Inflammation of the kidneys?

The advice that cat nap has given already looks good to me.   The most important thing is that your cat eats something @Mukkia.

This is a section quoted from icatcare.org on managing CKD.

Cats will often develop a strong preference for particular diets, and low protein diets tend to be less palatable. This means that changing cats with CKD to an appropriate therapeutic diet can sometimes be difficult. These tips may help:

• Always make a change in diet gradual - per several days at least and sometimes over a few weeks if your cat is quite fussy
• Start by mixing a very  small amount of the new food with your cats old food, and make sure it is well mixed
• Only increase the amount of the new food slowly, once your cat is happy to eat the old mixture. Make each step where you replace old food with a greater amount of new food slow
• Warming the food to body temperature (around 30C) may help increase the palatability
• If necessary, talk to your vet about using drugs to increase the appetite to make the transition easier

In most cases with sufficient care and time, cats can be very successfully transitioned to a new diet, and as this is such an important part of managing CKD it is worth taking the time to do this properly. If cats absolutely refuse to eat any of a new diet, it is important that they eat something, so keep offering their old diet in this situation and contact your vet for further advice.

 

Mukkia said:

Any input?

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I am a human doctor, not a vet and any advice that I give you should be checked by a vet.  However the urine test is consistent with mild kidney impairment.  There is a low urinary specific gravity - consistent with the kidney having lost the capacity to concentrate the urine.  This is one of the first kidney functions to be lost in early kidney failure, but the cat can currently compensate for this by the passage of frequent urination.  The thirst is to make up the fluid loss. 

Incidentally there is no evidence of any infection in this urine test.  The biochemistry reveals a normal blood urea and creatinine and this is a good sign, confirming that the renal failure is not severe.  The third eye lid being drawn across in the third photo suggests that the cat was not feeling well when this photo was taken.  The "knobbly" kidney may be due to cystic kidney disease but the ultra sound would help diagnose this.

With kind regards,

Geoffrey

Perhaps, on Tuesday, you can ask your Vet about a Feeding tube....there are many kinds.

I would only use one, if my cat had a chance of recovery, and quality of life, not to prolong suffering or length.

I don't know what the cost would be, and have never used one, but some members have.

Don't know if they only help for the short term, or are used long term, either.

This Article from TCS, has a few more ideas:
[article="33011"]How To Get Your Cat To Start Eating Again  [/article]
Another member mentioned grinding their cat's food, dry food, in a coffee grinder, and making a paste with it.

It sounded like a good thing to try.

http://www.thecatsite.com/t/277263/old-age-anorexia-my-solution   .... Post #1

Mega vibes on Tuesday, for Mukkia.       

Thank you for your replies,and help. I am about to give an update. It is going to take a few minutes to get it on here. I think this thread will most likely have to close after. I am not sure how the moderators are going to want me to proceed with any additional advice I may need in the future, because Mukkia's primary condition is not ( inflammation of the kidneys.) Nor does he have CKD.

Mukkia said:

Thank you for your replies,and help. I am about to give an update. It is going to take a few minutes to get it on here. I think this thread will most likely have to close after. I am not sure how the moderators are going to want me to proceed with any additional advice I may need in the future, because Mukkia's primary condition is not ( inflammation of the kidneys.) Nor does he have CKD.

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It should be fine to continue posting in this thread.

talkingpeanut Thank you. I want to apologize to everyone in advance. The following post is rather long due to a lot of pertinent information. I am still in the process of typing it out.

Sorry I have been out of the loop. Sending you hugs. One thing I want to mention=does the vet think that there is nausea going on?

There are a few things to try-

Pepcid is every 12-24 hours- ask the vet-many kitties are on Pepcid for kidney disease. Floey my angel=ate so MUCH better on Pepcid. We couldn't pill her so we did injection. There are pill pockets and pill poppers to use.

another thing is Cerenia or Zofran. Those are anti nausea/vomiting meds. those are at least Cerenia is once 24 hours. Zofran I don't remember how often. I would definitely ask about these two meds-I need to read your posts for the past 6 days..sending you hugs and prayers that we can get Mukkia to eat more!

