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Kidney Disease

post #1 of 66
Thread Starter 

A couple months ago, we noticed that my 12 yr old female cat was throwing up excessively, nearly every day.  When we took her to the vet, they did blood work, and found that her kidney function was low.  The vet noted that the values were not horrible, but that Cookie needed to start eating a special kidney disease wet food diet.  Since the food switch Cookie has been tremendously better. She no longer throws up, and she perked up a little bit.  We are due to take her back in to check her blood again, but I was wondering what the prognosis is for cats with kidney disease typically? I know it can vary a lot, and once the cats have symptoms, their kidney function is usually significantly decreased, but is it possible for her to live 2-3 more years?  Also, what do you think about feeding cats dry food in the first place? I am inclined to think that the dry is what led to her kidney disease in the first place, since cats naturally would be eating a diet high in moisture.  I want to prevent this from happening to my 5 yr old kitty if I can. 

post #2 of 66

Unfortunately, there is only one prognosis to kidney disease. It cannot be cured or reversed. CRF is the most common medical cause of death in cats. However, some cats live several years with CRF and others get worse quickly, so it is impossible to predict how much longer Cookie will live. If Cookie is not suffering in a way that cannot be controlled with the kidney-friendly diet, lots of water, and medication, you don't need to worry about euthanasia. She will let you know when it is time to cross the Rainbow Bridge and that could be years from now. At this point, you should concentrate on slowing it down by continuing to only feed the k/d (but please switch to wet if you have not done so already) and giving her sub-q fluids if they are recommended later.

post #3 of 66

Cats with CRF can live for years.  There are many on here with better advice.

 

holisticat is a good web site for more info as is felinecrf.org

 

I would not recommend the in-hospital iv infusion if offered by your vet.  This did not work for my kitty who was doing well with in-home sub-q fluids.  In-hospital was too much fluid at once and she could not handle it.

 

Hydration is very important, even if done with a syringe.  Keep fresh water out in many rooms your cat visits, a fountain is good for some kitties.
 

post #4 of 66

tjcarst--i bought a large cage and just in case if needed set it up on a table next to my bed. bought Iv solutions, needles, etc.

started him on the science diet kd wet food, science diet kd dry food and epakitin nutritional supplement and nefrotec tablets.

  his creatinine levels went from 2.75 to 2.0 in less than a week and the BUN went into range (upper limit, however)

  i have a fountain and also put water in 3 other places. and, yes, using a syringe i am giving him water. if i didn't know

better i'd swear you're living in my home. hahahaha. if it wasn't for the third eyelids still protruding, i'd feel better. i ahve

to believe all is not well until the third eyelids go back to where they belong.

  by the way i saw a site that claims a pill called renavast does wonders with feline liver failure. anyone here have any

testimonials????
 

post #5 of 66

Why a cage?  When I did at home sub-q, it took less than 5 mins.  Does your cat try to get away while you do the sub-q?

 

Your cats creatinine and BUN do not seem awfully high.  I would have to guess something else is causing the third eyelid to show.

 

There has been much debate on whether the k/d special diets actually work or do more harm.  I was of the mindset that any food was better than none, but my cat had refused to eat by the time she was diagnosed.  My kitty had creatinine of 6.2 mg/dl (0.3-1.4 normal) and urea nitrogen of 100 mg/dl (7-25 normal).  My cat's third eyelids did not show even though she was very sick, but maybe each cat shows different symptoms?  Sorry not too helpful here.

 

You caught it early, so you may want to ask advice from those who are more knowledgeable about the diet for CRF kitties.

post #6 of 66

My kitty lived for 5 years after being diagnosed with CRF.  We didn't do fluids (our personal decision not to do anything heroic), but put her on prescription food, meds, and monitored her BUN & Creatinine levels every 6 mos.  There are good days and not so good days.  Unfortunately, you can only prolong life, not reverse the damage done to the kidneys.  My girl LOVED dry food and it was a chore to get her to eat wet food, but we did get her to eat enough to get her meds in her.  I am a firm believer in dry food contributing to CRF, and have since put my kitties on a mostly wet food diet.

post #7 of 66
Quote:

Originally Posted by daddyincr View Post

 

...  by the way i saw a site that claims a pill called renavast does wonders with feline liver failure. anyone here have any testimonials????

