? 2/15-Flame- AMPS=279, PMPS=315, +3=291 - CKD folks - Help and encouragement - Thank YOU!!-

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Donna and Flame

Donna and Flame

Member Since 2009
Good morning peeps and kitties!

I have to admit, I am feeling a little discouraged today. I feel like this little boy is going thru so much and I'm trying to do everything I can to make him feel better, yet sometimes I feel like I'm just making him feel worse.

I'm trying the aluminum hydroxide phos binders and even though they are supposed to be tasteless and odorless, he apparently knows it's in his food b/c he'll eat a little bit when I first put it down b/c he's really hungry, but then he'll walk away and is hesitant to eat the food.

I know he's hungry, poor lil boy, and he tries to eat it with some encouragement from me, but I can tell he doesn't like it. I even cut the dose this morning thinking, I'll take it slow and try to get him used to it. I'm going to keep trying but the phos binders won't do any good if I can't get him to eat the food. And this is a cat who is very food motivated.

His phos shot up to 7.0, so he really needs them, but I'm not sure what to do. He did end up eating his food during the night last night and I'm hoping he does the same during the day today. He is a nibbler, not a gobbler so it's difficult for me to get the binders into him in one sitting and I work so I have to leave the food and hope he eats.

Other CKD folks, have you any tips for me that you've used with your kitties to get them to eat and accept the binders? His first dose was only last nite, so maybe I need to be patient, but he needs to eat. Anything you can tell me or any experience you can share would be so much appreciated.

He is SUCH a sweet boy, the sweetest cat I've ever met (and I've volunteered with rescue for 15 years so I've met a lot of cats). He's so tolerant of the testing, the shots, the inhaler, the pills...
He doesn't deserve any of this. He deserves to be happy and healthy. Between the testing, the shots, the pills, the inhaler, the phos binders, the fluids... it's so much for him.

So far, weaning him off the pred has been going OK, which is the one positive thing lately. His breathing remains stable... THANK GOD!! His BG has been a little bit better, at least staying in Yellows but I need to get his numbers down too. It's a lot to handle, for him and for me. Don't get me wrong, I'm not giving up... I'll do ANYTHING for my boy. It just gets hard sometimes.

Sorry to be such a Debbie Downer this morning. I'm just having a moment here. I'm so grateful that you are all here to allow me to vent. There is nowhere else I can go where I KNOW people will just understand and not judge. OK, I have to go cause I'm starting to tear up at work and need to get on a conf call in a few minutes.

BBL....
Sending prayers and vines to anyone and everyone who may need them today. Surf safely kitties...
:bighug::bighug::bighug:
 
I know it can get overwhelming at times, but remember you are helping him to be healthier and feel better. I'm glad his breathing is still okay. Sending prayers. :bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug:
 
Donna and Flame said:
He doesn't deserve any of this. He deserves to be happy and healthy. Between the testing, the shots, the pills, the inhaler, the phos binders, the fluids... it's so much for him.
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It's so hard on us beans. I've questioned what I do many many times especially since the HCM/CHF and IAA dx. At one point I was giving Doodles 5-7 shots of insulin a day:( He knows how much you love him.

I don't have any tips on the CKD. Some binder is better than none so maybe starting off with just a bit and increasing will help.

Sending vines, prayers and :bighug::bighug::bighug:
 
Hi Donna....so feel for you and understand the comfort it brings to be able to come to this precious, priceless Board not just for knowledge but for hearts that listen and understand. We had a CKD kitty, Socks(tuxedo) and just like Flame was one of the most gentle loving creatures to ever walk this earth. He was on daily sub q fluids for almost 2 years and lived to be 21. Unlike sweet Flame, his only other complications were hyperthyroid and slight heart murmur. For his upset belly we relied on organic Slippery Elm twice a day per homeopathic vet recommendations. That really helped the acid buildup with him. None or some of this may help/apply to Flame. My heart and prayers go out to Flame and you...believing for u to have continued insights into what will work for him and for his kidneys to strengthen .
 
