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Old April 16th, 2009, 10:18 AM
Mogsmum Mogsmum is offline
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Question Feline CRF, heart murmur & arthritis - just looking for support

Hi there, new here (just joined today!), so first time poster, but long time pet owner.

I was looking for some support & suggestions in regards to my 19 yo cat Mog.

First, a brief history:

Mog has lived a good life after being plucked from a barn (where I used to ride) at the age of about 2 months. She was always vaccinated on time, and she is spayed. Since becoming a strictly indoor cat (about 8 years ago), I have opted not to vaccinate her, as she always had reaction to her vaccines (had to make 2 appts for them). Mog has 3 much younger sisters (not actually related), who are also all strictly indoor cats (and spayed as well).

At any rate....last July, Mog was 6 lbs & diagnosed with Stage 1 CRF as well as a small heart murmur. I knew she had a bit of arthritis as well. She just didn't look herself, and due to her age, and her thiness through her hips, I decided to have her check out. I was quite shocked & distressed to find my girl had CRF. Once I'd calmed down, and read up on it, things were not so bleak.

Of course, the vet wanted her to be on daily subQ injections right away. I on the other hand, prefer not to jump the gun & educate myself on options. I didn't get a copy of her test results. I did find out that giving extra fluids to a cat with a heart murmur is not always advisible, and that giving her NSAIDS (for her arthritis, which is what the vet wanted to do as well) is not exactly good for her kidneys.

I did some research (but am definatetly no expert!), and decided that, for now, I would change Mogs diet only. Not an easy thing to do in a multi-cat house! Of course the other cats all wanted Mogs food, as she was strictly on a wet food diet. I switched her to Wellness, and she was eating about 1/2 can per day(1/4 can 2x). No more free-feeding in the house.

I took her in today, just to check up on how her kidneys were doing, so the tests should be back tomorrow. The vet thinks she looks better than when he saw her in July last year. She's up to 6 lbs 4 oz. I think she did weigh more a while back, but due to finances I changed her wet food brand and she wasn't keen on it at first. She's now on Medi-Cal Reduced Protein (I get a discount on it as I work at a vet clinic now), which I mix with Fancy Feast (not the greatest food, I know). She went off the Wellness, and wasn't keen on eating it anymore, even though she had a variety of flavours. I did try the Eagle Pack Holistic foods, but she never was keen on those. Of course, she always prefers the fish flavours...which makes it a little tougher as I know those should be avoided due to her CRF.

I am also giving her 1/2 tablet (so 500mg) of MSM a day for her arthritis. It gets crushed into her food and it definately does help.

Her vomitting has calmed down. She was always a cat who threw up sometimes from eating too fast, or being bothered while she ate. Now I can attribute it to the CRF most likely.

She's still decently active for her age & condition. She does jump up onto the couch to cuddle, or onto the chair & then the table/desk to eat.

I'm just posting wondering if there are any words of advice, encouragement, etc...anything I should look out for? What can I do to keep her other levels (potassium, phosphourus, etc) as normal as possible. Is there something better for her arthritis? Any sites you folks have found helpful? I'm no good at super techinal & medical terms, so plain old English is always best!

Thanks for reading about Mog!
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Old April 16th, 2009, 12:29 PM
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Quote:
Originally Posted by Mogsmum View Post
Hi there, new here (just joined today!), so first time poster, but long time pet owner.
Hi Mogsmum, welcome to pets.ca! I too have a cat with a heart condition (HCM), and quite severe arthritis (as well as diabetes, but not CRF).

Quote:
Originally Posted by Mogsmum View Post
At any rate....last July, Mog was 6 lbs & diagnosed with Stage 1 CRF as well as a small heart murmur.
Has Mog had an echocardiogram done to determine the nature of the heart murmur? That way, if it is warranted, medication can be tailored to the specific heart problem. My cat is on 12.5mg of Atenolol per day, and it's really helped control the tachycardia as well as smooth out the blood flow through his heart (he had a follow-up echo to make sure).

Quote:
Originally Posted by Mogsmum View Post
I did find out that giving extra fluids to a cat with a heart murmur is not always advisible, and that giving her NSAIDS (for her arthritis, which is what the vet wanted to do as well) is not exactly good for her kidneys.
Definitely no NSAIDS. Even for a cat with healthy kidneys, this isn't the best option. Fluids may or may not be okay, depending on the nature of the heart murmur.

