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When is Sub Q fluid inappropriate?

MiniTiga
June 28th, 2010, 12:00 PM
Hi.

My head has been spinning in research for the past month after I got my cat's latest blood work done. I was told she has kidney disease. She doesn't have any of the signs, i.e., vomiting... we are going by numbers.

A month ago, my cat's blood work came back with BUN/Creatinine: 92/2.9
She was also full of bacteria (neutrophils, moncytes, basophils)
She had a high White Blood Cell count, but low Red Blood Cell count.

An infection can make BUN rise disproportionately to Creatinine, as far as I know. Can someone factually negate or support this understanding?

My concern is: is it possible to do more harm than good with Sub Q fluids -- IF by some chance these numbers are not truly reflecting a kidney disease? Is that even possible to consider given the rise in creatinine?

When is it appropriate to start sub Q fluids for diagnosed renal disease? Is this too soon? If she is not dehydrated, eating and drinking normally (so far), is it beneficial to do this?

My vet thinks so, but he has been wrong about many things in the past, so I am very precautious -- especially considering the weight of kidney disease.

aslan
June 28th, 2010, 12:04 PM
I don't personally have any info to give you but here is a link by one of our members with all kinds of information that may help you'

www.pets.ca/forum/showthread.php?t=45017&highlight=growler

sugarcatmom
June 28th, 2010, 12:59 PM
When is it appropriate to start sub Q fluids for diagnosed renal disease?

Here's link to a post by our resident Dr. Lee on this subject: http://www.pets.ca/forum/showthread.php?p=437583&highlight=subq+fluids#post437583

Growler, one of our members here with lots of experience with CRF (see her thread that Alsan linked to), should be on later tonight with some advice as well.

MiniTiga
June 28th, 2010, 03:01 PM
I appreciate both of your responses, Aslan and Sugarcatmom.
The first thread has useful info about food. Amazingly, she is now eating wet food and I am in the process of finding the best low phos food she can enjoy. There is surely a benefit to making sure she gets quality protein and low phos. It's a long thread, so I could not sort through it all yet.

Sugarcatmom, according to the resident vet, I am nowhere near the threshold for starting sub Qs. I have learned to do it and will do it if it means a quality of life for my feline friend, but I hope it doesn't create an imbalance if there isn't really a need for it.

My vet also suggested phosphorous binders as a preventative measure, but her calcium to phos. ratios look normal to me. The calcium based one he recommends will only create a calcium imbalance with prolonged use, so this is something else that has my head in an indecisive knot.

Thanks for your efforts.

aslan
June 28th, 2010, 03:05 PM
MiniTiga,,,if you could post the numbers from the vet,,either SCM or growler could help you out with what they mean. They really are the best to get the advice on this from. Growlers thread went from Duffy first being diagnosed until just recently..

MiniTiga
June 28th, 2010, 03:33 PM
I'm happy to do that. I am looking for a function to upload a pdf file. Do we have that option here? If not, I'll type them, but if there's a better way, please let me know. Thanks.

aslan
June 28th, 2010, 03:41 PM
i don't know of a way to actually download it,,you could highlight it and copy and paste.

MiniTiga
June 28th, 2010, 04:01 PM
Results/Reference Range
Total Protein 7.5/ 5.2-8.8
Albumin 3.1/ 2.5-3.9
Globulin 4.4/ 2.3-5.3
Albumin/Globulin Ratio o.7/ 0.35-1.5
ASr (SGOT) 14/ 10-100
ALT {SGPT) 36/ 10-100
Alkaline Phosphatase 47/ 6-1 02
GGTP <5/ 1-10
Total Bilirubin o.1/ o.1-o.4
Urea Nitrogen 92 (H|GH)/ 14-36
Creatinine 2.9 (H|GH)/ 0.6-2.4
BuN/Creatinine Ratio 32/ 4-33

Phosphorous 4.9/ 2.4-8.2
Glucose 668 (HIGH)/ 64-170
Calcium 9.2/ 8.2-10.8


(There is more to post, but I want to make sure it doesn't post jumbled, first. This is a test.)

sugarcatmom
June 28th, 2010, 04:23 PM
Glucose 668 (HIGH)/ 64-170


Woa, wait a second. I don't even have to look at the rest of the numbers: that glucose value is EXTREMELY high. As in diabetic high. Did the vet not mention anything about it? If I were you, I'd run to the nearest pharmacy and get some Bayer Keto-Diastix (http://www.americandiabeteswholesale.com/-strse-301/Bayer-Keto-dsh-Diastix-Reagent-Strips/Detail.bok) (they usually keep them behind the counter). Watch to see when your kitty goes to the litter box and gently slide a clean shallow jar lid under her butt after she starts to pee. You just need a small amout. Dip a test strip in the pee and tap off the excess, then wait the required amount of time (I think it's 15 seconds for the ketones pad, and 30 seconds for the glucose one). Then let me know what colours you get on the 2 pads.

Or alternatively, take her back to the vet pronto and get a retest on her blood glucose level, along with maybe a fructosamine test. But if your cat does indeed have diabetes, that could be throwing all of the other values outta whack. It needs to be dealt with first.

MiniTiga
June 28th, 2010, 04:26 PM
Results/ Reference Range

Magnesiurn 1.9/ 1.5-2-5
Sodium 144/ 145-158
Potassium 4.6/ 3.4-5.6
Na/K Ratio 31 /
Chloride 11O/ 104-128

Cholesterol 144/ 75-220
Triglyerides - 59/ 25-160
Amylase 778/ 100-1200

Lipase 117/ 0-205
cPK 69 /56-529

Hemoglobin 8.7 (Low)/9-3-15.9
Hematocrit 26.1 (LoW)/ 29-48

(Anemia)

WBC 16.0 / 3.5-16,0
RBC 5.35 (LOW)/ 5.92-9.93
MCV 49 / 37-61
MCH 16.3 / 11-21

----------------------
Neutrophils 11200 (HIGH)
Bands 0
Lymphocytes 2560
Monocytes 1120 (HIGH)
Eosinophils 800
Basophils 320 ](HIGH)

Fructosamine 712 (HIGH)

(Her diabetes was inadequately addressed by Glipizide for the past 2 years. She was misdiagnosed with asthma and was taking prednisone and terbutaline. She has been on insulin for a month with marked observable improvement with decreased thirst and urination and NO ASTHMA issues. Glipizide did not agree with her system and the other meds made her BG worse.) The diabetes is another issue, but can't be isolated from the renal concern.

Thank you for your patience. I have a urinalysis, too. It reflects high glucose, blood, WBC and RBC ... and lots of bacteria. She took antibiotics for that.

MiniTiga
June 28th, 2010, 04:30 PM
Yes, sugarcatmom. How can we isolate this from the diabetes?

I checked her with Keto-Diastix today. No ketones, but even with 1 unit of 100 ProZinc, her urine glucose is off the meter. It is still not contained.

I went to her regular vet earlier to pick up more fluids and mentioned this to him. He wasn't even aware that ProZinc came in a 100 potency -- wasn't even aware that was what he prescribed. (Usually it's the 40 potency that gets prescribed.)

I am looking for another vet, for sure, but so many are just too busy for questions unless it is "Do you accept credit cards?" I'm sorry to sound that way, but it's really frustrating. Thanks.

sugarcatmom
June 28th, 2010, 04:40 PM
How can we isolate this from the diabetes?

I checked her with Keto-Diastix today. No ketones, but even with 1 unit of 100 ProZinc, her urine glucose is off the meter. It is still not contained.

Ah okay, I didn't realize she's already been diagnosed and is on insulin. When did you find out? How long has she been on the ProZinc? What was she eating before you switched her to wet food, and when did you do the switch? Do you test her blood glucose at home, by any chance?

Oh, and one more question I forgot, is that 1u once per day or twice?

MiniTiga
June 28th, 2010, 04:52 PM
She started ProZinc after her last exam - one month ago. She is getting 1u twice per day. She was eating the forsaken vet prescribed dry food before her exam. I had to mix the Purina DM with Hill's WD to get her to eat it, nibbles at a time. It was a huge challenge to get her on wet food, but she took to it -- for the first time in 14 years. Believe me, I tried in the past, but never found one she liked. I read many internet posters like yourself to get ideas on how to coax cats into trying wet, and I can't believe it worked. Unfortuantely, she got hooked on Natural Balance which she took to immediately, but I see it has a high phos count now. We are dabbling with Wellness Turkey. I hope she takes to that.

