Decreased appetite and some slight nausea,

Hi all,

It's been awhile but I have a question to run by you guys. Here is the back story. Well I took Kattie in to her vet back in June as she had lost some weight and looked kinda scruffy. We did some bloods and urine and she had a slight elevation in her BUN and Creatinine. Everything else was normal, though she had lost some weight and was down at 7 pounds, possibly because her fatty brother likes to steal her food. Anyways, the vet said she was at a very early stage renal insufficency, but not enough to stat her on phosphorus binders or rx food ect. We did start her on Standard Process Felnin Renal Support, A chinese herbal called Six flavor Rehmania tea pills and she gets 100 mls of SQ fluids 1-2 times a week. We also got her a microchip feeder to prevent our other cat from stealing her food. About a month after the supplements and new regimen she was perkier, had a great appetite, and seemed to gain some weight back.

Fast foreward to 2 weeks ago we did recheck on bloods and urine. Her BUN ad Creatine dropped back into high normal range which was awesome, but her CBC showed some slight anemia which apparently can happen to CRF kitties as well as ones with intestinal issues, which she has chronic low grade IBS that we've been treating pretty successfully for years. She did gain a half pound back though which was great. The vet recommended starting her on an oral B complex supplement with iron if I could get it. I started giving her nutrical but I don't think its that great and has corn syrup in it which I'm not a fan of.

She had been doing great until last Friday when she vomited. She has hardly vomited in the last 6 months since her diagnosis and adding the supplements, so I watched her. She seems to have a diminished appetite since the vomiting. She is still eating but a lot less and I have to coax her and entice her with treats and catnip. She is also licking her lips, and meatloafing next to the heater on the dog bed. I'm pretty sure she is nauseous, so I added a quarter tab of Pepcid AC once a day at night for any acid build up. I also gav her a 1/4 tab of Cerenia under my vets advice. That seemed to perk her up on Monday but Tuesday after the Cerenia she started to drool and feel terrible. I think she got a taste of it and it is bitter. 

Today she seems slightly better and much more interested in food though not back to normal. I switched her from the nutrical to a B complex supplement with iron that gets really good reviews, but I am wondering if I should start to supplement with extra B12, possibly in injection form. She is showing the signs of B12 defiency. Loss of appetite, nausea, lethargic, anemia, and the fact that she has a history of intestinal disease and now CRF would explain a lot. I bought some oral B12 in the methycobalamin form, but I read that the oral form might be less effective if there are digestive issues. I rang my vet today to ask her opinion but she was out and will return my call tomorrow. The receptionist though said that she will probably be on board with it because they treat with b12 alot in cases like this. Unfortunately B12 is rx only but I want to give it at home. I'll probably have to get a script from the vet.

Overall, I'm just seeing what you guys think on this. She had been doing so good up to this point, and even now she isn't terrible, just eating less than normal. Of course it has to happen right before christmas

B12 injections are a great idea, IMHO.  They are wonderful for IBD cats (I know you said IBS, but if they are good for IBD, I would think they are good for IBS), and they certainly are good for kidney cats, AND definitely good for anemic cats.  It seems like a win-win situation for me.  Plus they are just so much easier to administer than pills.  We had a kidney cat that we had to administer ALL meds via either injectibles or transdermal gels.  NO orals at all or she'd vomit

Did the Vet suggest you change food with her kidney values starting to rise?  Usually when this happens,the very first thing that happens is to switch to lower phosphorus foods, before anything else.  You just didn't mention that, so I'm curious.  Here is a chart of low phosphorus foods, in order of the amount of phosphorus in it. http://www.felinecrf.org/canned_food_usa.htm#canned_usa  That website is my "go to" for most things kidney related.  It has sections regarding Pepcid A/D and Cerenia also, along with B-12.  AND Anemia, etc.

I have an IBD cat and do B12 shots at home, you can also buy this from the pharmacy as well as it is the same as used in humans. If you can give your cat a sub-q then you can do B12 shots. My guy is IBD and is anemic and his B12 levels tank after about 2 months so he gets a monthly injection. When their B12 levels tank they should get a B12 shot weekly for a month and then another one a month later and they pull some blood and test their B12 levels. I would also check for hydration especially after the cat throws up because it is easy for some cats to get dehydrated which makes them feel poorly and have a low appetite. I found that with my last cat that was also an IBD cat with renal failure that the injectable Cerenia made a huge difference opposed to the pill form. With the current guy if he needs Cerenia I try to give it to him with a sub-q as it hydrates him and putting Cerenia in the sub-q works well and his body absorbs it much better. If your car is an IBD/IBS cat then it may be getting used to the proteins in the food so you may want to try another food if things don't get better. One of the easier ways to check for hydration is not put one of your fingers in the cats mouth and see if it is really dry which is not right. My gets 0.25cc B12 shots and with a 25 gauge needle he doesn't even feel them.