Slippery Elm Bark Questions

Hi Everyone! I just have a few questions about slippery elm bark. I've read it's good for kidney disease/nausea, and have started giving it to my CKD kitty Chyna. I saw on a forum somewhere (not here) that someones vet told them it has complex sugars? I haven't seen that repeated anywhere else in all the articles though, but I wanted to ask if anyone has used it if it has affected BG? So far it doesn't look like it.

Also, has anyone used it long term? How much do you use and how are you dosing it? I've been giving it twice a day in her food (one capsule split in two). I know it can affect absorption of medications/supplements so have been giving it a few hours from her vitamins/cosequin as recommended. But something I read said it can increase that if you use it long term. So I'm hoping for some feedback from people who have used it So far it is really helping her stay in the CPC! Thanks for any help you can give

 

Oh, I'm really interested in this also! Anything to help my kitty with stage 4 CKD...though he's still eating really well and only just showing signs of possible tummy upsets. I'm also wondering if you have any advice about this disease, my kitty is only recently diagnosed and he's only on ipakitine twice daily...I'm not sure if he should be having vitamin B and my vet is very inexperienced with CKD and diabetes (home testing, using lantus)...he suggested euthanasia straight away :-x !

Sorry to jump on your thread, I'm just really worried and stressed out with all the new information of late and am so lost. :sad:

 

I know how you feel, it's so stressfull! Have you been to Tanyas site? It has great kidney disease info...link is here: http://www.felinecrf.org/index.htm . There is a support group you can join too. It's pretty overwhelming with all the info on there, but I try to take it one step at a time ;-)

I'm not overflowing in knowledge, but learning slowly. My vet ignored me when I asked about vitamins. I was told by members on here that have cats with CKD that methylcobalamin and vitamin B (they recommended Jarrow BRight since it's got the right amounts of B and made with methylcobalamin) are good to give. I give twice a day, 0.25mg of methylcobalamin and 1/20 of a Jarrow BRight vitamin in a pill pocket. Plus I mix water in her food, and feed low phosphorus, low carb food. Hopefully some people will be on tonight to pass on some advice to both of us

 

Oh Tanya's site was a godsend, I stumbled upon it accidentally in tears thinking my kitty had to be put to sleep :sad:. I was able to breathe again after the first page! I know a little more, and have a constant note book next to me when reading through all these sites...there's just so much information, it's hard not having a vet I can rely on for advice, but I can't afford any other vet...they're all just sooo expensive!

I'm still stumbling through the whole 'what to feed them' bit, a lot of the foods on Tanya's page aren't available in Australia...well not that i've yet to find and I doubt my kitty would eat the prescription renal food, he went on a hunger strike when I tried putting him on the diabetes one (which strangely when he did eat would send his sugar through the roof). I'm sort of stuck on the foods, ones that won't affect the diabetes too badly, but won't make the CKD worse either. I'm usually standing in the petfood isle for an hour or so trying to read and compare foods, it gets to the point where I'm just so lost...but my boy is still eating well, so that's a plus so far from what i've read on Tanya's site.

I've been mixing some water into Milo's food, it also helps with mixing the ipakitine in, Milo is still drinking HEAPS of water so I'm taking that as a good thing so far. I will have to see if I can sign up to Tanya's forum (I didn't know there was one) and hopefully find some help with my panic attacks, lol.

*SIGH* Vitamins, really lost here, as I said before, my vet is really no help at all, he's lovely and cares so much, but he's a little 'over the hill' and i'm afraid he's still in the dark ages when it comes to a lot of treatments...he was shocked when I started home testing Milo's BG levels as he's never had anyone do that, I had to even show him the ear prick method as he'd never seen or heard of it. Then there's the whole Lantus thing...ugh! Miley is the first cat he's had on it, Milo had to go into an animal emergency place (you know the ones? they charge ten times the price of what an ordinary vet does lol) when he got sick late one weekend evening, so they put him on it.

So from day one, I've been struggling through this by myself, it was just instinct to home test as I had worked in the healthcare industry for over 10 years before I became unwell, and I just figured if humans had to test before and + whatever time, than I should be doing the same for my kitty. The only thing I had majorly wrong was his levels, I panicked when they were 14-15 and assumes that around 6-9 were good. Since I found this forum a few weeks back, I am slowly learning bits and pieces (thank you all sooo much!).

UGH went off track a lot there, sorry, my mind gets away on me! Anyhow, vitamins, are these ones I should get through the vet or are they available somewhere else? I hadn't heard of the methylcobalamin, just the vitamin B on Tanya's page. My vet told me he can't in good conscience give Miley any Fortekor because his creatinine level (500) was so high (he rang a cat clinic that costs a fortune and they said it's a no go), so I just want to be able to give him anything I can to help keep him as happy and comfortable as long as possible. I'm just not ready to say goodbye and he's still looking pretty good so far.

 

Hey Rachel!

Hope Miss Chyna is doing well!

