Cat With Kidney Problems

[Boban]

My cat Charlie, is almost five in he is diagnosed with chronic kidney disease. He is on IV therapy for a week and his creatinine levels got little worse around 1200 and urea is little better now 85, also phospohorus level dropped a little. He doesn't have anemia. He is still on IV, but my vet thinks that he can not be helped. Right now he got three times a day IV fluids, one time in vet clinic 120ml, and two times a day (120ml and 60ml) I gave him IV at home. At the beginning he didn't want to eat, and after two or three days he started to eat, mostly meat, and for three days he eat well, today he eat less then last three days. Vet suggested if he don't start to eat in next day or two we should stop with IV and he should be euthanized.
I read about some treatments with SubQ fluids but my vet is against and he will allow me to give him IV in home instead of SubQ. He also told me that I could give him IV for three months, and that that would not harm a cat. Does anyone have experience with this kind of problem? Does anyone know what might be better IV or SubQ? If he stops eat for a day or two does that mean that his condition will not get better?
Thank you

 

[furmonster mom]

CKD in a cat that young seems unusual to me. Nevertheless, if this is what you're dealing with, you will need to change his diet.

The key here is to manage the phosphorus levels.
It used to be (and for some old school vets still is) the thing to do with a CKD cat was to reduce their protein intake (because meat generally has a lot of phosphorus). So they would prescribe foods that were loaded with fillers like grains (corn, oats, barley, rice, etc.,.), and the protein sources would be plant based (soy) instead of meat (or there would be very little actual meat). The problem is that cats are not really designed to process those things, it puts a very heavy burden on the pancreas and digestive tract, which then can domino into various other issues. So you would be trading one problem for a host of others.

Phosphorus levels can be controlled by other methods without sacrificing the quality of your carnivore's food.

• First, I highly recommend a grain free wet food diet. Moisture is very important to CKD kitties, they often will not drink enough water on their own, so they need to get it from their food. Sub Q fluids are good for periodic treatments, but really can only carry you so far.
  
• You can also do a small percentage substitution with cooked egg white. Egg whites are a very good high protein, low phosphorus (zero, I believe) food. Feeding the yolk along with provides a great source of other vitamins (choline, vit B). Egg whites should be cooked to avoid an overload of the avidin enzyme (which could cause vit B depletion... which is another reason to feed the yolk)
• Egg shell and Aluminum Hydroxide are phosphorus binders that you can add to the food. If you use egg shell, please remember that a little bit goes a long way; too much can cause constipation. You can get Aluminum Hydroxide through your vet, who will be able to suggest a proper dosage for your kitty.

These are a few of the things I did for our angel kitty Belle as we managed her CKD for 4 years after her diagnosis.
I'm sure there will be more folks with good info as well.

 

[Boban]

Thank you for answer. I will consult my vet about changing diet but I am afraid it might be to late because he don't want to eat for second day now, and I don't know should somehow force him to eat food. Usually vet suggest that I give him liquid food with a syringe, but he don't like that . Vet will give him iv treatment for couple more days but after that it is on me to continue IV or sub q treatments and meds at home, but what good can come from all of it if he don't want to eat by himself.

 

[happilyretired]

I don't know why your vet is opposed to SubQ because that's what most vets recommend when CKD cats are in the late stages of failure. I've read that some cats do fine with SubQ for months, but my own experience was that it was not a solution for my boy. We did SubQ for a week, and although he seemed to be better at first, he steadily declined, and when he stopped eating completely (and seemed miserable), I opted for euthanasia--which my vet told me would be my call, as she knew he was in end-stage failure.

If SubQ gets your cat back to eating, then it would certainly be a good approach. I was afraid of the process, but I found that my cat was very compliant, and it was not a problem (I practiced a lot before doing it).

 

[Boban]

I don't know why your vet is opposed to SubQ because that's what most vets recommend when CKD cats are in the late stages of failure. I've read that some cats do fine with SubQ for months, but my own experience was that it was not a solution for my boy. We did SubQ for a week, and although he seemed to be better at first, he steadily declined, and when he stopped eating completely (and seemed miserable), I opted for euthanasia--which my vet told me would be my call, as she knew he was in end-stage failure.

If SubQ gets your cat back to eating, then it would certainly be a good approach. I was afraid of the process, but I found that my cat was very compliant, and it was not a problem (I practiced a lot before doing it).

My cat is still on IV , today is 8th day, and he is not getting any better, even little worse. Vet said that he don't need Sub Q until he is on IV, and that could go on with IV for months at home. He eat very little yesterday almost nothing today, I will force feed him later with some diet food, as vet suggested, and see if he will vomit that, but I am afraid that this will not end well. I had cat put to sleep last summer, she was 13 y.o. same kindey problems but I waited for euthanasia for to long and last couple of days was agony for her and for me. Euthanasia is something that I always feared the most about my pets.

