My Jengo is in Stage 3 now. How bad are his numbers?

[Sillycat41]

Hello - Would like some input from the CRF group. Took my Jengo in for blood-work on April 12th... only 8 weeks from previous blood-work because he was getting weaker. Unfortunately 3 test results were high: Bun = 70.8 Creatinine = 3.7 and Phosphorus = 8.1 putting him in Stage 3 now. Very depressed about this as I thought he was doing okay... just slowly slipping. I'd like some comments on how bad these numbers are and what to expect in the near future.

His current medications:
⦁ 1/2 Zofran / Ondansetron - AM & PM
⦁ 1/4 Prednisolone - PM every other day (reduced from 1/2 twice a day months ago)
⦁ Porus One - daily
⦁ 1/4 Mirtazapine every other day
⦁ 75 ml sub-Q - daily
⦁ sprinkle of Phos-Bind on several meals - daily (Was this a mistake??)
⦁ Miralax as needed if constipated
⦁ 1/4 Cerenia as needed - maybe once a month if he vomits

Apparently I wasn't giving him enough Phos-Bind to keep his phosphorus level down. The instructions on the container were confusing. After studying it again with the vet's help, it looks like I should be giving him about 400 mg a day. It says 100 mg per kg of weight and he is 8.7 # or 3.95 kg.... so 100 x 4 = 400 mg a day. Correct? I thought that seemed like a lot so I just sprinkled some on each of his 4 Fancy Feast meals. (Half of his meals are low-phosphorus cat foods.) I assume his kidney numbers got worse because his phosphorus was so high, right? So I caused this change by not asking questions. I was afraid if I put too much Phos-Bind on his food he'd taste it.

His current condition:
He still has an appetite but doesn't eat enough... let's me know when he's hungry. He's pretty thin how at 8.7# and has trouble jumping on and off furniture because he's weak. The vet agreed to try Adequan since he's almost 18 now and surely has arthritis. It might be too little to late since his kidneys are worse. Guess it takes a few weeks to a month to notice if Adequan is working.

After having an echo the 2nd vet said that he likely doesn't have HCM but a bad valve and a murmur. She took him off the Pimobendan. His old vet agreed that he didn't need Pimo. I monitor his breathing while resting with an app. It's always between 26 and 30. He sleeps more but still tries to play a little. Wish he wasn't so weak because I have to block the stairs off... I'm afraid he'll fall and get hurt.

I'm devastated about the test results, but not ready to give up on him. He doesn't seem to be in pain but likely has nausea that the Ondansetron isn't addressing. Have tried Pepcid but didn't notice any relief. Thinking about trying Slipper Elm.

I welcome any comments and suggestions.
Thanks, Barb

 

[ProMeower]

Hi Barb,

Our Ire has been at stage 3 since she was diagnosed. She was in and out of the ER for a bit, and it was gut-wrenching. On the one hand, the vets explained very clearly that this it is terminal and not reversible, and I couldn't tell whether I wanted to throw up or cry. But on the other hand, that was a year ago and she's still living a happy life and bossing us around.

Her last numbers were BUN 61, creatinine 3.3 and they don't check phosphorus at this clinic but hers was around 4.2 consistently. We don't use binders - the vet said she doesn't need it yet - but she is on Weruva low phosphorus exclusively. She's got the nausea and lack of appetite issues you'd expect for an 18 year old cat whose kidneys don't fully clear her blood of toxins, so we assume she will dislike binders if we ever need to use them.

I feed her basically every 90 minutes, for 16+ hours every day. That sounds insane but that is how I keep her calories up. I add hydracare pouch and/or water to her food too. She gets mirtazapine daily for appetite, and 75 mL subcutaneous fluids every other day.

I came up with a supplement regimen for her based on academic papers and Tanya's CRF site:
• vitamin B complex supplement
• omega 3 oil
• probiotic
After many months, I also added the Kidney Support Gold supplement and her kidney numbers actually improved! My suspicion is that there are a number of different mechanisms at work with CRF (it's a symptom, nobody has yet told me a cause), so in some cats it probably addresses some part of the issue.

Separate from that meal, she gets psyllium fiber to prevent constipation. The fiber can act as a binder so it is fed separate from vitamins. We initially gave Miralax per vet recommendation before we knew about kidney issues, but were told that it could add to dehydration by moving fluid into her colon.

Keeping the cat fed is a constant struggle. I've learned that nausea and lack of appetite are two different things. Pilling her with Cerenia reduced vomiting when she had it, but didn't really make her eat more. She sometimes has little "food strikes" because she wishes her food was tastier. I sometimes use my other cats' food as a topper and she'll very excitedly eat those bits only then turn tail. But basically I persist and offer food as many times a day as she'll let me.

Our Ire has other health issues but I wanted to just share the kidney experience with you. Hang in there - the blood work is just one part of the picture. Keep us posted on how Jengo does.

 

[FeebysOwner]

I don't really even know what to say - as Tanya's web site states, you don't treat the numbers, you treat the cat. While the numbers may help clue you in on some actions you can take, how your cat is behaving offers just as much of a clue.

