As expected, kidney issues after I131

Radtech49

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So, as expected, my jack has kidney disease. He had his one month blood work post i131 treatment. He'll have another blood test in 60 more days for a 90 day i131 follow up. His thyroid level is within range now and he's not yowling *as much* and is eating pretty good. He's gained 3oz, but he is drinking a LOT more water.

The vet gave 2 options of either changing his food to a low protein diet or doing sub Q fluids. Her recommendation was to keep him on his raw food/wet food diet and do subQ fluids since he's such an affable cat. She said he wasn't on the severe end of kidney disease, but of course that will only get worse. I've attached his results if anyone would like to share their experiences with this.
 

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Maurey

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It’s normal for cats on raw and high protein wet diets to have slightly elevated kidney values compared to cats on low protein/kibble diets, without it affecting their health. Were his kidney values significantly lower previously? Has his diet changed since his previous bloods?
 

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My Jamie is 4 and has had high BUN readings for a couple of years. Not going to insert his whole story here; yesterday his most recent test of 2 days ago was 50 BUN and 2.4 creatinine. He does eat a wet, high protein diet and is not a kibble eater, although he will take dry treats. His vet suggested doing sub Q fluids, which we have done before, but at great stress to him no matter how they are handled. In a cat who would accept sub Q fluids graciously, that would be my first course of action.
 
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Radtech49

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My Jamie is 4 and has had high BUN readings for a couple of years. Not going to insert his whole story here; yesterday his most recent test of 2 days ago was 50 BUN and 2.4 creatinine. He does eat a wet, high protein diet and is not a kibble eater, although he will take dry treats. His vet suggested doing sub Q fluids, which we have done before, but at great stress to him no matter how they are handled. In a cat who would accept sub Q fluids graciously, that would be my first course of action.
Thank you! I am leaning toward this. His BUN has always been normal, until this latest bloodwork. But i knew it was a possibility after having his thyroid treated. His urine specific gravity was low as well. I've never done subQ but he's altogether a pretty compliant cat, so I'm willing to try that. I'm also wondering about vitamin B shots to help him as well. Any experience with that?
 

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BUN isn't as good of an indicator for kidney disease as creatinine is. There are numerous things that can affect BUN more easily. Have you looked at felinecrf.com? All about CKD, and I would highly recommend you spend some time reading from this very informative, helpful web site. It is a lot of information, but well worth spending some time looking through it all. There are other factors to consider but generally speaking a 2.4 creatinine doesn't usually warrant sub-Q fluids.
 
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Radtech49

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BUN isn't as good of an indicator for kidney disease as creatinine is. There are numerous things that can affect BUN more easily. Have you looked at felinecrf.com? All about CKD, and I would highly recommend you spend some time reading from this very informative, helpful web site. It is a lot of information, but well worth spending some time looking through it all. There are other factors to consider but generally speaking a 2.4 creatinine doesn't usually warrant sub-Q fluids.
Thank you for that info. My vet was more concerned about his specific gravity and that he's drinking a tremendous amount of water every day. I have been to Tanya's website. It's overwhelming and I notice she doesn't recommend a raw food diet, Which my cat has been on for years. I certainly don't mind switching it to something else, but i absolutely will not use royal canin or hill's science diet.
I did see her recommendation for b12 or b complex injections. I just want to do whatever is best to make him more comfortable and will make his appetite better. He's a very active cat, but he seems worried(for lack of a better word) most of the time. He's very clingy and goes through phases of yowling. He does get to go outside in the fenced in yard. Supervised of course. And i used to think his yowling was related to him wanting to go outside. But he's antsy and paces and yowls. Some of that has gotten better since he had i131 treatment a month ago and I know there are still a few months of adjustment with that. He gets bloodwork again in 2 months. I want to do something in the interim to increase his appetite and decrease his anxiety
 

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Maybe this web site would also be helpful (see below for link)? I have used it for helpful information related to Feeby's H-T and CKD, even though she is not on a raw diet. And, although its title is related to IBD, there is a host of other data that does not have to be solely related to IBD.
Feline Nutrition & Health - Raw Feeding for IBD Cats
 
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Radtech49

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I'm (unfortunately) well-versed with CRF/CKD... my old girl Wintressia was diagnosed at age 14. She lived with the disease for another 6 years and died of a stroke in 2018, two months shy of her 20th birthday. She was actually a hyperT cat as well and I considered i131 for her - but her hyperT was pretty mild and was managed pretty easily with meds.

