CRF - Chronic Renal Failure:links and experiences with

[sharky]

I have to agree 1000% with Pat...

I would get lots of clarification.... I do know bun is often higher in raw feed animals ...

 

[pookie-poo]

Pat has given you some excellent advice. I concurr! Even though both of my CRF cats have a serum phosphorus level that is mid-range, I always put aluminum hydroxide gel powder phosphorus binder into their food. I included a link in several previous posts about phosphorus binders, but will include it again here. http://members.verizon.net/~vze2r6qt...es/binders.htm

Cleo and Maggie both eat Purina NF canned food or Hills Science Diet canned with phosphorus binders mixed in. For a treat they get Fancy Feast with phosphorus binders. Cleo gets sub-Q fluids three times a week, as well as Calcitriol and B complex vitamins. I have Cleo's bloodwork checked every 4 months. Maggie just has slightly elevated creatinine, so she only gets the renal food/phosphorus binder mixture. She's my 'fraidy cat, so she only gets bloodwork once a year (too traumatic for her.) Once her CRF advances, I'll have to bite the bullet and take her in more often. I dread the day she needs fluids or pills because she's so timid and neurotic that I doubt I'd be successful with either!

I would recommend having bloodwork checked in 6 weeks, and also a urine specific gravity done to see if Tigger is remaining stable or if her renal failure is progressing (I also agree with Pat that a creatinine of 3.4 is renal failure.)

Good luck to you and Tigger! I'll keep you both in my prayers.

Pookie & the girls

 

[kluchetta]

Thank you so much! I suppose I've been in denial for a day or so, but I'm getting my head around this. I will start by working on the food, although of course she is a bit picky. I am going to schedule a second blood test for 6 weeks from now, along with a urine test. Do a lot of vets just assume that kidney failure is inevitable? Oh, and I also have a great place I buy food from, and I will check about the phosphorous binder. And we have a fountain, which she REALLY likes to drink from.

Originally Posted by Pookie-poo

Pat has given you some excellent advice. I concurr! Even though both of my CRF cats have a serum phosphorus level that is mid-range, I always put aluminum hydroxide gel powder phosphorus binder into their food. I included a link in several previous posts about phosphorus binders, but will include it again here. http://members.verizon.net/~vze2r6qt...es/binders.htm

Cleo and Maggie both eat Purina NF canned food or Hills Science Diet canned with phosphorus binders mixed in. For a treat they get Fancy Feast with phosphorus binders. Cleo gets sub-Q fluids three times a week, as well as Calcitriol and B complex vitamins. I have Cleo's bloodwork checked every 4 months. Maggie just has slightly elevated creatinine, so she only gets the renal food/phosphorus binder mixture. She's my 'fraidy cat, so she only gets bloodwork once a year (too traumatic for her.) Once her CRF advances, I'll have to bite the bullet and take her in more often. I dread the day she needs fluids or pills because she's so timid and neurotic that I doubt I'd be successful with either!

I would recommend having bloodwork checked in 6 weeks, and also a urine specific gravity done to see if Tigger is remaining stable or if her renal failure is progressing (I also agree with Pat that a creatinine of 3.4 is renal failure.)

Good luck to you and Tigger! I'll keep you both in my prayers.

Pookie & the girls

 

[sharky]

Originally Posted by kluchetta

Thank you so much! I suppose I've been in denial for a day or so, but I'm getting my head around this. I will start by working on the food, although of course she is a bit picky. I am going to schedule a second blood test for 6 weeks from now, along with a urine test. Do a lot of vets just assume that kidney failure is inevitable? Oh, and I also have a great place I buy food from, and I will check about the phosphorous binder. And we have a fountain, which she REALLY likes to drink from.

I had a old country vet ( whom I do respect) tell me if a cat sees 16 about 90% have some kidney failure... And since that is about 80 in human yrs I totally understand the wear it out thought...

