Our cat's creatinine is 7.7 and rises fast. What can we do?

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tommy2015

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Our Dusty just turned to 16 years old last month. A very lovely girl. We adopted her one year ago. In the first week she joined our family, we got to know she had chronicle kidney failure and chronicle bowel disease.

In the middle of this January, her creatinine number was 5.8. The doctor kept her at the vet for SQ  and the number dropped to 4.8 the next day. Then we were asked to take her home and do SQ at home, 100ml / three times a week.

One month later we had her reexamined. The cre returned to 5.8.  

This Monday (3/15) Dusty was examined again, The cre was 7.7.  The doctor suggested us increasing the SQ to 100ml/ five times a week.

We did some research online.  Many said 7.7 is way too high and we should have our kitty hospitalized for intensive treatments asap. But this certainly is not our doctor's recommendation. 

Dusty behaves and eats normally. Generally have good appetite, drinking a lot of water. But some said with this cre level she may die at any second.

We are very worried but don't know what to do. Really hope our girl can go through all this. Any advice is welcome. Thank you. 
 

stephenq

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Our Dusty just turned to 16 years old last month. A very lovely girl. We adopted her one year ago. In the first week she joined our family, we got to know she had chronicle kidney failure and chronicle bowel disease.

In the middle of this January, her creatinine number was 5.8. The doctor kept her at the vet for SQ  and the number dropped to 4.8 the next day. Then we were asked to take her home and do SQ at home, 100ml / three times a week.

One month later we had her reexamined. The cre returned to 5.8.  

This Monday (3/15) Dusty was examined again, The cre was 7.7.  The doctor suggested us increasing the SQ to 100ml/ five times a week.

We did some research online.  Many said 7.7 is way too high and we should have our kitty hospitalized for intensive treatments asap. But this certainly is not our doctor's recommendation. 

Dusty behaves and eats normally. Generally have good appetite, drinking a lot of water. But some said with this cre level she may die at any second.

We are very worried but don't know what to do. Really hope our girl can go through all this. Any advice is welcome. Thank you. 
It is a high creatinine level but every cat is different and cats with kidney problems usually feel poorly and that is obvious with loss of appetite, energy etc, or other symptoms like vomiting.  Daily sub Q fluids is the most common way of keeping your cat's blood values as normal as possible and her feeling well.  I'm not quite sure why your vet would say 5 days a week instead of 7, you may wish to discuss that with her/him but regardless increasing the frequency of sub q fluids sounds like the right thing to do.  Personally I would only hospitalize if I couldn't get the symptoms under control or if she needed therapies and/or monitoring that I couldn't do myself at home.

Please keep us updated and good luck!
 
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tommy2015

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Thank you very much. We will talking to the vet regarding the frequency of sub q.  Luckily our Dusty is still active and eating well today.

May I have one more question?  According to the doctor, the so-called in-hospital intensive treatment is to intravenously inject the same type of fluids as we do sub q at home. So if the sub q doesn't work, the in-hospital  treatment is not very meaningful.  Is this true or false?   Thanks for any opinions  or suggestions.
 

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I'm not sure there is a clear answer to your question.  IV is a more direct route, and can support blood pressure if that was an issue (which it shouldn't be) and would be safer if there was a heart issue which you haven't mentioned.  If the cat was in real crisis IV may be the way to go, but sub q is normally fine for as long as it works, (along with meds that can address related issues), but in time it all stops working eventually.  But each cat is different and i've known cats who lived to almost 20 with kidney disease.

I have to say that it is really great of you to adopt a senior cat, they are great and one of the most ignored groups in shelters.
 
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tommy2015

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I'm not sure there is a clear answer to your question.  IV is a more direct route, and can support blood pressure if that was an issue (which it shouldn't be) and would be safer if there was a heart issue which you haven't mentioned.  If the cat was in real crisis IV may be the way to go, but sub q is normally fine for as long as it works, (along with meds that can address related issues), but in time it all stops working eventually.  But each cat is different and i've known cats who lived to almost 20 with kidney disease.

I have to say that it is really great of you to adopt a senior cat, they are great and one of the most ignored groups in shelters.
Thank you. Dusty does have hypertension and is on medication. And she does not have heart issue as far as we know. When there is a crisis we may insist on a few days' IV even if the doctor suggests giving up.   

We adopted Dusty from a friend's mother who was too old to take care of her. Although from the first week we realized it was gonna be a long goodbye, Dusty has given us tremendous joyfulness and treasured memories. 
 

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Thank you. Dusty does have hypertension and is on medication. And she does not have heart issue as far as we know. When there is a crisis we may insist on a few days' IV even if the doctor suggests giving up.   

We adopted Dusty from a friend's mother who was too old to take care of her. Although from the first week we realized it was gonna be a long goodbye, Dusty has given us tremendous joyfulness and treasured memories. 
Ah well IV's can be given to cats with low blood pressure as a way of raising it.  In any case good luck with him and I wish you the best.
 
