questions about kidney failure

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angieandmax

Member Since 2013
Max lost a couple of teeth before christmas and wasn't eating his dry food well so I started giving him Fancy feast . He was eating ok, not as much as he should have been. Yesterday he stopped eating at all, so I took him to the vet. His blood sugar was up and he was dehydrated so they gave him fluids and told me to up his insulin. Also gave him an antibiotic shot in case it was his tooth decay causing problems with his eating.

They gave me a can of Hill's A/D and a couple of cans of Purina DM. As soon as we got home, he started eating again. He hasn't been drinking much unless I put him in the bathroom sink to drink from the faucet or play in his water bowl so the water is moving.

Vet called with his bloodwork this morning and said his kidneys were failing.
his BUD was 150, Creatine was 4.1 and phosphorus was 9 something. No ketones in his urine. Elevated white count in his blood but not in his urine.

He said there were 2 paths we could take right now, See how he does this weekend and come in Monday so they could show me how to give fluids and see where his bloodwork was in a month or consider putting him down.

I will probably give it a month of fluids and see where we are because I can't bare the thought of putting him down. But I would like opinion of how likely he is to be ok and if there is anything I should discuss with the vet.
 
My Spot was just dx'd with CKD about a month ago....I am at work right now, so I don't have time or the opportunity to go look at my notes. I will put a shout out on the other boards to see if anyone is around that can give you some info now. If not, I will see what I can do tomorrow....working the full time AND part time job today, so I won't get home until 9ish..
 
Hello there, sorry to hear about your cat. Here is a good site on CRF. http://www.felinecrf.org This site is very optimistic about how you can treat him so I would try this first!
1. I would be inclined to try the fluids.
2. Look and see if you can find a food thats low in phosphorous and low in carbs since he is diabetic http://www.catinfo.org/docs/Food Chart Phosphorus 9-22-12.pdf
3. Ask about aluminium hydroxide etc for him too.
4. Maybe buy a moving water fountain to keep him drinking.

How is he behaving otherwise? Playing? Cleaning himself? Purring?


Hoping someone else will come on soon..
 
I think I might want to keep an option open in case he becomes dehydrated again tomorrow and needs another appointment for more fluids from the vet tomorrow. The vet can teach you how to give the fluids tomorrow, if that is the case.
I think you'll also want to look for low carb foods with less phosphorus http://catinfo.org/docs/Food Chart Public 9-22-12.pdf

Good luck with your kitty.
 
According to the food chart the Purina Dm wet is 263 or 1.27 depending on which number is more important. What numbers should I be looking for in phosporus levels?

And to the person who asked how active he was, he's 14 and to be honest he's always been a bit lazy so, no not really active and he never really purred a lot either.
 
Wow...I can't believe your vet suggested putting him to sleep. Yes, his numbers are up there but CKD is treatable and I'd give it a shot. My Gus has been in renal failure for 2-1/2 years and is doing very, very well and stable with all at-home treatment.

First, you need to get the numbers under control. The best way to do it and bring them down a little quicker is actually if the vet keeps him and puts him on IV fluids a couple days. His creatinine is not bad but the number that concerns me is the phosphorus. A high phosphorus level like that can really make him feel bad and can cause ulcers in the tummy and also the mouth. The IV fluids will help with the creat and the BUN (which is an indication of dehydration).

I would not wait until Monday. I'd get fluids and get them started today. I'd also get foods off of the list Wendy gave you which are low carb and lower in phosphorus. And get him off the DM and the a/d. I'd go for as low phosphorus as you can get and remember that if the carbs are a little higher....like 8%...you can always adjust insulin.

Here is a link to a video I did on giving fluids at home:
[youtube]TtSzMuDgx78[/youtube]

Please discuss all of the info I am giving you below with your vet and show him the website Wendy gave you if he is hesitant. That website is the gold standard for treating CKD. If your vet is hesitant to treat your kitty's CKD and you wish to treat it, I'd find a new vet. I've seen levels much higher than Max's come down. And it could be acute.....hard to say.

And yes, ask where you can get aluminum hydroxide....some vets are not onto this yet and want to give alternagel which is nasty in taste for cats (it's peppermint flavored). The aluminum hydroxide powder is tasteless. The way it works is you mix it with the food and it binds the phosphorus in the food. So it will not directly bring down his phosphorus level but by starting to feed him low phosphorus foods, that should help immensely. For his level of phosphorus, the dosing is 50mg/lb per day as anything over that could cause aluminum toxicity; there is approximately 300mg binder to 1/4 tsp. So if your kitty weighs 10 lbs, he'd get 500 mg or about 3/8 tsp of binder a day. A little needs to be sprinkled over his food every time you give it. I usually measure out Gus's daily dose and then every time I feed him (which is often), I sprinkle a little powder on it and mix it in well making sure I use the entire 1/4 tsp by the end of the day. CKD cats need to be fed small meals often because they can build up acid in their tummies.

If you can get some aluminum hydroxide locally....just enough for a few days, then you'll want to order it from thrivingpets.com which is the link above. It's cheapest there. The website Wendy gave you, Tanya's, has a great discussion on Phosphorus Control.

I also get my IV lines and Terumo 21g needles there. The 18g needles the vets usually give dispense the fluids quickly but they are like harpoons. You also want to ask the vet to give you Lactated Ringers Solution and not Normosol. If he can't, then ask for a prescription. I get my LRS 1000ml bags through Walgreens. I have a prescription card for Gus ($20/year) and the bags come 12 to a case for $22. Vets usually charge $18 a bag!