I never used to feed her by-products before her diabetes diagnosis (two years ago). For the past two years, it's been alot about vet prescribed by-products. This poor creature has been through a toxic mill. I don't understand how vets get licensed to push this type of poison. How can they be in this business and not know anything about by products?

I tried testing her BG at home with my mom's meter and was not very successful. She wouldn't sit still and I poked so many senseless holes in her poor ear. I gave up. I am looking at a Bayer brand Breeze which I believe requires only .1 micro of blood. This part especially is very challenging for me.

sugarcatmom
June 28th, 2010, 05:21 PM
I'm just on my way out but will try to post more later.

She started ProZinc after her last exam - one month ago. She is getting 1u twice per day.

Has she ever had a curve done at the vets? It may just be that she needs more insulin.

How can they be in this business and not know anything about by products?

It's not even so much about the meat by-products, which at least are meat(ish). It's the plant (ie grainy starch) products in cat food that's the real killer (and diabetes inducer).

I tried testing her BG at home with my mom's meter and was not very successful. She wouldn't sit still and I poked so many senseless holes in her poor ear. I gave up. I am looking at a Bayer brand Breeze which I believe requires only .1 micro of blood. This part especially is very challenging for me.

There's for sure a steep learning curve to getting the hang of home-testing, but keep trying. Did you warm her ear (like with a sock filled with dry rice heated up in the microwave)? This is key, especially in the beginning, to get enough blood flowing to the ear capillaries. Using the lancet device on the highest setting, and putting a folded tissue against the back of the ear where you're poking to give the lancet some resistence could also be necessary.

I'll get back to you later with more tips on home-testing.

growler~GateKeeper
June 29th, 2010, 03:29 AM
Hi MiniTiga :) welcome to the forum

A month ago, my cat's blood work came back with BUN/Creatinine: 92/2.9
She was also full of bacteria (neutrophils, moncytes, basophils)
She had a high White Blood Cell count, but low Red Blood Cell count.

An infection can make BUN rise disproportionately to Creatinine, as far as I know. Can someone factually negate or support this understanding?

Was she on antibiotics for the infection & retested after the full course was completed?

The BUN usually rises faster than creatinine because it is more affected by diet, stress and dehydration, where are creatinine is less so http://www.felinecrf.org/diagnosis.htm#creatinine they won't rise point for point at the same rate.

A kidney infection, hypertension, kidney stones, ketoacidosis can cause both to rise suddenly, higher than accurate.

My concern is: is it possible to do more harm than good with Sub Q fluids -- IF by some chance these numbers are not truly reflecting a kidney disease? Is that even possible to consider given the rise in creatinine?

When is it appropriate to start sub Q fluids for diagnosed renal disease? Is this too soon? If she is not dehydrated, eating and drinking normally (so far), is it beneficial to do this?

Providing there are no obvious symptoms/distress and the cat is hydrated enough through drinking, a very general guideline that some vets go by is to start fluids when Creatinine is over 3.5, but it depends on each individual situation.

When my :rip: grrl started fluids her previous Creatinine (3 months earlier) was 2.45, at the next appt because I was measuring the volume of her water consumption and had noticed a marked increase, we started fluids. When I got the results from that appt, her crea was 3.03, still under 3.50 but a blood value increase with increased symptoms.

The issues with starting too early is it puts more strain on the kidneys when the cat is hydrated adequately, they can even become over-hydrated & flush out too much nutrients like sodium for example.

Is she drinking alot, peeing alot?

Are her gums dry & sticky or smooth & wet? Are you familiar with the skin pinch test?

Still as physically active as before?

My vet also suggested phosphorous binders as a preventative measure, but her calcium to phos. ratios look normal to me. The calcium based one he recommends will only create a calcium imbalance with prolonged use, so this is something else that has my head in an indecisive knot.

Phosphorus binders are generally started when the blood phos level is 6 but starting earlier is fine especially if eating a food high in phos. Binders prevent absorption of more from the food, and will slowly drop the blood values, but will not do it dramatically.

There are other types of phos binders (http://www.felinecrf.org/treatments.htm#binder_types) including aluminum based binders, now most vets won't immediately recommend them because of the peppermint flavour, however there are tasteless/odourless aluminum hydroxide binders available at pharmacies often as a generic brand. Do not use binders containing magnesium such as Maalox, Mylanta, Milk of Magnesia or Aludrox, as they may cause UTI/stones. Always consult your vet for dosages and before starting any new treatments.

As you mention the calcium based binders will add to the blood calcium value so frequent testing is required, and are generally thought to be less effective than aluminum based ones.

Hemoglobin 8.7 (Low)/9-3-15.9
Hematocrit 26.1 (LoW)/ 29-48

(Anemia)

Some info here on anaemia (http://www.felinecrf.org/anaemia.htm)


Neutrophils 11200 (HIGH)
Bands 0
Lymphocytes 2560
Monocytes 1120 (HIGH)
Eosinophils 800
Basophils 320 ](HIGH)

The WBC are awfully high, did she atleast have a Complete Blood Count (CBC) re-test after the antibiotics?

Thank you for your patience. I have a urinalysis, too. It reflects high glucose, blood, WBC and RBC ... and lots of bacteria. She took antibiotics for that.

What is the Urine Specific Gravity (USG) value on the urinalysis?

Bacteria in her urine - did they run a culture & sensitivity?

There is blood in the urine - how much, any crystals detected?

Has your vet discussed an abdominal ultrasound with you - this will check the structure of the urinary tract, the kidneys and surrounding organs as well as check for urinary/kidney stones or crystals. The ultrasound is also the only way to rule out pyelonephritis (http://www.felinecrf.org/causes_of_crf.htm#pyelonephritis) ~ kidney infection where a urinary infection has risen up into the kidneys and you will also see blood value infection as well.

I agree that the diabetes needs to be brought under control first as it is a more critical issue at this time & can lead to more complications. :goodvibes:

sugarcatmom
June 29th, 2010, 02:46 PM
He wasn't even aware that ProZinc came in a 100 potency -- wasn't even aware that was what he prescribed. (Usually it's the 40 potency that gets prescribed.)

I don't know why I didn't catch this yesterday, but ProZinc DOESN'T come in U100, only U40. Are you sure it's actually ProZinc? Does your vial look like this one: ProZinc (http://www.1800petmeds.com/ProZinc+Cat+Insulin-prod11139.html)? And you get a prescription filled at the pharmacy? Because I was under the impression you can only get it from the vet. If that's the case, you might be using a compounded PZI insulin, which is not the same thing. As well, the syringes you use for a U100 insulin are different than for U40, so if you ARE using this U100 PZI in a U40 syringe, you're giving your kitty 2.5X more insulin than previously.

Let me know and hopefully we can get to the bottom of this.

MiniTiga
June 29th, 2010, 03:29 PM
No, I am definitely not mis-dosing with incorrect syringes. I tripled checked that and independently calculated the required dosage against a chart to make sure I wasn't overdosing. I have heard horror stories from animals' peeps about overdosing per vet direction, so I cross referenced back and forth before I injected my first shot (with shaky hands)...

I am using (full name) Protamine Zinc Insulin (PZI) 100u/ml - for veterinary use in non-food producing animals.

The syringe is a 3/10 cc 30 gauge x 5/16" length for use with U-100 insulin only.

Thanks for your concern about that. That is critical. I ran into a lady at a pet food store a couple of weeks ago who almost lost her beautiful (and I mean beautiful) 7 year old dog because the vet told her to start her newly diagnosed diabetic dog on 20 (yes 20) units of U-40. He almost died. It's remarkable that he didn't.

An Afterthought: Considering my vet thought he prescribed a U-40 insulin should be enough to alert anyone starting an insulin treatment to make sure they don't accidentally overdose. I had her BG and fructosamine numbers so I was able to work with that when calculating. There's another yarn to this insulin story to weave in: 100 u was shocking to her system even considering the calculations said it was safe considering how weak she was with the infection, anemia and loss of two vials of blood for the exam. When I called the vet to say she was acting very alarmingly lethargic, he just said it was due to kidney disease, and not possibly due to the insulin because it was so low. Talk about communication gaps. Well, I pulled back on the insulin just a smidgeon despite the vet's advice to maintain and it pulled her out of the deep glazey eyed, half-comatose lethargy. She was NOT lethargic before the exam. Know thy animal friend.

sugarcatmom
June 29th, 2010, 03:45 PM
No, I am definitely not mis-dosing with incorrect syringes. I tripled checked that and independently calculated the required dosage against a chart to make sure I wasn't overdosing.

