Possible diagnosis of CRF

My senior cat (15 years old) was having mucus in one eye. I also noticed that he was drinking quite a bit of water. That really red flagged me, since he eats exclusively canned/wet food. My other kitty who is also on wet food only, hardly ever shows interest in the water bowl. 

I got him checked out at the vet. They recommended Lysine for the eye. The vet did bloodwork and ruled out hyperthyroidism and diabetes. My cat's kidney values were slightly out of the normal range however. The vet wants to do a urinalysis to 100% know for sure, but he's leaning toward a diagnosis of kidney disease. 

Less than 6 months ago, my cat's bloodwork was totally fine. I did pre-anesthesia bloodwork before putting him under anesthesia and everything was fine. He did great with the anesthesia and the dental cleaning went really well. 

So, if he does have kidney disease it has developed very recently. The vet says that the plan of action if he has kidney disease is to give weekly subcutaneous fluids.

Just posting here basically for the support and encouragement. Feel free to share any experiences with kidney cats. 

We'll know for sure exactly what's going on, after I get the urine sample and get it analyzed.

I've had 3 kidney cats, and all I can say at the moment is it's a good thing you caught it early, IF that's the issue.  Just slightly above normal is better than WAY above normal 

For right now, here is a website that was my "go to" for anything kidney related.  Take a look around and then feel free to ask any questions you like:  http://www.felinecrf.org/index.htm

Not to jump the gun, but IF your furbaby does have the beginnings of kidney disease, your Vet is absolutely correct in that adding weekly sub-q fluids is a good thing, but also, food is important.  It's great that you are feeding a wet diet already, but the food itself is important.  The protein in the food needs to be a very good quality protein, and the phosphorus should probably be a lower amount.  Try to stay away from carbs in his food.  

(used to be they said kidney cats should eat low protein food, but the new way of thinking is that's why kidney cats lose so much weight and have muscle wasting,  so if your Vet suggests that, come back here and I'll try to locate some threads that discuss it, ok?) 

I completely agree with everything that mrsgreenjeens wrote about diet and fluids. There are lots of good canned foods with low-to-moderate phosphorus levels. When our previous, very senior, cat had mild/moderate kidney disease I used the food charts on Catinfo.org and the site that mrsgreenjeens linked to. Dr. Pierson also has mentions of muscle wasting and low-protein diets for kidney cats: her advice on the site, which I followed up with research into the protein controversy, was the big reason I refused to feed our cat the prescription food the vet recommended... and Brooksie's kidney levels improved on high-protein commercial canned foods with reasonable phosphorus. (Of course every cat is different but she was a complex case: her kidney disease was mild but she had numerous other ailments that meant she didn't live long after her kidney diagnosis.)

Good luck, Crazy4Strays, the fluids and continued wet food, with an eye on phosphorus levels, are a good start!

Hi Crazy4Strays !

Like mrsgreenjeans , my 'go-to' for all-things-kidney is Helen's "Tanya" site....for me, it's THE "Oracle".

So, here's what 'The Oracle" says about when to use fluids in kidney cats: "it is best not to begin fluids until the advantages are likely to outweigh the disadvantages i.e. when a cat would become dehydrated without them"  (see excerpt below).

Disadvantages...?  Yup !

I've pulled some key points from the section on fluids:

When To Use Subcutaneous Fluids

Although sub-Qs can be of great benefit to cats who need them, not all CKD cats need them immediately. As mentioned above, the purpose of sub-Qs is to keep the cat hydrated enough to avoid dehydration occurring. However, cats with early stage CKD can usually drink enough to offset their increased urination, and thus do not become dehydrated even without sub-Qs.

Processing sub-Qs in itself places an additional workload on the kidneys, plus it can flush out certain nutrients, reduce potassium levels and raise sodium levels. In Staged management of chronic kidney disease in dogs and cats (2009), a Presentation to the 34th World Small Animal Veterinary Association World Congress, Dr David Polzin states "Because recent evidence suggests excessive sodium intake may harm the kidneys, recommendations for long-term sodium administration in any form should be carefully considered."

Giving too many fluids or too soon may also increase the risk of overhydration.  This is a particular risk for cats with heart problems. Therefore it is best not to begin fluids until the advantages are likely to outweigh the disadvantages i.e. when a cat would become dehydrated without them.

Dr Katherine James of the Veterinary Information Network believes that this tends to happen and that most CKD cats will benefit from subcutaneous therapy once creatinine levels are consistently over 3.5-4.0 US (300-350 international). This equates to high Stage 3 of the IRIS staging system. If your vet thinks your cat's CKD is less advanced than this, and your cat does not appear dehydrated, then it is probably safer to hold off on sub-Qs for the moment.
However, there are exceptions......

http://felinecrf.org/subcutaneous_fluids.htm#when_use_sub-qs

(my emphases)

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So, you said his values were "slightly out of the normal range"......well, that's nowhere near "Stage 3" in the kidney disease spectrum....

