Harley's vet visit

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Rob & Harley (GA)

Rob & Harley (GA)

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I'm so sad.

The last time I cried all the way home from a vet visit was when he was dx with diabetes, but then I found this site and I knew that it would be ok because it was manageable.

Today I found out that Harley is now a Kidney Kitty too. While I know that this isn't an immediate death sentence I also know that this is one of those a ha moments when you realize that the timer is ticking. He has been my buddy for the last 15 years, never asking anything from me except love, which I hope I have fulfilled my end of the bargin.

So now we start Phospherous binders and something else that I can't remember because my head is pounding. The vet switched our insulin to Lantus to be able to keep him in better numbers for more hours in the day. I have a personal Lantus guru, Megan, from his office who will guide me through the switch for the next 6 weeks.

I'm going to go suck down that second glass of wine now.
 
Oh Robin, I am so sorry to hear that Harley has kidney problems. But I know what a great Mom you are and you will continue to care for Harley as you always have and keep him content and well.

As with the diabetes, I imagine once you talk to other kidney cats' parents, it will seem more doable and you will have support and help.

Hugs to you and sweet Harley.
 
Rob & Harley said:
I'm so sad.

The last time I cried all the way home from a vet visit was when he was dx with diabetes, but then I found this site and I knew that it would be ok because it was manageable.

Today I found out that Harley is now a Kidney Kitty too. While I know that this isn't an immediate death sentence I also know that this is one of those a ha moments when you realize that the timer is ticking. He has been my buddy for the last 15 years, never asking anything from me except love, which I hope I have fulfilled my end of the bargin.

So now we start Phospherous binders and something else that I can't remember because my head is pounding. The vet switched our insulin to Lantus to be able to keep him in better numbers for more hours in the day. I have a personal Lantus guru, Megan, from his office who will guide me through the switch for the next 6 weeks.

I'm going to go suck down that second glass of wine now.
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I'm so sorry, Robin. I know how in shock I was when Tabriz was diagnosed at only age 10. I took him to the vet thinking he had diabetes (drinking tons of water and peeing lots) and got a diagnosis I never expected. I thought the world was ending.

Kidney disease is also manageable though. Really. On the Yahoo CRF list we've got cats that have lived for many years (8 or more) after diagnosis. It also is one disease I unfortunately know plenty about. If there is anything I can help you with, please feel free to ask.

What were Harley's creatinine, phosphorus, and BUN levels? That will tell a lot as to how early he is in the process. What binder did the vet stick him on? I swear by Dr. Nagode's protocols. They worked amazingly well for Tabriz and for many others on the renal failure lists. If you want links, let me know.
 
I' m so sorry for you.

You are such a rock for so many of our DM kitties, and I hope so much someone can provide you that same support with the CRF. I can relate totally , to the tears because you know the timer is ticking.

I had a 10.5 year old FeLk+ cat that started having kidney problems. She was pretty much asymptomatic for the FeLk her entire life, so when her issues developed we treated the kidney problems as CRF-- not knowing it was the FeLk. So, for 4 months we went down the kidney path.

It is a very manageable disease, and for some reason I have an idea you will figure it out and be great at treating it.

Phosp. binders and sub Qs are 2 great tools in treating CRF. I was a member of the yahoo CRF group ---- a great informative group.

What were Harley's CRT and BUN?

I am certain you have fulfilled your end of your bargin with Harley-- and now you get to do a little more for him.
 
I can't sleep.

Thank you for all of your kind words. Especially Michele & Peeps, with all that you are going through right now, to offer us help means soooooo much.

Harley's BUN is 66
Phos 4.9
Creatin 2.9 up from 2.6 in October

Harley is his same inquisative comical self. His ritual of stretching and sticking a claw into the end of the sofa and pulling before he jumps up next to me continues and only reminds me that some day my furniture willl be perfect and I will hate that day.

Sorry, my eyes is leaking too much.
 
