My cat has early kidney disease, need advice

bugmankeith

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My 15 year old female cat had a vet checkup and blood tests came back elevated urea (BUN 44) and creatinine (CREA 2.6). The vet said this is early chronic kidney disease and cannot be reversed she also lost 2 pounds in a year. I was told I must change the diet and it won't fix the issue but slow it down.
I don't know anything about this health issue and the vet was talking like I'm in vet school and told me to put my cat on Royal Canin renal formula from the office, but I'm hearing bad things about the brand and ingredients and corn is high on it and my cat has a VERY sensitive stomach that's why years ago we took her off science diet and onto blue wilderness. The vets old food gave her diarrhea, gas and vomiting constantly. Once we switched those issues went away.

I tried switching foods and my cat got ill from them, so I don't know what to do now? Is there supplements I can give in can food to help this condition? Any food brand in pet stores good quality like blue wilderness yet helpful for her condition? I don't know what's in the food that causes kidney issues so I don't know what to look for in food I give?
 
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ruthm

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Chronic Kidney Disease is incurable, but it can be managed, many kitties live a long time after diagnosis, with proper diet and treatment.  Did you get a copy of your kitty's bloodwork? If not, request a copy, my vet emails everything and I keep it in a file at home. What are you currently feeding? 

I highly recommend Tanya's Website, it is everything you need to know about CKD. I was terrified when my Tiger first was diagnosed. She was treated for hyperthyroid, which exposed the fact that she was early stage CKD.  However, some really smart people showed me the Tanya's Website and I felt a whole lot better, I could then work with my vet to come up with a proper diet and treatment plan(My girl Tiger was also diabetic and some other issues, so it was complicated)   I also recommend you join Tanya's Support Group, plus the Yahoo Feline CKD group; there are wonderful people and current and useful information.

http://www.felinecrf.org/

My Tiger did the best on Wellness, Wellness  Core Chicken and chicken liver; Weruva Fowl Ball, and Paw Lickin Chicken. They are fairly low phosphorus. But the important thing is that your kitty eat, and that she keeps the food down, so you may have to trial and error. I used Dr. Lisa Pierson's food chart as a guide, looking for low phosphorus as possible.

http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf

Tanya's website also has a foodchart, but since mine was diabetic, I had to stick with low carb/low phosphorus foods that were canned.

Is your kitty throwing up white foamy vomit early in the morning? If so, that's a sign of stomach acid and will make her not want to eat. Tell your vet; and ask if Pepcid AC might be helpful.
 
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donutte

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I went through acute-on-chronic with my boy Lucky last month and now going through CKD (early also, less far along than yours even) with Sara. There are so many treatment regimens, that I'm shocked your doctor said the only thing you could do was change the diet. I'm guessing he means a kidney diet, but that is by no means the "only" thing you can do.

Sara's on Pepcid ever evening and that has helped tremendously with her hyper-acidity (common in CKD cats). As RuthM said, if your cat has foamy vomit, that is a good sign of hyper-acidity. Hyper-acidity can decrease appetite, and therefore cause inappetence. If the cat is nauseous, they can also give anti-nausea drugs (long term). Signs of nausea include things like smacking their lips a lot, or showing interest in food but then ultimately not eating. Nausea doesn't always cause them to vomit, ironically enough. Lucky only did once and I could literally feel his stomach heaving when he was on top of me other times. And lastly, appetite stimulants can be given. I wouldn't start off the bat with the appetite stimulants though. If a cat has a tummy that isn't feeling good, throwing things at it that make it hungry on top of not feeling good won't help much.

I second (and third, and fourth) Tanya's website. It was a lifesaver for me with Lucky. It is a LOT to absorb, try at the moment to focus on the early-stage stuff. Lucky was diagnosed with Stage IV so had to do a lot of reading in a very little bit of time. I plan on re-reading a lot (already have) now that I have more of the luxury of time.

I'm just can't get over that your vet didn't talk about any of this stuff. If you vet disagrees with all of this stuff, or won't even hear you out, I'd say get a new vet. I know that's harsh, but CKD isn't something you treat passively. True, it's incurable, but that doesn't mean you just let it take over either. I literally had to demand anti-nausea meds and ultimately got them. I think they took me seriously when I gave them the visual of how bad Lucky was doing (my vet wasn't in at the time, and the other vet felt weird giving meds at first to someone that wasn't her patient - we got past that though). Don't feel you have to play the nice person either. You are your cat's biggest advocate here.