Feeby's late January blood work shows her BUN at 63, creatinine at 3.5, and phosphorus at 5.9. Very close to her numbers from her 7/2023 blood work. And, yet she has developed new issues since then - howling, slow walking, and now litter box avoidance. While she still uses her box-steps to get up/down to/from the couch and bed, there is some hesitancy to do compared to 6 months ago. So, numbers only mean so much. I know there are cats who do better with worse numbers, and vice-versa.

Additionally, other health factors are going to play a role, so not all changes can even be blamed on the kidney function. Feeby is 19+yo, with hyperthyroidism, arthritis, high BP, a leaky heart valve and a murmur, not to mention lymphoma. So, any of these things can impact her as much as the CKD can. She is being treated for the hyper-T and the high BP. No treatment required for her leaky valve and murmur - as yet. She's been through the gamut for arthritis treatments and is now only being given pain meds (buprenorphine), as she won't take any of the joint supplements and she had side effects from Solensia.

Right before the January blood tests, I accidentally doubled the dose of Phos-Bind not realizing there had been a formula change, so she went from 125mg a day to 250mg. I am hoping that has helped to drop her phosphorus level to below 5.0. The increase in dosage did require me to start giving her Miralax.

I do tend to follow the phosphorus number more closely because if it is too high it can lead to weakness, 'foggy' thinking, and generally feeling unwell. It is said it can also exacerbate progression of CKD. Based on Tanya's web site and IRIS, at Stage 3 the goal is to try to keep the phosphorus level under 5.0. Stage 3 is based on creatinine between 2.9 to 5.0. IRIS says to give 14-28mg per pound, as the goal is merely to get below 5.0 (e.g.; not shooting for 4, as it is likely unattainable) So, for Jengo that would be 122 - 244 mg. But, if your vet gave you another guideline that they are confident with, then I guess you need to go with their suggestion. At 10 pounds, Feeby's range is 140 - 280mg. Phos-Bind is supposed to be odorless and tasteless, and Feeby does not seem to notice it in her food, even with the increased amount.

Feeby intermittently gets 4mg ondansetron, meaning she gets it when she is willing to take it. Personally speaking, whether she has 2 doses of that a day or none, I don't see much of a difference in eating habits. She eats well those foods she likes best, and less well on ones she isn't crazy about. I rotate her food because if she eats the same thing too often she tires of it.
1/2 dose of Mirataz every other day seems to have a better impact on her eating. My vet says ondansetron is really not all that effective, and Tanya''s support group seems to think Cerenia is more effective even when dealing with just nausea as opposed to vomiting. I don't give Feeby Cerenia as she refuses to take it.

I don't know whether I helped any, or just made things more confusing, so maybe this post should just be considered me commiserating with you.

 

[silent meowlook]

Hi. Have they done a urinalysis to see what his specific gravity is? I am not suggesting you bring him in to do that. You shouldn't stress him.

You didn't cause his phosphorus to go up. His kidney disease did.

You know to be careful with the fluids due to his heart? Always make sure the fluids given the prior day have been absorbed before giving more.

 

[Sillycat41]

Hi Barb,

Our Ire has been at stage 3 since she was diagnosed. She was in and out of the ER for a bit, and it was gut-wrenching. On the one hand, the vets explained very clearly that this it is terminal and not reversible, and I couldn't tell whether I wanted to throw up or cry. But on the other hand, that was a year ago and she's still living a happy life and bossing us around.

Her last numbers were BUN 61, creatinine 3.3 and they don't check phosphorus at this clinic but hers was around 4.2 consistently. We don't use binders - the vet said she doesn't need it yet - but she is on Weruva low phosphorus exclusively. She's got the nausea and lack of appetite issues you'd expect for an 18 year old cat whose kidneys don't fully clear her blood of toxins, so we assume she will dislike binders if we ever need to use them.

I feed her basically every 90 minutes, for 16+ hours every day. That sounds insane but that is how I keep her calories up. I add hydracare pouch and/or water to her food too. She gets mirtazapine daily for appetite, and 75 mL subcutaneous fluids every other day.

I came up with a supplement regimen for her based on academic papers and Tanya's CRF site:
• vitamin B complex supplement
• omega 3 oil
• probiotic
After many months, I also added the Kidney Support Gold supplement and her kidney numbers actually improved! My suspicion is that there are a number of different mechanisms at work with CRF (it's a symptom, nobody has yet told me a cause), so in some cats it probably addresses some part of the issue.

Separate from that meal, she gets psyllium fiber to prevent constipation. The fiber can act as a binder so it is fed separate from vitamins. We initially gave Miralax per vet recommendation before we knew about kidney issues, but were told that it could add to dehydration by moving fluid into her colon.

Keeping the cat fed is a constant struggle. I've learned that nausea and lack of appetite are two different things. Pilling her with Cerenia reduced vomiting when she had it, but didn't really make her eat more. She sometimes has little "food strikes" because she wishes her food was tastier. I sometimes use my other cats' food as a topper and she'll very excitedly eat those bits only then turn tail. But basically I persist and offer food as many times a day as she'll let me.

