My cat has kidney disease, but I don't understand what to expect...

Hi all,

I am new to this site, so apologies if this is in the wrong place, or is simply duplicating existing posts.

My beautiful boy cat Leroy was diagnosed with signs of kidney disease a couple of weeks ago, but I'm not sure what this means. I have read everything there is to read about Chronic Renal Failure and feline kidney disease, but it still isn't really telling me what I want to know... if that makes sense.

It's funny because his symptoms weren't pointing towards kidney issues at all... he wasn't being sick (any more than any other cat at least), not drinking loads, hadn't lost his appetite etc... in fact it was the opposite - he was ravenous! Traditionally Leroy has been a pretty picky eater - grazing now and again rather than wanting proper meals. In recent months he has got hungrier and hungrier to the point he has started scavenging, ripping into bins, vocalising etc. He seemed ok in himself, just hungry.

Because of that, I thought it was probably an issue with his thyroid or something, but following a full blood screening, the only thing to show up was kidney disease :*o(

FIRST QUESTION: I was told that he showed a kidney score of 242 - but I'm not sure what this refers to... apparently under 200 is fine, 200-400 is showing kidney disease but it may be managed by injections/diet etc, and over 400 is very serious - everything I have read online refers to BUN and Creatinine scores, but these are much lower numbers...?! What does 242 mean??

Within a couple of days of having the blood test the vet had given me some testers of the dry Royal Canin renal food. I started him off on it and he ate it without too many complaints.

Since then, he has been very unhappy - which you could put down to having kidney disease, but it seems more like the renal food is making him poorly and as a consequence he is quiet, losing his shiny coat etc. He was ok until I started treating him like a cat with kidney failure... maybe he knows!! (

He is sick most days (pale yellow like smooth polenta or similar), there are always runny yellow/neon poos in his litter tray, he has got more clingy and generally just seems 'sadder'.

He has had a couple of occasions where he has refused food/drink altogether, and sat in the corner of the room looking uncomfortable and poorly (frothy around his mouth as if he wants to be sick).

This morning he scoffed down his breakfast, then threw it all back up about 10 minutes later. He has done this a few times, but generally he is sick before we feed him in the mornings - not immediately after a feed.

I do sometimes wonder if it is all a mistake - he doesn't have kidney disease and we are trying to treat him for something he doesn't have and therefore making him feel rubbish. He is due to go back to the vets in 3-4 weeks time for a second lot of blood work to look at whether his 242 score has increased/decreased or stayed the same... this, I am told, will give us a better idea what we are dealing with.

Now - HERE'S MY NEXT QUESTION - do you think this "score" (whatever it stands for) is definitive kidney disease? Are there other conditions that could present as this on a blood test? 
 

I just don't know whether to keep him going on the renal food, knowing he is feeling a bit crap as a consequence - or just put him back on his Whiskas senior pouches which he loved. He still has an appetite - mostly - and will eat the renal food; it's just obviously not agreeing with him.

I love this little boy cat more than words can say and I cannot bear the thought of making him feel ill unnecessarily... or making him worse without realising it! 

MY LAST QUESTION FOR THOSE WITH EXPERIENCE OF CRF:

I guess at some point I do need to think about the worse case scenario here - if it is indeed kidney disease, how should I expect it to go...? I have been told there is no prognosis as far as time is concerned, but whether it's in a month or four years - what should I look out for? How does it all end? I know it's a horrible topic, but I want to be prepared for how it is likely to affect him and know what I need to look out for so I know when is "the time".

Thanks all xx

Hi and welcome to TCS. Sorry to hear that Leroy is sick. First of all, I would ask your vet for a copy of all tests. It is always good to have those on hand for various reasons (another vet, emergency vet, tracking the numbers, etc.). I don't know which number your vet is referring to. Also, different labs have different reference ranges, so the full test numbers are needed. The best site I know of for CRF is www.felinecrf.org. There's a page that helps you interpret test numbers. There are pages that address your other questions as well.

Where are you located? That seems to make a difference in terms of how kidney disease is treated by vets.

One other thing, was a urinalysis done? Cats with kidney disease usually have very dilute urine. But it seems like he hasn't been drinking or peeing more than usual? These are usually signs of chronic kidney disease. I suppose it's possible for him to have the acute version, although I do agree that his symptoms before testing seem more like a hyperthyroid issue. I really think you need the full test results and possibly a second opinion.

Hiya, thanks for your reply.

I'm located in the Midlands, United Kingdom. Is this site mostly British or American? Didn't think to check... cats are universal!

I will ask my vet for the results just to be sure. Good idea.

I wasn't asked to do a urine sample so I'm assuming urinalysis wasn't done... apparently the 'all singing all dancing' blood work looked at everything without requiring a urine test.