Great!

I am using (full name) Protamine Zinc Insulin (PZI) 100u/ml - for veterinary use in non-food producing animals.

Ah ha! This is not actually the same as the ProZinc, which is a new insulin developed specifically for cats by Boehringer Ingelheim (and is the replacement for the old bovine/porcine PZI Vet by Idexx that was discontinued). ProZinc is a manufactured human recombinant insulin in a protamine zinc formula, the one you have is a compounded PZI insulin, which can have variations from batch to batch. If I were you, I'd have your vet get in some ProZinc, which is better suited for felines. Or else try Lantus or Levemir.

MiniTiga
June 29th, 2010, 03:54 PM
Good to know. I wasn't aware of the difference.

MiniTiga
June 29th, 2010, 04:26 PM
Hi Growler. Thanks for the welcome!

RE: Disproportinate BUN/Creatinine
Yes, BUN rises more than C. However, according to a (new) local vet I shared a phone conversation with, with a BUN that high, the Creatinine would be expected to be in the "6" range, not 2.9, for it to be indisputably renal damage/failure. He said BUN/Creatinine numbers are more likely to be in relation to the Urinary Tract Infection (UTI), evidenced by bacteria count. The high count of White Blood Cells and depletion of Red Blood Cells (hence anaemia) are intertwined. This vet's take on it is that it is most likely transient depending on the UTI.

Let's not forget that she was also taking Glipizide for almost two years -- my understanding is that she was allergic to it. Imagine ingesting something you are allergic to consistently for almost two years. (My vet didn't entertain the possibility that she could be allergic to sulfa drugs despite whatever I told him. She was prescribed terbutaline and prednisone to alleviate the "asthma".)

The (new) vet confirmed that steroids could also make BUN levels rise -- and that prednisone is known to CREATE diabetes -- can you imagine what it would do to someone who already has off-the-meter BG levels.

So, yes, she took anitbiotics for the infection a month ago. She has not been retested because the exam and all the changes (food, medicine) left her very vulnerable. She can not handle another blood exam right now -- not even a "friendly" weigh-in vet visit.

Right now, I am administering Quantum Kidney/Bladder Formula for pets. The (new) vet said he loves that product and recommends it all the time. So, that's in case there's still some UTI issues lingering after the initial antibiotics.

So your grrl is on fluids, too, eh? It was really scary to me when I got the news that I had to do this. I have gotten used to it, but it still bothers me that I need to poke her. It's amazing what a person finds the courage and strength to do when it equates to the well-being of a loved one. I never thought I had it in me to do this. I was always deathly afraid of needles!

It seems that I really need to balance out an informed judgment with prescribed fluids. She's drinking and peeing normally (considering how insatiable her thirst and non-stop her pee was before the insulin).

I wish you the best with your furry friend.

I think I've written enough for now. I'll go through the rest of your thoughtful notes and respond more later.

For now, thanks.

But yes, even the (new) vet agrees: it's all about getting a handle on the diabetes foremost.

growler~GateKeeper
June 30th, 2010, 04:40 AM
Right now, I am administering Quantum Kidney/Bladder Formula for pets. The (new) vet said he loves that product and recommends it all the time. So, that's in case there's still some UTI issues lingering after the initial antibiotics.

The Quantum Kidney/Bladder Formula contains 7 diuretics - corn silk, goldenrod, horsetail, juniper berry, parsley leaf , pipsissewa, uva ursi - of the 9 ingredients. I would be cautious with this product given the possibility there may still be renal issues after the UTI is cleared up & the diabetes is controlled.

Diuretics shouldn't be used on patients with compromised kidneys as they are a strain on already weakened kidneys. Diuretics are designed to flush toxins/crystals/or to just remove (in the case of heart patients) the extra existing water from the body without replacing it. This can be very dangerous especially in a dehydrated patient.

When using subq or IV fluids to flush the toxins from the bloodstream/kidneys you are doing so by adding in more "water", rehydrating & flushing at the same time.

I know it says Kidney/Bladder Formula and pretty much all UTI formulas say that, but the kidneys are the upper urinary tract not the lower urinary tract for which these products are designed.


So your grrl is on fluids, too, eh? It was really scary to me when I got the news that I had to do this. I have gotten used to it, but it still bothers me that I need to poke her.

I wish you the best with your furry friend.

I would recommend you look into getting Teurmo Ultra Thin Wall 20g needles for the fluid administration, the poke is hardly noticable especially compared to the Monoject 18g that most vets use. The point is a very sharp beveled edge & the ultra thin walls allow for as fast a flow in a lighter thinner needle shaft.

She was, for two years & did wonderfully with fluid therapy, until Lymphoma took her 2 months ago :( :rip:.

MiniTiga
June 30th, 2010, 07:52 AM
Growler, I had the same trepidations. I did look up all the herbs in my nutritional healing book before giving her 2 drops. I saw how it could be helpful, as well as possibly damaging, so I called Quantum. They assured me it's beneficial whether or not she has compromised kidneys. I was on the fence until I spoke to the (new) vet and he enthusiastically supported its use. She has gotten VERY conservative dosages and will not be on this for more than four days. I was uncomfortable with the alcohol, as well, but I have used Quantum for myself in the past and have sworn by it. I have always called it my miracle "drugs." Quantum said that the low alcohol formula for pets is about the same amount of alcohol found in a banana.

I agree and thanks for raising the awareness: not to ignore the fact that there still are compromised or exhausted kidneys underneath the UTI and diabetes umbrella. These kidneys have been under alot of stress fighting all the toxins.

I am so sorry to hear that your beauty is no longer on this plane to share time with you. Guaranteed she was well taken care of and had the best quality of life anyone could have offered her during her renal decline. Given that, she is yet in a better place now, I'm sure.

Thank you so much for the tip on the needles. 18G was too painful -- especially as an amateur. Clearly, it hurt her. The vet said that was standard for cats. I asked the vet for a 20 or 22 gauge, anyway. He only had a 22 and that one of course is much slower. I will look into that. After using the 18G, she'd always leak... I tried pinching the area, but I noticed small leaks hours afterwards.

To be cont'd.

MiniTiga
June 30th, 2010, 02:07 PM
She was definitely dehydrated the day of the exam. Since the insulin, thirst and urination has decreased dramatically. She urinates more after she gets sub q fluids.

She used to constantly smack her lips and swallow hard... constant dry mouth... that, too, has improved. Terbutaline contributed to the dry mouth syndrome, as well.

The issues with starting too early is it puts more strain on the kidneys when the cat is hydrated adequately, they can even become over-hydrated & flush out too much nutrients like sodium for example.

That's the kind of stuff I was wondering about. I'm sure the fluids have done her good... but when is it "too much good"?

I read about the skin pinch test -- she passes that one.

Are her gums dry & sticky or smooth & wet?
I just checked: wet and smooth. I'll add this test to the rounds.

Still as physically active as before?
She was not lethargic before the exam, but she got the wind knocked out of her this month. She's so much better this week.



The WBC are awfully high, did she atleast have a Complete Blood Count (CBC) re-test after the antibiotics?

I asked the vet when she should come back for her next exam. He said in another 6 months. Her body can't handle the stress and blood loss of another exam so soon.

Specific Gravity: 1.021
No crystals detected
Blood in Urine: 3+
WBC 4-10
RBC 4-10

No culture & sensitivity run for bacteria. I did even know to ask for one.

One day at a time.

MiniTiga
June 30th, 2010, 02:19 PM
I told the vet her Keto-Diastix reading was off the meter high. Once grasping that she was taking u-100 insulin, he said try increasing dosage, but no more than 1/2 unit. I increased it by about 1/8 or 1/16 (there is no measure on the syringe for that). My latest Keto-Diastix reading showed an improvement. Hopefully, it was an accurate reading. That is hopeful.

By the way, I get an urine sample by simply holding the strip under her stream as she tinkles. At least this test is very simple for us.

Blood testing remains "impossible" to me right now... but of course, I'm trying to learn.

growler~GateKeeper
July 1st, 2010, 01:10 AM
I'll leave all diabetes related issues with scm as I have no experience there.

