Adding More Wet Food to Diet - Possible Kidney Issue

[mrsgreenjeens]

HOnestly, our Vet said the most important thing is for them to eat.  Period.  And some of the foods Callie likes have VERY HIGH phosphorus, and others are fairly low.  Our Vet figures that over the long run, maybe they average out to be okay, but if not, at least she is eating.  And if they don't eat, they certainly will die, so she said let her eat anything she wants.  This is what WE do.  She's had kidney disease now for almost 3 years and is doing better now (clinically) than she has since she was diagnosed.  Why...because her tummy is full.  And she is gaining weight.  I'm starting to see her groom herself again, after years if not doing it

I mean after meals, which tells me she's satisfied.  And she comes to me for food again

.  This all started when we increased her sub-q fluids and found foods she really liked.  Now with her full tummy, she doesn't even need her prescription Pepcid all that often either.  Oh, I did forget, she IS on an appetite enhancer.  She gets that transdermally twice a week, but has gotten that for over a year, and it didn't used to make any difference.

I say if he wants to nibble on the other cats' food, let him.  The KD food would still be the majority of his food, right? 

BTW, I feed my girl wherever she happens to be at mealtimes.  In OUR bed in the middle of the night

, in HER bed if that's where she is at times, on the couch, in a sunbeam if she's sunning herself in the exercise room...wherever when it's mealtime.  I usually find her and set the bowl in front of her and she digs in...IF I'm not late and she finds me first.

 

[ruthm]

Sorry to read your Jumbo's creatine has increased, just wondering what the rest of his labwork looked like: specifically, what was his phosphorus?  That can make a cat feel like crap just as high creatine can.  I agree with Mrs. Greenjeans, or should I say my vet always said the same thing, the cat has to eat, even if it's Fancy Feast aka kitty crack, you might just need to add a ph0sphorus binder if his phosphorus is high.

http://www.felinecrf.org/nausea_vomiting_stomach_acid.htm

I see you are giving Pepcid, but is Jumbo actually needing it? Pepcid is for stomach acid, vomiting clear or white foamy stuff on an empty stomach is a sign of this. i hear you saying he vomits food, pepcid won't help that at all. Do you think he is nauseous? (i.e.sniffing food, walking away, lip smacking etc?)   Have you considered spreading out his meals as mrs. Greenjeans suggested? We found the Petsafe 5 meal autofeeder was a lifesaver. You can freeze individual portions that will thaw out during the day and remain moist.

 

[catminionjess]

@mrsgreenjeens  - His vet agrees he needs to eat, but only the k/d Rx food, most of which he won't eat  

. And yes, if he's snags some of the other cats' food, the k/d foods are his main food. He hasn't been as picky about the dry k/d food. He was happy with the Hi-Tor Neo dry until the bag went stale. And this morning I gave him the last of the Royal Canin Renal Support A dry sample bag that I got 2 weeks ago. But he still hasn't been eating enough of the dry to put weigh back on. And cats with CKD should be eating more wet food than dry.

He still grooms himself. His coat has never really been shiny or soft. He's had skin and digestive problems since I first found him in 2011.

@RuthM  - Jumbo's phosphorous was 5.9 from blood work 9/12. It's not listed on liver test from 12/28. From what was tested in both tests, these are the changes.

ALKP went from 28 to 42

ALT went from 46 to 29

BUN/UREA from 33 to 31

BUN/CREA from 13 to 10

CREA from 2.6 to 3.0

He actually does need the Pepcid. The majority of his throwing up is the white foamy or clear bile. Even if I don't see him do it every day, I see evidence on his bedding or on the laminate floor in his room every day. Other times, maybe at least once a week or so, he throws up food after eating. Those times it includes the food and sometimes more foamy bile.

I ordered an auto-feeder a few months ago, but didn't like it when it arrived so I sent it back. Maybe I'll look at a different model. I suspect though, that I'd just end up with 5 compartments of uneaten food instead of just the one bowl.

 

[catminionjess]

UPDATE;

Jumbo had another liver test yesterday and his numbers are a little better than the last one. His weight is up just a tiny bit, from 8.8 to 9.0. His vet put on a 6 month retest instead of 3 month. Unless I notice any negative changes of course. He still has a wellness exam in 2 months. 