And please, feel free to reach out to us any time you have questions or just need support even. We've been there, done that. I'm still grieving the loss of Lucky - acute took him sixteen days after diagnosis. Sara on the other hand is doing really well. She's eating heartily while only on Pepcid at the moment. Been trying to do the kidney diet with her but with four other cats (three of whom are much younger - two are still kittens) it's a bit difficult. My big goal is to try to fill her up on k/d (since I have some from Lucky, I'm using it) as much as possible, but can't keep her from eating the other food completely.
 
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bugmankeith

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My cat is on blue wilderness dry and canned food, she and my other cat love it. However I heard from dog owners of small breed this food due to high protein has caused kidney issues, as my sister has a toy breed dog and was told to feed blue instead of blue wilderness, I hope this wasn't the cause as the vet called and my other cats results also came back higher than normal for the same thing but just barely over, not as high as my girl cat.

My girl cat has a good appetite, she has been eating, only when I tried switching foods and she got sick did it affect her and I'm still waiting to see how she does, no hers isn't frothy see here http://www.thecatsite.com/t/311064/...lood-in-either-vomit-or-diarrhea#post_3892944

My cat has been pooing out of the litterbox suddenly daily for months now and never did this and her water intake has increased a lot over the year. We took urine and that came back fine. Last year she was diagnosed with c diff and we were unable to get her to take the meds we tried by hand in her mouth and hiding it and she would hide hours after. She also had a nasty ear infection over the summer and has a tumor growing in one ear, so I've got a lot going on all at once and my head is spinning.

If we're talking vomit, my other cat if he eats grass vomits daily, he gets lots of froth and always wants grass to eat, always been like this. I'm wondering if he has acid trouble he burps a lot and drinks a lot of water too. He refuses to eat canned food only dry. Trying to get any meds in him is asking for a blood bath though, he hates being grabbed and he's strong and unlike my other cat won't allow us to hide things in food.
 

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It's better for cats with kidney issues to eat only wet food, to make sure they're getting enough water. It's possible that feeding dry food is what causes (or at least contributes to) kidney failure, since cats that eat dry food are chronically dehydrated. A fountain and/or having water bowls around the house so your cat's more likely to drink is a good idea too.

If your cat has stomach issues, it's more important to make sure whatever you're feeding it is something that it's stomach can tolerate, rather than trying to force it to eat some "kidney diet" with stuff that will make it's gut all inflamed and lead to it not eating. Kidney diets have two main components: low phosphorous, and low protein. It's debatable whether low protein is even a good idea, from what I've read it sounds like it's only really called for in end stage kidney failure. Low phosphorous does seem to be important, though. Prescription food has 0.4-0.7% phosphorous on a dry weight basis (for wet food, you have to calculate it yourself using the moisture content). I think I saw one prescription kidney brand that was actually 0.9%. Most non-prescription food is 1% or over. I've been feeding my cat various non-prescription foods with 0.7-0.9% phosphorous for the past nine months and her phosphorous has been staying in the normal range, so I think it's working out for her. (She was diagnosed with early stage kidney failure in February, and has very slightly high creatinine levels.) You can try doing that and monitor your cat's blood phosphorous levels every six months or so, and if its phosphorous starts going up but it can't tolerate the prescription food you can talk to your vet about phosphorous binders.

Tanya's CRF site has been really helpful for me. You'll probably want to skim it and re-read it later (a few times), it's really dense. The best first steps are just to increase your cat's water intake (wet food only and lots of water around), and since it sounds like there are possibly food problems that should be figured out first and then trying to make the diet more kidney healthy should come later.

I've convinced my vet to trust me to give my cat injections if she needs them (well she also had a vomiting problem so that made the convincing easier). That might be an option if your cat is impossible to pill. Eventually (hopefully not for a few years) you'll probably end up having to give your cat subcutaneous fluids by injection, so learning how to stick needles in your cat will be a useful skill to have.
 

