Jenny reyes
Member Since 2019
no i only started a few week ago i think but it is a much lower dose it is at 100 mg twice a day per someone i was talking to till i can get her to the vet
Need some help
- Thread starter Jenny reyes
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SS is now attached. More later but I’m not at home so I’ll post in the labs when I get there.
Jenny reyes
Member Since 2019
Thank u everyone for all ur help
Jenny reyes
Member Since 2019
Jenny reyes
Member Since 2019
Thank u I’m have been very worried about her
Thanks for posting better photos.
The gold standard for treating CKD is Tanya’s Comprehensive Guide to Feline CKD. As you will see there, there is a lot to learn and a lot of “moving parts” to CKD.
While there are several things that can be addressed, to me, you need to triage this and focus on getting that phosphorus down. It’s really the highest I’ve seen for where her other kidney-related numbers are. Phosphorus levels are tied to longevity so getting them down and keeping them down are critical. Right now, she is way past the number for calcification of tissues. If you multiply P x Ca, the total should be less than 70 and hers is over 180. Since her Ca level is good, the goal has to be the P bring lower.
Changing the diet will definitely help. The use of niacinamide for treatment of high P is new since my last CKD cat. I do know that some veterinary experts believe niacinamide can be effective in lowering phosphorus levels but that it’s not as good as aluminum hydroxide.
You’ll need to educate yourself on phosphorus levels and binders. While I’ve always used aluminum hydroxide and been able to keep the P levels normal below 5 in my CKD cats (but not the one that had PKD), it’s much easier to keep them low then to lower than especially from 20. You are going to have to work hard at it and have her retested every few weeks to be sure you are making progress. Because I don’t know everything about her medical history, it’s best for you to read the above links and make sure that there are no contraindications or issues for you to use aluminum hydroxide for her.
On the bright side, her calcium looks good, her potassium looks good, and her hematocrit looks good for now but you will need to keep an eye on this and you might think about starting her on the appropriate B vitamins to ward off anemia as all CKD cats will become anemic and I’d say it’s the second thing to really target.
Your vet should also be checking her blood pressure every time she’s there. It’s very common for CKD cats to have high BP and it’s easily addressed.
Her liver enzymes are a little elevated but it is really, really mild. I’d focus on the CKD and the phosphorus. I know you have limited dollars but getting updated labs will really help you.
And if you are able to, you might think about giving subq fluids at home. In the video description, I list supplies needed and sources.
I’m going to be honest with you.....this is going to take a lot of work on your part. It’s a positive sign that she is eating. Please let me know if you have questions.
The gold standard for treating CKD is Tanya’s Comprehensive Guide to Feline CKD. As you will see there, there is a lot to learn and a lot of “moving parts” to CKD.
While there are several things that can be addressed, to me, you need to triage this and focus on getting that phosphorus down. It’s really the highest I’ve seen for where her other kidney-related numbers are. Phosphorus levels are tied to longevity so getting them down and keeping them down are critical. Right now, she is way past the number for calcification of tissues. If you multiply P x Ca, the total should be less than 70 and hers is over 180. Since her Ca level is good, the goal has to be the P bring lower.
Changing the diet will definitely help. The use of niacinamide for treatment of high P is new since my last CKD cat. I do know that some veterinary experts believe niacinamide can be effective in lowering phosphorus levels but that it’s not as good as aluminum hydroxide.
You’ll need to educate yourself on phosphorus levels and binders. While I’ve always used aluminum hydroxide and been able to keep the P levels normal below 5 in my CKD cats (but not the one that had PKD), it’s much easier to keep them low then to lower than especially from 20. You are going to have to work hard at it and have her retested every few weeks to be sure you are making progress. Because I don’t know everything about her medical history, it’s best for you to read the above links and make sure that there are no contraindications or issues for you to use aluminum hydroxide for her.
On the bright side, her calcium looks good, her potassium looks good, and her hematocrit looks good for now but you will need to keep an eye on this and you might think about starting her on the appropriate B vitamins to ward off anemia as all CKD cats will become anemic and I’d say it’s the second thing to really target.
Your vet should also be checking her blood pressure every time she’s there. It’s very common for CKD cats to have high BP and it’s easily addressed.
Her liver enzymes are a little elevated but it is really, really mild. I’d focus on the CKD and the phosphorus. I know you have limited dollars but getting updated labs will really help you.