Donna,I know nothing about binders ,since we focused on daily flushing Socks kidneys with SQs , but can binders be syringed just before or after eating ??? As I said, I know zero about themo_O. :bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug: To you and sweetie pie Flame .....sending extra thoughts and prayers ur way this day :bighug::):bighug::):bighug:
 
Donna Benson is CKD and hyperthyroid... he wouldnt eat cause he was so nauseous... lost too much weight... he too wouldnt eat anything i added to the food... not sure if this is going to be much help but... i was able to get a paste... had the vet order it in ... then once he ate i would just put it in his mouth like a smear of peanut butter... he isnt crazy about me doing it but it got the meds in him and got him to eat... since we added an appetite stimulate and got the nausea under control he has gained back almost two pounds... i know it can feel so disheartening to be trying everything and have it just not be working

https://www.drugs.com/vet/aventi-ks-paste-for-cats-can.html
https://www.drugs.com/vet/aventi-kp-paste-for-cats-can.html

its a calcium based binder and it is in the KP... not sure if anyone else here has used or has an opinion on it... just was trying to give another option... maybe there is a paste / liquid you can give vs trying to sneak the powder in??
 
CKD on top of FD is tough, that's for sure.

There is this binder that is somewhat of a treat: Conseal AIH . I used it with Trix for a while - shaved a little bit into her food at each meal - and she seemed like and it seemed to work fairly well. The drawbacks for me were that it got a little pricey, and the only place to get it was my vet's office, so I did switch back to the aluminum hydroxide powder.

Slowly working the binder up may be a good approach and is certainly worth trying.

Others don't agree with me on this one, and I personally have never tried it, but I'm going to put it out there anyway because it may help and it certainly won't hurt to try it if you absolutely can't get Flame to eat food laced with binder. My vet told me that you can give them the binder separately, but it does have to be given pretty much right after they eat. This is also briefly mentioned on Tanya's CRF site on the binders page: Binders on Tanya's site. As I said, I've never tried it, but if he won't take binder any other way, there is no reason to not give this a try - as you said, he does need the binder at least this is a chance at getting some binder working for him.

The binder actually doesn't need to go all in one sitting - in fact, it shouldn't. It works by pulling the phosphorous out of the current meal, so in that sense it's not quite the same as other supplements, treatments, and meds. In other words, giving him a bunch of binder without food won't do anything at all, and plunking all of his daily binder into, for example, his breakfast, will only pull phosphorous out of that one meal - it won't pull it out of the other food he eats throughout the day. So you need to spread his daily allotment of binder throughout all the food he eats during a day.

I do think addressing nausea is one of the biggest factors in treating CKD....obviously when they aren't nauseated they'll eat better! So try to stay on top of that.

It can take a while to figure out what works for Flame, but with trial and error and working with your vet, you'll get there. When Trix's kidneys suddenly tanked, it took a few months to figure out what works for her (including a few months of assist-feeding). That was 3 years ago, and although she is definitely a bit slower, she's still with me today. Fortunately you've got lots of support here.
 
Amy, was checking on Flame and wanted to say thanks for ur info in above post:bighug::) . Such good experience and encouragement .....Elmo's numbers are ok right now but being proactive in guarding them and gathering info .:cat:
 
I found letting the binder sit in the food for a bit helped. As others have said, nausea meds or an appetite stimulant may help. So could raising the food bowl (I'm a big fan of this). Do watch for constipation.
 
Hey Donna, I don't know any thing about the Phos binder but it looks like Amy gave some great advice about separating it in all his meals and maybe he won't notice it as much. If that doesn't work, could you break up the amount to give a day and put it is a small hor'dorve of baby food since he eats that and then feed right away? @Amy&TrixieCat , would that work?

I hear your frustration and it broke my heart when you said, 'he doesn't deserve this' It stinks for all our cats to just have FD let alone all that you and Karen deal with for your boys. Sending hugs. :bighug::bighug::bighug::bighug::bighug::bighug:
 
Bobbie And Bubba said:
Hey Donna, I don't know any thing about the Phos binder but it looks like Amy gave some great advice about separating it in all his meals and maybe he won't notice it as much. If that doesn't work, could you break up the amount to give a day and put it is a small hor'dorve of baby food since he eats that and then feed right away? @Amy&TrixieCat , would that work?
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The binder does need to accompany an actual meal to do it's thing. According to the info on Tanya's site, giving it mixed with the meal is ideal, but it can work if given a short time after; and again according to Tanya's site, it doesn't seem to work as well if given before a meal. Like I said, I never actually tried this approach so I don't have first-hand experience; just sharing what my vet told me along with what's on Tanya's site. When my vet mentioned it to me as an option, she said that you can actually put the powder in a gelcap and then pill it right after they eat - but again, timing is key. You don't want to be giving binder at random times because unless it's given with food, it's not going to do anything at all.
 
(((Donna)))

I see others have also suggested spreading it out over several meals but I did read in yesterday's condo that you are only able to feed two meals a day due to work. I'm wondering if you can feed more, smaller meals at night somthe a,Lunt of P binder in each meal is less?

