My CKD cat's legs getting weaker... causes??

[Sillycat41]

My 17 yr old Jengo's rear legs have been getting weaker... he can't jump very high any more and wobbles when he walks. My vet said it could be low potassium but on Jan 25th his potassium was fine. Another suggestion was arthritis but don't think it comes on this quickly. He also said dehydration can make him wobbly but he does it even when hydrated. Another forum suggested some more blood tests for anemia. A Hematology panel done on Dec. 19th his RBC was slightly low at 5.95 (normal is 6.54 -12.20) His Hemoglobin was also a bit low at 9.4 (normal is 9.8 -16.2) MCV was a little high at 57.8 (normal is 35.9 - 53.1). Should I have the vet do this test over again to see if these slightly high results are higher???

Also I read that CKD cats have muscle wasting. Perhaps this is why he seems weaker. What tests are done to diagnose muscle wasting? I made a vet appointment but want to target the problem with the right tests and not run the same tests as on Jan.25th when he was diagnosed with early Stage 3 CKD. Could it be a uremic problem?

Re: his condition:
- still has an interest in food but only eats small meals 8 times a day
- still grooms, his fur is still soft and silky
- still plays a little and walks on his cat wheel
- he is thin but it weight is holding at 8.7 - 8.8#
- phosphorus was a bit high last blood test so added Phos-Bind to his meals and feed low phosphorus too
- gets 75ml sub-Q daily - plus he drinks on his own
- 2.5 mg Pred once a day
- Zofran twice a day for nausea
- B12 injection once a week
- Porus One

Has anyone had this problem with their CKD cat getting weak read legs? Sometimes he kicks them out after jumping off furniture. But it's the wobbliness like he's drunk that worries me.

Would appreciate any help or explanations... also suggestions for what tests to have done. Thank you. Barb

 

[FeebysOwner]

What do his kidney numbers look like in a Chemistry Panel? Weakness can also be a sign of too much toxin build up in a cat's system.

Do you use Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Index of Symptoms and Treatments (felinecrf.org) as a reference guide? There is an entire section on probable causes of back leg weakness.

One of the things I don't think you mentioned is having his BP checked for hypertension. Another cause is metabolic acidosis - which requires specialized tests known as blood gas analysis for accurate diagnosis. Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Metabolic Acidosis (felinecrf.org)

 

[silent meowlook]

Hi. Yes, repeat the bloodwork to see where you are now. Muscle wasting is determined through physical examination. Also, remember with kidney disease, the creatinine cannot be accurately evaluated if there is muscle wasting. So, if he has muscle loss his creatinine could be higher if the muscle was there. Hard to explain.

Let your vet do a full physical and blood work to see where you are right now, as these change fairly quickly.

Additional testing that would be helpful would be an abdominal ultrasound. But this should be done through a specialist.

Make sure they check his blood pressure as well.

If you are happy with your vet, great. But, if not, you can always ask for a referral to a specialist.

 

[white shadow]

.
Hi S Sillycat41

I'll just touch on one item on the 'things to check' list......I've had personal experience with the 'nitty-gritty' of this one......

Jengo's rear legs have been getting weaker... he can't jump very high any more and wobbles when he walks. My vet said it could be low potassium but on Jan 25th his potassium was fine....

So......exactly what was this "fine".....?

Here's a snippet from the "Tanya's Guide..." that Feebysowner gave you:

"Although laboratories vary, most have a range around 3.5 to 5.5. Ideally though:​

​

Your cat's potassium level needs to be firmly in the middle, at around 4.4, but definitely above 4."​

link: Goal for Potassium Level in Bloodwork - "Tanya's Guide..."​

If you have a copy of the lab report, it's there. [may be a good opportunity to suggest that you keep your own copy of his medical file]

In my case, the K level was just below 4, perhaps 3.7/3.8..........and, my Vet pronounced it......."fine"!

