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NEW: Diagnosed with CRF advice and suggestions appreciated deeply

Diana US
February 22nd, 2012, 02:45 PM
Hi all,

My 16 years old, Rainbow, has been drinking, peeping frequently and I also notice vomiting from time to time and often see him sit up instead of lying down when he is not sleeping. We had blood and urine test/analysis on him this past Monday showing high BUN 58 plus T4 in the grey 2.2. He has decent appetite, wanting to eat. My vet recommends k/d food, I think (He will be going over the test results with me in person), but I am concerned with all the negative things about it so I would love to have some inputs, advice and personal experience of how others do, given the understanding that each individual is different. Also, should I avoid to exercise him now?

Some background if helps. I have fed them (I have two of them, brothers, I caught them on school campus) exclusively dry food twice a day about 10 years ago when I first realized they were way overweight and reluctant to move, and would throw food for them to chase for exercise purpose when time permitted. Lately, I have given them homemade chicken broth as I noticed the frequent drinking, thought it might be better than water (maybe not??). Yesterday, I switched them on wellness canned food with added water (so the water would be retained if having with food).

I use reference from Tanya's comprehensive guide US Canned cat food data. From pure number perspective, Organic Turkey & Chicken by Nature looks pretty good low phosphorus .68%, low Sodium .23% with protein of 45.45% and high in fat 36.36% (fat is good I think I read somewhere). I looked up ingredents and did see any corn or rice or by-product on the list from By Nature's website, but I am not used to read any labels human or pet food :-(

Here is blood test results:
BUN - Result: 58 Reference Range: 15 - 34 mg/dL
creatinine - Result: 1.6 Reference Range: 0.8 - 2.3 mg/dL
Calcium - Result: 8.6 Reference Range: 8.2 - 11.8 mg/dL
Phosphorus - Result: 3.7 Reference Range: 3.0 - 7.0 mg/dL
TCO2 (BICARBONATE) - Result: 13 Reference Range: 13 - 25 mEq/L
Chloride - Result: 126 Reference Range: 111 -125 mEq/L
Potassium - Result: 4.2 Reference Range: 3.9 - 5.3 mEq/L
total protein - Result: 6.8 Reference Range: 5.9 - 8.5 g/dL
T4 - Result: 2.2 Reference Range: 2.3 - 4.7 Grey zone in old or symptomatic cats

Urine results:
pH 6.5
LEU 25 Leu/uL
PRO trace
S.G 1.020

The vet told me that he didn't see any protein or blood nor infection in his urine. Though he does say he is slightly dehydrated and has heart murmurs :-(

Many thanks in advice!


February 23rd, 2012, 02:10 AM
Have a read through the sticky here or even just the summary post linked at the end of the first post of: Early Stage Kidney Failure in Cat (

Some foods to get you started and yes the By Nature Organics Turkey & Chicken has good numbers/ingredients

By Nature Organics ( Turkey & Turkey Liver, Chicken & Chicken Liver, Turkey & Chicken, Chicken & Mackerel, Beef & Beef Liver

Innova Flex Beef & Barley Stew (
Evo 95% Chicken & Turkey (

Felidae Platinum (
Felidae Cat & Kitten (
Felidae Grain Free (

Merricks Before Grain 96% Beef (
Merricks Before Grain 96% Turkey (

Merricks Cowboy Cookout (
Merricks Thanksgiving Day Dinner (

Halo Spots Stew Wholesome Chicken (
Halo Spots Stew Wholesome Turkey (

Wellness ( Turkey, Chicken, Beef & Chicken, Beef & Salmon, Kitten, Wellness Core Chicken Turkey & Chicken Liver (other flavours are too high in phos)

Holistic Select Turkey & Barley (
Holistic Select Duck & Chicken (

Many more choices listed here

Short light to moderate but not heavy exercise will be good to keep the muscles strong which will play a role in the later stages, given the heart murmur you don't want him to the point of panting/wheezing.

