PLEASE HELP TYLER'S BROTHER PERRY WHO HAS KIDNEY DISEASE

Diane Tyler's Mom GA

Member Since 2018
  1. @Marje and Gracie
@Tina Marie and Jan


@Wendy&Neko

@Bron and Sheba (GA)

@Chris & China (GA)

@Red & Rover (GA)
I know I maybe should not be posting about Perry, Tyler's brother but I just don't know what to do

I posted about Perry last night when asking about Tyler

http://www.felinediabetes.com/FDMB/...its-time-for-an-increase.231041/#post-2585101
My vet just called with his blood work
His creatinine was 2.8 six months ago it is now 12.2
Phosphorus was 2.5 six months ago. It is now 12.3
Urea is 158
Red blood cells were 30 six months ago. It is now 32
He also has a slight heart murmur now

She said I can try SQ fluids for 10 days 100 cc once a day
And a phosphorous Binder

He is not eating have to syringe baby food
I know you might not be able to answer this question, do you really think the fluids and binder will really help
I forgot to ask her if it does do you have to do it for the rest of his life and what happens if you stop , I assume the kidneys will get worse again, waiting for her to call back again

If it were you what would you do
I am just so overwhelmed right now
I'm sorry I posted this here even though Perry is not diabetic
Thank you all
 
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For now I just wanted to get everyones opinion,
Right now Tyler's brother isn't doing so well, he is the one with kidney disease, I have mentioned it before on here.
He's been losing weight rapidly, was 14 lbs now 10.6 pounds, took him to my vet this morning , she did blood work, his urine is diluted, and now she heard a slight heart murmur which she never heard before. He won't eat so have been syringing baby food, he is not nausea at all, he's been in cerenia for a long time because he was throwing up, but that stopped a long time ago.
He was not dehydrated and his teeth are fine.She talked about SQ fluids but said what until she gets the blood work back , said we have to be careful with giving fluids because of the murmur which I already knew

But she said let's just see what the blood word shows
He has been in stage 2 for the longest time creatinine was 2.8 six months ago
He actually wasn't due for blood work until Aug
I love my vet and trust her , I told her about all of you and even printed tons of stuff showing how much you all :bighug:know :bighug::bighug: about everything and advice you give and she was so impressed. She always works with me and supports me.

So concerning Tyler I wanted to get everyone's opinion , if Tyler keeps up with all these blues I will most likely increase if you all think it's a good idea, but not until I see what's going on with my poor boy Perry
I am so sad right now and taking care of the 2 cats and my daughter who has a chronic pain disease for 15 yrs now which I have posted about so some of you know about her, I think I can only deal with one thing at a time.

Perry holds a special place in my heart, not that I don't love Tyler to pieces, but Perry is special to me , believe it or not Perry is the only cat I ever had and I have had 3 others before these 2 he is the only one that ever showed love to me, head butting me, licking my face, follows me around constantly, gets in his cat napper and wants me to rub his butt and then looks at me with his big eyes and wants me to put my face by him and then rubs his nose all over my face.
So he's special to me, Tyler leans more towards my daughter and Perry towards me, Ashley gets so mad lol.
So I just want to thank you guys for all your advice meant to put the hugs here :bighug::bighug:
 
With numbers that high he needs to be hospitalized on IV fluids. However he needs an echo to see the cause if the murmur to make sure fluids are safe. Did she take an X-ray to see if his heart is enlarged? Murmurs can be benign as tge one Max had for years or a sign of heart disease as he had at the end of his life so a cardiologist is a really good idea. I went to one when his was benign and she said it would not need to be followed. Unfortunately he years later did develop CHF that was unrelated.

I’ve been there was my kidney/lymphoma cat. With her it was caused by her oncologist missing a UTI. This could be an acute episode.

I just wanted to share my experiences. :bighug:
 
With numbers that high he needs to be hospitalized on IV fluids. However he needs an echo to see the cause if the murmur to make sure fluids are safe. Did she take an X-ray to see if his heart is enlarged? Murmurs can be benign as tge one Max had for years or a sign of heart disease as he had at the end of his life so a cardiologist is a really good idea. I went to one when his was benign and she said it would not need to be followed. Unfortunately he years later did develop CHF that was unrelated.