I used SEB for a year with my CKD kitty, Gus, before it started not working to treat the acid and I had to start giving 1/4 of a 10 mg Pepcid AC sid. Gus, however, is not diabetic. If you've not seen any change in her BG, then it's probably fine. I've not read that it is composed of complex sugars. It is from a tree and has a very high nutritional value. George Washington's troops survived at Valley Forge because they ate slippery elm bark ...a little history trivia

I also used it for my Teddi (also not FD) and she was on it for some time ...several months. Neither Teddi nor Gus would eat it in their food so I would make a syrup of the pure powder. The recipe is 1 tsp of SEB powder mixed in 1/2 cup spring water....warm gently in a glass or porcelain pan (don't use nonstick). Don't let it boil...warm slowly and it will just slightly thicken...be sure it's mixed well with the water. When it's just a little thicker, store it in a glass jar in the frig. For a 10 lb cat, you can give 1 tsp (5 mls) 20 minutes before each meal. Be sure it is give either one hour before or two hours after any meds.

Bebe Kaye....why are you giving epakitin? It's kind of old school for phosphorus control because of the calcium in it. It can raise calcium levels which you don't want to do. The gold standard for phosphorus control is aluminum hydroxide powder. Some vets give epakitin because it binds to toxins...perhaps that's why your vet is using it?

The B12(methylcobalamine) and the Jarrows BRight must be given together to work against the anemia. If your cats HCT or PCV is less than 20%, he will need an erythropoetin stimulating agent like Aranasp.

Are you giving fluids at home? If you aren't, here is a video I made on giving subq fluids at home: [youtube]TtSzMuDgx78[/youtube]

Hope I answered a few questions for you both.

 

My foster kitty has diabetes and CKD, and when I first got him he was having bouts of nausea/diarrhea. My holistic vet gave me a mixture of slippery elm bark, Purina Fortiflora, Thorne Gastriplex and bentonite clay. I'm not sure if it was equal parts of each. I would give him 1/4 teaspoon of the mixture twice daily for a few days and it always helped tremendously without raising his bg. I used to have to use it quite often, but he is doing so well now I can't even remember the last time I had to give it to him. So I don't have any information regarding long term usage, but it did help using it short term.

 

The vet gave it to me. Everything I now know about CKD is what i've learnt myself, my vet doesn't seem to know a lot about treatment, in fact he told me it was time to put Miley to sleep when he got the test results back saying Milo had a creatinine level of 500...even though he looks relatively healthy and is eating and drinking well. After I told the vet i wouldn't be putting him down while he was so obviously happy and comfortable, the vet gave him an injection (no idea what it was) and gave me the ipakitine. I'm at a loss what I should do and what I should be giving him. I can't afford to see another vet who all charge at least double if not triple what my current vet does. It sucks to have to put financial circumstances in front of this guy who I have loved and who has loved me for over 15 years, but sadly sometimes we have to. I've already been spending my own healthcare money on him, my doctors are going to kill me when they find out I haven't been doing my physio lol! I have written down what you wrote about the vitamins, so I can find out those levels at my next vet visit, are those vitamins a vet item or would I be able to get them elsewhere? I'm currently ringing around trying to find a cheaper place to get his BP done at, my vet doesn't have equipment to do it and the place he suggested wants $120 for a plain old blood pressure test :roll:.

How will I know when to start doing subq's? So far Milo is drinking water exceedingly well and eating wet food with water mixed in...will that be enough or should I be doing the subq's on top of the huge amounts he's drinking...he already looks quite bloated. I just want him to be comfortable. :sad:

 

Thanks Marje and Cindyh. I'm happy so far Chyna is ok with it mixed in food. Thanks for the history lesson :lol:

Bebe, you're doing great, it's so hard to go through all the information when you're stressed and exhausted and sad. Glad to see you are into hometesting it is a lifesaver! My vets haven't been very helpful so I'm thankful for this and Tanyas site! Marje rocks and helped me with the vitamins when I was looking a few months ago, to give them together for anemia. The Jarrow BRight can be bought here, it looks like they ship worldwide but maybe you can find a store closer? : http://www.iherb.com/Jarrow-Formulas-B-Right-100-Veggie-Caps/110 Methylcobalamin I bought at my local health food/vitamin store, just make sure what you buy doesn't contain xylitol as it's deadly for cats. There is also a version of methylcobalamin made for diabetic cats, it's called zobaline. Sorry I don't know much about foods available in Austrailia:*( Do you have ziwipeak? It's made in New Zealand. The lamb one is the lowest in phosphorus but is a little bit higher than recommended but it's low carb. It is pricey...have you seen Dr Lisas list of foods, listed by brand? It's here: http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf I'm not sure if many of them are internationally available either :?

