Blizzard diagnosed with kidney failure -- need advice

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Trish and Blizzard

Member Since 2011
Blizzard is 15 years old. Blizzard is diabetic and had been relatively well regulated and kept alive for the past 13 years on his insulin and high protein diet. He's always been a regular eater of his high protein food (Fancy Feast and DM) and has done well with his diabetes. We ear test and shoot twice daily with Prozinc. Two months ago he started eating less. This resulted in needing less insulin.

At the end of one month, he quit eating altogether. Took him to his vet for various tests. Results were that he had lost 2 pounds, was dehydrated, was severely constipated, but was well regulated with his diabetes. Other tests showed that he had no fever, is in the early stages of kidney failure but all other tests show regular health. Constipation and dehydration are now under control.

Vet suggested we switch Blizzard to kidney diet of KD. We have done this. Some days he eats a lot and other days he doesn't feel good so he eats very little. We have had to decrease his insulin due to the variance in his eating patterns. End result is very high levels for diabetes. If we increase his insulin, he goes too low (had to administer Karo on Sunday night) If we don't increase, his levels are out of control (over 600).

We are also giving Subq fluids of 250 ml every other day. This perks him up. Yet -- he is still losing weight and this week he is acting dazed.

We need advice on how to help him. Is KD an appropriate diet? We can't give him the high protein diet anymore because it harms his kidneys. Any suggestion on how to use insulin with KD will help.

Also -- are there any other tests that you can think of that we can ask for to look for other conditions? The Subq fluids are helping him but he continues to lose weight and is dazed. It's obvious he doesn't feel good. But he is in the very early stages of kidney failure (4.0) so I don't think he should be in this bad of shape. Looking for other conditions here that may be contributing to his not feeling well.

Thanks to everyone here. Without this site and all of the help and advice I've gotten here, Blizzard wouldn't have been alive with us for the past 13 years. He is a smart cat who has always helped us to help him. With his additional diagnosis and symptoms, we're just not sure what to look for next. He's still trying so hard and looking to us to help. Our vet is good and willing to do whatever we can suggest.

Thanks in advance for your help!

Trish and Blizzard
 
A very good resource for kidney disease is Tanya's CRF website. Lots of good reading there.

Do you live in the US or elsewhere? If in the US, you might want to try the Friskies Special Diet cat foods. In the early stages of kidney disease, a protein restricted diet is not recommended.
 
If he is in the early stages of renal disease, a low protein diet may actually result in muscle loss, per Dr Lisa Pierson of Cat Info. (Its down near the bottom of the page)
 
Can you the values that indicate the kidney problems?
Blood creatinine
Blood BUN
Blood phosphorous
Blood HCT (PCV)
Urine specific gravity
 
Deb and Wink Thank you VERY much for the link to Tanya's kidney disease site. I will go through it fully this weekend. It looks as if the site contains very much help and guidance. I will also look for Friskies food. We've have another old cat (18) in the later stages of kidney disease so he has to stay on low protein food. However, I'm looking forward to reading all of Tanya's advice and guidance. Thank you so much!
 
BJM -- thank you for the link. We have another old cat (Timmy) who is in the final stages of kidney failure. He has no muscle mass left at this stage. We've had him on a low protein diet (SD GD) since he was first diagnosed with kidney disease 7 years ago. He maintained his health and weight on that food. Now that his kidneys have moved to the failure stage, he has to have the lowest protein. However, Blizzard is in the early stages of the disease so we need to learn how to help him not lose all of his muscle and to still not due in his kidneys. This part is new to us because Blizzard is also the diabetic and has done very well on the high protein food for 13 years.
 
Hi Larry and Kitties,

Thanks for asking for the specific levels. I have them:

Blood creatinine @ 4.0
Blood BUN @ 64
Blood phosphorous @ 4.8
Blood HCT (PCV) (on my sheet it just says HCT under CBC Standard @ 35.7
Urine specific gravity @ 1.016
Also -- no Keotones and diabetic control at the time was in the Good range, though high at 371 from his Fructosamine test

The Vet says he has maybe 2 months at best to live. Our other old cat Timmy (18 yrs old and not diabetic) was at level 4 about a year ago and is just moving into his final stages (7) of kidney failure. We would certainly like to extend Blizzard's life for as long as possible for him. We need to learn how to manage both his diabetes and his kidney failure at the same time and THIS is new to us.
 
Those values are not that bad. The phosphorus is not that high at all. Yo are on the right track with fluids but I myself would give 125 ml daily vice 250 EOD.
You should be feed in low phosphorus food too.
 
It's been a week with lots of changes for us. Thank you for the links to both Dr. Pierson's Cat Info and Tanya's CKF websites! A great wealth of info in both!

We immediately moved Blizzard off the Science Diet KD diet as the high carbs in this diet was driving his levels over 700. Prior to the diagnosis of the kidney disease, when we were only dealing with the diabetes, Blizzard ate his dry Purina DM and Fancy Feast foods. We have now switched him to foods with low carbs AND lower phosphorus. He likes Merrick 98% Beef and Weruva Chicken Frick A Zee.

We are struggling with the amount of insulin he now needs on the new foods. On DM and Fancy Feast, he used to need 2.75 to 3.0 units twice daily. On the low carb/low phosphorus foods he has twice come dangerously close to crashing on just 1.0 unit. Twice this week we've needed to administer Laxatone (with corn syrup) and this has brought his levels up. But he doesn't feel good the next day.

For the last two days we've had him off of insulin altogether. Today we did a curve with NO insulin administered. In the morning (pre low carb/low phosphorus Merrick 98% beef food), his levels were at 420. For the first two hours he went down by 60 points. At 6 hours he has risen to 461. That's only 41 points higher than when he started today. Yet he didn't go down to the healthy levels of 250 of below that would indicate that his pancreas is working on it's own.

He's drinking lots more water so that indicates that he needs some insulin to process his food. We're at a loss of how much to give him when his levels are not swinging much and 1.0 unit makes him dive too low too fast. Should we try .25 or .5 units?

Any advice or experience with this would be greatly appreciated.

Thank you SO much.

Trish and Blizzard
 
If you get U-100 syringes with half unit markings, you can dose as finely as 0.2 units of Prozinc.

ProZinc is 40%, i.e. 0.4, of the concentration of a U-100 insulin.
This means that you can multiply the syringe marking by 0.4 to get the ProZinc dose.

syringe
mark * 0.5 = ProZinc dose
0.5 * 0.4 = 0.2
1.0 * 0.4 = 0.4
1.5 * 0.4 = 0.6
2.0 * 0.4 = 0.8
2.5 * 0.4 = 1.0

Alternatively, giving 0.25 or 0.5 units of ProZinc is possible with a U-40 syringe. You can make a reference gauge by following these instructions.
 
Thank you BJM. Got the U100 needles and they are much easier to use to accurately give smaller doses to Blizzard. Started him last night on .2. Today we increased to .4. Tonight he had .6. The .6 seems to be the correct dose for him as it brought his levels down to the correct place where he can process his food but not go so low that he is in danger of crashing. Your advice and conversion chart were the key. Thank you for making our weekend calmer and more peaceful. Blizzard is a big, longhaired Siamese. He's a rescue cat that I've had for 13 years. He loves to hug and he asked me to tell you he would give you a big hug if you were here now. Thank you so much for your guidance.
 
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