Failing Kidneys. Emergency

Ebony is really sick. I took him in last Monday his BUN was 94 and creatanine was 3.1 he was on an iv for 3 days and it came down. bun 31 (normal) creat. 2.6 (barely elavated). Vet said not to give him fluid, just the KD and bring him back in two weeks. He also has an enlarged kidney on the left side but vet didn't want to biopsy yet. Over weekend he didn't seem to be feeling well, eating less but not vomited. Took him back this morning to another vet. retested levels. bun 117 creatanine 6 red cell count dropping, phosphorus high (before it was normal) he has really gotten worse within 5 days of bing on the iv. he's on an iv again now and is going to get a needle aspirate on his left kidney.
i've been calling around about kidney transplants. i'm in Washington state. I see there's a place in Santa Rosa CA and one in ID that does them from an internet search. Davis isnt' doing them anymore.
Petcare is 16,000 dollars. I would have to withdraw money from my retirment fund but I cound't get it for 2 weeks. i don't know if he can even make it that long. the vet wasn't optomistic.
do you think that having subq fluids at home could help? I don't know why the first vet didn't recommend that.
if he has cancer, has anyone had a cat with kidney cancer? is there any treatment?
are there any meds he could take? the vets here are not specialized in anything. i don't have time to research this
what food should he be on specifically other than KD. I know everyone here thinks KD is bad.
he looks really bad. I don't think I can handle this. It happened so fast. I noticed he was losing weight slowing for many a month or two but wasn't really acting that sick and then he just crashed. i had no idea he was that ill.
what can i do?
i feel helpless. why is this happening??
does anyone have any practical advice for me?

 

Ask about a phosphorous binder that can be added to the food. High phos levels is what harms the kidneys the most.

Visit www.felinecrf.org for tons of info. You can also join the big feline crf support group at yahoogroups.com. This will get you started. With numbers this high (especially creat) IV fluids are best. Once the numbers are down you can do daily sub-q fluids at home daily.

 

(((SARA)) I'm so sorry what you're going thru! I can't offer any help - just prayers!!! Lots of prayers!!! (((((EBONY))))))

 

adding my prayers...

 

Thanks. I'm going to the vet now to talk to him and see Ebony. i expect they will want to keep him overnight. i've been on the phone all morning trying to work out arrangements to get him to WSU this week in Pullman. I don't know if I can do it because it is snowing really hard. Ive been calling about flying him but that doesn't sound good. thank god i have this week off work but i don't know how i can get him there. my car isn't good enough to make the trip. i could possilbly rent, but i'm not sure. thank you for the prayers. if only this vet clinic were better.

i could posssibly fly him to pullman but i have no one to meet him there.

i'll ask about the phosphorus binders. i also lookedup att b vitatims to iv and some other meds that can be used.
i am so scared. i have to leave now.

 

oh, sara, just wishing you luck with this. (((((SARA)))))

 

It's not normal for the renal values to go up that drastically in such a short time, so I have to wonder what happened there. I don't think he needed the IV's with the original numbers, but rather subq's at home. But depending on what has happened the past few days, I don't know that subq's could have prevented it.

Even the numbers you see now is not what I'd call "failing." I see numbers like this quite frequently and the IV's can usually bring them down. But with the sudden change, I think what needs to be happening is finding what caused it. Transplants are rarely done in cats. Did the vet mention this, or is that just what you think needs done? Why is the vet "not optimistic" about how long he'll make it? (It helps to understand why a vet says what they do, and not just know they said it. The pessimism is not in anything you've presented here.) Transplants are not always terrible successful - you need to be thinking carefully about that one. You also might want to check where that kidney is coming from. But I think you need to find out what is going on and why the drastic change in such a short time.

As for the enlarged kidneys, that could be PKD (genetic and certain breeds more likely to have it), cancer, and a couple of other odd things. If it were me, I'd probably have an xray done (which hopefully can be done right at the vet's) and then an ultrasound (which requires a specialist). If it's cancer you can look into chemo. Also consider that if it's cancer, it could have spread from elsewhere. The aspirate is a good idea. Here's a link to just a short blurb on cancer:
http://www.cat-health-guide.org/feline- ... phoma.html
Although if that's it, you'll need better information.

As for food, well right now what you feed him I think is less important than keeping food in him, though any sick cat needs good nutrition, which is why many of us (including me) don't like KD because it's very low quality food. Not to mention that it's high carb. (And I won't go into the low protein thing here. Been to Dr. Lisa's site recently?)

Even though "CRF" is sort of a nondescript term which has no implications of causes and such, anything going on with the kidneys can cause similar symptoms, and a non-fully functional kidney is a non-fully functioning kidney. Meaning as a general rule, the basic treatments for CRF can apply regardless of cause, because most treatments are to help the kidneys do their job and also to treat other symptomatic problems that arise. (Though you should check that there isn't some reason NOT to do some particular treatment.) You can do subq fluids, look into the binders... there's actually numerous things you can do, but it would be nice to know more first.

Check into the "big" CRF support group here:
http://www.cat-health-guide.org/feline- ... phoma.html
I'd recommend my own group, except it's small and right now I think it might be wise to join the big one and try to get some more immediate attention. And you can stay there for future use.