Feel free to post any questions you may have :)

Diana US
February 23rd, 2012, 07:57 PM
Dear Gowler,

Thank you so much for the information!!

I went to the sticky you mentioned but haven't been able to go through all. I would definitely read through everything, and it's wonderful there are so much information. I have already learnt quite a bit, though I feel the need to know more and everything... BTW. which brand or varieties are your top choices. Rainbow is not a picky eater, although I think I have not fed him any healthy food but unflavered I suppose.

I bought some wellness and add some warm water to it, and I am thinking of making some homemade chicken broth for that. I wonder if there is a thing of drinking too much water?

Thanks again for all your time and advice!!


February 24th, 2012, 01:02 AM
The sticky thread is a lot to read through so it'll definitely take some time :)

My late cat always like the Wellness, Evo & Innova varieties listed above, she didn't like Halo or Merrick but that was her personal preference, the other brands she didn't get try cuz she was switched to raw food. :cat:

Drinking "too much" water generally doesn't happen as they will regulate what they need and if it becomes evident that they are spending far more time than before at the water dish, then it's time for a trip to see the vet about starting fluid therapy. Once they reach the point of needing subq fluids they will still drink lots but since they'd be getting extra fluids so the amount they'd be drinking would taper off a bit.

Diana US
February 24th, 2012, 02:07 PM
well, I have added a lot of water to Wellness canned food for them, trying to get them drunk as much as possible. Since I have always regulated food, they do try to eat them all when they are food out there. Thus the worries. Now, overweight is less of concern, it is better that I should let them eat as much as possible?

I read a lot positive comments about raw food. Many people make their own. I am looking into that as well, one is knowing and having control over what I feed them, the other is to be more cost efficient. Do you make your own or buy from somewhere? Would you mind to share with me your experience?

Many thanks! It's such wonderful thing that I found people like you out there to share the love for our 4 legs companions!


February 25th, 2012, 12:53 AM
We had a cat with kidney disease. She lived with it for a few years. I found the following info very helpful and feel it gave our cat more years and a better quality of life. It also gave me courage to advocate on our cat's behalf:

I highly recommend Dr. Elizabeth Hodgkins book, "Your Cat: Simple New Secrets to a Longer, Stronger Life" (So glad it's recommended by Dr. Lisa Pierson on

Dr. Hodgkins recommends this site about kidney disease:

Feline Chronic Renal Failure Information Center,

"If your cat has just been diagnosed with CRF and you're frightened, confused and overwhelmed, click the Help button for a quick overview of what to do NOW and how to use this site to your cat's best advantage."

Little Big has info on conventional and holistic treatment, by Dr. Jean Hofve. I would refer to Dr. Hodgkin's info as well.

When I asked my vet about milk thistle, she wasn't sure. She looked it up and was surprised by some new studies. I think it might be considered mainstream treatment for both liver and kidney diseases now.

I used to give part of a tablet inside an empty gel cap combined with some other medications to try to minimize the number of pills I had to give.

"Milk Thistle – A Wonder Herb?",
by Dr. Jean Hofve

"Immune System Health and Anti-Aging",

There is also "TANYA'S COMPREHENSIVE GUIDE TO FELINE CHRONIC KIDNEY DISEASE" site. They have a support group on Yahoo,

Always check with your vet to have them look up medications and dosages suitable for your cat.

Fish oil is recommended, though my vet said wild salmon oil, not cod liver oil. Too much fish oil can cause depleted levels of vitamin K.

Dr. Pierson has helpful info on getting cats to transition to new foods on

If your cat likes Parmesan cheese but you're worried about the salt, you might try colostrum capsules instead; cats seem to find it irresistable. Non-dairy colostrum may also be available.

Hope this helps. Best wishes.

February 25th, 2012, 01:10 AM
As long as the cats are not more than 2-3lbs overweight I wouldn't limit what they are eating unless they start gaining excessive weight. Maintaining a good healthy weight is important as not to strain joints, heart, lung function etc.

