Civie with CRF/Hyperthyroid

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CamiF

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Hello,

Buddy, a civie, has been hyperthyroid for a couple of years and taking methimazole. We have known he was borderline CRF for a while, but the numbers are such now that the vet wants to add benazepril. I actually took him to a vet school in my state to get a 2nd opinion, and here are the results of testing there:

Here are the results from 2/17:
Blood Pressure, 150 mmHg
CBC, No significant findings
BUN, 41
Creatinine, 2.8
Urinalysis, 1+ Protein, SG 1.026
Urine Protein/Creatinine Ratio---.33
T4--1.4 (NOTE: WE ARE HALVING HIS THYROID MED DOSE AFTER THIS RESULT)
Ab Ultrasound: Small right kidney, one hypoechoic nodule in liver; hyopechoic left pacreatic lobe

I had a few questions:

(1) Prescription Food: Suppose Buddy eats this 1x daily and regular food 1x daily. Why would that not lower the protein and phosphorous by 50% as compared to no prescription Rx? Why does it have to be all prescription food or nothing? He is VERY picky and VERY skinny and pretty much always has been. This is an important issue. I am really stressed about the prescription food because he has not received it well yet. Food is very important to Buddy, and he used to enjoy bits of meat like turkey or chicken or tuna, and it is hard to imagine that he cannot ever have these treats!

(2) B12 Injections: Would a B12 pill work, or must it be an injection? He is not prescribed sub-Q at this point, and taking him weekly to the vet for this B12 shot would be very stressful to Buddy.

(3) Benazepril: He has been prescribed this 1x daily. I have not tried it yet. We had a trip planned for the end of March which would have us gone over 24 hours. Can this be skipped at all or would that cause ramifications?

(4) Sutures: This is a little off topic, but Buddy had dental extractions in November. I have one vet telling me that some cats that are older do not dissolve them quickly, and I have another vet telling me they could be irritating his mouth. Any thoughts? Do some cats have sutures this long after dental work?

Thank you!!

Cami and Buddy :)
 
CRF kitties really do not absorb B12 that well in the GI tract. That is why the injections are recommended. You can google for the B12 and buy it online and give the injections yourself using insulin syringes. It is not expensive at all. You may need a script. I give them to two of my kitties.

The though is that low protein is really not that necessary. What is necessary is low phosphorous. Do you have the phosphorous level and the range? You want to keep it in the lower part of the range.

After ten days or so the sutures can be removed if no already gone. They van be very irritating. At least ones that I had were.
 
I have been dealing with this issue in my civie for nearly 3 years now- we do not use the prescription food (he simply won't eat them). I just choose lower phos options when possible. He is also very very thin, and with his advanced age (he turns 18 in 2 wks) I am mostly just concerned with him eating anything, so the phos/protein issue is pretty much moot these days... I keep meat baby food on hand for times when he will eat nothing else. Currently he enjoys a mix of organic all meat turkey cat food with fancy feast blended together in my mini food processor.

We also manage his hyper-T to run slightly higher than if he were just hyper-T- that seems to keep his kidney values more stable... Per the B12. Injections are necessary, at least in my book- but it is easy to do at home. I use an insulin syringe so that he barely even notices the weekly shot. The one I use is for sub-Q or IM so I give it sub-Q.

We use norvasc for his high blood pressure- it works very well and is indicated for use in CRF kitties as it doesn't seem to harm the kidneys as much as some others (enalapril for example).

My vet and I both believe strongly in treating the whole cat, not the disease(s). It has worked very well for us over the years. If your civie won't eat the prescription foods, don't push the point- just feed him the best options that he WILL eat- and treats are fine, especially meat based ones.

I hope this helps...
 
Thanks to you both!! As to his phosphorous, it was in the normal range. I have another question: I noticed benazepril can cause decreased blood pressure as a side effect, which can potentially be hazardous. Why would I give this to him if his blood pressure is normal? Wouldn't that be later in the game when his blood pressure is too high because wouldn't something that lowers BP in the normal range make him TOO low? I will look into the B12 shots. Having had a diabetic kitty, that will be no problem to me.

Cami & Buddy
 
Hi Larry, found my labs, and phosphorous has been between 3.8 and 4.9 every test taken within the last 6 mos. It was actually higher previously and now is 3.8. Isn't that a pretty good number?
 
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