You also need his other numbers. I'd like to know what his potassium level is and what his HCT/HGB or PCV are. You want to know if he's anemic or not and the HCT/HGB or PCV will tell you that. You can also look at his gums and his paw pads...they should be a nice pink, not pale or white.

If Max is hunched over acting like his tummy hurts or is vomiting any clear, foamy liquid, he probably needs Pepcid AC 10mg...not Pepcid complete or any other pepcid....just Pepcid AC 10 mg. The starting dose is usually 1/4 tablet every other day unless he's acting really sick to his stomach and then you could give 1/4 tablet once a day. Pill pockets are best to administer it because it's bitter. Again...discuss with your vet.

Sending your Max healing vines and please let us know how we can help.
 
Marje gave you some really good advice. Another thing I agree with Marje about is to get those IV fluids asap. Absolutely, you can and should do home administered sub-q's, but your kitty needs to get the BUN number down first through an IV drip so you can maintain it - kitty appears to be very dehydrated.

I am feeding a 50/50 mix to my CKD/Pancreatic/Diabetic cat of Hill's m/d diabetic and Royal Canin Renal LP. It was quite the chemistry experiment. The m/d has a very reasonable phosphorus level. I would have fed just the m/d, but my cat nearly went into metabolic acidosis, twice, so I had to punt. Of course, my vet would rather me be solely on the renal diet, but my cat is doing pretty well with the mix. The Hill's k/d renal diet actually contains glucose - ugh.

However, until you are able to get kidney values under somewhat control (they most likely will never be normal again), please discuss with your vet doing just a renal food for maybe a month and adjusting the insulin. It won't be easy to regulate, though (which is why I do the 50/50 mix).

There are a lot of other things you can do, and joining the CKD group is your best bet (I am a member there also and have learned a lot). Please do post all of your labs to the CKD group, so many of us can comment on possible supplementation to discuss with your vet.

Hang in there.

DZ and Sarah
 
Hobbs had CKD but was dx much earlier. He's now on fluids 2x/week. Since he's asymptomatic it's hard to say if it's helping him. I have two friends who also have CKD cats, but they are both further along in the disease and they say that the fluids work wonders. One says it made so much of a difference she calls it the elixir of life.
 
CKD is treatable as the others have said. Tess is very early stage and just the change to less than 200 mg phos/100kcal food brought her Phosphorus level down a whole point very quickly. Adding the phos binder will help even more w/ Max's higher levels. I have a list of low phos and low carb food that I culled from Dr Lisa's list. It 's on one of the tabs in Tess's SS.
 
Hi Angie,

Well, I thought my Ketchie girl was on her last leg one month ago, but the vet pulled out an abscessed tooth, then that healed, and I was taking her in a couple times a week for fluids, but I finally said, sell a bag of fluids and the set up to me, and I will learn to do this at home.

By golly, after watching youtube video's about giving fluids, and watching Marje and Gus's video (one of the very best) I have now been giving Ketchie fluids, about 50 to 75 mls once a day. It has made a big difference in her, and she is now going up and down my kitchen on a few steps, she is no longer as weak as she was, and I am amazed she is still here. And she has a LOT of other health problems.

Interstitial cystitis, cardiomyopathy, arthritis, cancerous tumor on her back about 2 inches across near her tail, chronic nasal congestion, which could be allergies partially too, hyperesthesia, occasional pancreatitis, and I know I must have left a couple things out. But, she is still hanging in there! A couple of my family members told me to put her down on Dec. 7, 2012, but instead, that is the day I had the vet pull her abscessed tooth. She has been improving and starting to eat better again. She is 17 years 5 months and 4 days old. Born in my bathroom. A beautiful talkative tortie. Never have I had a cat live this long, but she has tremendous will power! I almost put her down three years ago, from the cystitis that got so bad. But, she made it through that!

SO, if my cat can make it, and I can give fluids, well, you have a good chance of keeping your Max around longer than the vet thinks!

Best wishes!
Jean and Charcoal (GA)
 
Thank everyone who has responded, it's good to know so many cats are doing well, even with the kidney problems.

I don't think my vet was actually pushing to put him down, so much as trying to make me feel that I wouldn't be a horrible person if that was what I decided. he made it seem like a lot of his clients weren't all that comfortable with giving fluids. I actually prefer the vet I saw over the others in the clinic because he doesn't make you feel terrible if you can't afford to do something for your pet or feel like an idiot for not noticing something was wrong sooner.

Max isn't drinking as much as I would like. Is there an amount I should be aiming for? I opened a bottle of water to add to his food so I can at least have an idea of the minimum amount he is getting.
 
You're welcome, Elizabeth!

With Maxs levels being what they are, you won't be able to get enough water in him through his food to compensate. You would need to talk to your vet on how much to give of the LRS subq. It depends on his general health...does he have a heart murmur or any heart issues; if so, it's a balancing act between the heart and kidneys. But if his heart is ok, he should likely be getting fluids daily...I say likely because its important to just be sure there is no other health issue which would contraindicate it.

The other thing is your vet needs to check his blood pressure. High blood pressure is very common in cats with CKD. It is also treatable. My Gussie has high BP and he takes one small capsule in a pill pocket once a day and is doing great with his BP.
 
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