I shared the "Tanya's Guide..." tidbit with her and ordered a bottle of NOW Potassium Gluconate Powder and began adding it into his food.........within ~ a week/two, no more wobbly legs. [start with only a few grains and very slooooowly increase the amount over a week/ten days, so your cat imperceptibly accepts its off-putting taste.....that's mentioned in there, too]

How much Potassium powder to use/give? That's covered further on down that page. There's lots of latitude in the range for potassium, so your measurements' accuracy isn't critical........that page suggests the upper max limit is 6. Have another blood panel run in a month or so but, most important: look for more steady legs!

One other tidbit for you: in your post, you mentioned "Another forum". Did you know that the author of the "Tanya's Guide..." runs/sponsors an online community/group dealing exclusively with kidney disease? It's been running for ages, some 20+ years, and is approaching 10K total members. If you want accurate, informed advice/info, well, that's where I'd be! How it works and a direct link is on this page: TANYA'S FELINE CKD SUPPORT GROUP.

Hope something there helps!
.

 

[Sillycat41]

What do his kidney numbers look like in a Chemistry Panel? Weakness can also be a sign of too much toxin build up in a cat's system.

Do you use Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Index of Symptoms and Treatments (felinecrf.org) as a reference guide? There is an entire section on probable causes of back leg weakness.

One of the things I don't think you mentioned is having his BP checked for hypertension. Another cause is metabolic acidosis - which requires specialized tests known as blood gas analysis for accurate diagnosis. Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Metabolic Acidosis (felinecrf.org)

Thanks for responding. His latest kidney numbers were on Jan. 25th. BUN was high at 66.7 and Creatinine was high at 3.3 also phosphorus was high at 6.2

I'll check the Tanya's links you sent. There is so much info on that site I get over-whelmed. He is such a nervous cat that I'm sure if would be hard to get an accurate blood pressure.

Thanks again.

 

[Sillycat41]

Hi. Yes, repeat the bloodwork to see where you are now. Muscle wasting is determined through physical examination. Also, remember with kidney disease, the creatinine cannot be accurately evaluated if there is muscle wasting. So, if he has muscle loss his creatinine could be higher if the muscle was there. Hard to explain.

Let your vet do a full physical and blood work to see where you are right now, as these change fairly quickly.

Additional testing that would be helpful would be an abdominal ultrasound. But this should be done through a specialist.

Make sure they check his blood pressure as well.

If you are happy with your vet, great. But, if not, you can always ask for a referral to a specialist.

Thanks for responding. Is there any way to stop muscle wasting? He has an appt. on Friday so I'm trying to figure out what tests to ask her to do. This clinic does do ultra-sounds but they are not a specialist clinic. Is it worth having that done by a regular vet??? There are no specialist vets in my area. Closest one is 180 miles one way. :-(

 

[Sillycat41]

.
Hi S Sillycat41

I'll just touch on one item on the 'things to check' list......I've had personal experience with the 'nitty-gritty' of this one......

​

So......exactly what was this "fine".....?

Here's a snippet from the "Tanya's Guide..." that Feebysowner gave you:

"Although laboratories vary, most have a range around 3.5 to 5.5. Ideally though:​

​

Your cat's potassium level needs to be firmly in the middle, at around 4.4, but definitely above 4."​

link: Goal for Potassium Level in Bloodwork - "Tanya's Guide..."​

If you have a copy of the lab report, it's there. [may be a good opportunity to suggest that you keep your own copy of his medical file]

In my case, the K level was just below 4, perhaps 3.7/3.8..........and, my Vet pronounced it......."fine"!

I shared the "Tanya's Guide..." tidbit with her and ordered a bottle of NOW Potassium Gluconate Powder and began adding it into his food.........within ~ a week/two, no more wobbly legs. [start with only a few grains and very slooooowly increase the amount over a week/ten days, so your cat imperceptibly accepts its off-putting taste.....that's mentioned in there, too]

How much Potassium powder to use/give? That's covered further on down that page. There's lots of latitude in the range for potassium, so your measurements' accuracy isn't critical........that page suggests the upper max limit is 6. Have another blood panel run in a month or so but, most important: look for more steady legs!

