BAD NEWS FOR MURPHY - DIAPHORESIS

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missmurphy2010

missmurphy2010

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Well, as excited as I was, Murphy's kidney values have went up again, BUN 56 or so and creatinine is 5.8. This is within one week. I was asked to bring her into the hospital for 3 days of diaphoresis, and I'm really having a hard time with this. In addition, her little front paws have never recovered from neuropathy, and she is now down totally on her carpals. As I considered athrodesis this morning, my vet then called and told me the bad news. Looking at the big picture, she is a very compromised little girl, and at some point, I will have to make a decision, but how long do you wait? Do they tell you? If she were to become diabetic again, I do not know if I could put her through it all, poking prodding, medications, fluids, asthma treatments. When I see those big green eyes, I feel like it would be abuse.

Murphy had a UTI some months back when I returned home from recovery for my fractured ankles. My vet did say, a glimmer of hope would be that, although not good, if the UTI returned and went into the kidneys, this would make the levels rise, but that is just a grasp at straws.

She also told me that definitely, now, and going forward, Murphy is going to need a renal diet, and I have no idea how to feed to keep the sugar within a range. Her fructosamine was normal, but that could change -- we all know that. Funny, once I got her off the N/F diet, and got back to basics, her levels went back to normal on BG.

Does anyone here know if CRF and the CRF diet affects BG and if non-diabetic would the kitty become diabetic, or am I asking things that don't need to be asked right now?

She could use some really big huge lift ups to God right now. Perhaps I'm jumping the gun, but I have cried all day today, my eyes are almost swollen shut and I cannot imagine how she feels. It's lonely here at home w/out her, and Oscie, my siamese, had a fit when I came home -- he's looking all over for her. That's the thing - we don't know how they feel. I feel as if I've led her astray somehow, but I've done all I could to keep her healthy.

Lisa
 
Many of us have cats with both diabetes and CRF. When Witn was alive, she had both. I fed her the Friskies Special Diet canned food. The only flavor I limited was the Chicken and Gravy because of the carbs. During the years she was on this diet, both her glucose levels and kidney values remained consistent. She lived for several years on this diet to the good old age of 19.
 
I don't know how to respond to all the medical stuff, but I can certainly relate to the emotions you're dealing with. My Gem has a complicated medical situation - diabetes, restrictive cardiomyopathy, kidney issues and finally a Dx of Cushing's, with the worst symptom being fragile skin with many open wounds. The vet advised there was nothing we could do for her, and I spent the night in tears. Other than the wounds, Gem looked OK, lethargic but not on death's door. I felt that there would be some sign that she was ready and I wasn't getting that, but thought maybe I was keeping it going for me and not her. Well, it's been 2 weeks and one trip to a very dedicated specialist, and Gem is hanging in there and showing signs of improvement. I don't know what the future holds for her, or how much longer she will be with us, but it wasn't her time just then. Follow your heart, it won't lead you astray.

Best of luck and good wishes to you and Murphy.
 
Lisa, you have always been so conscientious about Murphy's care. You researched and taken advice and gotten her better each time. I don't know what this time will bring, but she couldn't have a Mom that cared more or loved her better.

No advice about the CRF. But others have dealt with it successfully. Just hope you don't beat yourself up. There is no way you could have done more for her. And if she needs something else, you'll be able to give her what she needs.
 
Lisa

I am so sorry you are going through this - I have 3 cats - 1 with diabetes and 2 with CRF - there is another wonderful website www.felinecrf.com or google Tanya's comprehensive guide to kidney disease

The most important factor for CRF food requirements is low phosphorus (there is some discussion about protein but that is a debatable subject) so it will be possible to find a food that will fit the needs of missmurphy (at least fairly closely)

My one CRF cat - trouble - is not eating these days and has lost two pounds in two months so I understand the tears and the emotion as we desperately try to find out what else is wrong with him.

Just do your research and then follow your heart - I wish you and missmurphy all the best

Alix, Trouble, Mischief, & Scamp
 
Lisa, I am sending prayers your way for Murphy. I know, oh too well, how these pieces of news totally pull the rug out from under us. As someone PM'd me today about Jeddie, you need to be strong for her so you can be her advocate.