 

From a very well-respected site, endorsed by The American Association of Feline Practitioners:

Quote:

RenAvast is marketed as a dietary supplement. Dietary supplements do not need US Food and Drug Administration approval but the manufacturers make the bold claims that RenAvast "can halt the progression of chronic renal failure in cats" and that "unlike other products and drugs, RenAvast does not treat the symptoms of renal failure, it treats the cause." The FDA states that "a product sold as a dietary supplement and promoted on its label or in labeling as a treatment, prevention or cure for a specific disease or condition would be considered an unapproved - and thus illegal - drug."

 

...currently there is no evidence that RenAvast is the miracle cure it claims to be.....Based on the information currently available, I would save my money  and put it towards more proven treatments than RenAvast.

 

 

http://www.felinecrf.org/holistic_treatments.htm#renavast

post #8 of 66

I'm sorry you and your kitty have this diagnosis, but as others have said, yes, she may live with this for several years (I've heard of some kitties going another 10! though that has not been my experience with my crf kitties).  My best suggestion because it is so full of links and experiences of others here, is to go to this sticky thread: http://www.thecatsite.com/t/119727/crf-chronic-renal-failure-links-and-experiences-with


My Lyra is dealing with early crf (but with worse numbers than your kitty), and we are treating her with Calcitriol, something I've used with all my CRF kitties over the years.  It works well for my kitties.

Best wishes for your kitty to have good years to come.

post #9 of 66
Quote:
Originally Posted by tjcarst View Post

 

There has been much debate on whether the k/d special diets actually work or do more harm.

 

You caught it early, so you may want to ask advice from those who are more knowledgeable about the diet for CRF kitties.

 

The debate goes like this: Some vets say because protein is hard on the kidneys CRF cats need a low protein diet. Other vets say it is not the amount of protein, but the quality, that matters. Then there are vets who say all they need is low phosphorus, which is high in meat. This is all for early stage CRF. Near the end the kidney failure is so severe no diet can help and all you want to do is make sure the cat eats something. I read about this last fall, so that is current information.

 

Why is there such a thing as dry k/d? CRF dehydrates cats, so increased water intake is extremely important. In fact dehydration causes their weight loss more than not eating very much. It is more important for cats with CRF than healthy cats to only eat wet food because of this even if you give it sub-q fluids at home.

post #10 of 66
Quote:
Originally Posted by EmilyMayWilcha View Post

 

The debate goes like this: Some vets say because protein is hard on the kidneys CRF cats need a low protein diet. Other vets say it is not the amount of protein, but the quality, that matters. Then there are vets who say all they need is low phosphorus, which is high in meat. This is all for early stage CRF. Near the end the kidney failure is so severe no diet can help and all you want to do is make sure the cat eats something. I read about this last fall, so that is current information.

 

Why is there such a thing as dry k/d? CRF dehydrates cats, so increased water intake is extremely important. In fact dehydration causes their weight loss more than not eating very much. It is more important for cats with CRF than healthy cats to only eat wet food because of this even if you give it sub-q fluids at home.

Thank you, Emily.

 

My cat would only eat dry kibble her entire life.  By the time we found out she had advanced CRF, it was more important to just get her to eat, sadly.

post #11 of 66
Quote:
Originally Posted by tjcarst View Post

Thank you, Emily.

 

My cat would only eat dry kibble her entire life.  By the time we found out she had advanced CRF, it was more important to just get her to eat, sadly.

Emily was like that too, but by the time she was diagnosed it was too late to do anything and I had no choice but to end her suffering that day. There are so many causes of anorexia, weight loss, and dehydration, nobody considered it could be her kidneys.

 

I am glad the OP's cat was diagnosed early, when she can still do something to slow down its pregression.

post #12 of 66

My CRF cat lived for 3 years after diagnosis.  He was about 13 at the time of his diagnosis, and had been on dry kibble his entire life.  He did not like any of the kidney diets, so we just fed him anything he would eat.  NOW we have switched all our remaining cats to a raw diet, because I truly believe it was the kibble diet that caused the kidney failure in the first place.

post #13 of 66

My 19 yr old cat, Aztec, has had renal insufficiency for over 2 years now. He gets various supplements depending on his needs at the time (currently B12 injections, probiotics, and a nutraceutical from Italy with a phosphorus binder and potassium supplement). I think prescription kidney diets are more harmful than beneficial to cats so Aztec eats 50% raw, 50% good quality canned. 

post #14 of 66
Quote:
Originally Posted by mrsgreenjeens View Post

My CRF cat lived for 3 years after diagnosis. He was about 13 at the time of his diagnosis, and had been on dry kibble his entire life. He did not like any of the kidney diets, so we just fed him anything he would eat. NOW we have switched all our remaining cats to a raw diet, because I truly believe it was the kibble diet that caused the kidney failure in the first place.