One other tidbit for you: in your post, you mentioned "Another forum". Did you know that the author of the "Tanya's Guide..." runs/sponsors an online community/group dealing exclusively with kidney disease? It's been running for ages, some 20+ years, and is approaching 10K total members. If you want accurate, informed advice/info, well, that's where I'd be! How it works and a direct link is on this page: TANYA'S FELINE CKD SUPPORT GROUP.

Hope something there helps!
.

 

[Silver K]

My cat has stage 2 kidney disease. He also has wobbly back legs. It's muscle deterioration and the onset of arthritis. My vet prescribed him a monthly shot called Solensia and it has worked wonders. It's quite pricy however (at least here in Canada) but I think it's worth it. He went from falling off things to having the zoomies and climbing with no problems to the top tier of his cat trees.

 

[Sillycat41]

Thanks for your comments. On Jan 25th his potassium was 4.7 - normal listed as 3.4 to 5.3. I read that could vary depending on the in-house testing equipment. One vet uses IDEXX and the other Heska and that some clinics send the blood out to be tested which is more accurate. Is that true?

Interesting how the potassium helped your cat!

I am also on Tanya's feline support group. I get frustrated though because I get so many responses that they fill up my Inbox and many are just well-wishers. Thought I'd try thecatesite for other opinions. Thanks again.

 

[Sillycat41]

My cat has stage 2 kidney disease. He also has wobbly back legs. It's muscle deterioration and the onset of arthritis. My vet prescribed him a monthly shot called Solensia and it has worked wonders. It's quite pricy however (at least here in Canada) but I think it's worth it. He went from falling off things to having the zoomies and climbing with no problems to the top tier of his cat trees.

Thanks for the response. Did your cat's wobbly back leg problem seem to get worse rather rapidly? That's why I didn't think my Jengo had arthritis. I first noticed him kicking out his back legs in mid-Dec. but now he just seems really wobbly. I'll do some research on arthritis. Thanks again.

 

[Silver K]

Thanks for the response. Did your cat's wobbly back leg problem seem to get worse rather rapidly? That's why I didn't think my Jengo had arthritis. I first noticed him kicking out his back legs in mid-Dec. but now he just seems really wobbly. I'll do some research on arthritis. Thanks again.

It didn't get worse rapidly but the onset was fast. He seemed fine one month and then the next month he started to fall, it happened sometimes a few times a day. Nile has always been the most agile cat out of all the ones I've had in my life. That's when I took him in to get looked at and they recommended Solensia. The Solensia probably hasn't slowed the muscle deterioration but it manages his pain.
I should add he is also on subcutaneous fluids twice a week, blood pressure meds (which ironically will hurt his kidneys overtime) and a potassium supplement. He's on borrowed time but he's comfortable and happy which is all that really matters.

 

[silent meowlook]

Hi. I doubt it is low potassium, but of course, I am not a vet and just don’t know. I haven’t seen muscle weakness from low potassium until it is under 3.0. Also, you are supplementing it. So, to me, it seems unlikely that is the cause.

Having an ultrasound gone by a regular vet all depends on how many they do a week, and if they have had additional training. Also the ultrasound itself matters.

 

[Sillycat41]

What do his kidney numbers look like in a Chemistry Panel? Weakness can also be a sign of too much toxin build up in a cat's system.

Do you use Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Index of Symptoms and Treatments (felinecrf.org) as a reference guide? There is an entire section on probable causes of back leg weakness.

One of the things I don't think you mentioned is having his BP checked for hypertension. Another cause is metabolic acidosis - which requires specialized tests known as blood gas analysis for accurate diagnosis. Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Metabolic Acidosis (felinecrf.org)

That's what I'm worried about... toxin build-up. :-( On Jan. 25th his BUN was high @ 66.7 , Creatinine high @ 3.3 and Phosphorus high @ 6.2. Could it have changed that much in left than a month?? How is toxin build-up detected?? In urinalysis or blood work?? I'll study the links you sent today... my computer was down all day yesterday because of a Windows update problem. Thanks again.