She was on a raw diet at the time of her diagnosis and had been for about a year; prior to that she had been fed kibble almost exclusively (she was an outdoors cat as my mother refused to have pets inside, and I got her in 1998... long before much was known about feline diet and nutrition).

She got subQ fluids daily and bi-weekly B12 shots. I did scads of research and eventually refused to put her on one of the prescription kidney diets as she was already elderly and experiencing some muscle wasting - I was NOT going to reduce her protein intake and cause more wasting. Low protein diets in cats are just such anathema to me - I get that we are trying to reduce load on the kidneys, but cats are obligate carnivores and need that protein.

I think the B12 shots helped her significantly, as did the subQ fluids.

I was fortunate with Win - she took her subQ fluids like a champ and would calmly chill on top of the washing machine without even trying to escape. I kept her on her raw diet initially and mixed in a little extra water, but as her disease progressed and she got older and had less appetite in general, I had to switch her to wet food, and at the very very end, she was mostly chowing down on canned kitten food.

I strongly feel that keeping her on a raw diet for years, even after her diagnosis, contributed to her long, happy life after her diagnosis - the initial diagnosing vet gave her 3 months to live and recommended I euthanize her on the spot. (lol nope)

I dug up some of Win's old bloodwork -

In April of 2016, two years before she died (she would have been almost 17 years old at this time), her creatinine was 3.6 and her BUN was 62. This was 4 years after her initial diagnosis.

I think you should go with your heart/gut with Jack. He's about the same age Wintressia was when she first got diagnosed, and maybe Win was an outlier for CRF/CKD longevity and progression speed, but I stuck with my feelings with her treatments/diet, and I got to have another 6 wonderful years with her.

Here's a video of how playful and spry she still was in January of 2016 -

 
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Radtech49

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I'm (unfortunately) well-versed with CRF/CKD... my old girl Wintressia was diagnosed at age 14. She lived with the disease for another 6 years and died of a stroke in 2018, two months shy of her 20th birthday. She was actually a hyperT cat as well and I considered i131 for her - but her hyperT was pretty mild and was managed pretty easily with meds.

She was on a raw diet at the time of her diagnosis and had been for about a year; prior to that she had been fed kibble almost exclusively (she was an outdoors cat as my mother refused to have pets inside, and I got her in 1998... long before much was known about feline diet and nutrition).

She got subQ fluids daily and bi-weekly B12 shots. I did scads of research and eventually refused to put her on one of the prescription kidney diets as she was already elderly and experiencing some muscle wasting - I was NOT going to reduce her protein intake and cause more wasting. Low protein diets in cats are just such anathema to me - I get that we are trying to reduce load on the kidneys, but cats are obligate carnivores and need that protein.

I think the B12 shots helped her significantly, as did the subQ fluids.

I was fortunate with Win - she took her subQ fluids like a champ and would calmly chill on top of the washing machine without even trying to escape. I kept her on her raw diet initially and mixed in a little extra water, but as her disease progressed and she got older and had less appetite in general, I had to switch her to wet food, and at the very very end, she was mostly chowing down on canned kitten food.

I strongly feel that keeping her on a raw diet for years, even after her diagnosis, contributed to her long, happy life after her diagnosis - the initial diagnosing vet gave her 3 months to live and recommended I euthanize her on the spot. (lol nope)

I dug up some of Win's old bloodwork -

In April of 2016, two years before she died (she would have been almost 17 years old at this time), her creatinine was 3.6 and her BUN was 62. This was 4 years after her initial diagnosis.

