Civvie with CKD

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Acadaca

Acadaca

Member Since 2021
My civvie was diagnosed with CKD a couple of days ago. I haven't been able to speak with the vet (someone has had an initial conversation on my behalf), but I received the bloodwork results today. I am planning on emailing the vet with some questions, but was wondering if anyone could offer some insight first. I feel it best to go into the situation with some information and have tried to look at the felinecrf.org website and am still finding it confusing (likely just because I am trying to process everything).

She's 18, has no behavioural changes other than water consumption. I haven't been able to figure out her litter box activity because both the cats have decided to use both boxes. She gets really upset going places or really being touched by people other than myself so I am loathe to bring her to the vet again unless absolutely necessary.

I know I have to make some diet changes (she shares all the LC FF and Friskies Pates with FCC). I've attached the bloodwork and would greatly appreciate any feedback.

Thank you.
 

Attachments

Thank you both. I've been sifting through the site for a couple of days now and I'm still working on understanding a lot of it.

I know that information is key and it is so wonderful that people have worked so hard to make it available. I do wish my brain parsed these things a lot more easily than it does.
 
Hi Acadaca,

I'm really sorry to hear about your civvie's CKD diagnosis. I'm not used to reading labs in mmoL, but it doesn't look like the creatinine and BUN levels are that high, which is all good news. CKD is very common among older cats. Curious to know what kind of diet the cat eats--given your experience with FCC, she's probably eating a good LC wet diet.

Ruby had early stages of CKD but it's become diet controlled since we switched her to raw food in February. Her recent kidney values look like those of a cat with normally functioning kidneys. Have you ever thought of trying raw? I wrote a whole thing about raw feeding here:
https://www.felinediabetes.com/FDMB/threads/raw-feeding-senior-kitties.248460/

There are also a lot of good low carb, low phosphorus premade foods you can try by Weruva. I have a Weruva tab on Ruby's SS with ones good for CKD--they have an asterisk next to them. What you are looking for are foods that have less than 250 mg of phos per 100 kcal, or less than 1% phos on a dry matter basis.
 
Hi. Sorry for the potential ckd. The urine was dilute so it’s likely. Did your vet say anything about the possible anemia?
 
Katherine&Ruby said:
Hi Acadaca,

I'm really sorry to hear about your civvie's CKD diagnosis. I'm not used to reading labs in mmoL, but it doesn't look like the creatinine and BUN levels are that high, which is all good news. CKD is very common among older cats. Curious to know what kind of diet the cat eats--given your experience with FCC, she's probably eating a good LC wet diet.

Ruby had early stages of CKD but it's become diet controlled since we switched her to raw food in February. Her recent kidney values look like those of a cat with normally functioning kidneys. Have you ever thought of trying raw? I wrote a whole thing about raw feeding here:
https://www.felinediabetes.com/FDMB/threads/raw-feeding-senior-kitties.248460/

There are also a lot of good low carb, low phosphorus premade foods you can try by Weruva. I have a Weruva tab on Ruby's SS with ones good for CKD--they have an asterisk next to them. What you are looking for are foods that have less than 250 mg of phos per 100 kcal, or less than 1% phos on a dry matter basis.
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Thank you. When I was looking at the results and trying to figure it out I was thinking she would be in Stage 2, but I'm really not very good at understanding these kinds of numbers. I am also not sure how useful it is to assign a stage to the situation, but that is something I am reading more about. I think I am just looking for a time frame so I can brace myself. I'm pretty happy that she seems to be fairly content at the moment.

She is eating Fancy Feast and Friskies pates, but I have previously snuck her some of the gravy ones as well since she loves gravy and has always been on the skinny side. I am on a bit of a budget, but know her new food will likely be more expensive. Your post about raw food is really informative. I'm not sure I would be able to do it. I've been a vegetarian and then a vegan for decades and am not great around raw meat. I will have to reflect. I think it's amazing that you managed to control Ruby's CKD that way.

I appreciate the food information and will look at your SS. It is helpful to have that breakdown. All the vet said was low phosphorous, low high quality protein. Thank you so much for your feedback.

tiffmaxee said:
Hi. Sorry for the potential ckd. The urine was dilute so it’s likely. Did your vet say anything about the possible anemia?
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Thanks. He did say he thought she was anemic and from the stuff I have been wading through it sounds like that has the potential to be as dangerous as the CKD. I was going to run it through the vet in my email and then order some pet-tinic. I am still trying to sort out what other supplements she might need. I've changed clinics so I am hoping they will be helpful and welcome the questions. He hasn't really given me much information yet, but am hoping that his reply will contain more. I don't think Typewriter would let me near her with a needle so things like fluids/vitamin b shots are off the table. She was fully sedated for her blood work.
 