 

[Sillycat41]

My cat has stage 2 kidney disease. He also has wobbly back legs. It's muscle deterioration and the onset of arthritis. My vet prescribed him a monthly shot called Solensia and it has worked wonders. It's quite pricy however (at least here in Canada) but I think it's worth it. He went from falling off things to having the zoomies and climbing with no problems to the top tier of his cat trees.

Thanks for responding. If he does have arthritis, isn't Solensia hard on the kidneys? Aren't all drugs? Is that something you have to weigh.. the pros and cons? I would love for Jengo to have the zoomies again. His appt. is tomorrow.... I pray that it is something that can be remedied.

 

[Sillycat41]

Hi. I doubt it is low potassium, but of course, I am not a vet and just don’t know. I haven’t seen muscle weakness from low potassium until it is under 3.0. Also, you are supplementing it. So, to me, it seems unlikely that is the cause.

Having an ultrasound gone by a regular vet all depends on how many they do a week, and if they have had additional training. Also the ultrasound itself matters.

Thanks for responding. From what I've read low potassium symptoms are worse than what he had. No, he is not getting any potassium. Unfortunately this vet is rather young so I don't know how much experience she had doing ultra-sounds. :-(

 

[Sillycat41]

It didn't get worse rapidly but the onset was fast. He seemed fine one month and then the next month he started to fall, it happened sometimes a few times a day. Nile has always been the most agile cat out of all the ones I've had in my life. That's when I took him in to get looked at and they recommended Solensia. The Solensia probably hasn't slowed the muscle deterioration but it manages his pain.
I should add he is also on subcutaneous fluids twice a week, blood pressure meds (which ironically will hurt his kidneys overtime) and a potassium supplement. He's on borrowed time but he's comfortable and happy which is all that really matters.

Jengo has always been an agile cat too... it breaks my heart to see him like this. He gets 75 ml of fluids daily because he gets so dehydrated. No BP meds yet. Hope it's sometime that can give him more time and me less worry about him falling. Thanks again.

 

[FeebysOwner]

That's what I'm worried about... toxin build-up. :-( On Jan. 25th his BUN was high @ 66.7 , Creatinine high @ 3.3 and Phosphorus high @ 6.2. Could it have changed that much in left than a month?? How is toxin build-up detected?? In urinalysis or blood work?? I'll study the links you sent today... my computer was down all day yesterday because of a Windows update problem. Thanks again.

His phosphorus level is high enough to suggest toxin bulld up. The kidney numbers (above included), and urinalysis to some degree, usually provide indicators regarding toxins in the body. Outward signs can be lethargy and inappetence for the most part. As per Tanya's web site (and IRIS), Stage 2 is based on a creatinine level anywhere from 2.9 to 5.0, so to me your cat is Stage 2 not 3. At Stage 2 the goal is to keep the phosphorus level below 5.0.

Many CKD cats are also on an appetite stimulant (mirtazapine/mirataz) to help with getting them to keep eating better. That is the only thing I didn't see on your list. Otherwise, it looks like you are giving your cat all that is typically given. Phos-Bind can cause constipation, but you can help counteract that by using Miralax.

Regarding med/supplements, including Solensia, all are processed either by the kidneys or liver. As you inferred, it is a balancing act between benefits and risks. Solensia wouldn't help stop muscle wasting, other than from the perspective that if he is in less pain from arthritis he might move more. Exercise is always good for the muscles. There is also Adequan for arthritic pain and it also has a joint supplement in it, unlike Solensia. It has been around quite a bit longer than Solensia, so it could be a safer bet to try - you could talk to your vet about it.

None of the above necessarily explains your cat's leg weakness, but as you know each cat varies in terms of how their bodies respond to illnesses/diseases. The link I provided you with about leg weakness will give you some other possible causes, including metabolic acidosis and how that can be tested for.