My understanding, from the many posts I have read her about CRF, is that the proper diet is pretty much the same low carb diet as any cat needs, but with lower phosphorus foods or phosphorus binders added to "regular" low carb food at the point where the renal values are going up significantly.

Your point about the UTI raising the values is good - best to sort that out first. Maybe she just needs sub-Q fluids on a regular basis to fight off a bit of dehydration? Many here give fluids on a daily basis or every other day in small amounts for CRF kitties. I have not actually heard of giving a cat diaphoresis at the vet - for 3 days no less. That is very hard on all of you, as you point out.

I hope she comes home soon and is feeling better.

(((hugs)))
 
From what I'm learning about the CRF diet, N/F in particular, Murphy's BG shot up over 400 the other night, and I can imagine she was running that high for a few weeks. I was spot checking her for a few weeks. Then, when she got to 417, we decided to move her back to the higher protein diet, which is a big no no for CRF kitties, cos the kidneys cannot process the proteins well. Her phosphorus levels were normal, so I'm -- like everyone would be, angst about possibly this is a UTI. Maybe the UTI she had when I came home from the hospital came back. We'll find out, but she's in great hands.

Lisa
 
Hi Lisa. When Blackie was diagnosed with CRF I did a lot of reading on the CRF diets. I know that most vets say cats need to stay on low protein diets, but the fact is they have never done studies with a low protein diet that was high in phosphorus. In other words, we know that high phosphorus makes kitties feel bad, but its never been proven that the high protein makes their CRF worse. That's why people keep recommending the Friskies Special Diet - it is low in phosphorus, but also low carb. It might be worth a try to see if it makes her CRF worse or if she can maintain on that diet. Another option is to use a low carb food and add a phosphorus binder. I did that with Blackie using Wellness Chicken.

I'm so sorry you're going through this, but you are not alone. Sending healing prayers for Murphy and peace and comfort to you.
 
Dr Pierson has posted here that the low protein diets are only suitable when the cat has very compromised renal function, otherwise you run the risk of insufficient protein for maintaining muscle mass.

Here's the post with her comments.
"I am sick to death over watching cats starve to death on low protein Rx "kidney" diets. This is a topic that I hit on very heavily during my CKD phone consultations. I do not - and will not - ever use the Rx "kidney friendly" diets except in very rare cases since I don't find them to be terribly "friendly" to the rest of the cat's body.

I don't mean to be nasty here but it seems as if many of my colleagues have forgotten their second grade math as it pertains to HYPOREXIC cats (diminished appetite).

Diet A = 20% protein

Diet B = 40% protein (Note that most vets will gasp at the thought of feeding a CKD cat 40% protein but, again, they have forgotten their basic math.)

If a cat is going to eat a good amount (say, ~6 ounces give or take) of Diet A at 20% protein, he will probably meet his daily need for protein.

However, if he slows down to, say 3 ounces per day, he will end up protein malnourished when eating diet A yet so many vets stick to their guns with these low protein diets and forget that:

6 ounces of a 20% protein diet = 3 ounces of a 40% protein diet - in terms of daily protein intake.

Basic math.....it is the absolute grams of protein ingested per day that is critical."
 
Hi Lisa,
You have received some good advice about the food already. I am another who can attest from experience with a cat who had crf/ckd and diabetes, that there are other (often better) options than any special kidney diets. My kitty also had IBD/lymphoma, so we had to go grain free. The best food choice for us with the diabetes/IBD/CKD was wellness chicken or turkey. Her renal values hardly changed in 3yrs. If Phosphorus is above 6, then you definitely want to add a binder to whatever food you are offering.

Regarding the increase in creatinine...that is a pretty big jump. My Latte had acute renal failure, which has to be treated aggressively and promptly. This was done by leaving her in the hospital for IV fluids. I'm not sure what "diaphoresis" is in veterinary terms. When I googled it, the only definition I saw was 'profuse sweating'. So I am a bit confused. Did you mean your vet wants Murphy in the hospital for IV fluids? Considering the jump in creatinine, I encourage you to do this. High jumps like this usually mean acute kidney failure and/or infection. I wonder if Murphy's infection is back? Or never went away? That would also cause higher BG's.

