CRF - Chronic Renal Failure:links and experiences with

[pookie-poo]

Originally Posted by white cat lover

Bea is CRF kitty now, too.

Specific Gravity of her urine was 1024, after with holding water for 10 hours, it was still 1024.

Blood panel as soon as I can get her in. For now, she's on Hill's K/D with the chicken in it. Re-filling her water bowl several times a day, as she attacks any fountain I give her.

When I re-fill the bowl she eagerly drinks.

Reading through felinecrf.org as fast as I can. It's all so much to take in. I know she's having issues with constipation....I just didn't fully realize it. Will be asking me vet about that ASAP.

Oy my brain hurts!

Natalie, there's several ways to address the constipation. Adding Benefiber to her water, adding canned pumpkin or baby food peas to her food. If those don't work, you can always get a script for Lactulose from your vet. Actually, I think there's a non-prescription form of Lactulose available now over-the-counter, but I can't remember what it's called right now.

If she's so dehydrated that she drinks excessively, you might want to consider doing sub-Q fluids. Your vet might suggest them anyway, depending on what her bloodwork says when it comes back. I will definitely keep you and sweet Bea in my prayers. Now that she's been diagnosed with CRF, I'm thinking that God had meant for her to belong to me (He only give me the CRF kitties!) Good luck!

 

[white cat lover]

If you want her, I can transport her to ya!

I'm just not sure that I can actually get Sub Qs into her without dying. If she doesn't like something, she'll let me know.

Will be talking to the vet about that.

I will probably try to pick up some Benefiber & see if I can get that into her, although it doesn't sound like it's very reliable to get an exact amount into her if I just add it to her water?

ETA: I shouldn't be reading up on this. She was on Metacam post re-declaw. Continued to have issues, so was put back on it again.

ETA again! Can we talk foods? Bea is currently on Science Diet K/D & that's gonna kill my budget at the rate she's eating. She's already eaten an entire can today, the vet said the reccomendation is 1.5 cans/day!

I hate to restrict her food any, because then she gets ornery.

What OTC foods are "safe"? What do I look for in a food? (I'm reading up on felinecrf.org, too)

 

[pat]

Fwiw, I use Miralax for one of my kitties, and think you can use this for a crf kitty (best to check with your vet). I give Larissa 1/4 teaspoon of this a day mixed with a bit of wet food and water to make a slurry. We call it her "treat" and she waits for it each day

Larissa doesn't have crf, but I think I recall from the support list when I was still on there, that some were using this.

The other med mentioned was prescription - Lactulose (a liquid).

Foodwise, if you want cheap (sorry but I did use this with Tyler) I used Friskies Turkey and Giblets Special Diet it is actually decent on the phos levels.
To check phos levels on a kept up to date list, you can use jmpeerson's lists - even though composed for cats with diabetes it does also list phos content.
http://www.geocities.com/jmpeerson/CanFoodNew.html

hth,

 

[kittymonsters]

WCL, I am so sad to hear about Bea. That poor sweet kitty sure has had one hard knock after another. She is VERY lucky to have you.

Sharky and Dawn of Sierra, your experiences with Kandy and Sierra bring more hope. I am so nervous about this experience. I am actually dreading having to do Sub-q's tonight. I am afraid that Zoe wont tolerate it.

Her numbers went down with the fluids which is excellent, but they didn't go down as much as hoped. BUN went from 47 down to 30, so within the normal range. Creat went from 3.1 to 2.5, so out high by two tenths.

We have the enalapril compounded into a transdermal gel and I am to give 100 ml of fluid a day for 10 days then recheck her BUN and Creat. The hope is that her numbers don't start creeping back up.

We are going to get the calcitriol ordered.

I am glad that WCL asked about the food. I am not comfortable with KD or ND and really don't want to change Zoe from her homemade food to a commercial food that is low protein/plant protein based. Am I being stupid ?

From what I have read, which isn't enough, it is the phosphorus that is more critical than the protein content. Also that high quality animal protein creates less nitrogenous waste so raises BUN less than lower quality plant protein.

Also, do you all warm your fluids with a heating pad first or give them room temperature? Yes, I am obsessing.

 

[pat]

I did warm Patrick's fluids - I'd place the iv bag - being careful that the rubber ports and site of tubing insertion was out of the water, in a large stockpot filled with warm water., and let it sit for 15 minutes or so. Then I'd flush out the cold fluid from the line until I felt warm water (I'd test it on my wrist).

 

[pookie-poo]

I warm Cleo's fluids also, in a bowl of hot water. She loves getting her fluids, because I make them a special bonding time for the two of us. I boil up boneless chicken breasts, and give her about 1/4 cup, while she gets her fluids. She purrs and kneads throughout the entire process. She waits by the bathroom door (where I do the fluids) when she hears the microwave start up (to warm the bowl of water to warm the fluids in.) She will actually start to tease for her fluids the morning of. She's got the pattern totally figured out!