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tommy2015

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Ah well IV's can be given to cats with low blood pressure as a way of raising it.  In any case good luck with him and I wish you the best.
Thank you!
 
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tommy2015

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Dusty has started to eat less in the past two days. This may be the first sign of decline/crash.  

Should we send her to vet for intensive treatment asap, or hold on for some more days?  Considering she just went to the vet last week and it is such a torture for her to do the blood work, we are indeed hesitating...

Any suggestions are appreciated. 
 

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Have you visited TANYA's CRF web site?  They also have support groups and those members are real pros with all the sub Q's, all kinds of stuff that they give and do for their cats. I think the support group is through the YAHOO groups.  The group will ask you for all labs, levels etc. You can't believe the expertise of some of these members.
 
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tommy2015

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Have you visited TANYA's CRF web site?  They also have support groups and those members are real pros with all the sub Q's, all kinds of stuff that they give and do for their cats. I think the support group is through the YAHOO groups.  The group will ask you for all labs, levels etc. You can't believe the expertise of some of these members.
Thank you. I often visited Tanya's website. Will check the support group soon.
 

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You may have to syringe feed. That seemed to be a general trend when the cats would refuse food. Also, watch for constipation, as that usually is a problem with the kidney stuff. That site will explain what and why the creatinine is rising. And the use of Miralax to keep the stool softened. Also slippery elm bark tea that you make and put with food to keep the colon a little more elastic or soothed.
 
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tommy2015

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Have you visited TANYA's CRF web site?  They also have support groups and those members are real pros with all the sub Q's, all kinds of stuff that they give and do for their cats. I think the support group is through the YAHOO groups.  The group will ask you for all labs, levels etc. You can't believe the expertise of some of these members.
Tanya's support group refers to a web link that requires installing a software. I tried several times but not successful.   Anything wrong here? Or any other support groups are recommended?

Thanks
 

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The group is called BIG TENT, and I had to wait about 3-4  days before I was allowed in to the site. It is a YAHOO site. I think I went from the Tanya's site to join.  Sorry, I am not too computer literate.
 
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tommy2015

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We tried Mirtazapine (prescribed by vet) to stimulate Dusty's appetite, but it  does not work. A few month ago it  worked pretty well. With this medication Dusty ate much more, in the meantime became restless and had trouble sleeping. This time, none of those symptoms showed up.

As she is on anti-hypertension drugs, is it possible the effects of Mirtazapine were counteracted by the anti-hypertensives? 

Dusty was hospitalized in the vet for three days in the late of March. When she left for home her CRE was 5.0. Since then she has been doing well. Only until recent few days did her appetite turn downwards.

Thanks for any suggestions. Should we try a different type of appetite stimulant?
 

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We tried Mirtazapine (prescribed by vet) to stimulate Dusty's appetite, but it  does not work. A few month ago it  worked pretty well. With this medication Dusty ate much more, in the meantime became restless and had trouble sleeping. This time, none of those symptoms showed up.
 
As she is on anti-hypertension drugs, is it possible the effects of Mirtazapine were counteracted by the anti-hypertensives? 
 
Dusty was hospitalized in the vet for three days in the late of March. When she left for home her CRE was 5.0. Since then she has been doing well. Only until recent few days did her appetite turn downwards.
 
Thanks for any suggestions. Should we try a different type of appetite stimulant?
 
An appetite stimulate doesn't address the underlying discomfort that is likely causing her not to have an appetite.  I would be working on that side of it, by talking to your vet about sub q fluids, and anti nausea meds like cerenia, and possibly the use of percid .  High CRE levels will cause her to loose her appetite.
 
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tommy2015

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An appetite stimulate doesn't address the underlying discomfort that is likely causing her not to have an appetite.  I would be working on that side of it, by talking to your vet about sub q fluids, and anti nausea meds like cerenia, and possibly the use of percid .  High CRE levels will cause her to loose her appetite.
Thanks. What is percid, is it a type of food? I googled it but didn't get much.
 
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tommy2015

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This is comprehensive information. Thanks. Dusty has been on SQ fluids since Jan this year. It does help her go through a lot.
Sorry i typo'd, i meant to say PEPCID, the antacid.  2mg a day, (1/4 of a 10mg pill) is the usual dose but don't begin this without the advice of your vet.
 
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tommy2015

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Sorry i typo'd, i meant to say PEPCID, the antacid.  2mg a day, (1/4 of a 10mg pill) is the usual dose but don't begin this without the advice of your vet.
Thanks. We called the vet today and they also prescribed Pepcid. I checked Tania's CKD site. Looks this med may bring burden to cat's kidney. Can Pepcid be used in a long term, or only used as needed?   
 
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