Can you prevent kidney disease in FD kitties???

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Rachel & Gus

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My vet left a message with Gus's lab results. She said all his numbers are good except his kidneys are starting to show signs of decline. I don't have the numbers and I haven't spoke to her directly yet, but I'm distraught over the fact that he is on the verge of developing kidney disease at 14.

Is there anything I can do now to stop it?

I read that low phosphorus is one suggestion, but I have no idea how to achieve that. He is on high protein and low carbs in order to control the diabetes.

I'm so worried that I caused this. He gets 1/4 pepcid tablet and he's on about 5-10 drops of Milk Thistle - all of which the vet said are fine for him. Do you think these are ok or are they contributing to his kidneys declining? His kidney function was fine last year. I've felt on the verge of tears all night. I don't want his kidneys to start failing.

Can I stop this from happening or slow it down?
 
Gus is on a very low dose of Milk Thistle - which the vet wants him to stay on. He had hepatic lipsidosis last year, but his liver values are great now.

He is also on a very low dose of buprenex for pain. The vet isn't sure if the pain is coming from his arthritis or his pancreatitis. She also suggested cerenia because it is anti nausea and anti inflammatory. I've not found any information in long term use of cerenia and definitely don't want to damage his kidneys. She said they use it long term with cats at the clinic with no ill side effects.

I just want to make sure I'm not doing any further damage. I wish there was something I could do to stop it altogether.
 
Here's a great site that explains the different stages of CKD (the newer term for CRF): http://www.felinecrf.org/how_bad_is_it.htm Most cats have some loss of kidney function as they age--the good news is that the progression of kidney disease can be stalled with the right diet. My Gabby was diagnosed with borderline stage1/stage 2 kidney disease, and in the 2 1/2 years I had left with her her kidney values did not change at ALL with the kidney-friendly diet I had her on. She passed away from cancer, completely unrelated to the kidney disease. If it weren't for the cancer, I would have had more years left with her.

You simply need a low carb, low phosphorus canned food, preferably without byproducts (higher quality protein sources are easier on the kidneys). Keeping your cat as hydrated as possible is key to managing the disease, along with low phosphorus foods. Mixing water in with the canned food is one good way to help with hydration.

Here's an updated food list with the values for several premium foods: https://docs.google.com/leaf?id=0B8...MzhkYTkxOGM4NThk&sort=name&layout=list&num=50. You're looking for something with less than 10% carbs and less than 250 mg/kcal of phosphorus. The foods I would suggest are Merrick's Before Grain Beef, Merrick's Before Grain Turkey, Merricks' Cowboy Cookout, Merrick's Surf & Turf, Wellness Turkey, EVO 95% Chicken & Turkey, and Blue Wilderness Duck. If cost is a problem, EVO and Wellness both sell their foods in large cans, which makes the price comparable to grocery store brands of food. Because higher quality protein means less protein metabolism residue, you really want to try for the human-grade meat if you can.

If those are out of your price range, the next best thing to feed are the low carb Friskie's Special Diet flavors. These are Turkey & Giblets and Salmon Dinner--make sure they are the ones that say "special diet" on the can, though. PetSmart carries them, and some grocery stores. Here is an updated list of just the phosphorus values for many commercial foods. They can be cross referenced with Binky's chart for carb values if there's something on there that you want to feed. On this chart, you're looking for something that is less than 1% phosphorus (these values are on a dry matter basis, not mg/kcal): http://www.felinecrf.org/canned_food_usa.htm
 
Rachel & Gus said:
Gus is on a very low dose of Milk Thistle - which the vet wants him to stay on. He had hepatic lipsidosis last year, but his liver values are great now.

He is also on a very low dose of buprenex for pain. The vet isn't sure if the pain is coming from his arthritis or his pancreatitis. She also suggested cerenia because it is anti nausea and anti inflammatory. I've not found any information in long term use of cerenia and definitely don't want to damage his kidneys. She said they use it long term with cats at the clinic with no ill side effects.

I just want to make sure I'm not doing any further damage. I wish there was something I could do to stop it altogether.
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Talk to your vet about your getting a bottle of B12 and giving weekly shots at home for the pancreatitis issues. My Shadoe was always having problems and attacks but after I started giving her the B12 shots(the pink stuff), she has had no attacks.

For pain meds, both my cats get gabapentin daily for their chronic pains, but if something extreme happens, if Shadoe starts her meatloaf position, I can give her a bit of bupe as well.
I have found that gabapentin, mixed with a SUGAR FREE chicken flavor syrup was better for Oliver as he seemed to get kind of loopy on even a small amount of bupe.

For gas/nausea, I was giving Shadoe pepcid AC 10mg strength, 1/4tab BID. Daily max for cats is 5mg. I would try the B12 as it's good for much more than just the inflammation, and try the pepcid as it may be better and much cheaper than all the bupe.

For the pancreatitis, are you giving fluids at home? Even just a small amount, 25cc, can make enough of a difference.
For the arthritis, I am not sure what people are giving, maybe Adequan and Cosequin can help.

Please keep reminding yourself that all we can do is our best. We can search out all that may reverse, slow, stop their health issues and put them into action.
I am positive that he knows you are trying to do your best, and he grateful and loves you for it.
 
Thank you all for the wonderful info and advice.