Please read all the site Pat put up ... I would NOT have Had Kandie for 4 yrs past diagnosis by doing what the vet just said to do ( ie here is a RX dry)... OF COURSE always run what you learned by the vet , it can help with lines of communication

 

[xocats]

Originally Posted by kluchetta

Thank you so much! I suppose I've been in denial for a day or so, but I'm getting my head around this. I will start by working on the food, although of course she is a bit picky. I am going to schedule a second blood test for 6 weeks from now, along with a urine test. Do a lot of vets just assume that kidney failure is inevitable? Oh, and I also have a great place I buy food from, and I will check about the phosphorous binder. And we have a fountain, which she REALLY likes to drink from.

When Dexter & Sadie's kidneys were damaged from eating tainted recalled pet food, I was in shock.
The CRF support sites gave me an understanding of the dreaded disease and the vocabulary that I needed to communicate with our vet about their care.

With the help of the knowledgeable people on this thread, and other friends on TCS, I received the emotional support that helped me feel less alone.

You are already taking charge of Tiggers care.

My thoughts are with you.

 

[kluchetta]

Originally Posted by sharky

I had a old country vet ( whom I do respect) tell me if a cat sees 16 about 90% have some kidney failure... And since that is about 80 in human yrs I totally understand the wear it out thought...

Please read all the site Pat put up ... I would NOT have Had Kandie for 4 yrs past diagnosis by doing what the vet just said to do ( ie here is a RX dry)... OF COURSE always run what you learned by the vet , it can help with lines of communication

Yep, that site's fantastic.

I'm learning lots. Fortunately Tigger really likes wet food a lot, so we're looking at the list for the least phosphorous, and she's going on antibiotics for her teeth. I do like my vet, of course with where I am, she's a large animal doc too, but knows her cats as well. She said Tigger looked lots better than her 16 year old cat...

 

[pookie-poo]

You may be able to save yourself some money and only have the creatinine and BUN done instead of a complete blood panel. Check with your vet to see if it is any less expensive. If you decide to go for the complete panel, perhaps you should consider having the hemoglobin and hematocrit checked too. Often anemia can accompany CRF, but usually not in the early stages where Tigger is now. However, it might not be a bad idea to get a baseline for future comparison. The USG (urine specific gravity) can be done by cystocentesis, which is when the urine is drawn out of the bladder by needle. This is often done in conjunction with a culture and sensitivity to see if there's a bladder infection. As a side note, CRF cats tend to be more susceptible to bladder infections because their urine is very dilute. You might be able to just have a USG done on urine that is expressed from the bladder unsterilely (if no symptoms of bladder infection are present), which would also be less expensive. Just trying to give you ideas to help save some money. CRF can be an expensive disease to treat, so saving money on some of the testing can really be helpful.

I wanted to give you a little hope here....Cleo was diagnosed when she was 6 months old, when my vet did pre-op bloodwork for her spay surgery. Cleo turned 7 years old on May 27th, and with treatment, her renal failure has been extremely stable for the entire 6 1/2 years!

~~Hugs~~
Pookie & the girls

 

[sharky]

SO SO true... about the $$... with Kandie full blood work was over a hundred but just the CBC and kidneys was 30-60

 

[kluchetta]

Thanks, I'll check that out. I did notice that her hemoglobin is 13.2 (9.0 - 15.1); and her hematocrit is 33.7 (30.0 - 45.0).

All these numbers!

 

[pat]

All the numbers become very familiar, very fast, trust me!!

One other thing to keep in mind as well as the potential up the road for anemia, is that at some point, she may develop high blood pressure (Tyler did). We can discuss what you might see as a sign this is occuring, or leave that for the future (though I would ask your vet if she thinks a baseline bp now would be good, and if she is set up to do a doppler bp...my vet is, but not all vets have doppler machines).

 

[namrah]

Hello everyone,

I wanted, first, to thank you all for this thread, it has a lot of great information that I need to spend some time with.

A lot of the threads here seem to indicate older cats; I am currently dealing with a CRF cat who is only 4.5 years old. Her specialist has indicated that she has, at most, 1-2 years to live if we can get her on a low-protein diet; which I can't. She'll eat only cold-cuts: lo-sodium turkey and chicken. She had been eating freshly cooked chicken breasts but today showed an acute loss of interest in that.