And if you are able to, you might think about giving subq fluids at home. In the video description, I list supplies needed and sources.
I’m going to be honest with you.....this is going to take a lot of work on your part. It’s a positive sign that she is eating. Please let me know if you have questions.
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Sharon14
Member Since 2015
Thanks for your input Marje.
Jenny, how is Phoebe this AM? Like Marje, I have never seen such high phosphorus numbers. I know you’re transitioning to FFL EZComplete, but as you do, I think you really need to put Phoebe on the low phosphorus canned food.(If she likes pate, try the Proplan Focus I listed above) A blood test to check if the niacinimide is working is important, and some subQ fluids will help Phoebe feel better. If her levels are still high, the phosphorus binder is a must. I have some I could send you if she does need it.
Jenny, how is Phoebe this AM? Like Marje, I have never seen such high phosphorus numbers. I know you’re transitioning to FFL EZComplete, but as you do, I think you really need to put Phoebe on the low phosphorus canned food.(If she likes pate, try the Proplan Focus I listed above) A blood test to check if the niacinimide is working is important, and some subQ fluids will help Phoebe feel better. If her levels are still high, the phosphorus binder is a must. I have some I could send you if she does need it.
Jenny reyes
Member Since 2019
That would be great if you could I will start the binder as soon as I get it and also her bs level was high too it was around 400 something how do I do the fluids and where do I get them ?
Red & Rover (GA)
Member Since 2016
https://www.thrivingpets.com/catalog/product/view/id/892/s/aluminum-hydroxide/
You want to order the powder. The 200 gram jar will last a long time.
The aluminum hydroxide gel that you can get at the vet contains sugar and therefore not good for a diabetic cat.
You can read about phosphorus and binders here: https://felinecrf.org/phosphorus_binders.htm
Do pay attention to the Measuring Phosphorus Binders section. You will be giving a very small amount which needs to be divided and given with food.
There is a CKD forum you can join. https://tanyackd.groups.io/g/support
Jenny reyes
Member Since 2019
How much binder do I give her when I do get it ?
Red & Rover (GA)
Member Since 2016
For that, you would have to read the section listed in my post above. The dosing depends on the weight of the cat and the stage of the kidney disease. Also, if you join the CKD forum, you will have the knowledge and support of the members.
I also posted all of the info you need in my post 57 above and I already sent you the link to thriving pets for the aluminum hydroxide. Again, I would suggest you order the smallest bottle possible until you know you can get it in her food and she will eat the food with it in it.
While we are all happy to give you the basic info you need to get you started on helping her with CKD, we are a feline diabetes support group and that’s where our strength lies. The CKD group on FB or Tanya’s support group are the best places to get information on the most up-to-date treatments for CKD.
Insofar as her diabetes, Vetsulin is a very harsh insulin. It worries me that you are setting her up for symptomatic hypoglycemia by shooting 2u at a BG of 107 with no other tests the rest of the cycle. Her PMPS tells me she went lower than that 107.
I know dealing with the CKD is extremely important but please don’t neglect the diabetes because it won’t matter how much you do for her CKD wise if she has a symptomatic hypo from which she can’t recover. Diabetes is not “set and forget” so you can’t just keep giving her 2u and only testing at preshot.
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Darnell & Sprocket (GA)
Member Since 2015
Thanks Idjit's Mom. I learned from the best. ❤
Jenny, Did you get those instruction?
Can you do it?
I couldnt...lol.
Try it....your younger than me with more tech savy than me.
Sharon14
Member Since 2015
Sent you a PM
I already did it for her
Jenny reyes
Member Since 2019
Just curious I was told that you can add canned pumpkin to help lower protein levels for the kidney dieases it is 1 lb to each 3 lbs of the patch I can do that with ezcomplete? That was according to one the pre mix raw company’s I was talking to
Idjit's mom
Member Since 2018
You don't actually need to lower protein levels, Jenny. Here is some information I got from the staff at FoodFurLife (EZ Complete)
*******
Regarding your question about phosphorus, the typical guidance for phosphorus in earlier stages of CKD is to feed a food that is less than 1% phosphorus on a dry matter basis, or less than 250mg phosphorus per 1,000kcal. EZComplete is both.
The Veterinary / Rx renal diets typically have phosphorus at lower than AAFCO (which minimum is 0.5% on a dry matter basis). But they achieve this by trading protein for carbohydrates.
