CRF in 16 year old cat (Sneakers)

[nekochan]

Sneakers was diagnosed with CRF this week. Her numbers were really bad and she wasn't eating. She stayed at the vet for 3 days to try to improve her numbers and I brought her home yesterday... She is doing a little better now but I am still having trouble getting her to eat enough. I am worried because she is very skinny, she was down to 5 lb 15 oz when she went in to be hospitalized. She is a fairly large cat so this is very skinny for her, after her stay at the vet she was back up to what she had been when she was diagnosed on Tues (6 pounds something) still very skinny. I've been force feeding her in addition to what I can get her to eat on her own but I don't know if I can actually get her to eat enough to gain weight doing this.

I got Sneakers updated bloodwork results today. My vet emailed me:
Her creatinine has come down to 4.4 from 9.8 (high normal is 2.3) so we cut it in half. The BUN is now 114 down from 208 (normal 30) and the phosphorus is down to 8.6 from 22.7 (high normal is 7.0).

The higher numbers were from the original results on Tuesday when we got the diagnosis. My vet said she also has a regenerative anemia but her WBC is better than it had been.
She also has high blood pressure, she's been on meds for this for months but it is still high every time we go in to have it checked.

I am also worried because I am going out of town in a week or so and I am not sure whether it is better to have her stay at home or board her at the vet. My pet sitter is a vet tech but we had been planning to just have her come once a day.

 

[the_food_lady]

Hello there,

Do you know about/belong to the Feline CRF group on Yahoo? Here is the address, I encourage you to join:

http://pets.groups.yahoo.com/group/F...guid=485365100

Even though her BUN and Creat are much improved, did the Vet mention anything about giving her regular SubQ fluids at home?

Any suggestion about phosphorus binders to help lower phosphorus?

How is potassium level; was it ever checked? It can often become quite low in CRF cats...and often needs to be supplemented. Low potassium can cause weakness, poor appetite, nausea too. Potassium impacts muscle function and the heart is a muscle so it's critical that low potassium be supplemented (usually it's with Potassium Gluconate).

Is kitty on anything for stomach acid which is often quite high when their BUN is high, which then causes mouth ulcers, upset tummy, nausea/vomiting and lack of appetite? Pepcid AC (the regular one, not the extra strength....just plain Famotidine - that's the generic name) is commonly given to help with this.

Cyproheptadine or other appetite stimulants (there's newer one out there now, but I'm only familiar w/ Cypro as that's all that I've ever used in the distant past) can help to promote appetite.

Here's a really awesome website with tons of fantastic info on the common symptoms of CRF and the various treatments, meds, supplements, dosages, etc. This site is like a must-have "Bible" for CRF cat owners:

http://www.felinecrf.org/

How does your kitty do at the Vet? I know mine get very stressed there and if not wanting to eat to begin with, that's the last place they'd eat.....so if yours is the same, might be good if you can arrange to have your pet sitter/vet tech come into your home twice a day.........to reduce the amount of stress for kitty. She would be able to do regular subQ fluids and give whatever meds are needed........of course you giving her permission to take kitty to the clinic should kitty's condition deteriorate?

I've found with CRF cats or cats who are feeling poorly..........sometimes you have to try a zillion different kinds of food.........leaving out several kinds for them. Fancy Feast, although not high quality, is one that even sick kitties seem to like. It's always best to mix a little water with canned food.....the additional fluids are good for kidneys.........just mix it up good. Warmed canned food is more palatable to cats, too, and I think it triggers their sense of smell more, too. Just enough to warm it up, even if it's straight from the can (and particularly if you're serving refrigerated leftovers). I once had a vet tell me he'd been to a conference and learned there that if you sprinkle grated parmesan cheese (the kind you sprinkle from the can) onto canned food, it can entice some cats to eat.

Sometimes pouring a little tuna juice (tuna packed in water, not oil) over canned food can help, too.

With my first CRF cat, when she wasn't eating well and I was having to syringe feed her, sometimes I'd give her some Nutri-Cal. It's a high calorie paste in a tube......intended for cats who need supplementation because they're eating poorly .......or maybe not wanting to eat at all. It's very palatable to cats. I believe that PetsMart sells something like it. It's generally malt flavored and I've found that most cats will just like it off your finger...........similar to the furball stuff in a tube. I've been giving a little here and there to my current CRF kitty and even though she's been very fussy about eating canned food, she seems to like this stuff. Might want to look into that, too.

