May I have your advice please? (Urgent Esme story)

[badgerpup]

:hi:
Esme, my eldest (12+ years old) was down to a decent weight, thanks to a change in diet and her 'personal trainer', D'Artagnan. ;)

Then I noticed that 3 days after the visit to the vet of the Ninja Clowder she was noticeably thinner.

HIT THE PANIC BUTTON! :nuke:

Took her in to see the Sainted Vet again. He weighed her (she'd only lost about 6 oz) and took some blood.
Today we got the results back.
:yoiks:
Slightly elevated BUN and creatinine levels. As y'all know, this means the kidneys aren't as happy in their work as they ought to be.

The levels aren't high enough for ZOMGHOLYFARKIN'SHITHELPBBQ :hide:...but it'd be a REALLY good time to catch things before they go critical.
So...diet and supplemental fluids. I'm taking her in on Thursday and Sainted Dr Dave is going to show me how to give her extra fluid subcutaneously (she'll probably allow me to do this; they TRUST me- and if I 'splain things to her very carefully and thoroughly she'll be OK with it. I think.).

The thing I'm worried about is diet. First suggestion out of the box was kd. I'm going to try this on her, but Ezzle-may isn't much for canned food. There's a dry food that's s'posed to be good for kidneys, but
A). it costs the earth, and I have 4 cats and
B). according to Dr. Dave it's got corn in it and I want to stay RIGHT AWAY from cat foods that have corn, HFCS and its relatives as ingredients.

So...what do y'all suggest for a picky (well, more like 'dedicated vanilla') eater who needs kidney support? She likes her dry food (Diamond Active Cat), the water drained from human-type tunafish, and Greenies^TM.
When I put canned food down for everyone, she sniffs it and walks away...not interested, thank you.
She's not interested in any of the stuff I'm eating either, though the Fabulous Ninja Boys are horrible beggers (and it's all my fault- but I just can't resist those little faces...:crazy:)

Judging by her coat last fall (soft, silky and glossy), I think she may have been sharing the boys' kills (although I never saw her doing so. In fact, for all I know, she may have been catching her own...:shrug:).
Therefore all is probably not lost...and I've NO objection to cooking for me cats.
Any suggestions what oughta be on the menu?

Thanks, people...:grouphug:

[CC]

1. Giving the sub-q fluid

is not that hard to do. It looks scarier than it is. My vet tech calls it the purr juice because so many cats purr when getting it. Try setting a regular time and keep it relaxed. I used catnip and alone time as the bribes at first. Then Ayja got to reminding me when it was time.
Ayja would not eat the soft kd so ended up on the dry that he did like. I had to feed the cats separately and remove all food when it was not mealtime. That was a rude thing to them as they were allowed to free feed before.
I decided not to buy my sub-q from the vet because of price. I used Valley Vet Supply and bought it a case at a time along with lines and needles. Check prices online and there before you go in. When my cat was getting sub-q fluid valley vet was 1/4 the price the vet charged. Depending on how much Esme will need and how often it can get pricey. (Ayja was up to 100 ml twice a day for his last year and a half.)

Good luck and hope Esme does well.

[Lisa0825]

2. I do not know about specific foods, but here is a suggestion...

if you find that a food you try for her works very well, but is very expensive, try contacting local rescue groups to see if the might be able to order it for you at a discount. At the rescue I volunteer with, we have accounts with a few different brands, and thanks to the rescue or wholesale discounts, we are able to resell them at a much better price than most vets or retail stores do.

[Coyote_Bandit]

3. .

:hug:

I have a dog that came to me at 5 months of age. We was a renal failure dog and came with a recommendation that he be euthanized. His best prognosis was "wait and see." He is now a senior dog - and he has lived a pretty normal doggie life. His condition has been managed with diet (kd) for the last 9 years and he has responded well. While he may eventually require supplemental fluids that has not been necessary to date. He requires a multi-vitamin to compensate for iron deficiency (anemia). Recently, we have started him on thyroid supplementation. Otherwise, he takes no medication. We do take measures not to expose him to extreme temperatures or stress and we monitor his activity levels. His treats are restricted to things like apple slices, baby carrots, oatmeal and other natural things. His water bowl is filled with filtered water. His renal function is tested quarterly.

The good news is that you caught this early while BUN and creatinine levels are only slightly elevated. While that clearly suggests diminished renal function it also suggests that Esme does not have the extensive renal damage that accompanies renal failure.

This is a condition that can be managed. Esme can continue to lead a normal happy life. Learn as much as you can about renal disease. You will both benefit.

You may want to get a second opinion regarding Esme's course of treatment. I found widely divergent opinions regarding my renal dog. Most vets will likely agree that diet is critical in the management of the disease. However, you may find considerable disagreement as to when fluid supplementation is required. Be sure you have a vet that you trust.

