Early Stage Kidney Failure in Cat

[growler~GateKeeper]

L4H Duffy quite likes the Wellness Turkey so your girl might too Try adding extra water slightly warm to make a gravy works great

I bought an automatic water fountain today (super quite can't hear it unless you stick your head right next to the bowl) cuz I haven't noticed her drinking, so far she won't use it , I still have the regular porcelain double dish & a single one of water out for her.

When she was on EVO canned she would drink water after every meal and I was adding 2 tsp of water to her food. Now with trying the NV & Wellness I'm adding 4 tsp water cuz she doesn't seem to be drinking.

In the last 2 years everytime I had to take Duffy in for re testing because of the Hyperthyroidism, the vet techs have told me "she is slightly dehydrated" even when I knew via observation she was drinking water everytime she ate.

I'm going to open the last can I have of Evo tomorrow for her breakfast & see if she drinks water after - maybe if she will only drink water with the Evo I may have to go back to it & get some phos binders, or talk to her vet re sub-q fluids. Hopefully she will take to the fountain

I have noticed some hind end weakness esp when she turns corners. She will still play with & chase the new laser toy & jumps on the bed & also the table to get onto the window sill. This could be dehydration, or high phos - though her count was in the middle of normal range, could be other things as well - will be keeping an eye on it for sure

Only vomited (food) once this week (none prior except for a def hairball) after mixing Evo & NV Beef with a couple of krunchies. hmm maybe the krunchies? not the mixing of food - have done that since & no vomiting. She doesn't seem to be nausious, no retching/coughing, litterbox is good - little pees though - to be expected

The krunchies, which she isn't touching anyways, I took today down to the SPCA. I have also noticed with the Evo (high protein) she was eating 1/2 a can per day & wasn't hungry after her two meals. With the lower protein NV & Wellness she is eating between 3/4 of a can & a full can per day & is going back several times to the dish.

[chico2]

It sounds like you are doing ok with Duffy
My Rockys weightloss is mostly noticed on his backend,some weakness,vet says he's arthritic but I believe it's because of his HTism.
With my 3,it's really nervy at feedingtime,Vinnie slurps all of his food,I have to sit with Rocky until he finishes the teaspoon of food with his pill,usually no problem,after he finishes he gets the rest.
Chico might just sniff the food and walk away,only to return later to eat,it's a constant moving dishes around so Vinnie does not eat it all,pain in the butt,but they are worth it

[growler~GateKeeper]

L4H here's some of the NV info for the Instinct from their website
I included the dry matter conversion for calcium for you since Puddles needs lower level - though I'm not sure what the level she needs is but you can check lower end levels.

I didn't include the Vension variety cuz the phos level is high
The levels below are per can not converted into dry matter (except for the conversions I did )
Nature’s Variety Instinct Canned Chicken Formula
Guaranteed Analysis
Crude Protein (min) 9.0%
Crude Fat (min) 7.0%
Crude Fiber (max) 3.0%
Moisture (max) 75.0%

Calories
209 per 5.5 oz can

Minerals
Calcium: 0.384%
Phosphorus: 0.307%
Magnesium: 0.029%
Sodium: 0.114%
Potassium: 0.273%
Chloride: 0.181%
Ash: 2.206%

So the dry matter phos level is: 1.228%
Dry matter calcium level: 1.536%

Nature’s Variety Instinct Canned Beef Formula
Guaranteed Analysis
Crude Protein (min) 9.0%
Crude Fat (min) 7.0%
Crude Fiber (max) 3.0%
Moisture (max) 75.0%

Calories
220 per 5.5 oz can

Minerals
Calcium: 0.399%
Phosphorus: 0.341%
Magnesium: 0.023%
Sodium: 0.145%
Potassium: 0.252%
Chloride: 0.211%
Ash: 2.296%