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Oh and the other cat eating grass to vomit regularly is probably a sign that his stomach is hurting regularly, which could be from a food intolerance, inflammatory bowel disease, or high stomach acidity (that can come from kidney problems). My cat did that for years before any of her kidney stuff showed up on a test, she would eat grass and have foamy vomit at least a couple times a month. She also has food sensitivities, so I'm not sure which of her problems caused the vomiting actually.

catinfo.org has tips on how to transition dry food addict cats to wet food. My cat wouldn't touch wet food, I had to throw a lot away before she finally decided it was food. Which is frustrating, but something to just come to terms with when you're trying to switch food. I did the glob of wet food next to the dry food every day thing, and then under the dry food, and then in its own bowl (mashed with water to the perfect consistency....). For the first few days, maybe a week, she didn't even touch the wet and it was really discouraging. But eventually she got used to the smell and decided she liked it. I also just started with one flavor and was persistent in giving it to her.
 

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How was the diagnosis of C-diff made?  What were her symptoms?

How often does she vomit? My vet told me if it is more than once or twice every 3 months, there is likely an IBD issue. Not trying to scare you, just that white or clear foamy vomit before breakfast is typically an early symptom of CKD, whereas yellow bile colored vomit is a different problem.  Cats often eat grass when their tummy is upset and they need to vomit. If it is white and foamy, ask your vet about Pepcid AC. I had the best luck wrapping Pepcid and Cerenia in a small gelcap, wrapping with a Pill Pocket Duck Flavored, my Tiger are it up with no problems. Pepcid is horribly bitter, like most medications, which is why I like gelcaps, you just have to remember to offer either water in a syringe, or I offered a spoon ful of BeechNut meat baby food as a chaser.
 

donutte

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Originally Posted by samus  

Kidney diets have two main components: low phosphorous, and low protein. It's debatable whether low protein is even a good idea, from what I've read it sounds like it's only really called for in end stage kidney failure.
The truly ironic thing about that - by the time they are end stage, you're usually at a "feed them whatever they'll eat" point.
Pepcid is horribly bitter, like most medications, which is why I like gelcaps, you just have to remember to offer either water in a syringe, or I offered a spoon ful of BeechNut meat baby food as a chaser.
I really lucked out that I can give Sara her Pepcid in the pill pocket straight up. I thought I'd cry when she stopped taking them for awhile (because her T4 had spiked).
 

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The truly ironic thing about that - by the time they are end stage, you're usually at a "feed them whatever they'll eat" point.

I really lucked out that I can give Sara her Pepcid in the pill pocket straight up. I thought I'd cry when she stopped taking them for awhile (because her T4 had spiked).
Yes, even in the early stages of CKD, the elevated creatine and high phosphorus can make them feel crappy and they stop eating. That's why my vet and the IM who treated my Tiger for hyperthyroid said to give her a high protein/ low carb diet, but mainly find a good quality protein food that she would eat because you don't want any food aversions with a CKD kitty.

i hope your Sara never actually tastes the Pepcid because it is horrible tasting; that's why I went to gelcaps.
 

donutte

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Yes, even in the early stages of CKD, the elevated creatine and high phosphorus can make them feel crappy and they stop eating. That's why my vet and the IM who treated my Tiger for hyperthyroid said to give her a high protein/ low carb diet, but mainly find a good quality protein food that she would eat because you don't want any food aversions with a CKD kitty.

i hope your Sara never actually tastes the Pepcid because it is horrible tasting; that's why I went to gelcaps.
Sara doesn't really chew these things... she kinda swallows them whole. I know she bit threw the methimazole once (I could HEAR it) but it didn't seem to faze her.

What size gelcaps do you have? The ones I have are too long for the pill pockets. I think size 3 is what I have.
 

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I have size 4 from Thriving Pets. Swallowing whole is good; fingers crossed your Sara never bites into the pepcid!
 

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Both of my senior cats had kidney disease and though they did eventually pass from it, they lived to be 18 and almost 19 and were diagnosed years before they passed.

Here are the best things I learned in this process relating to their at home care:

- Warm up IV fluids to bath temperature, they really seem to tolerate it better if you end up giving them at home. 

- Baby food is your friend! Kidney disease can lead to lack of appetite but even at the late stages of their disease they always had room for baby food. My vet recommended baby food though of course you want to check with yours because they will know your cat's specific diet needs better. Once it got to the point that any food was a good thing I also shopped for the stinkiest fishes I could find and put them in the blender. Soooo gross but it made my cats super happy.

