time to pick anything up but they did have a can of Wellness on hand for her to have, she did eat some overnight & Friday morning.

Early Friday afternoon I discharged her from the Animal ER and transferred her to her Homeopath Vet for monitoring for a couple of hours till they closed, there she was given a remedy for the kidneys, the liver and nausea, set back up on IV. The homeopath also opened up a large can of Wellness for her which I took for her back to ER. When I went to pick her up from the Homeopath she was in even better spirits than earlier but we still hadn't gotten the lab results back so I transferred her back to the ER for overnight monitoring. Back in ER she was hooked back up to the IV and I gave the vet instructions on the next 2 doses of the remedy, we briefly discussed the results of the pancreas panel that came back negative. I was later allowed in the back to visit, coax her into eating, and say goodnight.

I got a copy of the lab results that were sent from the ER out of normal:

- elevated glucose to which the lab attiributes to stress
- decreased potassium - same value as the inhouse blood work despite having KCl added to the IV in the meantime - the lab has attributed this to anorexia lack of eating proper portion amounts
- elevated AST but lower than the inhouse test to which the lab attributes to muscle injury
- elevated CK Creatinine Kinase - this value elevates during struggling while blood is taked/hit by car/stress so not always indicative of - damaged muscles produce creatinine kinase, which goes into the bloodstream. High values indicate problems with muscle, possibly including the heart - the lab has also attributed this to muscle injury

The really interesting thing is:
- BUN/Urea is still in normal range but lower still than the inhouse test that was run :confused:
- Creatinine has dropped again from the inhouse test and is now in normal range! :confused:

Saturday morning I was to call ER between 9-10am for an update and speak to the vet on staff but they had 2 emergencies that came in so she didn't get back to me until ~ 11:45am. We spoke briefly and I was told I would be speaking to a vet upon discharge so I didn't get to ask all the questions I wanted to about the test results/theories of possible causes etc. She said they would wean her off the IV during the afternoon. I was then to call back at 1:30 pm to arrange a discharge time - that was set for 5pm.

They had a couple more emergencies that came in that afternoon, when I arrived at 5pm for Duffy's discharge appt they set Duffy & I up in an exam room with litterbox, water & food so I could get her to eat - I guess she hadn't had very much for them - and the Dr was to come talk with me. Duffy certainly looked ready to go home at that point. I asked the tech about her still having the catheter in since as of the morning they were going to discharge her then, but they wanted to keep her a few more hours longer to make sure she didn't vomit the food I was able to get her to eat. The Dr was not able to come in to talk to me then because while I was feeding Duffy there were several emergencies that just walked in. The tech came back in to take Duffy back to the kennel & reset the IV. I was told to check back around 9pm and she could be discharged around 10pm.

So I hung around the general area of the clinic for the next 4 hours, got something to eat then went for a walk & went back at 9pm which at that point I saw they had even more emergencies come in. The receptionist told someone on the phone at 9:30pm that the wait time to see the Dr for a less critical case was 4 hours. At that point I knew I would be waiting until about midnight, the receptionist came over to tell me about the new emergencies & that they couldn't discharge Duffy without me speaking to the Dr and having her instructions. The next 3 hours I waited in the clinic during which more emergencies came through, until midnight when I was finally given Duffy's discharge papers/instructions but I still never got to talk to the vet. Called a cab & got home at 1am Sunday morning.

I have a theory about the cause being a combination of a bad reaction to the new protein - duck - she had on Wed resulting in the diarreah but all other symptoms a result of the metabolic acidosis that was shown on the test 2 weeks ago but was normal on these last 2 tests plus the decreased potassium levels from these 2 tests. I want the vets opinion on the probability of that being the cause, since her ER discharge papers have undetermined cause.

Right now Duffy is doing good she's still a tiny bit shakey on the back legs but also has been kenneled for 64 hours, she's been to the litter box for both pee & poop - which was a little bit of a strain at first but came out normal size, consistancy and not at all dry. She has her appetite back is enjoying the canned Wellness she will be on for the next couple of days to settle her tummy down until the homeopath vet gives the go ahead to switch back to raw. I will be home Monday to monitor her, and will try to get her in for a check up and repeat bloodwork & do a UA on Wednesday. Unfortuately this weekend the homeopath is closed Sun/Mon - Murphy's Law :shrug:

growler~GateKeeper
June 7th, 2009, 08:50 PM
The patient relaxing at home after 64 hours in the hospital

hazelrunpack
June 7th, 2009, 08:59 PM
Holy catz!!! What an ordeal! :grouphug: And those blood results! :confused: but :thumbs up Normal range!!

I'm glad she's home and resting comfortably during her recovery--I 'spect you and Duffy feel the same only moreso :D :2huggers:

growler~GateKeeper
June 7th, 2009, 09:07 PM
Thank you Hazel :grouphug: we are both so very happy to have her home and feeling better :cat:

Wouldn't you know the first thing she did when I let her out of her crate was mush a bit with me then run over to see if there was any food for her at her table :rolleyes: :laughing:

hazelrunpack
June 7th, 2009, 09:09 PM
She obviously missed Mom's cookin'! :D

Magicwildwolf69
June 8th, 2009, 12:04 AM
oh what a scare! i'm so glad she's home now and seems to be a bit more stable. she's such a pretty cat. hope she continues to get well. :grouphug: for both of you!

growler~GateKeeper
June 8th, 2009, 12:36 AM
Thanks MWW :grouphug:

TeriM
June 8th, 2009, 02:44 AM
What a scary time for you both :eek: :grouphug:. Hope she has continued improvements :goodvibes::goodvibes::goodvibes:.

Lucy also can't handle duck and she can eat almost anything :shrug:.

growler~GateKeeper
June 8th, 2009, 03:22 AM
Thanks Teri :grouphug:

I think the duck might've been only part of the situation ~ possibly the catalyst :shrug: One thing for sure is she will never have duck again.

chico2
June 8th, 2009, 07:00 AM
OMG Growler,it must have been an ordeal for both you and Duffy,so glad you posted in the beginning she is ok..
I faintly remember having had problems with duck too at one time.
Duffy certainly is a tough little girl,maybe it's the way the pic was taken,but she looks to be a little skinnier than earlier pics.

Love4himies
June 8th, 2009, 07:07 AM
:eek: OMG, that must have scared the begeesis out of you :grouphug: :grouphug:. She is looking very relaxed and her normal beautiful self.

PMFan
June 8th, 2009, 11:15 AM
glad to hear Duffy is a-OK and her numbers are so good !




off topic -- shouldn't this thread be in the cat health forum ? I tried to find it there but it's actually located in the DOG health forum...?

growler~GateKeeper
June 8th, 2009, 08:03 PM
so glad you posted in the beginning she is ok..
I faintly remember having had problems with duck too at one time.
Duffy certainly is a tough little girl,maybe it's the way the pic was taken,but she looks to be a little skinnier than earlier pics.

That was why I put right at the top she's home & okay now :D
I think duck might be an issue for a number of pets - too fatty/rich/gamey I suppose
She's only lost a few ounces over the last 3 months since her previous checkup. This last incident likely hasn't caused any measureable weightloss.

:eek: OMG, that must have scared the begeesis out of you :grouphug: :grouphug:. She is looking very relaxed and her normal beautiful self.

She is doing good right now. Very happy to be home, purring anytime I go near her :cloud9:

glad to hear Duffy is a-OK and her numbers are so good !


off topic -- shouldn't this thread be in the cat health forum ? I tried to find it there but it's actually located in the DOG health forum...?

PMFan this thread was started long before the cat health forum was created :) - back when there was only the one health forum ;) It was just never moved, not quite sure how it works but I suppose it could be too large to now :shrug:

Thank you Chico, L4H & PMFan for the good wishes :grouphug:

luckypenny
June 8th, 2009, 08:50 PM
I have to remember the next time I'm not feeling well to go to your place for care, Growler :D.

YOU ARE AWESOME!!! What a lucky girl Duffy is to have such a mom :angel:. I'm so glad she's home with you and feeling better :thumbs up.

Jim Hall
June 8th, 2009, 08:59 PM
yah i tried meriick duck twiceaa and both kits threw it up
manda is like that too canttolerate real rich stuff

TeriM
June 8th, 2009, 09:06 PM
She is doing good right now. Very happy to be home, purring anytime I go near her :cloud9:


Woohoo :thumbs up :cloud9:.

growler~GateKeeper
June 8th, 2009, 09:15 PM
Thanks LP :D

Jim yeah it sounds like there are alot of pets who can't tolerate Duck :shrug:

I've got Duffy scheduled for a check up & a recheck of her bloodwork for Wed :)

growler~GateKeeper
June 10th, 2009, 08:49 PM
Back from the checkup w/Homeopath & Homeopath Vet. No blood work ran today we will wait a week to let her de-stress & see what her levels are at next wed.

So the homeopath has put together the cause of all these symptoms that prompted the ER visit etc. The food that Duffy was eating when the tainted recall came out was Rice & Duck........she's had Duck 2 times since then & both times she's had a reaction to it. The 1st time she was just really constipated & I thought there was too much psyillum husk in the food. This time a far more serious reaction than the last time. Basically her body reacted to the duck in the tainted food and so now views any duck as an allergen so that prompted the severe gastro intestinal reaction that the conventional vets could not figure out what was linking all symptoms. :wall: :wall: :wall: Duffy is now severely allergic to duck! because the food which was tainted also contained duck.

So my theory was half right & the actual cause is better than what I was thinking - far easier to treat an allergy to duck - never feed it again!, than it would be if it were an ongoing case of low potassium combined w/metabolic acidosis.

No Duck :cat:

hazelrunpack
June 10th, 2009, 11:20 PM
How did the rest of the checkup go? Does the vet think she's recovering reasonably well?

Allergies are nothing to sneeze at (no pun intended :p) but if it just means you can't feed her duck, that's an easy fix! :highfive:

:goodvibes: for next week's bloodwork!

growler~GateKeeper
June 11th, 2009, 11:19 PM
Thanks Hazel :)

The vet was so very happy to see how well she has recovered from this, I told them I think she is not quite but almost back to 100% :D

growler~GateKeeper
June 25th, 2009, 01:34 AM
So the bloodwork is in and everything looks good :) Duffy's liver values are normal, her Potassium is normal, glucose & CK are also normal. Her anion gap is normal & showing no signs of metabolic acidosis. Though she is still swallowing a bit more than normal but that could be due to the change in diet - temporarily back on canned & not eating as well as she did on raw. BUN is back to 14.7 and Creatinine is back to 240 both of which are lower than the regular tests run end of May :thumbs up USG is also slightly better than May's test right now it's 1.021 concentrating 0.001 higher than May :highfive: This is the 2nd test where her urine is concentrating better than the previous, I hope this trend continues :fingerscr

The sharp drop of BUN & Creatinine into normal prior to any treatment during the crisis was attributed to not eating, vomiting etc and after IV treatment the numbers dropping farther into normal are because of the fluids directly into the veins, flushing out the toxins.

Duffy's hemoglobin & lymphocytes are still lower than normal but about twice the number they were from the ER test which is great :) The lab attributes it to stress.

Interestingly though her T4 is back way down below 6 (normal is 19-50) some of you may know she had HyperT several years back, was cured w/ 131 Iodine and has had numbers in normal with a couple dips into low in the years since, something that may continue to happen occasionally :shrug:.

Something I didn't mention here before - the ER vet also found Duffy now has a heart murmur. Heart murmurs are graded from 1-6 with 1 being the least severe and 6 the most severe, often times audible even without a stethoscope. At the time she was 1st admitted (on a Thurs nite) it was graded at a 3 or 4 and when she was re-evaluated (a couple of days later on Sat morn) it was down graded to a 2. It is possible the murmur was brought on by the mild anemia and the allergy crisis that lead to the hospitalization, and it's also possible it is just normal aging. When the homeopath vet examined Duffy she had it as a 1 or 2.

Duffy is back on her homeopathic remedies and will start her supplements again with the 1st one tomorrow and adding the rest in one each week to be sure there are no reactions. She can then start back on raw the week after the last supplement is added back, so for the next 3 weeks she's still eating Wellness canned. Once back on raw there should be an improvement in the amount she's eating, she's not nearly so picky when eating raw. :cat:

chico2
June 25th, 2009, 07:13 AM
Growler that's great news,you and little Duffy have been fighting these problems so hard,some good news are very encouraging:thumbs up
Not only have you been fighting for Duffy,but helped so many others as well:grouphug:

hazelrunpack
June 25th, 2009, 04:07 PM
:highfive: :grouphug:

:goodvibes: for even more improvement once she gets back to her normal raw diet and supplements!

growler~GateKeeper
June 26th, 2009, 12:14 AM
Thanks Chico & Hazel :grouphug:

The restarting of one of the remedies on Sunday has shown it's working already - Duffy has definately been eating much better today :thumbs up

TeriM
June 26th, 2009, 12:22 AM
The restarting of one of the remedies on Sunday has shown it's working already - Duffy has definately been eating much better today :thumbs up

Woohoo :thumbs up.

growler~GateKeeper
June 26th, 2009, 01:02 AM
Thanks Teri it is great :D she's still being picky though :laughing: must be cold straight from the fridge or right out of a freshly opened can :rolleyes: :cat:

sugarcatmom
June 26th, 2009, 06:14 AM
must be cold straight from the fridge or right out of a freshly opened can :rolleyes: :cat:

Hilarious! Aztec is the exact same way. He rolls his eyes at me and walks away if I offer him refrigerated canned food that I've lovingly warmed up to mouse temperature, but if I just put it cold in his dish, he gobbles it up.

Glad to hear Miss Duffy is on the comeback trail. :thumbs up

growler~GateKeeper
September 10th, 2009, 12:46 AM
Since last report Duffy has been fully back on raw & all her usual supplements. She had a physio appt for IMS in mid July - looking much better there as well her back far less reactive than the previous appt :thumbs up

Near the end of Aug was her 3 month check up she was doing good, Dr listened to her heart as well & could not hear the murmur, eating, drinking, peeing & getting fluids well, but still an issue w/dry poop & vomiting stomach acid while attempting to go, so her homeopath recommended increasing the muscle meat amount to 75% of her diet and the rest as meat/bone/organ mix, and her Vet suggested we increase the volume of fluids from 150cc every other day up to 100cc everyday. The extra meat went over great with Duffy loving the extra chicken breast, however a few days later, when I added a very small amount of bone-in premade raw chicken mix to that again came the straining, diarreah, hard poop, drooling, vomiting, slight panting - thankfully not anywhere near as bad as the "duck allergy episode" (which prompted a weekend in ER). She was doing okay w/the premade turkey mix just reacted to the chicken mix. I had her dropped off at the Homeopath Vet for the day for monitoring, they checked her over, gave her some fluids & a remedy, kept an eye on her, tempted her w/some food which she refused :shrug: don't blame her it was a/d :yuck: thinking that would be easiest to digest. The dr on staff (not Duffy's primary vet) said she felt a "doughy" feeling in Duffy's abdomen, this could be fat cuz she is a bit chubby, it could also be the pancreas or kidneys reacting to infection etc or possibly IBD. Duffy was not blocked w/poop, none to be felt in her colon. She recommended an ultrasound to see what is what. I brought her home where she attempted a poop got a wee bit out & went to bed. Repeated a couple of remedies & she was looking far better around 11 pm that night. The next day looking so much better she stayed @ my mum's so she could check on her during the day. The recommendation now from her homeopath is no bone at all for Duffy - she just can process it anymore. The monday after she had a semi hard slightly dry poop & later in the week a good soft/normal poop w/having had no bone all week. Currently she is eating raw chicken breast, I'm considering sourcing chicken liver to add in (trying to find small package size like 1-2 or a butcher here open on sundays) though understandably hesitant to change anything in her diet right now and every 4th day premade raw no-bone Bison mix which she prefers seared :rolleyes:

Got her blood results in from the Aug 3 month check the vet is using a different lab so some of the reference ranges are slightly different
Out of range values:

BUN (5-12) 16 H.........last test in June was 14.7
Cre (83-181) 270.3 H.........last test in June was 240
Lipase (0-205) 323 H normal every previous test

In Duffy's situtation, as mentioned by my vet, the increase in Lipase could be due to the kidney issues as lipase is excreted by the kidneys, so here it is not necessarily pointing at anything else, though pancreatitis or IBD haven't been ruled out.

Platelet & lymphocyte counts are also low - this is nothing new for Duffy, both have been low in the past :shrug: The platelet count a bit lower than previous test but the lymphocytes climbing higher towards normal. Lymphocytes are white blood cells important in production of antibodies and immunity.

Her USG came in lower this time (as the last couple of tests it was climbing) it's at 1.015 the bottom end of "normal", urine pH is up at 7 again and the Urobil came out at 17 where it should read "normal". Everything else is neg or normal.

Urobilinogen is an intestinal bacterial breakdown product of bilirubin. Some of it is absorbed from the intestine into the blood stream and them small amounts are excreted from the kidney into the urine. Urobilinogen in the urine infers the bile ducts is at least partially open which of course is good, (no urobilinogen does not mean the duct is blocked). The amount excreted in the urine also depends on the amount excreted in the feces, the activity of the gi microflora and intestinal transit time. Severe haemolysis, constipaiton & gi haemorrahage all may increase the amount of urobilinogen present. Constipation issues she has had. :rolleyes:

The lab Dr who performed the tests remarked at the bottom the high lipase could be due to pancreatitis/pancreas injury or it could be due to the kidneys.

Got a call from my vet as he saw the referral request for diagnostics, he agreed it would be a good idea to get a clear picture of what is going on in her abdomen as we may still be looking at a pancreas issue even though her fPLI test from the ER came back normal, or there could be IBD - though at this point I'm thinking it's just gonna show the kidney disease as she has had no issues this last week & a half. My vet said he was marking me down for a referral for an abdominal ultrasound, but also told me to ask if they can take a quick peek at her heart while we're there :D to check out the murmur.

Duffy was playing w/her feather toy for a wee bit this weekend. :lovestruck: Just waiting on a call from the specialist to book the ultrasound. :goodvibes:

chico2
September 10th, 2009, 06:59 AM
WOW Growler,I just read this whole post and I think by now you have gone through the the whole gamit with Duffy,you are probably just about qualified to be a vet:cat:
I hope Duffy will get through this with no serious issues and the Ultra Sound will give you some treatable answers:fingerscr

hazelrunpack
September 10th, 2009, 10:14 AM
:goodvibes: that the ultrasound rules out pancreas problems and IBD! Glad she's doing so much better on the modified diet. When you see her playing, it must just warm your heart! :lovestruck:

PMFan
September 22nd, 2009, 06:17 PM
where do you buy the SP products?
thanks

Breakfast (usually btwn 4:30-6am)

3 supplements are pilled right before she eats:
1 Standard Process Feline Renal Support (http://www.standardprocess.com/display/VeterinaryCatalog.spi?ID=350) tablet as per her Homeopath Vets' directions
1 Standard Process Feline Whole Body Support (http://www.standardprocess.com/display/VeterinaryCatalog.spi?ID=351) tablet as per her Homeopath Vets' directions

growler~GateKeeper
September 22nd, 2009, 11:20 PM
PMFan I get the Standard Process from my Homeopath Vets, it is a regularly ordered item.

If there is a holistic or homeopath vet in your area, call & ask if they carry it & if they can order in for you, prescription not required.

If you are in the US you can click on the "how to order" at the top right of the page & enter your zip code it will show who carries the human products or for US or Canada the "contact us" to ask for someone in your area that carries the vet formulas.

PMFan
September 23rd, 2009, 05:02 PM
great, thanks much!

i'm thinking of starting her on the SP, probiotic and maybe the oil.

she's recently started howling more and i'm not quite sure how to pinpoint the cause. she recently had blood in urine so given a course of antibiotic (hence the need for probiotic).

BUN and CREA went down a few points from May 09.
Only changes I made was
-higher quality protein canned w/ near 1.0% phos (wellness, merrick, felidae)
-SD K/D and Purina NF infrequently - she actually likes these
-wellness salmon dry
-freeze-dried raw treats
-slippery elm bark as needed for upset stomach

2009 BLOOD WORK = US values
FEB / MAY 3 / MAY 26 / AUG 29 (ref range)
*=outside reference range
*BUN: 38 / 47 / 56 / 52 (15-34)
*CREA: 2.8 / 2.7 / 2.7 / 2.4 (.8-2.3)
PHOS: 4.2 / 3.9 / 3.5 / 4.8 (3.0-7.0) - increasing :(
CALC: 9.9 / 9.7 / 9.7 / 9.5 (8.2-11.8)
POTASSIUM: 5.8* / 5.0 / 5.1 / 4.8 (3.9-5.3) - decreasing :(
TCO2: 19 / 21 / 19 (13-25)
Thyroid: 0.4* / 0.7 / 0.4* (0.5-4.7)
HCT: 38.8 / n/a / 37.6 / 35.2 (29.45%) - decreasing :(
LYMPHOCYTES: 25 / n/a / 18* / 12* (20-55%) = dramatic fall - 1/2 it's value from 6 mos ago?
EOSINOPHIL: 17 / n/a / 18* / 17* (2-12%) - not sure what causes this
*absolute LYMPHOCYTE: 1425 / n/a /1080 / 636 (1500-7000) = dramatic fall ?


URINE USG
MAY 09 / AUG 09
1.022 / 1023

PMFan I get the Standard Process from my Homeopath Vets, it is a regularly ordered item.

If there is a holistic or homeopath vet in your area, call & ask if they carry it & if they can order in for you, prescription not required.

If you are in the US you can click on the "how to order" at the top right of the page & enter your zip code it will show who carries the human products or for US or Canada the "contact us" to ask for someone in your area that carries the vet formulas.

Love4himies
September 23rd, 2009, 05:48 PM
I missed this update, growler. Wow you have fantastic vets :thumbs up and of course you are the best cat mom :cloud9:.

Sending :goodvibes: to Duffy.

growler~GateKeeper
September 24th, 2009, 12:06 AM
great, thanks much!

i'm thinking of starting her on the SP, probiotic and maybe the oil.

she's recently started howling more and i'm not quite sure how to pinpoint the cause. she recently had blood in urine so given a course of antibiotic (hence the need for probiotic).

Since T4 has ruled out HyperT at this point, other causes of howling could be: urinary infection, bladder kidney stones, hypertension or by the toxins in the blood (BUN & Cre)

BUN and CREA went down a few points from May 00.
2009 BLOOD WORK = US values
FEB / MAY 3 / MAY 26 / AUG 29 (ref range)
*=outside reference range
*BUN: 38 / 47 / 56 / 52 (15-34)
*CREA: 2.8 / 2.7 / 2.7 / 2.4 (.8-2.3)
PHOS: 4.2 / 3.9 / 3.5 / 4.8 (3.0-7.0) - increasing :(
CALC: 9.9 / 9.7 / 9.7 / 9.5 (8.2-11.8)
POTASSIUM: 5.8* / 5.0 / 5.1 / 4.8 (3.9-5.3) - decreasing :(
TCO2: 19 / 21 / 19 (13-25)
Thyroid: 0.4* / 0.7 / 0.4* (0.5-4.7)

The BUN & Cre dropping is good, the potassium dropping is good it is falling back towards middle of normal which is where you want it. The phosphorus at a 4.8 it not that alarming, yes it has increased but still mid normal and the ratio of phos to calcium is good. The value you want is around 4 http://www.felinecrf.org/diagnosis.htm#phosphorus but still needs to be in a 2:1 ratio calc : phos.

The thyroid being a bit low doesn't normally happen in cats - more in dogs, shows the immature red blood cells are abnormal in size/shape. Have it rechecked with the next blood test.

HCT: 38.8 / n/a / 37.6 / 35.2 (29.45%) - decreasing :(
LYMPHOCYTES: 25 / n/a / 18* / 12* (20-55%) = dramatic fall - 1/2 it's value from 6 mos ago?
EOSINOPHIL: 17 / n/a / 18* / 17* (2-12%) - not sure what causes this
*absolute LYMPHOCYTE: 1425 / n/a /1080 / 636 (1500-7000) = dramatic fall ?


URINE USG
MAY 09 / AUG 09
1.022 / 1023

HCT is red blood cells left after the blood is spun down in relation to blood volume, it is a measure of anaemia but it's still in normal range. The lymphocytes, eosinophil and absolute lymphocyte all point towards infection as they function in detoxifying foreign substances (eosinophils) and destroying bad cells and in antibody formation (lymphocytes).

Antibiotics should be helping with the infection & that will raise those values back into normal.

USG not moving much is good.

One thing to remember is all values fluctuate constantly so sometimes it might be up other times down. The most important thing, even more than the numbers, is how your cat is feeling. :)

growler~GateKeeper
September 24th, 2009, 12:19 AM
I missed this update, growler. Wow you have fantastic vets :thumbs up and of course you are the best cat mom :cloud9:.

Sending :goodvibes: to Duffy.

Thanks L4H :D

Duffy had her ultrasound done today at the specialists everything went great :thumbs up Everything other than the kidneys are normal, no cancer, virtually no scarring on the kidneys :thumbs up - Radiologist said they look like 10 yr olds kidneys not 18yr olds :D Pancreas, Liver are normal, 3 very small areas in the intestines that look like they might have a bit if IBD but he said it wasn't anything to be worried about - I'm thinking this was being irritated by the bone, which she apparently can't handle.

Dr also checked her heart, again everything looks great very minor weakening of the valve on the right side which is what was causing the murmur (the sound of the blood seeping backwards out of the ventricle). So still rated between 0-1 :thumbs up The left ventricle is perfect - the left side is more serious/important if/when there is an issue.

Interesting little tidbit the radiologist who did Duffy's ultrasound also did a cardiac ultrasound on my :rip: :dog: Calvin back in 2001 :D also for a murmur

Love4himies
September 24th, 2009, 06:32 AM
I am glad to hear that her heart is in good shape!


Is it normal for cats who are going into kidney failure to have issues with bone, or is it that some cats just can't handle too much bone?

growler~GateKeeper
September 24th, 2009, 10:02 PM
L4H to my knowledge there is no connection between crf & issues with bone. Some cats and dogs don't do so well on certain meats and some need lower bone amounts. Older cats also don't need as much bone as younger ones, of course gaugeing by the condition of their poop is an easy way to spot any issues.

In Duffy's case it is likely the very small spots the radiologist noted on her intestines that is being irritated by the bone, like a very mild case of IBD - he wasn't told she is rawfed, but this was a possible cause of the recent issues she was having pooping, that was suggested by my vet. He should call me in the next few days to go over the radiologists findings.

growler~GateKeeper
December 5th, 2009, 11:46 PM
Since the last update Duffy was on butternut squash for the soft slightly squishy (but not liquidy) poops resulting from lack of bone (I can not just add in bone to her diet since that is one trigger of her mild IBD), we were upto 1tsp per day with not enough difference seen and she was still occasionally vomiting stomach acid (just when pooping0 as a result of the pushing. So I switched her to Slippery Elm Bark Powder she's at 1/2 tsp per day and I am seeing much improvement in the poop department not perfect just yet but definately easier for Duffy to go, so to speak, and no vomiting. Yay! :D

Another vet visit update, from Sunday 15 Nov, the visit went good silly grrl refused to pee for me in the morning before the appt so I could bring a urine sample in, therefore she had to hold it for a cysto. After the urine & blood samples were taken, she was offered a litterbox & she still refused to go in it :rolleyes: so after the appt on the way out to my mum's truck I leash walked her out to the parking lot & she peed beside a tree out in the pouring rain :laughing: :cat:

Treatment plan is same as before, wiith Azodyl in place of a regular probiotic, Duffy's homeopath has heard great results from some of the ultrasound techs so we started that on 1 Dec. Duffy's appetite has been awesome since on the Azodyl not sure if it's a result of that or just because I bought some of her favorite food topping treats in the same week :D Amazing thing too is that MC is going to cover the cost of the Azodyl :thumbs up which is fabulous considering it's expensive & I'll be going through 3 bottles every two months.

Blood results came back good, stable numbers a 1 point increase in her BUN currently at 17 and nearly a 27 point drop in her Creatinine :clap: currently at 243.4.

I have samples of Feline Future (http://www.felinefuture.com/) TC Inctincts and TC Instincts Plus pre-mix for rawfood so I'll see how Duffy likes that over the next couple of weeks, I mentioned this to Duffy's homeopath to let her know I was going to try her on it & she definately recommends the products as she was the homeopath for the company when they started - small world :D

So her blood results are looking good & she's feeling great :highfive:

TeriM
December 5th, 2009, 11:56 PM
I have used the instincts stuff in the past when I first introduced Bud to raw food (there wasn't the selection available like now) and I think it is very good stuff. I also recommended it to someone a while back whose cat wouldn't try raw and it really helped the cat to convert :thumbs up.

luckypenny
December 5th, 2009, 11:58 PM
What a wonderful update, Growler :goodvibes:.

Anyone take any pics of Duffy on leash peeing next to the tree by any chance? The dogs think she's the coolest kitty around :cool: :cat:.

Have you considered bone meal to replace the raw bone content in her food?

growler~GateKeeper
December 6th, 2009, 01:17 AM
Anyone take any pics of Duffy on leash peeing next to the tree by any chance? The dogs think she's the coolest kitty around :cool: :cat:.

Have you considered bone meal to replace the raw bone content in her food?

:laughing: nope no one was taking pics, but when I mentioned it to Duffy's homeopath she thought it was pretty funny especially given the rain & her refusing to use their litterbox :D

I mentioned bone meal to my homeopath she said that it would likely cause the same IBD reaction as the ground bone. There is one local rawfood company I know of that uses bone meal instead of ground bones but Duffy refuses to eat anything from them :shrug: My homeopath vet & homeopath are the ones who said to put her on a muscle meat only diet and that in Duffy's case she is fine on just meat right now as there is calcium etc in it plus she is taking NuCat Vitamins and her blood results for calcuim, phos, potassium etc were nearly identical to the previous tests where she was also eating bone & organs. I'll see how it goes with the TC Instincts.

growler~GateKeeper
December 6th, 2009, 01:21 AM
I have used the instincts stuff in the past when I first introduced Bud to raw food (there wasn't the selection available like now) and I think it is very good stuff. I also recommended it to someone a while back whose cat wouldn't try raw and it really helped the cat to convert :thumbs up.

Good to hear. Duffy's loved raw right from the moment I put her on it :D, and she's doing great on the recommended meat only so right now I'm just wanting to see if I can make her diet a little more complete without aggrevating the IBD by adding bone. :cat:

rainbow
December 6th, 2009, 01:40 AM
YAY for Duffy doing so well. :highfive:

You are doing an amazing job, growler. :thumbs up :angel:

hazelrunpack
December 6th, 2009, 07:05 PM
Oh, wow! I should have stayed up a bit longer last night! What a great update :highfive:

You really are doing an amazing job!!!! :grouphug:

luckypenny
December 6th, 2009, 10:47 PM
:laughing: nope no one was taking pics, but when I mentioned it to Duffy's homeopath she thought it was pretty funny especially given the rain & her refusing to use their litterbox :D

I don't blame her. Who likes using public toilets :shrug:?

:D

growler~GateKeeper
December 6th, 2009, 10:52 PM
My mum also thought it was pretty funny me being dragged up into & through the large raised planter thingy so Duffy could pee right in the middle by the tree instead of allowing me to walk around it to the other side :laughing:

growler~GateKeeper
February 18th, 2010, 02:48 AM
In late January Duffy had been showing some signs of a UTI just 2 weeks before her scheduled 3 month kidney recheck on 7 Feb :rolleyes: so in for a visit she went, UTI confirmed through urinalysis and a culture & sensitivity test, given her history of kidney disease the lab vet had questioned the possibility of pyelonephritis (kidney infection). Pyelonephritis can happen as a result of, among other causes, a bacterial UTI ascending into the kidneys. Pyelonephritis is a bit tougher to overcome than a UTI but far more so for one with already compromised kidney function. She was given a homeopathic remedy of Phosphorus which started working right away, as the next morning she was no longer peeing little bits every ten minutes :rolleyes: Within a week and a half she was only showing a couple of signs that the UTI was still present.

A few days later during Duffy's 3 month kidney check we ran bloodwork and another urinalysis with a culture if indicated, the inflammation showed as still present so a C & S was done again and the lab vet still had the question of pyelo, with an ultrasound as the only way to diagnose. Once the lab results came in & I spoke to my homeopathic vet, he mentioned again having the ultrasound done and I got his recommendation for the antiboitic he would use of the 5-6 the E. Coli was shown to be sensitive to. The amount of bacteria present was still listed as the same but the WBC in the urine had dropped significantly (from 40-60 down to 3-6) after the remedy.

Since being on Azodyl starting December 2009 Duffy's blood kidney numbers have dropped nicely :D BUN went from 17 in Nov to the current 13 *she's only 0.5 above the high normal for this lab 5-12.5* :thumbs up and her Creatinine (which is the one that is harder to get to drop because it is not affected by diet, stress or dehydration) went from 243.4 in Nov to the current 235 (ref for this lab is 83-181) :highfive:

Her USG number can't be considered accurate at this point because of the urinary inflammation as that affects the reading.

Also urinary inflammation with sepsis a "generalized inflammation" noted in the comments, which is reflected in the ultrasound results below.

I got her for an ultrasound in the day after getting the tests results in, the good news is there is no indication of pyelonephritits :thumbs up, definate inflammation in the urethra (UTI). There is also some localized thickening/inflammation in the ileocolic (beginning of the colon) region which will need to be watched for the very early potential for cancer - but it is not right now. As well her pancreas, liver and gallbladder are showing some signs of mild inflammation. Mild chronic changes in her kidneys, but they look pretty good overall. :) She'll go in for a repeat ultrasound in 2-3 months to check on the status of the various points of inflammation & progression of the kidneys etc.

After the ultrasound they didn't even bother to offer a litterbox as they all know by now Duffy won't use the one in clinic. I took her outside on leash & harness to the lot to go, there was a guy walking across the parking lot & asked "how is kitty today" so I said "she's doing pretty good" I was a bit surprised when Duffy walked towards & right upto him & stretched her nose up to say hi :laughing: :crazy: He then complimented her on her colouring & went on his way, after which she did find an acceptable spot to pee :cat:

Duffy was given a remedy of Thuja which is good for cancer, I have also found out that it is good for urinary inflammation among other things. I also asked for a prescription for Clavamox, the antibiotic that was recommended by my vet for the UTI to ensure the bacteria doesn't rise into her kidneys in the near future. Unfortunately the vet (not my regular) who called in the script to the pharmacy didn't know it comes in pill form - as a vet working with homeopathy as a primary modality antibiotics are not often used, so I got raspberry/orange :eek: :yuck: flavoured liquid Clavamox :yuck: to give Duffy. Duffy being the :angel: she is, is tolerating it remarkably well providing I syringe it directly down her throat, not into her mouth (which causes profuse foaming, drooling & vomiting) & of course I must treat profusely afterwards :D

A note to anyone who has to give antibiotics to their cat, it doesn't matter how hard your cat is to pill - trust me the kid-flavoured liquids will be a far worse experience for them, unless your cat is really weird :laughing:.

There are no contra-indications of using the combination of homeopathic remedies along with antibiotics so she has both modalities working for her right now. Duffy's on Clavamox for 14 days with a repeat urinalysis at day 10 (next Wed) to check if the bacterial infection is cleared up :fingerscr. If not we'll likely repeat a remedy and extend the Clavamox prescription.

Love4himies
February 18th, 2010, 07:02 AM
Wow, so glad to hear that Duffy's numbers are down a bit :thumbs up, way to go mom :thumbs up

Could the slight inflammation in her organs be due to the UTI?


:laughing: Duffy the doggy like kitty :cloud9: :lovestruck: I can't believe she will pee outside her vet office :laughing: and greet strangers :cloud9:

chico2
February 18th, 2010, 07:55 AM
Growler,Duffy must be an extraordinary girl for sure as are you,I wish my cats were only half as good at the vet.
:fingerscrour beautiful Duffy will be ok.

hazelrunpack
February 18th, 2010, 09:11 AM
Other than the anomalous inflammation, those results are just amazing, growler! :eek: Those numbers are absolutely remarkable! :highfive:

Good work, Mom! And good work, Duffy!!! :cat:

growler~GateKeeper
February 18th, 2010, 10:41 PM
Thanks L4H, Chico & Hazel :D

Could the slight inflammation in her organs be due to the UTI?