Our Ire has other health issues but I wanted to just share the kidney experience with you. Hang in there - the blood work is just one part of the picture. Keep us posted on how Jengo does.

Thanks for responding ProMeower. I can relate to the shock of hearing that your Ire was in Stage 3 kidney failure. From Feb. to last week (only 8 weeks) Jengo's Bun went from 66 to 70.8 and Creatinine from 3.5 to 3.7 but his Phosphorus jumped from norm of 4.6 to 8.1 so that must have pushed him into Stage 3. I assume that I wasn't giving him enough Phos-Bind but also whether I should have used another binder. Glad that you don't have to give Ire binders yet... lucky she eats low phosphorus food. Jengo is a fussy eater and can detect anything added to his food, but thankfully Phos-Bind is tasteless in case you ever have to give some.

I also feed Jengo frequently throughout the day and night... usually ever 3 hrs or so. You are really busy feeding every 90 minutes!! I'll have to check on hydracare. I also give a multi-B, but the probiotic gives him loose stools and he doesn't like fish oil.

I was kind of surprised that you give her Kidney Support Gold as many people on the cat forums say that herbal stuff doesn't work. I know that lots of people in reviews say it does though. I should switch from Miralax to psyllium and see if he is less dehydrated.

He had a bad day yesterday... his rear legs seemed weak and he had trouble jumping up on furniture. I was awake most of the night keeping an eye on him... afraid that he'd fall and get hurt. Neither vet can confirm what is causing the weakness. He's not anemic but probably has arthritis... doubt that would cause weakness to come on so fast. I read that leg weakness is common in Stage 4, but he doesn't have the other classic symptoms and he just entered Stage 3. I'm very worried today and both vets are off on Wed.

Thanks for sharing your experience.
Barb

 

[Sillycat41]

Hi. Have they done a urinalysis to see what his specific gravity is? I am not suggesting you bring him in to do that. You shouldn't stress him.

You didn't cause his phosphorus to go up. His kidney disease did.

You know to be careful with the fluids due to his heart? Always make sure the fluids given the prior day have been absorbed before giving more.

The vet did take a urine sample but didn't find anything remarkable I guess. I know, I hate taking him to the vet because he gets very stressed and that can't be good for his frail body.

I just meant that if I had been giving him more Phos-Bind maybe the phosphorus level wouldn't have gone up so high in 8 weeks. That is my fault. :-(

I always pull up the skin on his shoulders to see how dehydrated he is before giving fluids.

Thanks for your input.
Barb

 

[ProMeower]

Thanks for responding ProMeower. I can relate to the shock of hearing that your Ire was in Stage 3 kidney failure. From Feb. to last week (only 8 weeks) Jengo's Bun went from 66 to 70.8 and Creatinine from 3.5 to 3.7 but his Phosphorus jumped from norm of 4.6 to 8.1 so that must have pushed him into Stage 3. I assume that I wasn't giving him enough Phos-Bind but also whether I should have used another binder. Glad that you don't have to give Ire binders yet... lucky she eats low phosphorus food. Jengo is a fussy eater and can detect anything added to his food, but thankfully Phos-Bind is tasteless in case you ever have to give some.

I also feed Jengo frequently throughout the day and night... usually ever 3 hrs or so. You are really busy feeding every 90 minutes!! I'll have to check on hydracare. I also give a multi-B, but the probiotic gives him loose stools and he doesn't like fish oil.

I was kind of surprised that you give her Kidney Support Gold as many people on the cat forums say that herbal stuff doesn't work. I know that lots of people in reviews say it does though. I should switch from Miralax to psyllium and see if he is less dehydrated.

He had a bad day yesterday... his rear legs seemed weak and he had trouble jumping up on furniture. I was awake most of the night keeping an eye on him... afraid that he'd fall and get hurt. Neither vet can confirm what is causing the weakness. He's not anemic but probably has arthritis... doubt that would cause weakness to come on so fast. I read that leg weakness is common in Stage 4, but he doesn't have the other classic symptoms and he just entered Stage 3. I'm very worried today and both vets are off on Wed.

Thanks for sharing your experience.
Barb

Ire has had arthritis or at least a stiff hip since before the kidney issues showed up. Vet recommended dasuquin, which helped but she became too picky to eat the powder or the chews. Years later, Solensia became available and we started her on it, so now her motion is improved, though she is still willing to jump only a little above her own height. Sudden weakness in Jengo is kind of concerning though!

The thing about the Kidney Gold is that I don't know whether it's working by itself or along with the other stack of things we have her on. And even that stack of supplements was from an academic paper where they gave everything together and plainly said "this prolongs survival but we don't know which of these is responsible for it."

I hope you aren't blaming yourself for the phosphorus levels. It's something you can try to reduce in the food, or bind up, but it's just a part of the cat metabolism - seeing high levels means the kidneys aren't clearing it well, which is because they're impaired by illness. Binders are also capable of altering blood chemistry (like calcium levels) so it's good to have bloodwork to guide the process of changing/adding.

