? Managing concurrent FD and CKD - advice please

Vanda Kay

Vanda Kay

Member
Six months into managing Landa’s FD, we’ve finally been making some headway in regulating her BG levels, but have now found out that her CKD has progressed to Stage 3, which explains the recent lack of appetite and vomiting, making her FD so much harder to manage. We’d really appreciate any help with this new challenge, including resources to read and advice on diet and symptom management in a cat who is now a very picky eater and virtually impossible to medicate. I have some transdermal Cerenia to hand, but I don’t know if it helps when I do manage to get it onto her ear. I also wonder whether it contributed to the recent spates of diarrhea she’s had. I also have mirtazapine transdermal (specially compounded low dose), but that stuff makes her eat like a maniac! Thank you, friends!
 
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@Vanda Kay
You might want to try Weruva Pates
low carb/ low phosphorus


if you tap on this link and look at post #32 I listed some Weruva pates for another member that's low carb/ low phosphorus with kitties with CKD and diabetes
New member 11/8 and I am tired


You want the metabolizable energy profile percentage of carbs to be less than 10%, and the phosphorus which Weruva lists in Minerals to be less than 250 mg per 100 cals. So you have to look at two different places in the Weruva charts. This is where I was told where to look by a member


You can even check out the soulistic pates
PÂTÉ — Soulistic Pet
When you click in one of the flavors then click on

PÂTÉ — Soulistic Pet
COMPLETE NUTRITIONAL INFORMATION (link to page)
and look at the same two places like on the weruva.

NUTRITIONAL INFO PÂTÉ — Soulistic Pet

Here is a group with lots of information about CKD

Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Tanya's Support Group
 
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Sorry to hear you are dealing with that dual diagnosis, but it's something I had to deal with as well. One resource for diabetic friendly CKD files is listed in this file: CKD food Chart

With Neko it was a lot of experimenting with various low phosphorus foods to see which ones she liked. When she was first diagnosed with CKD, she would still eat her usual foods, but with the dual small cell lymphoma and heart disease conditions tacked onto her resume, I had to start the hunt for alternatives. Due to changes in her mouth due to acromegaly, I also had to add water and purree it into a mousse like texture. Sometimes I even had to syringe feed a bit of food first, to prime her stomach. She'd usually eat more on her own once she got the first few bites in. I even used some of the Royal Canin Recovery, which is low carb and easy to syringe. And better yet, Neko liked the taste.

I have used the transdermal maropitant (Cerenia) in a current kitty and do find it works for her. I haven't seen diarrhea resulting. I'm giving it for vomiting and support for pancreatitis episodes. For actual nausea, I like ondansetron better. You have to give it more frequently, but it works way better. If you have a hard time pilling, there is an injectable version, though I've heard it can sting.

Neko made me up my pilling game. She was part Maine Coon, big and strong! I ended up with a pilling gun that really helped. I stuffed as many meds as a I could into a blank gel cap, and used that to pill her. She was getting nausea meds as well as other oral meds for heart disease, lymphoma, and supplements for CKD.

If the Mirataz - presuming that is what you have - is making her a crazy eater, try giving a lower amount. With Mirataz that is easy to do as it is also transdermal, just measure out a smaller amount. I find I don't have to give it every day, maybe every few days.
 
Diane Tyler's Mom GA said:
@Vanda Kay
You might want to try Weruva Pates
low carb/ low phosphorus


if you tap on this link and look at post #32 I listed some Weruva pates for another member that's low carb/ low phosphorus with kitties with CKD and diabetes
New member 11/8 and I am tired


You want the metabolizable energy profile percentage of carbs to be less than 10%, and the phosphorus which Weruva lists in Minerals to be less than 250 mg per 100 cals. So you have to look at two different places in the Weruva charts. This is where I was told where to look by a member


You can even check out the soulistic pates
PÂTÉ — Soulistic Pet
When you click in one of the flavors then click on

PÂTÉ — Soulistic Pet
COMPLETE NUTRITIONAL INFORMATION (link to page)
and look at the same two places like on the weruva.

NUTRITIONAL INFO PÂTÉ — Soulistic Pet

Here is a group with lots of information about CKD

Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Tanya's Support Group
Click to expand...
Thank you so much! <3
 
Wendy&Neko said:
Sorry to hear you are dealing with that dual diagnosis, but it's something I had to deal with as well. One resource for diabetic friendly CKD files is listed in this file: CKD food Chart

With Neko it was a lot of experimenting with various low phosphorus foods to see which ones she liked. When she was first diagnosed with CKD, she would still eat her usual foods, but with the dual small cell lymphoma and heart disease conditions tacked onto her resume, I had to start the hunt for alternatives. Due to changes in her mouth due to acromegaly, I also had to add water and purree it into a mousse like texture. Sometimes I even had to syringe feed a bit of food first, to prime her stomach. She'd usually eat more on her own once she got the first few bites in. I even used some of the Royal Canin Recovery, which is low carb and easy to syringe. And better yet, Neko liked the taste.

I have used the transdermal maropitant (Cerenia) in a current kitty and do find it works for her. I haven't seen diarrhea resulting. I'm giving it for vomiting and support for pancreatitis episodes. For actual nausea, I like ondansetron better. You have to give it more frequently, but it works way better. If you have a hard time pilling, there is an injectable version, though I've heard it can sting.

Neko made me up my pilling game. She was part Maine Coon, big and strong! I ended up with a pilling gun that really helped. I stuffed as many meds as a I could into a blank gel cap, and used that to pill her. She was getting nausea meds as well as other oral meds for heart disease, lymphoma, and supplements for CKD.

If the Mirataz - presuming that is what you have - is making her a crazy eater, try giving a lower amount. With Mirataz that is easy to do as it is also transdermal, just measure out a smaller amount. I find I don't have to give it every day, maybe every few days.
Click to expand...
Thanks, Wendy. That’s incredibly helpful. Gosh, you had a lot more to deal with with your girl than I do! I have another senior cat who also has CKD. She’s lost a lot of her eyesight due to hypertension that I’ve not managed to get sufficiently under control as she’s a former feral cat whom I can’t pill at all and medicate with transdermal meds.

I had a couple of questions:
1. Is the k/d food (which she hates anyway) out for diabetic cats?
2. Does the CKD affect the insulin dosing/effect?
3. I’ve tried pilling Landa and I can’t even get close, let alone get her to swallow anything. It’s a miracle if I can rub the transdermal pen on her ear. My cat shelter manager friend, though, is able to pill her with gabapentin for every vet visit!
 
K/D is very high in carbs. Depends what your goals are, some people have to feed high carb foods for particular medical conditions and up the insulin dose. Neko was on raw, her internal medicine vet called it "the best thing for her". Not a common sentiment amongst vets.

CKD by itself didn't really impact dosing. If you are giving fluids that can have an impact by causing number to go down, but ECID, not with all cats. I gave the shots in a different location than the fluids. And would give fluids at the end of the cycle her numbers were going up anyway.

For the transdermal meds, I have finger gloves, and put the medication on my fingertip glove, then rub it in the ear that way. Like ear testing, get her used to ear rubs. Have you tried putting pills inside treats, like a piece of fresh meat? Have you tried pill pockets with the former feral?

I had spent a few years volunteering and working part time at the local shelter before Neko's FD. I had experience pilling before Neko. But she made me up my game. Plus being in their own home they probably feel less frightened and able to stand their ground.
 
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