6/28 Boo

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I guess it's time for an update. I had wanted to wait until I Boo's next GH & IGF-1 results, but Dr. Lunn is out of the country so I'm going to hold the blood in my freezer till she gets back.

Overall, Boo has been doing great. She is snuggly when she wants to be, which is generally when I'm trying to sleep or work on the computer. She's sweet to her little Mika-Monster...she licks her ears and face. She hates her kidney diet and generally waits until Macy is done and then finishes her food.

Boo (and Mika) had dentals and bloodwork on Friday. Boo-bear had one tooth removed. She woke up easily and spent the day trying to unlatch her cage and watching procedures. My vettybean loves Boo-boo and always comments on what a good, smart kitty she is. She truly is a very smart kitty. :smile:

Unfortunately, her kidneys are steadily getting worse. She's also steadily becoming anemic. The problem...we've reached the point that we need to start fluids for her kidneys, but that will make her more anemic. Once she reaches a certain number (20), we need to start Epigen (?) for her anemia. However, her body will become used to the Epigen, which will then no longer work. When her anemia gets bad enough, she'll need transfusions. And of course, all of this is terribly expensive.

In conjunction, Mika has some weird lab results. I've also always had a feeling that something serious is/will be wrong with this kitty. We just did a dental, x-rays on her hips, bloodwork, a full viral panel. Now, vettybean wants yet more bloodwork, including a GI Panel. She's concerned and mentioned "lymphoma", although she wants to see the results of the GI panel before going that route. The x-rays showed evidence of arthritis. Mika is only 2 years old.

On the positive side, both Macy and the drooler are doing fine and thank God, neither is sick. I'm simply overwhelmed right now...the issues and the expenses are getting to me and the idea that two of my babies are (or might be) sick is just so sad. Sorry to post a "downer".
 
Hey Boo,

I didn't know daily fluids could make them anemic.... I've been giving Cody daily fluids for quite awhile, probably at least a year and no problems here.

BTW Sams sells a box of 12 bags (1000ml ea) of LRS for about $24 (Rx needed). For some reason they won't sell the tubing and needles, so I order those from a place called vetsupplys.com ( I think) (prescription needed i believe) . You can reuse the tubing on several bags, especially if you are careful to use 'sterile technique' changing bags, and put a clean needle on after every session, and clear the line a bit. I can give you a lot more info on this when you are ready.

Does methycobalamin B12 help this kind of anemia? It says something about "supports red blood cell health"
I seem to remember that the kidneys produce a hormone (maybe erythropoetin? ) that stimulates RBC's. Is that related to this type of anemia/ kidney disease?

as for Mika, we'll be praying that everything is fine- I'm sure vetty bean is just being careful and hopefully everything will be just fine. We are here for ya ;-) :smile:
 
Boo definitely has a face that says "Hey, I am dialed, make no mistake!" Love that pic. Regarding the kidney situation - we adopted Jim's Dad's kitty after he passed away. Little Lady - a Siamese looking kitty, a little girl with the alpha gene. She developed kidney issues and 4.5 years ago they told us the prognosis was not good. With pepcidAC bid, and 200 ml of fluids bid (she also had a heart murmur), she surpassed everyone's expectations. Eventually time caught up but we had many good years and never did have to use the anemia drug you mentioned even though they predicted we would. When giving her fluids, she would purr & I'd ask her if she had all her parts working. Still miss her as she passed last August.

Keep your chin up. The best thing for a kidney kitty is a Mom that follow through with meds & fluids. It makes all the difference.
 
You certainly have your hands full, Heather. I'm glad to see an update, though. You help so many on the board it's nice to hear how you and your furbies are doing.

ECID so I hope Boo thrives with fluids and that your fears won't be realized.

Mika is young, hopefully your vet will get to the bottom of what's going on and get her on track. G

Good to know Macy and the drooler are doing well. Poor drooler, remaining anonymous when everyone else gets named. : )

Thanks for checking in KB, too, we do appreciate the visits and the support.
 
Hi Boo - Late in responding, but thinking about you and Mom! Bryce says hi, and knows that everyone there is going through a lot right now. Wanted you to know that we are thinking of you and LOVE reading your updates. The support you provide to others (including us!) is so appreciated. We are sending positive thoughts and hope all had a good Holiday weekend. Thanks for all you do.....
 
hey boo has a condo :) i posted a question on fb for you this morning. didn't think to look here first.

i peeked at her labs before falling asleep last night. [eta: for a non-acro (i don't know enough about acro-cats)] i don't think her values look that bad, except for creatinine (not great, but not-end-of-the-world-bad), imho. and this is before squids? you're not using a binder yet, are you? i don't think she's on the verge of checking out yet, kwim? the question i posted was is she on b vits? if not, ask vettybean if she thinks they would help with the anemia? i forget if it's b complex or b12 (we use both now), your vettybean should know. she doesn't look like she's iron-deficient; i'd be curious to see if b vits can help.

