Valium for a cat with kidney failure

Hey,

I'm Atahska from India.
I have a nine year old cat with a chronic kidney problem. He was diagnosed with it a year back, and his values have consistently worsened despite treatment. His creatinine level is now 10.91. His sodium and phosphorous levels are also very high. He is on daily sub cutaneous fluids- NS and 5D. He had been eating a little till a couple of days ago but now has completely lost his appetite and will not eat even his favourite foods despite much coaxing. Though he seems interested in food, comes to it, sniffs it, looks at it, he doesn't get round to eating. I have force fed him a couple of times as he must not go hungry but he resists and starts meowing loudly and backs off. The vet has suggested he be given 1/4th of a 2mg diazepam tablet daily as that might induce him to eat.

I am not sure how safe diazepam (Valium) is and what side effects it may have. He already is very passive and unresponsive and prefers sitting alone in unused corners of the house and backyard. I wonder whether the sedative effects of diazepam will make him worse. He has also lost a lot of weight. Should I give him Valium? Is it safe and will it really increase his appetite?

Another doubt I had was whether egg whites are good food for a cat with kidney problems.

Please reply soon. This is immensely urgent!!!
Thank you very much.

Yes, to both your questions.  Diazepam is sometimes used as an appetite stimulant, as well as other things, in cats, as long as they don't have liver issues, and egg whites are GREAT for cats.  My cat has kidney issues, and I feed her egg whites with every meal.  She prefers them raw, so I mix them into her wet food.  I buy the 100% pure egg whites in the carton rather than crack open an egg.  Have tried cooking eggs, and she doesn't like them, but if your guy would eat a whole egg (cooked mabe in a little butter even), that would be great, because the yolk contains lots of good things too, and has extra calories for putting weight back on. 

If your guy seems interested in food, but walks away, it sounds like he is nauseated.  Do you have Pepcid A/C there in India?  If so, lots of us give our kitties 1/4 tablet of that daily (or even twice daily) to help with that.  The only problem though,is that it shouldn't be given with Diazepam!  But maybe your Vet could administer some other anti nausea med? 

If you're not already familiar with this site, it is full of information regarding kidney cats.  Probably has more information than you could ever imagine, but I have found it very helpful over the years.  Keep it handy for things like which foods are good, etc. 

for your little guy. 

Thank you so much. I will get him started on diazepam soon.
About the eggs, I'd prefer giving him the eggs raw too, as he doesn't eat on his own and uncooked eggs are easier to feed with a syringe or a dropper. But won't avidin and salmonella be a problem?
About nausea, he used to be on domperidone but we cut that out as he reacted aversely to it and would invariably throw it up. I'll ask the vet about other options. Thanks again

  Just thought I would give you this link in case you might find it helpful for tips  about getting a cat with kidney disease to eat  . ( and it tells about the diazapam)   http://www.felinecrf.org/persuading_cat_to_eat.htm

atahska said:

Thank you so much. I will get him started on diazepam soon.
About the eggs, I'd prefer giving him the eggs raw too, as he doesn't eat on his own and uncooked eggs are easier to feed with a syringe or a dropper. But won't avidin and salmonella be a problem?
About nausea, he used to be on domperidone but we cut that out as he reacted aversely to it and would invariably throw it up. I'll ask the vet about other options. Thanks again

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I just read that specific page that Maewkaew provided you, and it actually says Pepcid A/C is OK with diazepam!  I knew Tagamet wasn't, so figured most acid blockers weren't be...sorry, my mistake.  So it may be as simple as picking up something none prescription (if it's sold there in India).  As far as the salmonella issue with eggwhites, that's why I buy the ones in the cartons (eggwhites only), because they are pasteurised, and, of course,I get the ones that are egg whites ONLY...many of them have added flavors like onion and garlic powder .  As far as the Avidin, I never worried (until now!), because I wasn't feeding the yolk with the whites, and I always thought the only issue was that the avidin blocked some of the nutrients from the yolk, not vitamin B from other foods.  That being said, there are some other folks here on this site that also feed their kidney cats a completely raw diet (I used  until my kidney cat decided to go on a raw food strike ) and they also add raw egg whites to their cats' diets.  So...I still think it's a good idea.  Since you are feeding via syringe right now, you could could just give them at a different time so they don't interfere with any vitamins he gets with his food.  I would just mix them with a little water as they can be a little sticky .  Now I'm off to discuss this avidin issue with the Raw Forum! 