Someone mentioned Tanyas crf site. HIGHLY recommend it! In case it was not linked in the other post, here it is:
http://www.felinecrf.org/

She also has a VERY active yahoo group (again, HIGHLY recommend it :mrgreen: )
http://pets.groups.yahoo.com/group/tanyas-crf-support/
(If you have all of Murphy's labs...especially kidney panel, you will get more feedback by sharing it with the group).

Sounds like you have some really tough decisions to make. I am really sorry for this. these kitties are just so darn special. cat_pet_icon If you want to get past the acute kidney issue, and then decide from there what may be best, please consider leaving your girl at the hospital for a few days. She needs the treatment to get better. Which btw...most acute cases of kidney 'failure' ARE reversible, if treated promptly and aggressively.
 
:RAHCAT :RAHCAT :RAHCAT :RAHCAT :RAHCAT Murphy's coming home tomorrow. I went to see her at the vet's office today and they brought her to me, she was like on speed! It was amazing to me. Diaphoresis is a flushing out of the kidneys of all the toxins. It is something that my vet said is a one time deal. And, holy shmoly, that's good, cos $$$!!!

Anyways, she was noisy, chatty, so hilarious, she hardly noticed I was in the room. She looks puffy, but she certainly did change overnight.

On the diets, yea, at this point, since the diabetes was there for just a short time, and I've seen what the kidney diets do to the BG, I'm not so certain this is the route I want to go. I want to do what's best for her, but to me, the glucose / diabetes thing would come before the CRF. It appears this is mostly the reaction I get from all. Treat the diabetes. And, even though she isn't diabetic any longer, showing me that just those few times I checked her glucose and she went clear up to 417, is enough for me to say no to those diets. I knew it was glucose related when I saw that darned demodex rearing its ugly head again!!!!

So, it appears that from diets, Tiki and Friskies are the only low phosphorus diets. Would that be correct?

How can we not see these things in our kitties? How did I not see that she was so dehydrated? I will never forgive myself. I was in contemplation yesterday and Murphy knew I was upset -- I have no idea what I'm walking into.

Whatever the case is now, I will do everything in my power to stave off the diabetes and hopefully with finding the perfect diet, and all the fluids she is going to need, I'll keep her around. I mean, when you really look at it, by all rights, she shouldn't be here now.

I'm writing a story about her for Cat Fancy hopefully by the end of this year. I think all pet owners need to understand what it takes to truly, truly love your babies, and the compromises we make to keep them healthy whether we are healthy or not and I can vouch for that right now. The time and persistence to keep them out of serious illnesses or keep them at bay, and the time and effort taken away from us is never even a thought in our minds. Like a loan we never expect to have paid back -- you just do it. Whatever I've done, it's always been for the babies. It would be no different if I had children. There's no bridge in sight for her -- no way.

Love is love. 'specially with those huge green eyes :)
 
Im so glad to hear that Murphy's coming home and feeling better Yay!!!! As for food low in phosphorus and also low carb consider Merricks Cowboy Cookout, Surf N Turf, or Southern Delight. I have a diabetic/ckd/inflammatory bowel disease cat and Merricks is working well. Another thing to suggest - there is a supplement called Azodyl which can help with kidney disease. It is OTC but enough reports of it working has the University of Colorado doing a blind study on it. Its a bit spendy ($35 a bottle) and has to be kept refrigerated but might be worth a try. Definitely check out Tanya's CRF site - it is just as good as this one is for certain. I've made sure to go out of my way to cuddle and give my kitty attention when not medicating her. I don't want her thinking every time I come near her its to give her a shot or pills (unfortunately though more often then not it is LOL). My husband and I say that our furbabies are just as much our kids as the two legged ones and we do whatever we can to make them feel as good as possible. Jan
 
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