I checked your other thread (the only one on the new forum) and do not see any additional info there. That just sounded like typical CRF. It would help if you'd do a link to your old profile. If you go under your profile here, there is a space for a URL and you can just paste in the URL from your old profile. You can also paste it into your sig. Go into your user control panel (upper left) and take a look around in there.

 

I'm afraid Pullman,WA is 8 hours away from me including driving over 2 mountain passes. We too are having tons of snow right now falling in the mountains. I can try to talk with Joe about maybe making a w/e drive and get back to you.

 

Sara I'm so sorry to hear this. Is your cat being treated with antibiotics right now? Any other drugs?

Do you know if there are any specialty/referral centers in your drive-able area? You can find a list of internists here: http://www.acvim.org/websites/acvim/index.php?p=228 . Is it possible that there is some toxin exposure? Did you do anything new in your home i.e. carpets, furniture, plants, aerosols?

 

Sara - I have no advice for you but want you to know I'm so sorry to see this post about your Ebony and am sending many heartfelt prayers and wishes for healing for your baby.

Emmy U Dude (& Mittsi too)

 

Sara, Jess started a thread to see if any of us living in the Pacific Northwest could help you. That thread is here: http://felinediabetes.com/FDMB/viewtopic.php?f=4&t=1266 Where are you in Washington?

 

Thanks everybody for all the great info and support! It really means a lot. I am going in today to visit him in a few hours. He's still on the IV. I'll post a separate update then. He did have a kidney aspirate yesterday. I think the result will be in tomorrow or next day. He had an ultra sound but not an xray. I will ask the vet about an xray today. I have a tentative appointment at WSU for next Tuesday at 9:30 a.m. but if I can get a definitive diagnosis and help here, I may not have to go. It is so nice of people try to find a ride for him... I will know more in the next day or two if I will be keeping that appointment and if I still need help with the ride. I am in Central Washington, about 4 or 5 hour drive from Pullman I think. I've never been there. I looked into the plane and it very expensive for me to go with him over $600 if I shipped him as cargo (which I'd rather not do) it is still over $300 and there's no one there to meet him anyway.
My vet doesn't seem to be that aggressive in wanting to treat him which is not a surprise because that is typical of his style. It's very frustrating. When I asked him about the phosphorus binder he said something like "well, it's this goopy liquid you have to give in a syringe and I don't think you'd want to be dealing with that" or something. Yeah, right. I only have given liquid meds hundreds of times in other situations in addition to constant hometesting blood sugar, shots, sub q... i just don't get where that is coming from. and the said about the shot for anemia "well, it's a twice a week shot" again like it would be a huge problem. there's more but I think I'll post again after I visit him today with updated info. thank so much for your support. this is very overwhelming to me.

 

Sara, if it were me, I'd be certain the vet understood that you are willing to and capable of administering goopy liquid and shots...and that you expect him to provide the same if that is what is best for your furbaby.

 

I sent a you PM with some ideas for transportation.

I don't remember the phos binder being a goopy liquid. I remember it as a powder that I mixed into food. (But then my memory is lousy.) I also don't remember having to have a vet script to get it, although I certainly would want my vet to be a partner in treating with it.

I am really sorry you are going through this Sara. If there is anything to do to help, please don't hesitate to ask.

Venita

 

we used Epakitin for the phosphorous binder and it was indeed a powder i mixed in Kitty's food. I still have some left actually if you or someone wants it. quite a bit actually. (you get first dibs though since i posted it here)

 

Yep, that's what I used.

 

I didn't get the "goopy liquid" thing either. Use the Epakitin if that's available for free, but also check on his calcium levels first. IMO, a better option is the tasteless generic aluminum hydroxide, also a powder and can be sprinkled on food. HECK of a lot cheaper. But it does work really well for most cats.
You can check them all out here:
http://members.verizon.net/~vze2r6qt/su ... inders.htm

My vet too would hesitate over doing some treatment, then do a double-take, like 'oh it's you,' and then say "Yeah, let's go ahead with such-and-such." They get really used to clients not doing anything. If he knows you, seems like he would get it by now.

 

My prayers are with you!

I have no idea if it is at all appropriate with his issues, but you mentioned sub Q fluids. If your vet recommends it, Sub Q fluids at home look scary but really are no problem.
I give my furball sub cutaneous fluids everyday and I actually think its easier than the Insulin injection, (which I've been doing for years). I now buy fluids kits in bulk from a website; vetsupplys.com out of Alabama, and its a lot cheaper than my vet. You do need a prescription.

 

Sara,
no advice but blizzards of snowflakes from across the sea. (((Ebony)))

 

what are his phosphorus and calcium levels?

aluminium-based binders like aluminium hydroxide is more effective than a calcium-based binder like epakitin. also, epakitin should not be used if his calcium level is elevated.

the goopy liquid is likely alternagel. it's aluminium-based, but it has a minty flavour and most kitties don't like it.

did you see jess' post to you earlier? she asked if ebony is being treated with any antibiotics or other drugs right now. she also posted a link for a list of internists, to see if any are close to you.

 

(((Sara))) and (((Ebony))) - sending hugs and well wishes your way.