? 3/13 Bubby OTJ day 11. Vet visit now KIDNEY problems. Food suggestions?

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LisaStew

LisaStew

Member Since 2016
Day 11 with OTJ and we are still seeing low BG #'s so we had a trip to the vet. So overwhelming, something new to learn about. Blood tests show beginning kidney problems. High BUN 35 (range 10-30) high CRE 2.2 (range .03-2.1) low ALP and K+.

Vet put Bubby on a med called Azodyl, says low protein/higher carb food, have to try giving sub Q fluids for a couple of days. How low protein should his food be to try and reverse this before its to late? Right now he is eating Ziwi peak venison protein 39, fat 59, carb ?2. And Iams tuna topia protein 55, fat 21, carb ?12-14, phos .84. I'm guessing his freeze dried shrimp are high in protein? Bag says crude protein 78%/high in protein.

I hope we can fix this and keep him OTJ. We believe he has food sensitivities to poultry. Vet suggested making white rice and beef broth to feed. ??? Does that sound right? Thanks in advance for all comments. I need to take a minute to catch my breath.
 
High protein is not the concern for CKD, that's old school thinking, what you want is low phosphorus and low cab fuds. On an As Fed basis, ideally the phosphorus should be under 200. Accodring to Dr. Lisa's latest chart, the Ziwipeak venison is 252 for phosphorus. Which is just a little on the high side. It would be ideal to find something a little lower. They are a few options that are non poultry and low carb/low phosphorus.

Bubbly would be considered early stage kidney disease. You might want to check out http://www.felinecrf.org/
If you post your lab results on the labs tab of the spreadsheet, we have some people who are really good at analyzing the results. I think it's a little early to start fluids yet.

Azodyl is a probiotic. I used it for a while with Neko, not sure how much it helped. I have heard mixed results with it. It was a pain to give cause it's supposed to be on an empty tummy and the capsules are fairly large.
 
Wendy&Neko said:
I think it's a little early to start fluids yet.

Azodyl is a probiotic. I used it for a while with Neko, not sure how much it helped. I have heard mixed results with it. It was a pain to give cause it's supposed to be on an empty tummy and the capsules are fairly large.
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Thanks Wendy, would it hurt to do sub q as I now have all the supplies? Bubby doesn't drink water, he gets all his water added to his food. Usually 1/2 to 1 cup per day.

Unfortunately I didn't read the bottle of Azodyl, just followed the doctors directions. He said I could open the capsule and put on food so hopefully that didn't hurt Bubby. Also no mention of an empty stomach. He made it sound like a miracle drug, said they had several animals that will be on it for lifetime kidney support. If I have to put it down Bubby throat he probably won't be taking it.

I will get his results up and check out that link at some point tonight. The doctor made it sound like we caught it so early it could be reversed. Is that even really possible?
 
Azodyl seems controversial. Those that use it swear by it but many vets feel it doesn't help. I don't think it can hurt though unless you gave a cat hard to pill. My IM doesn't use it.

You don't want to give fluids unless dehydrated. I added water to the canned food. Fluids have to be high sodium. Getting fluids into them orally is best until you can't any more. You just want them well hydrated. Feel the guns to see if slick or tacky. If slick you are good. Most don't need fluids until the creatinine is around 3.5 or higher.
 
I haven't heard of kidney disease being reversed, but it can be managed and kept at lower levels for quite a while. I agree with Elise, I wouldn't give fluids just yet, unless he's dehydrated. Adding lots of water to food is good. Sounds like you are giving quite a bit already. A side note on fluids, has the vet checked Bubby's heart? Giving fluids when kitty has a heart condition is contraindicated - I found out the hard way. :(

An alternative for Azodyl is to feed it in some high fat food, like yoghurt, either one hour before or two hours after food. My vet also said to sprinkle on the food, but it's said to be less effective that way.