The weight issue will come into play more at the later stages of the disease or if Rainbow starts refusing to eat certain flavours/brands. It is important to try to rotate as many different flavours/brands as possible so he'll accept different foods & hopefully won't refuse to eat all but one kind of food.

My experience with raw food is also in the later pages of the sticky thread, my girl passed away a couple of years ago so about the last 4 pages are more about other peoples experiences/questions. I started feeding a ground bone-in prepared raw by a local company, until my girl started having non-CRF related issues with bone. At that point I moved to buying human grade ground chicken, meat only no bone, from a local butcher & adding a powdered premix called TC Feline Plus ( (a company highly recommended by her homeopath) to the meat to ensure all essential nutrients were being met, the bone content was so finely ground that it didn't cause her any issues. She was also on a couple of supplements recommended by her homeopath vet as well as a vitamin formulated for senior cats. My girl loved raw & it was never a challenge to get her to eat until the very end :cat:

Diana US
February 26th, 2012, 05:32 PM
Twecent - thank you so much for all the information. I will try to locate these books to educate myself. As for fish oil, my boy has T4 2.2 in a grey area for a 15 years old, and I got the impression that I should avoid fish due to hyerthroidism. Maybe wild salmon oil is ok for him? I have him and his brother both on Wellness turkey, chicken canned varieties right now, and looked up their dry version, not for feeding but for exercise, since I have been letting them chase dry food as way of exercise, of course I will be extremely careful with it.

Growler – I am so sorry you lost Duffy, and I am sure I will get to know you and Duffy so much more and will get a lot of inspirations from it. I tried a little bit of raw chicken meat, and they both ate. So this might be a good option for the future. I met my vet yesterday and he wants me to give Rainbow food low in phos and sodium, low in protein but high quality protein and let him eat as much as he wants for a month to see if he will put on some weight, and do another blood test. He didn’t give me any meds, and said Rainbow is in early stage and said he is concerned of his T4 number as well. We will get a T4 test next time. He is ok with Wellness and By Nature Organic I choose to feed them.

BTW. Rainbow seems improved somewhat, not sitting up all the time. I tried to break their meals to small portions and feed through the day when I am home in hope that they can retain water better this way.

Thanks again,

February 26th, 2012, 06:20 PM
A good update :thumbs up I'm glad Rainbow seems to be improving :cat: A good thing to add is a snack just before bedtime, this will help with the weight gain.

Diana US
March 1st, 2012, 06:27 PM
Thanks for the bedtime snack tip! makes a lot sense. Will definitely follow it!

Rainbow wakes me up at 4:30am with loud howling lately, and I haven't seen him goes in and out without pee. And he doesn't howl every time go peeing either. Though I am a bit of concern if it's a sign of UTI. last night, I went downstairs to check him, he was done with #2, just standing in the middle of the room howling, then stopped when he saw me. I took him to get blood pressure test, and got avg BP of 120. The tech says it's very good. I feel somewhat relief.

I have switched to canned food for a couple of weeks, and feed them By Nature Organic I just received last night. They seem consuming no more than a can each per day, though per feeding instruction, it’s only for a cat weight of 6-8 lb, so I assume they need to eat at least one and half can to gain weight. Is that right calculation? I wonder if because I add too much of water, make them eat less than they could otherwise. What would a normal healthy average cat eats?

March 2nd, 2012, 03:54 AM
Much of the feeding guidelines depends on size, activity level of cat, calorie count of the food etc. A 6-8lbs cat in most cases should be eating between 5.5oz - 8.25oz so roughly 1-1.5 cans per day the label does give you the approximate amounts based on individual food content.

By slowly increasing the amount of food they're getting from 1 can each up by teaspoons for example you'll be able to see how much they actually need by what they leave behind. By the way you can leaved canned out for upto 8hrs for them to nibble on, some cats like it a bit crunchy.

