Kidney Failure

Hello All,

It's been a while since I came on here. If you can't remember, my cat is Twitch, she's a 16/17 year old tabby who was diagnosed with diabetes in June. This weekend I was concerned because she wasn't eating much, so I took her into the vet yesterday (she was scheduled to go in for testing related to the diabetes next Saturday, but I didn't think she could wait). We were given a doomsday prognosis. Her kidneys are failing. The doctor (a seemingly heartless man) recommended we put her to sleep. I have had Twitch since I was 11 years old, the idea of killing her is unfathomable. We opted to take her home and let her leave us on her own terms. A decision I'm heartily glad for after having done a little internet searching. It would appear cats can live with kidney failure for months or even years. My aunt has a friend who is a vet and he has a cat that has diabetes, and the vet has not treated him with insulin. He feeds him three times a day and my aunt said the doctor has been saying the cat will die for the past five years. He mentioned giving Twitch pureed baby food. With her diabetes, her diet was supposed to be high in protein, but from my reading about kidney failure, a lower protein diet is recommended due to the kidneys' function of filtering out toxins. Have any of you encountered this with your own kitties? Should I continue with her insulin? We never did figure out what level it needed to be, she was on half a unit once a day before. Please let me know of your experiences, I could really use some help here! I don't really trust my vet anymore. I sent my mom in to get Twitch yesterday because I was so upset over the prognosis and when she told him that we wanted to take her home he brought up the fact that he's moving to a state where it's okay to euthanize people. I don't feel that he would be much help in this situation.

Sorry this got so long, please, please, please let me know your thoughts!
Kali and Twitch

Hi Kali,
Please do not stop Twitch's insulin. You can treat the diabetes and the kidney failure. Here is a post from Holly that will give you a lot of resources: viewtopic.php?f=28&t=54419&p=588492&hilit=crf#p588492

Kidney failure/CRF is not necessarily a death sentence. My Blackie lived several years after his kidney failure diagnosis and we kept him on a low carb diet. Its the phosphorus in the food you need to minimize, not the protein. I would encourage you to join one of the yahoo CRF groups and read up on Tanya's CRF website.

If it is acute kidney failure, or the end stages of chronic kidney failure, she
will stop eating/drinking. She will bloat up as her kidneys are no longer able
to remove fluids and toxins from her blood stream.

Death by acute kidney failure is very uncomfortable.

If it is early or mid-stage chronic kidney failure, that's treatable.

We need more information....what stage of kidney failure is she in.

Where do you guys live? we absolutely NEED to find you a better vet

Hi again,

Karen -- I don't believe it's acute kidney failure. Twitch does not seem uncomfortable at all, and has been her normal self since we brought her home.

She is eating and drinking, a lot of drinking, of course!

How can we tell if a food is low in phosphorus? And how low is low protein? The Hills food she was eating (still sorta is) was 45% crude protein according to the label.

As for the insulin, I worry about that because she was on such a low dose in the first place, the doctors were considering taking her off, so I don't know if a different diet will affect that. We're near Boulder, Colorado if anyone knows of a vet other than the ones at Banfield in Superior, who I really did like, but they never seemed to know exactly what to do with Twitch. I don't really want to have to send her to doctors anymore either. She is 17 and deserves to live out her days happy and comfortable, but I am not sure how to make sure that happens...

Thanks for all your help!
Kali and Twitch

Also, I have no intentions of making Twitch suffer a painful death. This all happened yesterday and I'm only just able to get my head straight and do some research. I'd like to know all the options before I move forward.

I have a friend who has 2 cats w/CRF and they were dx in 2009 (they don't have FD tho).
My sister is currently in Denver, but lived in Boulder to go to Univ of C. I will try to text her for vet info. Sookie, her dog, was killed by a truck in Boulder earlier this year, but I am sure she has friends that uses vets in the area. Will also post on her FB page to try to get you some help in that area.

Thank you, Doombuggy!

KTwitch said:

Also, I have no intentions of making Twitch suffer a painful death. This all happened yesterday and I'm only just able to get my head straight and do some research. I'd like to know all the options before I move forward.

Click to expand...

I have had many cats at the Catnip Cottage in varying stages of kidney failure, some diabetic, some not. We do treat with as appropriate diet as the cat will eat and can maintain quality of life while being as gentle as we can on the kidneys. When possible, we have added sub cutaneous fluid therapy (administered at home by myself) to help the kidney function. We euthanize as needed when it becomes obvious that it is time... and when it is time, it has become very obvious to us. Generally, the kitty's stop eating and drinking at all, have lost a LOT of weight, lost all interest in their environment and surroundings and just want to sleep and disengage from us and the world. When I notice this all occuring together and it has continued for a bit with no recovery or upswing, I usually know it is time.