She has gotten VERY conservative dosages and will not be on this for more than four days.

Good to hear :thumbs up I'm glad you are treating naturally with a side of caution. Some people assume because something is natural it is automatically/irrevocably safe & can dose as they like.

I am so sorry to hear that your beauty is no longer on this plane to share time with you. Guaranteed she was well taken care of and had the best quality of life anyone could have offered her during her renal decline. Given that, she is yet in a better place now, I'm sure.

Thank you :pawprint:

Thank you so much for the tip on the needles. 18G was too painful -- especially as an amateur. Clearly, it hurt her. The vet said that was standard for cats. I asked the vet for a 20 or 22 gauge, anyway. He only had a 22 and that one of course is much slower. I will look into that. After using the 18G, she'd always leak... I tried pinching the area, but I noticed small leaks hours afterwards.

22g are fine :thumbs up providing she is okay with staying in one place a little longer. Vets usually go with the 18g's because it is a faster flow with a needle that is "not too big" - though to us & the cats they are pretty big. 22g's they usually use for drawing blood.

For the leaking, hold the pinch directly over where the needle was inserted for about a minute if you can. Also you can pinch the area & hold the skin up (as if you were to do a skin pinch test) & give it a little shake, that settles some of the fluid away from the skin in that spot & puts an air pocket there. You can also massage some of the fluids away from the injection site while you are waiting for the drip to finish.


She was definitely dehydrated the day of the exam. Since the insulin, thirst and urination has decreased dramatically. She urinates more after she gets sub q fluids.

Completely normal, my girl also used to tank up @ the water dish right after getting her fluids

She used to constantly smack her lips and swallow hard... constant dry mouth... that, too, has improved. Terbutaline contributed to the dry mouth syndrome, as well.

Lip smacking & excessive swallowing is also a sign of nausea, now obviously the meds have contributed/been the source for most if not all of this. I would recommend elevating her food & water dishes up between 2-6 inches off the ground. You can use a phone book, planter stand, block of wood etc, this is so she is not bending down & will place her head above her stomach so any excess stomach acid stays in her stomach.

That's the kind of stuff I was wondering about. I'm sure the fluids have done her good... but when is it "too much good"?

How much volume wise & how often is she getting fluids?

How long does it take for the fluids to absorb completely?

If she is still "squishy" after more 24 hours, she's getting too much or too frequent.

Never give fluids if the previous sessions' fluids haven't absorbed fully.

I asked the vet when she should come back for her next exam. He said in another 6 months. Her body can't handle the stress and blood loss of another exam so soon.

Specific Gravity: 1.021
No crystals detected
Blood in Urine: 3+
WBC 4-10
RBC 4-10

No culture & sensitivity run for bacteria. I did even know to ask for one.

Do you know roughly how much she weighs?

I agree she's had a lot to handle this past couple of weeks :cat:

Watch for signs of lethargy - the blood in urine combined with anaemia can make her weak. Also keep an eye on how she walks - the back legs up to the "hock" joint should never touch the ground (except while sitting/laying down), only the pads on her feet in a normal stance.

Urine Specific Gravity (USG) is low but that is to be expected with all the drinking & peeing before the insulin was started & also now with the fluids.

Next time in when they do a urinalysis, have them put "culture if indicated" on the report to the lab - that way if there is bacteria in her urine the lab will do a culture & sensitivity, if there isn't any - there is no need to have it done.

MiniTiga
July 1st, 2010, 07:20 PM
22g takes way long. I only recently realized that I have to hang it VERY high for it flow normally. The UTW 20g should be the happy medium.

She was prescribed 150 mL 2x/week -- but I haven't been completely following that for reasons discussed. I'll start paying attention to how long it takes for fluids to absorb. At least I know it's definitely being absorbed before the next round because I'm not doing it every day.

Her last weigh-in, a month ago, was 8.3 lbs. It gets uncomfortable for her quickly when the fluids go past 100 mL. It seems like she enjoys it at first, then when it gets past the 100mL mark, she gets uncomfortable.

Great tips for avoiding leaks...

Lip smacking & excessive swallowing is also a sign of nausea,
Good to realize.

I would recommend elevating her food & water dishes up between 2-6 inches off the ground.
I would do this on occassion, not because I realized it's stomach acid benefit but because I thought it might be easier on her neck to eat that way. Whenever I put the bowl in an elevated position, she eats more because she can spend more time comfortably in her bowl. This will now be a regular part of the dining routine.

I'm giving her (again, VERY conservative doses of) Ferrofood (for Iron) and B complex vitamins. Her energy level and alertness has improved a great deal since last week. I am so grateful.

All else you wrote has been noted.

You have to know enough about a subject to ask good questions, and there's no way of asking a question about something you're not even aware of, so anything you add to fill in the gaps is much appreciated.

This thread is helping alot.

growler~GateKeeper
July 2nd, 2010, 02:42 AM
22g takes way long. I only recently realized that I have to hang it VERY high for it flow normally. The UTW 20g should be the happy medium.

She was prescribed 150 mL 2x/week -- but I haven't been completely following that for reasons discussed. I'll start paying attention to how long it takes for fluids to absorb. At least I know it's definitely being absorbed before the next round because I'm not doing it every day.

Her last weigh-in, a month ago, was 8.3 lbs. It gets uncomfortable for her quickly when the fluids go past 100 mL. It seems like she enjoys it at first, then when it gets past the 100mL mark, she gets uncomfortable.

Gravity does play a big part in flow rate, just be sure you can accurately see where the marker is. I used to hang the bag from the top of a 5ft high floor lamp & sit on the couch w/Duffy in my lap.

Also try not to poke her in the same spot each time as bits of scar tissue may develop closing the wounds. If you imagine placing a saddle on her back, like you would a horse, anywhere in that area you can use for the fluids, it doens't always have to be between the shoulder blades. There's a picture here about 3/4 of the way down the page: http://www.weirdstuffwemake.com/weird/stuff/pets/cats/sophia/catjuice.html

Seems 150mL twice/week is a common starting point for most cats, but it is not written in stone, there is room for adjustment. She is telling you she needs the fluids but she's also telling you when her body has had it's fill - that's when/why she's getting antsy at the 100mL mark.

Drop it down to 100mL three times per week, she'll still be getting the prescribed amount each week just less more freqently. Next time you talk to or are in to see the vets tell them you've adjuested the fluid schedule because she's antsy & telling you she's had enough at that point. It's what the vet will tell you to do anyways ;)

She's a tiny one isn't she, just make sure she's getting adequate food as she doesn't have much room to loose.

I would do this on occassion, not because I realized it's stomach acid benefit but because I thought it might be easier on her neck to eat that way. Whenever I put the bowl in an elevated position, she eats more because she can spend more time comfortably in her bowl. This will now be a regular part of the dining routine.

This is part of the reason I say 2-6" in order to give more room to find what is comfortable for your cat, as they are all different and not all CRF cats will have an issue with stomach acid or nausea but it is common, and older cats in general can benefit from less overall joint strain.

I noticed w/my grrl who did seem to have a mild s.a. issue at first that 2-3" resolved that but as I sat watching her one night eat her dinner, it still seemed like she was not quite comfortable enough to reach down that far to eat. So I put the water fountain up about 2" (she always drank from the far side :D so I couldn't go too high and didn't seem to be an issue w/the water dish) and her food dish was placed up around 5".

I'm giving her (again, VERY conservative doses of) Ferrofood (for Iron) and B complex vitamins. Her energy level and alertness has improved a great deal since last week. I am so grateful.

Given the anaemia she likely needs the iron & Vit B, much of that improvement should also be attributed to the fluids flushing out the toxins and also the tinkering with the insulin amounts.

I know it doesn't sound like a bunch of extra "water" would have a great impact but boy does the crea & urea build up ever make them feel crappy. Even when my girl was on fluids every other day there was a small but noticible diference the day she had them as opposed to the day off, she was eventually switched to every day.

MiniTiga
July 2nd, 2010, 03:36 PM
Duffy sounds like a sweetheart!

Also try not to poke her in the same spot each time...
This isn't easy on them, no doubt. They adapt, but it's not in the top ten list of things cats love to do. When I poked myself with a 22 by accident, I felt it! They may be a bit more tough skinned, but repeated pokes sure will/does impact.