Boo said:
Unfortunately, her kidneys are steadily getting worse. She's also steadily becoming anemic. The problem...we've reached the point that we need to start fluids for her kidneys, but that will make her more anemic.
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1.see how kidney values look after you start squids, it should help.

2. i'm not so sure there's a cause-and-effect with fluids and anemia. dehydration can make the hct look higher than it is, doesn't mean that she's less anemic when she's dehydrated. and it stands to reason that when a kitty is rehydrated, the hct falls back to what it really is (i think). i don't think i've read anything about fluids directly causing anemia. if they do, i may be in big trouble since i drink a lot of water :mrgreen: check with jess or dr lisa? plus, you're not going to be giving her that much, are you?

Once she reaches a certain number (20), we need to start Epigen (?) for her anemia. However, her body will become used to the Epigen, which will then no longer work.
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huh? haven't heard of that. do you mean an antibody reaction? (it's not that common, but it's not impossible, and a pain when it does happen - see the epogen vs aranesp thread on health). but i've never heard of a kitty becoming so used to epogen that it no longer works confused_cat
 
Hi CF! Thank you so, so much for stopping by with your CRF expertise.

Do you know anything about Pet-Tinic or Nutrived? They are both B-Complex vitamins. I ordered both,along with my IV sets & needles. I'll also ask about injectible B.
http://www.thrivingpets.com/index.php/n ... ottle.html
http://www.thrivingpets.com/index.php/pet-tinic.html

Boo will start fluids this week. I need to pick up my case of LRS from Walmart and I'm waiting on the other stuff from Thriving Pets.

Vetty (back in January) really wanted to see if a kidney diet would help, so we haven't been doing phos binders. However, she's not eating much of her food, she IS eating the other's food. I started her on phos binders this morning. I guess I'll let her keep eating Wellness, and just mix the binder in. I also might check out some dry kidney food. Yes, that's bad, but I want her to eat.

I know she's not about to "check out" tomorrow. What's so depressing to me is that she seems to hit each bad "milestone" every 3 months, so it's just a very steady progression. It makes me NOT want to get any more bloodwork because i feel helpless on this one.
 
I also really want to know about fluids CAUSING anemia, because physiology wise, that does not make any sense to me.

What does make sense is that the kidneys do make the hormone that stimulates the production of red blood cells. It is called erythropoetin. If the kidneys are failing, perhaps they are not making enough erythropoetin either, and this is why they get anemic. ( Anemia is decreased number or quality of RBC's.) (I am not a Dr or vet, but I have taken or tutored my kids in college and high school Anatomy/ physiology 6x so its starting to stick! :lol: ) If anybody really knows the answer to this, I really want to know, because we do a lot of fluids around here.....
 
Boo said:
Hi CF! Thank you so, so much for stopping by with your CRF expertise.
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Not much expertise I'm afraid. I've read just enough to be dangerous, LOL. There's always so much to learn, and never enough time - and the Princess demands (as is within her right!) that I spend all my waking hours waiting on her ;-)

Do you know anything about Pet-Tinic or Nutrived? They are both B-Complex vitamins. I ordered both,along with my IV sets & needles. I'll also ask about injectible B.
http://www.thrivingpets.com/index.php/n ... ottle.html
http://www.thrivingpets.com/index.php/pet-tinic.html
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Pet-Tinic is said to be palatable. I think Joan's Maddie and/or Laura's Oreo was on it? It may raise BGs - it has corn syrup as one of the first ingredients - although that may not be a very big concern for Boo?

You can read a little more about Pet-Tinic and Nutrived here; scroll down to the part just before the section on injectables begins.

Pet-Tinic and Nutrived both contain iron, and generally the peeps on the CRF Support group don't like supplementing iron unless iron deficiency is suspected. Not all anemia is caused by iron deficiency - you probably saw the discussion in the Health thread Epogen vs Aranesp, which I think you posted on too. But some vets commonly recommend Pet-Tinic or Nutrived anyway. Suggest talking to Boo's vettybean to see what she thinks.

BTW, there's injectable B Complex (stings) and inj. B-12 (doesn't sting). Ask vettybean which one, or even both, could benefit Boo w.r.t. anemia.

Boo will start fluids this week. I need to pick up my case of LRS from Walmart and I'm waiting on the other stuff from Thriving Pets.
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Good luck with SQuids :) Let me know if you need links to youtube videos; I think I have them bookmarked at home. You've called Walmart for the SQuids? I always make sure I have the same brand of SQuids and IV lines - don't know if it matters, but I figure if they're the same brand, they'll fit better.

How much, and how often? Make sure it's full absorbed before you give the next round. Hope it'll help with Boo's values too, and help make her feel better :)

Vetty (back in January) really wanted to see if a kidney diet would help, so we haven't been doing phos binders. However, she's not eating much of her food, she IS eating the other's food. I started her on phos binders this morning. I guess I'll let her keep eating Wellness, and just mix the binder in. I also might check out some dry kidney food. Yes, that's bad, but I want her to eat.
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Kidney diets have higher levels of vits B and other supps, because they're formulated for CKD kitties. Doesn't help Boo if she's not eating it though, LOL.