If you want to feed a low carb diet, then yes, raw is your best option. In a traditional raw diet with bone, the phosphorus is over 2% on a dry matter basis. This is because bone is used as the source of calcium - but it is also the largest repository of phosphorus in the body. By removing the bone and replacing it with an alternate source of calcium like eggshell (which is what EZComplete premix powder uses), this alone reduces the food to less than 1% phosphorus on a dry matter basis, typically to 0.8% - 0.9% DMB if using very lean meats. You can lower the phosphorus further by using fattier cuts of meat.
That said, Laurie has had 5 CKD cats since she transitioned her cats to raw 7 years ago (half of her crew were seniors when they transitioned), and she now has 2 and Carolina has 1. We've both tried feeding low protein in order to lower phosphorus further (because outside of bone, the organs and meat are the source of phosphorus, which is why the Veterinary / Rx renal diets replace meat with carbs). Lowering phosphorus further in a homemade diet is actually quite easy to do with food made with EZComplete by adding fattier cuts of meat, as mentioned above. If you target 15% fat as fed, the food will have about has much phosphorus as the Rx diets (below the AAFCO minimum), and protein will be around 40% on a dry matter basis - not quite as low as the Rx foods, which are around 30%. At about 10% fat as fed (with food made with EZComplete), the protein will be just about 50% on a dry matter basis. BUT. But it turns out that - in our experience - phosphorus really isn't the only consideration in an ideal CKD food, unless your kitty is late stage 4 or in kidney failure. Again, based on our experience.
We went back to feeding mostly lean meats. Doing extensive research, we learned why our cats do better on the higher protein diet: senior cats need MORE protein, not less. Over time, on the higher fat diet, our cats got weaker in the back end. That's muscle wasting. In a referenced piece by Dr. Mark Peterson, one of the most widely recognized small animal endocrine specialists in the world, he walks through the known needs of senior cats from published studies. It turns out, based on that info, senior cats need a minimum of 53% protein (dry matter basis) to prevent muscle wasting. So we weren't imagining it when our observation was our cats did better on a high protein diet.https://endocrinevet.blogspot.com/2011/11/optimal-protein-requirements-for-older.html
Dr. Becker has a referenced article on a study conducted in cats, designed to determine if low protein made a difference in CKD. It turns out, protein control does not impact CKD, where phosphorus control does: https://healthypets.mercola.com/sites/healthypets/archive/2018/02/13/feeding-senior-cats.aspx
So we both feed food made with EZComplete to our cats, using a rotation of chicken breast (lean), chicken thigh (fattier than breast), pork loin (lean), pork shoulder (very fatty), turkey breast (lean) or thigh (fattier), and Laurie uses fatty cuts of beef (chuck beef) and very lean cuts of beef (like top round), and each of us typically feed 2 of 3 meals a day to our cats that are lean, and one that is made with fattier meat.
What we do is control phosphorus by using a specific form of vitamin B3, niacinamide. Laurie lost her 3 prior CKD cats to problems unrelated to the CKD, and the current two have been completely stable for 1.5 years since diagnosis with this approach. Carolina's CKD cat also has hyper-T, IBD, megacolon and a hiatal hernia, and he's been completely stable for two years. Totally stable! Some of it luck-of-the-draw genetically. But this approach has been serving our kitties well.
We hope this helps, please let us know if you have any further questions.
***********
I think you can use the phosphorus binder on the canned food you are feeding your cat now, then gradually, as the FoodFurLife website recommends, transition to the meat/EZ Complete diet you probably will not have to use the phosphorus binder. It would be worth your while to visit the FoodFurLife website again, and make sure you understand how to introduce this new food (it takes a long time to do it properly), and ask them if they think you would need a phos binder with the meat/EZ Complete diet.
*******
Regarding your question about phosphorus, the typical guidance for phosphorus in earlier stages of CKD is to feed a food that is less than 1% phosphorus on a dry matter basis, or less than 250mg phosphorus per 1,000kcal. EZComplete is both.
The Veterinary / Rx renal diets typically have phosphorus at lower than AAFCO (which minimum is 0.5% on a dry matter basis). But they achieve this by trading protein for carbohydrates.
