Cat with kidney disease has low potassium level under 3.0 mEq/L

[foxxycat]

I love all the pictures! I hope things stay stable for her. You are doing good! Sandi is very pretty and so is Thomas!

 

[zed xyzed]

What a beautiful girl. Thanks for sharing pictures of her

 

[donutte]

My vet was telling me about a cat of his own that had both heart failure and kidney disease, which is why he was so adamant about my checking Sara's breathing several times a day (she had a heart murmur). He said he made the mistake of taking on his own cat as one of his cases, but he didn't know any other way. He'd actually be checking her with a stethoscope several times a day. He'd check her breathing, if it was satisfactory, he'd give a small amount of fluids. Then he'd check again afterwards. For me, I had to check her resting breathing rate. I forget now what number it had to be under, but I was checking it constantly, because she was having hard breathing (for reasons we never really found out) even before she went into acute renal failure. After the acute renal failure, I couldn't afford to put her in the hospital on IVs so we had to do the next best things - higher than normal amounts of subqs at home. Her little body was so dehydrated it just sucked up the fluids so fast. I had to give 150 a day, broken up into two sessions a day. If her breathing seemed off at all, we would skip whatever the next fluid session was, and then check again throughout the day.

I'm guessing you'll have to do something similar, monitoring a lot. Which you already are, I'm sure.

 

[tamu708]

My vet was telling me about a cat of his own that had both heart failure and kidney disease, which is why he was so adamant about my checking Sara's breathing several times a day (she had a heart murmur). He said he made the mistake of taking on his own cat as one of his cases, but he didn't know any other way. He'd actually be checking her with a stethoscope several times a day. He'd check her breathing, if it was satisfactory, he'd give a small amount of fluids. Then he'd check again afterwards. For me, I had to check her resting breathing rate. I forget now what number it had to be under, but I was checking it constantly, because she was having hard breathing (for reasons we never really found out) even before she went into acute renal failure. After the acute renal failure, I couldn't afford to put her in the hospital on IVs so we had to do the next best things - higher than normal amounts of subqs at home. Her little body was so dehydrated it just sucked up the fluids so fast. I had to give 150 a day, broken up into two sessions a day. If her breathing seemed off at all, we would skip whatever the next fluid session was, and then check again throughout the day.

I'm guessing you'll have to do something similar, monitoring a lot. Which you already are, I'm sure.

Sandi's regular vet returns to the office tomorrow.  I will have to see what she recommends.  Right now, Sandi is tolerating the Enalapril well.  Her resting respiratory rate is 22.  Her breathing effort has calmed down.  And today she was purring a lot.  She definitely seems more comfortable.  I was reading online that anemia causes heart problems in cats.  She was severely anemic before she was hospitalized (HCT 15.1) After her transfusion, her HCT was at 23; even though there was improvement, the anemia is still very significant.  Maybe with the Aranesp, her anemia will be successfully treated and this will improve her heart function.  She had her first dose Thursday, and I have to take her to the vet next weekend to recheck her HCT.  Hopefully there is more improvement.  I am just hoping by some miracle that her HCT will become normal and reverse her current heart problems and she can go back on fluids.  The vet said the best way to bring BUN down was with fluid therapy.  He did mention that some people have used Azodyl, but he said he doesn't believe it works.  He did say it wouldn't hurt Sandi if I try it.  I am going to order some for her and see what happens.  I read a lot of people have used it and saw improvement in their cat's kidney numbers.  

Hopefully Sandi's  regular doctor will recommend a treatment plan that includes at least a small amount of fluid therapy as long as she is closely monitored and her breathing is improved.  I don't feel comfortable at all with completely stopping the fluids.  

 

[Geoffrey]

 
I took Sandi in this afternoon for a recheck of her chest.  The x-rays showed the fluid was starting to come back.  It was not bad like before, but was starting.  The vet wants to increase her Furosemide from .2ml to .3ml and he sent us home with Enalapril.  He said if I give Sandi fluids, even a small amount, she will just keep getting fluid accumulation in her chest.  He said she most likely has heart failure and treating the heart is the priority now.  He did say that the Enalapril could potentially help improve blood flow to the kidneys and her kidneys would stay at the level they are now and not get worse.  But there is a good chance that without the fluid therapy, her kidneys could very well deteriorate rapidly.  