My role is to make her as comfortable as possible. I hope to make this a "conscious participatory" experience for her. That's how I got her to take pills on a regular basis this past year.

But, to note, she's not a docile puddytat! I knew I couldn't fight to cram pills down her throat every day and expect to win even once. She was a willing part of the process. No stress. No fighting.

PS If you ever need tips with pill popping, let me know. We mastered that craft!

She is telling you she needs the fluids but she's also telling you when her body has had it's fill -
You understand.

She's def not dehydrated; not vomitting; no diarrhea; eating wet food and drinking water -- she always drank plenty of water -- since kittenhood. That's why I question it. This is mainly for clearing the toxins at this point, then.

I just got a supply of Azodyl. That is supposed to reduce those toxins. Did you use that?

She's a tiny one isn't she...
Yes. Now she is. I call her "kitten-lady" because she is as slim as she was when she was a kitten. She used to be chubsy - 2 years ago.

After her diagnosis, she ate prescribed Purina DM and very quickly dropped over 4 lbs which alarmed me, but didn't make the vet flinch. She's been holding at 8 lbs for 2 years, but she got a little skinnier before the last exam.

She has not been getting appropriate nutrition. The vet said I could also feed her Hills W/D, which is bulked up with fiber for overweight cats, and marketed as good for diabetic cats, as well. Neither product ultimately helped control HER diabetes, as it was so high. It did control her weight.

She was not getting any quality protein with her dry food diet, so I also wonder if that led to muscle mass breakdown, and hence a contributor to creatinine rise.

I am watching to see if her new diet helps her gain a pound or two, which would be a welcome cushion. Then we'll know for sure if the weight loss was a diet issue.

I know it doesn't sound like a bunch of extra "water" would have a great impact but boy does the crea & urea build up ever make them feel crappy.
After a good dose of fluids, I do notice a calm serenity envelop her.
:angel:

gardensgrow
July 2nd, 2010, 04:05 PM
My Nim is hydrated and not vomiting and not squirts. Her labs say kidney disease. Her demeanor says good day bad day. She is most probably 15 years old.

My goal for her is the best life she can possibly have as long as she possibly live it.

Sharon Frey

growler~GateKeeper
July 3rd, 2010, 01:13 AM
Duffy sounds like a sweetheart!

She certainly was :lovestruck: Quite the character too. :cat:

This isn't easy on them, no doubt. They adapt, but it's not in the top ten list of things cats love to do. When I poked myself with a 22 by accident, I felt it! They may be a bit more tough skinned, but repeated pokes sure will/does impact.

Cats adapt surprisingly well to a lot of things, especially once they see how good it makes them feel in the end. :cloud9:

Oh yes I think nearly everyone w/a CRF cat getting fluids has poked themselves at least once :laughing: One night I stabbed myself really good w/a 20g UTW while recapping it. After warming the fluids & running the line a bit, I wasn't paying attention & was holding the needle at the wrong angle, it went full force right through the side of the cap & just missed my knuckle lodging itself quite nicely into my finger. ouch! Given that the needle had bent on the way through & of course that I'd drawn my own blood I had to pull out a fresh one for Duffy.

My role is to make her as comfortable as possible. I hope to make this a "conscious participatory" experience for her. That's how I got her to take pills on a regular basis this past year.

But, to note, she's not a docile puddytat! I knew I couldn't fight to cram pills down her throat every day and expect to win even once. She was a willing part of the process. No stress. No fighting.

PS If you ever need tips with pill popping, let me know. We mastered that craft!

Awesome for her & you :thumbs up. It's great when they realize it's only yucky for a couple of seconds & sit nicely so as not to prolong the torment :laughing:

In addition to as needed Classic Homeopathic remedies, Duffy was getting twice daily holistic supplements & feline vitamins to a total of 9 pills a day, she went from being a pill spitter as a kitten to a senior cat who willingly came over for them & could be given pills 1 handed :cat: Just becomes part of the routine, nothing special to them.

You understand.

She's def not dehydrated; not vomitting; no diarrhea; eating wet food and drinking water -- she always drank plenty of water -- since kittenhood. That's why I question it. This is mainly for clearing the toxins at this point, then.

I do, I've been there. :)

Not only clearing toxins out but also replacing the fluids that she is peeing out.

Cats kidneys were designed to retain, clean & recycle as much water as possible, putting it back into use in their own bodies - they (all feline species) are the only ones who do. Once there is a breakdown in the function of the kidneys they start loosing the ability to maintain proper fluid balance & it becomes a loosing battle as they can't drink enough to keep up. There is a high majority of healthy cats that are mildly chronically dehydrated.

I just got a supply of Azodyl. That is supposed to reduce those toxins. Did you use that?

Yes though she was only on it for the last 5 months, Azodyl worked very well for Duffy dropping both the BUN & the crea. :thumbs up

Remember to keep it in the fridge, including the unopened bottles, & follow weight-dosing instructions on the label.

Yes. Now she is. I call her "kitten-lady" because she is as slim as she was when she was a kitten. She used to be chubsy - 2 years ago.

After her diagnosis, she ate prescribed Purina DM and very quickly dropped over 4 lbs which alarmed me, but didn't make the vet flinch. She's been holding at 8 lbs for 2 years, but she got a little skinnier before the last exam.

She has not been getting appropriate nutrition. The vet said I could also feed her Hills W/D, which is bulked up with fiber for overweight cats, and marketed as good for diabetic cats, as well. Neither product ultimately helped control HER diabetes, as it was so high. It did control her weight.

She was not getting any quality protein with her dry food diet, so I also wonder if that led to muscle mass breakdown, and hence a contributor to creatinine rise.

I am watching to see if her new diet helps her gain a pound or two, which would be a welcome cushion. Then we'll know for sure if the weight loss was a diet issue.

Not sure how you feel about raw feeding, but next time you are cooking chicken, you could see what she thinks of a small piece of raw meat. Try offering her some see what she does with it, if she doesn't go for it right away leave it beside her food dish for a couple of hours, it might make her curious. Raw is great for (re-)building strength & muscle back; plus it's their natural diet & good for them.

After a good dose of fluids, I do notice a calm serenity envelop her.
:angel:

:thumbs up

My Nim is hydrated and not vomiting and not squirts. Her labs say kidney disease. Her demeanor says good day bad day. She is most probably 15 years old.

My goal for her is the best life she can possibly have as long as she possibly live it.

Sharon Frey

I hope Nim is feeling good these days :goodvibes:

MiniTiga
July 4th, 2010, 06:44 AM
Well, I guess I've been intiated into the poke-yourself-with-your cat's needle club. Ouch and lol. It should keep me aware that we're all flesh and blood.

The (new) vet, believing the diabetes should be addressed first, suggested EVO, as the 2nd best thing to raw. EVO makes no health benefits claim for cats with CRF, but does so for diabetic cats.

Back on the fence with that one.

I don't eat chicken or red meat, only fish sometimes, so I'd have to buy meat for that experiment. The (new) vet prefers EVO over Wellness. He believes Wellness has too many added ingredients that could be hard on her kidneys.

She is eating a half and half mixture of Natural Balance Salmon Formula and Wellness Turkey right now.

And Nim: we all have our good and bad days. What to do? We do what we can.

sugarcatmom
July 4th, 2010, 12:15 PM
Well, I guess I've been intiated into the poke-yourself-with-your cat's needle club. Ouch and lol. It should keep me aware that we're all flesh and blood.

Here's a story for ya: I test my Aztec's blood sugar on my lap, and then give him his shot after I get the number. First, I warm up his ear with a rice-filled sock that has been heated in the microwave. Then, to warm up the insulin before I inject him so it isn't uncomfortable (cold insulin can sting), I wrap the still warm sock around the insulin-filled syringe for a few seconds. I do all of this in front of the TV, by the way. So something on TV had my attention, and when I pulled the syringe out of the sock, it left the cap behind. But I didn't notice. At this point in my routine, I would put the capped syringe in my mouth and bite down on the cap to pull it off. You can see where this is going...... I put the syringe in my mouth, but now that there was no cap on it, I stabbed myself in the tongue with the needle. Yup, that'll teach ya to pay attention!

The (new) vet, believing the diabetes should be addressed first, suggested EVO, as the 2nd best thing to raw. EVO makes no health benefits claim for cats with CRF, but does so for diabetic cats.

EVO dry or canned? If canned, which flavour (as in the original Turkey and Chicken, or one of the 95% meat versions)?