If you want to feed a low carb diet, then yes, raw is your best option. In a traditional raw diet with bone, the phosphorus is over 2% on a dry matter basis. This is because bone is used as the source of calcium - but it is also the largest repository of phosphorus in the body. By removing the bone and replacing it with an alternate source of calcium like eggshell (which is what EZComplete premix powder uses), this alone reduces the food to less than 1% phosphorus on a dry matter basis, typically to 0.8% - 0.9% DMB if using very lean meats. You can lower the phosphorus further by using fattier cuts of meat.
That said, Laurie has had 5 CKD cats since she transitioned her cats to raw 7 years ago (half of her crew were seniors when they transitioned), and she now has 2 and Carolina has 1. We've both tried feeding low protein in order to lower phosphorus further (because outside of bone, the organs and meat are the source of phosphorus, which is why the Veterinary / Rx renal diets replace meat with carbs). Lowering phosphorus further in a homemade diet is actually quite easy to do with food made with EZComplete by adding fattier cuts of meat, as mentioned above. If you target 15% fat as fed, the food will have about has much phosphorus as the Rx diets (below the AAFCO minimum), and protein will be around 40% on a dry matter basis - not quite as low as the Rx foods, which are around 30%. At about 10% fat as fed (with food made with EZComplete), the protein will be just about 50% on a dry matter basis. BUT. But it turns out that - in our experience - phosphorus really isn't the only consideration in an ideal CKD food, unless your kitty is late stage 4 or in kidney failure. Again, based on our experience.
We went back to feeding mostly lean meats. Doing extensive research, we learned why our cats do better on the higher protein diet: senior cats need MORE protein, not less. Over time, on the higher fat diet, our cats got weaker in the back end. That's muscle wasting. In a referenced piece by Dr. Mark Peterson, one of the most widely recognized small animal endocrine specialists in the world, he walks through the known needs of senior cats from published studies. It turns out, based on that info, senior cats need a minimum of 53% protein (dry matter basis) to prevent muscle wasting. So we weren't imagining it when our observation was our cats did better on a high protein diet.https://endocrinevet.blogspot.com/2011/11/optimal-protein-requirements-for-older.html
Dr. Becker has a referenced article on a study conducted in cats, designed to determine if low protein made a difference in CKD. It turns out, protein control does not impact CKD, where phosphorus control does: https://healthypets.mercola.com/sites/healthypets/archive/2018/02/13/feeding-senior-cats.aspx
So we both feed food made with EZComplete to our cats, using a rotation of chicken breast (lean), chicken thigh (fattier than breast), pork loin (lean), pork shoulder (very fatty), turkey breast (lean) or thigh (fattier), and Laurie uses fatty cuts of beef (chuck beef) and very lean cuts of beef (like top round), and each of us typically feed 2 of 3 meals a day to our cats that are lean, and one that is made with fattier meat.
What we do is control phosphorus by using a specific form of vitamin B3, niacinamide. Laurie lost her 3 prior CKD cats to problems unrelated to the CKD, and the current two have been completely stable for 1.5 years since diagnosis with this approach. Carolina's CKD cat also has hyper-T, IBD, megacolon and a hiatal hernia, and he's been completely stable for two years. Totally stable! Some of it luck-of-the-draw genetically. But this approach has been serving our kitties well.
We hope this helps, please let us know if you have any further questions.
***********
I think you can use the phosphorus binder on the canned food you are feeding your cat now, then gradually, as the FoodFurLife website recommends, transition to the meat/EZ Complete diet you probably will not have to use the phosphorus binder. It would be worth your while to visit the FoodFurLife website again, and make sure you understand how to introduce this new food (it takes a long time to do it properly), and ask them if they think you would need a phos binder with the meat/EZ Complete diet.
Jenny reyes
Member Since 2019
Thank u
I’m sorry but I really disagree with this statement. Her phosphorus is at 20. EZC is a lower P food but it isn’t, by a long stretch, considered to be low P. You’d have to use a renal diet to get to what is considered to be a low P diet.
I know Laurie and Carolina very well and they are amazing and awesome. But I have to wonder if they were aware that Phoebe’s P level is so high? I would agree 100% with their advice if the P level was 6 or so and just needed to come down a bit. But for it being 20, that’s dangerously high and I don’t think she’s going to be able to get it down without aggressive treatment using niacinimide and binders. IMHO.