KIbbles do cause CRF and I also believe they did it to Emily, who would not even sniff wet food. Other posters told me if I was smart and only gave her wet food in 1994, she would have loved it all 12 years. That looks too good to be true, but I feel guilty anyway. rbheart.gif

 

Consider yourself very lucky to have that cat three years after diagnosis. When Wilbur was diagnosed, his vets believed he would live several more years. Instead, his kidneys failed so rapidly he received hospice care for two weeks that involved eating treats on the couch. I will never know how old he was, but he was definitely in the double digits.

post #15 of 66
Quote:
Originally Posted by tjcarst View Post

Why a cage?  When I did at home sub-q, it took less than 5 mins.  Does your cat try to get away while you do the sub-q?

 

Your cats creatinine and BUN do not seem awfully high.  I would have to guess something else is causing the third eyelid to show.

 

There has been much debate on whether the k/d special diets actually work or do more harm.  I was of the mindset that any food was better than none, but my cat had refused to eat by the time she was diagnosed.  My kitty had creatinine of 6.2 mg/dl (0.3-1.4 normal) and urea nitrogen of 100 mg/dl (7-25 normal).  My cat's third eyelids did not show even though she was very sick, but maybe each cat shows different symptoms?  Sorry not too helpful here.

 

You caught it early, so you may want to ask advice from those who are more knowledgeable about the diet for CRF kitties.


first of all remember i'm in costa rica---******* torture. the vets, the medicines, nothing is up to the standards of the states. anyway, my vet said she wanted to put darwin on IV liquids

from 4 days to possibly a month depending on blood results.  do you mean go on a sort of " out patient " regiment. give him the IV bag and when it's done pull out the needle, and repeat

the next day, etc??? of course this would "free" him which i'd prefer---as long as it didn't stress him too much. believe me i feel perhaps i exaggerate his discomfort. i look at his third eyelid

and tears come to my ears, he hates pills but, twice a day he gets a pill, and i almost look for an excuse to pass---i just hate to give him one uncomfortable moment.

the vet said the science diet KD formula as that targets kidney malfunction. i would think there's no other food in this country that has a medicinal benefit. feel free to recommend

something and i'll ask the pet store to order special.

 

thanks everyone for your input. funny thing is if i go to internet and check kidney malfunction symptoms, darwin has absolutely NONE of them. if it wasn't for the protruding

third eyelids i wouldn't know anything. it was this that caused the vet to take blood samples.

post #16 of 66
One of my family's first cats was diagnosed with CRF when she was 16. . .no "treatment" except switching her to canned Fancy Feast, and she lived another 5 years. Hydration is very important.

Yes, if fluids are given it shouldn't take all day. Just inject the proper amount and he can go on his way. Some kitties fight it but some are very good about sitting still. Treats help biggrin.gif.
post #17 of 66

Hill's might be the only company to make a prescription diet for CRF, but that is not necessary if you have high quality protein, low phosphorus, and a lot of water. Weruva seems to fit those requirements so I would get that (look for Paw Lickin' Chicken and Nine Liver, which is also chicken). It is available on several pet supplies websites and you can buy a case of 24 on Amazon if your cat likes it.

post #18 of 66
Quote:
Originally Posted by EmilyMayWilcha View Post

Hill's might be the only company to make a prescription diet for CRF,

 

 

Pretty much all the big pet food companies have cashed in on the renal diet trend, so it's not just Hill's making them anymore (although they were the first).

post #19 of 66
Medi-cal makes Reduced Protein and Iams makes Multistage renal. The latter in the canned form looks like diarrhea and my crf cat will not touch it. My cat was diagnosed 3 years ago. He is in stage three (Iris) but is doing well. Subq fluids daily, all canned diet, a phosphorus binder started recently. But I think i have been yucky with Schweppie in that he hasn't had any major uremic crises. Knock on wood!