Hope Jengo feels better soon. Ire has good days and bad days in terms of appetite and activity, which are connected to absolutely nothing I can think of - fingers crossed that he's just having a bad day and will have a better one tomorrow.

 

[Sillycat41]

I don't really even know what to say - as Tanya's web site states, you don't treat the numbers, you treat the cat. While the numbers may help clue you in on some actions you can take, how your cat is behaving offers just as much of a clue.

Feeby's late January blood work shows her BUN at 63, creatinine at 3.5, and phosphorus at 5.9. Very close to her numbers from her 7/2023 blood work. And, yet she has developed new issues since then - howling, slow walking, and now litter box avoidance. While she still uses her box-steps to get up/down to/from the couch and bed, there is some hesitancy to do compared to 6 months ago. So, numbers only mean so much. I know there are cats who do better with worse numbers, and vice-versa.

Additionally, other health factors are going to play a role, so not all changes can even be blamed on the kidney function. Feeby is 19+yo, with hyperthyroidism, arthritis, high BP, a leaky heart valve and a murmur, not to mention lymphoma. So, any of these things can impact her as much as the CKD can. She is being treated for the hyper-T and the high BP. No treatment required for her leaky valve and murmur - as yet. She's been through the gamut for arthritis treatments and is now only being given pain meds (buprenorphine), as she won't take any of the joint supplements and she had side effects from Solensia.

Right before the January blood tests, I accidentally doubled the dose of Phos-Bind not realizing there had been a formula change, so she went from 125mg a day to 250mg. I am hoping that has helped to drop her phosphorus level to below 5.0. The increase in dosage did require me to start giving her Miralax.

I do tend to follow the phosphorus number more closely because if it is too high it can lead to weakness, 'foggy' thinking, and generally feeling unwell. It is said it can also exacerbate progression of CKD. Based on Tanya's web site and IRIS, at Stage 3 the goal is to try to keep the phosphorus level under 5.0. Stage 3 is based on creatinine between 2.9 to 5.0. IRIS says to give 14-28mg per pound, as the goal is merely to get below 5.0 (e.g.; not shooting for 4, as it is likely unattainable) So, for Jengo that would be 122 - 244 mg. But, if your vet gave you another guideline that they are confident with, then I guess you need to go with their suggestion. At 10 pounds, Feeby's range is 140 - 280mg. Phos-Bind is supposed to be odorless and tasteless, and Feeby does not seem to notice it in her food, even with the increased amount.

Feeby intermittently gets 4mg ondansetron, meaning she gets it when she is willing to take it. Personally speaking, whether she has 2 doses of that a day or none, I don't see much of a difference in eating habits. She eats well those foods she likes best, and less well on ones she isn't crazy about. I rotate her food because if she eats the same thing too often she tires of it.
1/2 dose of Mirataz every other day seems to have a better impact on her eating. My vet says ondansetron is really not all that effective, and Tanya''s support group seems to think Cerenia is more effective even when dealing with just nausea as opposed to vomiting. I don't give Feeby Cerenia as she refuses to take it.

I don't know whether I helped any, or just made things more confusing, so maybe this post should just be considered me commiserating with you.

Thanks for responding FeebysOwner. Yes, I've heard that comment about treatint the cat not the numbers, but it's frustrating when the vets don't offer much help.

Wow... Feeby's number didn't go up much in half a year! Sorry to hear that she is having issues in spite of that. I also put boxes around for steps and Jengo uses them sometimes. Make me nervous wheh he tries to jump up on the bed or furniture because he has slipped several times and almost fell. I'm so afraid that he'll hurt himself.

You said that you noticed her ability to jump decline in the last 6 month. I first noticed a big difference in Jengo last Dec. He'd jump of the bed and kick his read leg out. After that things seem to get gradually worse until the past couple weeks it has excellerated. He has a bad day yesterday... was weaving and weak. I didn't sleep hardly at all last night because I was worried that he'd fall.

You're right, other health factor do play a role other that kidney function. Age too... Jengo will be 18 in May if he makes it. :-( No thyroid problem according to last two blood tests, pretty sure he has arthritis though because of his age. As for high blood pressure one vet said it was hard to get an accurate reading at the clinic so he doesn't take it, the other vet took it and said it was high normal so no confirmation on that. :-( He does have a murmur and valve problem though which the vet said can't be treated unless he gets CHF. Sorry to hear Feeby has lymphoma... hope it is small cell and slow growing. I lost a cat 2 yrs ago to large cell. :-(

Last week the vet said we could try Adequan for his arthritis... didn't want to try Solensia because I read lots of negatives about it. What side effects did Feeby have? I'm not sure if Adequan is a good idea though... he has had loose stools and only had 2 injections so far. He won't eat the Cosequin treats either. I'll ask about just giving hijm Buprenorphine for pain.

I noticed that Phos-Bind changed their packaging. According to the container I have Jengo who is 8.8$ should be getting 400 mg a day. I thought that sounded high and wasn't giving him that much. Now I'm wondering if that's why is phosphorus went up. But you mentioned on 125 mg to 250 mg??? Something is not clear on their label!!! I didn't know that it was constipating.... will have to use Miralax if he get constipated again.