Or..does he like treats like freeze dried chicken that you can use as a topper? I have a Bullet and I put several pieces in it and make it into a powder and use as a topper. Do you think that might help him with the taste of the binder?

The only other thing I can think of is to put him on Hi Tor Neo renal. It's 9% carbs and the P is 0.72%. That's not really low P compared to the renal diets but it's better than most commercial diets and it is not as high carb as the renal diets. You could probably use a tiny bit of binder on it to bring the P down a bit more. If the increased carbs cause his BG to go up, you adjust the dose but some FD cats actually do better with carbs in the 8-10% range.
 
@Amy&TrixieCat
Thank you so much for your reply. I have been spending a lot of time on Tanya's site. I told Marje the other day that it makes my head spin a little because there is SO much information and one thing links to another thing and sometimes I feel like I'm going around in circles. So, I've been trying to concentrate on reading the sections that are most pertinent to me right now. I've also joined her support group, but haven't had a chance to post yet.

So, I do know about splitting the binder between meals. He's 9 lbs as of Sunday at the vet, so with a recommended starting dose of about 27mg per lb his dose would be 243mg (round up to 250). Marje said it doesn't have to be exact, so since 1/4 tsp is 300 mg, I could give a little less than that and split between meals.

He doesn't seem nauseous. He's been eating well (up until I tried the phos binders yesterday and today). Just to test, I gave him some FF without the binder and he ate it. He's been getting Famotadine (2.5mg) daily for a while now b/c of the Pred which can upset their tummy too.
I will have to watch for constipation with the binders.

One of the other issues I have is giving his pills (Famotadine, Zyrtec and Pred - for another few days while we wean him) away from the binders. And I'm not sure about SEB with the binders either for any constipation or for upset tummy. I had read on Tanya's site that they should be given 2 hours away from the binders. He usually gets his pills in the morning and I don't have that kind of time when I have to get to work. The only thing I can think of is to switch his pills to evening, but then he has to go all day without them and I'm not sure how switching to evening will affect his response to the meds since he's always gotten them in the AM.

I'm going to keep trying giving it mixed in his regular meal starting with smaller doses to see if he'll eventually accept it. But, worse comes to worse, I would try the other method where I'd feed him most of his normal food and then mix the binder with some baby food immediately after and see if I can get him to take it that way. I've had to crush Clavamox, Famotadine, Zyrtec and Pred in baby food and he ate it. The problem is, he is not a cat to eat all his food in one sitting... he grazes and nibbles throughout the day.

Pilling is not an option with him. He has asthma and breathing issues and god forbid he chokes on a pill and has a coughing episode.... that will be an ER visit for sure. I hide his regular pills in liverwurst and get him to take them that way. Sometimes he won't even do that, so I crush them in baby food.

@Marje and Gracie I can definitely try powdering the freeze dried chicken treats. Funny, I was thinking about that on my way in to work today! I haven't been able to find the Hi-Tor Neo food without having to order a whole case. I was hoping Onlynaturalpets would have it so I could order a few cans to try, but they didn't have it. Been looking for any local (or semi-local) food stores that might have it so I could get a few cans but so far, no luck. Also, I'm not sure I agree with the low protein approach and this food is very low in protein.

@Lincolns Mom - thank you for your reply as well. Not sure if that stuff is available in the US and it looks like more of a probiotic formulation, no?

And to everyone else who responded and offered support and encouragement today, my grateful heart thanks you!! This really is a special place, with very special people who have come to feel like family and for that I feel incredibly blessed!! :bighug::bighug::bighug::bighug::bighug::bighug::bighug:
 
Donna and Flame said:
@Amy&TrixieCat
Thank you so much for your reply. I have been spending a lot of time on Tanya's site. I told Marje the other day that it makes my head spin a little because there is SO much information and one thing links to another thing and sometimes I feel like I'm going around in circles. So, I've been trying to concentrate on reading the sections that are most pertinent to me right now. I've also joined her support group, but haven't had a chance to post yet.

So, I do know about splitting the binder between meals. He's 9 lbs as of Sunday at the vet, so with a recommended starting dose of about 27mg per lb his dose would be 243mg (round up to 250). Marje said it doesn't have to be exact, so since 1/4 tsp is 300 mg, I could give a little less than that and split between meals.

He doesn't seem nauseous. He's been eating well (up until I tried the phos binders yesterday and today). Just to test, I gave him some FF without the binder and he ate it. He's been getting Famotadine (2.5mg) daily for a while now b/c of the Pred which can upset their tummy too.
I will have to watch for constipation with the binders.