The original Turkey and Chicken Evo is just too high in phosphorus to be feeding a CRF cat. Plus, it has even more extraneous ingredients than Wellness. The 95% ones are decent though, except there is some doubt about the phosphorus content of the venison flavour.


The (new) vet prefers EVO over Wellness. He believes Wellness has too many added ingredients that could be hard on her kidneys.

Is the vet referring to the additional fruits and vegetables in Wellness? Those are really minuscule, and we know that because the total carb content of Wellness (grain-free varieties) is quite low. It's certainly not something I would be worried about, with either CRF or diabetes.

growler~GateKeeper
July 5th, 2010, 01:34 AM
The (new) vet, believing the diabetes should be addressed first, suggested EVO, as the 2nd best thing to raw. EVO makes no health benefits claim for cats with CRF, but does so for diabetic cats.

Back on the fence with that one.

I don't eat chicken or red meat, only fish sometimes, so I'd have to buy meat for that experiment. The (new) vet prefers EVO over Wellness. He believes Wellness has too many added ingredients that could be hard on her kidneys.

She is eating a half and half mixture of Natural Balance Salmon Formula and Wellness Turkey right now.

On a phos basis Evo 95% Turkey & Duck is good, 95% Beef is okay, the others are too high, Venison is questionable until we get an answer from the company. For phos Wellness Turkey, Chicken, Beef & Chicken all have good numbers, Wellness Healthy Indulgence Turkey & Duck also has good numbers.

You can try other things first to get her to eat more & leave the raw option for later if you want. Many people are vegetarians or otherwise not comfortable with raw & thats okay, there is nothing that says you have to try it.

One of the other members who also has a recently diagnosed CRF cat was feeding one of the NB flavours & the response she got when emailing the company for the phosphorus amount is:

I emailed Natural Balance ....... They provided this answer to the amount of phosphorus.......

Please know that the Canned Cat Formulas have an average sodium content of 0.25% and the phosphorous of 0.47% as fed.

Regardless of the moisture content of the food, that amount of as fed phosphorus is way too high and will convert to way too high of a dry matter phosphorus amount for a kidney cat.


I put the syringe in my mouth, but now that there was no cap on it, I stabbed myself in the tongue with the needle. Yup, that'll teach ya to pay attention!

Ouch!! :eek:

MiniTiga
July 5th, 2010, 08:41 AM
It's a cat's life. I'm just going along for the ride.

Thanks for helping me navigate through the mental forks on this mind-bending road. If it's good for diabetes, it's not good for CRF, and vice-versa, and back and forth and up and down with UTI and so on between conflicting vet opinions. Yikes.

Hole-y tongue piercing, sugarcatmom! That's an eye-popping story. Pro and novice alike must be present with needle in hand. I get it! Glad it wasn't anything worse. You sure have that blood test down packed. With all the poking going on, my kitten-lady is only an ear-poke away from becoming a full-body pin-cushion. It seems a bit overwhelming to me to try, again, but it's on the agenda.

I have no idea what the (new) vet meant by the added ingredients in Wellness that EVO doesn't have. I didn't see it, either. The info you extended about EVO is really helpful. If I can stretch my dollar and legs to a store that carries it, I'll sample the lowest phos one.

Yes, I was so-so-so happy when my kitten-lady DEVOURED a wet food for the first time in her life -- and it so happens it was the Salmon Natural Balance she fell in love with it -- instantly -- after rejecting COUNTLESS others. There was no trickery involved with getting her to dig into it. Love at first scent. At least that flavor is low in carbs.

It was only after I heard back from the company about the phos when my party balloon deflated.

Wellness Turkey is the only one flavor in the grain-free variety she'll eat, so far, and she'll only lick the bowl clean if it's mixed in with the NB Salmon. We keep experimenting, but I need to make sure she eats more than kibble-nibbles for her insulin shots.

Do you think a phosphorous binder will be helpful with meals like that? I read that binders are only good with low phos diets to begin with....

I wouldn't impose my vegetarian beliefs on a cat -- but I just have thoughts about "fresh hunt" versus "butcher-block stock." The bottom line is if it's healthy for her, I'm game.

growler~GateKeeper
July 6th, 2010, 12:19 AM
Must be something in that Natural Balance that's got them hooked :laughing:

Do you think a phosphorous binder will be helpful with meals like that? I read that binders are only good with low phos diets to begin with....

I never had to use a phos binder for Duffy as her blood phos levels were always middle of normal & she was started on a raw diet about 7 months after her diagnosis.

Yes a phos binder will help, though I'm not sure how effect it would be with such high phos content, your vet would have the dosage amounts based on the amounts in the food. Obviously it's easier to remove less phos content from the food then more, so the info out there would likely be based on using binders w/low phos foods.

Some info here: http://www.felinecrf.org/treatments.htm#high_phosphorus

MiniTiga
July 6th, 2010, 05:26 AM
Interesting. No binder ever for Duffy? Kitten-lady's phosphorous is normal, too. Vet 1 said keep on with Purina DM dry and give a calcium based binder to PREVENT disease from progressing.

Vet 2 said switch to EVO and no need for a binder because phos is normal.

I thought raw would be particularly high in phosphorous and bad for CRF - haven't my done homework there.

The NB/Wellness mixture averages out to about 1.5 phos based on DM, if my calculations are near accurate. Not ideal, no worse than the vet's Purina.

diet-- it's the most important medicine.

sugarcatmom
July 6th, 2010, 07:18 AM
I thought raw would be particularly high in phosphorous and bad for CRF - haven't my done homework there.

Depends on the raw mixture. There are some good low-phosphorus commercial frozen raw diets available, like Nature's Variety. And there are some that, while still a good product, aren't suitable for CRF situations (like Feline's Pride). It really is worth looking into though. Like you, I'm a vegetarian, so I find the commercial raw products are preferable to making my own cat food (although if I had to, I would). It's as easy as opening a can.

diet-- it's the most important medicine.

:thumbs up Absolutely!!

MiniTiga
July 6th, 2010, 07:32 AM
This is the best needle I've yet used for sub q fluids. 100 mL dispensed in no time. Amazing. It felt quicker than my 18G runs. Most importantly, she didn't flinch the way she does when 18G get inserted. And no leaks.

Blessings for recommending this. Blessings to the inventor and manufacturer for making this option available for all pets (and pet owners) who have to endure consistent needle pokes.

VETS SHOULD USE THIS Terumo 20G instead of the Monojet 18G. It is far superior. I am going to hand my vet a couple of these next time I go back there. If I was taking my pet to the vet for regular sub q fluids, I'd insist that s/he use these, instead. :thankyou:

MiniTiga
July 6th, 2010, 09:01 AM
The 95% ones are decent though, except there is some doubt about the phosphorus content of the venison flavour.

I just called EVO for numbers. They used the term "whole," which they said means "as-fed." So, whole or as-fed percentages are:

95% Venison: 0.62
95% Chicken & Turkey: 0.23
95% Duck: 0.35

Their regular Turkey & Chicken wet is 0.38

So, Venison is not a good option for CRF cats.

If anyone has contradictory info, I'm open to hear.

MiniTiga
July 6th, 2010, 12:51 PM
Must be something in that Natural Balance that's got them hooked

It smells good. It looks good. And it has this cool creamy texture. This was the first cat food can I opened that didn't make me gag.

In an absent-minded, multi-tasking moment, I came close to actually eating some. I was shuffling around with a used butter knife in hand, and the way someone licks frosting off a spatula, I almost licked the butterknife with NB Salmon on it. Its scent drew me closer to it, and for a nano-second, I forgot it was cat food.

Wellness was the second non-gagging can I opened -- the Turkey, especially. Its texture is less creamy. She likes that one, too. I haven't confused that one with human turkey spread, though.

DEAR NATURAL BALANCE: PLEASE MAKE A LOW PHOS CAT FOOD!!!

growler~GateKeeper
July 8th, 2010, 11:40 PM
Interesting. No binder ever for Duffy? Kitten-lady's phosphorous is normal, too. Vet 1 said keep on with Purina DM dry and give a calcium based binder to PREVENT disease from progressing.

Vet 2 said switch to EVO and no need for a binder because phos is normal.