That's what I'm hoping the reason is and that the Clavamox in combination with the Thuja will stamp out all the inflammation :fingerscr

Chris21711
February 19th, 2010, 09:54 AM
Growler you take such great care of Ms Duffy, the numbers are sounding good :thumbs up

growler~GateKeeper
February 22nd, 2010, 01:42 AM
Thanks Chris, yeah I'm pretty happy about the numbers & the ultrasound report has only mild chronic changes in her kidneys so fairly good there too :)

growler~GateKeeper
February 28th, 2010, 12:36 AM
Duffy went in on Wed 24th (day 10 of ABs) for a urinalysis & culture to check if the Clavamox had cleared the bacterial UTI or if she needed to be on for longer than the prescribed 14 days.

I got a call tonight from the vet, her USG has risen which is great I don't have the actual number but will get it tomorrow and the bacteria has cleared up and nothing grew in the culture :thumbs up.

I asked if she should continue the Clavamox until tomorrow night as that would make it the full 14 days or if she could stop with the last having been this morning (day 13 am). Dr said stopping now was good, just keep watch that it doesn't re-occur and to bring her back in 4 weeks to recheck her urine just to be sure, plus that will test her USG again which was quite low w/the UTI.

Often conventional vets will put a CRF cat on a course of 4-5 weeks of antibiotics to clear up a UTI instead of the usual 2 weeks to ensure there is no relapse infection as the bacteria found in UTI go through a dormant stage often returning as a relapse. I think the Phos remedy Duffy was given should take care of that as it had also started working right away & remedies are long acting correcting the imbalances at the root of the issue.

Duffy has also gained 0.3kg in the week & a half since her ultrasound which is great :thumbs up. She's currently at 5.3kg / 11.68lbs, she is a bit chubby but it's a better weight for her than 5kg, plus it gives her a bit of wiggle room should she lose a bit of weight again, she is also still eating great. It is so hard for most CRF cats to gain any weight at all & they just get thinner & thinner as they eat less & less :(

chico2
February 28th, 2010, 07:16 AM
Growler,although I don't understand most of the test-results,I am really happy for Duffy and you that she's doing better:thumbs up

Love4himies
February 28th, 2010, 08:01 AM
I am so happy for you and Duffy :lovestruck:. She has proven to be quite the fighter and not allowing that horrible poisoned food to overcome her. Of course it helps to have such a great mom and vet :thumbs up

hazelrunpack
February 28th, 2010, 01:49 PM
Great results, growler! I hope the USP continues to go up! :thumbs up She's doing so well! :grouphug:

Chris21711
March 1st, 2010, 09:59 AM
GREAT NEWS Growler :thumbs up

growler~GateKeeper
April 5th, 2010, 09:41 PM
Duffy had a recheck urinalysis on 21 Mar 4 weeks post Clavamox to ensure the bacterial infection has not returned, and as I had suspected starting the 18-19th (less appetite, frequent litterbox visits) the infection has re-occured :( She had lost weight from last month & was 5 kgs. Once we got the confirmation there was bacteria in the urine the lab cultured it, and Duffy was given her usual monthly remedy Nat Mur (as it was time and also) to ease the UTI symptoms. Once the C&S results came in 24 Mar confirming once again it's e.coli Duffy was given a dosing of Phosphorus to counter the infection as it had helped before and I was given a nosode/remedy pair to give in sucessive treatments.

A nosode differing slightly from a regular remedy (prepared from herb/plant/flower etc) as nosodes are originally prepared using cells from which they are fighting but given the amount of dilution there is no risk of infection from the nosode itself. Morgan Bach being the e.coli Nosode given for 2 days, followed by 3 days of Cantharis (remedy for bladder infections etc) definately not showing signs of UTI at the moment :thumbs up. A recheck urinalysis is set for Thurs 8 Apr., 1 week post remedies.

I also got a call from the clinic regarding the ultrasound in Feb as it was stated to repeat in 2-3 months, the ultrasound vet was coming in on 3 Apr & wouldn't be back again this month. My vet really wanted Duffy in to check on the aforementioned "suspicious inflammation" areas, so I booked & in we went on Sat. Again I was able to sit in on the procedure, ask questions, get instant feedback from the ultrasound vet etc. I think all clinics that offer ultrasounds should have the clients in the room.

Duffy has lost more weight due to inappetitance and nausea and is now 4.7 kgs :( where she really should be 5.3 kg a bit chubby but that is a good weight for her frame/size. She is being finger fed/assist fed, tempted with yummy cooked chicken, it's hit & miss as to whether she will eat on her own right now. :( I've picked up a couple of small cans of Wellness Chicken and Turkey went over good when I first opened the can :fingerscr she will at least be inclined to eat that on her own for the most part.

So for the ultrasound results:
The inflammation in the area where the bladder meets the urethra is unchanged, which is good in the aspect it's not cancer right now and I asked the ultrasound vet if that is a common area for cancer she said not in cats, it is very common for dogs to get it there though. She suspects that area is just irritated from the UTI, pee sitting in her bladder, frequency/straining during the 2 UTIs. Her urine is also not concentrated, given the CRF, so there is a higher chance of bacterial growth as opposed to normal highly concentrated urine.

The ileocolic region where the colon meets the illieum/intestines has a distinct tumor and the adjacent lymph node is also inflamed :( The liver, spleen and their adjacent lymph nodes are markedly inflamed :(

Kidneys, pancreas, small intestines, stomach, bladder vary between little chronic change (known CRF, IBD, possible cholangiohepatits with mild periportal lymphadenopathy as per last US) to no change.

Diagnosis is lymphoma, cancer of the lymphatic system. Lymphoma and more specifically gastro-intestinal lymphoma is the most common cancer in cats.

I will be at the vets on Tues to pick up a copy of the ultrasound report and new cancer fighting remedies, Duffy's 2 homeopaths & 2 vets will confer regarding treatment.

Little eating victory today :D took her out to the back courtyard of the apt bldg for a wee leash 'n harness walk as I've done a couple of times now these last couple of weeks (weather permitting) & she willingly ate more of the canned food in her dish without any prompting at all, she does get a bit tired coming up the stairs & on the final stretch in the hallway but that's expected. She looks much better after eating & being out in the fresh air walking about a bit :cloud9:


There is some suggestion of a link between the inflammation associated with IBD and lymphoma http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2007&PID=18053&Category=2980&O=Generic

One well-recognized, but poorly defined, example of inflammation-associated neoplasia is the proposed progression from inflammatory bowel disease (IBD) to alimentary lymphoma. This progression is documented in human patients with coeliac disease, and although reported in both the dog and cat, this appears to be far more of an issue in the feline species. In fact, the distinction between IBD and alimentary lymphoma on histopathological examination of gut biopsies still provides one of the most challenging interpretations for the diagnostic pathologist


A bit off topic but along the Lymphoma lnes ~ I do not smoke but thought I'd add this in as there have also been studies linking passive exposure to cigarette smoke and the development of lymphoma in cats and a change in normal cancer behaviour to affect areas other than the lymphatic system. All the more reason to ensure people are not smoking around pets.

In the context of lymphoma, a recent epidemiological study has suggested an association between passive exposure to cigarette smoke and the development of feline lymphoma--which if confirmed may be an additional example of inflammation-associated neoplasia.6 It is also of note that feline lymphoma may arise in tissues which are often affected by chronic lymphoplasmacytic inflammation (e.g., nasal mucosa, intestine, renal interstitium)

Love4himies
April 6th, 2010, 06:40 AM
Oh no, growler :( :grouphug:. Duffy is such a little fighter so I am sure she will fight this too :goodvibes::goodvibes::goodvibes:

chico2
April 6th, 2010, 07:48 AM
Growler,that was a lot to read and try to understand,but very thorough..
I know there is really no"safe"cancer in cats:(but if anyone will have a chance to recover it's little Duffy and I :fingerscr:goodvibes:for you and Duffy:grouphug:

diandpat
April 6th, 2010, 08:02 AM
Growler, :goodvibes::goodvibes::goodvibes: for you and Duffy. If there is a way to get through this, you and your always thorough research/knowledge will find the way.

All the best :fingerscr

14+kitties
April 6th, 2010, 08:16 AM
Sending lots of :goodvibes::goodvibes::fingerscr:fingerscr for Duffy and lots of :grouphug::grouphug::grouphug: for you. :pray:

hazelrunpack
April 6th, 2010, 09:08 AM
More :goodvibes: and :grouphug:s coming your way for both of you, growler!

mikischo
April 6th, 2010, 10:28 AM
Sending more :goodvibes::goodvibes::goodvibes: for Duffy and :grouphug: for you, Growler.

rainbow
April 6th, 2010, 01:51 PM
Duffy has the best mommy in the world. :grouphug:

Lots of :fingerscr :goodvibes: :fingerscr :goodvibes: coming from the rainbow house as well. :grouphug:

krdahmer
April 6th, 2010, 02:06 PM
Duffy has the best mommy in the world. :grouphug:



I have to agree there! :thumbs up

You've got me and all the kitties sending you and Duffy all our :pray: :goodvibes: :fingerscr too.

:2huggers:

TeriM
April 6th, 2010, 04:12 PM
Another vote here for best mommy :thumbs up.

I wish you all the best healing vibes and loving thoughts to help you and Duffy.

:grouphug: :goodvibes: :goodvibes: :grouphug:.

growler~GateKeeper
April 6th, 2010, 11:45 PM
Thank you everyone for your good wishes :) Duffy & I do appreciate them.

So instead of going in today I spoke to the homeopath on the phone & we are repeating a remedy I've used before for nausea/vomiting etc she'll get a divided dose of Nux Vomica today/tomorrow as that did have positive effects over the weekend and in the past for her, it's also very complimentary to the cancer remedies we will use.

Tomorrow will be another phone call to the clinic to give an update and then going in on Thurs for the cysto UA as previously mentioned to check for bacterial clearance. At that time I can pick up the cancer remedies & ultrasound report. The tumor doesn't appear to be a fast growing one so we have a couple of days to try to boost her appetite first.

A little tour of the back/courtyard again tonight proved to wake up her appetite a bit, she still isn't eating as much as I would like but she is doing so on her own :thumbs up

chico2
April 7th, 2010, 08:31 AM
Growler,I would think Duffy,unlike my guys,is getting used to vets and poking,so not too stressful for her,although she's been through a lot.
She's kind of a mascot for overcoming problems for us here,so I :pray:she'll be able to fight this hurdle too:fingerscr

growler~GateKeeper
April 8th, 2010, 08:46 PM
Thanks Chico, Duffy is very used to being poked as she gets fluids nightly at home, as for the vets ~ it's a homeopathic clinic so the environment & atmosphere is totally different from that of a conventional clinic.

Duffy's also at a point in her life where very little phases her, for example I brought her in today for a cysto to check on the uti (unfortunately she peed in her carrier when we were about 10 mins away, she just couldn't hold it any longer :shrug:), I had Duffy leashed & harnessed out of her carrier to clean up the mess & there was a shepherd mix in the clinic who was continually barking at her, he couldn't figure out why this cat was paying absolutely no attention to him, she wasn't even looking at him :laughing: and the lady's 3-4 year old son came over & very gently pet the top of her head, it was quite cute as he was telling the dog not to bark at the kitty. :D

A few minutes after they left, a lady came in with her very calm Dogue de Bordeux they had to walk right past Duffy in order to come in the door as she was sitting infront of it - didn't phase her in the least :laughing: :cat:

Of course Duffy did grow up with 2 large dogs, then later in adulthood had another large dog buddy but it has been 6 years now that she's had any consistant contact with a dog.

All in all I did pick up her remedies for the lymphoma treatment which we started today and the ultrasound report, she'll be back in on Sat for a try again at the cysto.

hazelrunpack
April 8th, 2010, 10:15 PM
Bummer about the timing for the cysto! She'll probably enjoy being out and about again on Saturday, though, even if it's an extra trip. :D

When will you start the new treatments?

growler~GateKeeper
April 8th, 2010, 10:37 PM
She was awake for the whole bus ride out there today so I guess that made her more aware of the need to pee. I'll get a truck ride on Sat & we'll be in an hour earlier than today so that'll help.

Started them already :cat: she'll be alternating between 2 remedies one per week.

On the way home I took a bus from the clinic to the bus loop to wait for the next bus, at the loop Duffy was getting a little antsy as she'd been couped up for a bit - so I took her out & she saunters around part of the bus loop like she owns the place :cat: bunch of people walking by were smiling at a leash/harnessed cat just wandering about not a care in the world :pawprint: :laughing: No unfortuately no pics I only had 5 mins before the bus came :D

hazelrunpack
April 8th, 2010, 10:56 PM
Bummer about the pics. :frustrated: You gotta do better next time, k? :p

How did she eat after her big trip into the excitement of the bus loop? :D

growler~GateKeeper
April 8th, 2010, 11:11 PM
When we got home she had a bath to fully clean off any remaining pee, then she got fed in the sunshine, she did fairly well at first for licking off my finger after I smooshed some onto her mouth, after a bit she would just lick it off her mouth, then I had to resort to force feeding her the rest to make sure she gets enough food for the day.

Left her alone for a few hours to snooze & she came looking for dinner & her supplements. She acted like she was going to eat on her own, but still required finger feeding at first, same as earlier in the day ending with a bit of force feeding. Though she isn't pleased being force fed she does put up with it without fuss/stress & the more she eats the better she feels.

The ultrasound report showed mild hepatic lipidosis as she hadn't been eating sufficiently that week - which is where she lost the weight, it's imperative that she eats. Now that I'm on holidays I can ensure she eating in the middle of the day instead of sleeping right through as she had evidently been doing when I was at work.

hazelrunpack
April 8th, 2010, 11:18 PM
How long does it take to reverse the lipidosis? I'm assuming that as it subsides her appetite may improve? :goodvibes:

She's such a good girl, letting her mom force feed her :angel:

growler~GateKeeper
April 8th, 2010, 11:40 PM
The lipidosis will start to subside once she gets her enough food in her to stop relying on the liver for nutrients, that will happen faster once her appetite is back a bit, and her appetite will come back when the lipidosis has started to subside :rolleyes: There's no real set timeline :shrug: it all depends on how well her body responds to the frequent caloric intake

Once she gets consistant meals in her she feels better, so the next meal time she's feeling a bit hungry that's what I want & once she starts gaining a bit more weight back the lipidosis will disappear

It's lucky it's only mild at this point & I can turn it around before it gets to a point that would require more drastic approaches.

hazelrunpack
April 8th, 2010, 11:44 PM
Well then, Ms Duffy, you keep being an :angel: and taking your meals for the day!

For once your vacation was well-timed by your boss. :thumbs up There are :angel:s looking out for you and Duffy!

growler~GateKeeper
April 9th, 2010, 12:09 AM
It certainly is well timed right now.

The homeopath said today that the cancer remedies should help with her nausea/lack of appetite too :fingerscr The first remedy started today has listed that it also helps w/"gradual loss of weight from impaired nutrition" :thumbs up

chico2
April 9th, 2010, 07:44 AM
Wow Duffy,what a wonderful very special kitty you are:cloud9:

diandpat
April 9th, 2010, 07:57 AM
:goodvibes::goodvibes::goodvibes:it is lucky you are home for a bit to get her back on track. Hope the cancer meds kick in quickly and wish you both all the best in the coming months!!! :goodvibes:

growler~GateKeeper
April 9th, 2010, 09:23 PM
Thanks Chico & diandpat :)

growler~GateKeeper
April 26th, 2010, 02:51 AM
As an update to this thread on Duffy's fight with CRF & Lymphoma - Duffy was back in on the 10th April for a urine sample which did show the UTI had returned. The vet, homeopath and I decided to go with antibiotics again to fight the UTI and help with the sepsis (overall infection) she was fighting due to the lymphoma. The vet was still concerned about the chance of the UTI progressing upwards from the bladder into the kidneys as pyelonephritis, this time we went with ClavaSeptin the vet formula of Clavamox in pill form.

Duffy had a good couple of weeks on a combination of antibiotics and homeopathic remedies, still being force fed but otherwise doing well, until this past week where she got weaker and the tumor was visibly larger, as it metastasized in her colon, into her spleen and through her lymph nodes.

I brought Duffy in to the clinic on the 21st April to check her blood electrolyte levels as she had become much weaker especially in her back legs, her leg sliding out from under her while walking across the floor & on carpets when sitting and was starting to walk with a very very slight plantigrade posture (where the animal walks on the entire hocks not just the feet). Plantigrade posture is often seen as a symptom of muscle weakness, potassium deficiency, diabetes among other causes. I decided to run a full blood panel not just electrolytes, with the results due the following day. Her weight showed an increase to 4.8kg from 4.6kg a week & a half earlier, however it was evident this was due to the increase in tumor size, not from eating.

That afternoon & night Duffy was given pain remedies to cope with the pain/discomfort she was experiencing especially when being picked up or moved, she did perk up a bit as the remedy worked though she was still very tired and I was seeing signs that she was ready to go.

I made the decision early in the morning of 22nd April that it was time to let her go, she was ready & I accepted that it was what she needed. I called the homeopath on her cell phone a couple of hours before the clinic opened for advice on dosing for pain at that point as Duffy seemed a bit worse, and told her that it was time. I got a call from the clinic as soon as they opened and we discussed my decision and how I wanted things and a time that was suitable. Duffy had a nice afternoon snoozing in the sunshine and was peacefully let go at home. :cry: :rip: Duffy ~ 9 May 1991 - 22 April 2010 (http://www.pets.ca/forum/showthread.php?t=69759)



**I would like to point out that CRF and Lymphoma are not directed related, so if your cat has CRF they are not necessarily/automatically going to get cancer.**

Anyone who has questions or experiences they wish to share on Chronic Renal Failure in cats please do post them, I would like this thread to continue to help others who are dealing with this condition.

Love4himies
April 26th, 2010, 06:48 AM
Growler, you have been in my thoughts since I heard about sweet Duffy. She couldn't have a better mom and without you, her life would have been years shorter. :cry: :grouphug:

:candle: Duffy :candle:

MissPurryJess
April 28th, 2010, 10:50 PM
I just saw this - I know I'm not a regular on here, but you've been so sweet and helpful to me in the past, and I always remembered Duffy. I'm so so sorry to hear about Duffy. :cry: My babies and I are sending you our love.

dogmelissa
May 31st, 2010, 09:09 PM
Canned:

Kidney cats do not require low protein, but high quality protein low phos food. Removing too much protein from the cats diet makes it less palatable therefore they often refuse to eat, plus cats are carnivores they need meat protein to keep their bodies functions to the fullest.

Fish should be avoided when possible especially tuna, but fed on occasion 1-2 per month is still okay. Cats often become addicted to fish and will eat nothing else and tuna especially creates an imbalance in vit e levels.


When looking at phos levels you want to convert to dry matter (meaning whats left if you remove all water) and find something as close to or lower than 1% phos dry matter.



One of my kitties was just diagnosed with renal failure last week. She also had a UTI, potential kidney infection, so I am hesitant to assume this is chronic but I'm also operating under the assumption that it is due to her age. Today she went to the vet for antibiotics (they did a culture to find out what would kill her infection,), subQ fluids and for me to get advice on hat to fee her. The vet *said* igh protein food but then handed me reduced protein food, so I'm a bit confused there. So that's my first question - her current/previous food was Horizon Legacy (dry) with 40% protein (good quality). Is this too high/low?
I understand about phosphorus and I have emailed the manufacturer to ask about it - no reply yet. However when I was out today buying food, before I realized the vet had said one thing but given me the opposite, I picked up some Go! Natural food with higher protein - I remembered about phosphorus and I am happy to report that the phosphorus levels are listed on the Go! Natural's bags. I got the fish formula - 50% protein & I think 1.2% phosphorus; its not on the website and I can't get to it right now. Assuming this is an 'as-fed' number, it will work out to less than 1% by dry matter, so is this good? I know you say fish is bad but I don't really understand why, and when we're talking about commercial food, how can that create any imbalances? At this point, I just need her to eat and know she likes fish food so that's what I got. Continuing with my thought above, is the protein level critical or is it just phosphorus? Is it better to have higher protein if the phosphorus is low? Or does it matter? I also got some Innova Evo - I don't know the phosphorus level but it is high protein (fish) too.
I also know that wet food is best, and this is where things get messy. All 3 of my girls eat from the same bowl, inside a modified dog kennel, to keep the boys out. There is no way that I can give one of them different food an I'm stubborn about it being dry food. Sierra (the crf kitty) gets 'supper' of soaked kibble with canned added so its not a problem to increase her water intake that way. So, is it ok for me to do this, in terms of water intake for her? I just can't do canned food for all of them and there is no way to only give it to her.

Any help/suggestions and/or answers to my questions is much appreciated.
Thanks in advance,
Melissa

sugarcatmom
May 31st, 2010, 10:37 PM
I'll leave most of your questions for growler to answer, but wanted to mention a couple things.

I know you say fish is bad but I don't really understand why,

Here is some info on that: http://www.littlebigcat.com/index.php?action=library&act=show&item=whyfishisdangerousforcats

I also got some Innova Evo - I don't know the phosphorus level but it is high protein (fish) too.

Stay away from the Evo. It's extremely high in phosphorus (396 mg per 100 kcal - you want to stay below 200-240 mg/100kcal, which is roughly 1% DM). http://binkyspage.tripod.com/dryfood.html The problem is, most of the high quality, grain-free kibbles are high in phosphorus. It's the nature of the beast.

There is no way that I can give one of them different food an I'm stubborn about it being dry food.

Remind me why that is again.

Sierra (the crf kitty) gets 'supper' of soaked kibble with canned added so its not a problem to increase her water intake that way. So, is it ok for me to do this, in terms of water intake for her?

It's not ok if this mixture sits out for more than 20 mins. There's a ton of bacteria in kibble that multiplies like crazy in a moist environment, as well as potential for mold toxins to become an issue.

growler~GateKeeper
June 1st, 2010, 01:33 AM
One of my kitties was just diagnosed with renal failure last week. She also had a UTI, potential kidney infection, so I am hesitant to assume this is chronic but I'm also operating under the assumption that it is due to her age. Today she went to the vet for antibiotics (they did a culture to find out what would kill her infection,), subQ fluids and for me to get advice on hat to fee her.

Do you have a copy of the BUN, creatinine, phosphorus, calcuim, & USG plus anything else out of normal range from her test results?

Sierra will need to have her urine cultured again a few days prior to finishing the antibiotics and again 2 weeks after finishing. UTI can be hard to erradicate especially in CRF kitties. It may take a longer course of treatment than the standard 2 weeks, sometimes between 6-8 weeks.

A ultrasound is pretty much the only way to definately rule out a kidney infection, and if there is already renal failure noted I would recommend having one done. The UTI can travel fairly quickly up from the bladder into the kidneys & from there it is much harder to erradicate.

An ultrasound will also give your vet a clear "map" of the kidneys size & condition that will be good to refer to with any subsequent ultrasounds.

I am hesitant to assume this is chronic but I'm also operating under the assumption that it is due to her age.

Kidney failure is either acute or chronic.
- Acute renal failure (ARF) happens suddenly, severely with the cat crashing in need of several days of IV hospitalization & is most often due to antifreeze poisoning etc. Usually it is seen in young pets & if treated early & aggressively the pet may make a near-complete recovery with a higher incident of kidney related issues later in life.
- Chronic renal failure (CRF) is a gradual progressive deterioration of the kidneys that is terminal & happens with about 10% of cats over the age of 10. Most cats develop CRF as a result of aging, though some young cats may have a genetic predisposition or as a result of severe infection.

If the reason for the kidney failure is age it's chronic.

The vet *said* igh protein food but then handed me reduced protein food, so I'm a bit confused there. So that's my first question - her current/previous food was Horizon Legacy (dry) with 40% protein (good quality). Is this too high/low? I understand about phosphorus and I have emailed the manufacturer to ask about it - no reply yet.

I'm more concerned with the phosphorus content of the food, please post the value when they respond.

Protein should be of high quality actual muscle meat (chicken, turkey etc not chicken by product etc) so Horizon is good in that aspect & the protein level looks alright but the % phos still needs to be considered.

It is not recommended to restrict protein below 400 kcal http://www.vin.com/VINDBPub/SearchPB/Proceedings/PR05000/PR00124.htm

However when I was out today buying food, before I realized the vet had said one thing but given me the opposite, I picked up some Go! Natural food with higher protein - I remembered about phosphorus and I am happy to report that the phosphorus levels are listed on the Go! Natural's bags. I got the fish formula - 50% protein & I think 1.2% phosphorus; its not on the website and I can't get to it right now. Assuming this is an 'as-fed' number, it will work out to less than 1% by dry matter, so is this good?

If 1.2% is as fed phos it works out to 1.3% dry matter that is too high.

100-moisture = dry matter; phos/dry matter * 100 = dry matter phosphorus

Go! Natural Trout Dry:
100-10 moisture (per website) = 90 dry matter; 1.2phos (per your bag)/90 = 0.013*100 = 1.33% dry matter phosphorus - too high


I know you say fish is bad but I don't really understand why, and when we're talking about commercial food, how can that create any imbalances? At this point, I just need her to eat and know she likes fish food so that's what I got.

As covered by scm :thumbs up

You may get to a point that you need to change foods to find one w/less phos than fish based, it is better to try to switch her to a non-fish food now rather than when she isn't feeling well. But yes she needs to eat in good healthy quantity, at some point it may come down to feeding whatever she will eat regardless of phos/protein level, just so she does.

Continuing with my thought above, is the protein level critical or is it just phosphorus? Is it better to have higher protein if the phosphorus is low? Or does it matter? I also got some Innova Evo - I don't know the phosphorus level but it is high protein (fish) too.

Phosphorus level is critical, protein less so as long as it is not restricted too low and it is quality protein.

Cat with protein levels restricted too far may start losing muscle mass & become weak, plus alot of the low protein foods aren't flavourful enough to be appetizing to many cats. If you offer a renal diet low in protein & phosphorus but the cat refuses to eat it - it does no good to the cat that won't eat it.

Sierra (the crf kitty) gets 'supper' of soaked kibble with canned added so its not a problem to increase her water intake that way. So, is it ok for me to do this, in terms of water intake for her? I just can't do canned food for all of them and there is no way to only give it to her.

If you are already giving her canned in her supper, why not increase the canned amount add some extra water & remove the dry from that meal? That way she is atleast getting 1 meal of just canned.

The problem with adding water or canned to dry is it needs to be consumed in a short amount of time, not snacked upon for more than 20-30 mins as scm mentions.

dogmelissa
June 14th, 2010, 01:07 PM
Here is some info on that: http://www.littlebigcat.com/index.php?action=library&act=show&item=whyfishisdangerousforcats

Thank you for that info. I still think it's a bit of a 'shock' opinion - especially the stuff about farmed salmon being fed colouring. And since none of my cats eat straight tuna (except as a very very rare treat), and especially with Sierra being sick, her being 'addicted' to food is a good thing and I'd take it if I could get it.


Stay away from the Evo. It's extremely high in phosphorus (396 mg per 100 kcal - you want to stay below 200-240 mg/100kcal, which is roughly 1% DM). http://binkyspage.tripod.com/dryfood.html The problem is, most of the high quality, grain-free kibbles are high in phosphorus. It's the nature of the beast.

Good to know. I haven't opened the Evo, so I can take it back. She has basically been refusing all dry food for the most part so even the Go! Natural isn't going over that well. However, I've opened that one (obviously) so I have to finish it. I could give it to the others, I suppose. Not sure yet.


Remind me why that is again.

To make a long story short, one of the girls refuses to eat canned food, all of them are nibblers, so the food sits out and canned food dries up (then they don't eat it at all and it gets thrown out), and I have a really hard time justifying spending $1.75 per tuna-sized-can of cat food; my tap water is much cheaper than the water in the canned cat food. Plus it's impossible to put canned food in the auto-feeder which is a requirement for a happy life with Taz.


It's not ok if this mixture sits out for more than 20 mins. There's a ton of bacteria in kibble that multiplies like crazy in a moist environment, as well as potential for mold toxins to become an issue.

When Sierra was feeling well, she would finish her soaked kibble meal within 2-3 minutes of it being made so it wasn't an issue. Now is a whole different story and I'm not even offering her soaked kibble right now.

Will reply to Growler's post right away.
Melissa

dogmelissa
June 14th, 2010, 01:23 PM
Do you have a copy of the BUN, creatinine, phosphorus, calcuim, & USG plus anything else out of normal range from her test results?

Sierra will need to have her urine cultured again a few days prior to finishing the antibiotics and again 2 weeks after finishing. UTI can be hard to erradicate especially in CRF kitties. It may take a longer course of treatment than the standard 2 weeks, sometimes between 6-8 weeks.

A ultrasound is pretty much the only way to definately rule out a kidney infection, and if there is already renal failure noted I would recommend having one done. The UTI can travel fairly quickly up from the bladder into the kidneys & from there it is much harder to erradicate.

An ultrasound will also give your vet a clear "map" of the kidneys size & condition that will be good to refer to with any subsequent ultrasounds.

I don't have a copy of her numbers, but I could ask for them today as we are going back to the vet. The vet called to check on her and I asked her if I need to get a repeat urinalysis done or something and she referred to herself as 'bad vet!' and then told me that she will do a 2nd injection of the antibiotics 2 weeks from the first and then a repeat culture one week after that. She didn't mention an ultrasound; I'm not going to ask because I don't want to offer them any more reasons to take my money but if there's still signs of infection next week then I'll consider it.



Kidney failure is either acute or chronic.
- Acute renal failure (ARF) happens suddenly, severely with the cat crashing in need of several days of IV hospitalization & is most often due to antifreeze poisoning etc. Usually it is seen in young pets & if treated early & aggressively the pet may make a near-complete recovery with a higher incident of kidney related issues later in life.
- Chronic renal failure (CRF) is a gradual progressive deterioration of the kidneys that is terminal & happens with about 10% of cats over the age of 10. Most cats develop CRF as a result of aging, though some young cats may have a genetic predisposition or as a result of severe infection.

If the reason for the kidney failure is age it's chronic.

Thank you for that explanation that makes a lot of sense. I'm not sure if the *reason* for the failure is age, but it doesn't really matter the cause, we're definitely looking at CRF. :(

I'm more concerned with the phosphorus content of the food, please post the value when they respond.

Protein should be of high quality actual muscle meat (chicken, turkey etc not chicken by product etc) so Horizon is good in that aspect & the protein level looks alright but the % phos still needs to be considered

It is not recommended to restrict protein below 400 kcal http://www.vin.com/VINDBPub/SearchPB/Proceedings/PR05000/PR00124.htm.

I haven't heard from them, they have a local (to me) phone number so I'm going to try to find time to call this week.

If 1.2% is as fed phos it works out to 1.3% dry matter that is too high.

100-moisture = dry matter; phos/dry matter * 100 = dry matter phosphorus

Go! Natural Trout Dry:
100-10 moisture (per website) = 90 dry matter; 1.2phos (per your bag)/90 = 0.013*100 = 1.33% dry matter phosphorus - too high

At this point I'm not going to stress about 0.3% too much of anything. If we were looking at 1% or 5% then yeah that's a concern but right now I'm just concentrating on getting her to eat, and she's really not that interested in doing too much of that regardless of what I put in front of her. :(


You may get to a point that you need to change foods to find one w/less phos than fish based, it is better to try to switch her to a non-fish food now rather than when she isn't feeling well. But yes she needs to eat in good healthy quantity, at some point it may come down to feeding whatever she will eat regardless of phos/protein level, just so she does.

Phosphorus level is critical, protein less so as long as it is not restricted too low and it is quality protein.

Cat with protein levels restricted too far may start losing muscle mass & become weak, plus alot of the low protein foods aren't flavourful enough to be appetizing to many cats. If you offer a renal diet low in protein & phosphorus but the cat refuses to eat it - it does no good to the cat that won't eat it.

We're already dealing with her not feeling well plus having lost muscle mass. She's incredibly thin, like to the point where I can feel every vertebra in her spine and she can barely jump up on the couch on her own; she used to run laps through the house and bounce all the way to the top of the cat tree (7' above the floor). She's not feeling well, and incredibly skinny. Now is not the time to be messing with her food, IMO. The good news is that I bought a few varieties of canned food and she was fairly interested in the Wellness Chicken & Salmon variety - she ate more of that than any of the others I've offered, but still hardly any. She weighed 2.3kg when she got her antibiotic and the most food she's eaten in a day was less than half a can and a few kibbles. Smart girl though has fully refused to even consider any of the 'prescription' vet foods. :)

If you are already giving her canned in her supper, why not increase the canned amount add some extra water & remove the dry from that meal? That way she is atleast getting 1 meal of just canned.

The problem with adding water or canned to dry is it needs to be consumed in a short amount of time, not snacked upon for more than 20-30 mins as scm mentions.

Again, right now the concern is just getting her to eat. Up until she got really sick, her 'supper' was really just a snack and did have more canned & water than kibble anyways. And as I mentioned in response to scm, she would eat it all within a few minutes so the time factor wasn't an issue. Now just getting her to eat anything is a small miracle.

And on that note, since she refused her breakfast this morning, I'm going to go offer it to her again. She goes to the vet for a re-injection of antibiotics at 3:20pm today and I think she's also going to come home with instructions for me to give her sub-Q fluids which I'm not excited about. I know how to do it because I worked at the local Humane Society for 3 years, but I've never done it to a cat in my care and I'm not looking forward to it - but I know it's probably necessary.

Thanks for everything so far.
Melissa

growler~GateKeeper
June 14th, 2010, 11:21 PM
dogmelissa Not every UTI will turn into a kidney infection, but there is a higher potential for it to happen in a CRF kitty. :fingerscr Sierra's doesn't progress that far.

I would say at this point give her whatever she will eat, if she's feeling that poorly :( give her anything to get her tempted to eat. You could try a little parmesan cheese sprinkled on her food, or some treats like PureBites Freeze Dried Treats (http://www.purebites.com/products.html), or a tiny dab of melted butter, a teensy pinch of catnip, shredded bits of deli meat etc just enough of something to peak her interest.

You can always discuss Phosphorus binders with the vet if Sierra has high blood phosphorus levels & will not eat something with a lower phos range.

Force feeding might also be an avenue that might need to be looked at.

2.3kg? :( man that's tiny she sure doesn't have any room to loose. Can you put boxes/stools infront of the couch/bed/fave places to give her "steps" to get up to where she is comfortable? For Duffy I had a sturdy cardboard box & a rubbermaid tote beside the bed so she didn't have to jump up, just step up & then up to the bed.

Are you able to place a phone book or such of a similar thickness under the food/water dishes? I found that helped a lot in reducing nausea, also makes it easier on the neck reaching the bowl.

Sierrra is likely also feeling pretty low because of the infection :goodvibes: for kicking that asap

It sounds like fluids would be very beneficial to start soon, the increased hydration makes them feel better, plus it flushes out more toxins from the body which will make them feel better as well. Giving sub q fluids to your own cat is honestly not as bad as it seems at first. Some good tips on it here: http://www.weirdstuffwemake.com/weird/stuff/pets/cats/sophia/catjuice.html

:goodvibes: :grouphug:

sugarcatmom
June 15th, 2010, 05:18 PM
I still think it's a bit of a 'shock' opinion - especially the stuff about farmed salmon being fed colouring.

Might want to research that a bit more before dismissing it:
http://www.nytimes.com/2003/05/28/dining/issues-of-purity-and-pollution-leave-farmed-salmon-looking-less-rosy.html
http://www.seattlepi.com/opinion/123199_dye23.html
http://www.cbc.ca/news/story/2003/05/01/salmoncolouring_030501.html
http://www.thefreelibrary.com/Salmon+dye+can+damage+eyesight+of+consumers.-a087749668

.....consumers learned about another difference, when the class-action lawsuit in Washington called attention to the little-known fact that farmed salmon are not naturally salmon pink or red, and that if they were not fed artificial colors they would range from gray or khaki to pale yellow or pale pink. Wild salmon turn pink from the krill and shrimp they eat. (Farmed salmon eat a fishmeal diet.) The lawsuit accused three supermarket chains of violating Food and Drug Administration regulations by not telling shoppers that farmed salmon were artificially colored, thus leading them to think they were buying wild fish. ....