Quote:
Originally Posted by Mogsmum View Post
Of course the other cats all wanted Mogs food, as she was strictly on a wet food diet. I switched her to Wellness, and she was eating about 1/2 can per day(1/4 can 2x). No more free-feeding in the house.
Honestly, all your cats should really be eating wet food. And not the reduced-protein crap. It's old-fashioned thinking that CRF cats should eat less protein. If Mog won't eat Wellness anymore, what about some other quality brands like Innova Evo 95% (the venison and beef are particularly low in phosphorus, which is really the concern with compromised kidney function), Nature's Variety Instinct, Precise, or even a raw diet. I also found that many cats prefer some variety when eating wet food, so perhaps she'll go back to eating Wellness again if you mix things up a bit.

Quote:
Originally Posted by Mogsmum View Post
She's now on Medi-Cal Reduced Protein (I get a discount on it as I work at a vet clinic now), which I mix with Fancy Feast (not the greatest food, I know).
Some of the Fancy Feast flavours are actually better quality than the Medi-cal. There is no good reason to feed reduced-protein foods at this early stage, and it will likely do more harm than good. Cats need protein! They start to catabolize their own muscle tissue on a protein-deficient diet. Here are a couple of good links for you to check out:
www.catinfo.org
http://felineoutreach.org/EducationD...=KidneyDisease

Quote:
Originally Posted by Mogsmum View Post
I am also giving her 1/2 tablet (so 500mg) of MSM a day for her arthritis. It gets crushed into her food and it definately does help.
You should ask Mog's vet about Cosequin (glucosamine/chondroitin supplement), which has really helped my cat with his arthritis. If it gets bad, other considerations are acupuncture, Adequan injections, and pain meds like Buprenex (better tolerated than NSAIDS). Special pet heating pads and orthopedic pet beds (like with egg-carton foam) can also help Mog feel more comfortable.

If you can get a copy of her latest test results, another member here (growler) can help interpret them for you.
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Old April 17th, 2009, 12:10 AM
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Hi Mogsmum

My almost 18 year old girl has CRF goin on 2 years now, I have a long thread here: http://74.55.158.149/forum/showthread.php?t=45017 if you wish to read it's pack with info, links, tips, food etc. There is also a condensed summary here: http://74.55.158.149/forum/showpost....&postcount=220

It will be much easier for you in regards to feeding Mog & keeping the others happy/outta her food if you switch all your cats to canned . Reduced protein is definately not the way to go especially the Medi-cal crap. You can entice Mog with some tasty toppings to get her back into eating the good stuff (Wellness, Innova, NV Instinct, Eagle Pack) stuff like a teensy pinch of catnip, melted butter, cheese, *Duffy loves a couple of Rice Krispies as her fave topping*, dried Bonito flakes etc.

Raising the food & water dishes up about 2-4 inches off the ground will help to reduce nausea caused by excess stomach acid, that should help with the vomiting, smaller more frequent meals will also keep the stomach acid happy

A probiotic will also go along way to help restore the good gut flora that may be outta wack from the food changes & may help her feel better about switches.

One of my fave sites is http://www.felinecrf.org/index.htm

If you can get a copy of the test results from last July as well as this current one I can give you some answers
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Old April 17th, 2009, 02:40 AM
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Welcome to the forum and good luck with Mog .
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Old April 17th, 2009, 02:51 AM
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I just wanted to add that sugarcatmom and growler are two of our cat gurus here. Both have extensive knowledge and have helped many members with their cat health problems.

Welcome to pets.ca and we would love to see pics of Mog.
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Old April 17th, 2009, 09:36 AM
Mogsmum Mogsmum is offline
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Well, quite the wealth of information in just a few posts! I think you know more than my vet. They get so stuck in the traditional "tried & true" method of treating things....even if new studies show it isn't the way to go.

I will definately look into those links, and will post the test results once I get copies.

After reading the one link about cat nutrition, I am definately thinking of switching them all to wet food. It probably will make it easier come feeding time. I'd heard something about raising the food/water bowls on another site I had googled. I just need to find the appropriate thing to raise them with. A few stable books will do for now though.

