Watery Urine - possible kidney failure = what now?

6 months ago took my boy in for  a regular exam & some elevations in sugars were noted with a few other abnormalities but the vet said at the time they were all probably caused by stress and suggested testing urine for diabetes just to make sure. So 6 months later I got his urine & turns out there's no sugar in it so the stress probably caused the elevated level BUT now they said the urine was watery and they were concerned that it means kidney failure even though there wasn't a sign of it 6 months ago they said a lot could change in 6 months. I don't see the sense of having another blood test because as far as I read - the signs of kidney failure would only show in the later stages anyway. Am thinking of just starting vitamin B supplement and trying to give him only low phosphorous foods to delay as much as possible. He seems ok but does drink an awful lot. I'd never heard of watery urine before and it came from left field. Anybody else ever experienced this and what did you do about it? Thanks. Be interested in hearing about your experiences.

Has your vet suggested giving your kitty a kidney diet? Might want to just run it by the vet first if not before you do that.

Did they do any blood work? They'd be looking at a few things, but the main ones would creatinine, BUN/urea and SDMA (if they run that one). 

They are right about both the fact that symptoms don't show until later stages (appetite gets affected usually when creatinine is at 5 in the US), and that a lot can change in six months. In my case, a LOT changed in a month and a half, but for Lucky it was acute on chronic. It sounds like what your kitty has is chronic, which is the more common one, and if caught early (which is also how it sounds) has a better prognosis.

I know this feels like someone just hit you upside the head with a brick. But it's not as bad as it sounds. This is something so treatable these days, and there is a LOT of literature out there about it. 

If you google anything about feline CRF/CKD, odds are you'll have Tanya's website in the top three search results. That website is like the bible for feline chronic kidney disease. And yes, it probably WILL be overwhelming to see so much. My biggest piece of advice - take everything you read, and everything anyone tells you, and discuss it with your vet. 

Btw - how old is your kitty?

Thanks yes I am reading all I can on Tanyas site. He is 12 years old. 6 months ago his blood levels were fine except his sugar was high due to stress but I thought I'd check his urine just to make sure it wasn't diabetes and that's when they said the urine was watery so he hasn't had another blood test. Money is an issue so I don't think I'll do another one which I doubt will tell much else. He is drinking a lot though and he will eat if he likes the food so I don't see that his appetite is affected and he hasn't lost weight - in fact I think he gained a little - although he has been bonier for awhile. I am just going to treat him like he is in end stages and give supplements and watch diet. I am trying to find pure vitamin B without added junk and will be using Tanya for food but he does really like his fancy feast although I have been on  a food crusade for the past couple years trying all sorts of better quality food so I have a few others - like Tiki which is good for him and he likes and I'm going to try the Organix. He does seem to have less energy though and doesn't play that much - only for a couple miniutes at a time.

Please try adding palo azul to the water.  You can buy it from any mexican meat market.  It is bark from a tree.  You put the wood chips in water, boil for about 15 minutes.  It turns a beautiful blue & tastes like water so can be added to drinking water.  It also has another name, kidney wood.  It heals kidney problems, bladder problems.  Just look it up & read the benefits.  I have an aquaintance that has had kidney problems all her life,  could never urinate a normal stream, it would tricke out, she took the palo azul & her kidney problem disappeared.   

Hazel

1st and foremost - check with your vet (even if just via a phone call) before making changes to your cat's diet or adding supplements of any kind.

If you cat is eating, I would not make the assumption it is end stage, so you should not treat it as such. End stage treatment is more like hospice care, and it doesn't sound like your cat is near that point. Plus, you are not even sure at this point if it is kidney disease, as you are going solely on the basis that the urine is dilute.

My Sara has had dilute urine for over a year. While she likely has early-stage kidney disease, nothing else pointed to it until recently, when her SDMA was a tad high. Only now are we even discussing having her on a kidney diet, which is geared more toward early-stage kidney disease. End stage, it's more along the lines of getting them to eat ANYTHING, as they are usually suffering from a severe lack of appetite at that point.

I hope this makes sense. I understand not being able to afford the blood work (having done it so many times this year, am well aware of how much it costs). Have they checked your kitty's blood pressure?

MOD NOTE:  Please remember our site guidelines about recommending alternative treatments:

Supplements and herbal remedies can be very potent and can cause adverse reactions in some cats. You should always consult your vet about any treatment, whether nutritional, natural or alternative and keep in mind they can interact with other treatments your cat receives and cause problems.