I think you should go with your heart/gut with Jack. He's about the same age Wintressia was when she first got diagnosed, and maybe Win was an outlier for CRF/CKD longevity and progression speed, but I stuck with my feelings with her treatments/diet, and I got to have another 6 wonderful years with her.

Here's a video of how playful and spry she still was in January of 2016 -

I'm (unfortunately) well-versed with CRF/CKD... my old girl Wintressia was diagnosed at age 14. She lived with the disease for another 6 years and died of a stroke in 2018, two months shy of her 20th birthday. She was actually a hyperT cat as well and I considered i131 for her - but her hyperT was pretty mild and was managed pretty easily with meds.

She was on a raw diet at the time of her diagnosis and had been for about a year; prior to that she had been fed kibble almost exclusively (she was an outdoors cat as my mother refused to have pets inside, and I got her in 1998... long before much was known about feline diet and nutrition).

She got subQ fluids daily and bi-weekly B12 shots. I did scads of research and eventually refused to put her on one of the prescription kidney diets as she was already elderly and experiencing some muscle wasting - I was NOT going to reduce her protein intake and cause more wasting. Low protein diets in cats are just such anathema to me - I get that we are trying to reduce load on the kidneys, but cats are obligate carnivores and need that protein.

I think the B12 shots helped her significantly, as did the subQ fluids.

I was fortunate with Win - she took her subQ fluids like a champ and would calmly chill on top of the washing machine without even trying to escape. I kept her on her raw diet initially and mixed in a little extra water, but as her disease progressed and she got older and had less appetite in general, I had to switch her to wet food, and at the very very end, she was mostly chowing down on canned kitten food.

I strongly feel that keeping her on a raw diet for years, even after her diagnosis, contributed to her long, happy life after her diagnosis - the initial diagnosing vet gave her 3 months to live and recommended I euthanize her on the spot. (lol nope)

I dug up some of Win's old bloodwork -

In April of 2016, two years before she died (she would have been almost 17 years old at this time), her creatinine was 3.6 and her BUN was 62. This was 4 years after her initial diagnosis.

I think you should go with your heart/gut with Jack. He's about the same age Wintressia was when she first got diagnosed, and maybe Win was an outlier for CRF/CKD longevity and progression speed, but I stuck with my feelings with her treatments/diet, and I got to have another 6 wonderful years with her.

Here's a video of how playful and spry she still was in January of 2016 -

Thank you so very much for sharing your story and the adorable video of Win. Just a beautiful kitty!. Being that he's in supposedly early stages, according to the vet, i am just going to continue his normal food and supplement him with fluids and pray i get 6 more years like you did with win
 

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Thank you! I am leaning toward this. His BUN has always been normal, until this latest bloodwork. But i knew it was a possibility after having his thyroid treated. His urine specific gravity was low as well. I've never done subQ but he's altogether a pretty compliant cat, so I'm willing to try that. I'm also wondering about vitamin B shots to help him as well. Any experience with that?
I have heard of vitamin B being given in the water SQ solution. Ask your vet about that option. B12 is light sensitive so you need to store it in a dark place, according to my vet when a cat needed them. (She was never put on SQ fluids because I can't do it.)
 
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Radtech49

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I have heard of vitamin B being given in the water SQ solution. Ask your vet about that option. B12 is light sensitive so you need to store it in a dark place, according to my vet when a cat needed them. (She was never put on SQ fluids because I can't do it.)
I have heard that as well. Some say b12 stings and if you put in the fluid bag, then the whole bag going in will sting. But i will confirm with the vet.
 

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I have heard that as well. Some say B12 stings and if you put in the fluid bag, then the whole bag going in will sting. But i will confirm with the vet.
People say what makes the fluid sting is temperature. Cats do not like cold, so some people warm it up.

