17 year old non diabetic with kidney issues

So Oscar has moved into a house with 3 other kitties one of who was diagnosed with kidney problems after a 4 day hunger strike while we where away this summer. When we got home she was nearly gone to the point that the vet wanted us to PTS. Well this wasn't happening it was during a heat wave when no one was feeling great. So after sub q fluids 3 times a day and a lot of different foods she finally decided to eat and bounced back until last week when she stopped eating again. Started the fluid back 3 times a day and she is bouncing back again....Any suggestions on what she should be eating that might help her put some weight back on she is nothing but skin and bones. She is 17 years old and is still missing her friend of 16 years Boomer who we lost last month but she's still a fiesty little girl. Would appreciate any suggestions.

 

Do you have any recent blood test results? Frequently CRF have a high phosphorous level which tends to make the cat not to eat. They can also have a low potassium.
My civi Stuart is an aluminium hydroxide phosphorous binder and potassium supplement as well as sub-q fluids, pepcid AC and B12 shots.
He originally stopped eating and had high phosphorous and low potassium. With thebinder and supplement he started eating again.

 

The only thing the blood tests showed in Jully were high kidney levels the Creatinine value were very high the vet said they were some of the highest values she has ever seen. But all other tests were good

 

Here's a link to a thread where I asked about what to feed my Diabetic & CKD cat. Something that's lower in phosphorous for her is important, lower carbs isn't as important. Really though, what to feed her is "whatever she'll eat." I've read that CKD cats sometimes starve to death before they die of the kidney disease because they refuse to eat. This site is also a great resource. http://www.felinecrf.org/

As for Hobbs, I mix 1/2 Royal Canin renal (Rx) with 1/2 Merrick's either Surf & Turf or Cowboy Cookout. He won't eat the renal on it's own, but he scarfs down the Merrick's.

 

First, I want to say I'm so sorry that your cat is having kidney problems. It is heartbreaking but my sweet Boo lasted 3 years when she had been pushing just near entering the final stage of kidney failure. I can't stand the smell of eggs but I would feel my Boo some egg whites which are supposed to be high protein but easy on the kidneys, and crush up 1/4 of Tums in her 4 meals a day. Actually, Boo hated the smell of the Tums and I had to hunt for a Calcium supplement that was basically an unflavored Tums tablet smash it up and mix it in along with the egg whites to the two cans of wet food she'd get a day. I was also doing SUBQ IV fluids every other day for months until Boo decided she had enough. It is challenging but if you have been wrangling a diabetic cat for BG levels regularly it is not as hard.

 

she is actually really great about taking the fluids. You can tell when she feels better because then she will growl and fuss but when she feels she needs it she will come running when you pick up the bag. Any suggestions on food brands she really likes the walmart brand special kitty premium and the Tiki brand. Any other suggestions? What should I be looking for on the label? I have to go read the web site suggested before I go shopping but any suggestions are welcomed the smellier the better (it seems she only likes if it I need to hold my breath to give it to here)

 

Please do join us over at the CKD group - wish I had joined them a year ago. A lot of excellent help and information. http://pets.groups.yahoo.com/group/tanyas-crf-support/

DZ and Sarah

 

The yahoo group is great. Some people have brought up some very good points. I would get some bloodwork done. I think it's great that your doing fluids. I saw that you are doing it three times a day. How much is your kitty getting every day? Have you given any thoughts for something for nausea? I've had some luck with solid gold tuna and trader joe's tuna in the past. Sometimes AD too.

Sandy

 

I just joined the yahoo support from people who have gone through it is great. Tuffy is getting 60 ml now twice a day she fights too bad if you try and give her the third right now. She's been offered all her favorite extra smelly fish canned foods but today has been turning up her nose at it all, she did eat a few freeze dried duck treats. We started back on appitite stimulants so hopefully she will start eating tomorrow she's nothing but skin and bones the poor little thing

 

Ask your vet for something for nausea. I use zofran twice a day for my kitty with pancreatitis. Occasionally I use cerenia as well. CRF cats get nauseous. It's good to have this on board before a stim if you can.
Sandy

 

OK I have to call the vet tomorrow anyways I will ask about something for nausea. She had been throwing up alot she's a long haired cat and anytime she rushed a meal she would get sick but since her diagnosis she has only vomitted once.

 

Is there any human over the counter products that would be good for nausea?