Thanks everyone. Digesting it all & trying to come up with a game plan but all vet is doing is suggesting junk food like Hills and junk supplements like Forti  filled with byproducts, salt and mendione and I am doing all the legwork. She thinks a 12 year old cat is OLD and thought it amazing when I said my other cats lived to 18 and I don't consider a cat old until 15. This is a young vet who is too lazy too do any real legwork so I'm on my own until I find someone decent. Thanks for the NYC info but that's too far to go with my cat - I need someone on LI who actually LOVES cats and spends time researching - if they did half as much research as is going on TANYA's CRF site I'd be happy. Sigh.

Donutte said:

 
1st and foremost - check with your vet (even if just via a phone call) before making changes to your cat's diet or adding supplements of any kind.

If you cat is eating, I would not make the assumption it is end stage, so you should not treat it as such. End stage treatment is more like hospice care, and it doesn't sound like your cat is near that point. Plus, you are not even sure at this point if it is kidney disease, as you are going solely on the basis that the urine is dilute.

My Sara has had dilute urine for over a year. While she likely has early-stage kidney disease, nothing else pointed to it until recently, when her SDMA was a tad high. Only now are we even discussing having her on a kidney diet, which is geared more toward early-stage kidney disease. End stage, it's more along the lines of getting them to eat ANYTHING, as they are usually suffering from a severe lack of appetite at that point.

I hope this makes sense. I understand not being able to afford the blood work (having done it so many times this year, am well aware of how much it costs). Have they checked your kitty's blood pressure?

Click to expand...

I looked at the Kidney food and it is junk - byproducts and mendione bisulfate that most cats wouldn't even eat. I pulled 3 foods from Tanya's chart though - Wellness Divine Duos and Weruva Truluxe plus TIki chicken - all have phosphate levels close to kidney foods - under 1.0 anyway - the Divine Duo is a little high in sodium and the Tiki is alittle high in protein but it all high quality protein without byproducts or mendione bisulfate and more importantly my cat likes it - he laps up the pate part of the divine duos but leaves the chunks which I then mush up with a little water but as long as he eats. I am happy with that food. I am planning to add Jarrow's complex B as soon as I can figure out how to measure 1/10th dosage and Aciphilos for probiotics (divine duos already contains locust gum - prebiotics so that's great) but all human grade without added salt or byproducts.  I don't like the crappy pet supplement the vet talked about - it is a lazy recommendation and my cat deserves better than animal digest and sodium for goodness sakes. Try the above foods especially the divine duos - it is expensive but I cut down my own food budget to afford him that food - I hope it helps your cat and no - this vet didn't take his blood pressure - she charges $80 for an office visit and another $40 for blood pressure test - another reason I need to find someone who considers an EXAM fee comprehensive.

I generally don't think of 12-year-old cats as being old, but I think from a medical standpoint, they are considered "senior" at like 7 or 8. Definitely not odd for a cat to be 12, unless the vet has only dealt with outdoor-only cats.

Have you tried to talk to your vet about other types of food or treatments? Not sure I'm familiar with supplements for CKD itself, just those that help with various side effects. Fortiflora is, I believe, for gut issues like bacterial imbalance (hopefully saying that right). Kidney diet is definitely not just a specific brand of food. I've been on another forum where people make home-made kidney food for their cats. My cat has multiple issues (hyper-t, early CKD and possibly FIC) so we have to figure that all out before determining the best diet for her. And of course, she'll still eat SOME of the other food. There's just no avoiding it 100% since I have other cats as well. She in particular LOVES the kittens' kibble. Probably not good for her but like I said, hard to stop them from sharing.

I will say Hills is particularly good if the cat is not eating (a/d especially), so I wouldn't completely discount them. I think "kitty crack" is one way it's been described. I had i/d recently for Sara and she just devoured it, much to my delight. So, if you get to a point you have trouble getting your cat to eat, you might want to turn to a/d. Not sure if k/d is the same way, but when your cat isn't eating, it doesn't matter at that point what food you're putting into so much as getting calories and nutrients into them. 

Regarding the cost of the vet... I am not sure if any vet actually includes it in their office exam. Mine does not either, and found out there are interesting ways they take the blood pressure. I was asking because that can be one of many things they use to come up with a diagnosis.

And on the topic of getting blood work... while this doesn't sound anything like your case, my cat went from borderline-early CKD to Stage IV in the span of a month and a half (point being things can change a lot in a short time). His was acute-on-chronic and his symptoms were way more profound. But, it does sounds like you are taking it seriously from the diet POV, and that's a big part of the battle. But even if you can't get the blood work now, I'd probably get it as soon as you are able to. 