The amount of water I was adding to the canned was sbout 1-2 teaspoons per meal & didn't have troubble getting her to eatb

March 18th, 2012, 10:41 PM
Diane US, I also have a 16 1/2 year old female, Abby, who is now a CRF patient. We lost her brother just 6 weeks ago to very fast onset renal failure. By the time we knew what was happening and began treatment, he did not respond. I digress...

I've learned alot over the last couple of weeks. Abby's levels aren't so bad that we can't try to improve them, so I'm doing everything I can!! Unfortunately, we are also dealing with fibrosarcoma in her, so we're having to be careful what we do for the cancer so as not to further stress the kidneys.

Apple cider vinegar is known to help return levels to normal, so I am adding a few drops to the water bowls each time they are refreshed. It is known to help with a mountain of ailments, so it's worth a shot. I got the raw, unfiltered, organic at the health food store for about $4 for a decent sized bottle. They all (dogs and cats) drink the water just fine with it added. I added an additional water bowl and will actually carry it to her everytime I think about it. She doesn't drink excessively, but will drink 8 out of 10 times that it is presented.

As far as eating goes, the K/D didn't go over real well. I did some research and found Hi-Tor Neo. It is a low sodium/low phosphorus/low protein food. It's higher in fat, so the cats seem to like it more than the K/D. Mine did not. Unfortunately, you can't get a few cans to try. You have to order a case. We have opened 1 can, so I guess I'm stuck with the rest. My cats have always eaten dry, so that's what they're used to. I ordered some Halo dry to see if she will eat some of that, in addition to what intake she does have. It's all about getting them to eat (awaiting its arrival). Halo is extremely high quality food. My vet is in agreement that the quantity of protein is not as important as the quality of protein. If it's a higher quality, the body can process it better. I grabbed a few cans of Wellness to see if she would eat that. She seems to want to lick the gravy off of it, but not really eat the meat. Otherwise, she's pretty much living on tuna. You can buy 'very low sodium' tuna. I've read in several threads that people will feed just a few bites of Fancy Feast everyday just to get them to eat something!! My vet gave us some Nutri Cal, but she won't do that either. I will squeeze some on my finger and just wipe it on her mouth so she has to lick it off. I do that 2-3 times a day.

In addition to reduced appetite, CRF patients tend to have more acid and will throw up alot. Pepcid can be given for that and we're going to have to start that tomorrow after what I found earlier this evening. We had not had the excessive vomiting until just the last couple of days. 1/4 of a 10mg pepcid is the usual dose for cats, but please consult your vet.

There are a couple of supplements available too. My vet gave me some Azodyl to try. The problem with this one is it is capsule form and the capsules need to be given whole for them to be effective. That is not happening at my house!! It did not go well. There is another one that I just learned about and have ordered. Renavast is the name of it. It supports the kidneys and positivity impacts creatinine, bun, phosphorous, hct, and urine specific gravity. It supposedly also give them their appetite back. Again, I have ordered it but have not received it yet. It is a powder that can be easily disguised.

We're doing several other things to help address the cancer. I can't help but think (and hope) that they will also help her kidneys.

She has not required any SubQ fluids yet, but the vet went ahead and did a round on Friday while she was receiving a cancer treatment, just to help take any additional stress off the kidneys.

Hope this helps!!!!! Good luck with your baby!!!

March 21st, 2012, 10:16 PM
she's pretty much living on tuna.

catdogmom Please get your cat off tuna asap and onto anything else she will eat. Tuna can be highly addictive for some cats to the point they refuse to eat anything else - this is critical for a CRF cat and it's really not that good for even healthy cats.

There are a couple of supplements available too. My vet gave me some Azodyl to try. The problem with this one is it is capsule form and the capsules need to be given whole for them to be effective. That is not happening at my house!! It did not go well.

While it is most effective given whole I've read some people with kidney cats/dogs still have success with opening the capsules & sprinkling it on the food so it's worth a try if you still have the Azodyl, remember to keep it in the fridge