Oh Robin, I am so sorry to hear you have to deal with another issue with Harley. I know you will do a great job tho, you are an awesome momma!
Digital hugs and good vibes comin you way, now and always. xoxoxoxoxo
:YMHUG:
 
Oh, (((((Robin)))). I know this is caught you by surprise, but you can definitely get through this with Harley. I think someone else mentioned the yahoo site. I believe a lot of our members are on that support group as well and those kitties do very well.
I'm sorry, I just woke up and haven't had my coffee yet so this probably isn't coming off as supportive as I want it to...
(((Robin & Harley))))
 
Kitty's CRT was 2.3 before starting the sub Qs (100 mls every other day) and her BUN was 81. After one month of sub Qs and no other changes her BUN dropped to 51 and CRT was down to 2.0. I am sure you know this but, the BUN can be influenced by diet (last few meals--protein content) and hydration.

It has always been my understanding, that CRT is the truest kidney indicator.

When my FeLk cat was on the CRF board with CRT levels of 2.6 --- Many felt like we were way to early to the party.

I can't remember much about Tripod's (3 legs- that's another story) phos. levels, but we were on binders.

I think you are early and will realize there is a lot of help for Harley. I think you will feel better once you search out the numbers.

Don't plan on getting any new furniture anytime soon, I think Harley will be scratching it for awhile.
 
I couldn't help but go look up Harley's values. It looks like the phosphorus is okay-- from what I read it appears you want to keep it below 6. Some protocals do not start binders until then. See, you are already ahead of the curve on that.

It appears he is considered more renal insufficient than renal failure-- just like Kitty.

I also read that normally sub Qs are not started until the CRT is at 4. My vet started Kitty on them at 2.3 as a preventive.

You and Mr. Harley are going to be just fine.
 
Ohhhh Robin!!

Harley is going to get through this! You're going to have plenty of more times to go get him food in downpour situations!! And when the leaves are falling from trees! And while it's snowing!! And when the buds are just coming out on trees!! And more downpouring!! And since this is MN, more snow!!! And then you'll go on a terribly hot day!! And then more snow!!! And maybe even quite a few New Year's Days!! And so on!!!

Lots more time with Harley!! LOTS!!!
 
So sorry about Harley's diagnosis, but it sounds like this was caught early and very treatable.
I know you will manage this just like you have his diabetes and there will be lots more sunny days and quality time for you and Harley.
It is shocking when we learn our beloved companions have a serious illness and we feel the tug of time slipping by. But I do think he was diagnosed early and he will still be with you for a long time.
 
kse said:
I couldn't help but go look up Harley's values. It looks line the phosphorus is okay-- from what I read it appears you want to keep it below 6. Some protocals do not start binders until then. See, you are already ahead of the curve on that. It appears he is considered more renal insufficient than renal failure-- just like Kitty. I also read that normally sub Qs are not started until the CRT is at 4. My vet started Kitty on them at 2.3 as a preventive. You and Mr. Harley are going to be just fine.
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There are a variety of protocols for binders as you say, but on the Yahoo list we usually shoot for keeping it as close to 4 as possible, which is the lower end of the range. In my opinion 6 is WAY too high. There are a number of scientific studies that show that controlling phosphorus levels is one of the most important things you can do. At Harley's levels I'd definitely suggest a low level of binder, preferably aluminum hydroxide, since it is far more effective than the epatikin that most vets want to sell you (it is cheaper too, and can be obtained without a prescription). I used Dr. Nagode's protocols with good success, and that seems to be what people follow on the Yahoo lists too. He suggests more binder than some, but I never had issues with Tabriz's phosphorus getting out of control after I started using them. We were getting nowhere controlling it using less, but we also had a long way to come down too. You can read more about the protocol here: http://members.bellatlantic.net/~vze2r6 ... inders.htm. This section at Tanya's site discusses it too: http://www.felinecrf.org/phosphorus.htm.