Thanks for the thoughtful response. So far he's been eating wellness divine duos - he doesnt like the chunks but he'll sit and eat half of it then lick at the rest when he wants to pick until I give another can. It is at least under 1% phosphate about 33% high quality protein - the only thing I don't like is that it is over 1% sodium but I guess that's where it is getting its taste from. No mendione bisulfate or additives or crappy things like cranberry, garlic, yucca etc. So I'm happy with it. He also eating the Tiki salmon & chicken - also under 1% phosphate and under 1% sodium but high protein - I'm not concerned with that though because I think protein restriction was based on human kidney disease - from all I read cats NEED protein as long as it isn't byproducts - which actually is what HIlls is filled with. It is low quality protein containing byproducts. So as long as I found 2 brands under 1% I"m good - I tried others on Tanya's food chart - Soulistic sold only by Petco, and Weruva truluxe but he doesn't like them.

The vet actually also mentioned fortiflora but when I looked into it - the first ingredient is animal digest - byproducts which I'm trying to avoid giving him - and a ton of salt -plus it contains only a small bit of probiotic and has vitamin supplements I'm not sure he needs. So I opted against it.

 My cat has multiple issues (hyper-t, early CKD and possibly FIC) so we have to figure that all out before determining the best diet for her. And of course, she'll still eat SOME of the other food. There's just no avoiding it 100% since I have other cats as well. She in particular LOVES the kittens' kibble. Probably not good for her but like I said, hard to stop them from sharing.

Click to expand...

Yep right now I"m home during the day to monitor feeding but soon I won't be so I'll have to feed both the low phosphate food but right now I'm giving the higher phosphate food to my other cat & keeping the kidney cat away from it even though he loves it - turns out the favorite foods were the higher phosphate ones (of course) but he does love the divine duos and so does the other - the problem is that it is so expensive and I had a bunch of the other food still here when I found out about his kidney so I'm just running it down and won't buy it again.

RemmieBrandt said:

 
Yep right now I"m home during the day to monitor feeding but soon I won't be so I'll have to feed both the low phosphate food but right now I'm giving the higher phosphate food to my other cat & keeping the kidney cat away from it even though he loves it - turns out the favorite foods were the higher phosphate ones (of course) but he does love the divine duos and so does the other - the problem is that it is so expensive and I had a bunch of the other food still here when I found out about his kidney so I'm just running it down and won't buy it again.

Click to expand...

How old is your other kitty? Low-phos isn't good if they are very young, not really sure what the cut-off is, though. 

Donutte said:

 
How old is your other kitty? Low-phos isn't good if they are very young, not really sure what the cut-off is, though. 

Click to expand...

Thanks but she's also over 7.   This food isn't prescription which I think is half about. 50 it is more like .90 but as close as I'm going to get knowing he'll enjoy eating his food and be getting no byproducts. I'm still trying others out . The Organix was an excellent food too but they wouldn't eat it and I tried 3 different flavors of it. Gotta start them out as kittens on that sort of food I guess.

Yeah, Fortiflora isn't very good as a probiotic. Better than nothing, though, and it's really useful for tempting a cat to eat when it doesn't really have an appetite. At least for a while.... Human probiotics are better, as long as they don't have any weird ingredients. (For example, Biokult is just the probiotic and cellulose as a flow agent and for the capsule.)

Are you putting out extra water, getting a fountain, adding extra water to food, etc?

If your cat can tolerate eggs, cooked egg whites are really low phosphorous, easy to digest protein you can use to cut the phosphorous level what you're feeding your cat. I can't remember where I saw it, but one website had a chart with protein quality, high quality proteins being more fully digested and absorbed (so less crap for the kidneys to process). Egg whites are up at the top. Milk protein was actually pretty high on that list, too, I think higher than any meat. Vegetable protein is generally lower than animal protein. I can't remember in what order the meat was ranked, though.

Did you try slowly adding in the Organix? Like, mashing it with the food they like?

And for splitting the B-vitamins... ever see a movie where someone uses a razor to make a line of cocaine? That method works pretty well for dividing up pills. The Jarrow B's I got are powder in gelatin capsules, so you can just open it up and partition it up pretty easily.

Non-prescription food between 0.7-0.9% phosphorous kept my cat's numbers stable for the past nine months. She's early stage, slightly high creatinine and slightly dilute urine. It's good to have a baseline, to compare against, though. Was the urine dilute at the first visit? If it's changed in the past six months, it probably would be a good idea to get the blood test done again. Is there maybe a cheaper option where they just test the parameters relevant to kidney function?