She also has a problem with recurring infections - the cause of which we haven't been able to pinpoint, and may be the reason for this if they spread into the kidneys at some point. The reason I am here, now, is because Mali is - for the first time in two years, up to 8lbs - a few months ago she was down to 5lbs. 8lbs is a good weight for her, she's a small bengal. Tuesday she had blood-work and a urine culture; I only just got the voicemail (no numbers in it, I'll know tomorrow) but her white blood cell count is up again and her creatanin (probably butchered that) and other values are elevated.

She also appears to have a congenital defect with her kidneys - one is much larger than the other.

Anyway, I feel like I'm rambling all over the place; I had really thought she was doing well as had her vet - no lethargy, eating, acting well - but her panels are not confirming this. I am gravely concerned that it's an act of some sort, that she is suffering and that none of what I am doing is helping. With only cold cuts, while it's better than her starving (I've tried everything, seriously) - her kidneys can't take that for long. The vet tech told me 3-6 months on her current diet; not 1-2 years. That was 2 months ago.

The problem I am also facing is that I *have* to move - from Mass. to Oregon. This is happening on August 4th. It will involve an overnight in NY and my vet has advised that I take her off her meds (she is on many) on the 3rd and get her back on them the evening of the fourth. She and her best pal - my other cat - will be in a carrier for up 10-12 hours during the flight; both in the cabin on the flight, at my feet.

This is a problem because I know that stress is going to cause her to re-lapse even more, and she's already re-lapsing with no stress. I do not know if I should even put her through this, because I don't know if she can make it. I have two new Sherpa carriers; the cats eat in them (via bribery) and have started sleeping in them on their own. I've got Feliway and I'll have SubQ fluids (every other day right now, looking like it'll be every day based on her panels) and needles read at my new apartment.

I've been trying to face the fact that I may have to put her down rather than put her through this move, because I don't know if she can handle it - there is no-one to take her, and I don't want to re-home her anyway.

Anyhow - this is long and I could probably write a few more novels on this whole thing, so I'm just going to stop rambling. I apologize if this should have been split into its own thread.

Thank you for reading, and again, thank you for an excellent resource.

 

[pookie-poo]

Here is an excellent resource for traveling (via airline) with a CRF cat. http://www.felinecrfhints.homestead....gwithacat.html

I would highly recommend trying to change your kitty's diet. You are doing her absolutely no good by feeding her exclusively cold cuts. There are nutrients that are essential for cardiac and vision health (Taurine) in cat foods that she cannot get from human foods. Without adequate Taurine in her diet, she runs a great risk of developing cardiomyopathy or blindness. If she insists on eating only cold cuts, you need to discuss adding Taurine into her diet by supplementation with your vet. Another problem with cold cuts, is the fact that they usually contain lots of sodium (even the so called low sodium kind.) Cats with renal failure often develop elevated bloodpressure due to the CRF. The added sodium in the diet could very well exacerbate the high bloodpressure problems. And thirdly, most CRF cats do better with a low protein/low phosphorus diet. I have no idea how to determine the protein or phosphorus levels of cold cuts, other than to continuously do bloodwork to monitor her BUN, Creatinine and serum phosphorus levels.

I wish you and your kitty luck with the move. Please feel free to PM me if there's anything that I can help you with!

Pookie & the girls - CRF Cleo, CRF Maggie & Lola

 

[namrah]

Originally Posted by Pookie-poo

Here is an excellent resource for traveling (via airline) with a CRF cat. http://www.felinecrfhints.homestead....gwithacat.html

Thank you, that should be very helpful.

I would highly recommend trying to change your kitty's diet. You are doing her absolutely no good by feeding her exclusively cold cuts. There are nutrients that are essential for cardiac and vision health (Taurine) in cat foods that she cannot get from human foods. Without adequate Taurine in her diet, she runs a great risk of developing cardiomyopathy or blindness. If she insists on eating only cold cuts, you need to discuss adding Taurine into her diet by supplementation with your vet. Another problem with cold cuts, is the fact that they usually contain lots of sodium (even the so called low sodium kind.) Cats with renal failure often develop elevated bloodpressure due to the CRF. The added sodium in the diet could very well exacerbate the high bloodpressure problems. And thirdly, most CRF cats do better with a low protein/low phosphorus diet. I have no idea how to determine the protein or phosphorus levels of cold cuts, other than to continuously do bloodwork to monitor her BUN, Creatinine and serum phosphorus levels.