She would not need fluids at this point. I had ate h come and help me with my first cat that needed fluids. Her technique was different and I was able to give them to her. If you look at Tanya’s crf food list you will find some lower phosphorus foods that are also not super high in carbs. Since your divvied isn’t diabetic and it’s early I don’t think it will be hard to find a better food than the RX. I didn’t like Pet Tinic because it contains sugar, and it’s missing some key ingredients but I don’t recall what. I’d try B complex and B12. With early ckd it’s surprising she would be anemic so I’d want to run the labs again in a month to double check.
I just looked again and the HTC is really low. That doesn’t usually happen until later stage ckd and with her bun and creatinine doesn’t fit.

Ask about the liver enzymes too. Was civvie having a pancreatitis flare?

,
 
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tiffmaxee said:
She would not need fluids at this point. I had ate h come and help me with my first cat that needed fluids. Her technique was different and I was able to give them to her. If you look at Tanya’s crf food list you will find some lower phosphorus foods that are also not super high in carbs. Since your divvied isn’t diabetic and it’s early I don’t think it will be hard to find a better food than the RX. I didn’t like Pet Tinic because it contains sugar, and it’s missing some key ingredients but I don’t recall what. I’d try B complex and B12. With early ckd it’s surprising she would be anemic so I’d want to run the labs again in a month to double check.
I just looked again and the HTC is really low. That doesn’t usually happen until later stage ckd and with her bun and creatinine doesn’t fit.

Ask about the liver enzymes too. Was civvie having a pancreatitis flare?

,
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Thanks for checking. I will look for a more appropriate source of vitamins than Pet Tinic. I was thinking of trying a phosphorus binder too because there will be times when she gets into FCC's food. I can keep him away from hers, but I don't think I will be able to take away the spoonfuls here and there that I leave for grazing. I'm still working on ways to solve this. Luckily her appetite is still very present.

I will be sure to ask about the liver enzymes. No pancreatitis as far as I know, but she hadn't been to vet in some time. She's presented herself as healthy until her water bowl behaviour changed. I have never met a cat who seems to find being taken places (like the vet) to be so traumatic. It breaks my heart to do it. I have all fingers and paws crossed that she will take to new food.

Katherine&Ruby said:
Low protein is old school thinking when it comes to CKD. Older cats need high protein to avoid muscle wastage. Focus on keeping the food low phos.
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I will take the cumulative advice that you guys offer to heart diet wise and pursue that option.

Bron and Sheba (GA) said:
Not sure @Marje and Gracie got the tag re the path results so I’ll send it again.
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Thank you so much.

I really appreciate everything that all of you guys have said.
 
Katherine&Ruby said:
Yeah. Many of us have cats that need to lose weight, but it’s important to maintain weight as well, especially if she’s 18. High quality, easily digestible protein helps with that.
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My civvie is the polar opposite of FCC and very skinny so I definitely don't want her to lose any weight.

I'm still reading about food, but could anyone explain what determines a high quality protein? So far I am just going by nutritional breakdown.
 
Acadaca said:
what determines a high quality protein
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Sorry to say this, but Fancy Feast and Friskies pates probably do not contain high quality protein, as they increase their protein percentages with things like by products that count as protein but are not as nutritious. Weruva and Tiki are some of the oft cited brands for CKD kitties that are also low carb. Both are independently owned companies with high standards for their ingredients.
 
Katherine&Ruby said:
Sorry to say this, but Fancy Feast and Friskies pates probably do not contain high quality protein, as they increase their protein percentages with things like by products that count as protein but are not as nutritious. Weruva and Tiki are some of the oft cited brands for CKD kitties that are also low carb. Both are independently owned companies with high standards for their ingredients.
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Yes, thank you. I have written down all of the Weruva varieties that you have in Ruby's spreadsheet. I know she needs different food, but the quality protein confuses me a little. I had assumed that it would be a type of meat, but quickly realized that wasn't the case. Is it just a matter of getting the brands that are listed (and starred) both on Ruby's spreadsheet and other CKD suggestions? I don't want to feed her super high carb food because I know it's not a great source of nutrition, but I'm not as worried about the civvie when it comes down specific percentages. I wasn't sure if there was something particular about the protein I should be looking for. From your post I assume it is to try and avoid by products?
 
Acadaca said:
I assume it is to try and avoid by products?
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Yes. Both Elise and I feed our cats raw, so when we say high quality protein we mean muscle meat, so avoid ones with by products or organs like liver, and look for foods that are at least 35% protein. There's no need to restrict protein to less than that unless the CKD progresses beyond IRIS Stage 2, then there is arguably a case for it. Renal foods make up for the protein by increasing carbs and fat, so phosphorus binders could be added to higher protein foods if phos levels are too high in bloodwork.
 
Katherine&Ruby said:
Yes. Both Elise and I feed our cats raw, so when we say high quality protein we mean muscle meat, so avoid ones with by products or organs like liver, and look for foods that are at least 35% protein. There's no need to restrict protein to less than that unless the CKD progresses beyond IRIS Stage 2, then there is arguably a case for it. Renal foods make up for the protein by increasing carbs and fat, so phosphorus binders could be added to higher protein foods if phos levels are too high in bloodwork.
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That makes a lot of sense. Thank you. I haven't yet read anything about avoiding organs so that is really good to know.
 