ALKP (ALP) from 42 to 43

ALT went from 29 to 57

BUN/UREA from 31 to 30

BUN/CREA from 10 to 14

CREA from 3.0 to 2.1

They said keep doing whatever we've been doing. I didn't say he hadn't been eating the k/d wet food. since It was a short phone call after the quick visit for the test. I had them email the lab results. He hasn't been eating the vet k/d food since after the liver test on 12/28/15. He's been eating Merrick limited ingredient wet food and Iams Renal Plus dry. He's happier I think and not throwing up as much. Not daily anyway. We'll see how the next few months go. Hopefully well.

 

[mrsgreenjeens]

Any time the numbers improve i take as a positive  

I agree...just keep doing what you're doing.  Great job 

 

[ruthm]

His labs look good, especially his creatinine! 

 

[catminionjess]

Yeah, the creatinine is even lower than it was on the original blood work in September. It was 2.6 then. I was surprised and relieved a little to see that. I'd still love for him to gain more weight back. He was almost 13 lbs when I found him 5 years ago. It's sad to see him all shrunken these days. But at least he must be feeling a little better than 6 months to a year ago. 

 

[catminionjess]

Jumbo went to the vet this morning for his annual wellness exam and 3 year rabies update. He has lost another half a pound since his March liver test. He really hasn't been eating as much since that test. I went through the list of k/d foods (at least 7 wet ones) he's tried and not liked. I asked him what other ones I should try. He said since he's already tried so many, he probably won't respond to any other k/d options either and that's the point you give in and let them eat regular food. I had mostly just been letting him eat Merrick LID or Iams purrfect delights anyway, but still offering the k/d cans I still have here and there. I would go with a k/d only if he would actually eat it. The dry k/d isn't a problem, he'll eat it, but not a whole lot. So I asked what else I could be doing to help his appetite. He's been on Pepcid since late September.the vet mention at home or in office sub-q fluids is one option, but he said he wouldn't say Jumbo is "wasting away" for now. Then he mentioned some drug I didn't really catch. And then said or this other thing is pretty cheap and some cats do well on it. So he ended up giving me a sample, 3 pills quartered of Mirtazapine, to give 1 quarter every 3 days. If that helps, they'll give me more or write a prescription. He also thinks Jumbo is probably older than 8. We just kind of estimated at least 5 back in 2011. 

I know I've heard other TCS members mention using Mirtazapine for their ckd cats. I haven't had a chance to give it to him yet today. I had to go have a tooth filling replaced not long after his appointment. What should I expect after giving it to him? Any weird behaviors or side affects i should watch for? I will probably give him the first dose tomorrow. 

 

[donutte]

I've had two cats on mirtazepine. It worked for Sara the first time she was on it, but not this last time. With Lucky, I think it worked the first day, but that was it. Sara only had the meowing side effects the first time she had it, afterwards she didn't. This last time, we ended up putting her on cyproheptadine, that seemed to work better this time.

 

[catminionjess]

I've had two cats on mirtazepine. It worked for Sara the first time she was on it, but not this last time. With Lucky, I think it worked the first day, but that was it. Sara only had the meowing side effects the first time she had it, afterwards she didn't. This last time, we ended up putting her on cyproheptadine, that seemed to work better this time.

That may be the other name the vet mentioned that I didn't understand well. So nothing really scary to watch for? It just may or may not work great depending on the cat?

 

[donutte]

I honestly think it depends not only on the cat, but their overall health at the time. When Sara was not eating due to severe hyper-t, it managed to work for her. She did get a bit more hyper as a result, and did meow a lot. But when your cat isn't eating, and something makes your cat eat, you don't really care about the meowing much! It did nothing for her this last time around with acute renal failure - didn't increase her appetite, nor did it have side effects. Cypro helped with the appetite but didn't really notice side effects.

You'll probably see a lot of people that don't like mirtazepine because of the side effects, but again, I think it just depends on the cat and its health at the time.

 

[catminionjess]

Jumbo seems healthy other than the kidney disease. They tested him for hyperthyroidism a year ago when he had lost over 2 lbs from the year before not due to a diet change. That was negative. Then kidney disease was confirmed 4 months later. He's VERY vocal, almost always loudly telling me about something so extra meowing wouldn't be any different than usual. So when he's not caterwauling I'm like, "oh no, what's wrong with you now?' My other cats would be more annoyed than I would. But they already are so still not anything different. We'll see how the mirtz works on him in the next several days. Fingers crossed for good results.