Dry matter phos level: 1.364%
Dry matter calcium level: 1.596%

Nature’s Variety Instinct Canned Rabbit Formula
Guaranteed Analysis
Crude Protein (min) 9.0%
Crude Fat (min) 7.0%
Crude Fiber (max) 3.0%
Moisture (max) 75.0%

Calories
222 per 5.5 oz can

Minerals
Calcium: 0.444%
Phosphorus: 0.327%
Magnesium: 0.022%
Sodium: 0.121%
Potassium: 0.327%
Chloride: 0.207%
Ash: 2.111%

Dry matter phos level: 1.308%
Dry matter calcium level: 1.776%

[growler~GateKeeper]

So it looks like so far she hasn't been drinking on her own outside of the water added to her food & the little bit I have been syringing down her throat - let me tell you she is NOT impressed with that

I will have to do a water measurement either sun/mon when I'm off work to accurately compare levels in the 3 dishes.

Chico As for her hind end weakness, I was also thinking arthritis, but since it can be an indirect side effect (through a second additional condition) of CRF I'm not ruling out anything. The weird thing is it just started on the 30Sept which is when I switched her off Evo to lower protein/lower phos & that is when she started to not drink. But when she sits it really looks alot like Callys' arthritis sit - very controlled careful placement of the legs/hips underneath them in a way to ensure they won't fall/lean over - several years ago I bought a hand-held electric massager for Cally to help alleviate his arthritis, so I have started using that on Duffy - good thing she is used to it from Cally - I would massage her too abit then & she likes it. Purrs away during her massage but still lets me know when she's had enough.

[chico2]

Rocky(11yrs old) has no trouble sitting,walking,running,but he went from 16lb's to 12lb's in a very short time,in losing so much weight,he also lost musclemass.
I don't think he's arthritic,but I am no vet...I just don't want to give him painpills if it seems he does not need it.
I hope your little girl will do ok,it's a worry when they don't drink,luckily all of mine drink quiet a bit,I change the water about 15 times a day
I had a waterfountain once,but they were afraid of it

[sugarcatmom]

Originally Posted by growler

So it looks like so far she hasn't been drinking on her own outside of the water added to her food & the little bit I have been syringing down her throat - let me tell you she is NOT impressed with that

Cats eating only canned often don't need to drink any extra water, especially if you're adding water to the food. I would skip the syringing part (less stress is always a good thing!) and maybe just put another tbsp or 2 in her meals. Even my diabetic doesn't drink out of his water dish anymore (and I was measuring the amounts twice a day for months just to be sure). I was thinking that maybe Duffy was drinking more with the EVO because it possibly has a higher sodium content? or lower moisture content? (haven't compared values so I could be wrong - just a guess).

As for the arthritis issue, I did read somewhere that 90% of cats over the age of 12 have radiographic signs of arthritis. Most commonly in the elbow, followed by the hips. It wouldn't hurt to ask your vet about Cosequin, or even the new Dasuquin. My Aztec started showing signs of a persistent limp in one of his front legs last year and after about 6-8 weeks of Cosequin, he is now limp-free. It's not a pain-killer but more of a joint-rebuilder and is easily mixed with food.

[growler~GateKeeper]

Sugarcatmom - thanks for the links I will check them out.
She's not limping just leaning/wobbly abit & sitting *carefully* & laying down more when she used to be sitting. The thing is I know the weakness could be related to not having enough water re CRF, I don't want to assume it is arthritis & ignore the other possiblilities which is why I'm probably too cautious with the water - though (arthritis) that's what it looks like



The EVO NA looks like this:
......................As fed Basis,............Dry Matter
............................%..................... Basis, %
MOISTURE..........74.03........................-......
PROTEIN.............13.23....................50.94
FAT...................9.23..................... 35.54
CARBOHYDRATES...1.01.....................3.88
FIBER..................0.19.....................0. 73
ASH....................2.30......................8 .85
CALCIUM..............0.45.....................1.73
PHOSPHORUS........0.36.....................1.38
POTASSIUM..........0.26.....................1.00
SODIUM...............0.16.....................0.61