Hoffmann-La Roche, one company that makes the dyes, canthaxanthin and the more expensive astaxanthin, from petrochemicals, offers salmon farmers the SalmoFan, a sort of paint wheel with assorted shades of pink, to help them create the color they think their customers want. ...

OtisIsMyCat
June 22nd, 2010, 12:30 PM
I am now joining this thread as the owner of a newly diagnosed CRF cat, one week ago today. My 11 year old Marshall.

I had this long, thoughtful post typed out but for some reason when I hit submit, it redirected me to the log in page again and I lost everything.

Anyway I will ask this one important question I did have in my reply and will type out the rest of my post later on today.

One quick question re: food.

I don't like how the Hill's K/D diet has fillers like glucose, corn gluten meal, corn syrup, pork by-products, etc.

I've been trying to find a good quality cat food that complements a cat in renal failure. I was previously feeding both my cats Evo Chickey & Turkey wet but see that it has too high of a phosphorus level for a cat in renal failure.

So... I have a quick question... how is 0.2% for a phosphorus level? Unfortunately the K/D wet is by far the lowest on all the lists but I don't like their overall ingredients. So I'm trying to find a safe alternative.

Also, is it true that it's actually the phosphorus that is damaging to CRF cats? And, not necessarily the protein itself?

THANKS!!

sugarcatmom
June 24th, 2010, 01:31 PM
I am now joining this thread as the owner of a newly diagnosed CRF cat, one week ago today. My 11 year old Marshall.

Sorry to hear about Marshall's diagnosis. Do you have a copy of his lab results (urine specific gravity, creatinine, BUN, phosphorus, calcium, etc?)

So... I have a quick question... how is 0.2% for a phosphorus level?

Which food is it that has 0.20%? Are you referring to the Wysong Chicken Au Jus from this list?: http://webpages.charter.net/katkarma/canned.htm I think there's some question about the accuracy of that value, but the bigger issue is that the Wysong Au Jus foods aren't a complete diet. They need to be supplemented with extra nutrients if you plan to feed it regularly.

The general goal when feeding kidney cats is to look for foods with 1% phosphorus or less (or roughly less than 200mg/100Kcal, as indicated on this chart: http://binkyspage.tripod.com/CanFoodNew.html) Keep in mind that phosphorus is an essential nutrient and cats, even those with compromised kidneys, still need SOME. Just not too much.

Unfortunately the K/D wet is by far the lowest on all the lists but I don't like their overall ingredients. So I'm trying to find a safe alternative.

There is no good reason to feed K/D, and many reasons not to. Good to hear that you're looking form something better :thumbs up.

Also, is it true that it's actually the phosphorus that is damaging to CRF cats? And, not necessarily the protein itself?

Cats NEED protein. If they don't get enough, they start to use their own muscles for a protein source, which is one reason you see so much muscle wasting in kidney cats. Unfortunately there was some lame study done on rats around 50 yrs ago where rats with renal failure did better on a reduced protein diet, and it's been held up as the standard to follow for dogs and cats ever since. HELLO???? Cats are not rats. This myth needs to be put to rest. But Hill's and their cohorts make too much money selling their "prescription" diets, and so it goes......

Depending on what Marshall's lab results are, you would probably be fine with feeding a good quality wet food like Wellness Chicken or Turkey, or Innova Evo 95% Venison or Beef.

OtisIsMyCat
June 24th, 2010, 07:20 PM
Thanks sugarcatmom!

Here's what I know of Marshall's initial diagnosis. I only obtained his BUN and creatinine. That first 48 hours were such a blur I never thought to get anymore results further than those two.

Upon diagnosis his BUN was at 70, creatinine was at 1500. After 24 hours of IV those figures went down to 55 and 1100 respectively. After 48 hours of IV they were down to 33 and 690.

It was a shock for me because I thought I was bringing Marshall in for a mouth infection as his breath smelled like a rotting carcass and he had strings of bloody drool dangling off his lips. Those symptoms came on in about 24 hours. I guess I figured bad breath + blood = Gingivitis? Broken tooth and infection? He hadn't lost any weight, still purred, cuddled, talked to me.

Turns out nearly his entire mouth was in ulceration as a result of the high levels of toxins that had built up in his body from his deteriorating kidneys.

Even the vet was surprised because she told me that when a cat comes in with levels that high (I believe she said his kidney function was 5-7%) they are emaciated, in muscular atrophy, and half-dead. But then there was Marshall, prancing round and demanding attention and cuddles.

He's strong, my boy. ha.

The cat food I'm referring to is "Felidae" Chicken & Rice. The exact product is HERE (http://www.canidae.com/cats/chicken_and_rice/canned.html). If you scroll a bit you'll see the guaranteed analysis as well.

I only bought two cans of Felidae but haven't opened them yet because I have several K/D wets left. I also didn't want to feed him anything different until those with more knowledge on the subject can advise me. I don't think I can approach my vet because I highly doubt she'd endorse this brand as opposed to K/D.

Another option I found was HALO (http://shop.halopets.com/Canned-Cat-Food) brand - the one supported by Ellen Degeneres. Their protein levels for wet can be as low as 4.2% depending on the flavour. There is no phosphorus level indicated though and I have emailed them but no response, yet.

It's been exactly a week since I brought Marsh home from his 48 hour stay at the vet. He appears to be doing incredibly well but I hesitate because that's how he seemed last time! He has no traces of bad breath though, has a fantastic appetite and drinking water all the time on his own (I've got fresh bowls in all his hang-outs around my apt.) + the sub-q therapy I've been doing every 2nd day.

Next Wed I bring him in for his follow-up checkup and blood analysis.

Thanks again for getting back to me! This has been quite the ordeal, in fact, I think I'm still recovering from it!

sugarcatmom
June 24th, 2010, 09:50 PM
Upon diagnosis his BUN was at 70, creatinine was at 1500. After 24 hours of IV those figures went down to 55 and 1100 respectively. After 48 hours of IV they were down to 33 and 690.

Oh wow. Glad that Marshall pulled through, and my fingers are crossed that he continues to recover. Did he have any other symptoms prior to the bad breath, like increased drinking and urination? He's pretty young to be in such an advanced stage of renal failure from natural causes. Is there any possibility that he ingested something toxic?


Turns out nearly his entire mouth was in ulceration as a result of the high levels of toxins that had built up in his body from his deteriorating kidneys.

If there were no prior CRF symptoms, I really have to wonder whether the mouth ulcers were actually caused by something he ate, and his current state of renal failure is a symptom of that, not the other way around.

Even the vet was surprised because she told me that when a cat comes in with levels that high (I believe she said his kidney function was 5-7%) they are emaciated, in muscular atrophy, and half-dead.

Exactly! More reason to think this isn't a case of CRF, but ARF (Acute Renal Failure - brought on suddenly by something external). Did the vet bring up this possibility at all?

The cat food I'm referring to is "Felidae" Chicken & Rice. The exact product is HERE (http://www.canidae.com/cats/chicken_and_rice/canned.html). If you scroll a bit you'll see the guaranteed analysis as well.

Ah okay. You're looking at the Guaranteed Analysis, which isn't too terribly useful. What you want is Dry Matter, and you can find that if you click the "Detailed Nutrient Analysis" just below it. It takes the "As Fed" values, which are more accurate than the Guaranteed Analysis, and removes the moisture content, making it easier to compare to other foods. So the true phosphorus content of the Felidae is 1.16%. Not too bad. Since Marshall already likes regular Innova EVO (the one that's too high in phosphorus - Turkey and Chicken), perhaps he'd be okay with the Innova 95% Venison, which is even lower than the Felidae. Do you think he'd go for a raw diet? Nature's Variety makes pre-made frozen raw that is also low in phosphorus ("Chicken and Turkey" and "Beef" flavours in particular).

Phosphorus binders are another option to consider, particularly if Marshall's blood phosphorus is above normal, or even at the high end of normal.

the sub-q therapy I've been doing every 2nd day.

What's the volume of fluids that he gets per session? You might want to consider giving smaller amounts more frequently to provide more even hydration.

This has been quite the ordeal, in fact, I think I'm still recovering from it!

No doubt! Scary stuff indeed. You're doing great though :thumbs up. Give Marshall some good chin rubs and bum pats for me and tell him to keep prancing and cuddling.

Here are a couple more links with good info that you might be interested in:

http://www.felineoutreach.org/Education/Kidney.html
http://www.holisticat.com/crf/Diet-what-to-feed-and-protein-issues.html

OtisIsMyCat
June 24th, 2010, 10:24 PM
RE: Bad Breath. He's had bad breath for the last several years. And, just before I moved to Vancouver from Ottawa I took Marshall and Otis to the vet to make sure they were healthy for travel in the plane. Turns out Marshall needed to get three teeth pulled and he would have been 8 then. So I guess I always attributed his bad breath as something more to do with his specific physiological make-up. But, now I'm wondering if it was just gradual kidney disease? Although the vet in Ottawa did a blood analysis before putting him under for his teeth extraction, and those results have since been faxed to the vet here and nothing in his kidneys stood out, although his liver enzymes were a little bit off. Otis is the same age and you can't ever smell his breath. When his mouth was in that state, that was the first time I ever noticed that carcass-type of smell.

On the day I started to notice smell and discharge from his mouth he was drinking a lot more than usual.

I too have wondered about acute. When I first brought him in and she realised how quickly the symptoms had come on she asked me about him ingesting something toxic. I wracked my brain and couldn't think of anything. Marshall's unique in that he has no "hips." The tips of his femurs were removed when he was a year old after he developed Legg-Perthes disease. So a) he can't jump up on anything to even access my plants and 2) I don't have any toxic plants in my apartment.

I live on the ground level of a two-story home I share with my landlady upstairs. She's got a fenced off front-yard garden that I let the cats roam around in. They're always attracted to the same leafy plants, or the grass shoots, and I've been living here for three years. If it was something outside, Otis should have been affected too, no? And why now?

Although, there is one specific instance I can recall which I think about often and am wracked with guilt. I use Nair on my legs and will often walk around my apt doing things while I wait for it to set. Marshall had brushed his tail along my legs about 3 days prior and did get some Nair on his tail. I wiped it off but I worry it wasn't enough. What if that's what it was? What if he was cleaning himself and became poisoned from the Nair because I didn't get all of it? That's about the only toxic thing I can possibly think of - and probably the only toxic chemical I have in my place! Even my cleaning and beauty products are non-toxic, all-natural.

:(

Maybe it was ARF but I think the level of deterioration his kidneys endured is past the point of repair. I do believe though that usually at initial diagnosis, if the cat is really in a crash, the kidney functioning will be extra low because at that point they are so dehydrated that the percentage can be much worse than after they are stabilized. After I get the results from his Wed blood test I will ask the vet what his kidneys are functioning at.

Re: Food. I did some more searching through this forum and found some strange reviews on Felidae, some with people finding bone and cartilage matter in the food? Gah!

I'm going to look into the Evo Venison or Beef. I hate keeping him on this K/D garbage. Especially since I know the primary reason that food is even endorsed by the clinic is because some rep went there and made a good sell.
It's full of junk and $56 for a case of 24 mini cans? What a rip.

I wonder when retail pet foods will make a food specifically for kidney issues in cats. Rather than just via the vet. They have food for weight, shedding, diabetes, I've even seen food specific to the breed! It would make my life so much easier.

I haven't looked into Nature's Variety, but I will.

RE: sub-Q. The vet prescribed 150 ml every 2 days. We've been doing really well on them. He doesn't seem to care as long as I'm tickling his face and his ears and he just purrs away in ecstasy. But today he got startled for some reason and wriggled sharply away from me. I had to let the needle go before he did himself harm as his upper body strength is powerful (with no hips in the back he compensates by climbing and pulling himself up rather than jumping). So, he only got 50 ml today, but I may try again later. It was funny though because after getting free he just ran straight to one of his water bowls and lapped water on his own. He's very independent apparently.

Thanks for those links as well. I'll check them out. I'm going to try to pay more attention to the 'Detailed Nutrient Analysis' vs the Guaranteed now as well.

Marshy... for bragging rights. ha

http://farm2.static.flickr.com/1315/4722363129_467b7d95a0_m.jpg

growler~GateKeeper
June 25th, 2010, 12:23 AM
I am now joining this thread as the owner of a newly diagnosed CRF cat, one week ago today. My 11 year old Marshall.

Hi OtisIsMyCat, welcome to the forum & the CRF cat club :grouphug:

So... I have a quick question... how is 0.2% for a phosphorus level? Unfortunately the K/D wet is by far the lowest on all the lists but I don't like their overall ingredients. So I'm trying to find a safe alternative.

Also, is it true that it's actually the phosphorus that is damaging to CRF cats? And, not necessarily the protein itself?

THANKS!!

When looking at the phosphorus levels on the can/site it needs to be converted to dry matter basis, as the formula below shows, the moisture content of the food is crucial as well as the phos:

100-moisture = dry matter; phos/dry matter * 100 = dry matter phosphorus

As an example Evo 95% Vension: 100-69.8 = 30.2; 0.62/30.2 * 100 = 2.05% dry matter phosphorus = way too high :eek:

As an example Evo 95% Chicken & Turkey: 100-73.9 = 26.1; 0.23/26.1 * 100 = 0.88% dry matter phosphorus = Good value :thumbs up

Phosphorus
http://www.felinecrf.org/just_diagnosed.htm#phosphorus
Phosphorus and calcium are minerals which are important for nerve function, muscle contraction and bone formation. A healthy body has a natural balance between levels of phosphorus and calcium.

CRF kidneys can no longer excrete phosphorus properly so levels of phosphorus rise (hyperphosphataemia), which can then adversely affect the cat's calcium levels, with potentially serious consequences (see secondary hyperparathyroidism).

Not only that, but high phosphorus levels may make the CRF progress faster and can make a cat feel lousy. So controlling phosphorus levels is one of the most important steps in managing CRF and helping your cat feel better.

Protein
http://www.felinecrf.org/nutritional_requirements.htm#protein
A healthy cat needs around 30% of its calorie intake to be protein, and since cats are obligate carnivores (which means that they need to eat meat in order to survive), virtually all of that must be animal protein. Protein contains essential amino acids which are necessary for maintaining muscle, but it also creates a large amount of waste, which is processed by the kidneys in the form of urea (BUN). Since urea/BUN levels tend to rise in a CRF cat because the kidneys are working less effectively, many vets recommend a diet low in protein so as to minimise the levels of urea/BUN which are produced.

However, there is a lot of controversy about how useful low protein diets are for CRF cats, and when they should be introduced. Many vets recommend a low protein diet immediately; but this is not necessarily a good move. Cats need a relatively high amount of protein in their diets, compared to say, dogs or humans; and if protein is reduced too early, it can cause weight loss, raised liver enzymes, and may in some cases contribute to the development of anaemia. This is particularly true of those CRF cats who leak protein in their urine (proteinuria), leading to low protein levels in the blood. Having said that, the low protein prescription diets claim to have sufficient protein for cats at all stages of CRF.

Low protein diets are also of concern for cats with metabolic acidosis, because studies of rats and humans with renal failure show that "acidosis may limit the ability of patients to adapt to dietary protein restrictions" (Nutrition and renal function in cats and dogs: acid-base, electrolytes and renal failure (1999) Polzin DJ, Osbourne CA, James K Supplement to Compendium on Continuing Education for the Practising Veterinarian 21 11(K)).

It is not yet certain whether acidosis also affects cats in this way, but it seems reasonable to suspect that it does, given the cat's relatively high requirement for protein.

Wellness has Turkey, Chicken and Beef & Chicken which have good numbers all under 1.2% dm phos

Here's what I know of Marshall's initial diagnosis. I only obtained his BUN and creatinine. That first 48 hours were such a blur I never thought to get anymore results further than those two.

Upon diagnosis his BUN was at 70, creatinine was at 1500. After 24 hours of IV those figures went down to 55 and 1100 respectively. After 48 hours of IV they were down to 33 and 690.

Ouch. It sounds like initially it was acute renal failure that has, due to the high levels, lead into chronic renal failure.

http://www.felinecrf.org/links_and_resources.htm#acute_renal_failure

With ARF even though the situation is critical at first, the cat will not always present all usual symptoms, you might just see reduced urination, increased drinking symptoms that can look like other things.

Turns out nearly his entire mouth was in ulceration as a result of the high levels of toxins that had built up in his body from his deteriorating kidneys.

Could be the excess blood toxins, could also be a result of infection or external ingested toxic substances.

The cat food I'm referring to is "Felidae" Chicken & Rice. The exact product is HERE (http://www.canidae.com/cats/chicken_and_rice/canned.html). If you scroll a bit you'll see the guaranteed analysis as well.

I only bought two cans of Felidae but haven't opened them yet because I have several K/D wets left. I also didn't want to feed him anything different until those with more knowledge on the subject can advise me. I don't think I can approach my vet because I highly doubt she'd endorse this brand as opposed to K/D.

Another option I found was HALO (http://shop.halopets.com/Canned-Cat-Food) brand - the one supported by Ellen Degeneres. Their protein levels for wet can be as low as 4.2% depending on the flavour. There is no phosphorus level indicated though and I have emailed them but no response, yet.

The numbers for that variety of Felidae is okay dm 1.16%, for the Halo I need to see the phos numbers to tell.

Next Wed I bring him in for his follow-up checkup and blood analysis.

:goodvibes: :goodvibes: Ask for a copy of the full blood & urine results

If it was something outside, Otis should have been affected too, no? And why now?

Not necessarily. If they are allowed free roam outside & not just out supervised on a harness they could've been anywhere in your neighbourhood or the next. One may have wandered away from the other.

Lilies are especially nephrotoxic but popular & pretty lots of people putting in gardens. Someone working on their car spills antifreeze - it is very sweet tasting which is attractive to cats. Most people think antifreeze poisoning will only occur in winter but some people do change out antifreeze when they do regular maintance or have a leak. I have heard of some free standing basketball hoops recommending to fill the base with antifreeze so it won't freeze & also for ballist :wall:

I do believe though that usually at initial diagnosis, if the cat is really in a crash, the kidney functioning will be extra low because at that point they are so dehydrated that the percentage can be much worse than after they are stabilized. After I get the results from his Wed blood test I will ask the vet what his kidneys are functioning at.

This may be true, same with the blood values, once the IV fluids have flushed much of the toxins out & starts to correct the imbalance the numbers will revert to pre crisis numbers - though it will not necessarily be close to/or in normal range.

I'm going to look into the Evo Venison or Beef. I hate keeping him on this K/D garbage. Especially since I know the primary reason that food is even endorsed by the clinic is because some rep went there and made a good sell.

Evo only if 95% varities but not vension or duck - those two are way too high. Beef is 1.23% dm I would feed this occasionally but not as a staple, 95% Turkey & Chicken is good at 0.88%.

It was funny though because after getting free he just ran straight to one of his water bowls and lapped water on his own. He's very independent apparently.

............

Marshy... for bragging rights. ha

I found that as well, my grrl would head right for the water dish after her fluids :shrug:

So cute :lovestruck:

sugarcatmom
June 25th, 2010, 06:30 AM
As an example Evo 95% Vension: 100-69.8 = 30.2; 0.62/30.2 * 100 = 2.05% dry matter phosphorus = way too high :eek:

Hmm, interesting. According to J&B's chart (http://binkyspage.tripod.com/CanFoodNew.html), the phosphorus level is 146mg/100Kcal, which is really quite excellent, and venison tends to be naturally lower in phosphorus than most other types of meat. I'm wondering if that 0.62% isn't a Dry Matter value already?

ETA: Here's a little list put out by a vet listing some of the lower phosphorus foods for CRF kitties: http://sites.google.com/site/felinehealthcare/home/low-phosphorus-diets-for-cats-with-kidney-disease

growler~GateKeeper
June 25th, 2010, 11:39 PM
Straight from the Evo website Nutrient Analysis page: http://www.evopet.com/products/default.asp?panel=na&id=1665

Unless they've changed the formula or just made an error on the site :shrug: but the way it stands right now from their offical site I wouldn't recommend this flavour.

driver8
June 26th, 2010, 04:46 AM
What an interesting thread - good to know this is a common enough problem to make a sticky thread.

My Lucy is about to turn 14. For the past two yearly check-ups, she has lost weight each time, and this time she had lost enough to start doing investigations. She throws up a fair bit, but she's always had hairball problems so we assumed that's what it was, but maybe it was the renal failure symptoms. Her liver function was normal, but her creatininine was elevated, thyroid normal, no diabetes. The vet said it was "mild to moderate" chronic renal failure.

She's always been a petite cat, and she is tiny but not emaciated. She has lots of energy still. Runs around the house, rolls on the carpet to get attention from guests, etc. Because she's had dry food most of her life, we're trying the dry food first - Renal LP from Royal Canin. She seems to like it so far, and hasn't thrown up at all since we started introducing it. She drinks tons of water on her own, so I'm not worried about dehydration so far.

For me, it's a quality of life thing and as long as she is happy and energetic and not in discomfort, I'm happy. But it's sad to know there is a tangible sign that she is becoming and older, more frail cat.

sugarcatmom
June 26th, 2010, 11:10 AM
Unless they've changed the formula or just made an error on the site :shrug: but the way it stands right now from their offical site I wouldn't recommend this flavour.

I sent Natura an email for clarification on this, because I know this food is frequently recommended for CRF kitties on other sites. I'll let you know what they say.

sugarcatmom
June 26th, 2010, 11:55 AM
Her liver function was normal, but her creatininine was elevated, thyroid normal, no diabetes. The vet said it was "mild to moderate" chronic renal failure.

Do you have any other lab values, such as BUN, phosphorus, calcium, potassium, etc, and the urinalysis results (particularly the urine specific gravity)?

Because she's had dry food most of her life, we're trying the dry food first - Renal LP from Royal Canin. She seems to like it so far, and hasn't thrown up at all since we started introducing it.

What was Lucy eating before being put on the Renal LP?

Any way you can try offering her some quality (ie non-prescription) wet food? It would be so much better for Lucy if you could transition her off of all dry food, which is problematic for even healthy cats. More so for those suffering a chronic illness. You might want to check out this link if you haven't already, particularly the section on health problems caused by dry food, and the part with tips for transitioning kibble addicts over to wet food: www.catinfo.org

Here are the ingredients for Renal LP dry:

Pork Meal, Corn, Chicken Fat, Rice, Wheat, Corn Gluten Meal, Powdered Cellulose, Natural Flavour, Wheat Gluten, Chicory Pulp, Fish Oil, ....

Tons of grains (corn, rice, wheat), fillers (chicory pulp and powdered cellulose - aka sawdust), and a poor quality meat source (pork meal). A much better idea would be to feed one of the lower phosphorus canned foods like Wellness Turkey. To compare, here are the main Wellness ingredients:

Turkey, Chicken Liver, Chicken, Chicken Broth, Carrots, Natural Chicken Flavor, .....

See the difference? Plus it's 78% moisture, compared to the 10% or less moisture in the Renal LP. Water is a crucial ingredient in cat food, and for those cats with renal insufficiency, it's an essential aspect of their treatment.

She drinks tons of water on her own, so I'm not worried about dehydration so far.

That can be deceiving. The reason that she's drinking so much water is because dehydration is already a factor. She's trying to catch up to all of the peeing she's doing since her kidneys aren't able to retain as much moisture as they should. I have a cat with diabetes, and prior to him getting regulated on insulin injections, he would camp out at the water bowl drinking several cups of water a day. How could he possibly have been dehydrated with all that water consumption? In order to get rid of all the glucose building up in his blood stream, he was peeing it out faster than he could replenish it. Very similar with CRF kitties.

But it's sad to know there is a tangible sign that she is becoming and older, more frail cat.

Many cats can live for years with compromised kidneys, so even though you may have to modify some things in Lucy's life, take heart in that this isn't necessarily a death sentence. Just love her and appreciate each day with her, as we all should with our beloved furry friends.

driver8
June 26th, 2010, 08:56 PM
I tried to transition my cats to wet food once before, on the advice of one vet I had seen. this was when we had three cats. They had been eating the dry Iams multi-cat, and when we mixed wet food in, they had a really hard time. They were always hungry, seemed much more anxious about food, were almost frantic. It was rediculous. This was giving the recommended amounts, still mixed with the dry food a bit. So we eased them back to the dry food and all was well.

I know that water in food is important, and probably easier on my cat than drinking water so much from her bowl. . But I read the labels on the canned foods, and they all have less protein content than the dry foods, and I wonder if that was why my cats were so hungry when we tried to transition. I'm going to go to pet valu this week and see what they have that I can try - I want to do the right thing for my cat and her diet, but it all depends what she will accept. Now that we only have one cat, the transition might be easier to make.

My mom's cat was 18 when she died, had CRF, hyperthyroid, and recovered from a bad bout of pancreatitis. She would never eat ANY of the special foods for renal, etc... she would only eat the cheap crap (wet) from super-valu. So that's what she ate... (She had quite a personality, that cat, and would tell you in no uncertain terms if things did not meet standards. :cool:)

Lucy isn't ravenously thirsty, so I will try and gently ease some changes in but not stress it too much if it distresses her. Older people don't often like the diet changes prescribed for them either, and at some point you've got to decide how much to push and when to leave it alone. So I'm going to do some investigating and definitely will try wet food. But my past experience made me a bit wary. I know it's different when cats are on wet food from the beginning, and with the next cat we get, that will likely be the case.

I didn't ask the numbers of her lab values, I don't want to get too focused on numbers. (Treat the patient, not the numbers) She still has lots of energy, etc, so I'm not too worried yet. I know that with CRI, diet is only a small part of it, and that the disease will still progress anyway. I'm pretty confident that she has a lot of living left to do.

sugarcatmom
June 26th, 2010, 11:53 PM
They had been eating the dry Iams multi-cat, and when we mixed wet food in, they had a really hard time.

Were you actually mixing canned and dry together in the same bowl? That might have been part of the problem. Some cats, mine being one of them, hate the combo of textures. Putting out just the wet food alone would be preferable.

But I read the labels on the canned foods, and they all have less protein content than the dry foods,

Most canned foods are actually higher in protein than dry food. You have to subtract the moisture content in order to compare the nutrient analysis of wet vs dry. Some info for you on that: http://www.catinfo.org/commercialcannedfoods.htm#As_Fed,_Dry_Matter,_Calo ries

she would only eat the cheap crap (wet) from super-valu.

The fact that it was wet was probably a big factor in her longevity. I've always maintained that it's better to feed cats the cheapest canned food than the most expensive dry food.

Older people don't often like the diet changes prescribed for them either, and at some point you've got to decide how much to push and when to leave it alone.

Exactly, which is why it's important when transitioning cats to a better diet to use techniques that are gentle and don't cause stress for us or them. This isn't a race. Just be patient and persistent, and I guarantee that even the most hard-core kibble addict can eventually be converted. If I did it with my boy (and it took months), anyone can do it.

I didn't ask the numbers of her lab values, I don't want to get too focused on numbers. (Treat the patient, not the numbers)

I totally understand that. But it's also a good idea to have a sense of what's going on, so you can make some adjustments along the way if necessary. Such as when to implement other treatments or supplements like probiotics, phosphorus binders, Calictriol, subQ fluids, potassium, omega3's etc. There is lots that we can do to help renal kitties be more comfortable and augment their health. Not all vets are current with these treatments and way too many of them just shove a bag of prescription kibble at their clients and call it a day.

I know that with CRI, diet is only a small part of it, and that the disease will still progress anyway.

I don't entirely agree with that, I think diet is a fairly big factor. Even to the point that it actually causes many cases of kidney disease in our cats.

I'm pretty confident that she has a lot of living left to do.

:thumbs upExcellent attitude! Staying positive can have a very real impact on cats, who are quite sensitive to the moods of their caretakers.

growler~GateKeeper
June 27th, 2010, 01:51 AM
What an interesting thread - good to know this is a common enough problem to make a sticky thread.

Hi driver8 :grouphug: Welcome to the forum & the CRF cat club.

Quite the opposite actually, it's heartbreaking :( that it is common enough for a sticky thread.

My Lucy is about to turn 14. For the past two yearly check-ups, she has lost weight each time, and this time she had lost enough to start doing investigations. She throws up a fair bit, but she's always had hairball problems so we assumed that's what it was, but maybe it was the renal failure symptoms. Her liver function was normal, but her creatininine was elevated, thyroid normal, no diabetes. The vet said it was "mild to moderate" chronic renal failure.

Is it hairballs she's bringing up or clear-yellow foamy liquid or food?

Find something to put under her food & water dishes to raise them between 2-6 inches off the ground, but make sure the dishes won't slip off. I used a phone book under my grrls water fountain dish & a planter stand on a block of wood under her food dish. This will make it easier on her neck to reach into the dishes as well as keeping her head higher than her stomach in order to keep any excess stomach acid in her stomach, reducing nausea.

She's always been a petite cat, and she is tiny but not emaciated. She has lots of energy still. Runs around the house, rolls on the carpet to get attention from guests, etc. Because she's had dry food most of her life, we're trying the dry food first - Renal LP from Royal Canin. She seems to like it so far, and hasn't thrown up at all since we started introducing it. She drinks tons of water on her own, so I'm not worried about dehydration so far.

How much does she weigh? How much has she lost in the last 2 years?

The reason she's drinking "tons" is dehydration in combination with the lack of water in her food.

Cats bodies are designed to retain as much water as possible by recycling it throughout their bodies. Unlike other species, their normally functioning kidneys concentrate their urine by removing as much water as possible, that water is then cleaned & filtered back to where it's needed. The concentrated waste that is removed as urine has very liitle water content in comparison to the other waste products. When the kidneys become compromised they can't filter efficiently and so they loose far more water than their bodies are designed to loose in flushing out the toxins as urine. Therefore they need to drink more to compensate.

If they aren't getting much moisture in their food and are instead drinking it straight, it flows through the body at a much faster raite - there is less to process during absorption.

For me, it's a quality of life thing and as long as she is happy and energetic and not in discomfort, I'm happy. But it's sad to know there is a tangible sign that she is becoming and older, more frail cat.

This is a good indicator of her overall health as well, her state of mind & how she's feeling is often a reflection of her health.

I sent Natura an email for clarification on this, because I know this food is frequently recommended for CRF kitties on other sites. I'll let you know what they say.

Hopefully it's just an error on their site :fingerscr

But I read the labels on the canned foods, and they all have less protein content than the dry foods, and I wonder if that was why my cats were so hungry when we tried to transition.

If you were to remove all the moisture from the canned food & the dry food you would see that the canned actually has a higher protein content.

They likely were hungry from not eating enough if they were so stressed about the change in food. Some cats can be so picky about what they'll eat so often the transition needs to take a longer time.

I didn't ask the numbers of her lab values, I don't want to get too focused on numbers. (Treat the patient, not the numbers) She still has lots of energy, etc, so I'm not too worried yet. I know that with CRI, diet is only a small part of it, and that the disease will still progress anyway. I'm pretty confident that she has a lot of living left to do.

Treating the cat not the numbers is essential, basing treatments on how the cat is physically doing, but you still need a frame of reference for the things that may not be so obvious or that take a little longer to show their effects. For example in the urinalysis some cats may have minute amounts of blood in their urine which you will not see as red (unless there is something seriously wrong) but may indicate other issues that have the same symptoms as CRF.

Among other things the lab values will also guide you when it comes time to start subq fluids, as it is better to start before the cat becomes dehydrated to the point of being very obvious & in need of IV fluids.

Yes she has lots of life left in her, keep up the positive outlook & it will transmit itself to her as well. :goodvibes:

OtisIsMyCat
June 29th, 2010, 10:35 AM
I heard back from Halo re: their guaranteed analysis of phosphorus. At that time I didn't know to ask for the more thorough breakdown to see what the dry matter would be.

Here is what they wrote:

Hi Andrea,

Thanks for visiting our website and caring for the ones we love naturally! If you have not already signed up to receive our Newsletter, please feel free to do so at Halopets.com, to receive the most current coupons and promotions we are offering.

The Phosphorous content for each of the varieties you've requested is below.

Chicken - 0.14%
Turkey - 0.18%
Lamb - 0.18%
Salmon - 0.20%

Please feel free to e-mail or call us at 800-426-4256 anytime with questions or to search for a store in your area. Wishing you and your pets GREAT health!

Halo, Purely for Pets
800.426.4256

Seems like Chicken, Turkey, and Lamb are all even lower than the Felidae I found (which I haven't opened yet). Seems okay to me, no? I tried doing the calculation you've included, Growler, but it's too confusing for me. :o


Not necessarily. If they are allowed free roam outside & not just out supervised on a harness they could've been anywhere in your neighbourhood or the next. One may have wandered away from the other.

Lilies are especially nephrotoxic but popular & pretty lots of people putting in gardens. Someone working on their car spills antifreeze - it is very sweet tasting which is attractive to cats. Most people think antifreeze poisoning will only occur in winter but some people do change out antifreeze when they do regular maintance or have a leak. I have heard of some free standing basketball hoops recommending to fill the base with antifreeze so it won't freeze & also for ballist :wall:

Marsh and Otis do not roam outside. They've never been "outdoor" cats free to explore past the boundaries of my sight, or out of my immediate sight when we're out in my landlady's garden. When they're out there, I'm out there and most of the time they sit right beside me under the sun and hang. They've been indoor cats all their lives and don't seem to have the urge to escape and do the outdoor cat thing. For the most part they're pretty chill and in fact will go back inside my place before I do. ha. There are also no lilies in my landlady's garden, and I double checked with her last week. Also, I've been living here for three years, same plants bloom every summer...

That's why I'm so confused over the idea of it being toxicity from anything outside my place. There is not much out there that they seem to be interested in and if there is something, they'll munch down in unison and it's usually little sprouts of grass that have come through the cracks in the path coming from the gate. So if it was something Marshall ingested from the garden, Otis would have too and thus Otis should have also become sick. But he's perfectly fine. :confused:

If it was ARF then the only thing it could possibly be is the Nair I mentioned from my last post. But I don't want to think about it because it upsets me and I can't go back now. *big sigh*

We've got the follow-up appt tomorrow evening so I will ask for the analysis from the blood tests including urine weight and post them here.

This is our first follow up since the catastrophe and I am crossing my fingers that he is okay. After that, I can concentrate on getting this food issue organized.

As a side note, T/D contains "pork by-products" - I always thought pork was bad for cats?

Thanks again for all the info. I am SO HAPPY I found this forum.

growler~GateKeeper
June 30th, 2010, 07:17 AM
The Phosphorous content for each of the varieties you've requested is below.

Chicken - 0.14%
Turkey - 0.18%
Lamb - 0.18%
Salmon - 0.20%


Seems like Chicken, Turkey, and Lamb are all even lower than the Felidae I found (which I haven't opened yet). Seems okay to me, no? I tried doing the calculation you've included, Growler, but it's too confusing for me. :o

Ideally it is always better to use the actual value for water since it is essential to the formula but the actuals for water are generally not too far off the max. Any other ingredient you are using in the formula must be exact, no using mins & maxs - it will throw the calculation way off.

Wholesome Turkey (http://shop.halopets.com/Canned-Cat-Food/Cat-Canned-Turkey-3-5oz) has max 85% moisture as listed on their site


100-moisture = dry matter; phos/dry matter * 100 = dry matter phosphorus

Break it down in to smaller sections:

100 (represents total of protein, fat, carbohydrate {not listed}, fiber, ash, and water) - moisture (water) = dry matter (what's left of everything without water)

100-85 (moisture) = 15 (dry matter)


phos (or whichever ingredient you want to check) / dry matter (calculation from above)

0.18 (phos listed above) / 15 (dry matter calculation from above) = 0.012


* 100 (* by 100 in order to get the percentage value) = dry matter phosphorus (the amount of phosphorus without water)

0.012 * 100 = 1.2 dry matter phosphorus percent in this brand flavour of food


100-85 moisture = 15 dry matter; 0.18 phos/15 dry matter * 100 = 1.2% dry matter phosphorus

Halo WholsomeTurkey 1.2% dry matter phos is good :thumbs up less than what I consider should be the max 1.25%


Halo Wholsome Chicken (http://shop.halopets.com/Canned-Cat-Food/Wholesome-Chicken-Recipe-3-5-oz) is too high 1.4% phos

100-90 moisture = 10 dry matter; 0.14 phos/10 dry matter * 100 = 1.4% dry matter phosphorus


Halo Wholsome Lamb (http://shop.halopets.com/Canned-Cat-Food/Wholesome-Lamb-Recipe-3-5oz) has good phos 1% :thumbs up

100-82 moisture = 18 dry matter; 0.18 phos/18 dry matter * 100 = 1% dry matter phosphorus


Halo Succulent Salmon (http://shop.halopets.com/Canned-Cat-Food/Succulent-Salmon-Recipe-3-5oz) is too high 1.66% phos

100-88 moisture = 12 dry matter; 0.2 phos/12 dry matter * 100 = 1.66% dry matter phosphorus


Of the 4 Halo cans only the Turkey & Lamb are low enough.


