Hi! I'm new here and haven't had a chance to read all the pages in this thread, but I wanted to report on my CRF kitty Keiko. She was diagnosed with renal failure a year or two ago and slowly went into decline. By the first of this year she wasn't eating as much as she had been, especially because we were trying to put powders and meds in her food, making it even less palatable than it already was. We started her on sub Q fluids, which she didn't tolerate well. Finally the vets told us our only other option was a feeding tube. I don't know about anyone else, but my immediate reaction to feeding tubes was, "No way!" That just seemed to be cruelly prolonging the inevitable.
After some research, though, it seemed like maybe an e-tube wouldn't be such a bad idea. It's not quite the invasive, horrific procedure I had always envisioned. The thing that forced our hand was the fact that we were leaving for Europe for two weeks on business, and even though we would have a live-in vet student as pet sitter, we didn't want Keiko to waste away and die while we were gone because she wasn't eating. After days of soul-searching and debating, we decided to give it a try.
We are very fortunate to live near the University of Missouri Veterinary Teaching Hospital. Even though it can be frustrating to deal with learning students sometimes, the diagnostic and care opportunities are fantastic. We knew that Keiko would be in capable hands. We took her in for the procedure, hopeful that she could withstand the anesthesia but knowing their anesthesiologists are top-notch. The tube insertion went well, but unfortunately she reacted badly to the anesthesia. By the time we took her home she was pretty lethargic, and by the next day she was flat on her side and staring, as cats will do when they're about to die. We sat with her constantly, waiting for the worst. The worst never came, and somehow she rallied and slowly perked back up.
Fast forward to the present, three months later. Keiko might as well be a healthy kitten, not a CRF 17ish-year-old. She runs around, plays with toys, meows for food, and generally acts more spunky than she has in 15 years. She still has her e-tube, but she eats quite a bit on her own. Her kidney values have actually IMPROVED a little and overall she is the star of the internal medicine department of the vet school!
I wanted to share her treatment here in case it would be useful to anyone else struggling with CRF. We are lucky to have all this cutting-edge research at our disposal, so I thought by passing along our story it might help others.
1. Food: Keiko gets a can of k/d per day through her feeding tube (3 feedings) plus she has dry k/d at her disposal all the time. We also give her canned Pet Guard once or twice a day.
2. Azodyl: this is a probiotic which is new in the treatment of renal failure (that's my understanding), so the test results are still circumstantial but the vets at the vet school told us they have seen amazing results with it.
3. Aluminum Hydroxide: this is a liquid that we give her at each feeding which helps keep her phosphorous levels down.
4. RenaKare (potassium gluconate): a powder mixed with her food (also comes in a paste like Laxatone) to increase potassium.
5. Famotidine (Pepcid): keeps the acid levels down in her stomach.
I would recommend consulting your vet about any of these options in case you're interested. I'm sure all cats and cases are different, but we're overjoyed at how well Keiko is doing and hope this might be helpful to other CRF cats.