Now, take a deep breath and relax.




FWIW, I have never like the idea of feeding the kd prescription diet. But my dog clearly has responded well to it. A few years back I tried to fabricate a homecooked diet that replicated the nutritional profile of the kd. I gave up and still feed the kd.

[CountAllVotes]

4. you might read my thread

It is a few lines down - Happy New Year from Mr. Flame.

He too was dx'd with kidney problems in November.

I was reluctant to feed him the K/D (not because of the expense however but because of the reasons you state in fact) plus I do get a slight discount on it of 10%.

In any event he was in rough shape and today he is doing very well. All of my cats are eating K/D and it is mixed with their old food that I've been feeding them (Life's Abundance).

This is working out well and by mixing the two together I have a lower phosphorus level now (about 6.5) which is apparently critical for kidney health and it is also more affordable by mixing the two foods.

I too have 3 cats and all of them eat this mixture now and all of them are doing very well, ages 17, 10 and 5.

I'd suggest you follow your veterinarian's advice. That is what I have done and the results are very good so far. Best of luck to you and you and Esme.

[sasha031]

5. this is a web site that is loaded with info. for CF cats

http://www.felinecrf.org/index.htm

my Sasha survived happily with kidney disease for 5yrs. What I did once I found out she had it was started her out with fluids right away in the early days. I aloud us to keep th disease under control. (note, make sure fluids are warm,)

As for food she was finicky also, I know I shouldn't have but I gave her Fancy Feast for those %yrs.

Another note, they appetite stimulants, (she was on one) when a kitty has CF they do lose their desire to eat.

Their is a bit of controversy on whether to have a cat on a low protein diet, With CRF they lose muscle mass.

If I had to do it over again I would go with a strict organic diet, and probably make her meals.
I hope this helps, I know what it feels like to have a furbaby who is ill and you will do anything in the world to save her.
Please feel free to IM me if I can help.
:hug:

[badgerpup]

6. Thanks, people!

:grouphug:

Tomorrow Esme and I will be learning all about sub-q fluid administration.
I don't foresee any real problems with this; as I've mentioned (probably ad nauseum) my monsters all trust me to an almost frightening degree. If she knows it's for her benefit (and if she either feels better or at least, doesn't feel worse afterward...as well as being rewarded for being such a good cooperative girl) she'll be OK with the procedure.

Figuring out what she will eat and will still be of benefit to her cranky kidneys is going to be the tough part...the bestest cat food in the UNIVERSE ain't gonna do her any good if she just turns up her pretty little nose and walks away from it.

I'm also enlisting the assistance of Sainted Dr Dave's partner- Sainted Dr Sonia.
She does a LOT of work with natural and holistic medicine...figure that might help.
She's the vet from whom I obtain the Bach flower remedies for when the boys are having behavioral issues that aren't related to health (e.g., Riktor's grief over losing Misha, Riktor's difficulty with a new kitten, Riktor and Wimsey knocking heads...Riktor is a sweet boy, but he's a bit...well...stubborn and he doesn't do 'change' well). She also directed me to Dr. Albright when Wimsey subluxated his elbow...chiropracty VS surgery. Chiropracty won, hands...er...paws down.

I called the vet's office today and talked to the lady who does the scheduling and some of the less-technical stuff and asked her if I'd be stepping on any professional toes or otherwise making people unhappy if I asked about this, and she assured me that there was no problem.

Whew...

[virgdem]

7. Another web site for Sub-Q fluids...

is www.bricomedicalsupplies.com/CRFpage.html

I've been using this company for Ringer's Lactate solution, Admin sets and needles since 2006 for my cat Sammy. She was diagnosed with Pancreatitis and needed fluid support. We continued to give her sub-q's since she was showing signs of Chronic Kidney Disease at age 16. She is now 19 going on 20 and is doing quite well. Brico Medical supplies is located in New Jersey and ships nationwide. We get 24 500ml bags/24 admin sets and 1-2 boxes of needles for about $130-140. If you get the 1000ml bags, it is even cheaper ($49.00/case vs. $68.00/case for 50ml bags).

As for food, Sammy eats Royal Canin L/P (low phosphorus) dry food, but doesn't really like the canned food, so I try to feed her high quality food (Wellness/Merrick/Petguard), which she does quite well on. I figure that at least she's getting the support with the dry food. It is a challenge, but it can be dealt with. Good luck in finding what works for you.

