Senior CKD cat - walking on hocks

My senior cat (18 years old) was diagnosed several months back with kidney failure.  She has been doing relatively well, though these past few weeks she has started to decline.  I adopted her as a senior - I have little history.  She recently stopped eating completely and became very lethargic.  I had her in to see the vet and found that her numbers had grown worse.  BUN, creatinine and phosphorus were elevated.  Potassium was normal.  T4 was checked and was actually low.

I assist fed her for a day and started her on phosphorus binders as well as upping the amount of fluids I give her daily.  She is on famotidine as well, which seems to do a good job controlling her stomach acid.  I was at the point of having her euthanized as she wasn't improving and seemed generally miserable and then one morning - there she was.  In the kitchen and wanting to eat.  She is eating enough now that she is (very slowly) regaining some weight.  She is jumping up onto low surfaces and asks to go into the garden (she has a catio, but also will accompany me onto the porch or into the garden.  She was an outdoor cat in her previous home and I will take her out with me as at this point - I just want her to be happy.  She sits beside me.  She isn't running off anywhere>)

What I have noticed is that she suddenly walks on her front wrists (this started first) and low on her hocks in the back.  Her back legs are definitely weak, and will sometimes go out from under her on a tile or hardwood floor.  On the rugs and carpets she is fine, if slow.  Her potassium was at 4.4 - I wouldn't supplement that without rechecking her blood and discussing with her vet.  Her glucose was 177 - high, but her vet didn't mention diabetes.  I called and asked for a kit to catch her urine at home to have her checked. Researching online - 177 is within the range you'd want to have a diabetic cat in (based purely on google searches - I have no experience here.)

I do give her a vitamin B supplement, but is a complex and so she possibly could use a separate B12 supplement.  She will see her vet this week - I will (hopefully) have the urine sample to hand in when her vet comes out to draw blood (at this point I don't want to drive her in - she gets very stressed)

So.  There we are.  Has anyone here seen a cat with normal potassium levels and who has not been diagnosed with diabetes (though certainly she may have it) with this plantigrade posture?  Any thoughts on what else it could be?  The B12 supplement shouldn't hurt and her vet was OK with my giving it so I have ordered it - it will arrive tomorrow.

I realize that I am in the home stretch with her, and the limit on what I will put her through to keep her with me a short while longer is very low.  If, however, this is something that I can easily fix or improve for her to improve her quality of life I will do that.  She has her problems but - she eats.  She makes it to the box and to the garden.  She "plays" with her catnip toys (she carries them and/or sleeps with them) and she occasionally knocks a kitten over just to show that she can.  She has her favorite spots by me and by the fireplace and purrs happily snuggled up next to me at night.  2 weeks ago I thought it was time to say goodbye.  This past week she has steadily improved and it seems she isn't ready to quit just yet.

177 mg/dl isn't a high blood glucose level. Normal is approximately 60 to 150 mg/dl. You also have to factor in stress as stress elevates blood glucose levels and what cat isn't stressed out at the vet's office? The vet can do a fructosamine test which will give the average blood glucose level over the past few weeks. The blood glucose test included with routine blood work just tells that your cat's level was at the time blood was drawn.

Urine glucose testing isn't very helpful. Diabetic cats always have some glucose in their urine. Glucose also builds up in the urine until the cat pees so when you get a sample, the glucose levels is typically on the high side.

Neuropathy tends to affect the hind legs, not the front legs. Methyl B12 (methylcobalamin), not regular B12, helps with neuropathy. Ask your vet for a recommended brand and dosage. Zobaline is a popular one for cats.

Or it could be a problem with the tendons or muscles or something nuerological.

Just my thoughts

Sadly, this is a common problem with kidney disease. My first kitty suffered from this and I think it's due to muscle wastage. Speak to your vet about this and hopefully they will find a solution. Hugs to you!!!