Acadaca said:
That makes a lot of sense. Thank you. I haven't yet read anything about avoiding organs so that is really good to know.
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Nothing wrong with organs, and in fact cats need the Vitamin A they supply, but often they are used as a less expensive source of protein than muscle meat and cats like the smell and taste like fish.
 
I ended up emailing the vet and figured if I was lucky enough to get some feedback from Marje and gracie I could do a follow-up. He didn't really answer my questions and just said feed both your cats Hills MD (I assume he skipped over the fact that one of them is a diabetic, but it was just a brief mention). He said if I wanted other options I could do bi weekly B12 and iron shots. I'm rather disappointed, but this just reiterates how valuable you guys are and how much I truly appreciate you.
 
I speak Canadian labs. :cool: What time of day was your vet appointment? Her USG (urine specific gravity) is low and shows she's not concentrating so that goes with the other bits of evidence in the bloods to show some kidney degradation. USG tends to be lower later in the day when they've been eating/drinking more. First thing in the AM urine is more concentrated. If you want to see what that would be, if you can capture some pee at home, you can take it in and they can do an in house test on it.

As others have said, lower phosphorus food options would be good to start introducing into the diet. And you can water it down so she's getting more fluids in her food. Neko got to the point I could not give fluids due to her heart condition, so fluids via mouth was all I could do. I'd also ask the vet about the liver and what he thought might be causing the anemia.

Great article find @Katherine&Ruby ! That also brings up the topic of blood pressure testing. Probably a good thing to do if they can. Though if she becomes fractious at the vet, it might not be that valid. Neko went sky high at the vet the first couple times we tried getting BP.

Another possible follow on is a consult at CanadaWest Vet with an internal medicine vet. A bit spendy but they know way more on CKD and aren't married to vet foods. Neko's IM vet was a fan of me feeding her raw.
 
Wendy&Neko said:
I speak Canadian labs. :cool: What time of day was your vet appointment? Her USG (urine specific gravity) is low and shows she's not concentrating so that goes with the other bits of evidence in the bloods to show some kidney degradation. USG tends to be lower later in the day when they've been eating/drinking more. First thing in the AM urine is more concentrated. If you want to see what that would be, if you can capture some pee at home, you can take it in and they can do an in house test on it.

As others have said, lower phosphorus food options would be good to start introducing into the diet. And you can water it down so she's getting more fluids in her food. Neko got to the point I could not give fluids due to her heart condition, so fluids via mouth was all I could do. I'd also ask the vet about the liver and what he thought might be causing the anemia.

Great article find @Katherine&Ruby ! That also brings up the topic of blood pressure testing. Probably a good thing to do if they can. Though if she becomes fractious at the vet, it might not be that valid. Neko went sky high at the vet the first couple times we tried getting BP.

Another possible follow on is a consult at CanadaWest Vet with an internal medicine vet. A bit spendy but they know way more on CKD and aren't married to vet foods. Neko's IM vet was a fan of me feeding her raw.
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The appointment was at 1:30 in the afternoon.

I am going to email the vet about the anemia again, but when I asked what I could do about it he just said the Hill's would help and to do the iron shot if I was worried.

When I think about catching Typewriter's urine I can just imagine the bloodbath that would ensue (my blood). I do know one of the spots in the litter boxes she likes to go so maybe I could create a trap. If I did manage to do that, what would the concentration tell me if I caught it earlier in the day?

We're auditioning some foods and hopefully will find something she likes. I am trying to be as cost effective as possible so that I can save for further vet care. I figure my best bet there will be to find something she'll deign to scarf down and then buy it in bulk.

I am sure her blood pressure would be out of whack at the vet. She is just so upset. I don't like that they had to use anesthesia, but don't see any other way around it when it comes to blood draws.

I will look into CanadaWest Vet. Thanks for the advice.
 
CanadaWest needs a vet referral. However, they had the skills to get a reasonable blood pressure for Neko that was not stress influenced. I also gave her Rescue Remedy before the visit, and sprayed her carrier with Feliway. Both seemed to help calm her down.

An earlier urine sample might not be as dilute, and tell you if her kidneys are working enough to concentrate it more. The bloodwork does have other indicators of early stage kidney disease, so not sure if it's worth it.
 
Wendy&Neko said:
CanadaWest needs a vet referral. However, they had the skills to get a reasonable blood pressure for Neko that was not stress influenced. I also gave her Rescue Remedy before the visit, and sprayed her carrier with Feliway. Both seemed to help calm her down.

An earlier urine sample might not be as dilute, and tell you if her kidneys are working enough to concentrate it more. The bloodwork does have other indicators of early stage kidney disease, so not sure if it's worth it.
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I used Feliway for the first time when I carried her to the vet and I do think I noticed a difference. I'll have to look into Rescue Remedy as well.

If that's the case I'll leave concocting the urine trap for another day. I don't doubt that she does have kidney disease. Not sure why the vet wouldn't give me any indication as to where she is in the grand scheme of things.

Thanks so much for your help as always. Above and beyond.
 
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