 

Someone has mentioned the ziwipeak o me but i've yet to be able to locate it. The other foods on the list have me lost, I think what I will probably do is print the whole list out and try and hit the grocery stores and pet places in my area and try to find something suitable that he likes. The lists with those numbers just confuse me, I guess I shall have to really sit down with it in front of me and try and highlight the better choices. At least after I get this sorted, we may have at least a bit of a list for others that live down this way lol.

I'm on some nasty medications and pain killers so my mind isn't as splendid as it once were, in fact there are times when it just won't work and information I just read escapes me and I have to read it over and over...I try to take notes to help. I really apologise if I ask something over and over. I never thought i'd be like that at this early stage lol, thank goodness for family!

 

Bebe

Usually subq fluids like lactated ringers solution are started when kitty's creatinine is over 3.5 in the US which I'm guessing is about 350 or so in Australia. If your kitty looks bloated, I'd be sure he doesn't have a heart condition that is causing him to retain fluids. It's always good to have the heart checked out before giving fluids because if the heart has any issues, the fluids can cause congestive heart failure.

To give an example, my kitty weighs 9.5 lbs ( a little over 4.3 kilos) and his creat is about U.S. 5 (about 440 there) and he gets 150 mls of LRS each day. Cats with CKD can't concentrate their urine and they pee copious amounts and get dehydrated. Check your kitty's dehydration level by rubbing your fingers over his gums...they should be slick and wet. Also, lift of his scruff and let it go...it should pop right back into place.

Basic things to do are:
1. Feed low phosphorus diet or use a binder like aluminum hydroxide powder (cheaper than epakitin, tasteless, and you can give indefinitely sprinkled over food).
2. Give subq fluids but you must do this with vets concurrence
3. Control acid tummy either with the SEB powder or an antacid (1/4 of a 10mg Pepcid AC starting once a day and increasing to twice a day, 30 mins before meal)
4. Address anemia if PCV/HCT is above 20 by using the B12 and Jarrows B Right vitamins. Check his gums and paw pads...they should be Ni e and pink. If not, he might be below 20 on the PCV/HCT.
5. What is his potassium level? You mentioned leg weakness...he might need a potassium supplement.
6. The BP is very important ....that's really expensive there!

 

All i can say is thank you, thank you, THANK YOU! This is so much help to me! Miley creatinine level is 500, so umm, way above the level of sub q's...the only reason i've yet to start after reading Tanya's page is that he is drinking a whole lot and doesn't seem to be urinating too much, though his urine is nearly clear which is not such a good sign I gather?

I've no idea how my vet will feel about me doing sub q's at home, he's a nice old man but is very hard to talk to and not very forthcoming with details of Milo's treatment and things I can do at home. When Milo was first diagnosed as a diabetic he instantly assumed i'd want him put to sleep (HELL NO), then again with the CKD; he's still shocked that I do home testing.I learnt how to do BG home testing off a you tube video, luckily my boy is a sweetheart and it didn't worry him at all (though I was in tears during that first few days). So it will likely be similar with sub q's.

I found a vet nearby that does the BP for $105...seems $120 is about right here after ringing around, so looks like i'll be going to get his BP done in the next few days...what should it be for a cat? I can't weigh Miley, we pulled out the scales last night to find them broken, but maybe the vet will weigh him for me while i'm there...just hope it's not another $50 for that lol. I am thinking I may have a talk to this new vet and see what her prices are like and her attitude towards me doing as much as possible from home. I just feel so up in the air with my current vet, he's been wonderful over the past 13 years, but I need help now and he doesn't seem to be able to give me the support I really need.

I have written down the things that you wrote and will try to ring up and find out what those levels are tomorrow. I just feel so let down that my vet isn't doing his utmost to help me keep my boy with me as long as possible. Again, thank you so very much for taking the time to help me out, to say i'm stressed about all this is an understatement lol.

EDIT: Just checked, Miley has completely black pads on all four feet, so checking for pink there is a no go LOL!!!

 

That is really expensive for a BP test. My vet charges $15 US. For a cat in the vet's office with vet stress, his BP should not be more than 160. They should let him settle a bit in your lap before they take it and they should do three separate BP checks allowing a few minutes in between each.

If you are able to get fluids and your vet tells you how much to give, see if he has any 20g or 21g needles. Usually in the US, they give you 18g needles which are like harpoons and will cause scar tissue over time.

No..it's not good that his urine is almost clear....that's pretty dilute. Did they run a urine sample? If so, what is his urine specific gravity?

Check Miley's gums.....are they black too (I know my Gracie's are). If his gums are not black, see if they are pink or white. White means anemia to the point that he needs the ESA like Aranasp.

I know you have a condo asking CKD questions. Sorry, Rachel, to have hijacked this one. Bebe....if you have other questions, let's move it to your CKD thread ok?

Good luck today.

 

Will do, very very sorry Rachel!!

 

No worries, Marje and cindyh answered my questions Happy to help when I can anyways so hopefully it did Marje Chyna is good as far as I can tell, lol. I did post a condo in LL saying hello and how Chyna was too the same day and referenced this link for my questions ;-)