I’ve been there was my kidney/lymphoma cat. With her it was caused by her oncologist missing a UTI. This could be an acute episode.

I just wanted to share my experiences. :bighug:
No echo , no x-ray
 
An X-ray would at least show if the heart is enlarged. With kidney values that high IV fluids are needed if safe. I should add the X-ray will only work if read correctly. Max’s wasn’t.
 
Diane

I’m so very sorry. I agree with Elise 100%. First, I’d try to get an echo and if his heart is not enlarged, the only way to get that high of a creatinine down is IV fluids and there’s no guarantee even at that. I can guarantee that subq fluids will not do it. I’d also get an ultrasound to see if he has a kidney infection because that can cause the creatinine to rise but this is a pretty drastic elevation.

Have you been feeding him lower P foods?

Can you post his complete labs because you are only giving me a part of the kidney picture. We also need to see what his calcium, potassium, and hematocrit (HCT) or PCV is.

I had a kitty who did this many years ago but he had polycystic kidney disease and this is very typical for them to have decent kidney levels and a few months later, they are horrific. I do believe there is something else going on for them to go that high that fast.

:bighug::bighug:
 
There is often a tricky balance between managing kidney and heart disease - especially with fluids. We had a senior with kidney failure and another senior with heart failure/lymphodenopathy (sp?), but neither had kidney and heart at the same time. I don't have advice to give... But some things I remember from my 2 seniors. ..sending good vibes to Perry :)

Kidneys - many kitties get the SQ fluids and that can jump start the kidneys and might prevent further acceleration into kidney failure. Hospitalized IV fluids can mean more fluids getting direct into the body faster, but with potential heart disease, I can imagine that balance is tricky. Might be why your SQ is only at 100ccs. Meds are sometimes given for nausea/appetite. It can be heart breaking to have to force feed them, and I understand how you are feeling.

Heart - if the kitty has an enlarged heart or is starting to go into heart failure, this can cause a fluid accumulation around the heart/lungs and can make the heart less efficient amongst other things. Our guy was given diuretics for a time to help 'drain' the fluid and try to clear things up. Our kitty had another issue at the time and needed steroids/other things for that... Which made the hydration/fluid situation more complicated. Xrays/ultrasounds can be done to help dx.

I'm sure there are other possible meds/treatments/diagnostics that I'm leaving out, so this is not advice, but this is what I can remember. I am glad you have a great vet that you trust. I'm sure they will have some great advice for you!

Hang in there, take a deep breath and know you are doing everything you can :bighug:
 
Sorry, Diane, I did not receive notification of tags. That is happening a lot recently.

You have been given good advice. The heart needs to be checked out before fluids can be given.

There are two types of phosphorus binder – a gel the vet sells that was designed for dogs and has sugar in it (I don't think anyone here has used it for that reason) and aluminum hydroxide powder that can be obtained online: https://www.thrivingpets.com/shop-by-treatment/herbal-and-natural/alu-powder.html (the mid-sized container will last a very long time, the small container will last a couple of months). You only use 1/8-1/4 tsp.

Also, there is a list somewhere here of foods that are low carb (obvs) and low phosphorus.
You need not worry about carbs but you do want to stay under a phosphorus of 200 if you can. The lower the better. Scroll through Dr. Lisa's list and see what is available and affordable. The steak frites is crazy expensive and Rover would only lick the very watery sauce.

Hang in there. It's a lot of unknowns right now and a steep learning curve.
 