I am also of the opinion that low phosphorus content is much more important in keeping CRF under control, than low protein. Cleo was diagnosed 7 1/2 years ago (12/00), and I've been aggressively keeping her serum phosphorus right around 3 - 4. She's also been on Calcitriol since 12/02, and I firmly believe that has had a significant impact on her CRF. Cleo gets fluids two to three times a week, 100 cc's at a time. She eats Purina NF renal food, and also Hills Science Diet Adult, with Aluminum hydroxide phosphorus binders added. My vet thinks that she's doing positively wonderful. As a matter of fact, she's put on enough weight that my vet says she needs to go on a diet...so I just switched her to Hills Science Diet Senior (slightly less calories.)

Cleo is living proof that CRF can be managed for quite a long time, with very good control. My vet said she would probably only live to be about 5 years old. She will turn 8 next month! I kind of hope she will be the TCS poster child for living well with CRF, lol!

 

[white cat lover]

How do you people deal with this?

I mean, the thought of giving Bea fluids can have me shaking in my boots!

My head is swimming from the phosphorus binders, Calicitriol, food information....I still can't make sense of the food info!

 

[pat]

Originally Posted by white cat lover

How do you people deal with this?

I mean, the thought of giving Bea fluids can have me shaking in my boots!

My head is swimming from the phosphorus binders, Calicitriol, food information....I still can't make sense of the food info!

It's just not that bad...it becomes a routine..am med (if any) pm med, fluids - takes 10 minutes or less, food - find the best you can that she'll eat, with a phos level (by dry matter analysis - as listed on the jmpeerson site for example) of under 1 %. You can do this, we can help you untangle it, but really, it took very little out of Patricks/Tylers/Frankies day for us.

Now assist-feeding...that takes a good 20 minutes each time...I personally think all of us who've done long term assist-feeding deserve a badge/medal!

 

[pookie-poo]

Originally Posted by white cat lover

How do you people deal with this?

I mean, the thought of giving Bea fluids can have me shaking in my boots!

My head is swimming from the phosphorus binders, Calicitriol, food information....I still can't make sense of the food info!

I know what you mean! Maggie was diagnosed with renal insufficiency a year ago. She is being managed by diet alone. The idea of giving Maggie pills (Calcitriol) or fluids, is abhorrent! Maggie is traumatized by too much handling, and she would never tolerate any treatment at all. I sure hope that diet controls her for a long, long time!!!

Here's two more terrific links for finding CRF friendly foods!
CANNED FOOD CHART
DRY FOOD CHART

 

[white cat lover]

OK, the jmpeerson site.....guide me further on food. What ranges am I looking for on what "stuff"(like phos, etc)? Or will that depend on what stage she's at?

(I'm swamped with homework & trying to sort this stuff out too, my brain is utterly fried)

 

[pookie-poo]

Originally Posted by white cat lover

OK, the jmpeerson site.....guide me further on food. What ranges am I looking for on what "stuff"(like phos, etc)? Or will that depend on what stage she's at?

(I'm swamped with homework & trying to sort this stuff out too, my brain is utterly fried)

If you look on the links that I posted, you will see that the prescription renal foods all have a DMA (dry matter analysis) percentage of 0.37 - 0.7%. When looking at commercial non-prescription foods, I try to keep the DMA phosphorus content as close to (or under) 0.7% as possible. If I feed food that is higher than 0.7% DMA Phos, I will add phosphorus binders to it, to prevent the phosphorus in the food from being absorbed in the gut.

 

[white cat lover]

Thanks! I'm bookmarking sites like mad, but not getting them all read right now....trying to get as much of a crash course as possbile!

Have I mentioned that I'm

yet?

This seems to daunting at times, but it really isn't once I get into the swing of things!

 

[kittymonsters]

Whoo Hoooo, first round of fluid over and it was a success. I on the other hand seriously almost had a heart attack from too much anxiety.

I warmed her fluid in the water then took her into the bathroom with her favorite blanket. I hung the bag from the shower rod and then sat on the toilet ( seat down,

)

Zoe was so good! I did the tent, inserted the needle and turned the fluids on. She was purring and rubbing her chin on me!

At about 60-70 mls she got a little agitated. I think because on of the other monsters was headbutting the door, certain the were missing something really good.

I got her settled again and gave her the last 30 ml then gave her a treat of lamaderm cat food. She is now on the back of the couch, on her blanket, purring.

I am glad to know about the phosphorus. her levels are low right now and I want to get the Calictriol ordered I am a little hesitant about this because Zoe does NOT do anything stuffed in her mouth. She starts drooling and smacking if she even thinks you are going to try. Then if you do try she freaks and will quit eating completely.