I see now the sodium is higher than others, so that maybe it.
With EVO I was adding 2 tsp, now with NV & Wellness I'm adding 4 tsp so it's quite gravyish.
What concerns me is the techs always mentioned she was a bit dehydrated {gums are def not tacky feeling} & of course I'd like to stall sub-q as long as possible.
According to some info the techs gave me from RC

The recommended water consumption of the cat is 55 - 70 ml/kg-body weight/per day or 1ml per kcal of metabolizable energy consumed

This is where I get
1 tsp=5ml 11 tsp = 55 ml low end of scale 11 tsp * 5.5kg (Duffy's weight) =60.5 tsp water per day
this would be assuming only straight h2o drinking - not including amount in canned food

If you take the ME kcal of Wellness Turkey:M.E. KCAL/KG = 1397.62 % per can as fed 165g can = 230 kcal/can * 1ml = 230 ml = 46 tsp = 1 cup h2o/perday


I'll be measuring water over the next 2 days to see if she has actually had any


Thank you everyone so much for all the help & suggestions posted so far

[sugarcatmom]

I found this website with tips for increasing water consumption: http://cl-ruth.s-ivil.tripod.com/id8.html

One of my favorites is to use the "juice" from a can of unsalted salmon or tuna, diluted about half and half with plain water. You can keep topping up the can with more water and store it in the fridge for 2 or 3 days to get the most out of it.

Also 'Baby Food Soup' works well. Plain chicken (no onions) mixed with plenty of warmish water is a big treat for my kitty.

I understand not wanting to do subQ fluids just yet, but if it ever does become necessary, it's not so bad if you follow a few tricks (like warming the fluids first, using a higher gauge needle, giving lots of treats, etc). In fact, I'd way rather give my cat subQs than anything orally! Many cats learn to associate the procedure with feeling better and become quite compliant about the whole thing. I have lots of links on subQ stuff if you ever need them.

[growler~GateKeeper]

Sugarcatmom Thanks you have been an amazing of resource & help for me & Duffy

[chico2]

SCM,that goes double for me,you are amazing
that Duffy will be fine

[sugarcatmom]

Awww shucks . . . thanks guys! It's my pleasure.

[growler~GateKeeper]

So yesterday I measured out exactly how much water is in the single, double dishes & fountain & will recheck the levels tommorrow

Duffy has decided she doesn't like the NV Prairie Beef anymore (after 2 days with other varieties fed alternative meals) that of course is the lowest phos food but soon to be not available anymore anyways so I'll have to take the remaining 4 cans of it back plus their Chicken & Turkey which she refuses to eat. Really funny since she loves the Wellness Beef & Chicken and also the Wellness Turkey You would think C&T is a better combo than B&T

The Wellness Turkey is the lowest of those she will eat @ 1.05% dry matter.

I have been playing with the laser pointer with her & giving her massages & she does seem to be a little bit more stable on the hind end <insert happy dance>

[growler~GateKeeper]

Not a single drop of water has been drunk from the bowls $50 down the drain ( pun most definately intended) on a water fountain cuz she won't use it

Talked to the vet today re blood tests/vaccines/phosphate binders/food etc etc etc

I'm so glad Dr is open minded she would prefer the prescription but is okay with Wellness & NV I did mention the dm phos level & I am forwarding some info on the food to her.

I asked her opinion on phos binders (not necessary now but always good to know what their stand is on these kinds of things) & the generally accepted level at which to start them. She hadn't heard of the tasteless/odourless ones & asked me to fax the info I have on them who knows perhaps may help someone else's pet too.