The Felidae chicken & rice (http://www.canidae.com/cats/chicken_and_rice/canned.html) you mentioned earlier is right in the middle of the two Halo cans @ 1/16% dm phos

From their site: Moisture actual 77.5; phos actual 0.26%

100-77.5 moisture = 22.5 dry matter; 0.26 phos/22.5 dry matter * 100 = 1.16% dry matter phosphorus :thumbs up



This is our first follow up since the catastrophe and I am crossing my fingers that he is okay. After that, I can concentrate on getting this food issue organized.

As a side note, T/D contains "pork by-products" - I always thought pork was bad for cats?

:goodvibes: for the appt :fingerscr

Pork is very high in fat which can lead to other issues including pancreatitis, I've read some that say pork is highly digestable but then when I asked at the raw food store here they said no it's not.

OtisIsMyCat
June 30th, 2010, 03:13 PM
Oh my... is it possible that I've actually found a healthy and safe alternative to K/D that both my cats can enjoy??

I'm so happy!!

:party:

Blur's_Mom
August 18th, 2010, 04:11 AM
Hi,
My 16 year old cat, Blur, was diagnosed this week with stage 2 kidney disease. I took him to the vet cause he was getting a bit thin.

I have found the information on this site to be a tremendous help and such great information.

Blur was also diagnosed with pancreatitis. The vet is focused on hydrating him and getting him to gain some weight back before doing anything else. She gave me pain pills for him for the pancreatitis, but I managed to get him to take 1 out of 4 over 2 days, so tomorrow I try a liquid! It is so hard to tell if he is even in any pain.

The vet suggested Sub-Q, 100ml daily for now. I said I would do it at home. He had one round at the vets office and one very successful one at home, but the last two days he has been like a leaky pincushion. I thought I had it figured out after talking to the vet today, but tonight same thing - ugh. I am going to take him to the vets tomorrow to go over it again.

Now to the food part -
I switched both my cats (I also have Spot who is 17) to Natural Balance dry and Merricks canned about a year ago, although Blur doesn't eat much dry food. I did this as a result of spending 4 1/2 years of trying to manage my Black Lab's seizures. After no help from the vet and bad reactions to prescriptions, I finally did the right research and realized I needed to change Naslund's food, and my cats too! On advise from the Natural pet store, I chose Natural Balance Limited Ingredient Diet food and his seizures went from every 4-6 weeks, to twice in the last year - both after he accidentally got into some food he shouldn't have!! End result - food allergies. Now he is almost weened off the harmful prescriptions that were actually causing liver damage and pacreatitis (that is a whole other story I am sure I should post elsewhere on this site).

Blur is a finicky eater at the best of times. Has never liked treats and as he has gotten older has been demanding canned more and eating less dry - maybe he is smarter than I thought!

The vet gave me some Royal Canin Recovery food to try to get Blur's weight up before the lab results came back, which he loved. Once the result came in she said a renal food like k/d would be better, but getting his weight up is important right now and he could stay on Recovery a little longer, so I have given a few cans of that. He has gained a bit of weight back (130 grams in the first 4 days).

I am not willing to put him on a steady vet food diet, so I dug through the cupboard for the Merricks (lower phos types), but he has been turning his nose up at it a bit, so today also bought some Wellness turkey, which he ate. I was thinking about RAW, but I don't want to change too much too fast, so I will go with this for now.

I will also lift his dishes up off the floor.

The vet suggested trying to feed him some Pepcid for nausea, but I think the pain pills are more important so I haven't even tried that. Has anyone else offered Pepcid to their cats for stomach upset and had good result?

Spot really likes her dry food, and currently has no health concerns, so I am hesitant to take it away from her and since Blur mostly isn't interest that is probably ok, but since he will eat it occasionally I would like to feed a lower phos dry food. Any suggestions? Yes I know I should try to get them off dry altogether, but for now it is baby steps :)
Thanks

Love4himies
August 18th, 2010, 06:52 AM
So sorry to hear about your kitty. :grouphug:

Growler will be able to assist you when she logs on again, she is so very knowledgeable.

Just out of curiosity, what pain pills did the vet prescribe?

Blur's_Mom
August 18th, 2010, 03:32 PM
Thanks.

The pain pills are Tramadol HCL 25mg. The vet said to give him 1/4 - 1/2 a pill every 12 hours.

Since he won't take those she has given me a liquid to squirt into his mouth that is absorbed through the skin - Buprenorphine 1mg/ml. He is to get 0.05ml every 12 hours. Because she said to watch him afterward to make sure he isn't wobbly I haven't given it yet. I didn't want him to have it unless I was going to be home/awake for a few hours to keep an eye on him.

She said if he gets a bit wobbly, to give a bit lower dose the next time, like 0.04ml. For such a minute dosage, I may err on the side of caution and go with 0.04ml the first try.

I went to a different pet store today and found Wellness Healthy Indulgence turkey and duck and some chicken pure bites. So far he doesn't like the pure bites. But worth a try.

growler~GateKeeper
August 18th, 2010, 11:44 PM
Hi Blur's Mom Welcome to the site & the CRF Cat Club :grouphug:

The vet suggested Sub-Q, 100ml daily for now. I said I would do it at home. He had one round at the vets office and one very successful one at home, but the last two days he has been like a leaky pincushion. I thought I had it figured out after talking to the vet today, but tonight same thing - ugh. I am going to take him to the vets tomorrow to go over it again.

When you are about to remove the needle, place your thumb over that poke hole, remove the needle & lift the skin up slightly away from the pocket of fluids you've just given. Hold for about a minute or three, this will allow the skin to start to heal & will draw a bit of air between the skin & the fluids, it helps slow the leakage.

You can also try massaging the fluids away from the needle entrance point while you are giving fluids, gravity will naturally bring it down under the chest & down the legs this just helps it along while at the same time prevents leaking.

I am not willing to put him on a steady vet food diet, so I dug through the cupboard for the Merricks (lower phos types), but he has been turning his nose up at it a bit, so today also bought some Wellness turkey, which he ate. I was thinking about RAW, but I don't want to change too much too fast, so I will go with this for now.

Some canned suggestions low in phos:

Wellness Turkey great dry matter phos number 1.05
Wellness Kitten good dry matter phos numbers 1.15
Wellness Beef & Salmon great dry matter phos numbers 1.06
Wellness Chicken good dry matter phos numbers 1.15
Wellness Chicken & Beef good dry matter phos numbers 1.17
Evo 95% Chicken & Turkey (/http://www.evopet.com/products/default.asp?panel=na&id=1662) has great dry matter phos 0.88
Halo Wholsome Lamb (http://shop.halopets.com/Canned-Cat-Food/Wholesome-Lamb-Recipe-3-5oz) has great dry matter phos 1.00
Halo Wholsome Turkey (http://shop.halopets.com/Canned-Cat-Food/Cat-Canned-Turkey-3-5oz) dry matter phos is good 1.2
Felidae Chicken & Rice (http://www.canidae.com/cats/chicken_and_rice/canned.html) dry matter phos is good at 1.16
Eagle Pack Holistic Select Turkey & Barley (http://www.holisticselect.com/product.aspx?pet=cat&cat=2&pid=33) canned has good dry matter phos 1.05
Eagle Pack Holistic Select Chicken & Lamb (http://www.holisticselect.com/product.aspx?pet=cat&cat=2&pid=29) has good dry matter phos 1.15

I will also lift his dishes up off the floor.

The vet suggested trying to feed him some Pepcid for nausea, but I think the pain pills are more important so I haven't even tried that. Has anyone else offered Pepcid to their cats for stomach upset and had good result?

I've never had to use pepcid, I found that just raising the dishes up between 4-6 inches and a late snack/small meal right before bed, kept any nausea issues away. My girl was given Zantac during a weekend stay in the ER with good results, though I think it also might have dropped her appetite down as well.

Spot really likes her dry food, and currently has no health concerns, so I am hesitant to take it away from her and since Blur mostly isn't interest that is probably ok, but since he will eat it occasionally I would like to feed a lower phos dry food. Any suggestions? Yes I know I should try to get them off dry altogether, but for now it is baby steps :)
Thanks

Yes definately both cats off the dry asap, but to tide you over until then here are some low phos dry foods:

Wellness Healthy Weight (http://www.wellnesspetfood.com/product-details.aspx?pet=cat&pid=20&dm=completehealth#guaranteed-analysis) has great dry matter phos numbers 0.79
Wellness Indoor (http://www.wellnesspetfood.com/product-details.aspx?pet=cat&pid=21&dm=completehealth#guaranteed-analysis) has great dry matter phos numbers 0.85
Wellness Complete Health Adult Salmon, Salmon Meal & Deboned Turkey (http://www.wellnesspetfood.com/product-details.aspx?pet=cat&pid=19&dm=completehealth#guaranteed-analysis) has good dry matter phos numbers 1.01
Wellness Complete Health Adult Deboned Chicken, Chicken Meal & Rice (http://www.wellnesspetfood.com/product-details.aspx?pet=cat&pid=18&dm=completehealth#guaranteed-analysis) has good dry matter phos numbers 1.12
Eagle Pack Holistic Select Dry Duck (http://www.holisticselect.com/product.aspx?pet=cat&cat=1&pid=28#guaranteed-analysis) has good dry matter phos numbers 1.13

Blur's_Mom
August 19th, 2010, 01:25 AM
Growler
Thanks for all the info.

Blur's Sub-Q went very smoothly today. So I am feeling much better about it again. I decided I knew I could do it and gave it a try without going back to the vets. Tomorrow's challenge will be doing it on my own.

Thanks for the information on dry food phos. I just went to do a search of the Natural Balance dry Spot currently eats and I see that the dry and cat food tables listing Phos (and other things) are all updated for the US & UK, just since earlier today - including the date of the information. :thumbs up

Here is the link: http://www.felinecrf.org/canned_food_usa.htm

In the US table it says the Merrick foods I had been using are as follows:
Merrick Cowboy Cookout 0.84
Merrick Thanksgiving Day Dinner 0.86
Merrick California Roll 0.88
Merrick Before Grain 96% Turkey 0.95
Merrick Surf N Turf 0.95
Merrick Turducken 0.97
Merrick Grammy's Pot Pie 0.97

These numbers seem really good, but Wellness, EVO, Eagle Pack and other foods, seem to be recommended more often. Is there some reason why Merrick may not be as good a choice?

I have Blur's food raised up, and my husband is going to build a special platform for his dishes.

Thanks again :)

growler~GateKeeper
August 19th, 2010, 01:40 AM
The fluids get easier as you go along, becoming more comfortable with them will boost your confidence.

Those are all great numbers for Merrick :thumbs up

The Wellness canned & Evo are also grain free so that is a big part of the recommendation there, cats being carnivores have little - no need for grains in their diets.

My girl never liked any of the Merrick flavours, possibly too much extra veggies & stuff for her tastes :shrug: So I couldn't give a "personal" go ahead without the actual numbers.

Most of the recommendations you will see are ones that have worked for others or because the nutrient analysis is known for the foods. The list has just recently been updated where the previous one I believe was 3 years ago, so one can't recommend with outdated numbers, unless one has contacted the company directly. :)

:highfive: Good for your dh making a feeding station

Blur's_Mom
August 20th, 2010, 12:31 PM
Can someone tell me why it is better to stay away from seafood catfood for CRF cats? I know I have read that you should, but I can't find the thread that say why.

Blur just love the Wellness Healthy Indulgence Turkey and Duck, in fact now he turns his nose up at the Wellness Turkey. The only other varieties of Healthy Indulgence that have lower phos all have seafood in them.

Last night when I did his Sub-Q on my own, I warmed the liquid first, until yesterday it has been very hot and I hadn't tried this yet. Blur sat completely still, I didn't even need to hold him and he purred the whole time once the needle was in, then wouldn't move once the needle was out. I guess he has now realized it makes him feel better.

Thanks again for all the help

binkybuff
August 20th, 2010, 12:49 PM
When my old cat was in the final stages of kidney failure, she would only lick at the juices of her wet food. She ate very little. I kept her on sub Q right up until the end. Her end came peacefully in my arms.

take care
binky

growler~GateKeeper
September 2nd, 2010, 04:23 AM
Can someone tell me why it is better to stay away from seafood catfood for CRF cats? I know I have read that you should, but I can't find the thread that say why.

Blur just love the Wellness Healthy Indulgence Turkey and Duck, in fact now he turns his nose up at the Wellness Turkey. The only other varieties of Healthy Indulgence that have lower phos all have seafood in them.

The main issue with seafood based catfood is often times a CRF cat will refuse to eat/become picky, and if they do & are given seafood alot of times they then won't eat anything else :rolleyes:. Non-crf cats are the same.

Some info here on some reasons to avoid fish foods as a regular diet for all cats: http://www.felinecrf.org/which_foods.htm#fish

I, personally, would be okay with feeding a seafood based food once every 2 weeks or so as a treat just so he doesn't get too used to having it. I'd also be okay with seafood as a 3rd protein source for a CRF cat, for non-crf cat as a 2nd protein source is good but I'd prefer not to have it as the main protein in any food. Just my :2cents:

Last night when I did his Sub-Q on my own, I warmed the liquid first, until yesterday it has been very hot and I hadn't tried this yet. Blur sat completely still, I didn't even need to hold him and he purred the whole time once the needle was in, then wouldn't move once the needle was out. I guess he has now realized it makes him feel better.

Warming the fluids always helps as it's quite an unpleasant shock to have cold water appear under the skin :eek: Animals w/CRF definately do come to quickly realize that the additional fluids makes them feel a whole lot better & will tolerate the process very well. :cat:

nemesis
September 3rd, 2010, 11:49 PM
Hi everyone, I thought I'd post here since this seems to be a general "CRF cat" thread, I hope that's ok. My cat Smokey was diagnosed with CRF back in mid-July. He's doing fairly well right now with the treatment, but I want to make sure I do everything possible for him and so I wanted to see what other people's experiences are like, etc. I'm just starting to educate myself about these issues, but I will try to contribute and be helpful as much as I can.

Basically back in July Smokey "crashed". Over the course of a week or so he gradually lost his appetite until he refused to eat at all and spent all the time hiding under the bed, not relaxing like he sometimes does, but refusing to come out at all. He was taken to the vet and diagnosed with CRF after urine tests, bloodwork, ultrasound, etc.

On July 17th his BUN was 40.5 and his Creatinine was 783, with slightly elevated phosphorus. He was put on IV fluids for a few days, and then started a regime of:

-150 ml of subQ fluids every other day,
-Fortekor once a day
-antacid once a day
-Azodyl twice a day
-Rubenal and Renal Essentials twice a day each (these are vitamin/supplements)

He was also given renal prescription dry food and wet food. He quite liked the dry food but wouldn't touch the wet food, so we resorted to Fancy Feast, which I know isn't very good but the main thing was getting him to eat that point, and that was all that he was interested in.

On July 22, he was tested again, and this time his results showed a BUN of 13.5, Creatinine of 200, and normal Phosphorus levels (1.54, normal range 1.10-2.74 according to this lab). Still not quite right, but a significant improvement.

After this, the vet changed his regimen to 150 ml SubQ's twice a week, with everything else the same, except that we stopped the antacid. Giving him the pills every day was ridiculously difficult at first but we are much, much better at it now, although he still tries to outsmart us from time to time. We have been doing the SubQ at the vet but are psyching ourselves up to do it at home, and after having gotten a couple of "lessons", will be doing the procedure next week at the vet myself before trying to do it all at home.

He was tested again on August 13th. His BUN was 12.9, Creatinine 204, and Phosphorus 1.44. Our vet was quite pleased with the results, saying that he seemed to be stable, and that we should continue giving the SubQ's twice a week and the pills, with the exception that we could try reducing the Azodyl to once a day. Her reasoning is that we should try to find the most conservative therapy that can keep him stable, which makes sense to me.

About 3 weeks have passed since then, and I am trying to evaluate his current state and make sure I am doing everything I can. There are a few things I'm wondering about.

1) Being quite pleased with his Aug 13 results, the vet thinks we should do the next testing in 4 months. Now, I've read up on this a bit, and it seems to be a roughly standard amount of time, but I confess to being a bit paranoid about waiting that long to monitor how he's doing. On the other hand, I have read that testing too often could be counterproductive and obviously stressful for the cat. I don't want to give the impression that I don't trust my vet either, since as far as I can tell, she has saved my cat's life. But I also don't want to be passive or complacent. Does waiting that long seem like a reasonable idea, and I should just relax?

2) I am wondering if you guys had any ideas about what it means that his numbers were so high, and then suddenly went down so low again, to where they are *almost* brushing up against normal. One reason I wonder about this is that I've heard that cats with low values shouldn't be put on SubQ's prematurely, but then, it's a bit different for him since he *started out* with much higher results.

3) The dosage for Azodyl is 1 pill for cats 5 pounds and less, and two for cats that are over 5. My cat is just over 5 at the moment, as he is regaining weight he lost when he wasn't eating. His normal weight is around 5.5 or so. So would it be a good idea to give him one Azodyl a day instead of 2, as the vet recommended? As far as I can tell, there's no pressing reason to reduce the dose of a probiotic, as opposed to a "drug" that can have side effects. However, it would certainly be easier to pill him only once a day (and he'd be happier as well I expect).

4) Since I've been lurking this forum for a while, I'm much more educated about cat food than I was before. Unfortunately the result is that I'm kind of appalled by the pseudoscientific and dishonest practices of the pet food industry and the collusion of many vets with these practices. It's really disappointing. Silly me to trust a prescription product sold by medical doctors! That being said, I'm considering moving Smokey off dry food completely, and off the prescription food as well, wet or dry. Does this seem like a good idea, and do you have any advice for making the transition? For example, would it be a good idea to mix some new, better wet food in with his Fancy Feast at first in order to get him to try it, and then gradually change the ratios? Or will this upset his stomach?

5) Finally, is there anything I should watch out for that I haven't mentioned? If we keep going with this regimen, and don't get him tested again for a few months, are there any signs or warnings I should be looking for, beyond the obvious? I realize I sound like a paranoid lunatic, but I want to do right by Smokey because he's a good cat and an excellent companion, and cats can be so frustratingly stealthy about their health. Again I apologize for asking so many questions, any advice, big or small, you could give at all would be greatly appreciated. I'll try my best to return the favour.

growler~GateKeeper
September 5th, 2010, 01:16 AM
Hi everyone, I thought I'd post here since this seems to be a general "CRF cat" thread, I hope that's ok.

Hi nemesis :) welcome to the forum & the CRF cat club :grouphug:. It is absolutely ok that you post here, this was my hope when I started this thread - that we could all gather our experiences & ideas in one place to help ourselves & others. :)

He was also given renal prescription dry food and wet food. He quite liked the dry food but wouldn't touch the wet food, so we resorted to Fancy Feast, which I know isn't very good but the main thing was getting him to eat that point, and that was all that he was interested in.

At this point the more important thing is getting him to eat, not really what he's eating, especially considering his previous refusal to eat. Fancy Feast does have a number of varieties that have good phos numbers, the most recently updated food table listing by dry matter phos (http://www.felinecrf.org/canned_food_usa.htm#food_data_tables) shows quite a few flavours under 1.20% dry matter phos :thumbs up. You want to stay below 1.25% max and try to stay away from fish varieties as much as possible.

On July 22, he was tested again, and this time his results showed a BUN of 13.5, Creatinine of 200, and normal Phosphorus levels (1.54, normal range 1.10-2.74 according to this lab). Still not quite right, but a significant improvement.

When posting blood/urine values please put the reference range for the lab that did the tests (like you did for the phos :thumbs up) depending on the equipment the numbers can vary quite a bit.

That is a very good drop from the previous numbers :highfive:

After this, the vet changed his regimen to 150 ml SubQ's twice a week, with everything else the same, except that we stopped the antacid. Giving him the pills every day was ridiculously difficult at first but we are much, much better at it now, although he still tries to outsmart us from time to time. We have been doing the SubQ at the vet but are psyching ourselves up to do it at home, and after having gotten a couple of "lessons", will be doing the procedure next week at the vet myself before trying to do it all at home.

Cats realize pretty quickly when something is making them feel better & will adapt relatively easily to the changes. My :rip: crf girl Duffy went from being a pill spitter to a cat who would willingly sit & wait for her twice daily supplement regiment.

Giving fluids for the 1st time yourself at home can be a scary thing, but if you go into it with confidence you'll do fine. It definately gets easier with practise to the point it just becomes routine.

Here's a step by step instruction guide you can refer to: http://www.weirdstuffwemake.com/weird/stuff/pets/cats/sophia/catjuice.html

I would recommend getting a price comparison of the fluids, lines & needles from the vet, a human pharmacy and/or a medical supply company if there is one in your area. I found a local medical supply company to be the cheapest, fastest & easiest to get supplies from.

Most vets will use a Monoject 18g needle for giving fluids to cats, ask your vet for a Monoject 20g instead, the needles are smaller & therefore the "poke" not so noticable. The fluids will run slightly slower through a smaller gauge needle, but in & out it's more comfortable for the cat. If your vet carries Teurmo Ultra Thin Wall needles that's even better :thumbs up, get those in a 20g. The Teurmo 20g UTW needles are super sharp, have a bevelled edged & the shaft is much thinner so the poke is hardly noticable at all - even compared to a Monoject 22g (even smaller needle). Given the thinner walls the fluid flow rate is about the same as a Monoject 18g.

1) Being quite pleased with his Aug 13 results, the vet thinks we should do the next testing in 4 months. Now, I've read up on this a bit, and it seems to be a roughly standard amount of time, but I confess to being a bit paranoid about waiting that long to monitor how he's doing. On the other hand, I have read that testing too often could be counterproductive and obviously stressful for the cat. I don't want to give the impression that I don't trust my vet either, since as far as I can tell, she has saved my cat's life. But I also don't want to be passive or complacent. Does waiting that long seem like a reasonable idea, and I should just relax?

Every 3 months is standard time between appointments, unless you notice something "off" ~ eating less, lethargic, change in behaviour/litter box habits or Smokey looks like he's slipping towards a crash.

You should always keep in mind that you can call the vet at any time to ask a question or give an update, if they think something is not right they'll have you bring Smokey in.

One thing I found very helpful is a cat journal - each day write down how Smokey is feeling (content/grouchy/playful), what his attitude is like (social/unusual hiding), how much he ate (more/less/same/doesn't like this flavour or that brand), litter box habits (more/less/same), what he did that day (slept all day/watched the birds/played w/toys/terrorized the dog). This will make it easy to spot any subtle changes before they become an issue.

A journal will also give a good reference point in relation to when he gets fluids - ie: the day before his fluids he feels really grouchy etc as compared to the rest of the week. A couple of months down the road maybe you notice the amount of time he feels better after fluids is getting shorter, so you can talk to your vet about changing the schedule or volume of fluids.

2) I am wondering if you guys had any ideas about what it means that his numbers were so high, and then suddenly went down so low again, to where they are *almost* brushing up against normal. One reason I wonder about this is that I've heard that cats with low values shouldn't be put on SubQ's prematurely, but then, it's a bit different for him since he *started out* with much higher results.

Most of that drop is due to the IV fluids, fluids directly in the bloodstream flush out far more of the toxins that cause the rise in values. However it also flushes out many essential minerals, nutrients etc that the body needs, which is why IV fluids is not done for an extended period of time.

Since Smokey was brought in with high numbers, it is best to keep him on Subq fluids for now until there is a stable value shown over the course of a couple of tests. Your vet has already adjusted the schedule to less frequent treatment to compensate for the better numbers.

3) The dosage for Azodyl is 1 pill for cats 5 pounds and less, and two for cats that are over 5. My cat is just over 5 at the moment, as he is regaining weight he lost when he wasn't eating. His normal weight is around 5.5 or so. So would it be a good idea to give him one Azodyl a day instead of 2, as the vet recommended? As far as I can tell, there's no pressing reason to reduce the dose of a probiotic, as opposed to a "drug" that can have side effects. However, it would certainly be easier to pill him only once a day (and he'd be happier as well I expect).

Personally :2cents: I would keep him on 2/day. According to the IRIS Staging Guide (http://www.iris-kidney.com/guidelines/en/staging_ckd.shtml) Smokey is in Stage 2 of kidney disease, Azodyl is ideally suited for stages 2-4. The Azodyl will not have a negative effect, but instead continue to help reduce the toxin levels making him feel better which in turn may increase his appetite.

4).....I'm considering moving Smokey off dry food completely, and off the prescription food as well, wet or dry. Does this seem like a good idea, and do you have any advice for making the transition? For example, would it be a good idea to mix some new, better wet food in with his Fancy Feast at first in order to get him to try it, and then gradually change the ratios? Or will this upset his stomach?

If Smokey is still at a fragile/unstable point weight wise I would keep him on both right now, until he gains more ground in that respect. At 5lbs that's just tiny :( w/no room to lose, once he gets a bit more weight on him you can try some of the tips here: Transitioning Dry Food Addicts to Canned Food (http://www.catinfo.org/docs/Tips%20for%20Transitioning%20green%20Pages%2012-18-09.pdf)

As for the canned food, that depends on Smokey, some cats will jump right in & try something different whereas others need it mixed so the change is less noticable. Slowly adding a tiny bit of new canned to the FF is a good way to "trick" him into eating a better food without turning him off right away. Some cats take better to change than others but slowly changing shouldn't be anymore upsetting to his stomach than if you did a straight switch, unless he's intolerant to a specific ingredient.

5) Finally, is there anything I should watch out for that I haven't mentioned? If we keep going with this regimen, and don't get him tested again for a few months, are there any signs or warnings I should be looking for, beyond the obvious? I realize I sound like a paranoid lunatic, but I want to do right by Smokey because he's a good cat and an excellent companion, and cats can be so frustratingly stealthy about their health.

Things to watch for: any changes in drinking/eating/litter box habits/mood/time spent sleeping, any new symptom you hadn't seen before like lip licking, vomiting, unusually bad breath, drooling.

Are you familiar with the skin pinch test for dehydration? Have your vet show you what to look for - grasp the skin between the shoulder blades between your thumb & first finger, gently pull it up so it's taut & let go. If it "tents" or takes longer than 2-3 seconds to go back to normal, your cat is showing clear signs of dehydration - if it tents & stays up go to the vet asap.

You can also, if he'll allow, rub your finger along Smokey's gumline - if it's wet & slick he's fine, but if it's dry, sticky/tacky - he's showing clear signs of dehydration & you should contact a vet asap.

I've found this site http://www.felinecrf.org/index.htm to be a invaluable resource written by a woman whose been throught it all before.

Paranoid lunatic? no Good pet parent? yes :thumbs up

nemesis
September 9th, 2010, 03:02 PM
Hi nemesis :) welcome to the forum & the CRF cat club :grouphug:. It is absolutely ok that you post here, this was my hope when I started this thread - that we could all gather our experiences & ideas in one place to help ourselves & others. :)



At this point the more important thing is getting him to eat, not really what he's eating, especially considering his previous refusal to eat. Fancy Feast does have a number of varieties that have good phos numbers, the most recently updated food table listing by dry matter phos (http://www.felinecrf.org/canned_food_usa.htm#food_data_tables) shows quite a few flavours under 1.20% dry matter phos :thumbs up. You want to stay below 1.25% max and try to stay away from fish varieties as much as possible.



When posting blood/urine values please put the reference range for the lab that did the tests (like you did for the phos :thumbs up) depending on the equipment the numbers can vary quite a bit.

That is a very good drop from the previous numbers :highfive:



Cats realize pretty quickly when something is making them feel better & will adapt relatively easily to the changes. My :rip: crf girl Duffy went from being a pill spitter to a cat who would willingly sit & wait for her twice daily supplement regiment.

Giving fluids for the 1st time yourself at home can be a scary thing, but if you go into it with confidence you'll do fine. It definately gets easier with practise to the point it just becomes routine.

Here's a step by step instruction guide you can refer to: http://www.weirdstuffwemake.com/weird/stuff/pets/cats/sophia/catjuice.html

I would recommend getting a price comparison of the fluids, lines & needles from the vet, a human pharmacy and/or a medical supply company if there is one in your area. I found a local medical supply company to be the cheapest, fastest & easiest to get supplies from.

Most vets will use a Monoject 18g needle for giving fluids to cats, ask your vet for a Monoject 20g instead, the needles are smaller & therefore the "poke" not so noticable. The fluids will run slightly slower through a smaller gauge needle, but in & out it's more comfortable for the cat. If your vet carries Teurmo Ultra Thin Wall needles that's even better :thumbs up, get those in a 20g. The Teurmo 20g UTW needles are super sharp, have a bevelled edged & the shaft is much thinner so the poke is hardly noticable at all - even compared to a Monoject 22g (even smaller needle). Given the thinner walls the fluid flow rate is about the same as a Monoject 18g.



Every 3 months is standard time between appointments, unless you notice something "off" ~ eating less, lethargic, change in behaviour/litter box habits or Smokey looks like he's slipping towards a crash.

You should always keep in mind that you can call the vet at any time to ask a question or give an update, if they think something is not right they'll have you bring Smokey in.

One thing I found very helpful is a cat journal - each day write down how Smokey is feeling (content/grouchy/playful), what his attitude is like (social/unusual hiding), how much he ate (more/less/same/doesn't like this flavour or that brand), litter box habits (more/less/same), what he did that day (slept all day/watched the birds/played w/toys/terrorized the dog). This will make it easy to spot any subtle changes before they become an issue.

A journal will also give a good reference point in relation to when he gets fluids - ie: the day before his fluids he feels really grouchy etc as compared to the rest of the week. A couple of months down the road maybe you notice the amount of time he feels better after fluids is getting shorter, so you can talk to your vet about changing the schedule or volume of fluids.



Most of that drop is due to the IV fluids, fluids directly in the bloodstream flush out far more of the toxins that cause the rise in values. However it also flushes out many essential minerals, nutrients etc that the body needs, which is why IV fluids is not done for an extended period of time.

Since Smokey was brought in with high numbers, it is best to keep him on Subq fluids for now until there is a stable value shown over the course of a couple of tests. Your vet has already adjusted the schedule to less frequent treatment to compensate for the better numbers.



Personally :2cents: I would keep him on 2/day. According to the IRIS Staging Guide (http://www.iris-kidney.com/guidelines/en/staging_ckd.shtml) Smokey is in Stage 2 of kidney disease, Azodyl is ideally suited for stages 2-4. The Azodyl will not have a negative effect, but instead continue to help reduce the toxin levels making him feel better which in turn may increase his appetite.



If Smokey is still at a fragile/unstable point weight wise I would keep him on both right now, until he gains more ground in that respect. At 5lbs that's just tiny :( w/no room to lose, once he gets a bit more weight on him you can try some of the tips here: Transitioning Dry Food Addicts to Canned Food (http://www.catinfo.org/docs/Tips%20for%20Transitioning%20green%20Pages%2012-18-09.pdf)

As for the canned food, that depends on Smokey, some cats will jump right in & try something different whereas others need it mixed so the change is less noticable. Slowly adding a tiny bit of new canned to the FF is a good way to "trick" him into eating a better food without turning him off right away. Some cats take better to change than others but slowly changing shouldn't be anymore upsetting to his stomach than if you did a straight switch, unless he's intolerant to a specific ingredient.



Things to watch for: any changes in drinking/eating/litter box habits/mood/time spent sleeping, any new symptom you hadn't seen before like lip licking, vomiting, unusually bad breath, drooling.

Are you familiar with the skin pinch test for dehydration? Have your vet show you what to look for - grasp the skin between the shoulder blades between your thumb & first finger, gently pull it up so it's taut & let go. If it "tents" or takes longer than 2-3 seconds to go back to normal, your cat is showing clear signs of dehydration - if it tents & stays up go to the vet asap.

You can also, if he'll allow, rub your finger along Smokey's gumline - if it's wet & slick he's fine, but if it's dry, sticky/tacky - he's showing clear signs of dehydration & you should contact a vet asap.

I've found this site http://www.felinecrf.org/index.htm to be a invaluable resource written by a woman whose been throught it all before.

Paranoid lunatic? no Good pet parent? yes :thumbs up

Thank you so much! All that is extremely helpful. One thing I should point out is that I made a very silly mistake. His weight is 11 pounds, or 5 Kilograms, NOT 5 pounds.:o

Things are still going well, so cross your fingers. I have another question, this time about pilling. He doesn't squirm too much, he doesn't try as hard to spit the pill out, but he vomits right afterward! Could he be doing it on purpose (is that even possible), or is something about the pills making him throw up? I can't imagine what it would be because he didn't used to throw up after getting his pills. And I'm quite sure it's connected to the pills and nothing else, because he rarely throws up otherwise, and in the last few days without fail a couple of hours after he gets his pill I find some vomit with the half-digested treats in it that he gets after his pills. Any ideas?

sugarcatmom
September 9th, 2010, 05:20 PM
I have another question, this time about pilling. He doesn't squirm too much, he doesn't try as hard to spit the pill out, but he vomits right afterward! Could he be doing it on purpose (is that even possible), or is something about the pills making him throw up?

After you administer the pills, do you chase them with a few cc's of water or tuna-juice in a syringe? If not, it could be that they're getting stuck in his throat and that's causing the vomitting. Coating the pills with butter might also help, but do try the liquid chaser as well just to be sure. Here's more info: http://www.catinfo.org/?link=pillingcats

growler~GateKeeper
September 11th, 2010, 03:01 AM
His weight is 11 pounds, or 5 Kilograms, NOT 5 pounds.:o

:thumbs up Ah that's much better then :D

Things are still going well, so cross your fingers. I have another question, this time about pilling. He doesn't squirm too much, he doesn't try as hard to spit the pill out, but he vomits right afterward! Could he be doing it on purpose (is that even possible), or is something about the pills making him throw up? I can't imagine what it would be because he didn't used to throw up after getting his pills. And I'm quite sure it's connected to the pills and nothing else, because he rarely throws up otherwise, and in the last few days without fail a couple of hours after he gets his pill I find some vomit with the half-digested treats in it that he gets after his pills. Any ideas?

Could be the the dry pill getting a bit stuck, if it's the Azodyl that he's vomiting it may be the size & the fact it's a capsule - they get sticky/start to dissolve when wet.

The easiest way I've found to pill a cat:
Sit the cat on the floor in the kitchen facing the cupboards, pills at the ready on the counter above, crouch behind him w/your legs on either side to block escape. One hand holding the head still, pill between the thumb & forefinger of the other hand, use your ring or middle finger, of the pill hand, to pry open the mouth. With forefinger on the pill place it on the roof of the mouth & slide it all the way down the back of the throat. This way there is no chance for them to spit it out, and it's over much faster. Treat afterwards.

nemesis
September 14th, 2010, 11:59 PM
Thanks guys, I took your advice and he's not throwing up the pills anymore! :)

In other news, we gave Smokey his first at home sub-q treatment. I would put in the "success" column simply because the needle was inserted with a minimum of fuss, and the fluid went where it needed to go. On the downside, he squirmed a lot more than he does when getting the sub-q at the vet, and I'm guessing this is because at the vet's he's uncomfortable and somewhat afraid. He just sits in his carrier and doesn't move much until we leave, whereas at home, his "domain", he feels perfectly entitled to just get up and leave whenever he feels like it. We'll try again in a few days and try to make him more comfortable.

One question I had was, is there any harm to the fluids flowing pretty fast? Usually at the vet it takes him about 10 minutes to get 150ml of fluid, whereas today it took about 5-6 mins. Our setup at home has the bag hanging higher than they have at the vet's, so the fluid was flowing faster. Is there anything bad that can happen because of this? If so I'll make sure to adjust the rate of flow next time.

growler~GateKeeper
September 15th, 2010, 12:46 AM
Thanks guys, I took your advice and he's not throwing up the pills anymore! :)

:thumbs up Awesome

In other news, we gave Smokey his first at home sub-q treatment. I would put in the "success" column simply because the needle was inserted with a minimum of fuss, and the fluid went where it needed to go.