Most cats can drink sufficient water on their own until the creatinine gets above a certain level. Tanya's CRF website and the Yahoo CRF list generally don't recommend subQ treatment until the creatinine is 3.5 or higher. Once a cat has an acute insult though (from acute renal failure, or a "crash") then giving subQ fluid even at lower levels may be required. Tabriz needed them even with a creatinine below 3, but we didn't start using them until after his crash when he had a creatinine of 12.4, BUN over 200, and phosphorus over 20. He was a mess, but we got it under control. I used a baby scale in addition to scruff tests on Tabriz to ensure he was adequately hydrated. While it is important to pay attention to hydration, but overhydration is also not a good thing either, especially if the cat has any heart issues. Hydration is also very important for pancreatitis cats because dehydration is pretty common. In Tabriz's case we found out later he had pancreatitis as well, and my guess is that is what actually triggered his acute crash but we'll never know. I wasn't using binders or checking hydration before then because I didn't know any better. Great information on fluid therapy here: http://www.felinecrf.org/sub-cutaneous_fluids.htm.
 
Rob & Harley said:
I can't sleep. Thank you for all of your kind words. Especially Michele & Peeps, with all that you are going through right now, to offer us help means soooooo much.

Harley's BUN is 66
Phos 4.9
Creatin 2.9 up from 2.6 in October

Harley is his same inquisative comical self. His ritual of stretching and sticking a claw into the end of the sofa and pulling before he jumps up next to me continues and only reminds me that some day my furniture willl be perfect and I will hate that day.

Sorry, my eyes is leaking too much.
Click to expand...

Robin, you caught this early! That's good news, really. Harley has an okay BUN/creatinine ratio for a cat being fed a non-renal diet, but his phosphorus is a little high so adding a binder is a good idea. I hope the vet gave you aluminum hydroxide to use? It should be relatively easy to get it down to 4 at his current level. Just keep checking hydration and you should be fine. He's not a level where I'd think subQ fluid or other treatments would be needed really. If you can get him on a lower protein food that might help, but with diabetics it is tough because the only way to do that is to go higher on carbs or fat. What I'm probably going to do with Shaikha (who also appears to have renal failure now; we'll confirm with tests next week) is just give her food that works for her pancreatitis and diabetes and just choose the lowest phosphorus foods I can that agree with her. There are some great food lists that give you phosphorus content in addition to carbs, protein, fat, and sodium. You may wish to check out this page: http://www.felinecrf.org/canned_food_us ... canned_usa.

I can't recommend Tanya's CRF website enough. When Tabriz crashed, I devoured that website along with anything else I could find. The more I learned, the more hope I felt, because I realized the disease could be controlled. While you can't undo the damage, you can keep it from getting worse. And amazingly, cats can do incredibly well even with very little renal function left. You are incredible with diabetes and I know you'll be just as incredible with CRF. Hang in there! It will be okay, really!! http://www.felinecrf.org/what_is_crf.htm

What always inspired and amazed me about Tabriz was how he took it all in stride. I worried, he just acted his normal cat self. Sounds like Harley is doing the same. :) cat_pet_icon
 
Robin, I am sorry to learn this news, but even tho it feels like he is dying now, he is not! True, it is another thing for you to deal with, but there are lots of helpful people around who would love to be able to help you as much as you have helped everyone else! ((((Robin)))). I feel in my heart that you will have lots more loving time with Harley.
 
Wendy-- after reading your comments regarding sub Qs-- do you think I should be giving them to Kitty every other day?

I am glad Robin caught this early and that there are experienced people like you to help Harley and her!

Thanks!
 
kse said:
Wendy-- after reading your comments regarding sub Qs-- do you think I should be giving them to Kitty every other day? I am glad Robin caught this early and that there are experienced people like you to help Harley and her! Thanks!
Click to expand...

Unless Kitty is showing signs of dehydration or has another problem like pancreatitis, then probably not. Do you know how to check for hydration? Basically you pick up their scruff gently and see how quickly the skin snaps back. It should go back in place immediately. If it doesn't, they are dehydrated. I also make a habit of weighing all my cats regularly. You will see some variation in weight, but large changes should not occur. It is really hard to tell if they are gaining or losing weight by just picking them up, and changes of just a few ounces are impossible to detect (in percent, such changes are huge since cats weigh so little) unless you use a scale. When Tabriz got more dehydrated, he'd camp out by the water bowl and get really water-obsessed. His weight also dropped, so at those times I'd increase his subQ fluids slightly to compensate (and also take him for a check of renal values). If a cat hasn't had a serious insult to their kidneys though like Tabriz did, they should be able to drink enough on their own at creatinine levels as low as your cat's. Other illnesses like pancreatitis or an infection may make them less able to keep up and they may need subQ fluids then, but usually if they are healthy other than that (even with diabetes) they should be fine at lower creatinine levels with just letting them drink water on their own. I have also have fountains everywhere, which seems to encourage them to drink more. I'd never give subQ fluids as low as 2.3 though. That seems to me to be overkill. If you check hydration on your own, there really isn't any need to put them through that. Save the needles for when they are really needed. Talk it over with your vet, of course, since your cat may have particular needs that make your vet want to use fluids at a much lower level than is typical.

