UPDATED + lab results: CRF+Diabetes+Dementia. Now what?

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oscarandlucy

Member Since 2010
Hi again!
Oscar and I spent a great deal of time on this board when he was first diagnosed. He has been diet-controlled for the last 4 years (March 19th is the actual 4th year anniversary) and doing well. He is a rescue cat but we estimate his age at about 18 years. Up until the current problems, he ate Wellness grain-free chicken and turkey and Evo 95% Chicken and Turkey.

About six months ago, Oscar started showing signs of dementia, subtle things like more vocalizations and having a panic when he couldn't find me. More recently, it has gotten much worse - he has started forgetting to eat. At first, I thought it was just normal age-related changes in appetite. But he started losing weight and no longer runs to his automatic feeder when he hears it turn.

To test his appetite, I tried bringing the food to him. He eats a bit and then walks away. But, if I immediately reintroduce the food, he eats again. Each time making his little "good food" noises, as if he hasn't been eating for the last ten minutes. He does the same with the water bowl, demanding fresh water even though I just refilled it 5 minutes ago. He is starting to have trouble with the water bowl, forgetting how to drink and getting water up his nose which results in sneezing.

His energy level when awake is excellent. He still climbs up and jumps down from furniture to get where he wants to be and goes for walks up and down our corridors. He is affectionate and purry and still will not let anyone sleep beyond 6:00 am.

At this point, he is eating about 200 calories/day made up of a mix of baby food, wet foods which are <5% carbs, calorie dense and low phosphorous (his kidneys are borderline), a teaspoon or so of butter and a soft-boiled egg yolk. His meds are miralax/restoralax 1/8 tsp bid (with lacutolose rescue when needed), 1/4 tablet pepcid.

We were at the vet this morning. She found him in general good health, but took blood to screen just in case. He has lost 1 kg (2.2 pounds) since September, mostly muscle wasting on his back and hind legs. She thinks this is all about dementia.

She cautioned me off baby food saying it is too high protein for a borderline kidney cat. Not sure what to make of that.

He showed her how strong he was by needing 4 techs to hold him down so she could draw blood (this from a cat who weighs 9.5 pounds!). I think it is like the aggression you sometimes see with dementia.

So, this long post to ask for any advice or tips or thoughts on any aspect of dealing with a cat with dementia, diet-controlled diabetes, borderline kidneys and chronic constipation....YIKES!

Especially, how do I shorten meal times and tips for getting him to eat when I am not home to follow him around with food. (He does not feed during the night or on his own at all anymore.)

Thank you so very much!
 
Re: Dealing with feline dementia. Advice and ideas apprecia

I give J.D. Denamarin for dementia. Do a search for Dementia on this board. There's another member Bruce who gives his cat Simon a different drug for dementia.
 
Re: Dealing with feline dementia. Advice and ideas apprecia

My vet thought Oscar was not a good candidate for a drug because of his kidneys. Do you think they make a big difference? The trials I've read are mostly about dogs and the effects seem small. What has your experience been? I will do the search (I was not very successful when I tried earlier) when I get home this evening.

Thanks
 
Re: Dealing with feline dementia. Advice and ideas apprecia

I don't know how much it helps J.D.. He doesn't yowl that often. Bruce said Simon was a real yowler / howler or whatever and he stopped when he gave him the drug he is using. I will be interested in any more replies you get.
 
Re: Dealing with feline dementia. Advice and ideas apprecia

Bad news - the blood work is back and his kidneys are in bad shape. Moderate damage, she said. About a loss of 2/3 function.
Urea: 33.7
Creatinine: 720

Now, I am completely lost as to what to feed him since she said the high protein food is making him worse. She recommended a renal food and said the kidney failure will kill him long before the diabetes comes back if I stay with the same food.

She also recommended subcutaneous fluids.
 
Re: Dealing with feline dementia. Advice and ideas apprecia

I would join the Tanya's Feline CRF Support Group
They can help answer your questions about what food would be best for Oscar.
I would pick up a copy of his bloodwork, because they will want all the values.

Best Of Luck to Oscar and you.
 
Re: Dealing with feline dementia. Advice and ideas apprecia

oscarandlucy said:
Bad news - the blood work is back and his kidneys are in bad shape. Moderate damage, she said. About a loss of 2/3 function.
Urea: 33.7
Creatinine: 720

Now, I am completely lost as to what to feed him since she said the high protein food is making him worse. She recommended a renal food and said the kidney failure will kill him long before the diabetes comes back if I stay with the same food.