:highfive: Excellent!

On the downside, he squirmed a lot more than he does when getting the sub-q at the vet, and I'm guessing this is because at the vet's he's uncomfortable and somewhat afraid. He just sits in his carrier and doesn't move much until we leave, whereas at home, his "domain", he feels perfectly entitled to just get up and leave whenever he feels like it. We'll try again in a few days and try to make him more comfortable.

This is definately from being more comfortable at home as opposed to at the vets. Smokey can also sense your nervousness & he's trying to take advantage of it :cat: :D

Be sure to have a hand on him at all times, if he likes his ear/face/nose/belly scratched you can try doing that while the drip is going, it distracts them & makes it seem like they're not "waiting" for something - in this case ~ to leave :D

For both cats & dogs whether it's fluids/nail clipping/bath/brushing/whatever I always use a phrase to let them know they're done ie: "That's it, you're done", gives them a cue that there is an end to it, they just have to wait for it. I'll also often say "You're not done yet" if they get fidgety during whatever it is I'm doing.

You might also try a couple of different spots for Smokey to be sitting/laying while getting the fluids, he may have a preference ie your lap, back of the couch, top of the dresser, counter in the bathroom etc as long as he's relaxed & comfy.

One question I had was, is there any harm to the fluids flowing pretty fast? Usually at the vet it takes him about 10 minutes to get 150ml of fluid, whereas today it took about 5-6 mins. Our setup at home has the bag hanging higher than they have at the vet's, so the fluid was flowing faster. Is there anything bad that can happen because of this? If so I'll make sure to adjust the rate of flow next time.

Nope, no problem there, just aslong as you can see the mL marker on the bag & know when to stop.

I would suggest starting to warm the fluids prior to administration, if you aren't already, with the weather getting colder even room temperature fluids will feel cold (bit of a shock :eek:) when injected under the skin of a cat, who normally have higher body temperatures than us.

There's one way of doing it shown here http://www.weirdstuffwemake.com/weird/stuff/pets/cats/sophia/catjuice.html, I used an extra large ziplock bag to put the fluid bag & line in, then placed it in the bathroom sink full of hot water for a few minutes - be sure to test the liquid so it's not too hot!

:goodvibes:

nemesis
October 8th, 2010, 10:19 PM
Hi everyone, I'm just popping back into the thread with an update and some more questions, if that's ok. So we've been giving Smokey his fluids at home for a while now, and it's going pretty well. He's also been eating well and generally looking good so I've got my fingers crossed, while trying not to be *too* optimistic.

I had a question about the fluids. He's been getting less squirmy during the fluid adiministration as time goes by, but the last couple of times, I've noticed he flinches more when the needle goes in, and has been squirming more than before while waiting for it to finish. I don't think I'm doing anything different, but it's possible that my technique is slipping a bit without me noticing. The last time he had his fluids, there were a couple of drops of blood that trickled out after the needle went in, which I'm told is normal if it happens occasionally. I just want to make sure I'm not seriously harming him. Could it be that I've been inserting the needle incorrectly the last couple of times? I'm not jabbing downwards or anything so I'm not going into his spine, but could I be poking into a muscle or something? How would he react if I had? Basically, how badly could I theoretically screw it up, and does it sound like I've been doing so? And, does anybody have any tips to help me get it right consistently? Thank you!! We've already got things so much more calm and comfortable than I expected at the beginning of this process, thanks in large part to the help I got here.

growler~GateKeeper
October 9th, 2010, 02:08 AM
Hi nemesis, happy to hear Smokey is eating well & looking/feeling good :highfive:

Are you warming the fluids before giving them? Some tips in above post.

What size needle are you using?

You can also warm the needle up a bit before using by holding it (capped of course) under your arm or between your hands for a few minutes or place it capped inside the ziplock bag & warm at the same time as the fluids.

When inserting the needle do you have a nice clear "tent"? As shown here from http://www.weirdstuffwemake.com/weird/stuff/pets/cats/sophia/catjuice.html
69676

Tenting the skin will ensure you cannot hit anything while inserting the needle, just don't poke through the other side. It is not necessary to hold the skin up during the entire fluid administration.

The needle should also have the open edge facing up as shown here, also from the same above mentioned site, ensuring the edge is facing up also helps reduce slicing the skin/muscle on the way in as the skin is tented up away from the end.
69677

Are you poking in the same spot each time? If you pick a different spot it will reduce the chances for tenderness and or scarring in that area. This picture, also from above mentioned site, shows the area you can safely use to insert the needle for fluids, anywhere the saddle covers is okay, it is always safer to place the needle parallel with the spine.
69678

A bit of blood usually means you've nicked a small vein, not generally something to worry about, lightly pinching the skin together for a minute or two is good to stop the bleeding. Sometimes it may happen if the needle doesn't go in smoothly or straight & the edge cuts a bit more of the skin on the poke.

Slightly skin flinching when inserting the needle can be caused by
- needle size is too big
- the needle going in on an angle
- the needle being too cold
- nicking a small vein
- a tender spot on the skin
- hitting muscle

If you had hit muscle you would likely see a fair sized flinch after the needle is inserted through the skin & possibly a meow if you've got a vocal one, sometimes they will turn their head around to see what that was/tell you off. Over time when you're more used to the process you can feel if the needle is entering something too dense to be just skin, if this happens slowly withdraw the needle, talk calmly to Smokey & try again in a slightly different spot.

Squirming while the drip is going could be from
- the fluid temp either too cold or too warm
- the flow rate is not fast enough
- some cats don't like to be restrained for the few minutes it takes - some can be distracted with a chin/cheek rub or a dab of food
- some cats also can feel when they've physically gotten enough fluids - but don't change the overall volume of fluids per week until directed by your vet

Smokey's still on 150mL twice a week right? Over the next couple of fluids days if Smokey continues to be squirmy during the last 50mL, you can change to 100mL three times a week - still the same overall weekly volume just slightly smaller amounts each time given more frequently. If you do alter the fluid volume/rate schedule be sure to mention this to your vet so they know what is going on.

You may also get a bit of fluid leakage after you are done, again lightly pinching the skin together in that spot & holding for 1-3 minutes will help the close the hole. I would also, while holding the spot in a light pinch, lift the skin up a bit & give a tiny shake as that will put a small air pocket between the fluid & the skin, reducing leakage. Massaging the fluids away from the injection site helps to spread the fluid pocket out a bit.

Doesn't sound like you are screwing up at all, sounds like everything is going pretty well :thumbs up just need a little refinement. Patience, practise & routine (same place giving fluids, same time of day, etc) will help things become smoother.

nemesis
October 22nd, 2010, 09:41 PM
Hi everyone, as usual your suggestions have helped a lot, especially you Growler :)

Unfortunately Smokey suddenly started feeling off today. Things had been going pretty well, no signs of anything wrong that I could notice. Then this morning, a few hours after his breakfast, he vomited. This in itself isn't necessarily a big deal, it happens sometimes due to a hairball or eating too fast. What worried me was that after vomiting his appetite seemed to be drastically reduced. Granted, he doesn't eat as much during the the middle of the day as he does in the morning and at night (in fact he often sleeps through the middle of the day), but it's unusual for him to be that uninterested in treats and wet/dry food even when he's not really hungry.

I eventually managed to get him to eat, by coaxing him with treats and some warmed up wet food, but I was definitely worried. In addition to this, he was licking/smacking his lips a lot, which as I understand is a sign of nausea. I didn't notice drinking more than usual, although he did seem to be "camping" in front of the water bowl for about 10 mins after having a drink.

He kept doing this for a while without getting better, so I took him to the vet. I could have waited until tomorrow but given that he has CRF, I don't want to take any chances anytime his appetite seems to be significantly reduced.

The vet gave him a physical exam, which showed nothing unusual. He did have a temperature slightly above normal, just on the borderline. They gave him an anti-nausea shot, and took some blood. We'll get the results of the blood test tomorrow. The funny thing is, when we got home from the vet, the first thing Smokey did is go to his food bowl. He didn't eat as much in one sitting as he usually might, but it was somewhat encouraging. He certainly ate more than he had the rest of the day, and seemed less "wary" of the food. I wonder if the anti-nausea meds could work that fast.

So basically I'm trying to remain calm and not freak out, but it's hard. His kidneys could be getting worse. If he is crashing again, I hope he can be stabilized again and we can continue on from there. Or even better, I hope it's something more mundane than that (could he just have stomach acid/nausea without necessarily meaning that he's crashing? I know that cats with CRF sometimes just feel nauseous...). But I don't want to get my hopes up too much either.

:pray:

growler~GateKeeper
October 23rd, 2010, 12:00 AM
Hi nemesis :) just glad to be able to share my little bit of knowledge from experience

How often are you meal feeding Smokey? When is his last meal of the night? I found my girl did better in the mornings if she was fed a small meal around 11pm-midnight. Less time between meals means there is less time with nothing but stomach acid in the stomach.

Yes the lip smacking/licking is most likely caused by stomach acid nausea - do you have Smokey's food dish elevated? What about his water dish - raise that one up between 2-6 inches as well. Place a phone book, low plant table or an upsidedown 24-can-flat box (like the ones the canned cat food or pop cans sometimes come in) under the dishes - just be sure to make it so the dish can't slide off (like a rubber/cloth mat to put under the dish) & scare him while he's eating.

Tanya's CRF site has more info on a new page all about Stomach Acid http://www.felinecrf.org/stomach_acid.htm


I think you did the right thing by taking Smokey in today & not waiting until tomorrow, just because once a sick cat especially a CRF cat goes off their food it can be more difficult to get them eating enough on their own again without associating it with nausea/feeling poorly/vomiting etc. You can also keep up the enticements w/treats etc see if that will stimulate his appetite throughout the day.

The anti-nausea meds usually do start to work pretty quick. :thumbs up

Yes it could just be an excess of stomach acid that doesn't mean he's crashing. :grouphug: remember to breathe :)

How is Smokey doing otherwise? Feeling like his normal self or has he been hiding again? How's the fluid administrations going?

You mentioned he doesn't seem to be drinking any more than usual, is Smokey your only pet? If so it's easier to try placing a measured amount of water in the dish & leave it for the day - at the end re-measure what is left & write down the difference (how much he drank), try it again a couple more times to see if it's a normal amount for him - this makes it easy to see how much he's actually drinking. If you have more pets this won't work cuz you won't know who drank it :laughing:

When you get the results/next speak to the vet ask if they think his fluids should be adjusted and if they think you should start giving antacids again at home. Sometimes the lip licking/hovering over the water dish indicates dehydration, to which you would need an adjustment in his volume or frequency, what usually happens during CRF progression is they absorb the subq amount faster & it doesn't hold them as long as it did so you increase either.

:goodvibes: for good test results :grouphug:

nemesis
October 23rd, 2010, 11:56 PM
Update: So it turns out we didn't get the blood work results today, as the "lab was running behind". Argh. :mad: It's more frustrating because when we called earlier in the day they made it sound like we would be hearing back very soon. Ah well, nothing to be done. I did get to talk with the vet, and she said that she didn't necessarily think he was crashing and he might just be going through a phase of nausea/bad appetite which we can handle by altering the treatments in some way. Unfortunately we won't know exactly what the situation is until tomorrow, but the vet thought it was ok to keep him at home until tomorrow, when we get the results. In the meantime, she recommended trying to get him to eat as much as possible, and she also recommended moving up his scheduled fluid dose from Tuesday to tomorrow, so we'll be giving him that in the morning.

On the bright side, Smokey seems to be feeling a bit better. He takes a nibble of food now and then and I'm throwing a bunch of stuff at him to see what'll stick, so hopefully in total it'll add up to a decent amount. He's also not hiding, which is a good sign. He seemed reluctant to move around earlier, but now he's walking around, using the litter box, and hanging out in his usual spots. I'm keeping a close eye on him though. He's still obviously not his usual self, tired, not interested in playing, etc.




knowledge


Thanks for all the tips! I will definitely try elevating his food and water bowls, and making sure he has enough food before going to bed at night. I have been measuring his water drinking as you recommended, and there's no major change as far as I can tell. I usually check every day to see how much water he's been drinking.

I picked up some baby food and canned tuna (for the tuna water) since they've been recommended as useful in getting sick cats to eat. I couldn't find the brand of baby food everybody seems to recommend, the best I could get were chicken and beef flavours, with no onions or garlic listed on the ingredients, but the ingredients list does have a generic "spices" ingredient so I'm not sure what that means exactly and whether or not it's safe for Smokey to eat. I also got some chicken broth but I couldn't find any with no sodium.:frustrated:

I also got cans and pouches of stinky wet food to try, and hopefully like I said out of all that he'll get some food into him.

growler~GateKeeper
October 24th, 2010, 01:28 AM
Being a bit more tired, not playful etc is to be expected with the nausea and/or possible dehydration, also if his numbers have risen that will reflect in how he is feeling. Keep in mind though the numbers may rise & fall slightly a number of times over the course of a year so it's not necessarily progression of the disease if the numbers have gone up a bit this time.

How are his poops? Good consistency? Any constipation or dryness?

To be on the safe side I would return the baby food with the generic "spices" as that could include garlic or onion powder.

Earth's Organic or Heinz Organics should be available in most North American grocery stores or some drug stores (Shoppers/London Drugs in Canada) or if you have a health foods type grocery (like Whole Foods/Choices in Canada). There may also be other organic brands that have no spices.

Not all cats will like the meat based baby food, Duffy wouldn't really eat it, she licked up a bit the first time offered & refused it after :shrug:

For the chicken broth you could also make your own, just boil a raw chicken breast/or smaller pieces in a pot of water, no salt or spices, until tender & cooked, remove chicken for your meals or see if Smokey wants to try cooked chicken either as a treat or topped on his food. Save the water, allow to cool & use that as the broth.

Have you tried Evo 95% Chicken & Turkey (http://www.evopet.com/products/default.asp?panel=na&id=1662) canned food? It is a good meat based grain-free low phos food.

Keep us updated on how Smokey does with the food & the test results :goodvibes:

nemesis
October 24th, 2010, 04:51 PM
The test results came in this morning, his numbers have indeed risen. His Creatinine is at 414 and his BUN is 21 (I don't have the ranges yet since I haven't seen the physical report). For reference, in August his Creatinine was 204 (range 27-186), and his BUN was 12.9 (range 3.6-10.7). So his values have doubled, roughly speaking. This was worrying, but the vet didn't seem to think it was an emergency. She said that we could put him on an IV at the hospital for a few days, and then increase the amount of subQ's at home, as well as resume giving antacids, and that this had a good chance of bringing his numbers back down or stabilizing him at levels that were somewhat higher than before, but lower than this new result.

So I opted to have him hospitalized with the IV fluids, hopefully I did the right thing and he won't be too stressed out there.

I'm a little perplexed because Smokey seemed to be gradually getting better on his own, despite us not doing that much. He just sort of fell into a funk on Friday, and then starting Saturday mid-day gradually started getting better, until late last night, when he voluntarily returned to his regular food bowl looking for food, and began soliciting pets and strokes again. If his blood work numbers are actually up, I would expect him to continue acting unwell until we had a more aggressive intervention. All we did was give him his regularly scheduled dose of fluids on Friday, try to make him comfortable and insist that he eat despite having no appetite.

Also, we just got a call from the vet, saying that originally they were planning on keeping him for 3 days or so, but that he was doing well (not sure what criteria they were using to evaluate this but I presume they mean what I was just saying, that he's not acting terribly sick) and so they thought they would only need him for 1-2 days.




How are his poops? Good consistency? Any constipation or dryness?


He generally has good poops, although he does have the occasional soft stool, which sometimes verges on just plain diarrhea. No constipation that I can detect.

Anyway, I'm a bit confused about what to expect, and how his test results relate to how he's behaving, but hey, at least he's feeling better than he was on Friday:)

growler~GateKeeper
October 24th, 2010, 07:45 PM
The test results came in this morning, his numbers have indeed risen. His Creatinine is at 414 and his BUN is 21 (I don't have the ranges yet since I haven't seen the physical report). For reference, in August his Creatinine was 204 (range 27-186), and his BUN was 12.9 (range 3.6-10.7). So his values have doubled, roughly speaking. This was worrying, but the vet didn't seem to think it was an emergency.

If the lab is the same as the last time & their machines haven't been recently updated the reference ranges would still be the same.

Given that Smokey generally (with the exception of this weekend) has been feeling good overall, the rise in numbers while not good, had he been feeling/acting worse it would be even more of a concern.

There is a saying in the CRF world - treat the cat not the numbers - you base treatment on how the cat is doing physically/emotionally while keeping an eye on the numbers and treat accordingly when there are changes but there are many cats that do great with numbers in the higher ranges.

Two different cats with the exact same numbers may not be feeling the same physically/emotionally, even with the same numbers they may have different symptoms so you treat them differently.

She said that we could put him on an IV at the hospital for a few days, and then increase the amount of subQ's at home, as well as resume giving antacids, and that this had a good chance of bringing his numbers back down or stabilizing him at levels that were somewhat higher than before, but lower than this new result.

So I opted to have him hospitalized with the IV fluids, hopefully I did the right thing and he won't be too stressed out there.

Given the symptoms he was displaying at home (not eating/nauseous/hovering over the water bowl) combined with his history of very high numbers (at the start) I think you made the right desicion to have Smokey in for IV treatments, most cats do fine at the clinic for a couple of days even in a busy environment.

As mentioned in the previous post, and given the increase in numbers Smokey would do well with a fluid adjustment, as it seems he's absorbing/using what he's given faster now. Adding the antacids back in will help with the nausea and should start to get his appetite back fairly soon, the vet will find the one that works best for Smokey while he's in hospital - overtime you may be able to reduce or stop giving them depending on how he does with the fluid adjustment etc. Remember to discuss all adjustments with your vet first though :)

I'm a little perplexed because Smokey seemed to be gradually getting better on his own, despite us not doing that much. He just sort of fell into a funk on Friday, and then starting Saturday mid-day gradually started getting better, until late last night, when he voluntarily returned to his regular food bowl looking for food, and began soliciting pets and strokes again. If his blood work numbers are actually up, I would expect him to continue acting unwell until we had a more aggressive intervention. All we did was give him his regularly scheduled dose of fluids on Friday, try to make him comfortable and insist that he eat despite having no appetite.

He was likely slowly adjusting to the rise in toxin levels, but it caught up with him this weekend or there was a bigger jump in the numbers this weekend. Cats are also notorious for hiding discomfort/pain and sometimes it seems to come on suddenly but it's just reached a point he couldn't handle/hide it anymore. It's times like these you wish you could just ask them to tell you how they feel :cat:

Kidney failure isn't physically painful so Smokey is not in pain, the symptoms just make him uncomfortable, often you will notice a difference in him about 5-10 mins into or after a fluid injection where they feel more relaxed/mellower cuz they are feeling more comfortable with a return to better fluid levels.

Also, we just got a call from the vet, saying that originally they were planning on keeping him for 3 days or so, but that he was doing well (not sure what criteria they were using to evaluate this but I presume they mean what I was just saying, that he's not acting terribly sick) and so they thought they would only need him for 1-2 days.

Ask if they are running a Mini Chem Screen blood test either an in-house or lab run, before discharging him, it doesn't need as much blood drawn because it tests less values but the Cre & BUN are tested in there. This can be run at the end of the 1st day on fluids and again during the 2nd day to mark the changes.

He's probably perked up & showing that he feels good, likely he's eaten something after a day on fluids.

Personally :2cents: from what you've described & the increase in numbers, I would have him there for 2 days of IV fluids. See how he's feeling by middle of the 2nd day, talk to the vet & discharge him at the end of the day.

If they run the blood test while on IV fluids you will see a dramatic drop in the numbers, which will come back up high out of normal once his body readjusts off the IV fluids but it will likely be in the same area or a bit higher than it was before this latest spike.

He generally has good poops, although he does have the occasional soft stool, which sometimes verges on just plain diarrhea. No constipation that I can detect.

No constipation or dry poop is very good :thumbs up Softer stool/diarreah could be the meds/food but as long as it stays occasional & he's not having issues with it, it's fine.

Anyway, I'm a bit confused about what to expect, and how his test results relate to how he's behaving, but hey, at least he's feeling better than he was on Friday:)

When the toxin levels (amount of creatinine & BUN) in the blood rise it makes them feel uncomfortable, irritable, tired, nauseaous, overall crappy so they tend to stop eating, hide, not want to be brushed/pet/picked up, whatever. You can see a change in behaviour because he's reacting to how the rise in blood level make him feel physically.

If you've ever skipped a meal or two & gone about your daily stuff, there usually is a point in the day where your blood sugar dips too low and as a result you get lightheaded, your energy tanks, you feel a bit nauseous, tired, muscle cramps, maybe even a bit of vertigo. At that point you feel cranky, don't want to talk to people etc, and when you do go get something to eat you sometimes feel a bit more nauseous until you've eaten enough to spike your blood sugar back up to normal, after that you feel better. The rise of blood toxins in a CRF cat is sorta the same thing but on a very basic level of comparison.

Once you are more in-tune/experienced with the symptoms of CRF you start to be able to tell when the blood levels are rising just by how the cat is acting/behaving in subtle ways.

:grouphug: :goodvibes:

nemesis
October 25th, 2010, 09:03 PM
Smokey is back from the vet this evening, the end of his second day there receiving IV fluids. We spoke to the vet earlier today and she said Smokey could come home and was doing better. In addition to the IV fluids, they had started giving him antacids again.

We spoke with the vet when we picked up Smokey and she said that we should go to subq's every other day. She also said that if we wanted to, we could even try every day, and see how that goes. So for now, I think we'll do every day, at least until Saturday, which is when the vet wants to do a blood test again (they didn't do a mini panel during his stay at the vet). We're also going to continue giving him the antacids at home.

The vet said that she hoped Smokey had mostly had a bout of gastritis, but his numbers are up, so it makes sense to increase his subq intake. We'll see how he does on Saturday on his test results.:fingerscr

The first thing Smokey did when he got home was go for his food bowl, which was encouraging. Then he wandered around, sort of like he was inspecting everything to make sure it was in order:lovestruck: He drank some water, used the litterbox, etc. I brushed him and he quite liked it, purring and stretching out like he usually does.

I'm watching him like a hawk right now, to see if he goes back to hovering over his water bowl, or displays any other signs similar to how he was acting on Friday. Unfortunately after hanging out for a while, he's gone to sit under the couch, which is where he stayed for most of the day Friday and Saturday when he felt sick.:shrug:

He's definitely got his appetite back, is less sluggish, and more himself than he was on Friday and Saturday, but the fact that he's back under the couch is worrying. I guess I'll just watch him really closely to see how he behaves over the next few days.

growler~GateKeeper
October 26th, 2010, 12:47 AM
Smokey is back from the vet this evening, the end of his second day there receiving IV fluids. We spoke to the vet earlier today and she said Smokey could come home and was doing better. In addition to the IV fluids, they had started giving him antacids again.

Glad to hear Smokey's home & doing better :highfive:

We spoke with the vet when we picked up Smokey and she said that we should go to subq's every other day. She also said that if we wanted to, we could even try every day, and see how that goes. So for now, I think we'll do every day, at least until Saturday, which is when the vet wants to do a blood test again (they didn't do a mini panel during his stay at the vet). We're also going to continue giving him the antacids at home.

How much fluid are you giving now?

When you give fluids everyday, you need to ensure the fluids from the previous session are compleletly absorbed before giving fluids again. You know the fluid pouch he gets under the skin & the "squishy" feeling of the skin in the back (where the needle goes in) and the chest/front leg area (depending on where the fluids settle before complete absorption) make sure that is gone & totally absorbed before giving fluids again. Smokey should have no problem absorbing the fluids everyday before the next session (unless giving higher amounts ie 250+) but it's always good to be sure. :cat: Should there be any residual fluid left just wait a few more hours until it's absorbed then give fluids.

The vet said that she hoped Smokey had mostly had a bout of gastritis, but his numbers are up, so it makes sense to increase his subq intake. We'll see how he does on Saturday on his test results.:fingerscr

:goodvibes: for the test on Sat :fingerscr Let us know what the results are.

The vet likely didn't do a mini panel as they already had in mind to run the tests on Sat & often vets don't want take blood so soon after a previous test - depletes the cats reserves & can be stressing.

The first thing Smokey did when he got home was go for his food bowl, which was encouraging. Then he wandered around, sort of like he was inspecting everything to make sure it was in order:lovestruck: He drank some water, used the litterbox, etc. I brushed him and he quite liked it, purring and stretching out like he usually does.

Good boy Smokey :thumbs up

I'm watching him like a hawk right now, to see if he goes back to hovering over his water bowl, or displays any other signs similar to how he was acting on Friday. Unfortunately after hanging out for a while, he's gone to sit under the couch, which is where he stayed for most of the day Friday and Saturday when he felt sick.:shrug:

He's definitely got his appetite back, is less sluggish, and more himself than he was on Friday and Saturday, but the fact that he's back under the couch is worrying. I guess I'll just watch him really closely to see how he behaves over the next few days.

I would say right now he's probably hanging under the couch just to catch a little alone down time, he's had a lot of excitement lately. Lots of cats do like a "hidey" place even when there is nothing wrong, and some prefer to be up high like a bookshelf - it's just a safe napping spot.

:goodvibes:

nemesis
October 27th, 2010, 03:45 PM
Smokey is continuing to get better. His appetite and demeanor are good. I think his remaining odd behaviour is due to him being annoyed at being taken to the vet for a few days and then having his fluids the next day (he get skittish if he sees people congregating in a conspiratorial way, i.e, "what are they up to now?"). I've been giving smaller meals more frequently to help ease his stomach and elevated his food and water bowls. I also heard about an herbal supplement called Slippery Elm Bark which is supposed to help with stomach acid, nausea, and so on, has anyone tried it?

Up to this point he's been receiving 150 ml of fluids twice a week. He had his last dose of IV fluids on Monday, and we gave him his Subq dose yesterday. The water pouch is gone. I'm trying to decide if we should give him another subq dose today, and just go with every day until Saturday, or give him a break. The vet said that we could give him his first dose right away the next day after he comes home, and then switch to every other day after that. But if receiving the fluids every day would be more beneficial, I have no problem doing it. My only concern is that it will upset him if we do it every day. He is more compliant than before, and we are better at controlling him during it, but he doesn't really "like it" per se. On the other hand, it's possible that he was more annoyed at us last night after fluids because he was still upset about having to be at the vet for a few days. Hmm. I wonder if I could even give him a break today, and then resume giving them every day until Saturday. I also wonder if it's better to be consistent in the timing of it, as in, not switch between every other day/every day, and just stick to one.:confused:

growler~GateKeeper
October 28th, 2010, 03:01 AM
Smokey is continuing to get better. His appetite and demeanor are good. I think his remaining odd behaviour is due to him being annoyed at being taken to the vet for a few days and then having his fluids the next day (he get skittish if he sees people congregating in a conspiratorial way, i.e, "what are they up to now?"). I've been giving smaller meals more frequently to help ease his stomach and elevated his food and water bowls.

Excellent :thumbs up

Do you think this most recent hiding/odd behaviour of Smokey's is very concerning/out of character or does it usually take him a couple of days to get over vet visits/changes in the household (visitors staying overnight etc)?


I also heard about an herbal supplement called Slippery Elm Bark which is supposed to help with stomach acid, nausea, and so on, has anyone tried it?

I did use SEB for a bit as it also soothes & coats the lining of the intestinal tract, soothes mouth ulcers and helps with constipation/diarreah by rebalancing the water absorption in the bowels.

For my girl the issue that prompted me to use SEB was constipation, it worked well for ensuring her poops were not too dry & she could pass them easier. At that time I was feeding bone-in ground raw food and as her homeopath & I discussed her food more we determined that she was starting to react to the ground bone - the content was too high for her system to handle, and once we switched her to a bone-free, calcium supplemented raw food she didn't need the SEB anymore.

A note of caution with SEB you should give it at least 1 hour before or after any other medications or supplements as it can interfere with their absorption, SEB stimulates the production of mucous in the gastro-intestinal tract. Also being that it is a herbal supplement, my animal homeopath & homeopath vet recommended it not be used as a daily long term solution, any herb can react against other herbs, supplements and medications, and as with any herbal remedy it is important not to overdose.

SEB is considered safe & effective however the magnesium content is high which is a concern if the urinary pH is high and it does contain calcium so it's not recommended for one with hypercalcemia.

Some info on SEB:
http://www.felinecrf.org/holistic_treatments.htm#SEB1
http://www.littlebigcat.com/?action=library&act=show&item=slipperyelm

Up to this point he's been receiving 150 ml of fluids twice a week. He had his last dose of IV fluids on Monday, and we gave him his Subq dose yesterday. The water pouch is gone. I'm trying to decide if we should give him another subq dose today, and just go with every day until Saturday, or give him a break. The vet said that we could give him his first dose right away the next day after he comes home, and then switch to every other day after that. But if receiving the fluids every day would be more beneficial, I have no problem doing it. My only concern is that it will upset him if we do it every day. He is more compliant than before, and we are better at controlling him during it, but he doesn't really "like it" per se. On the other hand, it's possible that he was more annoyed at us last night after fluids because he was still upset about having to be at the vet for a few days. Hmm. I wonder if I could even give him a break today, and then resume giving them every day until Saturday. I also wonder if it's better to be consistent in the timing of it, as in, not switch between every other day/every day, and just stick to one.:confused:

In your situation I would be comfortable giving fluids everyday providing the fluid is fully absorbed & re-assessing after Sat's bloodwork comes back from the lab, if you think Smokey needs a break then by all means give them every other day as your vet has already mentioned is okay.

If you skipped fluids on Wed & he acts worse/more cranky/drinking noticibly more etc during the day Thurs then give fluids each day starting Thurs through Sat & mention to the vet how his behaviour was during this week.

We do want to be as consistant as possible with the fluid schedule just so the cats are not going longer than recommended/needed without fluids, as that makes the symptoms more pronounced & constant dehydration is not that easy to overcome. It all depends on how much/how frequent each individual cat needs.

Overall shifting the schedule a few times isn't going to be too big of an issue while you figure out what works best for Smokey. The results back from the lab will help your vet determine if it's better everyday or every other day, your observations are also very helpful in determining which is better for Smokey.

A bit about fluid frequency http://www.felinecrf.org/fluid_therapy.htm#frequency_of_fluids

A bit about overhydrating http://www.felinecrf.org/treatments.htm#fluid_retention

What is he like a couple of hours or so after getting fluids? Is there a difference in his behaviour/demeanor than before giving fluids?

:goodvibes:

tigerbee
November 2nd, 2010, 02:02 AM
Hello!

I moved out of my parent's house a few years ago and was finally able to take my kitty, Tiger, to live with me this August. He will be 14 this month. I am very interested in proper nutrition and ever since he has moved in with me he has been put on a 100% grain-free canned diet (no more kibble!!). He and my boyfriend's cat, a 1.5 yr old calico female terror (that we love dearly) also get a few meals of raw weekly but their diet is mainly canned. They get a variety of flavors from Wellness, Nature's Variety, Weruva, Petcurean, and Evanger's. I am trying to familiarize myself with the lower phosphorous varieties as well as calculating dry matter and read some good pointers in the thread already concerning that, luckily he likes almost everything suggested! I will start making those a more prominent part of his diet. The cats get 2-3 meals a day. His appetite is great, he is my secondary alarm clock which has saved me from being late a few times! I'm glad he is always eager for breakfast. We have several water dishes across the apartment and he seems to drink a lot, perhaps a bit less after starting fluid therapy but I catch him drinking more than Asha. Living with a young and spunky (on the verge of violently insane) kitty has really livened up his life and activity level too.

Tiger went in for bloodwork last month. The following were the only things with abnormal ranges:
ABS Lymphs - 946 /uL L (1300 - 7000)
BUN/Urea - 51 mg/dL H (15 - 34)
CHOL - 274 mg/dL H (82 - 218)
CREA - 3.1 mg/dL H (0.8 - 2.3)

My vet advised me to begin sub-q fluid therapy at home, 300cc's twice weekly. We did not discuss any medications. He is due for another blood profile in one week. Are we supposed to see a drop in his levels? I am uncertain whether or not 300cc's twice a week is better or worse than a smaller amount more frequently. I just ordered a digital infant scale on amazon to track his weight/hydration a bit more accurately as advised by http://www.felinecrf.org which I was linked to in this thread. Lots of great info there (and here!). Glad I found you guys.

Any advice or thoughts on Tiger's specific situation would be greatly appreciated.

growler~GateKeeper
November 2nd, 2010, 03:17 AM
Hi tigerbee :) welcome to the forum :grouphug:

since he has moved in with me he has been put on a 100% grain-free canned diet (no more kibble!!).

Awesome :highfive:

They get a variety of flavors from Wellness, Nature's Variety, Weruva, Petcurean, and Evanger's. I am trying to familiarize myself with the lower phosphorous varieties as well as calculating dry matter

Good to see you have the holistic brands already, there is a newly updated listing here http://www.felinecrf.org/canned_food_usa.htm#food_data_tables, the numbers are already ordered by phos level and are listed all in dry matter. From here you can find the lower phos flavours of the brands you know your cats already like.

The cats get 2-3 meals a day. His appetite is great, he is my secondary alarm clock which has saved me from being late a few times! I'm glad he is always eager for breakfast.

Happy to hear he has a good appetite, I would suggest raising the food & water dishes up between 2-6 inches off the ground. Place a phonebook, box, planter stand/low table etc just be sure the dishes can't slip off & scare the cats while eating. Raising the dishes will ensure the cats head is above their stomach while eating, helps prevent nausea though it sounds like not an issue at this point.

Another tip is feed a snack before bed so there is something in the stomach to keep the digestive juices working properly & not causing trouble.

We have several water dishes across the apartment and he seems to drink a lot, perhaps a bit less after starting fluid therapy but I catch him drinking more than Asha. Living with a young and spunky (on the verge of violently insane) kitty has really livened up his life and activity level too.

Tiger went in for bloodwork last month. The following were the only things with abnormal ranges:
ABS Lymphs - 946 /uL L (1300 - 7000)
BUN/Urea - 51 mg/dL H (15 - 34)
CHOL - 274 mg/dL H (82 - 218)
CREA - 3.1 mg/dL H (0.8 - 2.3)

Very good that Tiger is active & playful & has a friend to keep him amused. :cat:

Was there a urinalysis done?

Absolute Lymphocytes being low can be a result of a stressful blood draw, low grade inflammation, or certain medications.

The high cholesterol can be a result of having recently eaten, also can be due to stress. It doesn't have the same meaning as humans with high cholesterol.

My vet advised me to begin sub-q fluid therapy at home, 300cc's twice weekly. We did not discuss any medications. He is due for another blood profile in one week. Are we supposed to see a drop in his levels? I am uncertain whether or not 300cc's twice a week is better or worse than a smaller amount more frequently.

Is that a total of 300cc per week or 300cc given two times a week?

Hopefully you will see the BUN & Cre blood levels start to drop, though it often takes sometime before you see large changes.

More frequency/lower volume vs less frequent/higher volume depends more on how Tiger is adjusting to getting fluids and how quickly he absorbs them. Also how does he feel fluid days vs non-fluid days - is he cranky & moody the day before fluids & feels much better after, perhaps more frequent might work better.

How is Tiger doing with having fluids given? Overall mood before/during/after fluids?

300cc is alot to give in one session & often people will divide that into two sessions per day. You can always speak to your vet about giving it more frequently so Tiger doesn't get so much at once. Be sure that all the fluids are absorbed prior to the next session.

Instead of 300cc two times a week, ask your vet about doing 150cc every other day. You would still be giving the same overall amount just less, more frequently, might be easier on Tiger with more even hydration levels from fluid to non-fluids days. *Please speak to your vet prior to changing the fluid schedule, as they have seen your cat & can tell if there is need to change the dosage.*

Are you ordering fluids & supplies from your vet? What brand/size needle are you using?

If you can find a pharamacy or local medical supply company to order from it is usually much cheaper than buying from the vets.