She is on a multi-vitamin to make sure she gets Taurine and all of the other things that the cold cuts lack - and I still try new food nearly every day, if not twice a day. The fact is, that cold cuts is what she eats and the only thing that she eats consistently.

I recognize the importance of what you say - I simply am not the one deciding this, she is. That is a large part of my distress. I have cooked up about 10 variation of Dr. Pitcairn's recipes, I have tried about 4 different commercial, prescription diets, as well as what I could find of normal food with los phos and protein. I had not yet seen the food list posted earlier in this thread and on felinecrf so that is my next attempts to get her eating.

Thank you for the advice and comments. I know the food is a major problem, we all do. Unfortunately Mali has always had a habit of going off food when her white bloodcell count is increasing and last time, she didn't start eating again until she was in the hospital. Since I can't force her to eat, I do what I can to keep her weight up and keep her happy.

She is also, currently, getting blood-work approximately every two weeks; though we had hoped it would stabilize so that it could drop to a monthly visit - doesn't look likely, though.

 

[kluchetta]

Hi! Me again! The store I frequent does not have Wysong, and I was wondering about this food:

"The sodium level in the can cat food will range from 0.26% to 0.4% on a dry matter basis. Phosphorus will range from 0.18% to 0.25% as-fed. The calcium phosphorus ratio will be 1.2 – 1.5:1. Calcium will be 0.23% - 0.32% as-fed."

So .18% to .25% is GOOD? Right? Thanks for putting up with my clulessness.

 

[pat]

Originally Posted by kluchetta

Hi! Me again! The store I frequent does not have Wysong, and I was wondering about this food:

"The sodium level in the can cat food will range from 0.26% to 0.4% on a dry matter basis. Phosphorus will range from 0.18% to 0.25% as-fed. The calcium phosphorus ratio will be 1.2 – 1.5:1. Calcium will be 0.23% - 0.32% as-fed."

So .18% to .25% is GOOD? Right? Thanks for putting up with my clulessness.

You need to convert the phos per centages from the as-fed to dry matter analysis. Without the other values (moisture content, protein etc) I can't do the conversion for you. Here is an article that tells you how (skip to the "Converting dry matter basis" paragraph for an explanation on how to do the conversion.
http://www.peteducation.com/article....&articleid=667

 

[pat]

Originally Posted by Namrah

Thank you, that should be very helpful.



She is on a multi-vitamin to make sure she gets Taurine and all of the other things that the cold cuts lack - and I still try new food nearly every day, if not twice a day. The fact is, that cold cuts is what she eats and the only thing that she eats consistently.

I recognize the importance of what you say - I simply am not the one deciding this, she is. That is a large part of my distress. I have cooked up about 10 variation of Dr. Pitcairn's recipes, I have tried about 4 different commercial, prescription diets, as well as what I could find of normal food with los phos and protein. I had not yet seen the food list posted earlier in this thread and on felinecrf so that is my next attempts to get her eating.

Thank you for the advice and comments. I know the food is a major problem, we all do.

Many folks simply feed what the cat will eat (though the point re sodium content of cold cuts is an important issue) and use a phosphorous binder to deal with the issue of high phos content.
Protein content is an issue, but as we all no, no food/no cat..you do the best you can.

ps fwiw, with Patrick (RB), over the 4 years we dealt with his crf, we had to deal with loss of appetite, though nothing like this. I used tricks such as Kitty Kaviar (which also comes as a fine powder - under the name of apPETizer) and crumbled beef - Rosie's Rosedust, atop his wet food.
Both worked very well.

