Angel's kidney values going up again - what to expect?

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Heather & Angel (GA)

Heather & Angel (GA)

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Angel went into CRF a little over a year ago, probably because of too many drugs that were hard on her kidneys. She spent a week at the hospital, where her kidney values went up every day all week. I brought her home with the expectation that she'd only live a day or two, but I was still giving her 100 cc of sub-Q 3x/day to try to help. Well, she did manage to recover from the ARF, but her kidney values never returned to normal. They've fluctuated a bit, but have mostly been Cr between 3 and 4 and BUN between 50 and 80 for the past year. The highest it's been was Cr of 4.2 once last summer, but it came back down.

The last 3 vet visits, her Cr has been creeping up again, over the past month or two. Last week, her Cr was 4.3. I hope this is just fluctuation again, but she also seems to be drinking more water than usual. Her BGs haven't been much different than ever during this time, so I don't think it's from that.

Note that after a month of the 300 cc of daily sub-Q last year, her heart started failing and we had to cut the fluids in half. At her last cardio checkup, the cardiologist said Angel's heart had come back down to normal size, and he thought we could increase the sub-Q a little if we needed to for the kidneys, but that's a scary balancing act.

For those who've been through renal failure, did you see a notable increase in water consumption when the kidneys started to finally give up? How long might Angel have, if this is the case? I want to be as prepared as I can be for whatever might be happening. I know it's going to be unspeakably traumatic when her little body can't take any more. :sad:
 
My experience is that that the toxins/byproducts that the kidneys normally build up and the cats stops eating/has very poor appetite.
 
Thanks for the bump, Phoebe!

Larry, Angel's appetite has decreased lately, and she's been throwing up more than usual. There are many other reasons related to her IBD and megacolon that sometimes cause her to lose her appetite, but given the higher kidney values I'm more worried than usual about it now.
 
Hi Heather,
I understand your worry and I sympathize. From my experience on various CRF yahoo groups, you can't always tell by the numbers how bad the CRF is. Some kitties can live with very high numbers for quite a while. From what I've seen, the signs of increasing CRF are the loss of appetite and vomiting. Do you have blood work you can share? How are Angel's phosphorus and potassium levels? Is she on a phosphorus binder? High phosphorus can make them feel pretty crummy. I hope you can find a way to make her feel better soon.
 
Hi Heather,

Spades has been CRF for a year and a half now, getting fluids 3-4 times per week (100-150cc at a time). About a month ago, her appetite dropped and she was having some vomiting issues. Blood work revealed that her BUN and creatinie had increased significantly and I now give her daily fluids, but only 125cc at a time. She seems to have improved. She also gets a potassium supplement which has been really helpful with the vomiting. (Kitties that get fluids often have a decrease in potassium levels which can cause nausea and vomiting.). Even if the potassium number is on the low end of normal, a supplement is sometimes needed. Her diabetes has also been for the most part unregulated---this also puts a strain on the kidneys.

So I agree with Ele to ask your vet about the potassium, and also phosphorus. If the phosphorus is too high, this can cause problems, but adding binder to food takes care of the problem.

I also sometimes use Pepcid AC for vomiting, 1/4 of a 10mg pill at a time (regular strength).

300cc daily for a month seems like a lot----maybe the cause of the heart problem. What is your current subQ protocol--just curious??

Anyway, my point being, a year and a half as a pretty long time---I didn't think she would last this long! (She is 17 now).

Hope that helps...
 
Hi Heather. If I'm reading this correctly, you're asking about signs of end-stage kidney failure? I'll preface by saying we haven't experienced that yet, thankfully, but IMO a creatinine in the 4s in a kitty without complicated health issues (I am not familiar with Angel's history) is probably not close to end-stage yet. ECID of course, and some kitties probably do feel quite ill at those levels, but many others do stay stable. My Meowzi's creatinine has fluctuated between the mid-3's to mid-4s over the past year, but she doesn't act like she's anywhere near end-stage *ANTIJINX*.

Have you checked with the Yahoo CRF Support group? They see a huge range of CKD kitties come through, and would probably be able to answer your questions better. Also, Tanya's site has an Index of Possible Signs of the Final Hours that may be helpful. I hope you won't need to refer to it for sometime yet.
 
Thanks, Ele and Colleen -

Yes, I'm using aluminum hydroxide as phosphorous binder, and I just finished giving Angel a potassium supplement twice a day for a couple of weeks, because her potassium level had dropped a tiny bit low. The checkup last week showed potassium had come back to normal level, but this was in-house blood work that didn't show the phosphorous level, so I don't know how that is at the moment. It's for the most part been okay over the past year (on the binder), except for once a few months ago when it had gotten a little high and I increased the binder a bit.

I also give her pepcid-AC every day, plus diltiazem 3x/day, norvasc once per day, and aspirin 2x/week for her heart, and cisapride 3x/day for her colon. She gets 75 cc of sub-Q fluids 2x/day. She has a congenital heart murmur (her son whom I rescued with her also has it, even worse), which made her predisposed to have problems with the high fluid volume last year. I was talking to her vet today about scheduling another cardio consult for next week, if possible, together with more blood work, to see if we can increase the fluids any if needed for her kidneys.

Angel has always responded erratically to insulin, and I've never been able to regulate her in 7 years, although I'm getting better results right now than most of her history, using Lantus 3x/day. I still hope and dream of getting her to a point where she'll respond to Lantus reliably in 12-hr cycles like so many other cats here! I know she'd feel so much better if she were regulated, her kidneys wouldn't be so strained from the sugar, and the bacteria that keep sneaking into her UT wouldn't have as much to feed on in the infections that she keeps getting. That's the other problem she's having right now, AB-resistant UTIs that just keep coming back.

Anyway, I'll never give up on her, I'll keep fighting to make my baby feel better, even though I do know that she can't live forever, as people are so fond of telling me, as if I didn't already know that... :sad:
 
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