Before Mukkia had his ultrasound done I spoke with the doctor about him losing weight, and vomiting.
He proceeded to tell me that Mukkia is almost 15 now, and that I was going to have to accept the fact that he is going to be a . . .
I stopped him there. He was telling me to accept the fact that Mukkia is old and he was heading down the ( old skinny cat syndrome speech. )

That was the first time I was ever stern with the doctor, and being a true advocate for Mukkia.
I told him, 'No, I have already had to accept the fact that Mukkia is no longer going to be the healthy 9.6 lb cat he has been his whole life. I trusted you when you told me that it is better for Mukkia to weigh 8.4 lbs, due to his health. Lower risk of fatty liver, diabetes, developing arthritis. However, I refuse to accept the fact that now not only is Mukkia not maintaining the 8.4 lbs; he is steadily decreasing in weight.'

That is when he decided to do the ultrasound. I found out from the doctor's office that Mukkia was referred to that they had intentions of doing a biopsy on Mukkia. Whoa, stop there! No, you are not going to biopsy Mukkia! End of story, stop there! So, I called Mukkia's doctor's office and told them what the referring doctor's plan was. And that was NEVER discussed between Mukkia's doctor, and myself. They said no, and I said I am not taking Mukkia there. I was referred to a different office. Everything was fine until they called me to go over the fasting process. Guess what, yep, biopsy again!
So, now I am livid! I called Mukkia's doctor once again. Finally, he relays to me from his staff the message. Yes, but make sure that I know "it is a biopsy of his kidney, and not the intestines."
At this point I have lost a huge amount of trust. I would have signed a paper with the initial referred doctor to perform the biopsy. I am sure that it is small print, and I would not have even read it.
Thankfully, the second reference I asked for explained to me that they do not do biopsies there, and the fasting with them was in case Mukkia was difficult to do the ultrasound on.

I contacted Mukkia's doctor's office at this point, and requested a copy of Mukkia's records. I honestly had no intentions of taking him back there after this level of deception. Biopsying the kidney is no less dangerous than a biopsy of the intestines!

As everyone knows he did have the ultrasound performed. I paid $405.00 to do this. However, I found out it was almost useless. I will get to that in a few.
After the ultrasound, Mukkia could not use the bathroom, I believe it is because he was dehydrated from them fasting him from water for nearly 14 hours! Remember, " no food or water after 10:00 p.m", his appointment was scheduled at 10:00 , or 11:00 the next day. I don't remember. I am sure i posted it on here in an earlier post. Then it took an hour to perform, then add in the drive home, I specifically remember that Mukkia had not had water for almost 14 hours. I called his doctor the next day to let him know that Mukkia was having trouble passing a small amount of stool. I also wanted the results of the ultrasound report, because I paid for his doctor to receive it within 24 hours. I was not able to speak with him until 6:00 that Friday! My mom stopped by his office to pick up the fluids, and he apologized saying that he thought they would have given him some. He only told me what the kidneys showed, said that everything else is good.
He gave my mom the KD, and that was that.

As you know, Mukkia's food intake dropped more. Last Wednesday through Saturday he only ate 5.25oz of KD and a few treats. Sunday, nothing except for a few crumpled pieces of Blue Buffalo Turkey and duck treat on the top of his food. So, essentially nothing. I could not get him to eat anything. Not even his favorite Turkey and cheese Fancy feast. Monday I called and told his staff what was going on, and that at that point Mukkia was basically 24 hours without eating, and Tuesday when his appointment was moved up to it would be 48 hours. She said that he was fine to go that long without food. I questioned her, because I didn't think an already Ill elderly cat should go that long to sustain health. She put me on hold and asked the doctor. She came back and informed me that he agreed that Mukkia is fine to go that long without food.
I was beyond livid now!