Gus isn't on fluids but he does drink a healthy dose of water. He has a mild cardiomyopathy so fluids can stress his heart. He can have them, but they have to be in small amounts. Secondly - it was a disaster when I tried to give them to him last year and very painful. I know some cats don't do well with them. Maybe I can talk to a tech about coming over and doing them.

Gus is on Purina DM. Along with everything else, he gets very sick on a lot of foods. I tried By Nature Turkey and he eventually got sick on it. Fancy Feast is definitely out and causes instant explosive barfing. He doesn't like Evo or Before Grain nor does he like Wellness :( This is so much of my problem - finding a low phosphorus food that doesn't cause him to vomit that also meets low carb requirements. DM is sort of middle of the road in phosphorus. A lot of people bash DM, but to be honest, Gus's fur has been softer and more dandruff-free on DM than any food. He has never gotten sick on it. There are no artificial flavors which cause instant problems for him.

He was getting some Instinct canned Chicken but saw cranberries listed at the end of the ingredients. I was reading this is bad for kidneys so I took that off the menu.

Maybe I will try Wellness again to see if he will at least eat a partial diet of it.

Yes - the Buprenex makes him goofy. I don't like that at all. He looks like an Agitated Zombie. However - I know it is helping because he was running through the house at full speed this morning and that's the first time in a month he's done that. I will look at the gabapentin - thank you for suggesting it.

He is already on daily pepcid.

The vet suggested Cerenia as an anti-inflammatory because of Gus's nausea issues. She said Cosequin can cause stomach upset especially in cats like Gus with GI issues. The problem is I can't find much info on cerenia use in cats because it's off label. Nobody is going to spend millions of dollars for the studies to prove if it is safe or not for long term use. The clinic I took Gus to is a cat only clinic in Chicago and my the vet said they use Cerenia as an anti inflammatory.

I'm still confused on bi-products because I was reading - either on Lisa Pierson's site or the book by Elizabeth Hodgkins - that bi-products aren't bad because a cat would consume an entire rodent which would include what we call bi-products.

Sometimes I think maybe I should just order that ground mouse from Hare Today because cats were meant to eat mice. I've never understood why we aren't using rodents for cat food anyway. It's what cats were designed to eat.
 
for the problems with the fluids, I wonder what gauge needle you are using?
Most vets give you 18ga with kits and they are like harpoons.... I am sure they are uncomfortable and hurt as well.
I still cringe when I recall giving Oliver fluids the first time with that size needle; it was like trying to puncture a car tire and he did NOT like it one bit.

I now will use only 22ga UTW needles as they are finer and slide into the skin easily. Both Shadoe and Oliver are fine on the 22ga, but both had issues with the 18ga. It may take a bit longer to get the fluids in, but at least there is no discomfort.

The fluids are kind of important, so try the smaller ga needles and give more sittings of smaller quantities.
 
I was just reading that gabapentin should be used with caution in cats with decreased renal or liver function. I'm guessing this is why she prescribed the burprenex. I'm only relaying what I'm reading online and I'm not an expert. I've an overwhelmed cat mommy who is just looking for answers.

In the end, everything gets filtered through the kidneys and liver so it's really hard to know what is and isn't going to cause damage.
 
Yes - it was the huge needle which I was prescribed at the ER last year - not through my regular vet. Thank you so much for the info on the smaller needles. I will discuss this with my vet.
 
Rachel & Gus said:
I was just reading that gabapentin should be used with caution in cats with decreased renal or liver function. I'm guessing this is why she prescribed the burprenex. I'm only relaying what I'm reading online and I'm not an expert. I've an overwhelmed cat mommy who is just looking for answers.

In the end, everything gets filtered through the kidneys and liver so it's really hard to know what is and isn't going to cause damage.
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bupe is an opiate and pretty powerful going through liver, gabapentin going through kidneys can be used at a reduced dose, and fortekor is also mentioned.

All three are mentioned on Tanya's site.
 
It looks like Fortekor is for advanced stages.

Yes - buprenex is a synthetic opiate. I was concerned about using it too, but my vet said they use it long term with no ill side effects - other than the goofiness it induces and I don't like that. It's better than being in pain though. I'm trying to do more research on it though because I still have concerns.

We are just in the beginning of declining numbers. I'm just wanting to prevent further decline because it will suck for Gus. He already has so many problems - most of which are manageable at the moment. I don't want to add another log to the fire.
 
Ok...I just got off the phone with the vet who owns the clinic where I took Gus and this is what we are going to try:

Calcitriol twice a week and then Gus has to get tested at 1 week and 1 month to see how he is doing. This is for

Cerenia for inflammation and pain for 4 days every day and then reduce the dose until he is eventually at 2 times per week.

She said if the cerenia helps with pain and inflammation then we could take him off the buprenex and only use it if he has a bad day and needs it.

She told me to leave his food as it is because his phosphorus levels are at 3.6 which is normal.

She said I could do fluids if I wanted, but she didn't feel they were necessary at this point and she said she wouldn't recommend more than twice a week. I think I will hold off and see how all these other things work for him right now. I can always decide to do it later.

Thank you everyone for suggestions and help. Sometimes all of this gets so overwhelming.
 
My female, Tjejen, which I once was diagnosed with severe kidney failure. She only lived a half year from there. This year it is 10 years since she's been gone.

But the youngsters, Gustav, 7 and Simba, 6 at that time, are now 17 and 16 (Simba the diabetic) and so far have fine kidneys. But I take it day by day, knowing how fast things can change.


Hpefully your kitty will live many more years.
 
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