Poor Leroy having a rubbish day today... all his breakfast came back up this morning, now he's refusing his dinner. He's clearly very unimpressed with this new regime

Hi Ghostsgirl, there are a few of us Brits on this site, I'm in Shropshire. The people in the know on here are very helpful and knowledgable and I'm sure you will get some good advice from the site. I've only been on here since the 14th April but everybody seems to care and give each other support and tips when required. How old is Leroy? I hope he soon gets better.

ghostsgirl said:

I will ask my vet for the results just to be sure. Good idea.

I wasn't asked to do a urine sample so I'm assuming urinalysis wasn't done... apparently the 'all singing all dancing' blood work looked at everything without requiring a urine test.
 

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Could you post his BUN and creatinine numbers and ranges here? I can't believe a urinalysis wasn't done if kidney problems were suspected. I really think you need a second opinion.

The diet that is usually recommended for affected cats is low in phosphorus and rich in high-quality proteins. I don't think dry foods fit that bill. 

mamabirdy said:

Hi Ghostsgirl, there are a few of us Brits on this site, I'm in Shropshire. The people in the know on here are very helpful and knowledgable and I'm sure you will get some good advice from the site. I've only been on here since the 14th April but everybody seems to care and give each other support and tips when required. How old is Leroy? I hope he soon gets better.

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Hiya Mamabirdy, thanks for your note Leroy is 11, nearly 12... not very young, but also not super old Really hoping that I can get to the bottom of all of this. x

vball91 said:

Could you post his BUN and creatinine numbers and ranges here? I can't believe a urinalysis wasn't done if kidney problems were suspected. I really think you need a second opinion.

The diet that is usually recommended for affected cats is low in phosphorus and rich in high-quality proteins. I don't think dry foods fit that bill. 

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Hi vball91

I don't have those values - all I know is that he was showing a score of 242, but I don't know what this was measuring I am going to call the vets tomorrow and ask for a full breakdown of his results... maybe this will have BUN and creatinine numbers included. Hopefully.

I specifically asked about whether they needed a urine sample and I was assured they didn't as the blood test would look at everything (it was a hefty comprehensive blood test costing nearly $200)... they weren't looking for kidney issues when they tested him, they suspected hyperthyroidism or diabetes initially... maybe that's why the didn't run urinalysis in hindsight.

x

ghostsgirl said:

Hi vball91

I don't have those values - all I know is that he was showing a score of 242, but I don't know what this was measuring I am going to call the vets tomorrow and ask for a full breakdown of his results... maybe this will have BUN and creatinine numbers included. Hopefully.

I specifically asked about whether they needed a urine sample and I was assured they didn't as the blood test would look at everything (it was a hefty comprehensive blood test costing nearly $200)... they weren't looking for kidney issues when they tested him, they suspected hyperthyroidism or diabetes initially... maybe that's why the didn't run urinalysis in hindsight.

x

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Oh, and food wise, I was offered the wet version of the renal food but it was twice the cost of the dry food and I simply cannot afford about $100 per month in food for one cat. I wish I could  

Instead he has the dry biscuits, but I mix with water to help him take in maximum fluids... this is what he has been given:

http://www.royalcanin.co.uk/products/products/vet-products/feline-veterinary-diets/renal-dry

x

ghostsgirl said:

Oh, and food wise, I was offered the wet version of the renal food but it was twice the cost of the dry food and I simply cannot afford about $100 per month in food for one cat. I wish I could  

Instead he has the dry biscuits, but I mix with water to help him take in maximum fluids... this is what he has been given:

http://www.royalcanin.co.uk/products/products/vet-products/feline-veterinary-diets/renal-dry

x

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This is a great overall site for CRF kitties. http://www.felinecrf.org/diet_and_nutrition.htm  The page I am directing you to has some alternatives to prescription renal foods available in the UK.

vball91 said:

ghostsgirl said:

I will ask my vet for the results just to be sure. Good idea.

I wasn't asked to do a urine sample so I'm assuming urinalysis wasn't done... apparently the 'all singing all dancing' blood work looked at everything without requiring a urine test.
 

Click to expand...

Could you post his BUN and creatinine numbers and ranges here? I can't believe a urinalysis wasn't done if kidney problems were suspected. I really think you need a second opinion.

The diet that is usually recommended for affected cats is low in phosphorus and rich in high-quality proteins. I don't think dry foods fit that bill. 

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No, no, Vball, the old diet for kidney cats (the ones many Vets still go by, is NOT really good protein, and it does come in a kibble form, since so many cats eat kibble,  It comes in canned too, but is very unpalatable.  Plus, it isn't common to do a urinalysis, simply because unless they suspect kidney disease BEFORE they run the bloodwork, why would they do it?  The cats are back home when they get the results of the test, so it would require them to come back in to the office.  Same exact thing happened with my Callie, so we didn't get a urinalysis done with her either

Ghostgirl, I had a cat with kidney disease for 3 years and I have absolutely NO IDEA what that 242 figure is!!  None.  Strange, huh?  Bun and Creatinine is what was important for us to know.  Maybe things have changed since we lost our old guy, but now our Callie was recently diagnosed with higher than normal BUN and Crea, and that's still what our Vet is using.

