My cat is in early stages of CRF

Sub-q fluids are easy. You may be leery to begin with, I was absolutely terrified, but it became a regular daily routine and it became much easier within a couple weeks. My Boo even got so comfortable that he didn't need a cat muzzle anymore. Just make sure when it comes down to giving Sub-q's that your vet shows your how to appropriately do it. There is also sites showing you how to do it (From the link below at Tanya's CRF site) if you start getting weirded out at home. I think everyone goes through the leery/freaked out part of the sub-q's, but everyone here told me I could do it and I totally did.

The experience I've personally had with Boo, his BUN numbers went from 36 and when he "Crashed" (when it was "discovered" he had CRF) it was off the scale at 130 and the machine couldn't read higher than that. We got it down to 77, it bounced up and down for a bit but did not have hyperthyroid, and in his final decline, the new vet had to dilute his blood or something to get a proper reading and it was 199-200 and some.
I don't know much about Creatinine.
A BUN level of 38 is "elevated' I believe but every vet is different and considers the numbers differently I believe.

A prescription diet is a good idea if your cat will eat one. I had my Boo on Hi Tor Neo (canned food) which had low phosphorus and low protein. I learned a lot of helpful things from Tanya's CRF Site: http://www.felinecrf.org/

Your vet can probably best guide you towards a good food otherwise.

I have read of cats living upwards of 10 years with CRF.

Do not fret but read your info and do research and learn all you can. Good luck with your baby and other posters will be able to give lots more info, I've only had experience with my one cat and CRF.

Bun of 38 with most test s is stage 2 crf which is insufficiency
creatine of 3 can be 2 or 3 depending on the test used

Sub qs are not hard but it depends on the cat....

Diet for both issues your dealing with is of great importance

I have a 14 year old who's also in early CRF, but she's been there for a couple of years. Off the top of my head (& I'm at work) I don't have her latest numbers, but the fluids question is one my husband & I have discussed. Cats can live for several years on sub-q fluids, but DH and I have already decided that we're going to consider quality of life vs. the stress of the injections and have decided that we're most likely not going to do fluids. It's a personal decision that you will have to make based on your cat's health and all that. There's a CRF Yahoo group that's amazing. When I get home, I'll post the link.

My Sven had a BUN of 57 at his last check-up (but creatinin with normal levels) , and has not started on sub-q's yet as he doesn't appear to be dehydrated when you do the skin testing (pull up on his skin and if it doesn't tent, then he's not dehydrated). We simply put him on K/D dry food and that's that (for now). Like StephanieTX, we probably won't do the Sub-Q's on him, because we know our cat, and just don't think he will want them.* We had another cat we did Sub-q's on, and he purred while he was getting them! Really, it kind of depends on your cat and how much she enjoys life, etc, as to how much you want to put them through, although I'm not sure that giving them Sub-q's is actually painful...I don't think it is.

* we also give him medication for arthritis and constipation via mouth twice a day through a syringe, and now he kind of moans each time we pick him up to give it to him, that's why I don't think he would want anything further, poor guy

if your Vet recommends it, then I would at least get the first one...can't hurt. Our Vet did not recommend it for our Sven...just said to keep it on the back burner for when he started showing signs of dehydration. My hubby was a nurse, so he knows the signs. BTW, our Sven is skin and bones, that was one of the signs of his kidney failure. He eats only dry too, and it's like pulling teeth to get him to eat anything, let alone the k/d. We cheat alot and feed him Temptations, not good, I know, but at least he sometimes will eat a handfull or so, and as I said, for us, it's quality vs quantity.

There are 4 stages of CRF ... stage 4 is where it is really not easy to manage...

My Rb Kandie was dealt with this way and through diet and some basic supplements she made it around 4.5 yrs ( she was near 15 at a stage 2 diagnosis

Here's the link for the Feline CRF Support group: http://pets.groups.yahoo.com/group/F...guid=353539644

We have managed Callie's condition for the past 4 years with diet. It's so important to keep them drinking, so we have water bowls and coffee mugs throughout the house. We have a water fountain as well, but we're not currently using it. She does receive Cosequin for arthritis and pumpkin for constipation/hard stools. Constipation is extremely common for CRF kitties and there are several good ways of treating it.

For any kitty, wet food is far better for them than dry. Dry food actually depletes the body of water, which contributes to constipation and a host of other issues, CRF included. Callie is a dry food junkie, but she gets 2 small servings of wet food daily. My 5 yo cat, Hannah, gets 2 wet servings a day, plus 1/8 C dry food (grain-free) daily. My newest kitty, Tumble is only 15 wks old, but he gets 4 wet food servings a day and access to dry whenever he wants it. As he gets older, we'll gradually wean him off of the dry and go straight wet with a little bit of dry.