This page is particularly useful, I think: http://www.felinecrf.org/sub-cutaneous_ ... use_sub-qs

EDIT: I just realized that your cat is prone to ketones. That could be why your vet suggested subQ fluids since they are often given when ketones are present. I also just found some great information at Tanya's website on diabetes. She updated the site recently and I learned some things about diabetes and CRF I'd not known previously. Robin may wish to view this page as well: http://www.felinecrf.org/related_diseases.htm#Diabetes1. You all will be glad to know she provides a link to this website! :)
 
Robin I am deeply sorry to hear this. Hope it is not as bad as it feels right now.
Lori
 
Oh noooooooooooooooooooooo! Hopefully once the shock wears off you will find it is not too hard to keep under control. Like the diabetes - I know we all were devastated when we got that diagnosis, and then for many of us found it was do-able. And even led to some good things, like getting that deeper bond, learning we actually can poke w/needles & stuff, and meeting everyone here on the board. Hopefully you will discover some silver linings like that, and will be able to keep Harley happy for a long time to come! Remember, HE doesn't know he's got a new condition, he just knows there's a couch that needs to be scratched! :lol: I know what you mean though. I dread the day when my furniture will be in good condition. Furniture is meant to be ruined by kitties, IMHO! :mrgreen:

:YMHUG:
 
Thank you everyone for the comfort and all the great information, I have alot of reading to do.

I know I'm taking this harder than I probably should but it just came out of left field. He was drinking alot of water and his bg's were creeping up, he was over 200 the last few days so I thought he had another sinus infection, that's why I brought him in.

I know that we caught it early, but my vet felt bad that we didn't catch it even sooner. I know that we have plenty of time left. With many more opportunities to run across town in torrential down pours and snow blizzards to pick up cat food :-D . It just hit me like a ton of bricks. My mom died from kidney failure about a year and a half ago, maybe that's what dredged up all of the emotions.

The Phospherous Binder is Aluminum Hydroxide Powder 1/4th tsp bid, he's been eating a raw diet since last fall that the vet wants him to continue with.

I'm going to go check out Tanya's website.

I know some of you are dealing with so many more issues with your kitties than I am right now so I really appreciate your support and help.

Thanks for all the information.

Robin
 
The problem with cats and kidney problems is by the time the numbers start creeping up, they are already far along. There aren't signs unfortunately before then so nobody should really beat themselves up. The good news is that even with little kidney function cats do very well compared to humans. I've read that it may have to do with their evolutionary background as desert animals. I am sorry about your mother, Robin. I'm sure that is part of why this hit you harder. I also know with my own cats that when a new condition popped up it seemed so unfair. We'd get one condition handled and another would crop up. Life is just that way sometimes, but knowing that intellectually is not much of a comfort when you are knee deep in it.

Your vet is using a good binder and dose should be okay presuming Harley weighs about 12 lb. and your vet wishes to follow Dr. Nagode's protocols (and assuming your binder contains 300mg per 1/4 tsp, which seems to be typical). You can tweak that down a little if he weighs less. Dr. Nagode's protocols call for 50mg/lb, but Tanya's site says 25mg/lb. Just divide up the total daily dose into all food eaten. If Harley eats more often, divide it more so that all food is treated. That's the key. Binder can be a little constipating for cats, so if you notice any change in stools you can compensate by adding a little canned pumpkin to the food, as that adds great fermentable fiber. Some people need to go further add Miralax, but I never had to do that with Tabriz but I also paid a great deal of attention to hydration and I think that made the difference.