You just confirmted my suspicious that his high phosphorus is causing his weakness!! I was going to research that this morning. At 8.1 on this bloodwork last Friday, now I'm wondering how much future damage it did to his kidneys. I'm kicking myself for not getting his Phos-Bind dosage right. I obviously caused this by not giving him enough. OMG! I'm depressed. :-(

Feeby's eating habits sound just like Jengo's... I also rotate foods because he tired of them. I also noticed that Ondansetron doesn't seem to be that effective. I only use Cerenia when he vomited. All of his meds go into capsules because it was impossible to pill him otherwise. All meds seem to be bitter.

Thanks for sharing your experience. I learned a few things.

 

[Sillycat41]

Ire has had arthritis or at least a stiff hip since before the kidney issues showed up. Vet recommended dasuquin, which helped but she became too picky to eat the powder or the chews. Years later, Solensia became available and we started her on it, so now her motion is improved, though she is still willing to jump only a little above her own height. Sudden weakness in Jengo is kind of concerning though!

The thing about the Kidney Gold is that I don't know whether it's working by itself or along with the other stack of things we have her on. And even that stack of supplements was from an academic paper where they gave everything together and plainly said "this prolongs survival but we don't know which of these is responsible for it."

I hope you aren't blaming yourself for the phosphorus levels. It's something you can try to reduce in the food, or bind up, but it's just a part of the cat metabolism - seeing high levels means the kidneys aren't clearing it well, which is because they're impaired by illness. Binders are also capable of altering blood chemistry (like calcium levels) so it's good to have bloodwork to guide the process of changing/adding.

Hope Jengo feels better soon. Ire has good days and bad days in terms of appetite and activity, which are connected to absolutely nothing I can think of - fingers crossed that he's just having a bad day and will have a better one tomorrow.

Hi again.... Jengo probably has had arthritis for years because he's old... almost 18. I should have addressed it years ago. He won't get the Cosequin chews either and just started Adequan shots. Probably too little, too late. :-(

I think FeebysOwner pointed out why Jengo suddenly got weaker... his phosphorus jumped too high in the 8 weeks between bloodwork. I was confused by the label on the container and wasn't giving him enough so it's my fault from not getting an accurate dosage. I'm so depressed... I made his kidneys worse. :-( OMG. He's my baby! I'm so stupid!! Hope it's not to late to get the numbers down but I assume tha the kidney damage is done. :-(

Good days and bad days here too... no obsvious connection like you said. Thanks again for sharing.
Barb

 

[FeebysOwner]

The Phos-Bind I buy clearly states that 1/8 tsp is the equivalent of 250mg. Rx Direct web site states to start with 100mg per day, and then have the phosphorus level checked 2-4 weeks later to determine if the dosage is adequate. The jar contains a 1/8 tsp scoop, but I measure it myself anyway due to the old formula requiring 1/4 tsp (which was also 250 mg). I accidentally increased hers because I didn't realize the formula change. The dosage on the jar is pretty broad scoped and could be a bit much for Feeby but I am sticking with it for now. If you do use the 400mg dosage the vet suggested, I would have his phosphorus level rechecked after about a month just to see where his level is at then. I can't imagine it going too low, but too low can be about as bad as too high when it comes to symptoms.

I don't know much of anything about Porous One, but you might want to see if it too contains a phos binder.

Feeby developed a crazy itchiness after about 3 months of Solensia. We kept giving it to her for another 3 months, not being too sure if that was the cause. However, shortly after stopping, the itchiness subsided. Tbh, she has some of the itchiness return, so now I don't even know. But, there were at least a couple of others on this site that mentioned itchiness too.

Feeby's biggest decline in terms of mobility has been in the last 6 months, but she was showing what I thought to be arthritic signs a couple or so years ago. I am sure her mobility is a combo of CKD and arthritis. Thankfully, she took to the steps as soon as I put them out - over a year ago.

 

[Sillycat41]

The Phos-Bind I buy clearly states that 1/8 tsp is the equivalent of 250mg. Rx Direct web site states to start with 100mg per day, and then have the phosphorus level checked 2-4 weeks later to determine if the dosage is adequate. The jar contains a 1/8 tsp scoop, but I measure it myself anyway due to the old formula requiring 1/4 tsp (which was also 250 mg). I accidentally increased hers because I didn't realize the formula change. The dosage on the jar is pretty broad scoped and could be a bit much for Feeby but I am sticking with it for now. If you do use the 400mg dosage the vet suggested, I would have his phosphorus level rechecked after about a month just to see where his level is at then. I can't imagine it going too low, but too low can be about as bad as too high when it comes to symptoms.

I don't know much of anything about Porous One, but you might want to see if it too contains a phos binder.

Feeby developed a crazy itchiness after about 3 months of Solensia. We kept giving it to her for another 3 months, not being too sure if that was the cause. However, shortly after stopping, the itchiness subsided. Tbh, she has some of the itchiness return, so now I don't even know. But, there were at least a couple of others on this site that mentioned itchiness too.