Terumo Ultra Thin Wall (UTW) 20g is what I and many others have found to be the best brand/size. The ultra thin walls allows the fluids to flow as fast as the Monoject 18g but with much more comfort upon insertion as the point is also beveled & sharper.

Are you warming the fluids before application? I found an extra large ziplock bag the perfect size to place the bag, line & needle into, to place in a sink full of hot (not too hot) water for a few minutes. This allows the fluids to warm up to cats body temperature, so it's not such a shock to the system having room temp/cold fluids under the skin.

Feel free to ask any questions

:goodvibes: for next weeks' blood results

tigerbee
November 2nd, 2010, 08:25 PM
Yes, a urinalysis was done. I didn't get a copy of those results because it took a second try a few days after the initial blood profile. The vet called and said that the results were what she expected, slightly diluted (this was prior to fluid therapy). I will get copies of everything when we go in next week for the check up.

It is total 600cc's per week. 300cc's at once. It seems like a lot to me when we're doing it. I hadn't thought of splitting it into 2x a day. He wiggles far to much for me to do it alone so I have to get my boyfriend's help. I think doing it every other day may work better for us since we're both only free at night. I will talk to my vet about doing it differently and see what she thinks.

He doesn't seem to be moody ever. He is always very alert and loving. He is always up to greet me when I wake up or get home. The only change is that now that he is older he seems uncomfortable with being picked up and really hates being brushed (although he never loved it..).

I got my supplies online. The vet's prices were about 4x more! The needles are Monoject 18g. I have a box of 100 but when I am out I'm interested in trying the ones you are recommending.

I do warm the fluid bag beforehand. Tiger doesn't notice the needle if I set him up with a small dish of 100% freeze dried chicken breast treats. There is another question! Should I try to cut back on treats? I certainly don't dish them out like crazy but he may get 1 a day, and a little more on his fluid days. I know cutting down on the phosphorous is important, can treats make a huge impact? Everything I have read has made me think that fluid therapy can help more than changing the diet.

Thank you so much for the tips and advice given in your reply. :)

growler~GateKeeper
November 3rd, 2010, 01:01 AM
It is total 600cc's per week. 300cc's at once. It seems like a lot to me when we're doing it. I hadn't thought of splitting it into 2x a day. He wiggles far to much for me to do it alone so I have to get my boyfriend's help. I think doing it every other day may work better for us since we're both only free at night. I will talk to my vet about doing it differently and see what she thinks.

Yeah that's a lot for one session. If you can manage it alone splitting the 300cc into 2 sessions each fluid day is not a problem, likely more comfortable for all since you're not confining him for as long.

Usually if someone is doing for example 150cc 2x a week & their cat gets antsy around the last 50cc or so I would say no problem to go 100cc 3x a week (overall same volume/week), but because of the higher volume of fluid Tiger is getting I think it's best to talk with your vet first before changing the volume/number of days.

Have you seen this site? http://www.weirdstuffwemake.com/weird/stuff/pets/cats/sophia/catjuice.html Great step by step instructions & tips for fluid administrations.

He doesn't seem to be moody ever. He is always very alert and loving. He is always up to greet me when I wake up or get home. The only change is that now that he is older he seems uncomfortable with being picked up and really hates being brushed (although he never loved it..).

Sounds like a sweetie :cloud9:
The last year & a half my :rip: CRF senior girl wasn't too thrill with being picked up often either, the joints get achy, tummy gets a bit touchy......

I got my supplies online. The vet's prices were about 4x more! The needles are Monoject 18g. I have a box of 100 but when I am out I'm interested in trying the ones you are recommending.

Quite the price difference eh? yikes. The Terumo 20g will slide in under the skin alot easier/smoother & less noticably than the Monoject 18g :thumbs up

I do warm the fluid bag beforehand. Tiger doesn't notice the needle if I set him up with a small dish of 100% freeze dried chicken breast treats. There is another question! Should I try to cut back on treats? I certainly don't dish them out like crazy but he may get 1 a day, and a little more on his fluid days. I know cutting down on the phosphorous is important, can treats make a huge impact? Everything I have read has made me think that fluid therapy can help more than changing the diet.

Great :thumbs up especially with winter coming you don't want Tiger getting chilled from the inside.

I wouldn't worry about the freeze dried chicken breast treats, especially since they are great for distracting him while he gets poked :D Pure chicken breast is not very high in phosphorus and the size of the treats certainly isn't going to make a huge impact.

Diet definately is important as it's an easy way to reduce the amount of phos the cat is ingesting. Changing the diet alone won't remove existing excess BUN/Urea & Cre from the body, just altering how much of them are being produced from the phos in the diet.

Fluid therapy is a fast & effective way of helping flush out the excess toxins BUN/Urea & Cre the body can't handle on it's own as well as helping to balance the electrolytes & re-hydrate the cat. So really both methods are equally important working in different ways.

If diet change and fluid therapy don't reduce the blood phosphorous numbers enough, phosphorous binders are an option to discuss with the vet.

nemesis
November 4th, 2010, 02:21 AM
Hi everyone, Smokey is doing much better now. Iíve been confused about his fluids though, and I think I need some help figuring out what the best option is, and how to communicate with my vet.

As you might recall, on October 22nd Smokey had a sort of mini-crisis were he refused to eat, became very lethargic and nauseous, and was generally acting quite sick. His blood test showed Creatinine 414, BUN 21. He received IV fluids for 2 days, then came home, and received subqís every day up until October 29th, when Smokey had his follow up blood test. His test results from that day showed that his creatinine went back to down to 185, and his BUN back down to 15. So good news there.

After this, weíve encountered some confusion about how best to continue with the fluids. I decided to switch to fluids every other day, which was between what he was getting before, which was twice a week, and the one week period after his mini-crisis, where he had it every day.
My reasoning for this is that he evidently was not doing well enough on twice a week, due to the fact that he stopped eating, was nauseous, acting very sick, and had to be put on IV fluids, and had elevated numbers, about twice what they had been a few months ago.

What Iím confused about that is the vet wants to do fluids every 72 hours, which is very nearly the same as twice a week, which we were doing on Tuesday and on Friday. I suppose there will be less time between each session, but not really a big difference, since there were 2 days between Tuesday and Friday and 3 days between Friday and Tuesday, whereas now thereíll be 2 days between each session. This change doesnít seem significant enough to me to compensate for how Smokey was behaving and the rise in his numbers, and how much they dropped after we gave fluids more often.

However, the most confusing part is the vetís rationale for this. She says that over-hydration can be harmful. Of course this I know, having read about it. But Iím not seeing any signs of over-hydration, and she hasnít indicated that sheís seen any either. Heís not sluggish or lethargic after fluids, quite the contrary. He doesnít feel squishy. The water hump doesnít take longer than a few hours to disappear. Heís not peeing more than usual. In fact, I can clearly see a difference in how heís behaving now, having been receiving more fluids for a while, compared to how he was behaving in the few weeks before his mini-crisis. It seems to me that if his numbers were twice as high, then surely he wasnít receiving enough fluids at that point? In other words, the degradation of his kidneys must have progressed to the point where he was becoming dehydrated sooner?

The vetís explanation for this is that the mini-crisis may have been caused by stomach irritation/acid, so in fact it may not be necessary to increase his fluids very much. But I donít understand this. How could stomach irritation CAUSE his higher numbers on the blood work? Isnít it the other way around? That is, doesnít stomach irritation, acid, nausea, etc, arise BECAUSE the kidneys are working less well, and thus filtering out fewer waste products (represented in creatinine numbers, for example)? Iíve never understood the causal relationship to flow in the other direction from my reading on the topic. It sounds like the vet is suggesting that Smokeyís kidneys are more or less the same as they were before, and so he doesnít need more fluids. He just needed to get over his stomach upset. But if that were the case, why even put him on IV fluids? Why was there such an obvious and dramatic improvement in his behaviour after getting fluids more often? If he was/is suffering from more stomach irritation, nausea, etc, doesnít this basically show that his kidneys are continuing to degrade, and that he might therefore need more fluids?

Was his mini-crisis caused by stomach upset, or by worsening numbers? If itís the former, then why did blood tests show worsening values? How can stomach upset by itself cause a 200% increase in creatinine, without there being worsening kidney functioning that justifies increased fluids?

:confused:

I fully admit that I may not know what Iím talking about, and could just be confused. I donít want to give the impression that I donít trust my vet, and I obviously have to defer to her expertise. But I donít quite understand her interpretation of whatís been going on lately, and I want to understand without stepping on her toes. Any advice? Sorry for the really long rant. :o

sugarcatmom
November 4th, 2010, 07:29 AM
Just a quick reply, and I'm sure growler will have more info for you, but it is far better to do a smaller amount of subQ fluids more frequently than a large amount less often.

growler~GateKeeper
November 5th, 2010, 03:20 AM
Is Smokey still on 2 Azodyl/day? Are you refridgerating the pills?

These last 2 blood test was there anything else that was out of normal?

In the 22 Oct test (Cre 414) & the 29 Oct (Cre 185) test do you have the numbers & ref ranges for Phosphorus (Phos), Calcium (Ca), Sodium (Na+), Potassium (K+), Chloride (Cl) and Bicarbonate (HCO3)?

Did they do a urine test? I'd like to see a timeline of the Urine Specific Gravity (USG) for the times a blood test was done if possible. USG is important for determining how much water is being excreted to flush out the kidneys. Obviously once fluid therapy is started the test is not as reliable as prior, but with a consistant fluid schedule and tests in between you can still get a good sense of when the kidneys need more water to remove the same toxins.

As you might recall, on October 22nd Smokey had a sort of mini-crisis were he refused to eat, became very lethargic and nauseous, and was generally acting quite sick. His blood test showed Creatinine 414, BUN 21. He received IV fluids for 2 days, then came home, and received subqís every day up until October 29th, when Smokey had his follow up blood test. His test results from that day showed that his creatinine went back to down to 185, and his BUN back down to 15. So good news there.

The creatinine at 185 is great, that is actually just inside high normal for your lab :thumbs up, the drop in BUN is good too.

The BUN : Creatinine ratio (http://www.felinecrf.org/diagnosis.htm#BUN/creatinine_ratio) however is higher now than it was before. Metabolic acidosis can be a contributing factor to this being high.

What Iím confused about that is the vet wants to do fluids every 72 hours, which is very nearly the same as twice a week, which we were doing on Tuesday and on Friday. I suppose there will be less time between each session, but not really a big difference, since there were 2 days between Tuesday and Friday and 3 days between Friday and Tuesday, whereas now thereíll be 2 days between each session. This change doesnít seem significant enough to me to compensate for how Smokey was behaving and the rise in his numbers, and how much they dropped after we gave fluids more often.

Did she want you to continue with the same volume 150mL? When does the vet want to do the next blood test?

One thing to consider now is Smokey's Cre number is lower than it was when you were doing twice a week and considerably lower than it was during his mini-crisis.

If you were to look at the numbers alone Cre 185 BUN 15 - if this was a just diagnosed cat it wouldn't even be put on fluids at this point - again based on numbers alone.

It's hard for me to advise which way to go because I've not seen how Smokey's acting/how he's feeling etc. My :2cents: based on the high levels at the start & this recent mini-crisis I would go with every other day see how Smokey does for 2 weeks, if he's showing any signs of over hydration, lethargy, starts fighting the fluid procedure or the fluids don't absorb as quickly anymore then cut back to every 72 hours. I'd also have another blood test likely a mini panel done at that point too. :2cents:

However, the most confusing part is the vetís rationale for this. She says that over-hydration can be harmful. Of course this I know, having read about it. But Iím not seeing any signs of over-hydration, and she hasnít indicated that sheís seen any either. Heís not sluggish or lethargic after fluids, quite the contrary. He doesnít feel squishy. The water hump doesnít take longer than a few hours to disappear. Heís not peeing more than usual. In fact, I can clearly see a difference in how heís behaving now, having been receiving more fluids for a while, compared to how he was behaving in the few weeks before his mini-crisis. It seems to me that if his numbers were twice as high, then surely he wasnít receiving enough fluids at that point? In other words, the degradation of his kidneys must have progressed to the point where he was becoming dehydrated sooner?

I think the reason she is concerned about over hydration is in part due to the creatinine now being back in high normal range. Smokey has cleared enough of the toxins to drop the cre back to normal (after all those extra fluids), so he doesn't need as much fluids for that particular purpose right now, he does still needs fluids for dehydration.

The vetís explanation for this is that the mini-crisis may have been caused by stomach irritation/acid, so in fact it may not be necessary to increase his fluids very much. But I donít understand this. How could stomach irritation CAUSE his higher numbers on the blood work? Isnít it the other way around? That is, doesnít stomach irritation, acid, nausea, etc, arise BECAUSE the kidneys are working less well, and thus filtering out fewer waste products (represented in creatinine numbers, for example)? Iíve never understood the causal relationship to flow in the other direction from my reading on the topic.

If the reason behind all this was over production of stomach acid, more fluids won't really fix that issue, the fluids will flush out the BUN & Cre but it doesn't reach/go through the stomach - so not much help there. Remember you've also just added back in the antacid to take care of that.

Increase in stomach acid/irritation etc won't cause higher Cre BUN bloodwork numbers, but the increase in creatinine or BUN also won't cause stomach acid levels to increase either. High levels of BUN, phosphorus etc may produce the feeling of lethargy/feeling sick/nauseous but the physical substance of stomach acid is caused by changes in the hormone gastrin.

Gastrin is a gastro-intestinal hormone which stimulates the secretion of gastric acid, which helps the stomach digest food. The kidneys are responsible for the excretion of gastrin, but in CRF this function may not work so well, resulting in the gastrin remaining in the stomach and stimulating the production of too much gastric (stomach) acid.

Your vet may have just had trouble explaining the relationship btwn high bloodwork & nausea, especially if she has not experienced/treated many cases of CRF :shrug:. Generally when cats have high blood work they also have high levels of stomach acid, it's not that high blood values cause it, but they are concurrent issues both related to (different areas of) kidney function. The higher the BUN value the higher chances are the cat will feel nauseous & vomit.

It sounds like the vet is suggesting that Smokeyís kidneys are more or less the same as they were before, and so he doesnít need more fluids. He just needed to get over his stomach upset. But if that were the case, why even put him on IV fluids? Why was there such an obvious and dramatic improvement in his behaviour after getting fluids more often?

I'm wondering if this mini crisis was brought on by metabolic acidosis (http://www.felinecrf.org/symptoms.htm#metabolic_acidosis) (thats why I asked at the top of this post for the Na+, K+ etc), may show similair signs to standard stomach acid but may account for the severity.

Smokey was put on IV specifically to flush the Cre & BUN out of the blood while the stomach issues were being worked out with antacids

Dramatic improvement because the blood toxins that made him feel super crappy were now gone. Most likely the blood toxins were causing him to feel worse than the increase in actual stomach acid was.

If he was/is suffering from more stomach irritation, nausea, etc, doesnít this basically show that his kidneys are continuing to degrade, and that he might therefore need more fluids?

Was his mini-crisis caused by stomach upset, or by worsening numbers? If itís the former, then why did blood tests show worsening values? How can stomach upset by itself cause a 200% increase in creatinine, without there being worsening kidney functioning that justifies increased fluids?

As above stomach acid is not neccessarily caused/fully connected to the degree of kidney function. It can also be a symptom of a pancreatitis inflammation. Sometimes with high values they crash (http://www.felinecrf.org/symptoms.htm#crashing) and there is not always a pinpoint explaination for why at that particular point, sometimes it's just the breaking point for an overloaded body.

Rant away if you need to :)

Blur's_Mom
November 6th, 2010, 12:22 AM
HI,
I just wanted to check in with one question, ok two.

Blue was diagnosed with early CRF in August of this year. The vet put him on Sub_Q's and gave him some pain medicine at first, as she said he also had pancreatitis, and he may need the pain meds to eat. For the last two months he has been eating low phos healthy food, with the very occasional can of something tasty and bad that he will eat when he is super fussy. He also has 100ml of Sub-Q twice a week.

I am wondering if everything seems to be going ok (happy, not losing weight, not dehydrated, not throwing up, etc), how often should I take him in for blood work. 3 months? 4 months? 6 months? I obviously want to make sure he is well taken care off, but he hates going to the vet, and I hate paying the bills!

And secondly, I have been getting Sub-Q supplies from the vet, mostly cause I had a credit from when I took back the prescription food that Blur wouldn't eat. My Pharmacist said he could order it in what ever I need, and I am sure it would be cheaper than the vet, but I think buying on line is a good choice. Does anyone have a site they would recommend?

Oh, one final thing. Last month I finally joined the "been stabbed" club. Silly Sub-Q needles!!

Thanks,

growler~GateKeeper
November 6th, 2010, 01:47 AM
Hi Blur's Mom :) good to hear things are going well for Blue :highfive:

I am wondering if everything seems to be going ok (happy, not losing weight, not dehydrated, not throwing up, etc), how often should I take him in for blood work. 3 months? 4 months? 6 months? I obviously want to make sure he is well taken care off, but he hates going to the vet, and I hate paying the bills!

For a CRF cat a vet visit with blood & urine work every three months is pretty standard when there are no obvious new issues (I think everyone hates those bills ;) :D)

And secondly, I have been getting Sub-Q supplies from the vet, mostly cause I had a credit from when I took back the prescription food that Blur wouldn't eat. My Pharmacist said he could order it in what ever I need, and I am sure it would be cheaper than the vet, but I think buying on line is a good choice. Does anyone have a site they would recommend?

Absolutely somewhere other than the vets would be cheaper, your local pharmacy can definately order in for you. Not sure where in BC you are, I'm in the lower mainland and was ordering from Grant @ Pacific Health Care (http://pacifichealthcare.ca/cgi-bin/phsupply?XwsSrvID=CAREca01,[a=01[b=12[c=01[d=ushpylpp[e=00011232[f=xxxxxxxx[g=1-84945) they are listed with www.felinecrf.org as a supplier for CRF cats, so mention that if you contact them. There is no minimum order, shipping cost is minimal and generally delivered within 2-3 days in the GVRD.

Oh, one final thing. Last month I finally joined the "been stabbed" club. Silly Sub-Q needles!!

Hope it wasn't too bad/hard :fingerscr Happens to everyone at one point or another :laughing: :D

tigerbee
November 6th, 2010, 09:37 PM
I made an appointment on 11/11 for Tiger's second blood profile since starting fluids one month ago. I had his old vet fax over blood results from 2008. I noticed the BUN and Crea were at the top of the range then and the vet never mentioned that I should anticipate kidney issues in the future... :frustrated: I'm giving a copy to my new vet. Can that tell us anything about the speed of progression?? I feel bad that I didn't catch it until now but I'm glad that I took him to the vet shortly after I got him from my parents.

It's hard to tell if he has been feeling better because of the fluids or because he likes living here. My parent's got a 45lb. dog over 2 years ago and Tiger pretty much went into hiding for half a year, then only laid around in his "safe spots" and had to creep around and act stealthy or else the dog would chase him playfully. The younger kitty girl's antics are nothing compared to a crazy dog so I think he is much more comfortable here with me. :lovestruck: He has been especially frisky the past two weeks. He is VERY into his toy bucket and digs out his favorite catnip toys at least twice a day that I witness. He has also been tackling Asha rather than letting her get him. :laughing:

He has been very loud and vocal this week before and after fluids so I don't think it is related. He stays by the door if one of us isn't home yet and yowls at the door/paces around yowling at nothing... "Screaming" at me even after I've fed him, given him a treat and paid lots of attention to him. I can't figure out what he wants!! Could be just be acting old and confused? He turns 14 this month.

growler~GateKeeper
November 7th, 2010, 01:15 AM
I made an appointment on 11/11 for Tiger's second blood profile since starting fluids one month ago.

If it's not included in this blood test already, ask them to test Tiger's T4 (thyroxine) thyroid hormone level. May be included already, may be an extra charge. HyperThyroidism is common in older cats 14 years & up.

Keep us updated on the results when they come in :goodvibes:

Can that tell us anything about the speed of progression?? I feel bad that I didn't catch it until now but I'm glad that I took him to the vet shortly after I got him from my parents.

There are no set progression timelines :shrug:, there are different stages to the diesease but no two animals are going to progress at the same rate even if they had identical values.

Many vets will take the wait & see approach & only treating when symptoms arise. :shrug:

He has been very loud and vocal this week before and after fluids so I don't think it is related. He stays by the door if one of us isn't home yet and yowls at the door/paces around yowling at nothing... "Screaming" at me even after I've fed him, given him a treat and paid lots of attention to him. I can't figure out what he wants!! Could be just be acting old and confused? He turns 14 this month.

Sounds like quite the character :cat:

Could be natural aging, could be high Thyroid levels - was his T4 level checked on the blood tests?, could be he wants/expects something specific & you gotta figure out what it is :laughing:.

How are his litterbox habits? Any straining/non-productive attempts/too frequent trips?

tigerbee
November 7th, 2010, 11:13 AM
His T4 was 1.7 (ref 0.5 - 4.7) last month. :party:

His litterbox habits are good although he was used to using an enclosed box and we have a second that is a little shallower that he lifts too high in sometimes and spills over the edge.. :yuck: He does urinate more frequently and in a higher volume than Asha.

Blur's_Mom
November 7th, 2010, 06:13 PM
Absolutely somewhere other than the vets would be cheaper, your local pharmacy can definately order in for you. Not sure where in BC you are, I'm in the lower mainland and was ordering from Grant @ Pacific Health Care (http://pacifichealthcare.ca/cgi-bin/phsupply?XwsSrvID=CAREca01,[a=01[b=12[c=01[d=ushpylpp[e=00011232[f=xxxxxxxx[g=1-84945) they are listed with www.felinecrf.org as a supplier for CRF cats, so mention that if you contact them. There is no minimum order, shipping cost is minimal and generally delivered within 2-3 days in the GVRD.


Thanks Growler. I checked the www.felinecrf.org page for info on where to get supplies, and it looks like Pacific Health Care will be the best bet for me too. I am in Victoria, so I am sure shipping won't be too big an issue. Even if it is a few extra bucks their prices are less than half what my vet charges. It will be worth checking with my pharmacist too.

:thankyou:
Blur's mom

Squeakypig
November 7th, 2010, 09:51 PM
Hi Growler.

I maintained my cat, Casper for two years after he was diagnosed with kidney disease in 2007. A serious kidney infection that almost took his life there and then resulted in one kidney damaged so bad that it shrank to half size. The other kidney was also compromised, just not as bad. Casper was given less than six months but I worked with him day in and day out and managed to nurse him through two years. Fluid build-up around his lungs and heart finally forced me to put him down but he enjoyed a reasonable quality of life up to then.

So, you have time yet!

From my experience, this is what you need to do and watch for:

1. Don't worry about holistic food. Just start your cat on the special reduced protein food your vet has recommended. The protein must come down because it will damage the kidneys even more and negate any benefit that you might have hoped for from the holistic food.

2. Get your vet to prescribe Epikitin. This is a natural supplement that you sprinkle over the cat's food. The cat won't mind it at all. What Epikitin does for the cat is bind up the excess phosphate so that it passes with the urine. It works really well! Those high counts will drop in about four to six weeks.

3. Check your cat's gums regularly. The gums should be nice and pink. If they go pale or creamy coloured then the cat probably has anaemia. It will happen because, and I didn't know this before, red blood cell production in bone marrow is regulated by the kidneys! As the kidneys weaken, anaemia becomes a problem.

4. Your cat is sixteen so I assume it sleeps a lot, even for a cat! None-the-less, watch for lethargy. It is another sign of anaemia for one thing but, it can also indicate other problems settling in. You cat's immune system may be compromised because of the kidney issue so, you must remain vigilant.

5. If your cat does become anaemic, it will have trouble keeping warm. I bought a heating blanket for the bed and left it on a medium-low setting all day long. When Casper felt cold which was pretty much always, he curled up on the bed in his own favourite blanket and the heating blanket warmed him up from below! It was the best money I spent in the whole affair.

6. Encourage lots of water intake. Put bowls of water everywhere! Leave water in cups. Buy one of those water fountains. The ones with falling water are best as the water tinkling sound will put drinking into the cats head! Another trick is to buy a Beta fish and put it in a fish bowl with an openning just big enough for the cat to poke his head through. Casper loved drinking the water from the fish bowl! (See the attachment)

7. Eventually, you will have to supplement your cat's fluid intake. The vet will show you how to administer subcutaneous injections of Ringers or Saline under the scruff on the cat's back. I did this every couple of days towards the end. Casper would look like a little camel with a big hump full of Ringers on his back! Also, my apartment looked like a little hospital ward with the bag of Ringers Lactate hanging from the chandelier! It was great conversation piece.

8. Much later I was introduced to a syringe that was designed for the purpose of hand-watering small animals. It looked like a regular syringe, about 100cc I think but, instead of a needle it had a tapered curved end moulded into the plastic body of the syringe. You could put the curved end into the cat's mouth even if the mouth was closed. You just wiggle the tapered end in between the moistened lips and once in, you slowly squirt the water into cat's mouth. They swallow it! It takes a bit of practice as you have to learn to allow the cat time to breathe, smack its lips and so forth. Ask the vet about this thing! It will reduce the need for poking your cat in back with a big needle. You'll both be happier.

9. If the kidney disease progresses, be prepared for what will come. Your cat will slowly waste away. No amount of love or encouragement will stop this but you sure can slow it down! So, be prepared for a long, slow, progressive weight loss.

10. Blood work will become something of a routine that your cat will come to hate, vehemently!

11. I spent a lot of time snuggling with Casper, especially in the final six months. He liked to snuggle because it kept him warm and he seemed to be at ease when we sat together. Find a good snuggle chair and spend time watching TV or reading with your cat. It is very rewarding.

Cheers,

Squeakypig

growler~GateKeeper
November 8th, 2010, 12:27 AM
His T4 was 1.7 (ref 0.5 - 4.7) last month. :party:

Ah excellent! No need to re-test this one then, since it was done not long ago :thumbs up

His litterbox habits are good although he was used to using an enclosed box and we have a second that is a little shallower that he lifts too high in sometimes and spills over the edge.. :yuck: He does urinate more frequently and in a higher volume than Asha.

Good that he's not showing any signs of litterbox issues other than missing occasionally. :rolleyes: :D

growler~GateKeeper
November 8th, 2010, 12:34 AM
Thanks Growler. I checked the www.felinecrf.org page for info on where to get supplies, and it looks like Pacific Health Care will be the best bet for me too. I am in Victoria, so I am sure shipping won't be too big an issue. Even if it is a few extra bucks their prices are less than half what my vet charges. It will be worth checking with my pharmacist too.

:thankyou:
Blur's mom

When you contact PHC ask for Grant, he's the sales rep I dealt with & he is wonderful :thumbs up

growler~GateKeeper
November 8th, 2010, 01:05 AM
Hi Growler.

I maintained my cat, Casper for two years after he was diagnosed with kidney disease in 2007. A serious kidney infection that almost took his life there and then resulted in one kidney damaged so bad that it shrank to half size. The other kidney was also compromised, just not as bad. Casper was given less than six months but I worked with him day in and day out and managed to nurse him through two years. Fluid build-up around his lungs and heart finally forced me to put him down but he enjoyed a reasonable quality of life up to then.

So, you have time yet!

Hi Squeakypig, thank you for your story & tips. This thread was actually started in 2007, I lost my CRF girl Duffy in April 2010 to Lymphoma after 3 years of successfully managing kidney failure with homeopathy, raw food, fluids & lots of love. :cat:

From my experience, this is what you need to do and watch for:

1. Don't worry about holistic food. Just start your cat on the special reduced protein food your vet has recommended. The protein must come down because it will damage the kidneys even more and negate any benefit that you might have hoped for from the holistic food.

Since the 2007 recalled tainted vet food was the cause of her kidney failure, there was no way I would've even considered feeding anything from the same manufacturer to my girl.

The reduced protein theory is outdated & not always a good idea especially in the early stages since cats are obligate carnivores & need meat protein to maintain muscle mass, stave off anaemia and it may also be contra-indicated when acidosis is present. More reading available here: http://www.felinecrf.org/nutritional_requirements.htm#protein

2. Get your vet to prescribe Epikitin. This is a natural supplement that you sprinkle over the cat's food. The cat won't mind it at all. What Epikitin does for the cat is bind up the excess phosphate so that it passes with the urine. It works really well! Those high counts will drop in about four to six weeks.

Not all cats will have high phosphorus levels, my girls was middle of normal for the entire 3 years of dealing with CRF, but definately good for those who need it.

You just wiggle the tapered end in between the moistened lips and once in, you slowly squirt the water into cat's mouth. They swallow it!

:laughing: you obviously never met my girl :D some cats will refuse to swallow whatever liquid it put in their mouth and either forcefully expell it or just let it dribble out :laughing:, Duffy had a fighting spirit & a stubborn streak a mile wide, very tough to make her do what she didn't want :cat:.

In order for this method to work, you need to position the syringe tip near the middle or back of the mouth, with the tip opening pointing towards the cheek or lower gums. Administer fluids very slowly to allow for swallowing & not to choke the cat with too much liquid at once.

It will reduce the need for poking your cat in back with a big needle.

Instead of using the Monoject 18g needles from the vet, a much better choice is the Terumo Ultra Thin Wall 20g. Flow rate is the same with a smaller diameter needle, thinner walls and a super sharp beveled edge/point makes for a nearly unnoticed poke, way more comfortable than the Mj 18g mini-harpoons.

be prepared for a long, slow, progressive weight loss.

Not if you feed a high quality protein diet. You can have good quality meat protein with reduced phosphorus levels and have the cat maintain weight. My girl was raw fed for 2.5 of the 3 years she dealt with CRF, there was no increase in blood phos, calcium or protein, she maintained weight and had fairly even stage 2 BUN & cre numbers. My vets were always delighted with her maintaining weight, in fact she did gain about 1/2 pound at one point. The only weight loss she had was as a result of lymphoma near the end.

10. Blood work will become something of a routine that your cat will come to hate, vehemently!

Not always, alot depends on the temperment of the cat & how good your vet is. My girl quite enjoyed going to see her homeopath & homeopath vets, for her blood work was no big deal. Duffy's homeopath called her a miracle kitty for coming through so strong after the toxic food recall of 2007 :cat:

nemesis
December 7th, 2010, 01:18 PM
Haven't updated in a while since I've been super busy.

Things have been ok for about a month, then on Saturday Smokey started feeling sick again, and I'm really worried. On Saturday he threw up once in the early afternoon, it looked like it was mostly hair and partially digested food. Then, later around 8pm he vomited some clear white foam.

The next day, Sunday, he had very little appetite, and only nibbled at his wet food a little, although he still had some appetite for treats and ate quite a few.

On Monday I took him to the vet. They took blood, and kept him there for a few hours. While he was there, he apparently had a bad bout of diarrhea, although he hadn't had any at home. The blood work came back ok, his Creatinine was at 228, which isn't bad, so the vet figures that's not responsible for how he's feeling. The vet said that the vomiting, not eating, and diarrhea suggests stomach irritation, so they sent Smokey home with some paste that is supposed to soothe his stomach, I believe it's called Progut (I think it's also known as Diarsanyl). They gave him one dose at the clinic, and gave us instructions to give him another in the evening, and to do that for a few days. Finally, they also gave him an anti-nausea shot.

When he came from the vet Monday afternoon, Smokey was in a better mood than he'd been the last few days, and actually seemed to be asking for food. I gave him some wet food and he had some, although much less than he would at a normal meal. He also ate a bunch of treats. However, after that, he barely had anything to eat the rest of the day except for a few treats. He also didn't respond very well to the paste and tried to spit it out, or would just sit there and drool so that it would come out.

The vet's instructions were to give him the paste and see how he did, and to call back and let them know on Tuesday, ie, today.

So this morning Smokey was not interested in eating anything except a handful of treats, which is worrying.

Aside from his appetite, his behaviour is definitely "off" but not that bad. He still walks around and jumps up on the couch and the bed, etc. He's been prone to hiding since he got back from the vet, but that seems to be mostly because he gets really annoyed every time we take him there and they do annoying stuff like take blood and make him eat weird paste he doesn't like. I say this because I saw him walking around and hanging out in his usual spots and then bolted under the couch when he saw me approach him.

So I'm not sure what to do at this point. I called the vet to let them know there hasn't been any change from yesterday and the nurse just said maybe we could try giving him his fluids a day early (tomorrow would be the day otherwise) to see if he's dehydrated. Otherwise she said she doesn't know what else to do. This is confusing because the doctor made it sound like we should give an update and then some new plan of action would be formulated. I mean shouldn't we investigate further if he's not getting better? For example, he was better after getting from the vet, so perhaps the anti-nausea shot helped, in which case, shouldn't that be investigated? I suspect the nurse didn't really understand, or may have not discussed Smokey's case with the doctor. In any case, I'm going to call back in a couple hours and ask to rely my questions to the doctor.

In the meantime, I'm trying to think of what I should do to get Smokey to eat, or what could have caused this. I tried lots of different types of food, and tried adding some tuna water to make it more appetizing. I tried Hills A/D food which he ate last time he refused to eat anything. I tried finding baby food but none of my local groceries have flavours without spices or tons of other ingredients I'm not sure about in them. I also wonder if one reason he's not eating is that he still feels upset about being taken to the vet and just needs to relax a bit, which makes me wonder if I should give him his fluids and stuff now, or leave him alone for a while?

Any thoughts? Thank you!

growler~GateKeeper
December 9th, 2010, 12:08 AM
Ask your vet about using Zantac for the nausea, they will need to give you the correct dosage based on weight. When Duffy was in the e-vet this is what they used with good results.

Is Smokey usually a hairball thrower? Is is possible he still has some hair left that needs to come out? If so you can give him a 1/4 tsp of butter to lick, that will help smooth things out, may get him interested in food again too.

What are his poops like right now? Okay or dry?

Duffy would vomit abit of white foam when she was trying to pass a particularily dry poop or if she went too long with nothing in her stomach so I made sure she had a snack at bedtime.

Sounds like he's running/hiding from you right now cuz you keep giving him the yucky tasting stuff :yuck: :D

You can try a 1/4 teaspoon of Slippery Elm Bark powder in his food, just be sure to mix in a teaspoon or 2 of water in as well This will also coat the stomach & intestinal tract, he may respond better to the flavour of it.

Have you tried bit of parmesan cheese, pinch catnip, warming the food, bits of roast or bbq chicken, crushed treat, dab of melted butter on top?

I would give the fluids early if you think he needs it, there is no rule that says the schedule can't be altered if need be.

:goodvibes:

nemesis
December 18th, 2010, 01:59 AM
Smokey is feeling much better now. He wouldn't eat at all so we resorted to syringe-feeding for a few days. He was relatively (and mercifully) cooperative. The vet did several tests and nothing out of the ordinary was found, so the current hypothesis is that one of, or the combination of his medications was making him feel sick and nauseous.

So the plan is to take him off the meds for a short period, and then gradually reintroduce them one by one.

It seems to make sense, because although syringe-feeding did *slightly* revive his appetite, his interest really started to come back a couple of days after stopping the meds. Of course, this doesn't actually prove that there's a causal relationship...the two events just followed each other in time. But I think it's a reasonable avenue to pursue.

It's tricky though, I'm starting to appreciate how difficult it must be for vets to diagnose and treat patients who can't speak! It's really like detective work.

Anyway, Smokey is eating again, although he is being very picky about what he will and won't eat. This might be a result of the way we treated him when he wouldn't eat, which was to be extremely indulgent just to get him to eat *something*. He seems like he really expects to get treats all the time, so I have to get him used to the idea of eating normally again.

His poops looking good and normal after a short bout of diarrhea.

Essentially, he's not acting sick anymore, but there does seem to be some kind of (recurring?)issue with nausea/acid/indigestion that is eluding us. Whether it's just a side effect of the kidney disease that has its up and downs, the vet's too many meds theory, or a separate gastrointestinal issue (IBD was briefly brought up but the vet hasn't spoken much about it yet), I have no idea. We're working on it though. In the meantime, I'm at least happy that his blood work is pretty stable and he's being a very good boy about his fluids.:fingerscr

growler~GateKeeper
December 29th, 2010, 11:55 PM
Good to hear Smokey has been feeling better, hope that has continued :goodvibes:

Unfortunately nausea is quite common in kidney cats, sometimes as a result of too much stomach acid & other times it can be from a combination of things including the meds.