Crashing, as I can understand it in my head, was, for example, when Boo lost weight suddenly, started drinking loads of water and peeing loads of water and just generally did not act himself. He was literal skin and bones, dropping from 12 pounds down to 7, and that is when we found out he had CRF and had "crashed" because his numbers were off the charts. We brought him back from that successfully though. I don't know how long he was in crash mode, because I was not the observant Momma I should've been. Sub-q's, IMO are very important as they help the body flush out toxins that the kidneys just aren't doing as well and they really are a must have in the later stages of CRF. That's just my two cents. Dehydration is a very real possibility with CRF and my Boo was severely dehydrated when he crashed. I learned about skin "turgor" (Pulling up on the skin at the back of the neck, like on the back of your hand) And if it stays standing up it indicates severe dehydration.

Boo's skin stuck up like a potato chip. It was so horrible. But it got better with Sub-q's.

I did my best to give Boo only the wet food as it had more moisture in it, and I didn't want him getting constipated, but he also got small helpings of Royal Canin Indoor Mature 27 and Iams Renal Formula (That was recalled a short time ago and I have tossed it in the garbage)

Good luck

IF you can get her to eat wet food, I agree with everyone else, that's the way to go. Sven will occasionally just lick the gravy off of wet food, but even that is rare. He won't even drink up tuna juice, although before his kidney disease, he used to do that. We had bought can after can of every brand and type (pate, shredded, chunks) and flavor of canned food, and tried to tempt Sven, to no avail. At one time, just to try to get some meat on his bones, I went back to dry Meow Mix, which was the only food he had ever eaten when we adopted him at 8 years old. He ate a little of that for a few days and that was that. We tried Wellness Core (before he was diagnose, but he was already losing weight, and that was a no go (probably a blessing in disquise).

Now he will occationally eat his k/d if I put it on the floor in front of him like it's a treat, but usually not. What I can usually get him to eat are Temptations treats (which say they are 100% nutritionally complete, and the Naturals have added vitamins and minerals), so right now every hour or so I give him a handfull of those, and he will usually eat them, as long as I sit right there with him and praise him and if he walks away, I pick them up and put them in front of him again. I try to trick up because I've put his k/d into a Temptations pouce and switch the handfuls between the actual Temptations and k/d, and sometimes mix the 2 together. Sometimes he'll eat the k/d, sometimes he won't. I guess he's on to me !

I think StephanieTX is doing something right, 'cause her Callie is in unbelieve shape for a CRf cat . When I saw pictures of her I could not believe she was CRF, she's not thin at all (at least not in the pictures). Heer's the link where she describes when and what she feeds her:

http://www.thecatsite.com/forums/sho...=219899&page=2

Just scroll thru to find her posts within this thread that is actually how to help one of my others cats LOSE weight!!

My cats are on a wet only diet. I have two CRFers, Cleo and Maggie. Lola has chronic UTIs and crystals in her urine.

All three girls eat Royal Canin Low Protein, and Hills k/d canned foods. I have a bag of Hills k/d dry, which is given as treats (approx. 1 tablespoon each) a couple of times a week.....believe me...the bag lasts forever!

Maggie's CRF is totally diet controlled. Cleo gets subQ fluids 2 or 3 times a week. She also gets Calcitriol, 24ng, every other day, to prevent secondary hyperparathyroidism.

If you'd like, I'd be happy to send you a can of each of the kidney foods to try. Just PM your address, and I will get them out to you.

I'd like to give you a bit of hope, even with the CRF diagnosis.

Cleo was diagnosed with CRF when my vet did pre-op blood work for her spay surgery. She was 6 months old. Cleo celebrated her 10th birthday on May 27. Maggie was diagnosed with early stage renal insufficiency when she was about 4 years old. Maggie turned 9 years old on May 2. Cleo started subQ's whe she was about 3 1/2, so she's been getting them for almost 7 years now.

My Callie eats SC k/d and she LOVES the dry. She won't touch the canned, but at this stage of the game, I don't push canned on her. I really just want her to eat! The canned I do give her is not enough to really equal a serving, just enough to disguise her meds and give her some nutrition. More important than WHAT you feed (other than it being a food that is easy on the kidneys) is that she eats. Keeping them eating is the key.