Tanya's site is wonderful, and HUGE! The one specialty vet I used heard me mention it and asked for the URL so he could check it out too. He was amazed at how comprehensive it was as well as how accurate. Things on the internet are not always reliable, but he wasn't able to find fault with the pages he looked at. He told me it was one of the "good ones" and was going to refer clients to it as a result. I wish I'd have known about it when Tabriz was first diagnosed, but I credit the site along with the Yahoo CRF email list with helping me to keep him alive despite the tall odds stacked against him after his crash a year after diagnosis. He was terribly sick then and both my old and new vets didn't think he'd survive, but he was a tremendous fighter and his mom didn't give up either. I know the same applies to you and Harley.
 
Robin, I am sure you are right, and it is your memories of your mother that are getting stirred up and making this extra difficult for you. So sorry for your loss. But I know you are strong and will take great care of Harley. (as usual!)
 
I echo Judy's comments.

Things will get easier and better. I have no doubt you will continue to be Great at taking care of Harley. He is a lucky little man!

I am very sorry for the loss of your mother.
 
Thanks guys, Harley seems to still be feeling a little punky but it is hot and humid now so it could be the heat, but I'm finally feeling better about it, I know we will be fine and will figure out our new normal soon.

Marcy, Harley started the Lantus last night and has had a great day bg wise. I've updated his ss. It's going to be a long night though, I don't trust myself to wake up to get a +4 so I decided to just stay up and get it. Gonna pop in a movie, maybe Better off Dead, I havn't watched it for ages and I heard over in Community that it is really funny, I don't really remember it but I could use a good laugh about now.
 
Robin my heart goes out to you. Very hard news to get. Reading through the posts, it looks like you have many reasons to hope as this can be manageable. Sending healing thoughts and prayers to you and Harley.
 
Hi Robin,
As you may or may not know, Latte had Acute Renal Failure with creatinine in the 10 range. It was up and down for many months and then her body settled, with creatinine ranging in mid to upper 2's the remaining 3.5yrs of her life. She received LOTS of fluids from the get go, which we continued both because of the kidneys and other health issues.
I guess my point being, a cat can live a very happy and long life with kidney issues. And, ecid. One cat may need more treatments even with a creatinine in the upper 2's. Others may not need it until its in the 4-6 range. Just like with fd, its about knowing your cat, working with your vet, and making informed decisions with good intentions. I think if you visit Tanya's group as suggested, you will see this to be true.

It sounds like you already have the binder???? If not, let me know. Its really expensive, for an amount that one cat would never go through in an entire lifetime. I have a LOT left over. Does not sound like you are starting fluids yet? If so and you would like some, I have a half dozen bags that expire in Sept, a ton of needles, and some lines. I was just going to give them to the shelter. Since we live near each other, it would be an easy exchange.

Just an fyi....Dr Polzin at the U of M is one of the top feline kidney specialists in the country. I think the best thing I ever did for Latte was pay for the initial 'eval'. Once you are connected, the cost is not really any more than other vets, and you have a wealth of knowledge at your finger tips day/night. I used him for 4-8 month rechecks, and more serious concerns our vet couldnt address. They work with your regular vet, too,

Let me know if you need anything. Im just a hop skip and a jump away!
 
I'm so sorry to be reading this....haven't read through all of it but I know you will do the best you can for Harley!

:YMHUG:
 
Oh Robin!

I am so so very sorry to hear that .
Just try to take it one day at a time and you are such a great mom
and great friend to all of us,
I am sure you will do whatever needs to be done

Try to stay strong
You are both in my thought and prayers

Denise and Shakes
 
Hi Carolyn,

I do remember, I remember the night you joined our group because you were local, so I have followed you and Latte on your journey. You took such good care of her.

Yes we have started the Phospherous Binders but not the fluids yet. The vet mentioned that we would have to start fluids someday but for right now his hydration is ok. I will take you up on your offer for the fluids and equipment though knowing we will need them in the near future. Thank you so much, every little bit helps.

I'll look into the U of M. I've been doing alot of reading this weekend.

Again, thank you.
Robin
 
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