Hi Onemeower, sorry to hear about your Bandit's troubles
My grrl Duffy had HyperT that was caught early, it was just a bit higher than normal so no meds were given and was cured w/Radioactive Iodine Therapy. A few years later she developed crf as a result of the Royal Canin toxic food recall. One thing I have not dealt with is HPB, Duffy's has been checked a couple of times and always been the ideal 120.
I see that you've found my thread already so I'll just post these links for you incase you missed them:
http://www.felinecrf.org/index.htm
http://www.weirdstuffwemake.com/weir.../catjuice.html
Have you tried
Wellness canned foods? The chicken, turkey, chicken and beef are the lowest phos level food they have and they all have good protein amounts with all healthy ingredients. Low protein theories are outdated and not ideal for cats.
Basically what happens with cats who have kidney failure -diagnosed or not- and HyperT is the HyperT masks the symptoms of kidney failure so it doesn't look as bad as it actually is, and once they are on meds to control the HyperT the kidney values increase - this is not caused by the oral methimazole she was on originally. Increased thyroid hormone levels actually raise the level of blood flow through the kidneys making them more efficient, so when HyperT treament begins it appears that the kidney values get worse. Untreated HyperT however can lead to heart disease incl heart murmurs and high blood pressure, this is a far higher concern than kidney failure.
Approx 15% of cats experience side effects when taking oral methimazole, one of the more common ones is decrease in appetite. When this occurs the cat should be taken off the meds until the condition resolves then restarted at a lower dose which is gradually increase to the level it is prescribed.
Transdermal methimazole has fewer side effects involving the GI tract (vomiting etc) but lack of appetite is also common and when that occurs the meds should be stopped until symptoms resolve and then restart at a lower dose while gradually increasing.
To have the Iodine therapy, they want the thyroid levels to be controlled therefore they need to be on meds (unless the T4 is barely above normal), this also ensures they know about any kidney issues that may have been masked by the high t4 levels.
Please speak to your vet regarding the lack of appetite while on meds. It is difficult enough to get a kidney failure cat to eat, when they are on meds that cause lack of appetite as a side effect that is even worse. A cat that refuses to eat for a prolonged period of time is also at risk of fatty liver disease.
How soon after the Covenia was the baytril and buprenex given? When needed Covenia can be readministered 14 days after the 1st shot to provide longer treatment period.
Some sites say Baytril is contraindicated for cats with kidney disease but has been used for kidney infections and there is a risk of retinal problems including blindness, Buprenex is also contraindicated for cats with kidney disease and those with liver issues as it is metabolized by the liver
I would speak to the vet about using an ACE inhibitor such as
benazepril in combination with the amlodipine instead of baytril or buprenex. ACE inhibitors relax the blood vesses making it easier for the heart to pump blood throughout the body reducing hypertension. Proteinuria (protein in the urine) generally is reduced after 2-6 weeks of amlodipine therapy, so it make take some time yet before that is completely cleared up.
Hematuria is blood in the urine which is generally caused by either infection or high blood pressure, meds for hematuria that are not condraindicated for kidney issues include
Clavamox http://www.marvistavet.com/html/clavamox.html and the aforementioned Covenia
Is Bandit meowing while peeing? Or is she peeing tiny tiny amounts frequently? This may indicate pain while peeing and may require pain management therapy - but not something contraindicated for kidney issues.
Generally speaking 150-200 mls of subq fluids every other day is fine, giving less is not doing any good when she is peeing all the fluids she is taking in therefore not retaining as much as she should which only prolongs her dehydration. You can ask your vet about giving 100mls every day instead of 150-200 every other day.
Bandit's kidney numbers are actually not that bad they are right around where my girl was in Aug 2008, however I've never really had any issue getting her to eat
.
Do you have a homeopath vet in your area and would you consider taking Bandit there?
My recommendations:
- try different foods like Wellness mention above
- try using cooked chicken breast, cheese, cat treats such as PureBites freeze dried chicken breast as a topper on her food to entice her to eat and if that doesn't work:
- talk to the vet about stopping the transdermal methimazole until her appetite returns then restart at a lower dose, increasing gradually
- talk to the vet about changing to 100 mls subq fluids per day instead of 150-200 every other day
- talk to the vet about adding an ACE inhibitor ie benazepril and discontinuing the baytril and buprenex or changing to another pain management therapy