- Also a huge fan of Tanya's CKD site and got my vet hooked on it too.

The best thing I can tell you in general though is that your cat can be happy and normal and have a high quality of life for a long time with CKD. It doesn't always work out that way but it can. The best thing anyone told me about having a cat with CKD was that my job was not to keep my cats alive, it was to make every day that they were alive the best day it could possibly be for them. So that is what I did. I work a lot and am super busy but always made time to be with them and enjoy them without any of the medical stuff in the way. 

Hang in there, it is really tough but you and your cat will get into a routine before you know it. 
 

cat lady 42

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My 15 year old female cat had a vet checkup and blood tests came back elevated urea (BUN 44) and creatinine (CREA 2.6). The vet said this is early chronic kidney disease and cannot be reversed she also lost 2 pounds in a year. I was told I must change the diet and it won't fix the issue but slow it down.
I don't know anything about this health issue and the vet was talking like I'm in vet school and told me to put my cat on Royal Canin renal formula from the office, but I'm hearing bad things about the brand and ingredients and corn is high on it and my cat has a VERY sensitive stomach that's why years ago we took her off science diet and onto blue wilderness. The vets old food gave her diarrhea, gas and vomiting constantly. Once we switched those issues went away.

I tried switching foods and my cat got ill from them, so I don't know what to do now? Is there supplements I can give in can food to help this condition? Any food brand in pet stores good quality like blue wilderness yet helpful for her condition? I don't know what's in the food that causes kidney issues so I don't know what to look for in food I give?
 

cat lady 42

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About Blue Wilderness, there's a website with all the latest class action news and I just read one about Blue Wilderness. Google Class Actions to find the site. What's coincidental and a stroke of luck because I will never buy Blue Wilderness was just before I read about the class action, at PETsMART I met a lady shopping for kd diet. I showed her where it was and she told about her cat got kidney disease from eating Blue Wilderness. And she told of another cat owner had the same problem with their cat. So I will not use Blue Wilderness ever. At another time, I will write about my cat that got kidney disease when 6 years. Lived till 13. Needed subcutaneous fluids twice a day.
 

cat lady 42

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The website is TopClassActions.com to read about the Blue Wilderness lawsuit.
 

donutte

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Both of my senior cats had kidney disease and though they did eventually pass from it, they lived to be 18 and almost 19 and were diagnosed years before they passed.

Here are the best things I learned in this process relating to their at home care:

- Warm up IV fluids to bath temperature, they really seem to tolerate it better if you end up giving them at home. 

- Baby food is your friend! Kidney disease can lead to lack of appetite but even at the late stages of their disease they always had room for baby food. My vet recommended baby food though of course you want to check with yours because they will know your cat's specific diet needs better. Once it got to the point that any food was a good thing I also shopped for the stinkiest fishes I could find and put them in the blender. Soooo gross but it made my cats super happy.

- Also a huge fan of Tanya's CKD site and got my vet hooked on it too.

The best thing I can tell you in general though is that your cat can be happy and normal and have a high quality of life for a long time with CKD. It doesn't always work out that way but it can. The best thing anyone told me about having a cat with CKD was that my job was not to keep my cats alive, it was to make every day that they were alive the best day it could possibly be for them. So that is what I did. I work a lot and am super busy but always made time to be with them and enjoy them without any of the medical stuff in the way. 

Hang in there, it is really tough but you and your cat will get into a routine before you know it. 


I've dealt with both acute and chronic kidney disease with my cats. The acute was horrible, like riding the craziest roller coaster ever and crashing into a wall at the end. Chronic is soooo different. A lot harder to diagnose, but once it's diagnosed, you can put a plan of action into place.

Lucky had acute and there was no time. It was all about feeding him anything he'll eat, and as much of it as possible. And giving subqs every day of course. And in the end, just making him as comfortable as possible his last two days. God, that made me cry just thinking about that. Sara on the other hand has early-stage chronic. She likes pretty much everything right now, which I'm so thankful for. Although, she broke into a bag of jalapeno cheetos and ATE ONE. And now she keeps wanting to get more since that day. I had to hide the bag. Anyway, I am giving her k/d for now, but still still eats regular food also. I have four other cats - another 13 year old, a 3 year old and two 7 month old kittens. So can't put them all on a lower-phos diet at this point. And of course, Sara eats some of their food.