I just wanted to chime in and say that I'm yet another member who has administered sub-Q fluids in the past. It is normal to be worried, but you can do it! I also wanted to add that when I was doing it (this was about four years ago), the equipment did not strike me as expensive, at least not relative to other treatments I've paid for over the years. Good luck to you!

My vet advised me as she showed me how to do sub q s .. Always HAVE two people to do it .... she nor the tech would with their experience do a cat alone

Hi Keith-
I'm glad you'll be doing the sub-q fluids (hydration) - it's the single most important thing for a CRF kitty. The sooner you start, the better.

Once a week is a cinch - some folks do it every day.

A couple of tips:
1) Make sure to warm the fluids before you administer them. You can put the fluid bag right into a sink full of warm water. Many vets won't take the time to do this, but you should when giving fluid at home. To warm a full bag (1000mL), about 5 -10 minutes should be fine; it will take less time as you use up the bag. Always test the fluid before you give it by letting some run out of the needle onto your wrist.

2) Use a 20 gauge needle. Vets use an 18 gauge because it's a larger needle and the fluid comes out a bit more quickly, but a 20 gauge is finer and will be more comfortable for Jasmine. Always use a new needle each time you hydrate her.

The websites other members gave you are good ones. I referred to them plenty of times when I first started.

Jasmine's numbers aren't too bad right now. With regular hydration, they should go back into the normal range. BUN can change often, depending on what the cat has eaten. Creatinine is considered the more "important" number to watch. At the lab my vets use, a creatinine of 2.4 is high normal.

As other members have pointed out, diet is important, and wet is better than dry food. I'm not crazy about Hill's products - IMO it's inferior food at a premium price. Most vets recommend that food because they sell it. You want the highest quality food that you can buy. For my cat, Wellness (grain free) canned food worked best. She got California Natural dry food only as a treat, not for meals. We also gave her fresh roasted white meat chicken and turkey. Keeping weight on cats with kidney disease can be challenging. Don't force Jasmine to eat food she doesn't like.

Very important: please keep a very careful eye on Jasmine's blood pressure. High bp often accompanies kidney disease and can be deadly. Make sure you get regular blood pressure readings at the vet. If she does develop high bp, there are meds to control it.

Since Jasmine is hyperthyroid and the meds are causing appetite problems, you might want to look into I-131 treatment. It's expensive but in most cases it cures hyperthyroidism, eliminating the need for meds.

I did sub-q fluids for my Mickey for over 6 years. We started as soon as she was diagnosed. For the last 2 years of fluids we hydrated her 4 times per week. In addition to CRF, Mick had liver disease and IBS. I lost my beautiful Mickey this past December. She was 21. I have no doubt that hydration extended her life.

I hope you and Jasmine will have many more happy years together.

I would also suggest to administering the fluids in different spots. One between the shoulder blades and then maybe two other spots on either side of her body. Meaning split the fluid amount amongst those three spots.

Essentially sub q fluids should be administered more than once a week but most people cannot do it every day and their cat may not tolerate it. Vets suggest once weekly for the convenience of the owner. You can also try force feeding water or alternating these methods.

Using a smaller needle may be more comfortable for your cat. You can always wrap him up in a blanket like a burrito so he can't move around too much. Good luck!

I really love this website: http://weirdstuffwemake.com/weird/st.../catjuice.html

I can't belive that no one has posted it yet. It shows you step by step with pics. Just scroll down to "STEP TWO: ADMINISTERING THE FLUIDS."




Good luck, it sounds like you caught it early!

It's a good idea to try to vary the injection site. Just "south" of the shoulder blades is where it's safest, and most comfortable for the cat. You can do it in the center of this area, but must always be extremely careful to stay away from the spine. A little to the left or right of the center is fine too - the skin is usually loose enough to insert the needle comfortably. Unless you are giving a large amount of fluid (over 200mL) you want to avoid multiple needle sticks. My Mickey was getting 200mL and was fine with one injection site. The fluid will settle in different areas depending on the cat. I wouldn't suggest more than 2 injections per hydration session.

Sub q's are administered according to each individual cat's requirements. The frequency and amount of fluids will vary depending on the severity of the CRF. Some cats are fine for years with twice weekly administration, others require daily fluids, some even twice daily. I have never heard of a vet suggest just once weekly simply for the convenience of the owner. It would be like giving a med whenever the owner could get around to it. Likes meds, hydration is effective only if you stick to the prescribed schedule. It takes commitment - the cat's health depends on it.

For most CRF kitties, "force feeding" water isn't necessary or desirable. The majority of these cats drink quite frequently. A CRF cat can never drink enough water on her own to hydrate the kidneys. That's why sub q fluid is so important.