[BrklynLiberal]

8. I googled Feline Kidneydisease, natural remedies...here are some of the hits I got

http://www.nativeremedies.com/petalive/pa-kidney-support-dog-cat-urinary-tract.html?ysmchn=GGL&ysmcpn=Google%20PetAlive&ysmgrp=PA+Kidney+Support&ysmtac=PPC&ysmtrm=cat%20kidney%20natural

http://www.healthypetjournal.com/default.aspx?tabid=25105

http://www.felineinstincts.com/

http://www.2ndchance.info/homemadediets.htm
Home Cooked Pet Diets, Home Made Recipes And
Pet Nutrition

http://www.catsofaustralia.com/cat-kidney-disease.htm
Diet for Kidney Failure in Cats: The Protein Controversy

You may have heard that restricting protein is recommended for cats in kidney failure. Although this has been the "standard" treatment for decades, as far as cats are concerned, it has always been--and remains--very controversial. According to experts at Colorado State University's veterinary teaching hospital, restricted protein does not prevent kidney failure in a healthy cat, and has no effect on the ultimate progression of renal disease. Research also shows that even very high protein diets do not make renal failure worse in cats (although high protein does worsen the disease in dogs and humans). (One pet food maker recently completed a study it claims shows that its restricted-protein diet increases lifespan in CRF cats. However, because the study has not yet been published, it is impossible to evaluate the data, which is contradicted by other research.) The real culprit is actually phosphorus, which meat contains in large amounts. Decreasing phosphorus intake (by restricting protein) can help some cats feel better, so it may be worth a try in a symptomatic cat.

However, some studies have suggested that excessive restriction of protein may actually cause further damage to the kidneys and other organs, because there is not enough protein for normal body maintenance and repair. Experts say that these diets are not appropriate until the BUN (Blood Urea Nitrogen) is at least double what it should be normally (about 60-80 mg/dl).

Furthermore, there is one big problem with using the protein-restricted commercial diets: many cats don't like them, and won't eat them. Obviously, it does little good to provide a special diet if the cat is going to starve to death! Experts emphasize that it is much more important to feed the cat what he likes and will eat, and maintain weight and body condition, than to be overly concerned about protein content. (Please note that if you add any other protein source to the diet, it will completely negate any possible beneficial effect from the low-phosphorus renal diet. It is useless to feed both a renal diet and a normal protein food or meat-based treats at the same time.)

...more at link...

[badgerpup]

10. From what I understood from my Sainted Vet...

...about protein-
You don't want to necessarily restrict it, but you want to give them proteins that are REALLY easy to break down and 'access'.

Looks like I've got a LOT of studying to do...

Thanks to EVERYONE...I can't tell you how much I appreciate the links and the encouragement and back-up!

Esme does, too!

[BrklynLiberal]

11. Sweeeeeeeeeeeee eeeeeeeeeeeeeeeeet

[glinda]

9. Join this Group. It is very good and helpful

http://pets.groups.yahoo.com/group/Feline-CRF-Support/

also...heed all the advice given. It is very good. I have five on Royal Canan Renal wet and dry. One with kidney failure at 3/4 loss and I do subQ every day. Two with heart problems. @ elderly. So all of mine just get the same stuff.

Giving SubQ is easy. Just put them in a nice chair with sides on it and a blanket and they will lay down as they get comfy. : > ) SubQ prevents them from getting nauseous also and my cat likes to eat right after it.

Good luck!

ps. Keep a good clean litter box also.

[Curmudgeoness]

12. This brings me nightmares, since I just lost a cat to renal failure.

She was diagnosed in September with slightly elevated levels, and every few weeks she was retested with jumps every time, and passed away in December, so my experience was that it progressed much to quickly for me to get a routine down.

I did the kidney disease foods---tried all available. My cats hated them, but would eat the Royal Canin dry. If I had it to do over again, I would feed them the same food they always ate and seemed to like. I spent a fortune on all the special foods that the cats refused to eat. You do say you feed an "active cat" food, and that would probably be really high in protein (active=protein), and I don't know whether that is a good choice. Just do not let the cat go downhill by playing games with her food.

Sub-q is not hard and does seem to help. I also bought a water fountain so that the water was always moving and very tempting. I do think she drank more because she was intrigued by it. I used an appetite stimulant that I got from the vet, and wish I would have started that sooner too.

Someone also suggested a supplement that I wish I would have tried, and I will try to find what it was and share it with you. I believe that the more you do to help your cat, the better.

Best of luck. I really do sympathize with you. Love your kitty like crazy.

[Curmudgeoness]

13. I found the name of that supplement. It is Azodyl.

This was the thread from when I first found out about the kidney disease and there was a lot of good advice. This supplement was mentioned in #32.

http://www.democraticunderground.com/discuss/duboard.php?az=show_topic&forum=105&topic_id=9498170

Best of luck.

:hug: