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Old September 5th, 2010, 01:16 AM
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Quote:
Originally Posted by nemesis View Post
Hi everyone, I thought I'd post here since this seems to be a general "CRF cat" thread, I hope that's ok.
Hi nemesis welcome to the forum & the CRF cat club . It is absolutely ok that you post here, this was my hope when I started this thread - that we could all gather our experiences & ideas in one place to help ourselves & others.

Quote:
Originally Posted by nemesis View Post
He was also given renal prescription dry food and wet food. He quite liked the dry food but wouldn't touch the wet food, so we resorted to Fancy Feast, which I know isn't very good but the main thing was getting him to eat that point, and that was all that he was interested in.
At this point the more important thing is getting him to eat, not really what he's eating, especially considering his previous refusal to eat. Fancy Feast does have a number of varieties that have good phos numbers, the most recently updated food table listing by dry matter phos shows quite a few flavours under 1.20% dry matter phos . You want to stay below 1.25% max and try to stay away from fish varieties as much as possible.

Quote:
Originally Posted by nemesis View Post
On July 22, he was tested again, and this time his results showed a BUN of 13.5, Creatinine of 200, and normal Phosphorus levels (1.54, normal range 1.10-2.74 according to this lab). Still not quite right, but a significant improvement.
When posting blood/urine values please put the reference range for the lab that did the tests (like you did for the phos ) depending on the equipment the numbers can vary quite a bit.

That is a very good drop from the previous numbers

Quote:
Originally Posted by nemesis View Post
After this, the vet changed his regimen to 150 ml SubQ's twice a week, with everything else the same, except that we stopped the antacid. Giving him the pills every day was ridiculously difficult at first but we are much, much better at it now, although he still tries to outsmart us from time to time. We have been doing the SubQ at the vet but are psyching ourselves up to do it at home, and after having gotten a couple of "lessons", will be doing the procedure next week at the vet myself before trying to do it all at home.
Cats realize pretty quickly when something is making them feel better & will adapt relatively easily to the changes. My crf girl Duffy went from being a pill spitter to a cat who would willingly sit & wait for her twice daily supplement regiment.

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

Here's a step by step instruction guide you can refer to: http://www.weirdstuffwemake.com/weir.../catjuice.html

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

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

Quote:
Originally Posted by nemesis View Post
1) Being quite pleased with his Aug 13 results, the vet thinks we should do the next testing in 4 months. Now, I've read up on this a bit, and it seems to be a roughly standard amount of time, but I confess to being a bit paranoid about waiting that long to monitor how he's doing. On the other hand, I have read that testing too often could be counterproductive and obviously stressful for the cat. I don't want to give the impression that I don't trust my vet either, since as far as I can tell, she has saved my cat's life. But I also don't want to be passive or complacent. Does waiting that long seem like a reasonable idea, and I should just relax?
Every 3 months is standard time between appointments, unless you notice something "off" ~ eating less, lethargic, change in behaviour/litter box habits or Smokey looks like he's slipping towards a crash.

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

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

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

Quote:
Originally Posted by nemesis View Post
2) I am wondering if you guys had any ideas about what it means that his numbers were so high, and then suddenly went down so low again, to where they are *almost* brushing up against normal. One reason I wonder about this is that I've heard that cats with low values shouldn't be put on SubQ's prematurely, but then, it's a bit different for him since he *started out* with much higher results.
Most of that drop is due to the IV fluids, fluids directly in the bloodstream flush out far more of the toxins that cause the rise in values. However it also flushes out many essential minerals, nutrients etc that the body needs, which is why IV fluids is not done for an extended period of time.

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

Quote:
Originally Posted by nemesis View Post
3) The dosage for Azodyl is 1 pill for cats 5 pounds and less, and two for cats that are over 5. My cat is just over 5 at the moment, as he is regaining weight he lost when he wasn't eating. His normal weight is around 5.5 or so. So would it be a good idea to give him one Azodyl a day instead of 2, as the vet recommended? As far as I can tell, there's no pressing reason to reduce the dose of a probiotic, as opposed to a "drug" that can have side effects. However, it would certainly be easier to pill him only once a day (and he'd be happier as well I expect).
Personally I would keep him on 2/day. According to the IRIS Staging Guide Smokey is in Stage 2 of kidney disease, Azodyl is ideally suited for stages 2-4. The Azodyl will not have a negative effect, but instead continue to help reduce the toxin levels making him feel better which in turn may increase his appetite.

Quote:
Originally Posted by nemesis View Post
4).....I'm considering moving Smokey off dry food completely, and off the prescription food as well, wet or dry. Does this seem like a good idea, and do you have any advice for making the transition? For example, would it be a good idea to mix some new, better wet food in with his Fancy Feast at first in order to get him to try it, and then gradually change the ratios? Or will this upset his stomach?
If Smokey is still at a fragile/unstable point weight wise I would keep him on both right now, until he gains more ground in that respect. At 5lbs that's just tiny w/no room to lose, once he gets a bit more weight on him you can try some of the tips here: Transitioning Dry Food Addicts to Canned Food

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

Quote:
Originally Posted by nemesis View Post
5) Finally, is there anything I should watch out for that I haven't mentioned? If we keep going with this regimen, and don't get him tested again for a few months, are there any signs or warnings I should be looking for, beyond the obvious? I realize I sound like a paranoid lunatic, but I want to do right by Smokey because he's a good cat and an excellent companion, and cats can be so frustratingly stealthy about their health.
Things to watch for: any changes in drinking/eating/litter box habits/mood/time spent sleeping, any new symptom you hadn't seen before like lip licking, vomiting, unusually bad breath, drooling.

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

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

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

Paranoid lunatic? no Good pet parent? yes
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