It does sound like Twitch can still have some very good time left with you, and the advice you got above can help you and Twitch make that time as good as it can be.

fwiw, my late Kitty lived 2 years with kidney disease and up until her final week, didn't even seem to know it. she took her meds every day in a pill pocket which she thought was a treat, ate her low phosphorous Special Diet Friskies foods, and drank bottled water.

i now have 2 more, aged 17 yrs, that were just diagnosed with early kidney disease and are getting the Special Diet Friskies foods, drinking bottled water, and getting subq fluids at home every other day because they have much more patient personalities than Kitty did

check out felinecrf.org. it's the bible of kidney disease if you ask me.

Here's a list of premium cat foods (no byproducts) and their nutrition values: https://docs.google.com/leaf?id=0B8...MzhkYTkxOGM4NThk&sort=name&layout=list&num=50

You want to pick a food that has a phosphorus level of less than 200mg per 100kcal. Wellness Turkey, Evo 95% chicken and turkey, and Merricks Before Grain Turkey are good low phosphorus/low carb foods.

There are other foods with byproducts that you'll find on Tanya's chart that are lower in phosphorus, but human grade meat is preferable because the kidneys don't have to work so hard. Also, you want to keep her as hydrated as possible to help the kidneys out--so adding water to her food is a great idea.

The important thing is that she eats--cats with kidney disease can get picky with food as it gets worse. If she won't eat a lower phosphorus food, then you also have the option of getting a phosphorus binder and feeding whatever food she will eat.

My Gabby lived with a CRI diagnosis for 2 years until she passed away from a completely unrelated illness (cancer). She ate a low phosphorus, premium foods for those 2 years and my vet said that when she compared her values at diagnosis to her values right before she passed away, they hadn't changed at all. I likely would have had many more years with her if it weren't for the cancer.

I have had two cats that had both diabetes and CRF. They lived for several years (more than 6) after their CRF diagnosis which came before the diabetes.

I fed both of them Friskies Special Diet canned foods. Try to limit the fish flavors and the Chicken with Gravy (because of the carbs). While they both were on this diet, both their kidney values and glucose reading remained stable. I lost both of them to old age, not the CRF or diabetes. Rascal was 17 and Witn was 19.

You definitely need to find a new vet.

My Willie is in the early stages of renal failure, but we are controlling his phosphorus content in his foods. I would get a copy of the lab results as we have some folks here who may be able to break down the various values for you, and Tanya's CRF page is also extremely helpful with that. In addition to the foods already listed, Blue Wilderness Duck is another low carb/low phosphorus food. You should definitely avoid fish flavors as they tend to be high in phosphorus (and for some reason, BG Chicken and Quail... crazy high!). If Twitch's numbers merit it (generally, a phosphorus value above 5.0), you can also use phosphorus binders... these work by binding to the phosphorus molecules in the food and preventing them from being absorbed in the GI tract.

You were definitely smart to ask here... once you have the labs, you can get a better sense of where you're at in the CRF process and what options are available to you. Tanya's site is truly an amazing (if daunting) resource. I'd encourage you to check it out!

Wow, you all are simply amazing!! Thank you so much for all your suggestions and support! I have already been asking around for other vets and I think I'm going to give a few a call on Monday to see what experience they have with diabetic cats in kidney failure. I think the lab results from Thursday are a little worthless and Twitch would need new tests run. We took her in on Thursday because she hadn't been eating, and since she wasn't eating the nurse told us to stop her insulin shots, so her levels were crazy. She had some stuff that was so low they couldn't record it and other stuff that was so high they couldn't record it. She's been eating really well since then so I think the test results would be drastically different if taken today. I will certainly keep you all posted as I figure out what to do next.

Thanks again everyone!
Kali and Twitch

It's been 4 years since our 18 y/o angora mix was diagnosed with kidney failure. She's still here, and stable thank you very much. We worked with our vet to change her diet, and now our diabetic cat has kidney issues too. I just had a really bad vet experience too, so I know ho you feel.

Hang in there, we can all get through this together. These people are amazing.

I just wanted to let you know that I haven't gotten an answer from my little sis to my text (which is not unusual, as she doesn't answer unless she's on the phone, and don't bother leaving her a VMM!) and I have gotten no hits on her FB page nor on Hoodie's page (one of her BFFs). I asked my dad if she took the dog to a vet while she was livng there, but Sookie spent more time at my dad's house in PA than with my sister in Boulder (she spent a semester in Italy a few months after adopting the dog, so Sookie stayed with my dad for a year). I am sending an email to my dad again, as I thought he was working with a group of vets in the Denver area and maybe I can get some names for you. I am trying....from Fl! hang in there!

I should have checked FB this am before posting. Here is my sister's response:
I'm not too sure about the vets there..but some people told me they love the vet right nearby in gunbarrel

If I hear anything back from my dad I will PM you.

Ktwitch, I sent you a PM with the name of a doctor to contact that works with my dad.