An X-ray would at least show if the heart is enlarged. With kidney values that high IV fluids are needed if safe. I should add the X-ray will only work if read correctly. Max’s wasn’t.
Hi there, To tell you the honest truth, I am totally broke, my husband died 11 yes ago, my daughter has a very painful chronic pain disease for 15 years. I'm collecting social security, have bills up the wazoo.
Between Tyler's diabetic supplies and Perry's med for seizures, thank god hadn't had one in 13 months, cerenia I just don't have the extra money

So right now I went to my vet and they showed me how to give the fluids and gave me a phosphorus binder. He had the fluids today
At least I can try the fluids for 10 days and see if he improves at all. After 10 days he will have more blood work to see where he's at. I will know if he's feeling better if I see him start to eat on his own
If he's the same or worse then I'll know what I have to do
Thank you
 
Diane

I’m so very sorry. I agree with Elise 100%. First, I’d try to get an echo and if his heart is not enlarged, the only way to get that high of a creatinine down is IV fluids and there’s no guarantee even at that. I can guarantee that subq fluids will not do it. I’d also get an ultrasound to see if he has a kidney infection because that can cause the creatinine to rise but this is a pretty drastic elevation.

Have you been feeding him lower P foods?

Can you post his complete labs because you are only giving me a part of the kidney picture. We also need to see what his calcium, potassium, and hematocrit (HCT) or PCV is.

I had a kitty who did this many years ago but he had polycystic kidney disease and this is very typical for them to have decent kidney levels and a few months later, they are horrific. I do believe there is something else going on for them to go that high that fast.

:bighug::bighug:
Hey Marje I will ask my vet for his labs tomorrow and will put them on the SS
The only thing he has been eating is the K/D dry. I have tried for many years for him to eat wet but forget it.,If you read my reply to Elise you will see where I'm at. I will get the labs. Thank you, the strange thing is he's not lethargic, he's grooming himself, he is coming to me for me to rub his butt which he loves, @Marje and Gracie :bighug:
 
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Sorry, Diane, I did not receive notification of tags. That is happening a lot recently.

You have been given good advice. The heart needs to be checked out before fluids can be given.

There are two types of phosphorus binder – a gel the vet sells that was designed for dogs and has sugar in it (I don't think anyone here has used it for that reason) and aluminum hydroxide powder that can be obtained online: https://www.thrivingpets.com/shop-by-treatment/herbal-and-natural/alu-powder.html (the mid-sized container will last a very long time, the small container will last a couple of months). You only use 1/8-1/4 tsp.

Also, there is a list somewhere here of foods that are low carb (obvs) and low phosphorus.
You need not worry about carbs but you do want to stay under a phosphorus of 200 if you can. The lower the better. Scroll through Dr. Lisa's list and see what is available and affordable. The steak frites is crazy expensive and Rover would only lick the very watery sauce.

Hang in there. It's a lot of unknowns right now and a steep learning curve.
Hi Kel I have the aluminum hydroxide binder, have to give 1/8 tsp. Just so I don't have to copy and paste if you want you can read whstbI wrote to tifmaxee above
Thanks so much :bighug:
 
Thank all of you for replying back to me with good advice but this is where In stand

Hi there, To tell you the honest truth, I am totally broke, my husband died 11 yes ago, my daughter has a very painful chronic pain disease for 15 years. I'm collecting social security, have bills up the wazoo.
Between Tyler's diabetic supplies and Perry's med for seizures, thank god hadn't had one in 13 months, cerenia I just don't have the extra money

So right now I went to my vet and they showed me how to give the fluids and gave me a phosphorus binder. He had the fluids today
At least I can try the fluids for 10 days and see if he improves at all. After 10 days he will have more blood work to see where he's at. I will know if he's feeling better if I see him start to eat on his own
If he's the same or worse then I'll know what I have to do
Thank you all :bighug: I will keep you updated
 
Diane

I’m so very sorry. I agree with Elise 100%. First, I’d try to get an echo and if his heart is not enlarged, the only way to get that high of a creatinine down is IV fluids and there’s no guarantee even at that. I can guarantee that subq fluids will not do it. I’d also get an ultrasound to see if he has a kidney infection because that can cause the creatinine to rise but this is a pretty drastic elevation.

Have you been feeding him lower P foods?

Can you post his complete labs because you are only giving me a part of the kidney picture. We also need to see what his calcium, potassium, and hematocrit (HCT) or PCV is.

I had a kitty who did this many years ago but he had polycystic kidney disease and this is very typical for them to have decent kidney levels and a few months later, they are horrific. I do believe there is something else going on for them to go that high that fast.