Feeby's biggest decline in terms of mobility has been in the last 6 months, but she was showing what I thought to be arthritic signs a couple or so years ago. I am sure her mobility is a combo of CKD and arthritis. Thankfully, she took to the steps as soon as I put them out - over a year ago.

Interesting... the last container I got from Amazon.com had a label over the top of the regular label that said "new". I got kind of suspicious and called the company. They said they changed it... the older Phos-Bind was granular and the newer is a fine powder. Well, what was in that latest container I bought was granular with a "new" label!!! Not sure I trust this stuff any more. It also says the scoop is a 1/4 tsp. = 250 mg. You said yours was a 1/8 tsp = 250 mg. Actually the vet was supposed to get back to me about a dose based on the labels I sent him. Just responded yesterday suggesting another binder instead: "Naraquin. It is a non-aluminum based supplement recommended by specialists." Never hear of this one... found it on Amazon but some comments were negative... like black stools. It has iron in it. I'm afraid to try another binder now.

I don't think Porus One contains a phos binder from what I've read. It takes certain toxins out.

Jengo's biggest decline in mobility has also been in the last 6 months too. He has only had 2 injection of Adequan for arthritis but he seemed to be out of sorts the days I gave it to me. Today would be the third dose but I'm afraid to give him any more for fear I am making him worse. I also put boxes around for steps, but he woke us up at 7 am when he fell. Not sure if he was trying to jump up or down. He ate breakfast and has been sleeping for 2 hrs. so I don't know for sure whether he got hurt.

Thanks for sharing your experiences.
Barb

 

[FeebysOwner]

the last container I got from Amazon.com had a label over the top of the regular label that said "new". I got kind of suspicious and called the company. They said they changed it... the older Phos-Bind was granular and the newer is a fine powder. Well, what was in that latest container I bought was granular with a "new" label!!! Not sure I trust this stuff any more. It also says the scoop is a 1/4 tsp. = 250 mg. You said yours was a 1/8 tsp = 250 mg.

Rx Direct DID change this product. The 'old' version was granules and the scoop was for 1/4 tsp equaling 250mg. The 'new' version, which is denoted as such right on the jar itself is powdery and 1/8 tsp now equals 250mg due to the change in composition. It sounds like you have an old jar that someone incorrectly placed a new label on. I don't know what went on with the added label on your jar, but if it is granules, then the directions on the back for 1/4 tsp = 250mg is correct. It is just the older version.

I read about Naraquin, but chose not to use it as it is a calcium based binder, which in some cats can elevate their calcium level and shouldn't be used in cats with a high calcium level to begin with. This product can also be rendered less effective if a cat is taking acid reducing products, such as famotidine. This product contains a 'proprietary' blend of ingredients - which I also don't like, as any product that can't be upfront about its content and amounts is not one for me. Phos-Bind contains nothing more than aluminum hydroxide, The only 'side effect' with Phos-Bind is the potential for constipation. There is mention of possible aluminum toxicity, but apparently that is very rare in cats and more likely to happen with dogs or perhaps cats on extremely high doses.

Porus One binds protein digestion byproducts in the intestines where they are excreted in the feces. Because of this binding, the byproducts cannot be converted into uremic toxins, which require the kidneys for excretion. As a result, the binding of these byproducts with Porus One supports kidney health. It must be administered a few hours apart from any oral meds because of how it works.

I can't speak to Adequan other than to say there seem to be a lot of forks using it without issue. I do know that some felt it was not as effective as they would like and have added Solensia alongside of it.

 

[Sillycat41]

Rx Direct DID change this product. The 'old' version was granules and the scoop was for 1/4 tsp equaling 250mg. The 'new' version, which is denoted as such right on the jar itself is powdery and 1/8 tsp now equals 250mg due to the change in composition. It sounds like you have an old jar that someone incorrectly placed a new label on. I don't know what went on with the added label on your jar, but if it is granules, then the directions on the back for 1/4 tsp = 250mg is correct. It is just the older version.

I read about Naraquin, but chose not to use it as it is a calcium based binder, which in some cats can elevate their calcium level and shouldn't be used in cats with a high calcium level to begin with. This product can also be rendered less effective if a cat is taking acid reducing products, such as famotidine. This product contains a 'proprietary' blend of ingredients - which I also don't like, as any product that can't be upfront about its content and amounts is not one for me. Phos-Bind contains nothing more than aluminum hydroxide, The only 'side effect' with Phos-Bind is the potential for constipation. There is mention of possible aluminum toxicity, but apparently that is very rare in cats and more likely to happen with dogs or perhaps cats on extremely high doses.

Porus One binds protein digestion byproducts in the intestines where they are excreted in the feces. Because of this binding, the byproducts cannot be converted into uremic toxins, which require the kidneys for excretion. As a result, the binding of these byproducts with Porus One supports kidney health. It must be administered a few hours apart from any oral meds because of how it works.

I can't speak to Adequan other than to say there seem to be a lot of forks using it without issue. I do know that some felt it was not as effective as they would like and have added Solensia alongside of it.

Thanks for writing again. I'm having a bad day. Woke up a 7 am to Jengo falling... either jumping up or down... and worrying that he hurt himself. He's so unsteady and weak. He slept for a couple of hours and walked to the litter box okay... no limp... but drank a lot of water... twice... after eating.