The differences in treatment if the kidneys are suddenly a lot worse than six months ago could include phosphorous binders (if the P level is high already) and subcutaneous fluids. If the test shows kidney values just slightly out of range, you'll probably be advised to do about what you're doing already (try to manage it with diet).

samus said:

 
If your cat can tolerate eggs, cooked egg whites are really low phosphorous, easy to digest protein you can use to cut the phosphorous level what you're feeding your cat. I can't remember where I saw it, but one website had a chart with protein quality, high quality proteins being more fully digested and absorbed (so less crap for the kidneys to process). Egg whites are up at the top. Milk protein was actually pretty high on that list, too, I think higher than any meat. Vegetable protein is generally lower than animal protein. I can't remember in what order the meat was ranked, though.

Did you try slowly adding in the Organix? Like, mashing it with the food they like?

And for splitting the B-vitamins... ever see a movie where someone uses a razor to make a line of cocaine? That method works pretty well for dividing up pills. The Jarrow B's I got are powder in gelatin capsules, so you can just open it up and partition it up pretty easily.

Non-prescription food between 0.7-0.9% phosphorous kept my cat's numbers stable for the past nine months. She's early stage, slightly high creatinine and slightly dilute urine. It's good to have a baseline, to compare against, though. Was the urine dilute at the first visit? If it's changed in the past six months, it probably would be a good idea to get the blood test done again. Is there maybe a cheaper option where they just test the parameters relevant to kidney function?

Click to expand...

You know, I never really thought about it, but I guess it makes sense. Not all carbs are created equal, so of course not all proteins would be either.

Re: blood work, I think the only thing they could cut out is the CBC. The rest is part of what they call a "senior panel", and even if they did just test for the specific things to the kidney, it would probably cost the same. They like to see a variety of things, even those not necessarily kidney-specific as a rule. If I remember correctly though, cutting out the CBC (and T4 if it was there) reduces it pretty drastically.

I'm still giggling at the mental image of cutting B-vitamin powder like cocaine Hey, if it works, it works!

hazy said:

 
Please try adding palo azul to the water.  You can buy it from any mexican meat market.  It is bark from a tree.  You put the wood chips in water, boil for about 15 minutes.  It turns a beautiful blue & tastes like water so can be added to drinking water.  It also has another name, kidney wood.  It heals kidney problems, bladder problems.  Just look it up & read the benefits.  I have an aquaintance that has had kidney problems all her life,  could never urinate a normal stream, it would tricke out, she took the palo azul & her kidney problem disappeared.   

Hazel

Click to expand...

I did some reading, and it sounds like it's a diuretic, which would make the urine even more dilute. Possibly useful (if it's not toxic) for stones/crystals or UTIs, probably not for kidney failure though (it would likely stress the kidney more if it's causing more urination).

Nettle seed, though, has a track record of actually restoring kidney function in humans. I haven't been able to find anything on its use in cats, but I have seen people use nettle leaf without any negative effects. I was using a pinch or so on my cat's food for a couple months (June to Aug), didn't see any negative side effects. I might have had positive results, or my cat could have been acting more lively because of finally getting over a gut issue flare up in March/April. I didn't get any blood tests done during the time I gave her the nettle seeds but her most recent results showed no change from February, so at least nothing got worse!

Thnak you for all the helpful information. I appreciate it. They wouldn't touch the Organix no matter what I did and the Turkey and Spinach one had such a smell that I couldn't tolerate it either but they would eat a few bites of the one with Brown Rice if nothing else was around but you could see they weren't enjoying it.  I don't know how dilute the urine was the vet never said and I havent retested or done the bloods again. I really need to find a more knowledgeable , concerned vet. This one hasn't even called to see what is going on since it took me days just to get to talk to her the first time after the test results came in. I'll keep fortiflora in mind but right now has a good appetite but I can hear all sorts of grumbling and almost like hiccups in his stomach after he eats because he likes to sit on me so something is happening there which is why I want the probiotics but I couldn't find a human grade without a lot of other garbage in it when I went out looking. I will get the powder for the b vitamins too although I still think its hard to divide a tiny little amount into 1/10th. But since he is eating well, I didnt think the supplements were that important right now. Seems to be drinking and hydrated well enough too. Thanks for the positive note and good luck with your baby too. I hope they both get nother 5-7 years !