I am going to keep a close eye on her with the Enalapril.  I remember when Thomas was put on this at first, he had appetite loss and got very weak.  He was switched to Benazepril and did really well with that.   

This was very disheartening news.   Sandi's regular vet is back on Monday.  Maybe she will have a different take on how she wants to treat Sandi's going forward.   Maybe Sandi can at least have some fluids, possibly twice a week?  It just doesn't seem right to completely discontinue the subQ fluids.

Right now Sandi seems to be doing ok.  Her appetite is increased.   When we got home, she ate a meal and is now resting.  I hate to keep constantly taking her to the vet's office. She hates going there, and I hate upsetting her.  

Hopefully she will be ok.  

Does anyone have experience with having their cat treated for kidney disease and heart disease at the same time?

Tamu708,

As I mentioned many posts ago, I am a human Doctor, not a Veterinary, so you should check any advice that I may give you with your Vet who is treating Sandi.

Kidney failure can cause heart failure so that the two conditions together often co-exist and treatment for one can improve the other.  For instance treatment for anaemia will improve heart failure because the heart's function is to pump blood containing red blood cells (reduced in anaemia) around the body. Unfortunately kidney failure can cause anaemia as well so that the management of one usually affects the other condition. 

Increasing Sandi's frusemide will cause an increase in urination, this may increase her dehydration and the Vet will therefore have to juggle the amount of fluid that Sandi is having, Too much fluid can cause an overload of the heart and make heart failure worse.  Sandi appears to be doing well and is coping very well with a very complicated regime but she must go to the Veterinarian's office until she stabilises.    She may also have to have blood tests because frusemide can cause a potassium loss!  Electrolyte reduction may then have to be managed as well.

You must not give up at this stage, I have to say that Sandi has been so lucky to have you.  She would never have survived without your devotion to her management.

Keep the faith!

Geoffrey

 

[tamu708]

 
Tamu708,

As I mentioned many posts ago, I am a human Doctor, not a Veterinary, so you should check any advice that I may give you with your Vet who is treating Sandi.

Kidney failure can cause heart failure so that the two conditions together often co-exist and treatment for one can improve the other.  For instance treatment for anaemia will improve heart failure because the heart's function is to pump blood containing red blood cells (reduced in anaemia) around the body. Unfortunately kidney failure can cause anaemia as well so that the management of one usually affects the other condition. 

Increasing Sandi's frusemide will cause an increase in urination, this may increase her dehydration and the Vet will therefore have to juggle the amount of fluid that Sandi is having, Too much fluid can cause an overload of the heart and make heart failure worse.  Sandi appears to be doing well and is coping very well with a very complicated regime but she must go to the Veterinarian's office until she stabilises.    She may also have to have blood tests because frusemide can cause a potassium loss!  Electrolyte reduction may then have to be managed as well.

You must not give up at this stage, I have to say that Sandi has been so lucky to have you.  She would never have survived without your devotion to her management.

Keep the faith!

Geoffrey

Thank you.  As long as Sandra is eating, using the litterbox and still doing her normal kitty stuff, I will not give up on her.  She is a little fighter and I will always be there to support her!

 

[tamu708]

I spoke with Sandi's vet yesterday evening. I asked her if it was possible to monitor her breathing and if she's doing well give her a small amount of fluids (50 ml) possibly 2-3 times per week. The vet said it would be better to get Sandi to drink extra fluids instead by like mixing extra water with her canned food. She believes it is too risky to use subQ fluids at 50 ml. She said she may be willing to have Sandi possibly do 25 ml depending on how her breathing is looking but she said we may try this as a last option. The best thing right now is to get her to try and drink more on her own. Sandi drank better this morning than yesterday and I added extra water with some chicken baby food. I'm just concerned she will end up getting dehydrated again even though she is on a small amount of Furosemide (.30 ml). Another thing that was concerning me is this morning her nose looked slightly more pale. I hope the anemia isn't getting worse. She is scheduled for a vet appointment Saturday morning to check her HCT and depending on how her numbers look, she may be getting another dose if Aranesp if her HCT is still low. She ate good this morning and my brother is watching her today while I'm at work.