I will have to see what the Pet Valu has by way of wet foods. There aren't too many pet stores in my area, and travel is hampered by not having a vehicle. I know they carry Wellness & Eagle Pack Holistic as that's where I was buying it before. I'll keep an eye out for the other suggested foods....perhaps one of those is more to Mogs liking. I always do buy a variety of flavours, so she's not bored with her food. She also likes to share my tea, my toast with butter, anything with cheese, and sometimes the odd bit of ice cream. Yes, maybe bad, but she enjoys a little nibble and I figure she deserves it!

I have gone the route of smaller meals more often for the last couple of months and Mog seems happier with that, so no worries there. What sort of probiotic should I be looking for, and where on earth would they be found? I've heard of some people adding a spoonful of yogurt to the cats food. Would that be acceptable?


As to a picture of Mog, lemme see if I can post one or two:



Sleeping on my legs, one of her fave things to do last at night.



On her chair in the kitchen.
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Old April 18th, 2009, 09:35 PM
Mogsmum Mogsmum is offline
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Hmmm...I made a post yesterday, long one, and it's not shown up. Oh dear.

Well, I did speak with the vet. I'm getting the reports on Monday or Tuesday, so will post the test results then. The vet did say that urea/creat levels were "normal". Well, one of them was 2 points above normal. He did say the "specific gravity" was high. I belive he said somewhere around 1.71, and it should be 1.25-1.35. Otherwise, all other levels (protein, sugar, glucose, etc) were perfectly normal.

I'm also looking into the food/nutrition info you folks have posted. There's a huge wealth of info there and it takes a while to wade through and understand. I'm also on the lookout to see what foods are carried in the pet stores nearby as I'd like to check those out.

Keep the info coming! I've passed along a lot of it to my mum. She's got an older cat (no known kidney issues though), and really appreciates the info and finds it all very interesting. She wants me to decipher it all & then she'll pick my brain about it. LOL!
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Old April 18th, 2009, 10:50 PM
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Quote:
Originally Posted by Mogsmum View Post
He did say the "specific gravity" was high. I belive he said somewhere around 1.71, and it should be 1.25-1.35.
Normal USG for cats is about 1.035-1.060. When it goes below 1.030, it can indicate renal insufficiency (among other things). But a USG of 1.071 does not indicate a CRF cat by any means. I would say, however, that your cat is dehydrated (all the more reason to feed wet food). What is the vet basing a CRF diagnosis on, because I'm not seeing it.
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Old April 18th, 2009, 11:03 PM
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Can you get the test results from last year as well, your vet will have them on file.

From what you just mentioned I see dehydration but not CRF. It will be interesting to see what the results from last year say.
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Old April 20th, 2009, 08:35 PM
Mogsmum Mogsmum is offline
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Yup, I'm picking up both test results tomorrow. So will post them. Last year I had the full senior/geriatric work-up done. The other day I only had them do urea/creat & urine analysis.

I'm not 100% sure what the kidney failure is based upon. That was the the phone call I received after Mogs test results last July. I figured the vet knew what he was talking about. Lately I've been having my doubts.

I surmise, at this point, there was something within the test results, combined with her age & the muscle "wastage" across her back legs/hip area (which is also an old age thing, not necessarily just a kidney failure thing).
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Old April 20th, 2009, 09:41 PM
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Just wanted to wish you good luck with your girl, Mogsmum!

Mog is gorgeous--what a wise face she has!
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Old April 21st, 2009, 09:04 AM
Mogsmum Mogsmum is offline
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Aw, thanks! She's my baby girl. She chose me all those years ago....followed me around at the barn every time I was there. So, after begging my mum, she got to come to our house permanently. I paid for everything myself (I was 12, it was my paper route/babysitting money).

At any rate....I picked up the test results this morning. Remembering these are in Canadian values (as I've noticed it's slightly different from US values)..

I'll post what seems to be the most commonly looked at levles. If there is somethign I missed, let me know.