If it doesn't taste bad, like the cosequin sprinkle caps I can put it in he food. The enalapril I had to have made into a transdermal ear gel. I haven't gotten the bill for that one yet...I have a feeling it is going to be YIKES!

All and all reading here and have all this wonderful advice made tonight go way better than i could have dreamed it would. I think we might just pull this off.

Pookie Poo, I have to say you have done amazing things with Cleo. She is so gorgeous and doesnt look at all like a CRF kitty.

Time for me to go off to bed. I think I used up every last bit of energy I had on my three hour needless anxiety attack, LOL.

 

[pookie-poo]

Originally Posted by kittymonsters

Whoo Hoooo, first round of fluid over and it was a success. I on the other hand seriously almost had a heart attack from too much anxiety.

I warmed her fluid in the water then took her into the bathroom with her favorite blanket. I hung the bag from the shower rod and then sat on the toilet ( seat down,

)

Zoe was so good! I did the tent, inserted the needle and turned the fluids on. She was purring and rubbing her chin on me!

At about 60-70 mls she got a little agitated. I think because on of the other monsters was headbutting the door, certain the were missing something really good.

I got her settled again and gave her the last 30 ml then gave her a treat of lamaderm cat food. She is now on the back of the couch, on her blanket, purring.

I am glad to know about the phosphorus. her levels are low right now and I want to get the Calictriol ordered I am a little hesitant about this because Zoe does NOT do anything stuffed in her mouth. She starts drooling and smacking if she even thinks you are going to try. Then if you do try she freaks and will quit eating completely.

If it doesn't taste bad, like the cosequin sprinkle caps I can put it in he food. The enalapril I had to have made into a transdermal ear gel. I haven't gotten the bill for that one yet...I have a feeling it is going to be YIKES!

All and all reading here and have all this wonderful advice made tonight go way better than i could have dreamed it would. I think we might just pull this off.

Pookie Poo, I have to say you have done amazing things with Cleo. She is so gorgeous and doesnt look at all like a CRF kitty.

Time for me to go off to bed. I think I used up every last bit of energy I had on my three hour needless anxiety attack, LOL.

Way to go!!! Congratulations on the 1st sub-Q! I know the feeling of anxiety related to doing the first needle stick. OHMYGOD!!! It was absolutely awful for me.....and I'm a nurse!!!

You can get Calcitriol compounded as a liquid. Actually, most of the people in the CALCITRIOL USER GROUP seem to get theirs in liquid form. Cleo is just so easy to pill, that I decided to go that way. It might be easier for you to give Zoe her Calcitriol in liquid form. Most dosages are in the 10th of ccs, so it's really a minuscule amount. I think the price is pretty similiar regardless of the dosage formulation. To be honest, I don't recommend giving medications in food, because they just might not eat all of the food, therefore not receiving the whole dose of the medication.

Again...congratulations on the 1st sub-Q! I want to tell you that it does get easier...although, I remember that I was nervous for the first month or so, until I figured out that I could really do it, and Cleo really didn't mind it!

 

[pat]

I never even thought of calcitriol except as a liquid...too many years of using it...my compounding pharmacy must love me!

 

[white cat lover]

Back to Bea....USG was 1024. Blood panel today:

BUN 24
(normal 10-30)
CRE 1.7
(normal .3-2.1)

Only thing elevated was total protien & that was 9.3 (normal 5.4-8.2).

 

[pat]

Originally Posted by white cat lover

Back to Bea....USG was 1024. Blood panel today:

BUN 24
(normal 10-30)
CRE 1.7
(normal .3-2.1)

Only thing elevated was total protien & that was 9.3 (normal 5.4-8.2).

I would question a diagnosis of crf based on just the above. From the 2005 World Small Animal Association's overview on crf "Non-renal diseases, such as diabetes mellitus, diabetes insipidus, liver failure, etc can also produce a low urine specific gravity. " Herre is the link to read all of it (and I did just skim, I may very well have missed something else pertinent or of interest)

http://www.vin.com/proceedings/Proce...0999&O=Generic

 

[white cat lover]

I was wondering about that, too....

If it was diabetes insipidus, she'd be like me & having to pee all the time...although it may be different in cats.

Off to research.

 

[luvmy2cats]

How bad does CRF need to be before cats need routine sub-q treatments? See Popsie was just diagnosed yesterday with the very begining stages. The vet said it's not that bad but I do have to put him on a renal diet.

 

[white cat lover]

Originally Posted by luvmycat1

How bad does CRF need to be before cats need routine sub-q treatments? See Popsie was just diagnosed yesterday with the very begining stages. The vet said it's not that bad but I do have to put him on a renal diet.

I think that will depend on the cat. IMO, with SubQs you have to be proactive....if he's dehydrated start on them. Someone else who is more familiar with CRF should be along to help.