Dr wants to do FVRCP every other year while she is still stable (to be stopped when she is not longer holding steady) & continue with the 3 year rabies due this year - though she did leave that decision up to me (Rabies infected Bats are not known in my town but are 2 cities away~less than 1 hour away) I'm thinking I will have to think abit more on this We will of course continue with the 2x yearly geri panel & UAs

[Love4himies]

Originally Posted by growler

Duffy has decided she doesn't like the NV Prairie Beef anymore (after 2 days with other varieties fed alternative meals) that of course is the lowest phos food

Puddles was the same way when I started her on NV Instinct. She loved the first can of chicken and also of beef, but she won't touch it anymore? She will eat the Wellness Turkey now, but not much of it before she tries to bury it.

[chico2]

Growler,do you think Duffys current problem has anything to do with her Thyroidtreatment??
Cats can be the most frustrating when it come to food,I have a supply of Merricks,now mine don't like it anymore,Fancy Feast must be like a drug to cats
They still eat Pet-Values own brand,but for how long,I think I have tried every kind of canned in the store...this morning they all 3 gulped down Performatrin Adult Life Stages Turkey-Formula,probably only a small step up from FF,but still a good thing
for Duffy and you.

[growler~GateKeeper]

L4H - have you tried mixing varieties? mix turkey in with beef or chicken? That helped to get Duffy to eat the last of the NV Beef

Funny thing is when she was a kitten & eating crappy food she would bury it all the time - then come back for more 5 min later . As an adult, when she was on RC she never buried the dish, since switching to Wellness & NV Duffy only once buried the NV Beef surprised the heck outta me she did that (which she won't eat now-no more for you punkin ) & hasn't done any burying since


Chico - no I don't think the HyperT treatment (radioactive iodine) has affected her kidneys though some studies have shown a link between CRF & T4 treatments - not mentioning which kind of treatment though she had the RaId 2 years ago december & all kidney function tests have been perfect since then until April this year

Duffy's test results were all perfect in March
food recall came down (she was on the recalled RC) test results in April -> early kidney failure
The large spike (35.5 points ) in her creatinine levels after 1 month says (to me anyways) it was the food especially since her last geri panel was in Sept 5 months after the recall testing & the creatinine level has only risen 11 points - that to me is a normal rate

11 points in 5 months would be natural progression of the disease but 35.5 points in 1 month is toxin related in my opinion

march creatinine 165 normal I remember her vet said before the results came in "I would be surprised if she didn't show some signs of kidney failure" (because of her age) I was so so happy when I saw the results because she was perfectly healthy @ 16yrs with not even the slightest thing out of normal
april creatining 200.5 high
sept creatining 211.8 high

I emailed Royal Canin/Medical re compensation/help w/future medical bill payments, the vets there spoke to my vet & RC/MC vets are now reviewing all of Duffy's test results to see if they come to the conclusion that it was food related & they will get back to me. RC/MC was not part of the Menu recall & I have found no class action lawsuit against them & I have not heard of any animals getting sick from their food. So we shall see what they decide.

Thanks for the continued good wishes for Duffy =) - right now she is holding steady in terms of how she feels, tests in 6 months, I faxed phos binder info to my vet this morning for her to read (not neccessary now but I like to be prepared for what's to come), we're skipping FVRCP vaccines this year & I still haven't decided about the rabies yet

[chico2]

Growler thank's,not that I am considering the HyperT treatment at the moment for Rocky,but I am having problems with him still.
I am going for a consult with the vet monday morning(without Rocky)he is on meds,but drives me crazy at times,with pacing and sometimes aggression towards Chico..I'll see what she says.
We are going away thursday,my youngest son
(37)will stay here with the cats,so that worries me a bit.