I don't look forward to the days it will get worse. So just trying to enjoy things the way they are now, and try to make them stay that way as long as possible.
 

psychomama

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Oh and the other cat eating grass to vomit regularly is probably a sign that his stomach is hurting regularly, which could be from a food intolerance, inflammatory bowel disease, or high stomach acidity (that can come from kidney problems). My cat did that for years before any of her kidney stuff showed up on a test, she would eat grass and have foamy vomit at least a couple times a month. She also has food sensitivities, so I'm not sure which of her problems caused the vomiting actually.

catinfo.org has tips on how to transition dry food addict cats to wet food. My cat wouldn't touch wet food, I had to throw a lot away before she finally decided it was food. Which is frustrating, but something to just come to terms with when you're trying to switch food. I did the glob of wet food next to the dry food every day thing, and then under the dry food, and then in its own bowl (mashed with water to the perfect consistency....). For the first few days, maybe a week, she didn't even touch the wet and it was really discouraging. But eventually she got used to the smell and decided she liked it. I also just started with one flavor and was persistent in giving it to her.
My cat Psycho is 8 and on his mid year wellness in December some of his blood values were high. My vet did mention the beginning of renal insufficiency but said we would retest in June. He gets a monthly B 12 shot since his UTI last year and I bought him a drinking fountain which he drinks from everyday. He pees every 12 hours about 5-6 ounces and pops every other day so that is normal.
We have a house at the beach and sometimes not every time he will throw up when he realizes we re going. He picks it up from our patterns. I learned to feed him the night before so it is mostly white foam . This just started this past year. I never put it together but it does seem it is the beginning of CKD. He sometimes wants to eat grass too which I thought all cats did normally.
He has also been picky lately with wet food and sometimes the dry. I vary the wet flavors from type to brand daily but maybe as you suggested I should keep feeding him the same wet food until he tired of it. He gets 3-4 T each day dry and I vary between Orijen and Acana. I am trying to increase the wet but it seems he hits a wall with it and needs the dry to keep weight on. He was down to 8.2 last January after the UTI but is now 9.3. He s a small cat and the vet said 10 would be tops.
I would appreciate thoughts and suggestion to help me do the best for him to keep this from progressing quickly. At this point he is very playful and active and I want to keep him that way. Thank you all in advance for any help. This site is marvelous !
 

donutte

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My cat Psycho is 8 and on his mid year wellness in December some of his blood values were high. My vet did mention the beginning of renal insufficiency but said we would retest in June. He gets a monthly B 12 shot since his UTI last year and I bought him a drinking fountain which he drinks from everyday. He pees every 12 hours about 5-6 ounces and pops every other day so that is normal.
We have a house at the beach and sometimes not every time he will throw up when he realizes we re going. He picks it up from our patterns. I learned to feed him the night before so it is mostly white foam . This just started this past year. I never put it together but it does seem it is the beginning of CKD. He sometimes wants to eat grass too which I thought all cats did normally.
He has also been picky lately with wet food and sometimes the dry. I vary the wet flavors from type to brand daily but maybe as you suggested I should keep feeding him the same wet food until he tired of it. He gets 3-4 T each day dry and I vary between Orijen and Acana. I am trying to increase the wet but it seems he hits a wall with it and needs the dry to keep weight on. He was down to 8.2 last January after the UTI but is now 9.3. He s a small cat and the vet said 10 would be tops.
I would appreciate thoughts and suggestion to help me do the best for him to keep this from progressing quickly. At this point he is very playful and active and I want to keep him that way. Thank you all in advance for any help. This site is marvelous !
If you think he's getting worse at all, you may want to get the blood work done sooner than June so you can plan appropriately.

Is the food you are feeding him a pate-style? If so, it may help to heat it up and add a tablespoon or two of water to each feeding, and make a sort of gruel. Sara has literally eaten up every bit of food since I started doing that. Before that there were always a little bit left.
 

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I do all that already. I will monitor him and if he starts to loose weight I will ask for the blood work to be done again . Does anyone have an opinion about a regular vet vs a all feline vet?
 

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Psycho had not been eating much the last few days. He plays and uses the litter box fine but his appetite is off. When he had his wellness in December the vet said he had some renal insufficiency. I called them tonight and they want me to bring him on Thursday and drop him off so they can recheck his blood work. Wish us luck .
 
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