Anyway, as far as your guy getting sick and having very loose stools, has anything changed other than the food?  Are you giving him any meds or anything?  If nothing else has changed, I would go back to the old food.  (was he on canned food before or did you need to slowly introduce this new food)   Check out that link directly above my post to the nutrition page of felinecrf.org and see all the foods there.  What you are really looking for is just foods that are lower in phosphorus.  What I did was compare the prescription renal foods to over the counter foods to find comparable phos and tried those.  Who knows,  your old food might be in there.   If you fed canned before, maybe add some water to it to give him more. 

The most important thing you can do is make sure he doesn't lose weight, because that is generally what happens.  And mainly they lose muscle mass, and I, personally, think that happens because they get put on these diets that reduces protein!  My Sven went down from 12 lbs to 6 lbs.  But what also happens is they get sick to their stomachs a lot, and might need Pepcid A/C to help with that, plus at some point need to receive fluids under their skin (usually at home).  It's really an easy process, just seems intimidating at first.  We didn't have to do that for Sven until the last year.  But, before panicking, let's see those lab report figures AND get him off that food that obviously doesn't agree with him.  (BTW, there are other kidney foods he could try, if you want.  They are also listed on that website)

mrsgreenjeens said:

No, no, Vball, the old diet for kidney cats (the ones many Vets still go by, is NOT really good protein, and it does come in a kibble form, since so many cats eat kibble,  It comes in canned too, but is very unpalatable.  Plus, it isn't common to do a urinalysis, simply because unless they suspect kidney disease BEFORE they run the bloodwork, why would they do it?  The cats are back home when they get the results of the test, so it would require them to come back in to the office.  Same exact thing happened with my Callie, so we didn't get a urinalysis done with her either

Ghostgirl, I had a cat with kidney disease for 3 years and I have absolutely NO IDEA what that 242 figure is!!  None.  Strange, huh?  Bun and Creatinine is what was important for us to know.  Maybe things have changed since we lost our old guy, but now our Callie was recently diagnosed with higher than normal BUN and Crea, and that's still what our Vet is using.

Anyway, as far as your guy getting sick and having very loose stools, has anything changed other than the food?  Are you giving him any meds or anything?  If nothing else has changed, I would go back to the old food.  (was he on canned food before or did you need to slowly introduce this new food)   Check out that link directly above my post to the nutrition page of felinecrf.org and see all the foods there.  What you are really looking for is just foods that are lower in phosphorus.  What I did was compare the prescription renal foods to over the counter foods to find comparable phos and tried those.  Who knows,  your old food might be in there.   If you fed canned before, maybe add some water to it to give him more. 

The most important thing you can do is make sure he doesn't lose weight, because that is generally what happens.  And mainly they lose muscle mass, and I, personally, think that happens because they get put on these diets that reduces protein!  My Sven went down from 12 lbs to 6 lbs.  But what also happens is they get sick to their stomachs a lot, and might need Pepcid A/C to help with that, plus at some point need to receive fluids under their skin (usually at home).  It's really an easy process, just seems intimidating at first.  We didn't have to do that for Sven until the last year.  But, before panicking, let's see those lab report figures

AND get him off that food that obviously doesn't agree with him.  (BTW, there are other kidney foods he could try, if you want.  They are also listed on that website)

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Hiya! Thank you so much for your thoughtful and informative reply.

I took your advice and rang my vet. His numbers are BUN 24.9, and creatinine 242 (apparently, although this doesn't look like a normal creatinine score does it?). I have searched this 242 figure, and it looks like it is from the IRIS system, indicating Stage 2 kidney disease...?

Other than that the nurse said the results showed that he had high cholesterol, low blood sugar (although he hadn't eaten for about 8 hours when he had blood taken), and his T4 result for his thyroid was 'low'.

I have tried reverting Leroy to his old food (wet food: chunks in jelly), but he's just taken to licking the jelly off and leaving the chunks - which is annoying! The only thing he is eating without complaint are kitten biscuits - but I am not encouraging this and I am sure they are very rich and tough on his poor kidneys. I will keep trying. I will feel much happier when he goes a couple of days without having an upset tummy/being sick.. then I will think a bit clearer about how to treat him.

x

How's Leroy doing? Hope he has improved?

Ae those kitten bisquits treats, or actual food?  If food, are they listed on the list on that website?  It's possible they aren't too bad, because extra fat is actually good for kidney cats, and kitten food is usually higher in fat.

I wonder why Leroy isn't eating his regular food anymore?  Have you tried mushing up the chunks with a fork or even blending it a in a blender so it's ALL gravy?  Maybe he's developed mouth ulcers or something?  Does he appear to be sick to his stomach?  (licking his lips quite a bit?)  Or is he throwing up froth?  It seems awfully strange that so quickly he's stopped wanting to eat when before his Vet visit he was just fine in that department .

So are you giving him anything for his low thyroid numbers? 

(BTW, sorry, I completely forgot about the european scores...yes, crea of 242 now makes sense!  But usually they always give you TWO numbers, as you have now...the BUN & Crea)