As you said, I obviously have the old granular formula of Phos-Bind so I guess I will measure out 1/4 tsp equaling 250 mg and spread that out over all his meals during the day. I doubt that would be an overdose. 250 mg seems to be what most are giving their cats.

I'm so frustrated with the two vets (different clinics) that I have been taking him to. I get more good info from this forum that those vets!! Plus it takes them so long to get back to me after saying that they will. One vet was supposed to sort out the dosage of Phos-Bind from the photo of the label I sent him. He was the one who wrote back a week later and suggested Naraquin. Jengo's calcium on his last blood test was 10.7... high normal range which is 11.9. Like you said, probably not a good idea to use a binder that will elevate his calcium.

I have been giving Jengo Miralax when he is constipated bbut lately his stools have been a bit soft.... not sure why.

That's for the reminder... I do try to keep the meds and other treatments like Porus One a couple of hours apart so they don't interfer with each other.

I'm supposed to give him another Adequan injection today but I am hesitant. Thought I saw a reation to the last one. It's probably too late to be treating his arthritis anyway. I think his weakness is caused by something else.

Thanks for your input.... appreciate it.
Barb

 

[Sillycat41]

Rx Direct DID change this product. The 'old' version was granules and the scoop was for 1/4 tsp equaling 250mg. The 'new' version, which is denoted as such right on the jar itself is powdery and 1/8 tsp now equals 250mg due to the change in composition. It sounds like you have an old jar that someone incorrectly placed a new label on. I don't know what went on with the added label on your jar, but if it is granules, then the directions on the back for 1/4 tsp = 250mg is correct. It is just the older version.

I read about Naraquin, but chose not to use it as it is a calcium based binder, which in some cats can elevate their calcium level and shouldn't be used in cats with a high calcium level to begin with. This product can also be rendered less effective if a cat is taking acid reducing products, such as famotidine. This product contains a 'proprietary' blend of ingredients - which I also don't like, as any product that can't be upfront about its content and amounts is not one for me. Phos-Bind contains nothing more than aluminum hydroxide, The only 'side effect' with Phos-Bind is the potential for constipation. There is mention of possible aluminum toxicity, but apparently that is very rare in cats and more likely to happen with dogs or perhaps cats on extremely high doses.

Porus One binds protein digestion byproducts in the intestines where they are excreted in the feces. Because of this binding, the byproducts cannot be converted into uremic toxins, which require the kidneys for excretion. As a result, the binding of these byproducts with Porus One supports kidney health. It must be administered a few hours apart from any oral meds because of how it works.

I can't speak to Adequan other than to say there seem to be a lot of forks using it without issue. I do know that some felt it was not as effective as they would like and have added Solensia alongside of it.

I am thinking about ordering a fresh container of Phos-Bind to make sure I am giving him the correct amount.

I think that I'll stick with Phos-Bind instead of switching to Naraquin. I also don't like the idea of possibly elevating his calcium. I agree with you about the blend of ingredients too. I also read that aluminum toxicity is very rare.

He has been on Porus One for a couple of years... hope it is doing it's trick.

I am depressed because he seems to be slipping away more every day. I wonder what I am missing??? Did the high phosphorus on his blood test April 12th damage his kidneys? He has gotten so weak and I worry about him jumping up and down off furniture. Put boxes around for steps but sometimes he slips. Wish there was something more I could do for him.

Thanks for your input.... appreciate it.
Barb

 

[Sillycat41]

I am thinking about ordering a fresh container of Phos-Bind to make sure I am giving him the correct amount.

I think that I'll stick with Phos-Bind instead of switching to Naraquin. I also don't like the idea of possibly elevating his calcium. I agree with you about the blend of ingredients too. I also read that aluminum toxicity is very rare.

He has been on Porus One for a couple of years... hope it is doing it's trick.

I am depressed because he seems to be slipping away more every day. I wonder what I am missing??? Did the high phosphorus on his blood test April 12th damage his kidneys? He has gotten so weak and I worry about him jumping up and down off furniture. Put boxes around for steps but sometimes he slips. Wish there was something more I could do for him.

Thanks for your input.... appreciate it.
Barb

I'm losing it... I think I just responded to you twice. Sorry. Only got 3 hours of sleep last night worrying about Jengo. Better try to take a nap.

 

[Twylasmom]

Twyla is 16-17, fluctuates between stage 2 and stage 3, with one functioning kidney. She is hyperthyroid, has high bp, a heart murmur, arthritis and asthma. She has had 14 Solensia injections so far and has not experienced any side effects, it does seem to help, though the difference seems less dramatic than it did at first.

Phosphorus binders - even if you are using them you should still try to feed the lowest phosphorus food your cat will eat as the binder will only bind some phosphorus, not all. Most Fancy Feast varieties are high in phosphorus (unfortunate since they are like kitty crack). So you may want to experiment with some other foods as well as adding binder. I use the Thriving Pets version of aluminum hydroxide so I can’t speak to dosage. I have also tried the Naraquin, which has the advantage of not interacting with certain medications that aluminum hydroxide does, but isn’t quite as effective. Twyla does seem to sense taste/smell with the Naraquin. My understanding is any binder can be constipating and it’s best to start with a lower dose and work your way up.