 

[foxxycat]

Have you tried fancy feast classic pate? My kidney girl eats these but right now she is on a fish kick. For weeks she was eating turkey and giblets. I mix one can of HOT water into her food and mash with a fork. She LOVES it. for years she never eat wet food until now. Her kidney numbers have stabilized the past year doing this method. She still eats kibble but I cut it back. You can try adding water to fancy feast. my girl leaves the meat still but it definitely helps.

 

[tamu708]

 
Have you tried fancy feast classic pate? My kidney girl eats these but right now she is on a fish kick. For weeks she was eating turkey and giblets. I mix one can of HOT water into her food and mash with a fork. She LOVES it. for years she never eat wet food until now. Her kidney numbers have stabilized the past year doing this method. She still eats kibble but I cut it back. You can try adding water to fancy feast. my girl leaves the meat still but it definitely helps.

Isn't the phosphorus level in the fancy feast high?  I've just been trying to feed her canned foods lower in phosphorus.  Her phosphorus level is at 10 even though she is on a phosphorus binder. Right now she's been eating a lot of the Hills canned foods and also the Wellness Divine Duos.  She also like some of the IAMS canned foods.  She also likes the Gerber meat baby foods.  I will a lot of time mix water with the baby food so it kind of looks like those cream soups and she licks it up.  The vet also mentioned I can give Sandi chicken broth, but all the chicken broths I see in the stores have onion in them.  I don't know if there is a certain brand.  I'm going to research these online.

 

[mrsgreenjeens]

Yes, the phosphorus level in the Fancy Feast CLASSICS is pretty high...over 2%, as I recall. 

You can always make your Own chicken broth...just cook up a chicken or parts of chicken on water and there you have it.  You can use the chicken for whatever, and she can have the broth.  That way you don't have to use any seasonings at all in it, or maybe just put a sprinkle of sea salt or something for little flavor.   I would at minimum use bone-in thighs for extra flavor...just be sure you strain the broth so she doesn't accidentally get any cooked bones.  OR, you could make bone broth!  That's the best!!!!! 

http://www.thecatsite.com/t/301643/...-make-broth-for-cats-very-simple-instructions

 

[tamu708]

 
Yes, the phosphorus level in the Fancy Feast CLASSICS is pretty high...over 2%, as I recall. 

You can always make your Own chicken broth...just cook up a chicken or parts of chicken on water and there you have it.  You can use the chicken for whatever, and she can have the broth.  That way you don't have to use any seasonings at all in it, or maybe just put a sprinkle of sea salt or something for little flavor.   I would at minimum use bone-in thighs for extra flavor...just be sure you strain the broth so she doesn't accidentally get any cooked bones.  OR, you could make bone broth!  That's the best!!!!! 

http://www.thecatsite.com/t/301643/...-make-broth-for-cats-very-simple-instructions

Thanks for the information.  I'm going to make just the basic chicken broth.  Is there too much calcium in bone broth?  Sandi's calcium levels have been elevated.  I don't want to take a chance on causing her levels to increase more.

 

[mrsgreenjeens]

Oh you're probably right in that there's too much calcium in the bone broth.  Not sure how much there is, but since the bones pretty much dissolve in it, I'm guessing there would be too much.

 

[tamu708]

Update on Sandi - She had a vet appointment earlier this morning.  Her HCT has gone up to 26.  I am to give her another Aranesp injection today.  Next Saturday she will go into the vet's office again to recheck the HCT.  She is still anemic, but it's good that her number has improved.  She was originally at 15.7.  After the transfusion, she was at 23.  Hopefully she continues to respond good to the Aranesp.  Her doctor said when her HCT gets into the 30s, I can reduce the injections to once every 2-3 weeks.  

The vet said her breathing looks much better too.  She said Sandi doesn't at all look like a cat in distress.  The bad thing however, was that she has lost a pound.  She is right now at 6 pounds. She is eating better but still not enough.  I am right now boiling a whole organic chicken to make her some broth.  Hopefully that will get her to eat more if I mix it in with her canned food.  I am also going to pick up a weight scale so I can keep weighing her.  I just gave her her weekly B12 injection also.  I am also going to buy her some more flavors of canned food.  I hope I can help her gain a pound before next Saturday.  

 

[foxxycat]

Have you thought about adding kitten food to her diet? Also Wellness has a dry kibble that is 600 calories a cup. All I remember is the bag is hot pink/maroon on top and yellow at the bottom if my memory is correct. They sell it at most Pet stores/big box pet stores but I never see it at walmart/grocery stores.