The veterinarian search began. I am so mad at myself for not paying attention when I found this vet, I thought were accredited. After searching for a different veterinarian i discovered THEY ARE NOT ACCREDITED! I was reading a review that said they were, when in fact, they are not. They are actually no where near this, and they have only a handful of reviews! Half good, half not good.
I found an actual accredited veterinarian's office! They are expensive, but AMAZING! I spoke with them on the phone, and they said I could bring him in the same day. They agreed with my concern for Mukkia not eating. I called Mukkia's doctor's office and told them to cancel his appointments and all future appointments. I even told her why I was canceling. She said OK have a nice day! Unbelievable! I figured the doctor would have at least called me and question his staff as to why I was pulling Mukkia from his care, no, nothing.

Now, three doctor's including the owner of the ACCREDITED veterinarian's office reviewed Mukkia's entire files. I can thank @Kittens Mom for having those on me.
Wow! She said that there has been a lot of testing done that should have which ruled a lot out, but still testing that was not done to find out what is going on. There was a veterinarian's term for this, but I don't remember. She asked me a lot of questions about Mukkia, and gave me a lot of information. We spoke for over an hour. During this time she was checking Mukkia throughout certain points in our conversation, and taking notes.
First off she was astonished at what the last two veterinarians did, and did not do.
The first veterinarian obviously should never have told me based on an x-ray that he had gastrointestinal lymphoma, and not long to live. That is not how it is diagnosed. The last veterinarian which I gave almost 7 months to diagnose made many mistakes. The first one was by ruling out lymphoma without biopsy. Even though I chose to not do it, he ethically could not do it. Second, a barium study would not have shown if Mukkia has an ulcer in his stomach. Some members on here will recall that was one thing he was looking for in that test. She said that a cat's stomach looks just like a humans. There are ridges, and grooves just like ours. The barium study would not show an ulcer if it is small and in the ridge, or groove.
She said that he should have tried a certain type of medicine on Mukkia when nothing else helped. I don't recall the name of the group of the medications, but I can tell you one that is in it, because she prescribed Mukkia some. It is, Sucralfate 1gm. She also asked me if he ever tried Mukkia on another class of medicine, again I don't recall the name, but we are going to try this on him next week. Back to the ultrasound, it is useless because there are no still frames of the intestines. She said she always looks at this when an ultrasound is done of the abdomen. Also, I found out it was sent off to IDEXX laboratories to be read by a radiologist!
That was valuable information not looked at. She described the intestines to me and the layers.
He did not have Mukkia's urinalysis cultured!
She took a sample and it is being cultured. It will take a week. She said what he did was send the urine to ANTECH where a person looks at a sample of the urine under a microscope and determines if they see bacteria. There sometimes so few that it is missed. Also, something where it never shows up. Again, I forgot the name of which causes this. I am so sorry, I was given so much information it was difficult to remember all of it.
She does not want to give Mukkia medicine before she knows for certain that he has an infection. Also, she wants to know what type of bacteria it is so she can treat him accordingly, because he is so sensitive to medicine. Impressive, huh?
As for the glomerulonephritis, it is usually a secondary issue, due to a primary problem. Ig. IBD, lymphoma. She is concerned about this. However, she agrees with me on not wanting to put Mukkia though biopsy. I did ask her, since he has been this long without any Prednisone would not we be able to rule out the lymphoma? She said no. They actually recently treated a 17 yr old cat with lymphoma just by giving her Wei Qi. They were thinking maybe an extra 6 months of quality life? No, she made it to another year and a half! So, I have this for Mukkia. She said it will help him with muscle loss, possible weight gain. Definitely help strengthen his immune system. I found out that the way I have shown, and explained to the past vet that when Mukkia sits with his rear end up, this is called a praying position. It is an indication of abdominal pain! Now I feel horrible.

She is very concerned with how much weight Mukkia has lost, and the way he lost it . A lot in the beginning. She said there are other things they could, and should have tried to give Mukkia but didn't. She also explained to me that there is a recent study on Mirtazapine in felines. she explained to me why it causes most cats to have the increased heart rate, and how it stimulates the cat's chemicals in their brain, because that is what it is used for in humans. side effect, there is a technical name, but I don't remember. Anyway, they discovered that even when cutting the pill you are still giving the cat too much. Somehow, I don't remember, it is nearly impossible to give them a correct dose this way. There is a different way of doing it I think she said that ensures that your cat is getting the correct dosage.
She said she doesn't want to give Mukkia too much medicine for different reasons or the same, so that we can know for sure what is actually working for him. [emoji]128077[/emoji][emoji]128568[/emoji]
We will know by next week if in fact Mukkia does have an ulcer, and infection in his urine.
If the sucralfate 1gm, doesn't work, next week she is going to prescribe him a barbiturate that starts with a B? I am sorry. I seriously was given so much information.
Oh, also, Mukkia should not be on the KD!