:bighug::bighug:
@Marje and Gracie
I assume that the K/D dry is not good pertaining to the phosphorus

Guaranteed Analysis
CRUDE PROTEIN 26.0% min
CRUDE FAT 20.0% min
CRUDE FIBER 4.0% max
PHOSPHORUS 0.3.0% min
PHOSPHORUS 0.75% max
SODIUM 0.4% max

I have no idea if this is bad
 
KD dry is low phosphorus. It is an RX food for CKD. If you can get him to eat canned food it’s better because any water he gets helps to hydrate.
Thank you Elise, I have tried for years to get him to eat wet, he aggravated me so much in the past that I actually shoved some in his mouth.
No Tyler the one with diabetes always ate dry and when I introduced the Fancy Feast Pate he just started eating it with no problem
I'm really trying to do all I can for Perry, Thanks so much:bighug:
 
The fact that he is already in a renal diet and his P shot up befuddles me and, honestly, at those numbers, he should feel like crap and not want to eat. At P levels like that, ulcers can start to form and the kitty is usually quite nauseous. Did your vet actually give you a copy of the labs to be sure they didn’t get mixed up with another cat? Yes, I have seen that happen.

The KD dry diets are all about 0.50% P which is better than you will get in most non-renal foods although it’s not as low as some of the other dry renal diets. If he refuses to eat wet food, now is not the time to try and change that.

Also found this on the chewy site
What is the percentage of phosphorus on an ad fed basis? Thank you
At this time, the manufacturer does not have the as fed value available. This variety contains 0.51% Phosphorus content on a dry matter basis
Have no idea if this is bad also
You don’t need the as-feds. The amount on DMB is fine and yes, that’s is almost as low as you will get in a dry food.


Hi Kel I have the aluminum hydroxide binder, have to give 1/8 tsp. Just so I don't have to copy and paste if you want you can read whstbI wrote to tifmaxee above
Thanks so much :bighug:
That is not much binder for where his P level is. Here is a discussion on dosing aluminum hydroxide. For a P over 7, the middle of the road is 40 mg/lb so if he weighs 10 lbs, that’s 400 mg. You’ll have to see how much there is in what you are using but the Aluminum hydroxide powder from Thriving pets is 600 mg for 1/2 tsp. I’m thinking he needs a lot more than 1/8 tsp but Bret to discuss again with your vet. Remember that it has to be put on the food and allowed to settle on it so it binds the P in the food. You don’t give it orally to him.

Here is the video we did to teach how to do subq fluids.
 
The fact that he is already in a renal diet and his P shot up befuddles me and, honestly, at those numbers, he should feel like crap and not want to eat. At P levels like that, ulcers can start to form and the kitty is usually quite nauseous. Did your vet actually give you a copy of the labs to be sure they didn’t get mixed up with another cat? Yes, I have seen that happen.

The KD dry diets are all about 0.50% P which is better than you will get in most non-renal foods although it’s not as low as some of the other dry renal diets. If he refuses to eat wet food, now is not the time to try and change that.


You don’t need the as-feds. The amount on DMB is fine and yes, that’s is almost as low as you will get in a dry food.



That is not much binder for where his P level is. Here is a discussion on dosing aluminum hydroxide. For a P over 7, the middle of the road is 40 mg/lb so if he weighs 10 lbs, that’s 400 mg. You’ll have to see how much there is in what you are using but the Aluminum hydroxide powder from Thriving pets is 600 mg for 1/2 tsp. I’m thinking he needs a lot more than 1/8 tsp but Bret to discuss again with your vet. Remember that it has to be put on the food and allowed to settle on it so it binds the P in the food. You don’t give it orally to him.

Here is the video we did to teach how to do subq fluids.
No she didn't give me a copy but I will get it to tomorrow
I looked at the container of the aluminum hydroxide powder and all it says is 16 DRAM, have no idea but I will ask the vet also.
 