[growler~GateKeeper]

Chico from this quote is seems like any kind of treatment (meds/surgery/RaId) for HyperT can result in CRF esp since most cats with HyperT are not treated with RaId because of the cost & availability of this treatment.

http://www.ncbi.nlm.nih.gov/sites/en...=pubmed_docsum
Hyperthyroidism and chronic renal failure (CRF) are both common diseases of older cats. Hyperthyroidism increases GFR (Glomerular Filtration Rate) by a variety of physiologic effects. Chronic renal failure can suppress total T4 concentrations in cats with concurrent hyperthyroidism, and free T4 is not a useful distinguishing test. Medical therapy (ie, methimazole) is recommended in cats with pre-existing CRF. Overt renal failure occurs in approximately 30% of cats treated for hyperthyroidism. It usually occurs within one month of treatment and tends to remain mild and stable over time. There is no practical way to predict which cats will develop CRF after treatment of hyperthyroidism, although GFR measurement does seem useful.

Good luck w/Rocky @ the vets Monday

I made the decision re the Rabies vaccine & made the appt for end of the month for the poke

[chico2]

Growler,I am holding off on Rockys vaccines this year,he's been vaccinated every year for 11 years,it's just that we have enough to deal with right now,without adding possible problems from the vac's.
Thank's for all the info. I sent you a PM.

[sugarcatmom]

Growler, did your vet mention anything about using calcitriol at any point in Duffy's treatment? I've been reading some interesting (well, to me at least ) info on it and by the sounds of it, calcitriol might be a good thing to start early on in CRF management. Check out this link: http://members.verizon.net/~vze2r6qt/calcitriol/

Calcitriol is the key to controlling hyperparathyroidism. When it's used early in renal failure, the dose that will be effective is predictable and less expensive monitoring is necessary. This is the best use of the drug -- to start it before the parathyroid hormone levels increase. However, it's never too late in the progression of renal failure to start it -- but starting later means the dose of calcitriol is less predictable, so more monitoring of parathyroid hormone levels is required. In addition, starting later usually means that we have to work first to make the phosphorus level drop below 6.0 mg/dl -- calcitriol physically can't work when the phosphorus level is higher. To do this requires a combination of a low protein (also low in phosphorus) diet, and frequently the use of aluminum hydroxide (trade names Amphogel, Alternagel, Basaljel) to bind phosphorus in the diet. Once the phosphorus level drops, then usually the phosphate binder isn't required for the long run.

Not only is calcitriol working silently to prolong survival, but it actually causes the animal to feel better--better appetite and more activity.

A preventive use of a low (2.5-3.5 ng/kg) dose of calcitriol to supplement dogs and cats in early stages of chronic renal disease appears safe, effective and advisable.

We are of the opinion that the majority of uremic dogs and cats will benefit from use of low doses of calcitriol as part of their treatment plan whether in correction of hyperparathyroidism that has previously developed or in prevention of its occurrence.

[growler~GateKeeper]

Sugarcatmom no she hasn't mentioned that as yet since Duffy's phos, calcium & even her creatine phosphokinase levels are still in normal range, BUN 14.3 & Cre 211.8 are high USG is 1.038 so not too too bad, she's eating good (even looks like she's put on some weight she didn't really need ), water in every meal, and her T4 thyroid level is at the low end of normal since the radioactive iodine therapy 2 years ago - it actually just within the last 6 months came up into normal range from low

I did send her info on aluminum-based tasteless/odorless phosphate binders she wasn't aware of, so I will print this info off to show to her.

Thanks for the link I will ask her about it & see what she says re the effect it might have on her T4 level, when Duffy goes in for her Rabies Vx @ the end of the month

And no you are not a you are an

Thanks again

[growler~GateKeeper]

I found a great site for converting the US values to Canadian/International values:

http://www.vin.com/scripts/labquest/converthtml.pl

[pravalgi]

My 6 yr old Tortie Persian was diagnoses with CKD. She was put on Hills K/D wet food and pediolyte right away. Now I keep a bowl of both the wet and dry K/D out for her and she eats up a storm and has gained weight. Her blood work is back to normal. You can only buy the food from your Vet, but I highly recommend it. It worked wonders for my baby!