 

No nothing over the counter is available. You could try 1/4 tab of pepsid. Make sure it is plain 10 mg tabfamantidine. Will help with stomach acid. Many CRF cats take this. Some cats take 1/2 tab twice a day

 

which would be more important the anti nausea meds or the Pepcid she hates taking any pills so I don't want to freak her out with to many

 

The antinausea med is probably more important. They both do different things and can make them feel better. I'm lucky that my cats are easy to pill. I usually put my meds in a pill pocket and pill them that way. I believe that you have to do what is best for you and your cat. Not all cats can tolerate what we try to do to make them feel better and we as their parents have to respect that. See what her blood work is. It will tell you and your vet a lot. I lost Bookmark to CRF in 2007. We did subq fluids on him for 3 years. Getting him to eat was always a struggle. I would open so many different cans of food. In the last few years it seems that there are a lot more options to help support these kitties. I don't think anti nausea meds were really used then. There are also phos binders that can be used if her phosphorus is high. I know first hand how hard this is.

Sandy

 

Thanks for your help I am willing to try anything for my girl. I think I have opened 6 cans of food today :sad: that the other kitties have enjoyed but Tuffy turned her nose up at.

 

My crew gets there share of extra food too. Vandow has pancreatitis and can be very hard to get to eat. Good luck tomorrow. Let me know how things go

 

Have you tried Pill pockets? They're a wonderful aid for getting meds in. I chop tablets inhalves or quarters and wrap half a pocket around them. Small tasty balls on the outside and since cats don't chew their food much, the pill part often slips in unnoticed.

 

Has anyone ever tried Kidney Support Gold http://www.petwellbeing.com/products/cat-kidney-disease? Just wondering if anyone had any thoughts on it helpful or hurtful?

 

Vomiting in CRF cats is frequently caused by stomach acid and Pepsid (2.5 mg twice daily) helps. Zofran (ondansetron) is a very good anti-nausea drug.

 

Started her on Pepcid today.

 

Re: 17 year old non diabetic with kidney issues Test results

Apparently whe Tuffy had her blood work done every thing was in the normal range except her CHOL = 6.34 mmol/L, CREA was over 212 which is as high as they register and PHOS = > 5.2 mmol/L. Now all of this means nothing to me except that the numbers are too high if some one can explain these to me I would appreciate it.

 

Are you in the US? The creat number seems very high. I'm guessing that it is in mmol/L. I'm used to mg/dL and I don't know what the conversion is. The number sounds pretty bad. Is this blood work from today or older? If it's older I would encourage you to have more blood work done. If I knew the conversion I would have a better idea of how bad it is. I've had a cat with a creat of 3.9 and he was totally assymptomatic and a kitty with a creat of 2.8 that showed significant symptoms of CRF. You should join the yahoo feline CRF support group. They will ask you to post Tuffy's results but they also want you to post the reference ranges. Cats in CRF can get very sick. They can become so nauseated that they don't eat. They can slowly starve to death. The yahoo group has a lot of good links as well. It sounds like Tuffy is pretty sick. I'm glad you're doing fluids.

Sandy

 

We are in Canada and I don't know the conversions either. This work was from July. I have to take her back in soon but she freaks out so bad even at the sight of the carrier that it's very hard to get her there. I don't want to stress her out any more when she arlready feels crappy.

Jen

 

Blood work can change dramatically in a few months. Maybe you could try to get her into a different kind of carrier. I have to put one of my cats into a top loading carrier. I understand that you don't want to stress her out. It's hard to know what to do if you don't have recent blood work. Fluids and pepcid are good and maybe you could google a phos binder. It's alot to do. Like I said before you have to do what is best you and Tuffy. If Tuffy gets too stressed out maybe it's not fair to put her through too much. Are there any vets in your area that make house calls? Google mobile veterinarians or even hospice vets. Maybe it is best if you could get someone to come out to you. If you can get someone to come out make sure you get a copy of Tuffy's records. Is she eating at all? How are her urine puddles?

Sandy

 

Hi
A couple of things. My Fred had CRF for 6 years---and never progressed until he was 19 years old and only then did I give him fluids.

BUT BIG RED FLAG. My damn vet never said--OH WE SHOULD FIRST MAKE SURE THAT YOUR CAT DOES NOT HAVE UNDERLYING HEART DISEASE before we start pumping him with fluids. Asshole. My cat had an already diagnosed heart murmur. I had no clue this was a concern--but in an old cat--like you're, it is.

If you can afford it, you should really get an ultrasounds--echocardiogram to make sure your kitty does not have underlying cardiac hypertrophicmyopathy (HCM). Otherwise by pumping in all those fluids you can induce heart failure (fluids in the lungs and the heart gives out trying to pump them out.) This is what happened to Fred. And my damn vet had me giving 100 ml every single day--without building up This is a hugely excessive amount---and Fred's kidney values were not even all that bad.

So my words of advice because this DEFINITELY sped up Fred's demise...is check for the HCM with an echo i you can. If you cannot afford it, then go much more slowly with these fluids---try to figure out how LITTLE you can give him and still have him feel good. The fluids are a HUGE strain on the heart. Just like insulin, less is more. It's good that you are doing it several times a day instead of one giant wallop but if your cat were mine, I would drop the doses way down and see how he does--even 20-30ml a day....If I had done that with Fred, his heart could have handle THAT amount.