The back leg weakness could be lots of things - the arthritis, loss of muscle (common in CKD cats) low Potassium levels, etc.

You are doing the best you can for your kitty and haven’t done anything that worsened the CKD. It is a progressive disease that we can only try and manage and give our cats the best quality of life we can for as long as we can.

 

[Sillycat41]

Twyla is 16-17, fluctuates between stage 2 and stage 3, with one functioning kidney. She is hyperthyroid, has high bp, a heart murmur, arthritis and asthma. She has had 14 Solensia injections so far and has not experienced any side effects, it does seem to help, though the difference seems less dramatic than it did at first.

Phosphorus binders - even if you are using them you should still try to feed the lowest phosphorus food your cat will eat as the binder will only bind some phosphorus, not all. Most Fancy Feast varieties are high in phosphorus (unfortunate since they are like kitty crack). So you may want to experiment with some other foods as well as adding binder. I use the Thriving Pets version of aluminum hydroxide so I can’t speak to dosage. I have also tried the Naraquin, which has the advantage of not interacting with certain medications that aluminum hydroxide does, but isn’t quite as effective. Twyla does seem to sense taste/smell with the Naraquin. My understanding is any binder can be constipating and it’s best to start with a lower dose and work your way up.

The back leg weakness could be lots of things - the arthritis, loss of muscle (common in CKD cats) low Potassium levels, etc.

You are doing the best you can for your kitty and haven’t done anything that worsened the CKD. It is a progressive disease that we can only try and manage and give our cats the best quality of life we can for as long as we can.

Thanks for writing. It's so sad to hear about the health problems of our beloved cats. Your Twyla sure has her share. :-( How do they tell is only one kidney is functioning? An ultra-sound or xray? Jengo's old vet seems to think that his weakness is do to his kidney's failing even though he's still in stage 3. I'm wondering if it is his heart since he has a murmur and valve problem or muscle wasting? Seems like the vets can't figure it out. :-(

Glad that Twyla's Solensia injections seemed to work. I'm thinking that I waited too long to get Jengo's arthritis treated. He has only had 3 injections of Adequan and no improvement yet. Perhaps too little, too late. :-(

Yeah, I hear you... Fancy Feast is kitty crack! I can't get him to eat prescription diet but he will eat some of the low-phosphorus foods. I should just feed him those and get rid of the Fancy Feast!

I read that Naraquin has iron in it and turns their stools black. Not sure if giving him iron is a good idea. He's not on any other meds that would interfer with the Phos-Bind so I'll probably stick with it until his next blood tests to see if it's working. Also Jengo doesn't taste the Phos-Bind so that's an advantage. I do give him Miralax if he gets constipated but lately is stools are a little soft.

I spent a lot of time this morning reading about all the causes of back leg weakness. I was hoping it was something simple like low potassium which could easily be fixes, but his potassium was in the normal range at 4.5 so that's not it.

I'm feeling guilty for not giving him more Phos-Bind between his blood test on Feb. 16th when it was in the normal range at 4.6 (2.9 to 6.3) then 8 weeks later it jumped up to 8.1 which surprised me. This probably damaged his kidneys too. :-(

It's such a delicate balance trying to treat a cat with CKD. There are no definitive answers to treat the wide range of symptoms. I just pray that I'm not making things worse.

Thanks for writing. It's good to have the support of others going thru the same thing with their kitties. Take care now. Barb

 

[Twylasmom]

Thanks for writing. It's so sad to hear about the health problems of our beloved cats. Your Twyla sure has her share. :-( How do they tell is only one kidney is functioning? An ultra-sound or xray? Jengo's old vet seems to think that his weakness is do to his kidney's failing even though he's still in stage 3. I'm wondering if it is

It was diagnosed through ultrasound. We are two years since her diagnosis and she has gone back and forth between stage 2 and 3, and her phosphorus has also fluctuated during that time. It has increased recently and I have transitioned her to prescription dry and the lowest phosphorus wet food she will eat (she is extremely picky about wet food so the dry is absolutely necessary for her to eat enough to maintain weight.)

 

[Sillycat41]

It was diagnosed through ultrasound. We are two years since her diagnosis and she has gone back and forth between stage 2 and 3, and her phosphorus has also fluctuated during that time. It has increased recently and I have transitioned her to prescription dry and the lowest phosphorus wet food she will eat (she is extremely picky about wet food so the dry is absolutely necessary for her to eat enough to maintain weight.)

Thanks for writing again. I suppose I should have an ultrasound of his kidneys to find out where we stand. Like you said the BUN, Creatinine and other numbers fluctuate so it's hard to figure out where we're at. I wish I could get him to eat prescription diet... he refuses. Tried gradually mixing it in with his regular food but he's too smart and detected it. He doesn't eat dry food so I just add Phos-Bind to his wet. Wish I could get him to gain weight.