If she's willing to eat Wellness, just add in binder. You can also add other supplements if needed.

BTW we started Meowzi back on Wellness a little over three months ago, and her creatinine came down from 4.6 three months ago to 3.5 (ref 0.8-2.4) now. Go figure :roll: We do load it up with binder though. And a bunch of other supplements.

No comment on dry kidney food; some peeps on the CRF Support group do feed that. Just make sure she has enough hydration, k? And keep an eye on BG; all the dry renal foods are very, very high in carbs. But then I'd rather deal with FD than CKD.

And I'll probably be criticized for this - but Hills M/D is reasonably lower in phos and carbs, so maybe look into that too, and consider adding binder to that. Only problem is it's not formulated for CKD kitties, so while it's lower carb and lower-phos, it doesn't have the low-sodium, high-potassium, high B's and whatnots that K/D has. Input quality-wise, they're both very junky, but you already know that :mrgreen:

We've dealt with inappetance for over two years, so I fully understand wanting her to eat. A very wise person on the CRF group says: no food, no kitty. It's as simple as that. Is she inappetant, or does she just want the other foods? If she's inappetant, SQuids may help, as may vit B-12 (diff from B Complex).

Don't like Mika and the rest get into the binder-laced food, k? Baby Mika's too young to have aluminium. It doesn't come without risk; it's a heavy metal.

I know she's not about to "check out" tomorrow. What's so depressing to me is that she seems to hit each bad "milestone" every 3 months, so it's just a very steady progression. It makes me NOT want to get any more bloodwork because i feel helpless on this one.
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Take a look at Meowzi's labs, Oct-Nov 08. Her creatinine leaped more than steadily progressed, IMO anyway. It was depressing. I had a good cry (or two or three, ok, maybe more :razz: ) even after Jojo said M wasn't in any danger of dying in the immediate future. But you know what? All that crying and moping around just upset her. She didn't understand why I was grieving, and she kept headbutting me to try to get me to feel better. She didn't care what her numbers were. Neither does Boo. All they care about is how they feel, and we can try and help with that. That's why we're treating. Don't ever lose sight of the whole kitty for the numbers.

BTW is Boo on any other supps? We use fish oil and also a supplement called Renal Essentials (from Nutramax, I think). And we're not sure about this, but vettybean and I are wondering (just wondering, I haven't found any publications referring to it, but I also haven't looked very hard) if putting Meowzi on Denosyl for her arthritis, may have helped her CKD as well. We don't know. We also added B-12 to the mix around three months ago to see if it would stimulate her appy, and tweaked her calcitriol dose, and raised her fish oil dose as well. We basically took the kitchen sink approach - threw everything we could at this stupid disease b/c it seemed to be spiralling out of control, and something(s) may have worked, but now we don't know what, LOL. I don't know how long our good phase will last, but I'll take any we can get. Anyway, to get back to the point, ask your vettybean if she's come across any supplements that may help. And if you're in touch with Dr Lunn, check with her too as she's probably kept up with current research; I know there are a couple of studies ongoing, on antioxidant therapy and arginine supplementation.
 
Nancy and Cody said:
I also really want to know about fluids CAUSING anemia, because physiology wise, that does not make any sense to me.
...

If anybody really knows the answer to this, I really want to know, because we do a lot of fluids around here.....
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Pick up the phone and call your vet :) And let us know what she/he says :)

I highly doubt it causes anemia though. I've seen at least one post on the CRF group where anemia was resolving (with epogen I think) at the same time the cat was in fluid overload (the kitty has undetected heart disease).
 
About the anemia thing....vetty specifically said that the fluids could make the anemia worse (not that it causes anemia), but I have no idea why. I'm a very bad mama-bean about this whole CRF thing...I would just like to ignore it. Diabetes was a challenge...something that you could possibly beat, where CRF is something that will win in the end.

Squids was Rxed at 150 ml(?) 2 or 3 times a week (my choice). I actually do know how to do them - my Kayro (GA) was on them for several years. Vetty trusts me so much that she didn't even offer a refresher course! :mrgreen:

How much binder are you using? Mine says 1/4 teaspoon per meal.

The only good news on all of this is that I really don't have to worry about BGs - she truly has a normal pancreas. I can throw her dry and get a very nice drop. I actually give all the babies about a tablespoon of dry with each meal - everybody deserves some dessert.
 
Boo said:
Squids was Rxed at 150 ml(?) 2 or 3 times a week (my choice)
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That's 300 - 450 mls a week. Why not split it up so it's an even 50- 70 mls per day? You don't drink plenty of water 2 or 3 times a week, and skip drinking the rest of the days in the week.

Glad you know how to do them!

How much binder are you using? Mine says 1/4 teaspoon per meal.
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We use 100 mg/lb/day of aluminium hydroxide dried gel powder, and another 50 mg/lb/day (approx) of Fo$renol.

Has Boo never had her PTH level tested?
 
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