Also look for early signs o cardiac heart failure---and my vet never believed me when I told him of these early on--he had no clue what they were and denied it was the lfuids--I KNEW they were becuase 1) I knew my Fred and 2) it happened immediately after fluids: his legs would collapsed, he would go to the litter box and collapse and could not stand up or stay up or walk. Just temporarily, but it was something with the vagus nerve or something but def. a reaction to the fluids. Also, very slight open-mouth breathing--as it got worse--fluids in the lungs.

But don't let it get to this point, just be very conservative about pumping him up with them. My Fred got a ton better AT FIRST as well so I was fooled into thinking that 100ml in a 19 year old skinny cat was OK...it wasn't. I should have gone very low and slow and barely progressed.

2. Food. Dont give hte renal food. Give all the good high protein, low carb, no grain food we all feed our Db cats: Wellness, Evo, Nature's Variety, Merrick, BG, etc. Only canned.

3. Give a phosphorus binder with the food...as described above. I switched between the two main types--so not to deplete Fred of certain other minerals by over using one. I'd use one type for breakfast, one type for dinnier. IT's easy and cheap and order them online.

4. USE SMALL NEEDLEs..The vets use 18 gauge which is a spear that hurts the kitty...some people go to 22 which is still massive. I kept experimenting in sizes until I got to 25 and 26 gauge needles for the fluids. These are teeny and will make kitty enjoy the experience and also NOT create that lump because the fluid goes in a bit slower. IT's an extra 10 minutes, not much, but worth it for the comfort of your kitty. The only diff. betw. the 25 and 26 is the length. The 26 is quite short needle so you have to keep your hand on it while the fluids are going in--if he shifts around it can pop out. Otherwise the 25 gauge are longer and you don't have to worry about that as much, but they are still very very thin and make the experience pleasant.

I would put my fred on the kitty donut bed on my couch. Put a towel on him, then a heating pad on that. I had the fluids hung up on a picture hook by my couch and when he was nice and warm, I would then put the needle in and then place the towel and heading pad back on top of him, often with my hand under it as well so I could test the heat and since I used the 26 g, hold the needle in place. Fred purred the entire time.

Just be careful of those fluids, please do not fatigue his heart...Vets don't often think of this and I learned the hard way.

By the way, after the heart failure, Fred stopped the fluids...another long story but he lived for 10 more months--on NO fluids, and never on renal food. The only heart drug he was on was Plavix. I made them take him off the 3 others they prescribed when after the 2nd dose he didn't move for 10 hours straight. My poor baby.

5. Also Pepcid A/C 10mg tablets. I gave Fred 1/4 tablet (of the 10mg, so 2.5 mg) only once a day in the morning. This was a safe amount and totally removed all nausea. I simply mixed the crushed pill (buy a bill crusher too) in a little water and put that on his food.

 

Thanks for all the info I know they did some heart tests on her 2 years ago when they removed a lump from her back (it was cancer) and her heart was fine and I will keep a really close eye on her. She did eat a can of FF with egg white in it tonight and she pees a lot and it is very very strong smelling. Unfortunetly the only time vets make 'house' calls around here is for cattle one of the pit falls about living in the country.

 

I googled converting creatine mmol to mg/dl. Tuffy's creat wasn't horrible in July. It rounds out to 2.4 which is just out of the normal range. That is if I did it right. Like I said things can change. Many CRF kittys don't eat well. Unfortunately alot of these cats will not eat what is good for them. That's when you go and buy all different kinds of food and just try to get her to eat something. Some food will work one day and then a no go the next. Try to give just canned. The moisture is good for her.

 

trust me I think I have some of every brand from every store in every flavour. She had a tiny bit from last night left that nope no way was she eating this morning she wanted a new flavour than she ate just fine. She knows she has us wrapped around her paw. Her creatine level was something over 212 they have no idea how much over because they would have had to thin it and do another slide till they could read it and they didn't know how much it would cost cat(2)_steam too bad they couldn't pick up the phone and ask if we wanted to spend the money they answer would have been "no, not really but we want to know so go ahead and do it no matter what it costs"!!!! Most of them at the vet know us well enough to know we want answers no matter what.

 

Tuffy seems to be feeling a little better the last few days she is so skinny but coming out of the bedroom jumping up looking for attention and eating some what better the problem with her eating is partially because she is so picky what she likes one meal she doesn't the next and she only eats a little at a time so you have to feed her frequently. She is going in for a blood test tomorrow to see what's what and to make sure there is nothing else going on..I even tested her blood sugar a couple of times to make sure that was normal. I'm just scared we are missing something with the last vet only focusing on her kidney levels