Now that I'm back at my computer, I made a list of the low carb/low phos foods from the lastest list from Dr. Lisa and compared with the food list on felinecrf.org. There are a number of non chicken ones there. If he can't do poultry, he still might be able to do duck.
 
Hi Lisa,
My vet thinks along the same way as yours.
When Rico had a little higher values than you kitty he said to start SQ and we did it for 6 years. His blood panel 2x a year after that were normal due to the fluids although others may not agree. I have no proof except he is doing very well and they went down not up.

He then developed a heart issue and could not get fluids-
It is my belief that the SQ helped preserve his kidneys and I honestly do not think he would he here (almost 19) had I not done SQ. I have no medical proof but I have had several cats (rescue) that have had values go back in normal range when started early with SQ. I did give it on a regular basis-

Dre has a normal creat. but his BUN is elevated more than your kitty-
His creat was out of normal range by about 5-6 pints and I started SQ
He recently had blood work and his creat is in the normal range (high end but normal) and his BUN has gone down a little.

I have the utmost respect for Wendy and Elise and their knowledge I have just had a different experience with SQ.

I have found that for us starting SQ earlier than later has been very beneficial.
Dre who is diabetic gets a low carb diet and he gets fluids daily. He is also very good for it which helps:bighug:

Edit to add --As Wendy said PLEASE make sure the heart is ok for fluids. I also found out the hard way.
 
Wendy&Neko said:
Tanya's site has an entire page on subq fluids. http://www.felinecrf.org/subcutaneous_fluids.htm
Including a section on when to start them and it could be ECID. Sounds like they can lower potassium, which is already low in Bubby. Did the vet talk about starting potassium supplements?
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A little disappointed with today's visit as he only drew blood. Did not listen to heart or lungs as we could not get in a waiting room for a long time as they were working on a dog emergency. And I specifically mentioned that I had started giving Bubby his inhaler again about the time his BG started getting low. He didn't mention potassium supplements at all but I was just reading about them in an older post from someone else.
 
Was a urinalysis done? If so post that as well. The USG is part of the kidney puzzle. An infection can cause numbers to be off as well.
 
I'd ask about potassium. You don't need the vet brand either. NOW makes a powder and tge starting dose is just 1/8 or less of a teaspoon. It mixes easily into food and mine never noticed it was there.
 
tiffmaxee said:
Was a urinalysis done? If so post that as well. The USG is part of the kidney puzzle. An infection can cause numbers to be off as well.
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He did not do or suggest a urinalysis. Bubby was treated in Dec/Jan for urinary infection with AB. Then again in Feb as it seemed his issues were coming back. A different Doctor in the practice checked the sample which I took to them. He wasn't seen by the vet for these issues.
 
I agree with the others about their dietary suggestions - with an FD kitty in particular you don't want to go high carb/low protein. Trix has been in advanced CKD (toggling back and forth between Stage III and Stage IV) for 3 years now, and one thing I never did was put her on low protein food. She's OTJ, and I just don't want to throw insulin back in to the mix!

With Bubby's recent history of UTIs and the return of his symptoms, I would definitely do a urinalysis and run a culture to make sure he doesn't have a kidney infection, because as Elise mentioned, infections can throw values off, too. In order to run a culture, they would need a sterile sample taken by needle; samples that we provide from home wouldn't be sterile enough for the culture.

I would also have Bubby's BP check if you can. Elevated BP can cause kidney issues as well, and sometimes when the BP is brought under control, the kidney values will improve. This happened with Trix.

My vet was also on the fence about Azodyl, so I never got it for Trix. Vetty said that some patients seemed to feel better with Azodyl, but they never saw any sort of improvement in the numbers because of it. However, feeling better is a big part of the picture, too - it's hard to remember, but our kitties are more than their numbers, so if they feel good, that is always a win.
 
Finding a low phosphorus and low carb food is hugely important. If your kitty will eat raw, Darwin's has a prescription raw kidney food for cats. It's low in carbs and low in phos. Alternatively, you can use a phosphorus binder and feed your cat whatever you'd like.
 
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