It's always best to restart meds one at a time to make it easier on the tummy and also helps to point to which one may be the issue.

PMFan
February 4th, 2011, 04:40 PM
how do i know when it's time to start sub q fluids?

i have two with CRF

female 17yo CREA is 2.7 and holding steady for a year w/ no intervention

male 16.5 yo CREA is up to 3.5 from 2.7 six months ago

growler~GateKeeper
February 5th, 2011, 01:25 AM
how do i know when it's time to start sub q fluids?

i have two with CRF

female 17yo CREA is 2.7 and holding steady for a year w/ no intervention

male 16.5 yo CREA is up to 3.5 from 2.7 six months ago

One indication is when you see a significant consistant increase over time of the amount of water consumed per day.

How much water are they drinking per day? Can you pour a measured amount in the water bowls, write it down, then re-measure after 24 hrs, write that down. I would do this once a week for a few weeks to get a clear view how much they are drinking.

If the cat is showing consistant signs of dehydration ie: pinch test, drinking more, feeling grouchy/not themselves.

Some vets will wait until there is 2-3 tests (showing consistant numbers) with the cre between 3.5-4. Many will base the decision of when to start on a combination of the numbers & physically how the cat feels. There is no strict guidelines since every cat will be different, some are better able to use the water they are drinking to combat dehydration even with higher numbers.

When I started Duffy on fluids the amount she was drinking had increased noticably in the three months since her previous exam/test, and her cre was at 3.03 up from 2.45 - the decision to start her on fluids was actually made before the vet & I got the results of that test back.

Have a chat w/the vet see what their opinion is on how both Rachel & Max are dealing with hydration, if there are any personality changes (more grumpy than usual, not sitting in a favorite place/interacting as much w/you or each other anymore etc) and see when they have recommended starting fluids for other CRF clients.

:goodvibes:

sugarcatmom
February 5th, 2011, 09:41 AM
I agree with growler's comments about discussing it with your vet and that individual cats may have different requirements for fluids. One of my vet's guidelines is to consider fluids if the cat starts losing weight (which can indicate dehydration and loss of appetite).

PMFan
February 7th, 2011, 07:39 PM
thanks for the feeback/suggestions!

we have 3 cats so i'd have to quarantine them to get an accurate fluid intake measurement.

max has been on the lethargic side even before his numbers were elevated. he did seem more a little more alert after his dental which included IV fluids.

to me, the pinch test seems to indicate both are fairly well hydrated.

Can you pour a measured amount in the water bowls, write it down, then re-measure after 24 hrs, write that down. I would do this once a week for a few weeks to get a clear view how much they are drinking.

If the cat is showing consistant signs of dehydration ie: pinch test, drinking more, feeling grouchy/not themselves.

Some vets will wait until there is 2-3 tests (showing consistant numbers) with the cre between 3.5-4. Many will base the decision of when to start on a combination of the numbers & physically how the cat feels.

Have a chat w/the vet see what their opinion is on how both Rachel & Max are dealing with hydration, if there are any personality changes (more grumpy than usual, not sitting in a favorite place/interacting as much w/you or each other anymore etc) and see when they have recommended starting fluids for other CRF clients.

max has been gradually losing weight for the past 3 years. he is down to 12# from 16#. he eats well if it's a food he likes. he is on both (non-CRF) canned and dry food. he loves raw turkey and liv a littles dehydrated chicken treats.
One of my vet's guidelines is to consider fluids if the cat starts losing weight (which can indicate dehydration and loss of appetite).

growler~GateKeeper
February 8th, 2011, 01:11 AM
thanks for the feeback/suggestions!

we have 3 cats so i'd have to quarantine them to get an accurate fluid intake measurement.

max has been on the lethargic side even before his numbers were elevated. he did seem more a little more alert after his dental which included IV fluids.

to me, the pinch test seems to indicate both are fairly well hydrated.

Ah I didn't know you have 3 kits, that may make quarantine a bit more interesting/difficult/(and depending on the cats) possibly stressful, to get a reading from each cat. If that wouldn't reasonably work, even measuring what all 3 combined drink in a 24hr period while not separating the cats would give an indication when there is an increase. That wouldn't tell you who but you might also notice a behaviour change that would tell you which one it most likely is.

Do you also have the BUN/Urea and phosphorus numbers for both cats?

When was the dental done? With the test 6 months ago or just recently with this latest test?

max has been gradually losing weight for the past 3 years. he is down to 12# from 16#. he eats well if it's a food he likes. he is on both (non-CRF) canned and dry food. he loves raw turkey and liv a littles dehydrated chicken treats.

Are you adding a teaspoon or two of water to Rachel & Max's canned food? I would recommend it if you aren't already, this will provide a little extra moisture with slightly longer time to absorb because it's mixed into food. It's also recommended for all cats since they do drink so little & most of their moisture comes from canned food (unless fed a strictly dry diet which is not recommended for any cat).

How is Max with eating a canned he may not be particularily fond of but is dressed up w/treats in the food?

You can also always add a "treat time" to your day like before bed or something where they get a couple of teaspoons of raw turkey or canned food or some treats.

Kidney cats have a tendency to lose weight and also not want to eat because they don't feel well/no energy, they have no appetite/nauseous, etc so it's always good to encourage them to eat even if that means adding treat toppings to their meals.

:goodvibes:

PMFan
February 8th, 2011, 08:02 PM
both had dental in Jan 2011. max has 2 extractions.

below are the blood work results for both from the monday prior to friday dental. w/ previous for reference. i plan to start having BW done every 4 months.


RACHEL - JAN 11 / AUG 10 / OCT 09 [REF RANGE]
BUN 46 / 39 / 45 [14-36]
CREA 2.7 / 2.7 / 3.2 [.6-2.4]
PHOS 4.8 / 4.7 / 4.2 [2.4-8.2]


MAX - JAN 11 / AUG 10 / NOV 09
BUN 49 / 32 / 40 [15-34]
CREA 3.5 / 2.5 / 2.4 [.8-2.3]
PHOS 4.5 / 4.1 / 4.5 [3.0-7.0]
LYMPH 10 / 5 / 20 [20-55]
URINE PRO/CREAT RATIO IS 0.2
URINE RBC 6-10 [0-5] - i just noticed -- blood in his urine - vet didn't mention this ... she said his P/C ratio was .2 = normal? even tho the report from the lab shows .2 is borderline proteinuric

yes, i add water to canned.

i am going to buy some bonita flakes to see if that will encourage max to eat more. he won't eat more when i sprinkle the liv a littles (go figure?)
If that wouldn't reasonably work, even measuring what all 3 combined drink in a 24hr period while not separating the cats would give an indication when there is an increase. That wouldn't tell you who but you might also notice a behaviour change that would tell you which one it most likely is.

Do you also have the BUN/Urea and phosphorus numbers for both cats?

When was the dental done?

Are you adding a teaspoon or two of water to Rachel & Max's canned food? this will provide a little extra moisture with slightly longer time to absorb because it's mixed into food. It's also recommended for all cats since they do drink so little & most of their moisture comes from canned food (unless fed a strictly dry diet which is not recommended for any cat).

How is Max with eating a canned he may not be particularily fond of but is dressed up w/treats in the food?

You can also always add a "treat time" to your day like before bed or something where they get a couple of teaspoons of raw turkey or canned food or some treats.

Kidney cats have a tendency to lose weight and also not want to eat because they don't feel well/no energy, they have no appetite/nauseous, etc so it's always good to encourage them to eat even if that means adding treat toppings to their meals.

growler~GateKeeper
February 10th, 2011, 02:51 AM
both had dental in Jan 2011. max has 2 extractions.

below are the blood work results for both from the monday prior to friday dental. w/ previous for reference. i plan to start having BW done every 4 months.


RACHEL - JAN 11 / AUG 10 / OCT 09 [REF RANGE]
BUN 46 / 39 / 45 [14-36]
CREA 2.7 / 2.7 / 3.2 [.6-2.4]
PHOS 4.8 / 4.7 / 4.2 [2.4-8.2]


MAX - JAN 11 / AUG 10 / NOV 09
BUN 49 / 32 / 40 [15-34]
CREA 3.5 / 2.5 / 2.4 [.8-2.3]
PHOS 4.5 / 4.1 / 4.5 [3.0-7.0]
LYMPH 10 / 5 / 20 [20-55]
URINE PRO/CREAT RATIO IS 0.2
URINE RBC 6-10 [0-5] - i just noticed -- blood in his urine - vet didn't mention this ... she said his P/C ratio was .2 = normal? even tho the report from the lab shows .2 is borderline proteinuric

Bloodwork is definately recommended every 3 or 4 months for kidney cats allows you to keep on top of any changes. Here is a spreadsheet to help track all the changes in bloodwork, just change the Reference Range values to match the ones the lab your vet uses. Chronological Lab Results in Excel Spreadsheet (http://www.digitalcaptive.net/ebony/ChronologicalLabResults.xls)

Both phos numbers are good, Max does have a decrease in Lymphocytes which can be an indication of inflammation/infection. Rachel's BUN & Crea are not too bad, Max's I'd look into the urine RBC (see below) first before going to fluids, but they'd be on my list to speak to the vet about.

Has the vet mentioned Azodyl (http://www.vetoquinolusa.com/CoreProducts/CardioNephrologyRenal/Azodyl.html)? Something to discuss with him/her, I had good results lowering both BUN & Crea with it.

Some vets will consider anything less than 0.5 Urine P/C ratio to be normal. I've also noticed many vets will not mention/not be too concerned about 1 borderline test but will wait until it's either consistantly out of range unless it's a big jump.

There is some talk about the benefits of supplementing Omega3 fatty acids to help reduce proteinuria, though the claims are unproven at this point. A small amount of say pure salmon oil or capsules may be helpful if you've noticed a dryness to Max's coat or if he's having hard dry poops.

Any WBC in the urine?

Have you noticed smaller than normal pee deposits in the litterboxes? (I realize this may be harder with 3 cats) Is Max showing any signs of frequent trips to the litterbox? Straining? Any peeing outside the box?

My :2cents: I would have Max back into the vet for a cystocentisis, run a urinalysis with a note to the lab "culture if indicated", this will tell them to go ahead with a culture & sensitivity if there is the presence of bacteria without waiting for permission.

Male cats have a smaller urethra opening than girls do & are therefore more prone to complications with urinary crystals/stones. Rechecking the urine will allow for another look at the RBC count, urine pH & if any crystals or stones have developed.


yes, i add water to canned.

i am going to buy some bonita flakes to see if that will encourage max to eat more. he won't eat more when i sprinkle the liv a littles (go figure?)

Excellent :thumbs up

Ah those cats they can be picky eh? :D

:goodvibes:

Gale911
February 11th, 2011, 05:21 PM
My little girl cat passed away last week from renal failure, I gave her sub Q fuilds and Azadyl ( a probiotic baceteria ). She was diagnosed in October with ealy stage but by Christmas she was pretty bad.
Try to keep your cat eating and drinking fluids, these are the most important things other than love.
Good luck :fingerscr:cat:

growler~GateKeeper
February 12th, 2011, 12:26 AM
My little girl cat passed away last week from renal failure, I gave her sub Q fuilds and Azadyl ( a probiotic baceteria ). She was diagnosed in October with ealy stage but by Christmas she was pretty bad.
Try to keep your cat eating and drinking fluids, these are the most important things other than love.
Good luck :fingerscr:cat:

Hi Gale sorry to hear about your girl :candle: :grouphug:

I'm not sure if you are responding to me or PMFan, if this was directed at me (as I know sometimes people only read the first post :)) I originally started this thread a little over 3 years ago when my girl was diagnosed & she had 3 good quality years with CRF before unrelated Lymphoma took her, this thread has kept going to help others dealing with feline renal failure. Any and all tips and good wishes for others are always welcome as something you tried may help someone else. :) :pawprint:

Rumor
June 19th, 2011, 09:18 AM
Recently, after a series of blood tests, my vet said that my 16 1/2 year old girl may be starting crf. She wants to do more blood tests next month, but in the meantime, I want to switch her catfood. For the past year, I have been feeding her EVO dry, which is obviously way too high in phosphorous. I would like to switch her to a canned food. I prefer to remain in the better quality, grain-free range of catfood, if possible. The problem is I am in Japan on a military base, so we are severely limited in catfood choices. I had been ordering the EVO through Amazon after deciding the stuff I was getting off the shelf here just wasn't healthy for my kitties.

I have spent many late nights reading websites on CRF and I am having a hard time making sense of the catfood info. I had pretty much determined that the EVO 95% Beef and 95% Venison might be the way to go, but all the info on here is several years old. Does anyone know if they still fall into a low phosphorous range? I have looked through the charts of cat food, canned and dry, but they are a bit outdated (2005, 2008). Anything more recent that I am not finding?

Any help would be greatly appreciated. Thank you!

mikischo
June 19th, 2011, 09:28 AM
The last post on the following recent thread gives a number of choices as well as some links for high quality canned foods low in phosphorus:

http://www.pets.ca/forum/showthread.php?t=77119

Definitely try to switch her over to entirely canned food. It is far better than dry for all cats and particularly for cats with CRF.

growler~GateKeeper
June 19th, 2011, 05:42 PM
Hi Rumor, welcome to the forum, would love to see pics of your girl if you have some you'd like to share :)

I have spent many late nights reading websites on CRF and I am having a hard time making sense of the catfood info. I had pretty much determined that the EVO 95% Beef and 95% Venison might be the way to go, but all the info on here is several years old. Does anyone know if they still fall into a low phosphorous range? I have looked through the charts of cat food, canned and dry, but they are a bit outdated (2005, 2008). Anything more recent that I am not finding?

The EVO 95% Beef (http://www.evopet.com/products/default.asp?panel=na&id=1664) is okay, after conversions works out to 1.24% dry matter phosphorus, you want to stay below 1.25% dm.

The EVO 95% Venison (http://www.evopet.com/products/default.asp?panel=na&id=1665) is far too high, after conversion works out to 2.05% dry matter phosphorus :eek:

The Evo 95% Chicken & Turkey (http://www.evopet.com/products/default.asp?id=1662) is great, after after conversion works out to 0.88% dry matter phosphorus :thumbs up

As mentioned by mikischo :) above there are more listed in that post, I'll repost them here too:

Some good quality low phos canned food choices for you:

By Nature Organics (http://www.bynaturepetfoods.com/productpages/organiccannedcat.php) Turkey & Turkey Liver, Chicken & Chicken Liver, Turkey & Chicken, Chicken & Mackerel, Beef & Beef Liver

Innova Flex Beef & Barley Stew (http://www.innovapet.com/products/default.asp?id=1693)
Evo 95% Chicken & Turkey (http://www.evopet.com/products/default.asp?id=1662)

Felidae Platinum (http://www.canidae.com/cats/platinum/canned.html)
Felidae Cat & Kitten (http://www.canidae.com/cats/cat_and_kitten/canned.html)
Felidae Grain Free (http://www.canidae.com/cats/grain-free-cat-food/canned.html)

Merricks Before Grain 96% Beef (http://www.merrickpetcare.com/store/detail.php?c=114&s=20481)
Merricks Before Grain 96% Turkey (http://www.merrickpetcare.com/store/detail.php?c=114&s=20480)

Merricks Cowboy Cookout (http://www.merrickpetcare.com/store/detail.php?c=52&s=20246)
Merricks Thanksgiving Day Dinner (http://www.merrickpetcare.com/store/detail.php?c=52&s=01803)

Halo Spots Stew Wholesome Chicken (http://shop.halopets.com/Canned-Cat-Food/Wholesome-Chicken-Recipe-3-5-oz)
Halo Spots Stew Wholesome Turkey (http://shop.halopets.com/Canned-Cat-Food/Cat-Canned-Turkey-3-5oz)

Wellness (http://www.wellnesspetfood.com/recipes.aspx?pet=cat&ft=2) Turkey, Chicken, Beef & Chicken, Beef & Salmon, Kitten, Wellness Core Chicken Turkey & Chicken Liver

Holistic Select Turkey & Barley (http://www.holisticselect.com/product.aspx?pet=cat&cat=2&pid=33)
Holistic Select Duck & Chicken (http://www.holisticselect.com/product.aspx?pet=cat&cat=2&pid=30)

This is a currently updated list 2010-2011 the foods are listed in order of lowest amount of dry matter phosphorus, it's up to you to decide what ingredients are acceptable, the manufactures websites are also listed to help in that regard. Tanya's Feline CRF US Canned Food Data Tables (http://www.felinecrf.org/canned_food_usa.htm#food_data_tables)

Rumor
June 27th, 2011, 12:39 AM
Thanks so much for the quick and informative reply!

Armed with the new information, and after much searching, I found that Petco.com would ship the Organix canned catfood to me (it's sooo hard to get stuff like catfood shipped to an APO...) I also ordered some dry Now! that I will carry back after a Stateside trip.

Right now, I have switched my kitty to Hill's Mature Adult Active Longevity dry and canned food (I'm shocked they sell it on base!) but the ingredients are garbage, and I can't wait to get her back on something more healthy.

Now I just have to learn the fine balance between good, low phosphorous catfood and maintaining her weight. She has struggled with being overweight most of her life, (or is it *I* have struggled with it? She's perfectly happy trying to eat whatever she can and staying fat!)

Thanks again! I'll post some pics of the Gollum over in the Pet Photos. :)

growler~GateKeeper
June 27th, 2011, 12:52 AM
As long as Gollum continues to eat and doesn't start rapidly losing weight it's all good. :) A little extra weight is a good thing for a kidney cat as they often lose weight and it then becomes quite hard to gain it back to get them back to a healthy weight.

If you can get her on mostly canned food with little to no dry food that would be even better for her kidneys as that will provide some extra moisture and not dehydrate her like the dry food will.

Kattaclysm
July 8th, 2011, 04:22 PM
I must admit I wept a little when I saw this website. My best friend Greymalkin was diagnosed with CRF 2 months ago and I'm in the thick of things testing different foods to see what he will and will not eat. I've sat up with him at night pleading that he would atleast finish a 1/2 a mini can of K/d... this whole thing is heroing.

That said, Grey is taking it like a champ, he's perfectly happy. As far as he is concerned mommy is just a nut job. He also likes all the extra attention.

On the talk about water intake I found a great article on making flavored waters :
" While you are working toward getting your cat to eat canned food, you can increase their water intake by using flavored waters such as tuna water, beef or chicken broth, clam juice, lactose-free cat milk, etc.You can make you own tuna water by adding 3 cups of water to a can of tuna. Mash it up and let it sit for ~15 minutes then pour the water into covered (to help maintain freshness) ice cube trays. 3 cups of water will fill two 16-cube trays. The ice cube trays can be used for other flavored liquids as well."

I've given him the lactose-free catsip to boost his caloric intake and he loves it but the tuna slurry is in the freezer now so I can try it. It sounds disgusting but if it works

Just thought I'd pass that on!

Off to go try a new food now (Fussie Kitty)

growler~GateKeeper
July 9th, 2011, 12:07 AM
I must admit I wept a little when I saw this website. My best friend Greymalkin was diagnosed with CRF 2 months ago and I'm in the thick of things testing different foods to see what he will and will not eat.

Welcome to the forum. Sorry to hear about the diagnosis, but you've found the right place for support & info :grouphug:

I've sat up with him at night pleading that he would atleast finish a 1/2 a mini can of K/d... this whole thing is heroing.

Ah clever kitty :laughing: he knows that k/d isn't very tasty :D Just 4 posts up you will find a short list of lower phosphorus foods to try and at the end of that post there is a link to a table listing a whole lotta foods in order of phos content.

If you have any questions or tips feel free to post them :)

mandyedwards
July 12th, 2011, 04:03 PM
Hello,

Wow, what a great forum!!

Here's my dilemna. I have 4 cats.

one kidney kitty - 14 years old, 6lbs, very picky and mind of her own - eats science diet seafood

one fat kitty - needs hypoallergic food due to pancreatis, 9 years - eats the k/d brand but hypoallergic (not sure the letters?) kibble, she will not eat cans

one kitty with no teeth - well had them pulled in different stages due to rare gum disease, 7 years - eats natural balance green pea and duck cans (mainly becuase she was on hypoallergic with her gum disease but now that we've pulled the teeth its not as much an issue)

one kitty with no problems - 3 years, eats chicken soup kibble

so, they all have seperate foods, all get fed in seperate bedrooms. Its a wee bit high maintence, especially for when we go away and we have "helpers"

So, kidney cat is my main concern. She gets fed 3 times a day (we found the extra feeding before bed was useful to maintain the 6lbs), and takes 0.45 calitrol once a day. She only likes science diet seafood (looks like its not bad in pho at 0.65) and the vet said that was ok given how picky she is. Now, she only likes it warmed up, with a few k/d kibbles on top (and we must put it in a pile after she eats a bit as she doesnt' like putting her nose in the bowl!). Yes, picky. Well, she goes through spurts every other week of "I dont want to eat, but I will puke instead". So i'm wondering if I should change her food to something better for her. It seems the science diet is better than the wellness for the pho rating, but i realize it's more crap food. I have bought some wellness turkey to see if she'll eat it.

Now, my question is, for the other 3, is there any kidney failure food that is hypoallergic? That way I can leave some kibbles out and not worry about the kidney cat having an issue if she actually decides she wants a few pieces? The other issue is NO Teeth kitty, as of course, she has no teeth (not that any of them actually chew their food - but she currently is on soft). So i'm not sure if there is a solution that is less hetic at feeding time for us, given all the cats seem to have one issue or another. Then getting them all to like the same food is another story.

Thoughts? Crazy cat lady? I think so.

growler~GateKeeper
July 13th, 2011, 02:56 AM
Hi mandyedwards, welcome to the forum :)

Let's see if we can't get them all on canned to start :fingerscr the canned food can be left out even after it dries & gets a bit crusty - some cats actually like it like that, adding a bit of water to it will soften it back up again. I would leave it for no more than about 8hrs out though, depending on how hot it is.

Have you considered a raw diet?

one kidney kitty - 14 years old, 6lbs, very picky and mind of her own - eats science diet seafood

If she won't eat the Wellness Turkey, there is also the Beef & Salmon w/good numbers, & a fishy content. Also have a look at Wellness Healthy Indulgence Pouches. Their Chicken, Duck & Shrimp recipe, and the Chicken, Crab & Herring recipe both have good phos numbers and may appeal to the fish lover. Stay away from the Tuna though! While the phos number is good, tuna is more addicting than other fish it seems & constant feeding can cause a vit imbalance.

one fat kitty - needs hypoallergic food due to pancreatis, 9 years - eats the k/d brand but hypoallergic (not sure the letters?) kibble, she will not eat cans

Much as I don't like the prescription foods, have you tried her on the canned z/d (I'm guessing she's on this one the low allergen)?

Were you able to determine what exactly she reacts against? a specific/all protein, grain, anything over a certain fat content, etc?

one kitty with no teeth - well had them pulled in different stages due to rare gum disease, 7 years - eats natural balance green pea and duck cans (mainly becuase she was on hypoallergic with her gum disease but now that we've pulled the teeth its not as much an issue)

Will she eat other canned foods? The NB green pea & duck canned is high in phos & while it may not be an issue w/this cat and if the CRF cat has a couple of nibbles it wouldn't be an issue, you wouldn't want that available to the kidney cat all the time.

one kitty with no problems - 3 years, eats chicken soup kibble

Will s/he eat canned? Can you switch her/him to canned something/anything & off the dry as a main food source? :fingerscr That would at least eliminate 1 of the different foods being bought

Even getting the kidney cat, the no teeth cat & the healthy cat all eating the same brand of exclusively canned will go along way to helping ease the feeding circus & then you can work on slowly switching the pancreas kitty to canned.

so, they all have seperate foods, all get fed in seperate bedrooms. Its a wee bit high maintence, especially for when we go away and we have "helpers"

So, kidney cat is my main concern. She gets fed 3 times a day (we found the extra feeding before bed was useful to maintain the 6lbs), and takes 0.45 calitrol once a day. She only likes science diet seafood (looks like its not bad in pho at 0.65) and the vet said that was ok given how picky she is. Now, she only likes it warmed up, with a few k/d kibbles on top (and we must put it in a pile after she eats a bit as she doesnt' like putting her nose in the bowl!). Yes, picky. Well, she goes through spurts every other week of "I dont want to eat, but I will puke instead". So i'm wondering if I should change her food to something better for her. It seems the science diet is better than the wellness for the pho rating, but i realize it's more crap food. I have bought some wellness turkey to see if she'll eat it.

Now, my question is, for the other 3, is there any kidney failure food that is hypoallergic? That way I can leave some kibbles out and not worry about the kidney cat having an issue if she actually decides she wants a few pieces? The other issue is NO Teeth kitty, as of course, she has no teeth (not that any of them actually chew their food - but she currently is on soft). So i'm not sure if there is a solution that is less hetic at feeding time for us, given all the cats seem to have one issue or another. Then getting them all to like the same food is another story.

No kidney specific hypoallergic diet, however the Hills z/d is low phos. Ideally you would want to eliminate all dry food as canned (or better yet raw) is much healthier for them all.

This CRF specific site has some tips for persuading your cat to eat (also good to try when starting a new food) http://www.felinecrf.org/persuading_cat_to_eat.htm

This site has some tips for transitioning off dry food http://www.catinfo.org/docs/Tips%20for%20Transitioning%20PDF%201-14-11.pdf

mandyedwards
July 13th, 2011, 09:46 AM
Thanks so much for the response!!

To be honest, I was hoping to switch all to kibble (other than kidney kitty) just for ease of leaving the food out. We tend to go away for hte weekend here and there and currently with our feeding schedule, we have to have 2 cats stay with my mom and 2 with my dad (stressful for them). Mainly because you can't leave soft food out for them. What are hte benefits to the canned? I know the water content, but is there others? Is there any other solution for going away if they are all on canned? Another consideration for us is the cost of course. Hard to hide the fact of how many cans we go through with all 4 being on canned. Do any of these come in big cans?

We are not sure what fat kitty is allergic to, she just stopped eating bout 5 months ago (odd for her, she's fat!) and so we took her in. They did xrays, ultrasounds etc to rule everything else out and then diagnosed pancreatis and suggested hypoallergic food. We bought her some NB green pea and duck kibble and she loved that last night. Not sure if this was the right move. She doesn't like canned but I certianly could try some of the techniques to persaude her more. she did try the z/d canned and wanted nothing to do with it. but this was also during when she was not feelign well, so that might have something to do with it. it is hte z/d kibble she is on right now (other than us trying the nb duck/green pea last night kibble)

No teeth kitty will eat anything, she's not picky. So she's not an issue. She was on the NB green pea (its actually venison, I checked last night) just because of her gums but now that her teeth are out the vet said she can eat anything. she loves canned.

Kidney kitty tryed a bit of the wellness turkey and so far loves it. She's bad for loving a new food for a few feedings though and then deciding she's done with it. so we'll see how that goes. being turkey i'm sckeptical. she always seems good on teh sd seafood, but its because she consistantly will eat at least a quarter of a can at a time. until she goes through a not eating phase, which shes in. Just a note but we put a bit of the wellness turkey on top of her sd seafood this morning and she vomited it up. Not sure if it was the wellness being different on her belly or if it was jsut becuase she's vomited a few times this week. hopefully she's working on furball and it's unrelated.

As a side note, bought a cat it water fountain last night. fat kitty loves it and decided she needed to guard it and sleep by it last night. healthy kitty thought it was atoy and there for her amusement. kidney kitty seemed not interested in it (other than the noise was apparently disturbing her). The plug seemed to get quite hot after a few hours of having it on. i'm hoping its not an issue to leave it runnign as that was kinda the point of hte thing.

growler~GateKeeper
July 14th, 2011, 02:03 AM
http://maxshouse.com/feline_nutrition.htm

Dry Food vs Canned Food. Which is really better?

A carnivorous diet is comprised of primarily protein and fat from animal tissue. They have teeth designed to tear flesh and a short and simple gastrointestinal tract, one suited for digestion and absorption of a concentrated, highly digestible diet. Dry foods typically contain 35-40% carbohydrate. Carbohydrates are nearly absent in the cat's natural diet. The cat obtains small amounts of carbohydrate through the stomach and intestines of her prey. Commercial dry foods, however, may contain as much as 45% - 50% carbohydrates. Since the cat metabolizes primarily fat and protein for energy, most of the excess carbohydrate is stored in the body as glycogen and fat. The primary adverse effect of excess carbohydrate is obesity. The effects of obesity are heart disease because of the increased workload on the heart; orthopedic problems are increased because of increased physical stress on the frame, leading to arthritis and early debilitation; diabetes mellitus, a condition in which the pancreas doesn't produce the amount of insulin that it should to help metabolize blood sugar, is one of the most common problems in obese cats; several liver disorders occur more frequently in overweight cats. Surprisingly, the deadliest one, hepatic lipidosis, happens when the cat stops eating. Changes in the operation of the liver cause fat to be deposited there, which eventually can shut down the liver altogether.

Not all protein sources are of equal value to the carnivore, and the quantity of protein in a commercial dry cat food often says nothing about its quality. Before domestication, cats hunted their prey and consumed a diet very high in meat protein, low to moderate in fat, and very low in carbohydrates. This diet provided both the proper quantity and quality of protein for the carnivore's unique digestive system.
.... Thus, a carnivore's optimum diet must be concentrated, highly digestible, and low in residue because its body is designed to digest primarily protein. If an excess of carbohydrates is included in the diet, much of what the carnivore eats is only partially digested by the time it reaches the large intestine for fecal formation, overloading the digestive and excretory systems. ...

Protein digestibility in pet foods is about 80 percent for dry foods, 85 percent for semimoist and canned foods containing large amounts of cereal grains, and 90 percent for canned diets with meat as the primary protein source. Digestibility is influenced both by the source of the protein and by how it is processed. Protein in cat foods comes from both animal and plant sources. Animal protein is generally more expensive and often of higher quality than plant protein. The composition of canned foods allows the use of protein and fat sources of higher biological value than can be used in dry food.

The cat's natural diet, live prey, contains between 65%-75% water. The cat, having evolved on the plains of Africa, has adapted to obtain her water requirements almost entirely on the moisture content in her prey. Cats can live for long periods without drinking water when receiving food containing 67-73% water but become dehydrated when the water content of the food is 63% or less. The water content of the commercial foods commonly fed to cats varies from 8% in dry foods to over 75% in canned foods; thus the amount of drinking water required is affected substantially by the water content of the food. {All dry-fed-only cats become chronically dehydrated because they cannot drink enough water for their bodies to restore what they loose, re-hydrate & maintain it adequately}

In addition to canned food ensuring adequate hydration, a high water turnover helps eliminate crystallogenic substances before they grow to sufficient size to interfere with normal urinary function. This is a very important consideration for male cats. Cats that cannot urinate for more than 24 hours due to urinary tract obstruction can die from acute renal failure and/or severe damage to the urinary bladder. In addition to the removal of crystals, benefits of increased water intake include dilution of any noxious substances in urine, and more frequent urination to decrease bladder contact time with urine that may reduce the risks of urinary tract disease. For that reason, canned diets are usually prescribed as the first-line therapy for feline lower urinary tract disease.

The alkalizing nature of carbohydrate-laden dry food requires more than twice to three times the amount of acidification than does canned food increasing the risk of acidosis and kidney damage proportionally.

Acidification of the urine is not without potential toxicity. Dl-methionine causes hemolytic anemia, met hemoglobinemia, and Heinz body formation in cats. Dl-methionine is commonly used in dry foods as a urinary acidifier. Additional concerns about chronic acidification are its potentially detrimental effects on renal function and bone development.

Dry cat food is generally unpalatable to cats because of its dry nature. Palatability of dry cat foods is enhanced by animal fats, protein hydrolysates, meat extracts, acid, and the amino acids alanine, histidine, proline, and lysine. The preference for protein breakdown products and acidity may explain the use of "digest" as an ingredient in nearly all dry foods. Digest is "a microbiologically stable material resulting from digesting animal tissues. . . ." It is produced by enzymatic hydrolysis of animal tissues and by-products, which yield a viscous solution of amino acids, peptides, and fatty acids. Digest also contains significant quantities of phosphoric acid, which is added to stop the enzymatic degradation process and to preserve the product. Digest is sprayed onto the outside of cat foods at 4 to 10 percent of the final finished product or is incorporated directly into the food. Digest can enhance the palatability of foods by as much as two- to threefold over the uncoated product. Once incorporated into cat food, the phosphoric acid increases the amount of acid ingested by the cat. Because of this manufacturing practice, urine acidifiers should not be given to cats fed commercial cat foods, however, nearly all dry foods contain urine acidifiers, most commonly, dl-methionine. Chronic, overacidification leads to metabolic acidosis, demineralization of bone, calcium oxalate crystal formation and possibly renal damage. This may be a contributing factor in increase of incidence of calcium oxalate urolithiasis and high prevelence of chronic renal failure in middleaged cats.

......most dry pet foods are hard but brittle so that the kibble shatters without much resistance and so there is little or no abrasive effect from chewing. {Thereby giving no "teeth cleaning" benefit. Besides the cats teeth are a scissor bite not designed for a lot of chewing and with the lower jaw in a straight hinge there is no side to side chewing movement}

Very simply put it's not natural for cats (& dogs) to eat dry food, it was designed for our convenience not their health.

More reading here:
http://feline-nutrition.org/health/species-inappropriate-the-dangers-of-dry-food
http://www.littlebigcat.com/health/why-cats-need-canned-food-2/
http://www.littlebigcat.com/health/does-dry-food-clean-the-teeth/
http://www.littlebigcat.com/health/the-right-weight-loss-program-for-cats/
http://www.littlebigcat.com/health/feline-obesity/
http://www.littlebigcat.com/health/kidney-disease-in-older-cats/

Many brands Wellness, Felidae, Holistic Select etc do come in a 12-13oz size can, which after opening can be refrigerated and yes you can even freeze canned food into portion sizes. Some stores offer discounts for buying by the case as well.

Instead of 2 cats going here & 2 cats going there, can you have someone come to your house for the weekend while you are away? Less stress all around.

Do you have the kidney cats' food dishes elevated 2-6 inches off the ground while they are eating? This is good to keep the excess stomach acid that tends to happen w/kidney issues in the stomach & out of the throat reducing nausea & vomiting as a result.

If the fountain is a good quality brand (ie PetMate etc) it is designed to be on all the time & there should be only mild heating of the plug. I've not purchased Hagen products before, however they have had this question asked in their site FAQ http://faq.hagencrm.com/details.asp?kbfaqid=24423&usa seems they are aware and are assuring their customers this is normal. You can always contact the company for more info.

Sometimes it takes a while for the cats to get used to the sound, running water and the different-ness of the fountains. It took my cat a few days before she was comfortable w/the PetMate fountain I bought & it was silent when the water full.

mandyedwards
July 14th, 2011, 10:05 AM
wow. that's alot of information! Thanks for that.

we will definately look into finding a canned food that they'll eat. fat cat does nto like canned food - perhaps that is why she is fat. and we've struggled with that. She only gets the prescribed amount of food, supervised, twice a day. no access to any other food. it has been that way for years (but the food has changed). and we have no idea why she is overweight. none of the other cats are overweight. now i'm wondering if it is because she wont eat canned. the only other cat on kibble is the 3 yr old who is terribly active given her age. interesting. and i'm not sure what food to put her on (canned) since her pancreatis - which addmittly, they dont know what caused it, just hta she was in alot of pain, not eating at all and had every test under hte sun done on her to find nothing. so they said when they find nothing then pancreatis is diagnosed. So i have no clue what she shouldn't eat. I'd love it if I could feed the the same as the others (wellness turkey? or something kidney cat can eat). thoughts on that?

to answer your other questions, we have started elevating kidney cats food dish - did this after i read that in this forum. she ate very well for her before bed snack of wellness turkey. not so great this morning but might have been full from last night. still doesn't want anything to do with the fountain. but on the plus side, fat cat loves the fountain and since she's on kibble it's probably a really good thing.

no one can come into our house unfortuatley. boht my parents are about 40 mins away from us (in opposite directions) so it's a bit much to ask for them to stop by twice a day. we are in a new neighbour hood so we dont have any neighbors yet. this would be our perfect solution though. is there any automatic timer dishes for soft food? it'd be hard cause i need to feed 4 cats with it (do i get 4 feeders?) but might be worth a shot.

ultimately, i just wnat the process to be hopefully easier (switching all to canned is not a big inconvenice and one i'm willing to deal with anyway) but i'd like to hopefully have them not on 4 different foods. that's the hard part right now.

mandyedwards
July 14th, 2011, 10:35 AM
Sorry, one more thing. Any thoughts on the SD seafood that the CRF kitty was on? It's lower in pho and protein (0.65 pho, 35.10 protein, 0.4 sodium) so i'm wondering if it's a better choice than the wellness? Or is the wellness better due to the better ingredients?