Most other food is around 200-300 calories a cup. Dry food has more calories than wet food if you are trying to add weight. Not sure about the mineral content though.

The anemia improving is WAY AWESOME!!

Keep up the good work!

 

[tamu708]

Have you thought about adding kitten food to her diet? Also Wellness has a dry kibble that is 600 calories a cup. All I remember is the bag is hot pink/maroon on top and yellow at the bottom if my memory is correct. They sell it at most Pet stores/big box pet stores but I never see it at walmart/grocery stores.

Most other food is around 200-300 calories a cup. Dry food has more calories than wet food if you are trying to add weight. Not sure about the mineral content though.

The anemia improving is WAY AWESOME!!

Keep up the good work!

Thanks. I will look into the Wellness dry food. She does like the Wellness canned foods so hopefully the dry food will be to her liking also. I keep buying different flavors of canned foods. She's very picky and stubborn. Sometimes she'll just it from a can once and that's it. We've had success with mostly the Hills and Wellness wet foods. The problem is she will only eat a spoon at time. I'm hoping the broth will help her to eat bigger portions.

I remember when she was healthy last year, I would open up a can of food and divide it among all three cats. She would finish her bowl and clean the other plates of any leftovers.

Her chicken broth is almost done. Hopefully it will help.

 

[foxxycat]

I have a cat who doesn't like broth or chicken but if its rotisserie chicken she will climb in your lap looking for a bite!

Another cat I have loves Shrimps-I have to shred them for her and put in a dish.

At this point I know dry food isn't the best but when trying to get calories into them-it may do the trick!

 

[tamu708]

I tried giving Sandra some of the chicken broth I made.  She licked a couple of times and decided she didn't like it.   That was so disappointing.  I noticed, in general, her appetite was not good at all yesterday.  I noticed when she would eat her wet food she keeps turning her head from side to side and licking around her mouth and some bits of food fall out of her mouth.  It's almost like the wet food is getting stuck in her teeth or like the top of her mouth and she is trying to dislodge it if that makes sense.  And afterwards she swallows a lot.  I looked in her mouth and didn't see any sores.  The vet does check Sandi's mouth and teeth when I take her in and she has not seen anything out of the ordinary, just a bit of tarter buildup.  I gave her some Cerenia this morning just in case she was having nausea.  She has not had any vomiting.  I don't know if she is getting constipated.  I noticed yesterday morning she had only a small bowel movement and some of it was outside the box.  I increased her Miralax a bit, but so far this morning she hasn't gone.  I did also notice that she keeps moving from one spot to the other like she can't get comfortable.  In the past when she has done this, it was constipation related and once she had a good bowel movement, the behavior stopped.

Hopefully she eats better today.  I'm so scared she will end up losing more weight.

 

[foxxycat]

yes my Floey moves around a lot when she needs to go. She has stopped eating her wet food which has miralax in it. Now I feed her tuna with miralax-its the only way to get it in her-otherwise we will have to do an enema and that sounds way too tramatic for my old girl.

Keep trying! What about pumpkin or squash for fiber? I had good luck with babyfood squash-but I cant find it anymore without cinnamon. Plain canned pumpkin but I have to make them eat it-they fight me-but it makes a bowel movement 12 hours later.

Thank you for taking good care of your baby!

 

[pgalore]

My kitty, Lucy, had CRF and was put on Benazapril for the protein in her urine. So, maybe the Benazapril would help in 2 ways. I would ask your veterinarian. I was taking Lucy to an internal medicine specialist and cardiologist. She also had rapid heart rate and high blood pressure. Good luck with your kitty. Lucy lost her battle last year, but she is the black and white kitty in picture.

 

[tamu708]

I just looked at Sandi's front upper and lower teeth and they have a greenish discoloration on them.  I don't know what this is, if it's food particles from the canned food stuck in her teeth and now it's turning into bacteria?  Or if this is a result of the renal failure advancing more rapidly since she hasn't gotten subQ fluids.  I wiped a little off with a wet napkin and it came off stained.  I imagine whatever this is is causing her to have a decreased appetite.  I did not notice any of this a couple of days ago and she was eating much better then.  I'm going to go to the pet store and buy a tooth brush and try to get it off.  Looks like we may be back to the vet's office before her Saturday appointment  

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