I get the rx foods and understand they have their place, but sometimes I wonder if the research is done to rationalize the food or vice versa? Like Emily said, why dies a dry k/d exist when it goes against one of the main principles in dealing with crf. another example is Hills' Healthy Advantage diet for cats wherech is not rx bit doesn't come in cannedbeven when all their research says cats need Hydration from their food. Although I see why they exist, I always researchmy options before resigning to feed an rx diet.

You may find that your cat doesn't always have an appetite and this happens because the foods with lower protein don't taste as good as higher protein foods. So you may have to rotate foods like I do because even if the food isn't appropriate for a crf cat, your cat must eat! I would look for a food with moderate to high protein, lower phosphorus or use a phosphorus binder and encourage drinking by getting a water fountain or adding water to the food. Give omega 3 fatty acids, probiotics. Ask your vet what he or she thinks about benazapril or calcitriol. Some dvms believe in starting these right away. With benazapril, it has been shown to increase the glomular filtration rate in the kidneys which helps rid the kidneys of wastes. Im not too clear on calcitriol but it's worth looking into. You have to get your cat's ionized calcium tested to see what dose of calcitriol will suit your cat. And expect to do Bloodwork, urinalysis, culture and sensitivity testing , urine-protein-Creatinine ratio and blood pressure checks regularly, usually every three months or so.

There are a number of supplements out there. One of them is Azodyl. I was giving this to Schweppie but stooped because while it may reduce the urea and Creatinine, these are only two of the things that contribute to kidney failure and are used as markers in Bloodwork. There are other nutrients or waste products to be concerned about and I didn't want a false sense of security due to the BUN and Creatinine being low.

Good luck keep checking in as many here are very knowledgeable and experienced.
post #20 of 66

what's really strange is that my son, darwin, actually doesn't exhibit any of the symptoms one can pick up surfing the internet.

post #21 of 66

The progress of PKD in people is quite variable.  A friend of my father's lost his wife when she was in either her very late 70s or (more likely) her 80s.  She knew she had PKD for quite some time, but it was only in her last few years it caused her problems and she had to start dialysis, which lead to other problems.

 

I suspect it's equally variable in cats.  When the FAB started their ultrasound screening program (before the gene test was available) some cats still slipped through as when they were scanned they have very, very tiny cysts or no cysts. 

 

http://www.fabcats.org/breeders/infosheets/pkd/pkd_scheme.php

http://www.fabcats.org/breeders/infosheets/pkd/pkd.html

 

However I suspect most cats that have kidney failure don't have PKD.

post #22 of 66

is it possible for a cat to have a creatinine level of 2.5 and not show any outward problematic symptoms?

eating and drinking normal. urine and feces normall. no vomiting, no diarhea. playing normally with his "sister."

i don't get it! meanwhile some sites say 2.4 is at the maximum range and others say 1.8 and others even less.

what is the normal creatinine level???

post #23 of 66

Did you get a printout from the vet's office?  If so, it should have the range on it of what's normal and all that.  On paperwork that I've gotten, it says that 0.8-2.3 is normal.  If your kitty's creat is 2.5 most likely you won't see many symptoms, but it does need to be monitored.
 

post #24 of 66

they don't do that in costa rica. i checked out different sites and have had bllod test results from different labs and each

and every source has a different range. torture. looks like myn son will be caged - in my bedroom--i bought the biggest cage i could fine--

and put on iv's for 4 days. too much stress for cat to put in and take out iv on daily basis. this f'in sucks

post #25 of 66

Each lab has its own range of what's considered "normal". 
 

post #26 of 66
Quote:
Originally Posted by daddyincr View Post

they don't do that in costa rica. i checked out different sites and have had bllod test results from different labs and each

and every source has a different range. torture. looks like myn son will be caged - in my bedroom--i bought the biggest cage i could fine--

and put on iv's for 4 days. too much stress for cat to put in and take out iv on daily basis. this f'in sucks

 

Is it that the results are in Spanish, not in English, and you don't speak/read Spanish?

 

You are going to administer the IV? How will you do this? Most kitties with CRF/CKD are given sub-Q fluids once per day, not continuous fluids. Sub-Q fluids are not the same as IV fluids.

post #27 of 66
Quote:
Originally Posted by stephanietx View Post

Each lab has its own range of what's considered "normal". 
 


you're right!!! i just discovered that this morning

post #28 of 66

I would not do IV fluids for days.  If your cat has "crashed" (creatine 3-4) is when IV fluids are used as rescue, not as maintenance.

 

Lactated Ringers given 50-100 ml each day is about the most I would give subcutaneously.  This is not a one time fix, this is a daily or every other day necessity.