Idjit's mom
Member Since 2018
Ok, I certainly accept that, and the email reply from the FFL staff I posted was to me, not to Jenny. I did recommend that she check with them and see if they would advise using the phos binder with the meat & supplement. Jenny has posted on the FB page since and Chris & China did tell her to use the phos binder with the meat & supplement.
Withdrawing oar from this stretch of water.
Excellent!
Jenny reyes
Member Since 2019
she is okay just here levels on her phosopurs are high and she cant gain weight right due to the diabetes she eats well just has been throwing up
Priya&Missy
Member Since 2019
She needs Niacinamide if her phosphorus is over 8.
Aluminum hydroxide is not going to bring it down fast enough. The longer she has high phos levels the worse she’ll feel and the faster her ckd will progress.
AliceMeowliss (GA)
Member Since 2019
How long has she been throwing up?
For me personally, this sets off my DKA alarm, especially combined with weight loss, an insulin that does not last very long (like Vetsulin or NPH), the high numbers. Has this been addressed at all yet? I’m just now jumping in and I read from the beginning but maybe I missed something.
sandscout
Member Since 2018
Hi Jenny, I’m sorry to hear Phoebe is vomiting. Is your Vet willing to prescribe an anti-vomiting drug that might help her, Cerenia is a good one- and an anti-nausea drug such as Ondansetron? They both work really well for vomiting and nausea. I don’t know things like phosphorus levels, but one thing I do know about is vomiting. Check those out if you get a chance. And keep us posted. You and Phoebe are in my thoughts
Jenny reyes
Member Since 2019
Hi Jenny, I’m sorry to hear Phoebe is vomiting. Is your Vet willing to prescribe an anti-vomiting drug that might help her, Cerenia is a good one- and an anti-nausea drug such as Ondansetron? They both work really well for vomiting and nausea. I don’t know things like phosphorus levels, but one thing I do know about is vomiting. Check those out if you get a chance. And keep us posted. You and Phoebe are in my thoughts
Thank you
Jenny reyes
Member Since 2019
I just a vet yesterday they did bloodwork and her phosphorus levels have come down a lot so she was getting an infection so they gave her antibiotics and a few other things. This is her blood work
Attachments
Jenny reyes
Member Since 2019
Let me see because the vet sent it to me like that I will ask the vet to resend it and post it again
Jenny reyes
Member Since 2019
Jenny reyes
Member Since 2019
Chris told me to leave her food on Merrick and just to add the binders so I just need help with that
Sharon14
Member Since 2015
I’m on an iPad and when I zoom in to read it, it gets blurry. It’s also upside down. It make look ok on a desktop though, I don’t know. I can’t remember how to calculate the amount of binder. I think a lot depends on the phosphorus number. I hope @Marje and Gracie will be around to help with that
How is she feeling?
How is she feeling?
Jenny reyes
Member Since 2019
She is okay she isn’t not feeling well because of the infection she has eating small amounts right know she is only 5 pounds as soon as her new insulin comes in I hope it will help her with her sugars better
I can’t read those labs....too tiny
Jenny reyes
Member Since 2019
Can I email them to u ? I can see them very clear on my emailI can’t read those labs....too tiny
If you could, please, just add to her lab tab as we discussed in the PM, then they are there permanently and that helps for futu comparisons.
Thank you!
Jenny reyes
Member Since 2019
She has a bad infections she is been throwing up because of the antibiotics I need to call the vet tommrrow ask them what to do
Jenny reyes
Member Since 2019
I did give her some ondansetron they is help
Thanks for loading labs.
The parameters that are red flag to me are:
WBCs: which indicate an infection, as you know
Phosphorus: great improvement but still needs to come down as close to 4.5/as you can
Potassium: too low, discuss with vet about supplements
Hematocrit: really trending towards anemia; you should start methylcobalamin and multiB as soon as possible. I posted the link for info about Vitamin B in post #57 above.
pls let me know if you have questions.
The parameters that are red flag to me are:
WBCs: which indicate an infection, as you know
Phosphorus: great improvement but still needs to come down as close to 4.5/as you can
Potassium: too low, discuss with vet about supplements
Hematocrit: really trending towards anemia; you should start methylcobalamin and multiB as soon as possible. I posted the link for info about Vitamin B in post #57 above.
pls let me know if you have questions.
Jenny reyes
Member Since 2019
Jenny reyes
Member Since 2019
If you read the links I left you, they will tell you. The vet should determine the potassium.
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