One of the other issues I have is giving his pills (Famotadine, Zyrtec and Pred - for another few days while we wean him) away from the binders. And I'm not sure about SEB with the binders either for any constipation or for upset tummy. I had read on Tanya's site that they should be given 2 hours away from the binders. He usually gets his pills in the morning and I don't have that kind of time when I have to get to work. The only thing I can think of is to switch his pills to evening, but then he has to go all day without them and I'm not sure how switching to evening will affect his response to the meds since he's always gotten them in the AM.

I'm going to keep trying giving it mixed in his regular meal starting with smaller doses to see if he'll eventually accept it. But, worse comes to worse, I would try the other method where I'd feed him most of his normal food and then mix the binder with some baby food immediately after and see if I can get him to take it that way. I've had to crush Clavamox, Famotadine, Zyrtec and Pred in baby food and he ate it. The problem is, he is not a cat to eat all his food in one sitting... he grazes and nibbles throughout the day.

Pilling is not an option with him. He has asthma and breathing issues and god forbid he chokes on a pill and has a coughing episode.... that will be an ER visit for sure. I hide his regular pills in liverwurst and get him to take them that way. Sometimes he won't even do that, so I crush them in baby food.

@Marje and Gracie I can definitely try powdering the freeze dried chicken treats. Funny, I was thinking about that on my way in to work today! I haven't been able to find the Hi-Tor Neo food without having to order a whole case. I was hoping Onlynaturalpets would have it so I could order a few cans to try, but they didn't have it. Been looking for any local (or semi-local) food stores that might have it so I could get a few cans but so far, no luck. Also, I'm not sure I agree with the low protein approach and this food is very low in protein.
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SEB should be given two hours away from any meds or supplements and also binder. If you are giving famotidine, you don't need SEB as they both address tummy acid. None of my CKD cats ever got constipated with binder and one was on it for almost four years but ECID. You could give the SEB at night right before you go to bed. Then maybe it's possible to give it as soon as you get home, wait two hours, and give him anything else he needs?

I definitely do not believe in the low protein approach but you can up his protein by feeding him boiled chicken breast as long as it doesn't make up more than 10% of his diet. Or you can use the Hi Tor Neo during the day and feed his regular food with binder at night. Don't tie yourself to only one way of addressing the issue. You'll drive yourself crazy :confused::joyful:

I know if you buy from Chewys and he won't eat it, if you call them, they usually refund your money and have you donate it to a shelter. They have done that with me on a couple occasions.
 
Hi Donna, You've gotten so much great help here. I just want to send support. Are chopped, cooked egg whites still used in the treatment of CKD? Long ago I read in Elizabeth Hodgkins' book, "Your Cat", that egg whites have no phos. but are high in protein. I just found the passage (p. 217): If you add egg white to your cat's wet food it "effectively 'dilutes' the phosphorus in the food". This may be old fashioned, or even debunked now, but at least egg whites are food.

Sending many hugs for you and vines for Flame,
 
He threw me a number at PMPS that I wasn't expecting. Keep reminding myself it's only one number. Hadn't seen any pink in the last couple days so I was hoping we had a good trend going here. I'm tempted to up his dose by a bit this weekend, but this Saturday will also be his last dose of Pred so I'm torn as to what to do. Opinions, suggestions? I don't like to increase during the week when I'm not home to test. Wondering if I can just fatten that 2.25 up by a drop or two. Although measuring that could be tough.

So the good news is that he ate his food with the binder during the day today and is eating his food tonite. Slowly and a bit hesitantly, but he is eating it. He's hungry. My shipment of low carb/low phos food won't be here till Tues, so maybe if he behaves himself this weekend, I might be able to run down to the store I was going to go to last Sunday when he decided to give me the scare of my life. Since I am introducing the binders slowly and all I have is FF, at least if I can get the low phos food into him until I can get him up to full dose maybe that will help some.

I just want to thank you all so much for lifting me up today!! For all the good advice, for the support, encouragement, hugs... I am truly grateful!! I go to bed with a heart full of gratitude tonite for this wonderful family called the FDMB and for my sweet, darling boy Flamie who brought me to all of you and who, by Grace, is still here for me to love, still fighting the good fight with his mama by his side. Sending you all so much love!! :bighug::bighug::bighug::bighug::bighug::bighug:
 
Ususally fine tuning the dose by fattening only works when a cat is regulated. Although ECID. It can't hurt to try it if you're not comfortable increasing by 0.25 units because you can't monitor.
 
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