July 2008 results, we had a full senior work-up done, but no urinalysis (I'd thought it had been done?! Oh well):

Potein 74
Glucose 2.7
Urea 16.3
Crea 226
Potassium 4.8
Calcium 2.75
Phos 1.9
Sodium 153

Apprently they did a T4 test with a result of 31.4

April 2009 results (just the urea/cret & urinalysis):
Urea 15.2
Cret 152
Spec Gravity 1.017 (I was mistaken when I said 1.7!!)
pH 6.0
Urine tested negative for protein, ketones, glucose, blood



So...........what does all this mean exactly?
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Old April 21st, 2009, 09:06 AM
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I have to agree with sugarcatmom and growler, I don't understand why your vet was thinking your kitty was in CRF.

I second rainbow's post about growler and sugarcatmom, they are a wealth of up to date knowledge and have total trust in their advice.

I believe they were instrumental in extending my Puddles' life.
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Old April 21st, 2009, 09:13 AM
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Just saw your post with the results.

I thought one of the ways to tell if a cat is in renal failure is by the amount of protein in the urine. SCM and growler will know.

Also the decrease in urea and creatine levels are down in 2009 so that doesn't indicate to me that the kidneys are failing.

Here is a link to reading bloodwork:

http://www.thepetcenter.com/pha/cp.html
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Old April 21st, 2009, 11:35 AM
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Quote:
Originally Posted by Mogsmum View Post
I'll post what seems to be the most commonly looked at levles. If there is somethign I missed, let me know.
One thing that would help is if you have the normal reference ranges for each of the values. Different labs have different ranges, so what's within normal for one lab may not be for another.

Quote:
Originally Posted by Mogsmum View Post
Apprently they did a T4 test with a result of 31.4
Is there a T4 number for the April results? I'm a little concerned with how high this value is, even if it is still within the "normal" reference range. As cats age, their T4 should go down, not up, and it should typically be in the lower half of the range. Given that Mog's urine is also very dilute, I would seriously consider having a Free T4 test done (along with an updated total T4). This usually gives a more accurate picture of what's going on. Does Mog drink a fair amount of water?

ETA - forgot to mention that hyperthyroidism can also heart problems, so I really think it's worth looking into. Growler has experience with hyperT and can give you advice on that as well.
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Old April 21st, 2009, 08:14 PM
Mogsmum Mogsmum is offline
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No, there is no T4 number for the 2009 results.

The "norms" for the lab are as follows:
2008:

Potein 60-85
Glucose 3.9-8.0
Urea 5.0-13.0
Crea 50-177
Potassium 3.7-5.8
Calcium 2.0-2.9
Phos 0.8-2.5
Sodium 145-158

The norm for the T4 is 13.0-52.0

Same norms for 2009, but there is no norm shown for the specific gravity. the vet has written beside it 1.025 - 1.035.

Does Mog drink a lot of water? Not sure. She's been on strictly wet food for a long time, and I know she does drink water. It's hard to measure just how much she herself drinks, as there are 3 other cats in the house.

Hyperthyroidism? Hmm....I'll have to look more into that.

So......is it possible the vet misdiagnosed Kidney Failure?

I'm off to check out the link re: test results.
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Old April 22nd, 2009, 02:31 AM
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The urea/crea/USG results show Mog does have kidney failure even though the creatinine has dropped back into normal range with this last test. The fact that the urea & creatinine numbers have dropped from last year is good, but the values will fluctuate (sometimes even in & out of normal) so there is no guarantee they won't be higher next time. The USG (urine specific gravity) is showing a definate lack of urine concentration.

There are no strict rules regarding the kidney values not every cat will fit into a category, some will flow between stages, some may never have abnormal values for things like phosphorus or calcium.

Quote:
http://www.felinecrf.org/diagnosis.h...ction_measures
If BUN (urea) levels and phosphorus levels are high yet creatinine is normal or only a little elevated, it can mean that there is a pre-renal factor at work, for example:

-the cat is dehydrated;

-the cat has gastro-intestinal bleeding (see BUN:creatinine ratio above);

-the cat is eating a high protein diet;

-the cat has severe metabolic acidosis; or

-in some cases it may indicate heart failure.
Pre-renal basically means there is an issue in the tubes or area leading into the kidneys, but not yet in the kidneys.

Even with a low USG a cat can still be dehydrated since pretty much all their fluids are being constantly flushed out.

Cujos' Urea/Crea ratio is normal & no blood/protein in urine so this doesn't apply

Metabolic acidosis is the measure of CO2 or TCO2 on the blood tests. This level will affect nausea.