Nope never a phos binder for Duffy, her blood phos value stayed fairly consistant through the 3 years, the highest her phos went was US 5.05mg/dL (1.63mmol/L) and that was soon after diagnosis, from there it dropped & stayed between US 3.84-4.87mg/dL (1.24-1.41mmol/L).

About 6 months after her diagnosis I took Duffy to a Homeopathic Vet, went RAW, started on holistic supplements & homeopathic remedies & never looked back :cat:

I personally would hold off on a binder as long as the blood value is normal & she will eat a lower phos food. And if I went with a phos binder I would use an aluminum based binder not a calcium based one so as not to create further imbalance in the calcuim : phos ratio, or create issues with the blood calcium value. The aluminum based ones are also apparently more potent.

http://www.felinecrf.org/treatments.htm#binder_types


I thought raw would be particularly high in phosphorous and bad for CRF - haven't my done homework there.

The NB/Wellness mixture averages out to about 1.5 phos based on DM, if my calculations are near accurate. Not ideal, no worse than the vet's Purina.

diet-- it's the most important medicine.

If you were to look at raw boiler/fryer chicken - meat/skin/giblets/neck you would be looking at *very roughly* about 74mg phos/100kcal way lower than canned. For just ground raw chicken again *very roughly* about 125mg phos/100kcal, also way lower than most canned, of course you can't feed just ground raw meat as a diet.

For me I wouldn't go higher than about 1.25% dm phos or about 230mg phos/100kcal :2cents:

This is the best needle I've yet used for sub q fluids. 100 mL dispensed in no time. Amazing. It felt quicker than my 18G runs. Most importantly, she didn't flinch the way she does when 18G get inserted. And no leaks.

Blessings for recommending this. Blessings to the inventor and manufacturer for making this option available for all pets (and pet owners) who have to endure consistent needle pokes.

VETS SHOULD USE THIS Terumo 20G instead of the Monojet 18G. It is far superior. I am going to hand my vet a couple of these next time I go back there. If I was taking my pet to the vet for regular sub q fluids, I'd insist that s/he use these, instead. :thankyou:

Awesome aren't they :highfive: I wouldn't use anything else.

I just called EVO for numbers. They used the term "whole," which they said means "as-fed." So, whole or as-fed percentages are:

95% Venison: 0.62

Yeah that's what I thought as they have that posted on their official site but we were just waiting for clarification from EVO themselves. Thanks for the confirmation :thumbs up

In an absent-minded, multi-tasking moment, I came close to actually eating some. I was shuffling around with a used butter knife in hand, and the way someone licks frosting off a spatula, I almost licked the butterknife with NB Salmon on it. Its scent drew me closer to it, and for a nano-second, I forgot it was cat food.

:laughing: :eek: Glad you stopped yourself in time :yuck:

I will also pass this Excel Spreadsheet along for you Chronological Lab Results (http://www.digitalcaptive.net/ebony/ChronologicalLabResults.xls) (it will ask you to download & save - I've done so many times without issue). I found it one night searching for CRF info, it was posted by a CRF cat mom (on a website I lost track of :o) as a way to keep track of appts, results etc., I found it an excellent tool for keeping track of progress on lab tests & to compare results quickly, just change the "normal range" values to what your lab has listed on the test results.

MiniTiga
July 10th, 2010, 08:20 AM
Yes, agreed - lower phos is the goal.

After several rejections, I'm happy that she has now accepted Wellness chicken -- but only when mixed in with wellness turkey -- and Natural balance Salmon.

This combo makes her meow for more! THis is a first!

With an approx. 1.21 total phos - I say YAY! We're headed in a good direction, gratefully.

I have left several messages for Wellness and have not received a response regarding their phos levels.

I'm going with the only #s I can find on-line:
.92 turkey
1.0 chicken

No one knows how long anyone or any creature will live, whether they are in perfect or compromised health, but it is so beautiful to realize that the CRF is not an immediate death sentence, which is how I felt leaving the vet's office over a month ago. It makes me so happy to see her REALLY enjoy a nutritious food.

I'll be sampling real liver and chicken, soon, but I'll start off boiling, first.

Her urination/thirst has never been so infrequent since I upped her insulin. The last I checked, which I hope will remain consistent, there was no glucose indicated in the urine.

She's doing better than she has in a REALLY long time!

growler~GateKeeper
July 11th, 2010, 01:50 AM
After several rejections, I'm happy that she has now accepted Wellness chicken -- but only when mixed in with wellness turkey -- and Natural balance Salmon.

This combo makes her meow for more! THis is a first!

With an approx. 1.21 total phos - I say YAY! We're headed in a good direction, gratefully.

I have left several messages for Wellness and have not received a response regarding their phos levels.

I'm going with the only #s I can find on-line:
.92 turkey
1.0 chicken

That is great she is eagerly eating :highfive:

I'm guessing you got these numbers here http://webpages.charter.net/katkarma/canfood.htm? This list is actually from 2003 & not currently updated. When Duffy was first diagnosed in 2007 I emailed Wellness for their actual numbers & was sent the full lists for every food they made at that time both dry & canned.

Dry Matter Phosphorus (2007) - Canned:

Chicken = 1.15
Chicken & Herring = 1.48
Chicken & Lobster = 1.31
Beef & Chicken = 1.17
Turkey = 1.05
Turkey & Salmon = 1.44
Salmon & Trout = 1.28
Sardine, Shrimp & Crab = 1.30
Kitten = 1.15
Beef & Salmon = 1.06

I know some of the fish flavours have acceptable (or slightly above) phos levels, but I always tried to stay away from fish as much as possible, mainly for the "addictive" reasons ie if at any point you had to feed them something that didn't have any fish in it they would be more likely to refuse (like my mum's healthy non-crf cat won't touch any canned except tuna :rolleyes: picky little brat :laughing:)

No one knows how long anyone or any creature will live, whether they are in perfect or compromised health, but it is so beautiful to realize that the CRF is not an immediate death sentence, which is how I felt leaving the vet's office over a month ago.

A lot of people feel that way upon hearing the diagnosis, but we are coming a long way in at-home patient supportive care that more & more people are realising they can do so much to help their furry friends live comfortably for as long as possible.

She's doing better than she has in a REALLY long time!

So happy to hear that :thumbs up :grouphug:

MiniTiga
July 13th, 2010, 06:33 PM
Those new numbers mean, back to the mixing board. That's a link I definitely visited. I suspected it wasn't up to date.

Thanks!

And why not just add this to the numbers mix:

Called Wellness, again, and got these (as-fed) numbers:
phos/carbs
Turkey .28 / 1.67
Chicken .31 / 1.74
Turkey & Salmon .31/4.73
Beef & Salmon .26 (did she mean chicken?)
(beef & chicken made her queasy.)

Your mum's cat is finicky? Say it isn't so! How unheard of. :)
:wall:

I tried boiling liver and chicken. She loved it. She loved the chicken broth, too -- and it was just plain ol' chicken water, no spices, no flavorings. Her energy level and alertness was observably better after these treats. I'd like to make more home-made meals. I'm definitely not comfortable with raw at this point. I am too concerned about bacteria. But I did present raw chicken thighs at here before cooking. She sniffed out of curiousity and walked away. When I presented her with the cooked thighs, she jumped up and dug into as if she was waiting for this her entire life!

sugarcatmom
July 14th, 2010, 07:26 AM
Beef & Salmon .26 (did she mean chicken?)

There is a beef & salmon flavour (light blue can).

I tried boiling liver and chicken. She loved it. She loved the chicken broth, too -- and it was just plain ol' chicken water, no spices, no flavorings.

Homemade chicken broth is excellent for diabetic/CRF kitties, glad she liked it.

I'd like to make more home-made meals. I'm definitely not comfortable with raw at this point. I am too concerned about bacteria.

Bacteria is not an issue for cats the way it is for the human digestive system. Their intestinal tract is considerably shorter (designed for eating raw meat, in fact), so the food doesn't stick around long enough for bacteria to take hold. Plus, they have highly acidic digestive tracts that make for a rather inhospitable environment for bacteria to thrive. Here are some links for you to check out on this subject:
http://feline-nutrition.org/nutrition/spooked-by-salmonella-raw-food
http://consciouscat.net/2010/03/08/feeding-raw-food-separating-myth-from-fact/
http://rawfed.com/myths/bacteria.html

I would say that there really is no point to making a homemade cooked diet. You might as well just save yourself the effort and buy a decent commercial canned food in that case. The whole point of homemade diets for cats is to take advantage of the freshness factor, which means RAW. But for sure, giving your kitty pieces of cooked meat for treats is a great idea :thumbs up.

