Kidney disease

[silver seraph]

 
I just wanted to contribute to this thread because I sadly just found out today that my beloved orange and white tabby Pilsen is also looking like he has kidney disease. His BUN is ok but his creatinine is at 3.7...which I believe is possibly stage 3?

Anyway, I'm devastated, as he is basically my baby of 14 years (he was a stray rescue from the city streets and has since been a very spoiled much loved cat), but this also helps to explain why he's been losing his appetite steadily and losing so much weight. Now I'm beating myself up about not noticing earlier when he'd gradually stopped eating as much

My vet spouted a lot of numbers at me but didn't do a great job of explaining exactly what to expect and what the possibilities for Pilsen are. It all seemed very vague. I scoured felinecrf.org and have slowly been reading up, but honestly, it's all a bit overwhelming to me. Luckily, Pilsen seems to be happy and not suffering or in pain.

A few newbie questions:

-There seems to be a lot of conflicting info about low protein special kidney diets vs. other quality protein low phosphorous foods. I have a few days before my vet gets back to me w/ the final results of a further urinalysis and the actual k/d food...in the meantime, is there any regular commercial food I can feed a cat who's allergic to chicken/turkey/duck but won't strain his kidneys too much? He will not eat more than a teaspoon of raw, so canned is what I'm looking at.

-Pilsen is drinking a lot of water, but his urine is not concentrated. I read many ppl put their cats on sub-q treatment. Is this necessary when the cat is still drinking tons of water, or is it a later-stages sort of thing?

-Lastly, if you guys have any practical advice on how to deal w/ this emotionally -- ie, is it pretty normal for a cat to get this and live a lot longer?  or is it definitely gonna be a swift decline? because i'm battling a whole slew of emotions here, but also not sure if i'm jumping the gun and it's a thing that can be treated and lived with normally for years...

Any helpful advice would be enormously appreciated.

Hello, I'm new here, I happened to see your post and decided to sign up to offer a few comments to your questions.

My cat was diagnosed in July of 2013, her numbers were outrageous, if I remember correctly her BUN was 117 and her creatinine was 7.9, her phosphorus and potassium and all other values were horrible too.  We stabilized her and she's still hanging in there with me today.  For the past 7 months her BUN hovers between 60-66 and her creatinine hovers between between 4.3 and 4.7.  We check her blood every 6-8 weeks. So yes, your kitty potentially can hang in there for quite awhile. All cats are different. Some do ok with high numbers, some don't. Some stabilize and hang on for awhile.  Some will "crash" where their values go downhill almost overnight.  If you catch the crash early, some will crash several times and recover several times, and for others they crash and never recover.  Some never crash, but just plod down the road with ever worsening values until you reach "the end".   There are so many scenarios, but don't give up.

As for your food question, I'm not sure.  We have 5 kitties, only one has kidney disease. Our cats have always been "free feeders" where they always have access to food, so it was extremely hard to feed her by herself and keep her out of the other cats food.   I tried doing it for awhile and she kept getting into the other cats food.   As result her phosphorus numbers became elevated.   We had to put her on a phosphorus binder ( aluminum hydroxide) and she HATES it....so we ended up just feeding ALL our cats prescription kidney food.   We fill all the feeders with prescription food and they can all eat normally throughout the day like they're used to and I don't have to worry about taking food up and hiding bowls etc and she can eat when she wants, which is VERY important.  They start losing weight with this disease, due to sour stomach and nausea so you want to keep them as "fat" and happy for as long as possible.   As for feeding all our cats the prescription food... the vet said the prescription food is safe for our other cats...and so far it's working, as her phosphorus has gone back to normal now that she doesn't have access to regular kibble.        We don't have problems with allergies like you do, so you'll likely have to ask your vet for options since you have specific allergies.    Ours eat  IAMS prescription diet K/D "kidney disease" dry food, and she likes Purina prescription R/F "Renal diet" canned food.  These foods are working for us...so I'm going to stick with them.

You asked about your kitty drinking a lot, and giving fluids.   My cat's drinking habits were how I initially knew something was wrong.  She drank and drank and drank. She was constantly in her litter box too.   Unfortunately with this disease the cat begins drinking more and more because their body is trying to compensate for the lack of kidney function....they drink copious amounts and then urinate out the toxins, but eventually they just can't drink enough. Not only do the toxins start building up, but they also become dehydrated because they're urinating it all out so quickly as their body tries to flush the poisons out.  So, no, just because your cat is drinking a lot and the urine doesn't look concentrated, doesn't mean it's getting enough. In fact it probably means you should ask your vet about the need for fluids.   Your cat might just need fluids once or twice a week.    My cat needs fluids daily. We've been giving her 100ml's of fluids every single night since she was diagnosed.   Giving fluids at home is pretty easy, at first it was a bit daunting, but now it's just routine. ...so don't be discouraged or worried about using needles etc.

Something else to keep in mind...kidney disease cats are prone to urinary tract infections because they're constantly urinating and in the kitty litter box.  And having a urinary tract infection can cause their numbers to spike. Some vets actually put their kidney failure patients on injection antibiotics as a precautionary measure throughout the course of the cats treatment/life.  Other vet's don't think it's necessary.   Depends on your doctor I guess...but it's something to consider.

Anemia is another aspect of kidney failure, you'll need to pay attention to that too.  I don't quite understand how it all works but the kidneys are responsible for making erythropoietin.  Erythropoietin is what their body uses to make red bloods cells and as their kidneys get worse, it mucks up the production of erythropoietin and they get anemic.   My cat is hovering on the edge of needing erythropoietin injections or "EPO" for short (same thing lance armstrong was injecting to cheat at cycling) . We give her iron supplements twice a day trying to keep her red blood cell count up, because EPO is expensive and requires a lot of testing to make sure the dosage is correct.

Theres so much to discuss with this disease it's hard to talk about without starting to ramble a bit, so I'll stop adding information unless asked. 

Hang in there, and I would definitely ask your vet if you should start giving fluids.  When the vet spouts off a bunch of numbers,  try to at least jot down the  BUN, Creatinine, Phosphorus and her Red Blood Count/packed cells.   Even better, if you can, ask your vet for a copy of your cats lab work and post it on the Tanya's CRF mailing list. People share their cats numbers all the time and there are people on the list who can answer very specific questions on just about ANY lab value.