? Cronic Kidney Disease - Is this the beginning?

Hi all! It's been quite a while since I've posted here. Mochi has been doing well and is still OTJ, but we have a new hiccup. His BUN was a bit high and he's lost some weight. I've updated his sheet with the most recent labs. The Vet is concerned that this could be the start of CKD mostly, I think, because of the RenalTech result (as follows):

This patient's RenalTech status indicates that it will develop chronic kidney disease within the next 24 months with greater than 95% accuracy.
Suggested Follow-Up: Within the next 3 months, and every 3-6 months thereafter, perform a complete evaluation of kidney function to evaluate the patient's progression toward developing chronic kidney disease. It is recommended that a minimum database including a chemistry panel, CBC, and urinalysis are performed. Additional diagnostic testing and imaging should also be considered to investigate for comorbidities and underlying conditions that may contribute to the development of chronic kidney disease, including hyperthyroidism, diabetes mellitus, cardiomyopathy, and systemic hypertension.
The International Renal Interest Society (IRIS) has guidelines for the diagnosis, staging, and treatment of chronic kidney disease.
Visit the website http://iris-kidney.com/ for more details.
For more information, please see: https://antechdiagnostics.com/RenalTech
​

The vet is supposed to be calling me back sometime soon to discuss "options of supportive care and other diagnostics" I'm afraid he'll want to put Mochi on a "prescription" food.

He lost his 'voice' about three weeks ago for a few days. Don't know if that could be related to anything? Since then, he's been an extra picky eater, going on mini hunger strikes (never more than half a day or a day at most). Yesterday was one of those days where he didn't eat until late evening. He has IBD and a benign heart murmur. He vomits frequently. Last time was Monday and then a little bit of clear/foamy vomit yesterday (before he ate). There was white foam in with the food Monday as well. No increased thirst. No increased peeing.

He mostly eats Lotus Just Juicy Venison (11 carbs, 263 phosphorus per the chart, but he does well on it) and a bit of Young Again LID Zero Mature. A month or two before the appetite change I had switched him to Dr. Elsey's Clean Protein (salmon) kibble, which he likes a lot better but I wonder if that's not the reason for his sudden pickiness & digestive issues?

Any insight would be appreciated.

Thanks!

 

Easy way to find out is to remove it from his diet and see if it makes a difference! Sometimes there can be some ingredient that just doesn't agree with them

 

The bag is almost empty and I don't plan on getting any more. I don't know why it would take more than a month to start causing issues though?

 

Which lab was used? There’s protein in his urine that could be a one time thing but I’d check that again when next labs are done. Max also had a benign heart murmur checked by a cardiologist when he was 14. At 19 he developed CHF not related to the benign murmur. So watch for any changes such as reluctance to jump, decreased energy, coughing, or episodes that seem like asthma. It’s also good to see what the sleeping respiration rate is once in awhile so you see what’s normal for Mocha. The protein in urine was tested and not an issue for Max. . It was there on and off. So if it’s in the next test have them run the test to check if it’s anything you need to treat. Max did have high blood pressure years before he developed CKD. I asked to have it checked to get a baseline and my vet and I were both surprised he had it as he didn’t have CKD or diabetes at the time. Just things to watch for that may not apply to Mocha at all. These early diagnosis tests were not available when Max was younger. I hope the next tests are normal which they very well could be.

 

Hi!

We had a kidney kitty named Marlin. I'm not an expert by any means, but from I can remember... Lack of appetite, nausea, vomiting is a common symptom (amongst others). Marlin received appetite stimulant that can be given that helps to get the kitty eating again. We also gave sub q fluids (but caution if Mochi may also be in a heart failure stage), IV fluids at one stage, medications and a vitamin supplement named Renal Pro. Often, vets will recommend a low phosphorus, lower protein diet, because lowering the protein can help lower the amount of wastes in the bloodstream - which would make the kidneys job a little easier. With a remission kitty, I imagine that may be more challenging. I have found from our OTJ cat Elie that vets are really scared to change much of anything. They treat them like glass LOL. (Elie was a 22lb Maine coon).

I hope it all goes well!!!!

 

You can get all the info on kidney disease at tanyascrf.org.

 

I'm tagging @Marje and Gracie -- she's great with labs and many medical issues.

Tanya's is a great site for information.

It looks like you have the labs on Mochi's spreadsheet. I'm more familiar with SDMA as a predictive test for kidney values. I have no clue what Antech does. SDMA is an IDEXX test. (If you look at the IRIS staging, it's based on SDMA.) Also, were the labs done based on Mochi having been fasted? FWIW, the IRIS staging also suggest 2 tests.

Plenty of cats survive for a long time if you catch kidney disease early and manage it. Mochi's phosphorus is normal. You'll see on Tanya's list that you can lower the phos in food using a binder. I will leave it to Marje to fill in whether a binder is needed, but I don't think so.

 

I agree that a binder is not needed at this time. You want it under 5 and it’s well under that.

 

I am unclear as to what you are asking for? The name of the test, or the name of the lab that ran the tests? For the former, the name of the test is included in the text I quoted. RenalTech is basically an algorithm based on historical lab results. (I have just received all of Mochi's previous labs and am working on adding them to his sheet). For the latter, I have no idea. It's not stated anywhere on my copy of the results.

Well, I was pleasantly surprised that our vet didn't want us to change food just yet. And, yes, it seems to be because Mochi is in remission and OTJ and that is "such a rare thing" that he doesn't want to mess with it.

Yup! I had already found that website. Thanks! Now I just need to wade through everything.

No, he wasn't fasting at the time of the most recent lab draw.

The vet wants me to purchase a baby scale and weigh Mochi weekly because he is concerned about the weight loss (the scale has been purchased and I've added a tab for weight checks to his sheet). I am also concerned, but more because his loss of appetite and increased vomiting rather than because of the drop in weight. The vet also wants me to add an Omega 3 supplement to Mochi's food, which I will do. Looking back at his labs it appears that he had/has mild pancreatitis in addition to the (presumed) IBS. This new round of decreased appetite and vomiting makes me wonder if it's not a flare up of that?

The vet also wants a repeat urinalysis at the end of November.

 

I was asking for the name of the lab or if tests were run in house. The different labs have different ranges for the tests. I saw the names of the tests.
Max had chronic pancreatitis and that can cause elevation in some of the results.

 

Nordic Naturals makes a high quality omega-3 that is available for pets.

The vomiting may be related to his IBS. Take a look at this site or Raw Feeding for IBS Cats. Even if you don't use a raw diet, their information on supplements, novel proteins, etc. is excellent.

 

Tanya's website seems not working. Don't know what happened.

 

Looks like tantascrf is being updated. It says will be back on the end of July so should be very soon.

 

@Mochi & Me I belong to Tanya's kidney support group it's working
Here is the link if you want to join, and yes I see the other one will be back the end of July
https://tanyackd.groups.io/g/support