Gail & Houdini said:
My poor sweet civvie Squeak has never recovered from the UTI some months back and now he is in the end stages of renal failure. He is refusing all foods so i'm assist feeding. His Phos is really high (12) and I know that can make them feel really awful so I was wondering if the liver shake would help or if it's too high in phos or what. I've been using AD but I wondered if the liver shake would be better.....
UTIs can often cause acute failure, and the resulting insult can leave the kidneys in a more chronic form of renal failure after that (undiagnosed CRF can also lead to UTIs and then acute failure too, so it can go the other way as well). Regardless of the cause, if your cat is refusing foods you need to take action. I don't know anything about a liver shake (I'd guess it is higher in phosphorus though since liver is:
http://www.mcw.edu/display/ClinicalServ ... atient.htm), but I know tons about renal failure, having nursed one cat through it for many years after they said he would "die in a month or two."
Don't get hung up on a stages or numbers when it comes to renal failure. My cat was "end" stage for three years and lived a good quality of life. The key is good treatment. Follow the links someone posted in the forum. I especially recommend the Yahoo CRF list (PM me for a link) and Tanya's CRF website (also in those links). Between the two of them, they saved Tabriz's life. When he was first diagnosed, he had chronic renal failure but was judged at having maybe 20% of function left at best. My vet said he was dying so I gave him renal food and waited for the end, thinking I couldn't do a thing. I knew nothing about phosphorus binders, potassium supplements, or other common treatments used. A year later (!) he finally developed acute failure because I didn't know about fluid therapy or other treatments. His appetite had fallen off and he got very sick over a Memorial Day weekend, but thinking this "was the end" I didn't know better. By the time I got him to a new vet (we'd moved by then) after the holiday they were not sure he'd make it. He survived with IV fluids, a feeding tube, and lots of love, but my education in renal failure began -- with a vengeance. I wish I'd had known all I learned in just a few short weeks about how to treat renal failure a year before, as I probably could have prevented the damage the acute failure caused.
If your cat's phosphorus levels are high, you need to get those down with a binder, preferably aluminum hydroxide in powdered form. There are a ton of links that help with dosing that, but most of the people on the renal failure list use Dr. Nagode's protocol. I credit that also with saving his life. You can read more here:
http://members.bellatlantic.net/~vze2r6 ... inders.htm.
Do check to ensure that Squeak is really over the UTI. Cultures don't often work well on CRF cats, so you may need to get him on an antibiotic for a longer period than usual if it is still around. You want it gone. Also, make sure Squeak has decent hydration. If phosphorus is high, likely creatinine and BUN are as well. He may need subQ fluid as well if hydration is poor. For food, when I assist fed I used canned renal food that I diluted in water and strained to remove chunks with a mesh kitchen strainer. Worked great. At times I had to switch to other food because he also had pancreatitis and IBD, but I tried to stick to low phosphorus food as much as possible.
I assume you are using an anti-nausea drug like ondansetron? If not, that would also be a recommendation. When phosphorus is high, they get really nauseated, so drugs like that help get them over the hump. The change in Tabriz's appetite after getting him on that was like night and day. I never used appetite stimulants, just treated nausea and that worked for us.