I think I'd be joining Helen's specialized online kidney community if I were in your shoes...that's here: Tanya's Feline CKD Support Homepage

Wow, thank you for the detailed replies. I dropped off his urine sample at the vet's office, we'll see what happens with the urinalysis.

Any recommendations on low phosphorus canned foods that won't break the bank? I do a LOT of shopping at Tractor Supply Company for canned food, mainly because of the sheer number of cats that I'm feeding. (Right now, I have two resident cats and FIVE foster cats) My own cats eat mostly 4Health brand canned food, often grain free, but lately have been using their non grain free formula because it's still pretty good and the cost is much lower.

Likely, though, we're going to eventually downsize to having just one foster cat at a time, especially if my cat has chronic health issues that require more time and money to manage.

OK........here's "Tanya's" canned food 'table' for US-available varieties (you want phosphorous levels under 1%):  http://felinecrf.org/which_foods.htm

If you want the background info on the why's and wherefore's, that's here (again, plain-language reading):  http://felinecrf.org/which_foods.htm

I think I might first go to the store(s) and make a list of what's on the shelves....(but, I don't have a "device" in my palm )

White Shadow said:

 
Hi Crazy4Strays !
 
So, here's what 'The Oracle" says about when to use fluids in kidney cats: "it is best not to begin fluids until the advantages are likely to outweigh the disadvantages i.e. when a cat would become dehydrated without them"  (see excerpt below).

Disadvantages...?  Yup !

I've pulled some key points from the section on fluids:

When To Use Subcutaneous Fluids

Although sub-Qs can be of great benefit to cats who need them, not all CKD cats need them immediately. As mentioned above, the purpose of sub-Qs is to keep the cat hydrated enough to avoid dehydration occurring. However, cats with early stage CKD can usually drink enough to offset their increased urination, and thus do not become dehydrated even without sub-Qs.

Processing sub-Qs in itself places an additional workload on the kidneys, plus it can flush out certain nutrients, reduce potassium levels and raise sodium levels. In Staged management of chronic kidney disease in dogs and cats (2009), a Presentation to the 34th World Small Animal Veterinary Association World Congress, Dr David Polzin states "Because recent evidence suggests excessive sodium intake may harm the kidneys, recommendations for long-term sodium administration in any form should be carefully considered."

Giving too many fluids or too soon may also increase the risk of overhydration.  This is a particular risk for cats with heart problems. Therefore it is best not to begin fluids until the advantages are likely to outweigh the disadvantages i.e. when a cat would become dehydrated without them.

Dr Katherine James of the Veterinary Information Network believes that this tends to happen and that most CKD cats will benefit from subcutaneous therapy once creatinine levels are consistently over 3.5-4.0 US (300-350 international). This equates to high Stage 3 of the IRIS staging system. If your vet thinks your cat's CKD is less advanced than this, and your cat does not appear dehydrated, then it is probably safer to hold off on sub-Qs for the moment.

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WOW!  I KNEW there were risks if a cat had heart disease, certainly, but guess I never read this section, since none of my cats started sub-q's before they absolutely needed to (mainly because WE were resistant for all the reasons everyone else gives...don't want to hurt the cat, yada, yada, yada).  This info is good to know.  Thank you @White Shadow, for setting me straight!

Interesting link. It's saying that veterinary prescription diets are good for CRF. I might just go with one of those, if the cost is not prohibitive. My senior cat is not picky at all, so I'm fairly confident that getting him to eat the food won't be a problem.

I found this option. It looks like it could be a decent, affordable choice.

Based on urinalysis results, the vet feels that we should treat with antibiotics for a silent UTI. I don't know how my cat got a UTI on a canned food only diet, but at least I have answers now.

UTI's can be brought on by stress, or other things other than dry food .  Stress is oftentimes the biggest contributor to UTIs.  Has anything changed in your furkid's life to bring on some stress lately? 

Hmmm...stress. That's a good thought.

I went to the vet's today and discussed the results. Spottie definitely has CRF. The vet said that for now we'll hold off on doing subcutaneous fluids. He recommends feeding a prescription canned kidney diet, so that's what I'm planning to do.

That is a very nice resource on the foods. It was surprising to see so many of the standard available foods. I also thought what she had to say about raw diets very interesting too. Even though commercial freeze dried foods like Primal and Stella and Chewy are put through some process to lessen the risk of pathogen, it isn't risk-free. I personally hadn't thought of the immune issue for cats with kidney issues.

Crazy4Strays said:

I went to the vet's today and discussed the results. Spottie definitely has CRF. The vet said that for now we'll hold off on doing subcutaneous fluids. He recommends feeding a prescription canned kidney diet, so that's what I'm planning to do.

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If he's he'll eat them, that'll be great.  If not, then at least there are plenty of options out there that aren't half bad.  And you can always add phosphorus binders if need be.

Spottie will eat any type of wet food. I've ordered full cases of new canned food before and never had a problem with him eating them.

My plan is to either go with Hilks or Purina NF prescription canned food.