Lastly, about the CKD support group forum and too many notifications - check the 'Subscriptions' section (when you are logged on), and you will see some different options for choosing how you receive notifications.

 

[Silver K]

Thanks for responding. If he does have arthritis, isn't Solensia hard on the kidneys? Aren't all drugs? Is that something you have to weigh.. the pros and cons? I would love for Jengo to have the zoomies again. His appt. is tomorrow.... I pray that it is something that can be remedied.

Any medication would be a strain on the kidney but my vet said because it's a monthly shot it's not as bad. She really was more concerned about his Amlodipine (blood pressure med) and warned that one could be what affects his kidneys the most.
He had a full panel done last December he is still at stage two. He's been there well over a year now. He's doing okay all things considered.
Best of luck with your appointment, hope it goes well and keep us posted!

 

[Sillycat41]

His phosphorus level is high enough to suggest toxin bulld up. The kidney numbers (above included), and urinalysis to some degree, usually provide indicators regarding toxins in the body. Outward signs can be lethargy and inappetence for the most part. As per Tanya's web site (and IRIS), Stage 2 is based on a creatinine level anywhere from 2.9 to 5.0, so to me your cat is Stage 2 not 3. At Stage 2 the goal is to keep the phosphorus level below 5.0.

Many CKD cats are also on an appetite stimulant (mirtazapine/mirataz) to help with getting them to keep eating better. That is the only thing I didn't see on your list. Otherwise, it looks like you are giving your cat all that is typically given. Phos-Bind can cause constipation, but you can help counteract that by using Miralax.

Regarding med/supplements, including Solensia, all are processed either by the kidneys or liver. As you inferred, it is a balancing act between benefits and risks. Solensia wouldn't help stop muscle wasting, other than from the perspective that if he is in less pain from arthritis he might move more. Exercise is always good for the muscles. There is also Adequan for arthritic pain and it also has a joint supplement in it, unlike Solensia. It has been around quite a bit longer than Solensia, so it could be a safer bet to try - you could talk to your vet about it.

None of the above necessarily explains your cat's leg weakness, but as you know each cat varies in terms of how their bodies respond to illnesses/diseases. The link I provided you with about leg weakness will give you some other possible causes, including metabolic acidosis and how that can be tested for.

Lastly, about the CKD support group forum and too many notifications - check the 'Subscriptions' section (when you are logged on), and you will see some different options for choosing how you receive notifications.

Glad to hear he is still in Stage 2. One vet told me he was in Stage 4!! So the goal is to keep phosphorus below 5.0 wish the vet had explained that I thought anything under the top number... 2.6 to 6.0 was okay. Frustrating as I could have been giving him Phos-Bind all along.

I do give him Mirtazapine twice a week but it seems to take hours before it has an effect and he whines a lot. Sorry, I forgot to list it. I didn't realize that Phos-Bind caused constipation and he does have hard stools. I have been giving him a little Miralax for the past few weeks and that seems to help.

He does get some exercise as he walks on his cat wheel every day... 5 minutes here and there... but I noticed that he doesn't track as straight as he used to because of weakness in his rear legs. I'll talk to the vet tomorrow about Solensia vs Adequan.

Thanks for the tips. Hope the tests tomorrow give some answers that can improve his condition. He's the neatest cat I've ever had and it breaks my heart that he is failing. :-(
Barb

 

[FeebysOwner]

My name is Barb too! But, I go by Barbara. Anyhow, it sounds like you have been headed in the right direction.

I use the transdermal form of mirtazapine (Mirataz). My cat has been on it for quite a while now (2021), and I only give her 1/2 dose every other day. I switch it up if needed, but I have never yet given her a full dose. Funny thing about this appetite stimulant, at least in transdermal form, is that it can take hours to make an effect, or it can take a day - I just think it is also somewhat due to the food that is being given too as my cat has her preferences. If you are feeding multiple foods, which I have to do with my cat, I think that can contribute to the 'reaction'.

Let us know how the tests go.