 

[nekochan]

Thanks for the info! Yes we joined the Yahoo group the other day, I saw it on the CRF sticky post here. I forgot to mention my previous cat Sylvia also had kidney disease so I am pretty well-versed on giving the sub-q fluids (unfortunately I've had to do sub-q with other pets for other reasons since then too.) In Sylvia's case though they caught it very early, during routine screening bloodwork before she was going to have a dental done so in her case it was caught before she had any symptoms or anything, and over time we were able to go down to fluids just once or twice a week and she never even needed any other meds...

Sneakers was already on pred and on benazepril and amlodipine for her blood pressure and when we got the diagnosis earlier in the week my vet had me start giving her cyproheptadine, and pepcid.. I already had the cypro because my allergy/immune issue cat takes it.
Since Sneakers came home from the hospital the vet is also having me give her Baytril, Reglan, Azodyl(probiotic/kidney supplement) and Epakitin which I think is a phosphate binder. She is also getting Epotin twice a week for her anemia. My vet is having me give her 150 cc of fluids twice a day for 3-4 days, she was getting 300 cc per day on her IV at the hospital so they want to taper it down slowly.

I tried to buy Nutrical when she wasn't eating earlier in the week but the pet store only had GNC High Calorie Booster for cats and Sneakers spits it out when I try to give it to her. I'm not sure if it is just that this brand tastes bad or what. I had bought a whole bunch of different brands of canned food earlier in the week when she really wasn't eating well, but she would only lick a small amount but I still have some different types left, although right now I'm trying to stick to the renal food as much as I can so her phosphorus levels don't go way up again.

Her potassium is normal, my vet just forwarded me the full reports and it was 4.8 Tues and 4.6 yesterday, normal range is 3.9-5.3.

She doesn't like to be at the vet, but they said she did eat for them while she was there the last few days even though they were also tube feeding her.
I think I'll discuss it with the pet sitter when she comes over for her pre-sitting visit and see what she thinks, and will also see how Sneakers seems to be doing the next few days. I am mostly worried because I have been offering Sneakers food multiple times a day to try to get her to eat enough so even if the pet sitter came twice I'm not sure if she would be able to get Sneakers to eat enough, you know? Today she does seem to be eating better than she had been at least.

 

[uglm61]

You're in luck. There is a new product coming out called RenAvast that has been clinically proven to reduce BUN and Creatinine levels in CRF cats. It's an all natural product that will be on the market very soon. Google it over the next couple of weeks and ask your Vet about it. I know a few people with cats that were in the study and the results have been AMAZING!! Sending love to Sneakers!

 

[the1mag]

My cat Cleo who's almost 18 was also just diagnosed with CRF and I've been all over the internet looking for info. There are all kinds of great resources out there. The main problem is getting her to eat enough and we have a real kitty buffet here. Of course the food that's best for her is the least favorite! She stopped eating and drinking on Sunday so we went off to the vet on Monday morning. Vet felt she had a slight infection so gave an injectable antibiotic, some subq fluids and sent me home with a feeding syringe just in case. She was obviously feeling better during the day but I really felt I needed to get some food into her somehow so back the internet to look for instructions on syringe feeding. I found this video

which was so incredibly helpful. Got some food into her last night. She's way better this morning but still not eating much so I may be syringing again today. The crazy thing is that apart from the CRF there's absolutely nothing wrong with her! Oh, and we're in Canada so many of the helpful supplements etc aren't avilable here or cost a fortune to ship/

 

[orientalslave]

The best place I know for CRF cat owners is:

http://www.felinecrf.org/

Sound advice tempered with common sense.

 

[arlyn]

When my CRF kitty would crash and go off her food, slightly warmed all meat human baby food did the trick every time.

I kept a case of it on hand in the event of a crash.

She passed last month after fighting it for almost 4 years, though she hadn't had a crash in over a year.

I bought a drinkwell fountain and switched her completely to canned food.

Any food is good food as long as you get it in them.

 

[mrsgreenjeens]

My 16 yr old, Sven, has CRF, and he's also skin and bones.  H give him Pepcid AC twice a day, and Reglan 3 times day, just for his nausea.  I also feed him freeze dried chicken pieces, which are pretty high in calories, and he not only loves them, he's actually putting on a little weight.  These are very high in protein, and some Vets are still under the impression that high protein is bad for CRF cats, but the latest theory is that GOOD high protein is not bad at all!