Love4himies
July 14th, 2010, 07:36 AM
I tried boiling liver and chicken. She loved it. She loved the chicken broth, too -- and it was just plain ol' chicken water, no spices, no flavorings. Her energy level and alertness was observably better after these treats. I'd like to make more home-made meals. I'm definitely not comfortable with raw at this point. I am too concerned about bacteria. But I did present raw chicken thighs at here before cooking. She sniffed out of curiousity and walked away. When I presented her with the cooked thighs, she jumped up and dug into as if she was waiting for this her entire life!

I wouldn't worry about bacteria too much with feeding your kitty raw, unlike humans, they have the digestive tract and juices to digest it just fine.

Just keep in mind that cooking destroys some essential nutrients and cooked meat should only be used as a treat ;). You may find that slightly cooking the chicken, leaving some raw behind will entice your kitty, plus give her the essential nutrients her body requires, and you are killing any bacteria that is on the outside of the meat so you will feel more secure. There is nothing that beats a properly prepared, species appropriate diet to help heal the body.

Sending lots and lots of :goodvibes::goodvibes::goodvibes: for your kitty.

growler~GateKeeper
July 15th, 2010, 01:14 AM
Called Wellness, again, and got these (as-fed) numbers:
phos/carbs
Turkey .28 / 1.67
Chicken .31 / 1.74
Turkey & Salmon .31/4.73
Beef & Salmon .26 (did she mean chicken?)
(beef & chicken made her queasy.)

Okay the only change in formula from my 2007 list is the Turkey & Salmon which now has much better phos numbers :thumbs up

providing they haven't changed the moisture level:
Turkey & Salmon (2010) dry matter phosphorus = 1.27

That's quite a jump in carb level though for Turkey & Salmon 4.73 as fed from 2007s 1.79 as fed :eek: The others you posted are the same, so the rest of the list is likely still correct from 2007.

and yes it is Beef & Salmon, actually has slightly better numbers than the Beef & Chicken but I didn't feed any fish formulas so not sure how the taste would go over :laughing:

I should give you the carb numbers too:

2007 (T&S 2010) - Canned Dry Matter phos/carb:

Chicken = 1.15/6.48
Chicken & Herring = 1.48/8.40
Chicken & Lobster = 1.31/15.16
Beef & Chicken = 1.17/5.91
Turkey = 1.05/6.22
Turkey & Salmon = 1.44/7.35
Salmon & Trout = 1.28/11.17
Sardine, Shrimp & Crab = 1.30/19.82
Kitten = 1.15/7.40
Beef & Salmon = 1.06/8.66


I tried boiling liver and chicken. She loved it. She loved the chicken broth, too -- and it was just plain ol' chicken water, no spices, no flavorings. Her energy level and alertness was observably better after these treats. I'd like to make more home-made meals. I'm definitely not comfortable with raw at this point. I am too concerned about bacteria. But I did present raw chicken thighs at here before cooking. She sniffed out of curiousity and walked away. When I presented her with the cooked thighs, she jumped up and dug into as if she was waiting for this her entire life!

Excellent :highfive: you can always add teensy bits to her canned food, smoosh it in good to encourage her to eat the whole thing not just the treats.

Sometimes it takes awhile for them to recognize raw meat as food since they haven't had it before and are therefore naturally suspicious, the aroma of cooked meat is also stronger than raw.

scm & L4h are correct for cats & dogs bacteria in raw fed meat is not as much of an issue as it is with people, their immune & digestive systems take care of most of it on their own.

MiniTiga
July 17th, 2010, 07:45 AM
Thanks for your input and most of all the good vibes, Love4himies! (lol on the "cat maid" tag~ we must be working in the same union!)

Ease relieves Dis-ease.

Good ol' chicken soup. How fantastic that chicken broth can be good for her body and tastebuds! Now that's the kind of meds that make us both happy.

I poured a batch of broth into an ice-cube tray. (She doesn't know what to do with it in frozen form - not into licking ice on a hot summer day, apparently.)

I set out a cube yesterday which she didn't touch it all day, and then I forgot to dump it before bed time. By the time I woke in the morning, it was empty -- including a tiny piece of fatty chicken. I am assuming it was her that ate it! :)

So, that's good for when I can't be home and want to leave something for "later." (I have to figure out how to make that work for wet food, too. It gets crusty when left out too long.)

Anyhoo... Next round, I'll boil the chicken thighs in less time and see if she digs into it "medium-rare."

Oh, and my bad -- got confused about beef and salmon wellness. That was the flavor she tried -- and got queasy over. I tested it twice just to make sure it was that flavor. I tried it against my better judgment - wondering when and where in the wild a tiny cat would hunt or find a cow to eat. And I know other cats don't have a problem with it, but it's no los if we stay away from it. I steer away from pork ingredients, as well -- for the same reasoning.

Venison is too high in phosphorous, but I could see that in the food chain. Big cats eat deer -- and I've seen my cat interact with wild deer. She intimidates deer -- as well as squirrels and chipmunks. No one is canning squirrels, are they? (Commercial food has to be palatable to the human, as well, or they'd be selling farm-raised frozen mice.) :)

Peace.

sugarcatmom
July 17th, 2010, 08:59 AM
(Commercial food has to be palatable to the human, as well, or they'd be selling farm-raised frozen mice.) :)


They do, actually :D:
http://www.rodentpro.com/catalog.asp?prod=3
http://www.hare-today.com/index.php?cPath=23_47

MiniTiga
July 17th, 2010, 12:21 PM
They do, actually :
http://www.rodentpro.com/catalog.asp?prod=3
http://www.hare-today.com/index.php?cPath=23_47

Mmmm, Sugarcatmom... you sure know how to work up an appetite. Peach fuzzies, anyone?
:laughing:

I used to work at a zoo and would see the handlers pull these babies -- or rather, full grown adults -- out of the pantry freezer. :eek::yuck: I'd leave before the big chef knife was swung, so I remain in my ignorant bliss as to how the zoo kitchen prepares these delicasees.

I'm waiting for the day we see a commercial featuring mouse flavored Friskies.

This is why commercially-fed, urban, domesticated cats don't know what to do with a real mouse, except play with it, at best. And since we poison rodents in the wild, we sure wouldn't want these cats developing a taste for peach fuzzies.

What a wild mess! :eeew:

MiniTiga
July 17th, 2010, 04:01 PM
Why am I getting a different phos # than what is listed above?

This is the formula I am using:

100-78 (moisture) = 22 (DM)

.28 (Phos) divided by 22 (DM) = .0127

That's not 1.27% phos?

What am I missing here?

growler~GateKeeper
July 18th, 2010, 05:33 AM
Multiply your final number 0.127 by 100 to bring it back to the percentage. 0.127*100=1.27%

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

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

100-78=22
.28/22=0.0127
0.0127*100=1.27%

Just make sure that you are using the moisture content from each flavour to do the conversion as the various canned flavours can range between ~70-85% moisture.

In the spreadsheet Wellness sent me with their values & conversions they have a slightly different way doing the formula but arrives at the same result:

phos/((100-moisture)/100)

.28/((100-78)/100)=1.27

Break it down to inner most bracket first (100-moisture) to get the dry matter

100-78=22

Then the outer bracket ( () /100)

22/100 = .22

Then whats outside the brackets phos / ()

.28/.22 = 1.27


Good to hear she's liking the chicken stock cubes :highfive:

MiniTiga
July 19th, 2010, 05:50 AM
I appreciate the breakdown.

So, the Turkey phos went from 1.05, as listed, to 1.27 -- that's a whole new perspective. Again, is there something I am missing from this calculation? Is the Ash ignored?

I do wish manufacturers could help us along with publishing these numbers on their websites.

growler~GateKeeper
July 30th, 2010, 01:59 AM
I appreciate the breakdown.

So, the Turkey phos went from 1.05, as listed, to 1.27 -- that's a whole new perspective. Again, is there something I am missing from this calculation? Is the Ash ignored?

I do wish manufacturers could help us along with publishing these numbers on their websites.

This calculation very basically just removes all moisture content from the phosphorus so the only thing involved is phos, water equaling dry matter phosphorus.

Ash is not involved in this calculation, ash is used if you are checking carbohydrate content.