Can you post the CO2/TCO2? It might be listed as Carbon Dioxide or Bicarbonate.

Protein, potassium, Phos & Calcium look good all in normal range.
Sodium is in normal but still a bit high ~ the Medi-cr@p & Fancy Feast might account for this as salt is often added to enhance taste especially in lower protein foods. The kidneys also excrete sodium so the increase in the blood is also an indication that the kidneys are not filtering the blood as efficently as they should be.
Glucose is lower than normal ~ could be just because of the timing of Cujo's last meal before the test.

As for the T4 it's still in normal range but on the higher side of the median, you may want to have that rechecked just to be sure, any cat over 7 should really have the T4 checked either every 6 months or every year. HyperThyroidism can cover/copy the symptoms of CRF, plus HyperT can have secondary complications involving the heart ~ namely hypertension (high blood pressure) and heart disease called thyrotoxic cardiomyopathy. Since Cujo has already been diagnosed with a murmer it should be watched.

Kidney failure can also have the secondary complication of hypertension

Did the lab Dr write anything in the Notes section at the bottom of the tests?


L4H - the proteinuria (level of protein in the urine) is not exclusive to kidney failure, and not all crf cats will have it ~ Duffy for example in the tests she's had since diagnosis she has only tested positive for proteinuria 2 out of 7 times (not concurrent tests) & both were non-significant trace amounts. Cats with hypertension or diabetes can also have protein loss in their urine.
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Old April 22nd, 2009, 06:56 AM
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L4H - the proteinuria (level of protein in the urine) is not exclusive to kidney failure, and not all crf cats will have it ~ Duffy for example in the tests she's had since diagnosis she has only tested positive for proteinuria 2 out of 7 times (not concurrent tests) & both were non-significant trace amounts. Cats with hypertension or diabetes can also have protein loss in their urine.
Hmmmm, on Puddles' last vet appt he was going to send out her urine to have the protein checked as he stated this was a good indication of initial kidney failure.
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Old April 22nd, 2009, 08:15 AM
Mogsmum Mogsmum is offline
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Thanks Growler.

There is nothing on the test results indicating Carbon Dioxide/Bicarbonate/ There is one that says "Na/K Ratio" and that is 32 with the norms being between 25-40.

Does that help?
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Old April 22nd, 2009, 10:17 PM
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Originally Posted by Love4himies View Post
Hmmmm, on Puddles' last vet appt he was going to send out her urine to have the protein checked as he stated this was a good indication of initial kidney failure.
If there were high levels of proteinuria then yes that would be a possible indication but I wouldn't want a diagnosis based just on that, you would still want blood tests to coroborrate that result or distinguish which condition is causing it.

Gastro-intestinal bleeding will also cause high levels of proteinuria because blood is a protein.

A cat with proteinuria might have hypertension or diabetes not kidney failure or the test could shows no proteinuria but they still might have kidney failure, like Duffy.

Quote:
Originally Posted by Mogsmum View Post
Thanks Growler.

There is nothing on the test results indicating Carbon Dioxide/Bicarbonate/ There is one that says "Na/K Ratio" and that is 32 with the norms being between 25-40.

Does that help?
Na/K is the sodium/potassium ratio, so Mog is good in that regard since it is at the middle of normal for the ratio, plus the individual values are in normal but I would still prefer the sodium number be a bit lower. High levels of sodium can cause/exacerbate hypertension ~ same as people with high blood pressure have to watch their salt intakes.

Many of the values not only need to be within a certain normal range but also be at an acceptable level in relation to each other.

The MSM you are giving for her arthritis is there a low/no sodium option? Or ask your vet about Cosequin.

Did Mog have her blood pressure checked when they diagnosed the heart murmur?
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Old April 24th, 2009, 01:30 AM
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Question Need Help for my Hulu

Hi, I just joined the forum today.. but i have cats since young

I read through the conversations between Mogsmum and growler and I really hope to get some feedback from both of you after reading my case.

My 6 years old Hulu was a healthy cat who eats well, very active, attaching, and good temper, he's just my little baby. He had Urinary problem 2 years ago, with some small kidney stones in his urethra which was caused of i think the food i fed him ( I have 2 other cats at home,1 girl, another boy, and i wasn't aware of cat food can cause health diseases at that time plus due to financial problem, i fed them with Whiskas)
Soon, I took him in to see Vet and Hulu was cured completely after taking doses, and by the time I started to feed them with Science Diet.