[Love4himies]

Originally Posted by pravalgi

My 6 yr old Tortie Persian was diagnoses with CKD. She was put on Hills K/D wet food and pediolyte right away. Now I keep a bowl of both the wet and dry K/D out for her and she eats up a storm and has gained weight. Her blood work is back to normal. You can only buy the food from your Vet, but I highly recommend it. It worked wonders for my baby!

Are you talking about chronic renal failure, because as far as I know, kidney damage is permanent and non-reversible. Chronic meaning "on going"

[growler~GateKeeper]

Originally Posted by pravalgi

My 6 yr old Tortie Persian was diagnoses with CKD. She was put on Hills K/D wet food and pediolyte right away. Now I keep a bowl of both the wet and dry K/D out for her and she eats up a storm and has gained weight. Her blood work is back to normal. You can only buy the food from your Vet, but I highly recommend it. It worked wonders for my baby!

Glad your cat it doing good but chronic renal failure is an ongoing disease of the kidneys in which damage to the kidneys is irreversiable. Perhaps your cat had Acute kidney failure which is usually caused by poisoning, trauma etc that can be reversed if aggressively treated immediately.

By the way the ingredients in Hills or any other prescription food is mostly chemicals, grain & fillers that our pets do not need in their diets. A grain free holistic food with all natural human grade food is far better for their health. If I had been aware of this before feeding my cat Royal Canin - she wouldn't have been affected by the food recall which lead to the kidney failure she is currently going through.

[growler~GateKeeper]

So Duffy has an appt for her Rabies Vx on Oct 30, & I am researching herbal supplements to talk to her vet about, there unfortunately is alot of conflicting info on which herbs to use. I have info on the combo I'm thinking to use & I can get it locally through a trusted supplier, so no shadey internet buys . Trying to be proactive & not just wait until her phos levels increase to the point she needs a phos binder & her cre levels increase to the point she needs sub-q fluids.

Speaking of fluids - seems Duffy has been drinking from the pet water fountain, the water level dropped 500ml within 2 weeks & there is no way that was all just evaporation - it's been cold here lately, I just never SEE her drinking

[hazelrunpack]

It's good that she's drinking and holding her own, growler. She's very lucky to have such a proactive mummy!

[growler~GateKeeper]

Thanks Hazel, she has her more active/less active days too (today a less active day - no play tonight) not sure whether that's her age or the CRF perhaps a bit of both. I'm glad I have a visit scheduled next week & can talk more indepth w/her vet then & bombard her with all my gathered info

[growler~GateKeeper]

Duffy had her Rabies Vx (skipped the FVRCP this year) a few days ago, had a long talk w/the vet on a variety of topics related to CRF - ratio of calcium-phosphorus, potassium levels, vaccines, food, drinking water, supplements, herbs, the plethora of conflicting info on the web etc Her vet is very glad I have been doing tons of research on my own & becoming more informed - even passing along tidbits of info she wasn't aware of

Since her vx she has been eating a little less during the day & @ dinner time, but did eat all her breakfast Friday morning

Duffy also seems a little more lethargic & seems to be a wee bit drooly - I know that can mean several different things (mouth ulcers/teeth/nausea/just plain old age) so I will be keeping an eye on those things, hopefully it is just a mild vaccine reaction. She did ask to go out for a "hallway walk" tonight & we did, a wee stroll through the halls of the apt bldg silly

I have also booked an appt for a Homeopathic vet consult for the end of the month (earliest available that is convenient & my day off since it's not an emergency) we'll see if that helps I don't want to look back a couple months down the road & think "I wish I had tried that"

So far she is stable, no supplements, medication or fluids necessary right now it continues for a long long time

[chico2]

Growler,I have not commented much since I know very little about treatments etc.for Duffys problem,but I have been reading every post,to learn and also of course to find out how Duffy is doing.
that Duffy will improve,with such a caring loving owner,she just has to