There is often a tricky balance between managing kidney and heart disease - especially with fluids. We had a senior with kidney failure and another senior with heart failure/lymphodenopathy (sp?), but neither had kidney and heart at the same time. I don't have advice to give... But some things I remember from my 2 seniors. ..sending good vibes to Perry :)

Kidneys - many kitties get the SQ fluids and that can jump start the kidneys and might prevent further acceleration into kidney failure. Hospitalized IV fluids can mean more fluids getting direct into the body faster, but with potential heart disease, I can imagine that balance is tricky. Might be why your SQ is only at 100ccs. Meds are sometimes given for nausea/appetite. It can be heart breaking to have to force feed them, and I understand how you are feeling.

Heart - if the kitty has an enlarged heart or is starting to go into heart failure, this can cause a fluid accumulation around the heart/lungs and can make the heart less efficient amongst other things. Our guy was given diuretics for a time to help 'drain' the fluid and try to clear things up. Our kitty had another issue at the time and needed steroids/other things for that... Which made the hydration/fluid situation more complicated. Xrays/ultrasounds can be done to help dx.

I'm sure there are other possible meds/treatments/diagnostics that I'm leaving out, so this is not advice, but this is what I can remember. I am glad you have a great vet that you trust. I'm sure they will have some great advice for you!

Hang in there, take a deep breath and know you are doing everything you can :bighug:
Thank you Tanya for sharing your story, have to tell you Cosmo is adorable:cat:
 
The fact that he is already in a renal diet and his P shot up befuddles me and, honestly, at those numbers, he should feel like crap and not want to eat. At P levels like that, ulcers can start to form and the kitty is usually quite nauseous. Did your vet actually give you a copy of the labs to be sure they didn’t get mixed up with another cat? Yes, I have seen that happen.

The KD dry diets are all about 0.50% P which is better than you will get in most non-renal foods although it’s not as low as some of the other dry renal diets. If he refuses to eat wet food, now is not the time to try and change that.


You don’t need the as-feds. The amount on DMB is fine and yes, that’s is almost as low as you will get in a dry food.



That is not much binder for where his P level is. Here is a discussion on dosing aluminum hydroxide. For a P over 7, the middle of the road is 40 mg/lb so if he weighs 10 lbs, that’s 400 mg. You’ll have to see how much there is in what you are using but the Aluminum hydroxide powder from Thriving pets is 600 mg for 1/2 tsp. I’m thinking he needs a lot more than 1/8 tsp but Bret to discuss again with your vet. Remember that it has to be put on the food and allowed to settle on it so it binds the P in the food. You don’t give it orally to him.

Here is the video we did to teach how to do subq fluids.
@Marje and Gracie Hi Marje
Concerning the amount of phosphorus binder for Perry, boy did I make a big mistake no wonder why you thought that dose was not enough
I just looked at the directions and it did not say give one 1/8 of a teaspoon once a day
It said give an 1/8 of a teaspoon every 8-12 hours
Thank god I just looked at it again
Going to call my vet tomorrow and ask her do I give the 1/8 of a teaspoon every 8 hours which would be 3 times a day
or 1/8 of a teaspoon every 12 hours which would be 2 times a day
What does she want me to do take my pick whether I want to give 3 times a day or 2 times a day doesn't make sense to me
So my question to her would be how many MG'S are in an 1/8 of a teaspoon and how many total of MG'S would he be getting a day depending if I give it 3 times a day or 2 times a day is that correct. Thanks
 
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@Wendy&Neko
Calling my vet tomorrow because I don't know if I should be giving 1/8 of a teaspoon for every meal he eats
The directions are confusing to me
It says give 1/8 teaspoon every 8-12 hours
Do I give the 1/8 of a teaspoon every 8 hours which would be 3 times a day
or 1/8 of a teaspoon every 12 hours which would be 2 times a day
What does she want me to do take my pick whether I want to give 3 times a day or 2 times a day doesn't make sense to me
Good thing I looked at it again because so far I only gave him 1/8 teaspoon total one on Tues and one on Wed
 
Good plan to call the vet and find out the total amount to be fed every day.
Thanks Wendy I read the directions in her office so fast that I didn't even realize what it said, usually I'll go over everything with her to be sure but I was so upset about Perry that it didn't even dawn on me what I was reading. I'll let you know what she says . Thanks again:cat:
 
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