Approximately a month ago, I've noticed that Hulu walked with a limp of his hind legs, but other than that, he looked all normal ( normal eating, watering, and excreting). he weights 6 kg (13 lbs approx) He was all healthy and active just like 2 others. However, his abnormal behave did go away in few days but still i can see him sitting differently, like say he was trying to avoid sitting on hind legs instead he would lie down on the side of his body.

Until last Friday, he suddenly started to cry and sound panic and looks like his hind legs starts to bothering him again. I brought him to the Vet yesterday, the Vet said he might have heart problem that his heartbeat pump faster then normal and saying Hulu is probably born with a larger heart then normal. then she kept to say there might be a chance Hulu has problem of some small stones that block his blood vessels causing temperature of his palms (only hind legs) to be little bit colder then front palms. also the blocking vessels might lead to stiffness of hind legs. However, all she said was just what she has concerned, she suggested to do an exam to check if that is the case. The exam costs about $600CND which is way out of my financial support (Im still a student), and that is just to do a test.

Hulu now has difficult to jump, like he is now not capable to jump up to my bed, it looks like he can't bounce his legs.

here I really hope any of you can give me some advises with your knowledge and experiences. what should I do other then the exam? could it be the food i fed has something to do with it? now i massage Hulu's legs whenever i have time as though it would stimulate his blood circulation and help to avoid stiffness

I'm a bit in a rush since I will be on my vacation starting from next Thursday until July 1st. my bf will take care of my cats when i am away, but still I hope I can do something and make both of Hulu and me feel better.

highly appreciated

Ian
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  #22  
Old April 24th, 2009, 02:31 AM
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growler~GateKeeper growler~GateKeeper is offline
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Annla I think the first step is an exam especially concentrating on the kidneys & bladder, with blood & urine testing including a urine culture & sensitivity. You need to rule out the possibility of this being the stones reoccuring, if it is stones it can become fatal if left untreated. Ask your vet about payment plans, your family & friends for a loan, use a credit card, speak to the people at http://www.petcard.ca/.

for Hulu
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Old April 24th, 2009, 12:44 PM
Annla Annla is offline
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thx for your advises, but I'm wondering if kidney problem will cause him not be able to bounce? I thought Kidney problem will cause them not be able to pee and urethra inflammation.

However, could it be Arthritic problem? because when I push his legs toward the body, he looks pain, but while i straight his legs he looks ok.

do you known any symptoms of Arthritic? like the beginning stage of disease.

Also, is there any choices of food i should give him, besides Science Diet, any other good suggestions?

Ian
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Old April 24th, 2009, 01:09 PM
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sugarcatmom sugarcatmom is offline
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At only 6 years old, I think Hulu is a little young for arthritis, although anything is possible. Do his toes feel cold to you? Since your vet suspects a heart-related issue, I wonder if maybe he's thrown a blood clot and it's blocking blood flow to his hind legs (called a saddle thrombosis). Was the test your vet wanted to do called an echocardiogram (heart ultrasound)? Since money is tight, perhaps even just a chest x-ray would help.

Other possible causes could be diabetic neuropathy, dehydration or an electrolyte imbalance. Like growler mentioned, blood tests would help to rule those out. Is it possible he injured himself?

As for food, wet food is the best for cats, especially one that has had urinary tract issues. Here is an excellent link on feline nutrition that you might want to read: www.catinfo.org
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  #25  
Old April 24th, 2009, 01:39 PM
Annla Annla is offline
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I don't feel cold of his toes, but i just did another body check by myself.
I massage both of his hind legs, apparently, he doesn't have problem on his toes. But when I massage on the bones of his feet, the left one seems ok, but the right one, he reacts. Then I push both of his legs toward the body, i think the right one is very painful. Also, I've noticed that when he is trying to jump up to my bed, like I said, he isn't capable of bouncing, but I saw his left leg was trying to bounce however, the right one can't support the bouncing strength instead he crawl.

Does the check-x-ray exam can diagnosis if there is blocking blood flow on his hind legs? Do you know how long would the test take? since i will be away for vacation from next thursday, a week is enough to detect the problem?
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