 

[namrah]

Originally Posted by Pat & Alix

Many folks simply feed what the cat will eat (though the point re sodium content of cold cuts is an important issue) and use a phosphorous binder to deal with the issue of high phos content.
Protein content is an issue, but as we all no, no food/no cat..you do the best you can.

ps fwiw, with Patrick (RB), over the 4 years we dealt with his crf, we had to deal with loss of appetite, though nothing like this. I used tricks such as Kitty Kaviar (which also comes as a fine powder - under the name of apPETizer) and crumbled beef - Rosie's Rosedust, atop his wet food.
Both worked very well.

Thank you, again!

I think yesterday may have been an off day. Today I have her eating chicken breats - finely diced (she abides the chew 100 times rule) and she cleaned up. She gets many small portions throughout the day as large meals cause her to vomit.

I did just talk to my vet, and she doesn't think this is yet chronic renal failure - she called it "kidney insufficiency", but without proper management it could become CRF. However, Mali's phosphorous levels are totally normal, so the vet said not to worry about that right now.

It will be interesting to move with her, and interesting to get more opinions on this whole thing. Unfortunately her medical history is novel-length.. I did find some vet suggestions from CRF cat caregivers here, with some suggestions in the area that I am moving to, so it will be a relief to have that pre-setup. Plus I need subq fluids and needles at my friend's so that I can give Mali SubQ fluids the night I arrive, she was just moved back up to daily fluids (100ml/day) from her latest test results.

Thank you again for all of the wonderful information. I'll keep trying to incorporate a more balanced diet, but at least she's off the cold-cuts, and that is, itself, at least a small victory. She only went on those because she tried to steal a turkey sandwich from me when she was refusing all other food. It was the most baffling thing, trying to keep her away from my food when I couldn't get her to eat a single thing I had tried, including "human" food.

The next day she almost got a pizza crust, but I can't rightly feed her pizza, even if she is starving.

She's sneaky when she's feeling well - and FAST.

 

[kluchetta]

Originally Posted by Pat & Alix

You need to convert the phos per centages from the as-fed to dry matter analysis. Without the other values (moisture content, protein etc) I can't do the conversion for you. Here is an article that tells you how (skip to the "Converting dry matter basis" paragraph for an explanation on how to do the conversion.
http://www.peteducation.com/article....&articleid=667

Oh gosh... so:

Guaranteed Analysis
Crude Protein (Min.) 10.00%
Crude Fat (Min.) 3.00%
Crude Fiber (Max.) 1.5%
Moisture (Max.) 78.00%
Ash (Max.) 1.80%
Magnesium (Max.) .025%
Taurine (Min.) .08%

and there's .25% phosphorus, so I take the .25% and divide by 22? That is about 1.136%??? That's not so good, I guess.

 

[sharky]

Originally Posted by kluchetta

Oh gosh... so:

Guaranteed Analysis
Crude Protein (Min.) 10.00%
Crude Fat (Min.) 3.00%
Crude Fiber (Max.) 1.5%
Moisture (Max.) 78.00%
Ash (Max.) 1.80%
Magnesium (Max.) .025%
Taurine (Min.) .08%

and there's .25% phosphorus, so I take the .25% and divide by 22? That is about 1.136%??? That's not so good, I guess.

under .9 is better ....

on the srpead it looks better ...

.25 is 1.1 but .18 is .8 if I did that right

 

[namrah]

Just to follow up on my postings, the vet e-mailed me the numbers for Mali's recent blood-work (Tuesday):

Mali's WBCs is starting to rise, 17.4 (4.2-15.6), as are BUN 82 (15-34) and Creat 4.3 (0.8-2.3). rec trial course Doxy, con't other medications although Ursodiol is not a priority, increase SQ fluids to 100ml SID and repeat CBCChem in 2 wks, sooner if she's not feeling well.

She is on Ursodial til I talk to her specialist - her liver crashed a few months ago but has been solid for a month now, so we're weaning her off the liver meds and getting her on more kidney support.

Just reading this email exhausts me, and the numbers aren't new, Mali has had problems for 2 years now, though her diagnosis is more recent.

Is my vet accurate in that this may not be CRF yet, but just kidney insufficiency? Am I just best to wait til I get to Oregon and get other opinions?