 

The actual process should only take 2-5 minutes.  If it is takiong longer, you need to figure out why.

 

http://www.felinecrf.org/subcutaneous_fluids_tips.htm

post #29 of 66

as if you can't tell, i'm in love with both my cats, but, here i'm speaking of my 2 year old male, darwin.

just had the creatinine level checked  at two separate labs. one result was 2.4 and one 2.5.

to say i'm sad is an understatement.

we're looking at sodium chloride and ringer lactated.

my vet believes inserting the iv and taking it out on a daily basis would be more stressful

for the cat then caging him, giving him the fluids, watching him closely.

i only want wants less stressful and more healthy for my "son"

just not sure which is best
 

post #30 of 66
Quote:
Originally Posted by daddyincr View Post

as if you can't tell, i'm in love with both my cats, but, here i'm speaking of my 2 year old male, darwin. just had the creatinine level checked  at two separate labs. one result was 2.4 and one 2.5. to say i'm sad is an understatement. we're looking at sodium chloride and ringer lactated. my vet believes inserting the iv and taking it out on a daily basis would be more stressful for the cat then caging him, giving him the fluids, watching him closely. i only want wants less stressful and more healthy for my "son" just not sure which is best
 


Aw...alright.gif don't feel sad, hon. You've come to a great site to give you a helping hand! For what it's worth, a Creatinine of 2.4/2.5 is not terribly high if the lab reference range is .6 - 2.4. It would be at the high end of normal if that is the reference range used by the lab. I'm just guessing as to the lab reference range. At other labs the 2.4/2.5 would be considered high, but not in the end stage of renal failure, more like the second stage of CRF. That is why it is vital to have these for the specific lab used.

 

So...that brings me to my next questions:

 

Besides his Creatinine, what was his BUN (blood urea nitrogen), Specific Gravity (urine), Ca (calcium), P (phosphorus), K (potassium), Na (sodium), and any other values you can get out of your vet. He should furnish these records--just request them and don't quit requesting them until the vet gives them to you.

 

Oh man, that is just absurd thinking on your vet's part about the fluids. You won't be doing a long drawn out process (around 5 minutes to administer the fluids!), you will do sub-Q fluids where the needle is inserted under the skin, not IV drip where it needs to be in a vein. It would be more stressful to have Darwin hooked up to a needle, etc. in a small cage for days on end when all he needs is a small amount of fluid (50-75mL) given once a day or every other day. Plus, how the heck would the needle stay in for that extended amount of time--my kitties would be bouncing off the walls of any cage! Honestly, I think you need to find a different vet. Your vet sounds utterly clueless when it comes to giving CRF kitties sub-Q fluids.

 

You need "ringer lactated" (Lactated Ringers Solution [LRS]), not sodium chloride because sodium chloride burns. Here's a link to different common sub-Q fluids. You want LRS because for one thing, that is closer in pH to what a kitty's body pH is. The sodium one, besides burning, has a very low pH--which you don't want.

 

Here's a video on how to administer sub-Q fluids demonstrated by a vet (one thing I should mention that he didn't is that you should always use a NEW sterile needle each time--never re-use a needle):

 

 

That being said, if you can add extra water to Darwin's food (and daily keep track of how much--you would have a log of how much for every day and how much each time by the end of that day) and/or use a dropper or needle-less syringe and syringe water by mouth (again, keep track of how much), you may not need to do the sub-Q fluids. You could aim for 5-10mL (cc's) per pound of Darwin's weight per day. Just add to his food and/or dropper/syringe by mouth that amount per day. Say he weighs 10 pounds, if you did 5mL per pound that would be 50mL per day. If doing 10mL it would be 100mL per day. You just spread it out the daily amount by adding to his food and by mouth with the syringe. Hope that made sense. If not, let me know and I'll try to explain it better.

 

I've got to say that my Tuffy hated getting sub-Q fluids, so on those days when he wasn't cooperating, I mixed extra water into his canned food, and if that wasn't enough I syringed water at the back side (between his back teeth on one side) of his mouth in small amounts--if I was going to give him 20mL/cc's I would do about 5mL at a time to make sure he didn't choke. I ended up doing it this way 90% of the time because it just wasn't worth the battle and stress that took place for my little guy giving sub-Q's.

 

Hang in there, sweetie, we're here to help! rub.gif

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