Again, I apologize for the long post.
Also, any grammar errors, or typos.

I am so glad you found a great vet, sadly there seems to be a lack of them. I wish you and Mukkia the best and think that with your new vet your are on a better path. 

Zed Xyzed said:

I am so glad you found a great vet, sadly there seems to be a lack of them. I wish you and Mukkia the best and think that with your new vet your are on a better path. 

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Sadly,, that is true. Thank you! Let's pray for an ulcer only!

Oh, also now I can view his records, schedule an appointment, refill prescriptions and many more options from their pet portal! That's convenient!

It sounds like you have found an awesome vet.   Massive positive vibes for Mukkia that this now gets to the root of what has been happening, and to start seeing him recover his health.  Do please keep us all updated with how things go now.     

Yes, she sounds like a very thorough vet. Hoping that the Sucralfate and immune booster help to get Mukkia eating again.

Did she prescribe another type of prescription food, or is Mukkia back on his CD food?

Mega vibes that Mukkia starts feeling better quick.    

cat nap said:

Yes, she sounds like a very thorough vet. Hoping that the Sucralfate and immune booster help to get Mukkia eating again.

Did she prescribe another type of prescription food, or is Mukkia back on his CD food?
Mega vibes that Mukkia starts feeling better quick. :rub:    

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. Yes, his CD, but at this point in the game, I think just what ever he will eat.

MServant said:

It sounds like you have found an awesome vet.   Massive positive vibes for Mukkia that this now gets to the root of what has been happening, and to start seeing him recover his health.  Do please keep us all updated with how things go now.     

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I am so holding out hope. I truly appreciate your help, and vibes. I know that Mukkia does took. [emoji]128571[/emoji][emoji]128575[/emoji]

Thank you for all of the vibes. We honestly need all that we can get.
So far, no improvement in Mukkia. He did eat one whole can of the small size Fancy Feast Turkey and cheese Wednesday night. However, he has only eaten a half of a small can since then.
I guess it is fair to say that the sucralfate 1gm, is not working. [emoji]128575[/emoji]

He absolutely wants nothing to do with food. Just in the past week I know for sure he has lost more weight. He was 7.6 at the new vet, but not he is seriously sunken in all over.

He spends most of his time hiding behind the couch. I am trying to figure out if I am doing the right thing for him at this point.

I am truly heartbroken. I cannot stand to watch him hide, and continue to essentially deteriorate. When he is not hiding he is sitting at the door trying to get outside.[emoji]128575[/emoji][emoji]128575[/emoji][emoji]128575[/emoji]

I will post an update when I have one.

I am not sure how the Wei Qi is going to work, or how long it will take. I am hoping, and hoping, and hoping.

Sending you hugs and prayers. Maybe he is trying to tell you something by waiting by the door. I am so sorry. Crying with you. I hate it when it's time for them to leave us.

It is upsetting to hear that he is not doing better. Sending you both hugs and prayers.  

foxxycat said:

Sending you hugs and prayers. Maybe he is trying to tell you something by waiting by the door. I am so sorry. Crying with you. I hate it when it's time for them to leave us.

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I am heart broken. I put a call in to the vet. I think today gas to be it. [emoji]128575[/emoji][emoji]128575[/emoji][emoji]128575[/emoji][emoji]128575[/emoji][emoji]128575[/emoji][emoji]128575[/emoji][emoji]128575[/emoji][emoji]128575[/emoji][emoji]128575[/emoji][emoji]128575[/emoji][emoji]128575[/emoji][emoji]128575[/emoji][emoji]128575[/emoji][emoji]128575[/emoji][emoji]128575[/emoji][emoji]128575[/emoji]

Didn't the new vet have an idea about a plan b?