She also recommended subcutaneous fluids.
You may have misheard the numbers. I'm just saying because J.D.'s last BUN/UREA was 45 and Creatinine at 1.6.
Maybe Oscar's Creatinine was 7.2 and not 720?
 
Re: UPDATED: CRF + Diabetes + Dementia. Feeding advice, ple

Possibly, it may also be an issue of units. I did not write any down and it may differ between Canada and other countries, like BG numbers. I will clarify with the vet.
 
Re: UPDATED: CRF + Diabetes + Dementia. Feeding advice, ple

To cover see:
http://www.vin.com/calculators/default.htm
or
In the United States, BUN is measured in mg/dL. To convert BUN to a concentration in mmol/L (SI units), multiply by 0.357 ( (10 dL/1 L)/(28 mg of N/mmol of urea) = 0.357 ).
Creatinine mg/dL 88.4 µmol/L
Mulitiplu USA creatinine by 88.4 to convert to SI
 
Re: UPDATED: CRF + Diabetes + Dementia. Feeding advice, ple

Thank you for that link, as my almost 17 y.o. cat has started doing some rather strange things recently.
 
Re: UPDATED: CRF + Diabetes + Dementia. Feeding advice, ple

I have the blood results. And yes, it was an issue of conversion. Thanks for pointing me in the right direction.

Here are some data (it does not look good at all):

Urea (BUN): 94.40 mg/dL (normal range: 14-36.4)
Creatinine: 8.14 mg/dL (.55 - 1.96)
Phosphorus: 8.6 mg/dL (2.8 - 8.67)
Calcium: 9.6 mg/dL (8-16.6)
Calcium X Phosphorous: 82.6
BUN:Cr: 11.6:1
No evidence of elevated BG or of anemia.

So, I think I will go with a mix of the renal diet (Royal Canin LP, I guess, but I would love your suggestions for which is best of an OTJ cat) and the commercial foods with the closest profiles to the renal diet (eg: Evo 95% Chicken and Turkey). I am thinking about trying the raw Nature's Variety Chicken which is even closer to the renal diet but I have no idea if he will eat it.

Behaviourally, he actually seems better the last couple of days. Eating more on his own, even while I am sleeping. More himself.

Thoughts? Advice? All much appreciated.

Thanks
 
Re: UPDATED: CRF + Diabetes + Dementia. Feeding advice, ple

What normal range was specified for those values?
Do you have vale for urine specific gravity?

oscarandlucy said:
I have the blood results. And yes, it was an issue of conversion. Thanks for pointing me in the right direction.

Here are some data (it does not look good at all):

Urea (BUN): 94.40 mg/dL
Creatinine: 8.14 mg/dL
Phosphorus: 8.6 mg/dL
Calcium: 9.6 mg/dL
Calcium X Phosphorous: 82.6
BUN:Cr: 11.6:1
No evidence of elevated BG or of anemia.

So, I think I will go with a mix of the renal diet (Royal Canin LP, I guess, but I would love your suggestions for which is best of an OTJ cat) and the commercial foods with the closest profiles to the renal diet (eg: Evo 95% Chicken and Turkey). I am thinking about trying the raw Nature's Variety Chicken which is even closer to the renal diet but I have no idea if he will eat it.

Behaviourally, he actually seems better the last couple of days. Eating more on his own, even while I am sleeping. More himself.

Thoughts? Advice? All much appreciated.

Thanks
 
Those values are not good. You should:
- either feed low-phosphorous food or use a phosphorous binder
- If you a binder an anti-constipation suppliment like Mirlax is also likely necessary
- Giving sub-q fluids
- Giving potassium is that is also low
- 2.5 mg Pepcid AC one or twice daily if vomiting white foam
- B12 shots
 
Larry and Kitties said:
Those values are not good. You should:
- either feed low-phosphorous food or use a phosphorous binder
- If you a binder an anti-constipation suppliment like Mirlax is also likely necessary
- Giving sub-q fluids
- Giving potassium is that is also low
- 2.5 mg Pepcid AC one or twice daily if vomiting white foam
- B12 shots


Thanks, Larry.

Some of those bases are covered - transitioning to a low phosphorous food (although I worry about the diabetes) and will start sub-q fluids next week. He's been on Pepcid and Miralax for some time.

I will talk to the vet about a binder and about B12 shots.
 
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