That is true whether B12 is in the fluid or not IIRC.
 

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Did the vet say Jack may already have CRF and you will know for sure after the I-131 treatment? Somehow HT hides CRF in the blood - not to mention both diseases have similar symptoms. It is why the urine specific gravity (USG) matters: without that, vets will not know whether a hyperthyroid cat has kidney failure or not.

Although creatinine is the most important thing to look at, blood urea nitrogen (BUN) matters a lot too.

When vets push for low protein diets, they are trying to lower the phosphorus levels. The only things with a lot of digestible protein and a very low amount of phosphorus are eggs - not exactly cat food because they lack taurine (although some raw meat feeders substitute eggshells for bones). Pet food manufacturers know it would be too expensive and time-consuming to remove most phosphorus in meat so they have to settle for reducing the amount of meat. Too much phosphorus, not too much protein, taxes the kidneys.
 
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Radtech49

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Did the vet say Jack may already have CRF and you will know for sure after the I-131 treatment? Somehow HT hides CRF in the blood - not to mention both diseases have similar symptoms. It is why the urine specific gravity (USG) matters: without that, vets will not know whether a hyperthyroid cat has kidney failure or not.

Although creatinine is the most important thing to look at, blood urea nitrogen (BUN) matters a lot too.

When vets push for low protein diets, they are trying to lower the phosphorus levels. The only things with a lot of digestible protein and a very low amount of phosphorus are eggs - not exactly cat food because they lack taurine (although some raw meat feeders substitute eggshells for bones).

He's already a month post i131 treatment. Which uncovered his kidney deficiency. His phosphorus level was normal. His bun and creatinine were elevated, but she was mainly concerned about his urine specific gravity and his symptoms. He's been drinking a LOT of water and he's sleeping a lot more. It can take a few months for the thyroid to settle, but he does seem to be more calm already and his t4 is in normal range. She didn't stage him, but she certainly seemed to be sure of his crf. She's an extremely easy going vet. She basically leaves it all up to me. She'll give me the information and do whatever tests i ask for, but ultimately she never pressures me to do anything. Her opinion was to keep him on his normal food and do fluids. She said how often really depended on his symptoms. If we started at 1x a week and his water intake seemed normal, then that was enough. If he started drinking more water, then the frequency would increase. I've attached the test results in the first post. He eats raw food. But he also eats canned food sometimes too. My refrigerator has been broken and while I'm waiting for it to be fixed, He's been on canned food mostly.
 

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My boy Sundar was diagnosed with kidney disease three and a half years ago, and was put on a special diet and Semintra. The diet was just not going to happen long-term and I was pleased to be able to have a more normal one as the Semintra has worked wonders. My vet's cat has renal failure and it's working brilliantly for her too. It reduces proteinuria. I'm not sure how much it's used in the States, but I know friends in Europe, and of course here, swear by it.
 

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My boy Sundar was diagnosed with kidney disease three and a half years ago, and was put on a special diet and Semintra. The diet was just not going to happen long-term and I was pleased to be able to have a more normal one as the Semintra has worked wonders. My vet's cat has renal failure and it's working brilliantly for her too. It reduces proteinuria. I'm not sure how much it's used in the States, but I know friends in Europe, and of course here, swear by it.
Out of curiosity, have you or your vet noticed any of the side effects? Lack of appetite and dehydration seem concerning with CKD cats, but I don’t know how common they are in practice.
 

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Out of curiosity, have you or your vet noticed any of the side effects? Lack of appetite and dehydration seem concerning with CKD cats, but I don’t know how common they are in practice.
Do you mean, with the Semintra? None with Sundar and he's been on it all that time.
 

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Do you mean, with the Semintra? None with Sundar and he's been on it all that time.
Yep, the Semintra. Good to know, thank you! Knock on wood, my two are very healthy, and will remain so for a good few years, but it’s good to know about more options for treatment :)
 
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