Also bought a can of the Evo Chicken and Turkey - comparison numbers with the wellness turkey are:

evo - 0.88 pho, 40.68 protein, 0.46 sodium
Wellness - 1.05 pho, 46.33 protein, 0.30 sodium

So in comparision, maybe kidney kitty should be on the evo (assuming she likes it, as I haven't given it to her yet). but are the increased sodium numbers more of a concern than the decrease in pho and protein (although the SD seafood she's been on has 0.40 sodium)? If she liked both equally which should I choose?

Would one be better for fat/hypoallegic kitty than the other (or both a risk due to similar ingredients)? Or am I stuck feeding her the one different food from the other 3?

Thanks for all your help.

growler~GateKeeper
July 15th, 2011, 01:23 AM
i'm not sure what food to put her on (canned) since her pancreatis - which addmittly, they dont know what caused it, just hta she was in alot of pain, not eating at all and had every test under hte sun done on her to find nothing. so they said when they find nothing then pancreatis is diagnosed. So i have no clue what she shouldn't eat. I'd love it if I could feed the the same as the others (wellness turkey? or something kidney cat can eat). thoughts on that?

I think it's highly likely it's the dry food that has caused or at least contributed to the weight issue. Probably the easiest canned food to try to transition her with would be either the z/d ~ don't buy a full case to start though maybe just a can or two ~ or the NB that no teeth kitty is on due to the limited ingredients, and you currently have it on hand :) The NB is still too high for kidney cat though unless the vet puts her on a phos binder ~ depending on the bloodwork probably not necessary at this point as phos is still an essential nutrient.

to answer your other questions, we have started elevating kidney cats food dish - did this after i read that in this forum. she ate very well for her before bed snack of wellness turkey. not so great this morning but might have been full from last night. still doesn't want anything to do with the fountain. but on the plus side, fat cat loves the fountain and since she's on kibble it's probably a really good thing.

The higher quality foods have less fillers so they sometimes eat a bit less than the other food, as long as she is maintaining weight/activity level, and is within the foods' recommendations.

Some cats also prefer a variety of brands/flavours, so this may be an option for you saving a little money in the long term if you rotate through the low phos holistic foods and mixing in some low phos Science Diet or Fancy Feast etc. Ideally a variety is better so if/when a cat decides they won't eat X-food anymore, you know they already like/will eat Y-food.

Rotating flavours/brands may help keep the interest of the currently-kibble-only kitty too.

She may still get there with the fountain, especially when she sees the others into it all the time, cats are great copiers :)

no one can come into our house unfortuatley. boht my parents are about 40 mins away from us (in opposite directions) so it's a bit much to ask for them to stop by twice a day. we are in a new neighbour hood so we dont have any neighbors yet. this would be our perfect solution though. is there any automatic timer dishes for soft food? it'd be hard cause i need to feed 4 cats with it (do i get 4 feeders?) but might be worth a shot.

There are some auto feeders with a cooler that you can use canned in, I've not heard from anyone that has actually used them, so I'm not sure how fresh the food stays or how the cats react etc. Plus there's no guarantee each cat is eating their own portion & not eating another cats unless they were all separated for the entire time.

Another option is once you find a local vet, asking a receptionist/tech that you are comfortable with to stop in check on, feed etc.

ultimately, i just wnat the process to be hopefully easier (switching all to canned is not a big inconvenice and one i'm willing to deal with anyway) but i'd like to hopefully have them not on 4 different foods. that's the hard part right now.

Or if they will all rotate through the same variety at the same time :)

Sorry, one more thing. Any thoughts on the SD seafood that the CRF kitty was on? It's lower in pho and protein (0.65 pho, 35.10 protein, 0.4 sodium) so i'm wondering if it's a better choice than the wellness? Or is the wellness better due to the better ingredients?

Personally my :2cents: I would stay away from fish flavours unless there is at least 1 other named meat source preferably higher in the ingredient list than the named fish. I also personally am not a fan of SD, and I feel the ingredients in Wellness are better.

However, (a) you know kidney cat will eat it so that's a plus ~ hopefully not :fingerscr but there may come a time where it will be a battle to get her to eat anything and at that point you feed whatever they will eat regardless of phos value or ingredients just so they will eat

There's a saying to do with CRF cats ~ The best food for a CRF cat - is a food they will eat. ~ The food with the lowest phos or the best ingredients will do no good to a cat who won't eat it.

http://www.felinecrf.org/which_foods.htm#best_crf_food
In 11 guidelines for conservatively treating chronic kidney disease (2007) Polzin D, Veterinary Medicine December 2007, Dr Polzin makes the shocking observation that "in many or most dogs and cats with chronic kidney disease, death or euthanasia results directly or indirectly from starvation."

(b) it's got a great low phos value
(c) if you are comfortable with the food/ingredients, can afford to feed it, cat is doing well on it, etc then by all means continue or keep it in a rotation
(d) it's not my cat :) I'm just here to guide a little, I don't want to say you have to do this or you must feed that, there are no absolute answers what works for one may not for another.

Also bought a can of the Evo Chicken and Turkey - comparison numbers with the wellness turkey are:

evo - 0.88 pho, 40.68 protein, 0.46 sodium
Wellness - 1.05 pho, 46.33 protein, 0.30 sodium

So in comparision, maybe kidney kitty should be on the evo (assuming she likes it, as I haven't given it to her yet). but are the increased sodium numbers more of a concern than the decrease in pho and protein (although the SD seafood she's been on has 0.40 sodium)? If she liked both equally which should I choose?

Just be sure you are always getting the Evo 95% C&T with the orange label not the regular C&T with the purple label.

Assuming that she (& the others) like both, rotate the flavors. Add the SD & anything else that's low phos they will eat to the rotation, that way you will even out both in nutrients and costs too.

The 0.30-0.46 sodium is not a huge difference and definately not the highest on the market, if kittys bloodwork indicates high or high end normal sodium then you would want to look a little closer.

Would one be better for fat/hypoallegic kitty than the other (or both a risk due to similar ingredients)? Or am I stuck feeding her the one different food from the other 3?

I would see how she does with the attempt at the canned z/d or NB first, if she still can't tolerate those or refuses all transitioning attempts you may have to leave her on the dry.

mandyedwards
July 15th, 2011, 10:37 AM
I think it's highly likely it's the dry food that has caused or at least contributed to the weight issue. Probably the easiest canned food to try to transition her with would be either the z/d ~ don't buy a full case to start though maybe just a can or two ~ or the NB that no teeth kitty is on due to the limited ingredients, and you currently have it on hand :) The NB is still too high for kidney cat though unless the vet puts her on a phos binder ~ depending on the bloodwork probably not necessary at this point as phos is still an essential nutrient.

ok, NB for fat cat. WE have the venison one I believe. we also have a few z/d cans kicking around for when we tried her on it - I can give it try again. So I assume all the other foods we're considering (wellness, evo and SD) are a risk for fat cat and her allergies? I'm really hoping we can get her on the same food and her allergy was more related to the dry (she was on the weight control prescription when she got sick, I think it was O/M?) This is when she was switched to z/d, but admittly, she gained weight as well. Prior to this, she had lost a pound on the o/m (from 13 to 12lbs) and she was on it for a year and a half with no issues. I kinda think there was some other stresser that caused her illness. She was acting very skiddish with everything, hiding under the bed etc - which is not her regular behaviour. She is normally the outgoing one.

The higher quality foods have less fillers so they sometimes eat a bit less than the other food, as long as she is maintaining weight/activity level, and is within the foods' recommendations.

She eats about 1/4 of a can, twice a day. Sometimes a bit mroe, sometimes less. I believe the recommendation is a can or a can and a half a day. She has never eaten this much (at least not for hte last 5 years).

Some cats also prefer a variety of brands/flavours, so this may be an option for you saving a little money in the long term if you rotate through the low phos holistic foods and mixing in some low phos Science Diet or Fancy Feast etc. Ideally a variety is better so if/when a cat decides they won't eat X-food anymore, you know they already like/will eat Y-food.

Valid point. Oddly enough, she did not want the wellness turkey last night, or but ate the evo c&t. Then this morning wouldn't eat the evo at all (not even sniffed it) but i opened another new one, the wellness beef and chicken and she gobbled it up without breathing. She seems to want just different food - she'll be done with this beef one by tomorrow i'm sure. So perhaps I hsould just open a different food each time i'm done a can. Would I run the risk of tummy upset if I do this? Or now that she's tried them all I should be ok? I'm thinking i'll do the SD seafood, Evo C&T, Wellness Turkey, Wellness Beef in the rotation and just maybe every few cans switch it up (for all 3 kitties). Let me know your thoughts on that plan.

Rotating flavours/brands may help keep the interest of the currently-kibble-only kitty too.

Definately, just need to find a few she can have! lol. She really is not huge on the canned food, I gave her the rest of the evo C&T that kidney kitty didn't touch last night and she was all excited, had a few bites then decided she was done. For a cat that rarely eats half of the recommended food intake I really don't understand how she is overweight. I really think that something else is wrong with her but the vet assures me that its probably just her activity level. Granted she is older but she does play here and there but I just dont see the amout of food she's actually eating causing this much overweightness.

She may still get there with the fountain, especially when she sees the others into it all the time, cats are great copiers :)
Score! Caught no teeth kitty drinking last night!



There are some auto feeders with a cooler that you can use canned in, I've not heard from anyone that has actually used them, so I'm not sure how fresh the food stays or how the cats react etc. Plus there's no guarantee each cat is eating their own portion & not eating another cats unless they were all separated for the entire time.
True.

Another option is once you find a local vet, asking a receptionist/tech that you are comfortable with to stop in check on, feed etc.

I think I might look into some of those "pet sitters" to see if I can find a good one. PRobalby is they need to give kidney kitty teh calitrol. I might just try to bring her to my mom's so I know she's eating getting her drugs then leave the other 3 with dry for the few days.

Or if they will all rotate through the same variety at the same time :)


Personally my :2cents: I would stay away from fish flavours unless there is at least 1 other named meat source preferably higher in the ingredient list than the named fish. I also personally am not a fan of SD, and I feel the ingredients in Wellness are better.

Totally agree. If I had my way she wouldn't like this one. BUT, she does go back to this one most times (and when she's done a few feedings of any other new food she decides she's done with it). And its not bad on pho, or protein.

However, (a) you know kidney cat will eat it so that's a plus ~ hopefully not :fingerscr but there may come a time where it will be a battle to get her to eat anything and at that point you feed whatever they will eat regardless of phos value or ingredients just so they will eat

There's a saying to do with CRF cats ~ The best food for a CRF cat - is a food they will eat. ~ The food with the lowest phos or the best ingredients will do no good to a cat who won't eat it.



(b) it's got a great low phos value
(c) if you are comfortable with the food/ingredients, can afford to feed it, cat is doing well on it, etc then by all means continue or keep it in a rotation
(d) it's not my cat :) I'm just here to guide a little, I don't want to say you have to do this or you must feed that, there are no absolute answers what works for one may not for another.

Still totally appreciate your thoughts!

Just be sure you are always getting the Evo 95% C&T with the orange label not the regular C&T with the purple label.

I will check on this tonight. i've had so many new cans in my pantry that I can't be positive! I know it says 95% on it though!

Assuming that she (& the others) like both, rotate the flavors. Add the SD & anything else that's low phos they will eat to the rotation, that way you will even out both in nutrients and costs too.

The 0.30-0.46 sodium is not a huge difference and definately not the highest on the market, if kittys bloodwork indicates high or high end normal sodium then you would want to look a little closer.

I got the vet to fax me kidney kitties results so I could figure out where she sits.

From April 2010
Urea 12.8
Creatine 343
Phos 1.96

Last bloodwork from April 2011
Urea 17.6
Creatie 298
Phos 1.17

So she has gone down in the year she's been on calsitrol (other than the urea - which admittly, i'm not sure what that means). So she is in Stage 3 according to the links you provided.

I would see how she does with the attempt at the canned z/d or NB first, if she still can't tolerate those or refuses all transitioning attempts you may have to leave her on the dry.

I will look over the ways to transition her. For someone that just refuses to eat alot of foods (including her dry z/d - she only ever eats about half the amount recommended) I really dont understand how she is so overweight.

Again, thanks for your help!!

growler~GateKeeper
July 16th, 2011, 01:20 AM
So I assume all the other foods we're considering (wellness, evo and SD) are a risk for fat cat and her allergies? I'm really hoping we can get her on the same food and her allergy was more related to the dry (she was on the weight control prescription when she got sick, I think it was O/M?) This is when she was switched to z/d, but admittly, she gained weight as well. Prior to this, she had lost a pound on the o/m (from 13 to 12lbs) and she was on it for a year and a half with no issues. I kinda think there was some other stresser that caused her illness. She was acting very skiddish with everything, hiding under the bed etc - which is not her regular behaviour. She is normally the outgoing one.

Hard to say considering we don't know what it was she reacted to. If she has no ill reaction to the C&T she ate or the z/d or NB, then expanding her choices slowly would be a start.

Sometimes tummy upset can be caused by a "bad" batch of food - close to expiry date or not properly cooked etc. As well as a new formula, slight change in ingredient volume, incorrect nutrient additive amounts, new source for ingredients etc. Then when the tests come back fine just the pancreas shows slightly inflammed, the cat is given hypoallergenic food & all is fine ~ it's then assumed the cat has pancreatitis & must be on this food for life. While this may be true in some cases, sometimes they just needed a little more time to adjust & overcome the inflammation.

Acting skiddish/hiding when not normal behaviour could've just been her displaying discomfort. Subtle personality changes can often indicate there is a medical issue or emotional stress.

She eats about 1/4 of a can, twice a day. Sometimes a bit mroe, sometimes less. I believe the recommendation is a can or a can and a half a day. She has never eaten this much (at least not for hte last 5 years).

If kidney cat is eating dryfood as well that needs to be considered into the daily intake amounts, as does activity/metabolism level. Some cats are just small eaters, my mum's cat doesn't eat very much & maintains a healthy weight.

Valid point. Oddly enough, she did not want the wellness turkey last night, or but ate the evo c&t. Then this morning wouldn't eat the evo at all (not even sniffed it) but i opened another new one, the wellness beef and chicken and she gobbled it up without breathing. She seems to want just different food - she'll be done with this beef one by tomorrow i'm sure. So perhaps I hsould just open a different food each time i'm done a can. Would I run the risk of tummy upset if I do this? Or now that she's tried them all I should be ok? I'm thinking i'll do the SD seafood, Evo C&T, Wellness Turkey, Wellness Beef in the rotation and just maybe every few cans switch it up (for all 3 kitties). Let me know your thoughts on that plan.

Cats usually have pretty strong stomachs and do well with flavour switching. When my kidney cat was on canned she would get a different flavour each day, I used to buy Wellness 12 oz by the case containing the 3 different flavours that she liked/low phos. Some members here do each meal different a flavour/brand, some each day something different.

Sounds good :thumbs up I know the Wellness & Evo come in the 12oz cans so that can save you a bit, canned food can be refrigerated up to 3-4 days or frozen.

For a cat that rarely eats half of the recommended food intake I really don't understand how she is overweight. I really think that something else is wrong with her but the vet assures me that its probably just her activity level. Granted she is older but she does play here and there but I just dont see the amout of food she's actually eating causing this much overweightness.

Calories and carbohydrates/sugars contribute a lot to that. It also can be difficult for a cat to safely lose excess weight while still on a dry food diet.

Score! Caught no teeth kitty drinking last night!

:highfive:

I think I might look into some of those "pet sitters" to see if I can find a good one. PRobalby is they need to give kidney kitty teh calitrol. I might just try to bring her to my mom's so I know she's eating getting her drugs then leave the other 3 with dry for the few days.

Some will give meds & some won't, if you can talk to people & get recommendations that's best. The vets office/pet food supply store might know a reliable pet sitter aside from their own staff of course.

Totally agree. If I had my way she wouldn't like this one. BUT, she does go back to this one most times (and when she's done a few feedings of any other new food she decides she's done with it). And its not bad on pho, or protein.

Since she's consistant with it, I'd keep it in the rotation.


I will check on this tonight. i've had so many new cans in my pantry that I can't be positive! I know it says 95% on it though!

Most likely the right one then, if not you can always feed it to the others.

I got the vet to fax me kidney kitties results so I could figure out where she sits.

From April 2010
Urea 12.8
Creatine 343
Phos 1.96

Last bloodwork from April 2011
Urea 17.6
Creatie 298
Phos 1.17

So she has gone down in the year she's been on calsitrol (other than the urea - which admittly, i'm not sure what that means). So she is in Stage 3 according to the links you provided.

Do you have the reference ranges for those numbers? Not all vets/labs have the same machines and or they are calibrated slightly different, so one needs the ref ranges to compare accurately.

Good drop on the Crea & Phos :thumbs up The Urea increase is not too bad considering that's a year between tests.

Urea is aka BUN Blood urea nitrogen, the measure of urea nitrogen in the blood on it's way to the kidneys for elimination in urine.

When protein is digested the resulting ammonia (a nitrogenous waste product) is absorbed into the gut, and then converted by the liver into urea. The urea nitrogen travels through the blood stream from the liver to the kidneys, where the kidneys filter it out of the blood & excreted it into the urine. That's where the strong ammonia smell of cat pee comes from, especially with a cat that has a high USG.

Urea levels are subject to fluctuations due to food, stress, urinary blockages and water intake - a dehydrated cat will have a higher urea level.

Was there a urinalysis done as well? Do you have the Urine Specific Gravity (USG) and the urine protein values?

Again, thanks for your help!!

You are most welcome :)

mandyedwards
July 17th, 2011, 10:59 AM
Urea ref is 5.0-12.0 (she is 17.6)
Creatine ref is 71-203 (she is 298)
Phosphorus ref is 1.00-2.4 (she is 1.17)

These were done in April of this year. kidney kitty is now not eating, it's been about 3 meals that she has only eaten maybe a teaspoon of food. We try all 4 each time and she takes a nibble from each one and that's it. I wonder if we should be taking her to the vet? Would it be worthwhile to get her bloodwork done again? Is there anything they can do for her? She is also quite restless, prior behavior is to sleep all day - now she walks around the house, mostly following us. No other symptoms though (weak legs, vomiting, etc). she has done this no eating before, and we've gone through a few times a month prior of her doing this - but it's been half a year since she's done this. And before her other behavior didn't change, she'd still sleep all day and not follow us around. She just seems to keep looking for something.

Do you know if microwaved food can be put back in the fridge to be used again? trying all 4 foods every meal leaves alot leftover. is it best to throw it away?

growler~GateKeeper
July 18th, 2011, 12:47 AM
Urea ref is 5.0-12.0 (she is 17.6)
Creatine ref is 71-203 (she is 298)
Phosphorus ref is 1.00-2.4 (she is 1.17)

These were done in April of this year. kidney kitty is now not eating, it's been about 3 meals that she has only eaten maybe a teaspoon of food. We try all 4 each time and she takes a nibble from each one and that's it. I wonder if we should be taking her to the vet? Would it be worthwhile to get her bloodwork done again?

Has your vet mentioned decreasing the time between blood & urine tests?

Often blood/urine tests are done every 3-4 months for CRF or other chronic conditions.

Is there anything they can do for her?

You can ask your vet about an appetite stimulant, something that will just increase her desire to eat.

She is also quite restless, prior behavior is to sleep all day - now she walks around the house, mostly following us. No other symptoms though (weak legs, vomiting, etc). she has done this no eating before, and we've gone through a few times a month prior of her doing this - but it's been half a year since she's done this. And before her other behavior didn't change, she'd still sleep all day and not follow us around. She just seems to keep looking for something.

Is she restless and irritable or is she alert and wanting to be w/her people? Have you tried feeding her when she's following you, do you think she's hungry? What does she do if you stop & sit down?

I know when I had my kidney cat I could tell by her behaviour when her levels were going up. An increase in toxin levels will make her cranky, irritable, not wanting to sit w/me, she'd be in & out on the balcony all the time etc.

Do you know if microwaved food can be put back in the fridge to be used again? trying all 4 foods every meal leaves alot leftover. is it best to throw it away?

I personally wouldn't warm the food in the microwave (course I couldn't either cuz I don't have one :laughing:) - it changes the molecular structure of the food - makes me nervous about cat food in there.

Adding a teaspoon or two of warm water, or placing the dish in a sink of hot water for a few minutes (as long as the dish isn't hot when served) will warm the food sufficiently to release the flavour/scent.

Have you tried offering it without warming it? Why not offer kidney cat a food & if she doesn't eat it feed that to one of the others?

mandyedwards
July 18th, 2011, 08:23 AM
I am staying home today in the hopes that we can get in with the vet.

I bought 4 cans of fancy feast, of which all day yesterday she managed to eat half a can (they are the really small cans). this morning she didn't want her regular SD so again, i opened up a can of the fancy feast(seafeood) and she is gobbling it. she got about 1/2 of a can done.

i do feed the remaining food to the others, they just have usually finished their own by the time kidney cat is done. could you put the warmed (with water etc) food back in the fridge after? or would you throw it out?

thanks for all your help

mandyedwards
July 18th, 2011, 08:29 AM
Sorry, to answer your other question she wont eat when i stop. she just wants something - to be honest it might be to just go outside. she loves outside and we sit on the patio with her on her leash. she loves it out there. normally though, she just sleeps all day and doesn't care what goes on around the house. she's not really sleeping at all, which is very odd for her. she is sleeping in bed with us during hte night though - which is typical for her. just normally she sleeps all day as well.

mandyedwards
July 18th, 2011, 11:14 AM
Just got back from teh vet. She is wondering if she is hyperthyroid as well. It would explain the not wanting to settle down and the lack of appetite as well. She pulled blood to check her kidneys and hte thyroid. So we'll see. Not consitpated and has actually gained a wee bit of weight since last exam.

growler~GateKeeper
July 19th, 2011, 12:22 AM
I am staying home today in the hopes that we can get in with the vet.

I bought 4 cans of fancy feast, of which all day yesterday she managed to eat half a can (they are the really small cans). this morning she didn't want her regular SD so again, i opened up a can of the fancy feast(seafeood) and she is gobbling it. she got about 1/2 of a can done.

i do feed the remaining food to the others, they just have usually finished their own by the time kidney cat is done. could you put the warmed (with water etc) food back in the fridge after? or would you throw it out?

thanks for all your help

Yes you put canned with water added, or warmed in the sink back in the fridge to try again later, if microwaved I'd probably toss it :shrug:.

Sorry, to answer your other question she wont eat when i stop. she just wants something - to be honest it might be to just go outside. she loves outside and we sit on the patio with her on her leash. she loves it out there. normally though, she just sleeps all day and doesn't care what goes on around the house. she's not really sleeping at all, which is very odd for her. she is sleeping in bed with us during hte night though - which is typical for her. just normally she sleeps all day as well.

Is she meowing more than normal? In particular any yowling?

Just got back from teh vet. She is wondering if she is hyperthyroid as well. It would explain the not wanting to settle down and the lack of appetite as well. She pulled blood to check her kidneys and hte thyroid. So we'll see. Not consitpated and has actually gained a wee bit of weight since last exam.

Nice that you could get her in so quick :thumbs up

Did the vet check her blood pressure? Hypertension can also cause restlessness

Hyperthyroid is a possibility, usually the cats are ravenously hungry and loosing weight, but each cat is different and there are always exceptions. The restlessness and wandering around also fits w/hyperT

Little bit of weight gain is good I say for kidney cats, far more common for them to loose too much weight than it is for them to gain even a little.

:fingerscr for good blood results, did the vet take a urine sample for testing?

mandyedwards
July 19th, 2011, 10:50 AM
Yes she did check blood pressure and advised it was normal (other than the small elevation due to being in the clinic).

No urine sample. I checked and the last one done was 2009 - so i'm not sure why this is not being tested. I can ask when she calls with teh results today.

She has had 2 solid meals now (about half of a small can of fancy feast). Also was given 1/4 tablets of Pepcid AC, and she's had 2 now. Perhaps that is helping ease her tummy.

She is just acting odd. She is standing by the front door alot, yelling at us for not letting her out. Not terribly odd considering she went out for the first time this year on the weekend - so she just wants to go back out. The house is quite hot right now, about 26 with the afternoon sun. So we've been catching her downstairs on a chair she never sits on. Not sure if hte heat is doing this. Normally she sleeps all day on a chair with a heating blanket under her as she likes the heat. She is still quite restless but yesterday she did sleep most of the day, which is a big departure from the last few days - but then by dinner and the rest of hte night she was awake.

We are going away for the next two weekends and my mom has offered to take her so we know she's getting food offered and her calsitrol. The others will stay at home with dry food.

I'll let you know when the vet calls today.

mandyedwards
July 19th, 2011, 05:48 PM
ok, got back the results. Her thyriod is actually low (she said typical of a cat not feeling well) so no issue with her being hyperthyriod, which is great.

Her kidney levels have gone up since april of this year.

phos is now 2.15 (1.17 in April)
Urea is 24.7 (was 17.6 in April)
Creatinine is 357 (was 298 in April)

They also circled her Calcium, at 2.51 (range 2.00-2.9) - perhaps because it went up. I dont have her April in front of me (only what I typed out on the forum). Ranges all the same for this testing period as last.

She was most concerned with the phos increase. She is ordering a phos binder for her to take. Hopefully that helps out. She suggested this doesn't really indicate why she is not eating right now, and only that she is progressing through the disease. She didn't mention changing her dosage of calcitrol - I didn't think to ask. Not sure what necessitates a dosage change?

She said she might just nto be eating due to her tummy being upset, perhaps the pepcid ac will help that. she has eaten well the last two meals (half a fancy feast, which are the very small cans). i'd like to get her off hte fancy feast but we'll see if she allows me to. her behavior is still odd, not sleeping where she normally sleeps if at all etc. but perhaps its just that upset tummy again.

So all in all, I have a very picky cat that is excessivly picky as a kidney cat. So what do I do to control these numbers? The SD that she likes is actually the least phos of all the foods she likes (wellness and evo) so I dont see how that is causing the increase in phos numbers.

growler~GateKeeper
July 20th, 2011, 02:42 AM
Those increases in numbers is the most likely cause for her being "off" & a bit cranky - the build up of toxins makes one irritable.

Ask your vet about starting her on Azodyl http://www.vetoquinolusa.com/CoreProducts/CardioNephrologyRenal/Azodyl.html

In regards to the phos rising even on a lower phos foods:
Her kidneys can't excrete enough phos so it's building up, even on a food with the lowest possible value the blood phos would still rise because nothing is going out.

The phos binder will not remove much/any of the blood phos but it will prevent absorption of more phos from the food which is why while on a phos binder a kidney cat can safely eat a higher phos food.

Just a guess but the vet likely circled the calcium because the use of calcitrol will cause an increase in calcium values

The ideal Calcium to Phosphorus ratio for cats is 1.2:1 so her numbers fall not too far off 1.16:1.

The changes in calcium levels especially and also phos levels would be determining factors for the dosage amounts, since calcitrol basically regulates the production of calcium.

mandyedwards
July 20th, 2011, 10:28 AM
Thanks for that link - I will ask the vet about it.

She is currently not eating again. Yesterday breakfast she ate ok, dinner nothing and bedtime a small amount. Then breakfast this morning she ate a bit of fancy feast salmon (after 3 other food attempts), ate a bit and puked it all up. So no food in her belly again.

I just need to figure out how to make her eat! We have 6 different types of food in our rotation and we try all 6 at each meal just about with no results. i'm goign to look up the values of some other (maybe other wellness?) and see if she just wnats something different again (assuming thats why she ate the salmon as she hadn't had that one before).

she did eat a bit of chicken and chicken broth baby food yesterday, a bit. Then the next meal she wouldn't touch it. So frustrating!!

I think i need some type of appetite stimulant!!

growler~GateKeeper
July 21st, 2011, 12:42 AM
Definately ask the vet about an appetite stimulant.

Is she looking nauseous at all before she eats? Lip licking, excessive swallowing, drooling, head hanging over the water dish?

Perhaps it's also time to ask the vet about subq fluid therapy.

mandyedwards
July 21st, 2011, 04:48 PM
no, no sypmtoms of nausea. other than vomiting yesterday (we gave her salmon for the first time, so that might have done it).

vet said she wasn't dehydrated which is good. she is now drinking from the fountain :thumbs up

last night bedtime she looked really hungry so we fed her and she inhaled half the food, then stopped lol. this morning she had another solid eating (after 2 foods). So w'ell see tonight. if she's good tonight she might be getting her appetite back.

we also went and got 10 more other foods that are ok for her to eat so we have some backups for when she doesn't eat.

growler~GateKeeper
July 21st, 2011, 11:45 PM
no, no sypmtoms of nausea. other than vomiting yesterday (we gave her salmon for the first time, so that might have done it).

Good she isn't showing any symptoms, :fingerscr it was just a one time thing

vet said she wasn't dehydrated which is good. she is now drinking from the fountain :thumbs up

:highfive: awesome

last night bedtime she looked really hungry so we fed her and she inhaled half the food, then stopped lol. this morning she had another solid eating (after 2 foods). So w'ell see tonight. if she's good tonight she might be getting her appetite back.

we also went and got 10 more other foods that are ok for her to eat so we have some backups for when she doesn't eat.

:fingerscr kitty eat more :goodvibes:

CXP
January 12th, 2013, 02:10 PM
Help! I'm so overwhelmed with kitty food info!!
My kitty was recently diagnosed with early stages ckf as well. He is 12 years old... the vet gave me Purina NF Kidney Function(dry) and Medi-Cal Renal LP( wet) - my kitty has always had the option of both. I understand they are low phosphorus and low protein but I can't help but question the ingredients....soo much corn,starch,flour,rice,soybean,etc....what I always thought was NOT good to feed our carnivore friends. I don't know..the more I read, the more links I click into, the more confused I get. :(
I love my kitty so much...I just want the very best for him.
This new NA information ( and mathematical calculations) has confused me even more. Can someone explain to me what all these percentages mean? and which we should be looking at? I've run into a lot of positive reviews about "Wellness" but isn't that too high a protein content for a crf kitty? <sigh>
Any help would be appreciated. Thanks kitty lovers!

growler~GateKeeper
January 13th, 2013, 12:34 AM
Welcome to the forum CXP, sorry to hear you kitty is having kidney issues.

The percentages listed on the can are "as fed values" if you wish to compare foods & to get an accurate amount of each item (protein, phos etc) you need to "remove" the water content from the value.

Calculation goes like this:
100-moisture=dry matter

So if you take the example of Evo 95% Chicken & Turkey (http://www.evopet.com/products/1401)

100-73.99(moisture listed)=26.01(dry matter)

To check dry matter phos level:
0.23%(as fed phos listed)/26.01(dry matter from calculation above)=0.0088*100=0.88% dry matter phos - which is under the target of 1% dm phos most vets like to see.


Kidney cats do not require low protein, but high quality protein low phos food. Removing too much protein from the cats diet makes it less palatable therefore they often refuse to eat, plus cats are carnivores they need meat protein to keep their bodies functions to the fullest.

Fish should be avoided when possible especially tuna, but fed on occasion 1-2 per month is still okay. Cats often become addicted to fish and will eat nothing else and tuna especially creates an imbalance in vit e levels.

When looking for a canned food look for quality ingredients, no fillers, actual meats ie chicken, turkey avoid anything that says "meat" meal cuz you don't know what the "meat" is, and low phos. Really read the ingredients in the food if there actual food listed in the first 6 ingredients and in the first 3 being specific meat or meal variety listed and there are not mostly chemicals it's a better quality food. Compare the ingredients in any can of Wellness to any can of the prescription foods which would you rather eat?

A listing of low phos canned can be found here however this list may not be up to date *formulas do change* and does not include Wellness Chicken 1.15% dm phos, Turkey 1.05% dm phos, Chicken & Beef 1.17% dm phos, Kitten 1.15% dm phos which are the lowest of the Wellness varieties, Nature's Variety Instinct Chicken @ 1.22% dm phos good for occasional meal, the other NV flavours are too high.

When looking at phos levels you want to convert to dry matter (meaning whats left if you remove all water) and find something as close to or lower than 1% phos dry matter.

Foods need to be compared using "dry matter amounts" instead of "as fed amounts" because there is so much difference in moisture content, therefore there is varying amounts of nutrients in different foods

It is always a good idea to add water to the canned food, this helps the cat get more fluids as healthy cats usually drink very little.


When you have an animal with compromised kidneys they should not be eating dry food, it does not add any moisture to their diet. If absolutely necessary however the majority of the diet should be canned with minimal dry. The same dry matter calculation can be used to remove the little moisture in the dry foods for comparison.


Some good quality low phos canned food choices for you:

By Nature Organics (http://www.bynaturepetfoods.com/productpages/organiccannedcat.php) Turkey & Turkey Liver, Chicken & Chicken Liver, Turkey & Chicken, Chicken & Mackerel, Beef & Beef Liver

Evo 95% Chicken & Turkey (http://www.evopet.com/products/1401)

Felidae Platinum (http://www.canidae.com/cats/platinum/canned.html)
Felidae Cat & Kitten (http://www.canidae.com/cats/cat_and_kitten/canned.html)
Felidae Grain Free (http://www.canidae.com/cats/grain-free-cat-food/canned.html)

Merricks Before Grain 96% Beef (http://www.merrickpetcare.com/consumer/products/product.jsp?id=52&page=1&view=list&sort=category_3&order=asc&name=Beef&categories=Cat-Before-Grain-Wet&age=All_Life_Stages)
Merricks Before Grain 96% Turkey (http://www.merrickpetcare.com/consumer/products/product.jsp?id=97&page=3&view=list&sort=category_3&order=asc&name=Turkey_&categories=Cat-Before-Grain-Wet&age=All_Life_Stages)

Merricks Cowboy Cookout (http://www.merrickpetcare.com/consumer/products/product.jsp?id=88&page=1&view=list&sort=category_3&order=asc&name=Cowboy_Cookout&categories=Cat-Classic-Recipes-Wet&age=All_Life_Stages)
Merricks Thanksgiving Day Dinner (http://www.merrickpetcare.com/consumer/products/product.jsp?id=91&page=2&view=list&sort=category_3&order=asc&name=Thanksgiving_Day_Dinner&categories=Cat-Classic-Recipes-Wet&age=All_Life_Stages)

Wellness (http://www.wellnesspetfood.com/recipes.aspx?pet=cat&ft=2) Turkey, Chicken, Beef & Chicken, Beef & Salmon, Kitten, Wellness Core Chicken Turkey & Chicken Liver

Holistic Select Turkey & Barley (http://www.holisticselect.com/product.aspx?pet=cat&cat=2&pid=33)
Holistic Select Duck & Chicken (http://www.holisticselect.com/product.aspx?pet=cat&cat=2&pid=30)

This is a currently updated list 2010-2011 the foods are listed in order of lowest amount of dry matter phosphorus, it's up to you to decide what ingredients are acceptable, the manufactures websites are also listed to help in that regard. Tanya's Feline CRF US Canned Food Data Tables (http://www.felinecrf.org/canned_food_usa.htm#food_data_tables)


Feel free to ask any questions :goodvibes:

CXP
January 13th, 2013, 03:46 PM
Growler,

You have no idea how much relief and joy you gave me today when I opened up my blog to find that you'd already replied! I feel alone in this as I don't want to worry my family and my husband thinks I'm becoming a little too OCD! lol
In any case you answered exactly what I was confused/wondering about.
Thank you soooo much!!

:)

growler~GateKeeper
January 14th, 2013, 10:36 PM
You're welcome, I've been there & happy to help where I can :)

kimouette
October 21st, 2013, 10:01 AM
Here is the most up to date low phosphorus cat food list :

http://catinfo.org/docs/FoodChartPhosphorus9-22-12.pdf