We've begun him on another anti nausea pill- ondansentron. The weird thing is he throws up a kind of clear fluid only after his anti nausea medicines, whichever ones we try. He doesn't react like this to his other medicines. Ever noticed anything like that? Also, he's taking to cooked egg yolk wonderfully well though not to egg whites. In fact it is the only food he responds to. Is that a safe option? Will he be able to digest the proteins from the egg yolks? I'm a bit anxious about that. Thanks again

The yolk is full of good stuff, the only problem is that it's quite a bit higher in phosphorus.  Here's a chart that shows the nutritional breakdown of an egg, so you can see exactly what's in each part, then maybe you can make your determination. http://www.incredibleegg.org/health-and-nutrition/egg-nutrients/nutrient-chart Is he on a phos. binder, or does he need one?  My Callie's phos are fine, so she can eat egg yolks with no problem (if only she would!)  Don't know your guys' numbers.  How are you cooking the egg?  I'm just wondering if you tried cooking it differently if he might eat both the white and yolk together.  did you try scrambling it in a little butter?  Most cats can't resist butter, and the extra fat shouldn't hurt him.  My Vet said I could add veg oil to my cat's food, but I'd rather add butter (from nature), than veg oil. 

As to throwing up that clear froth, that's supposedly a sign of over acidity.  Every kidney cat I've ever had has done that when it's been too long between meals and the acid has had a chance to build up.  Now I know to give some food right before bedtime, and immediately when I get up to try to prevent it.  (and all throughout the day...I keep freeze dried 100% meats (chicken, turkey, beef (whatever) on hand at all times for quick snacks for them)

We have to perforce stop his anti nausea medicines. Previously he only threw up the clear froth. Today, he vomited after frothing. But I think we will be continuing his Zantac.. Thank you again. Sorry to bombard you with questions, but his vet isn't being very helpful.

A couple of things - about Salmonella - just wash the eggshells well before you crack the eggs and you should be fine. you can also spray a solution of diluted vinegar if you want to be extra safe.

On the egg yolks. You can balance the phosphorous with egg shell calcium - egg shell calcium is also an excellent phos. binder.
You need slightly less than 1/32 TSP for each large egg yolk.

Here is how you make the calcium:
Crack a bunch of eggs, carefully wash the shells and remove the membranes.
Bake in the oven at 350F for 30 minutes.

Crush it to a fine powder.

I use tiny little baking measuring spoons (like these) to measure the Calcium (that's what I use to balance my meat and the yolks too)

atahska said:

 Sorry to bombard you with questions, but his vet isn't being very helpful.

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We're here to help as best we can.  Sadly, there are lots of us with experience with kidney failure . 

Hope the Zantac helps   Plus Carolina's measurements for offsetting the phos in the eggyolks are great.  If you don't want to make your own eggshell powder, you may be able to buy it somewhere over there.  I know there are lots of places here where you can buy it...also via the internet. 

I'm sorry if this comes off as abrupt. I have a cat with chronic kidney disease and she is only two years old. From what you have described it sounds like your cat is suffering. It is likely off food due to nausea, it may also be in pain, or anxious and stressed because it is unwell, the valium will help with that. But it is not a permanent solution. I'm currently trying out valium for my cat because she is staying up all of the night and keeping me awake. Your cat sounds like it is at end stage kidney failure. Essentially you are keeping it alive with subcut fluids, it cannot maintain it's own kidney function. If it is not interested in food and has lost a lot of weight, to be honest to me it sounds like you are prolonging his suffering. It will be starving and feeling sick all the time. Steroid tablets (prednisolone) can sometimes stimulate a cats appetite. It worked for mine and she is always hungry, I have got her to put on about 500 grams. I mostly offer her tuna and foods that have a lot of gravy, which I mix with water to increase her fluid intake. However, acting withdrawn and sitting alone in corners is a sign of a cat that is not doing so well. I tried all I could with my cat with IV fluids and kidney diet when she had an acute attack and initially it helped but she also cannot maintain her kidney function on her own. Now I am just comfort feeding her and as soon as I feel like she is declining again I am not going to put her through that again or any other invasive interventions for the sake of keeping her. I'm sure your cat appreciates all the help you have given it but prolonging it's suffering is not doing it any favours. I am a nurse and I guess that is why I can be so frank about these things. Again, I'm sorry if this is offensive to you and you think I sound heartless. I love my cat and it's hard knowing at some point I will have to let her go, but the thought of her suffering hurts me even more. Just an outsiders point of view, who is also going through the same thing.