 

[happilyretired]

I don't know how you'd manage IV at home--doing SubQ is possible, but it seems to me that IV requires a vet's expertise.

I have had two CKD cats, and I know the decision to euthanize is very difficult, but in both cases, the cats stopped responding to any treatment and were not eating, and my vet assured me that while the decision was mine, it was 'time' to let them go. With my second boy, I'd hoped for a few more days with him, but he was not eating at all, and I didn't want him to suffer.

What was true with both of them is that at the 'end,' they seemed to rally, and my vet told me that she'd seen that with both dogs and cats, and sometimes the human decides not to euthanize, only to call the next day to plead for it because the animal is so miserable. So you really have to be objective about what's going on with the cat and not be deceived by their natural inclination to hide illness.

 

[Boban]

I live in Serbia and it is vet practice is different here. I have to take my cat two times a day to vet clinic and set down with her during IV treatments. IV needle is in his leg all the time, so vet gave me bottle of ringer lactate solution to take home and I gave her dosage that they decide. Sometimes vet came to my home to help me set up system, but now I know how to do it myself, because I had a lot of practice when one of my cats got poisoned and she was receiving IV treatments couple of times a day.
That was hardest for me to decide is it time or not.

 

[SAKitty]

I just went through this with my 15 year old cat, unfortunately we did have to put him down but not due to his kidney failure, he also had cancer.
We did 200ml to 300ml of SubQ fluids daily, at home, as well as had him on a special diet of "renal support E" wet food from Royal Canin right from the time he left the vet until we had to put him down, which was four months later. But during that time he went from deaths door with zero kidney function to his old self again.

 

[Boban]

Thank you for answer, did you gave him same medications at home? How did you lower his creatinine levels, is there some medications or just diet?

 

[SAKitty]

No medications. Just the SubQ fluids and the new diet. You can get the food in hard or soft. I chose to do the soft food because it gave my cat extra fluid plus he loved soft food. This specific food is a prescription food from the vet.
He did go in weekly for blood tests for about a month but his levels went back to near normal and then he only went once a month after that to get it checked.

 

[SAKitty]

Oh I should also mention that he did not eat anything else but this special diet food that specifically helped to treat his kidney issue. No treats, no table scrapes - nothing - and I made sure he couldn't get into anything too.

 

[cat princesses]

Hi!
Are you part of Tanya's renal cats support group? They are by far the experts on all things CKD. They helped me tremendously with my last CKD kitty - please check them out as well!

 

[furmonster mom]

So sorry you are struggling with this. If this is indeed last stages (which it's sounding like), then remember that your kitty is struggling as well. If it's his time to cross the rainbow bridge, the kindest thing you can do is make his last journey as easy as possible. It's hard, because we humans have our own dilemmas regarding that, but remember that they do not. Animals do not have the same kind of morals or philosophical thoughts that we do, all they know is how they feel here and now. You have the power to offer a peaceful and gentle passing.

 

[Antonio65]

I read about some treatments with SubQ fluids but my vet is against and he will allow me to give him IV in home instead of SubQ. He also told me that I could give him IV for three months, and that that would not harm a cat. Does anyone have experience with this kind of problem? Does anyone know what might be better IV or SubQ?

Hi and welcome.
I think that your vet isn't against the subQs, but I think he presumes that if IVs aren't working, the subQs won't do any better and hence they're useless.
IV fluids are much more effective and give out results much quicker than subQs.

What I don't understand is how he thinks to be giving your cat the IV fluids for three months. The needle that rests in the vein of your cat cannot stay there indefinitely. As far as I know there's a maximum length of time, then it has to be removed and a new one has to be inserted into a different vein. And that length of time is a week.
I hope someone else will prove me wrong.

I had been giving subQ fluids to my cat for over 10 years. She had a renal failure too.
It is very important to change the cat's diet to a low phosphorus one. Generally these diets aren't much appreciated, but they get used to them eventually.
And the meds that the vet usually prescribe.
A well managed CKD can give your cat many years of life.

 

[Boban]

Thank you all, I just ordered Royal Canin renal food and I will start with that tomorrow. Today I gave him some medical food with low protein and he didn't vomit food, just some yellow foam later. Vet said that I give him some more time and try with food. Maybe my mistake was that during IV treatments last week when he got better I gave him meat (beef) to eat and he eat a lot, so that might got him little worse.

 

[Boban]

Hi!
Are you part of Tanya's renal cats support group? They are by far the experts on all things CKD. They helped me tremendously with my last CKD kitty - please check them out as well!

Yes I know about that support group and I read their website, they give me a little hope to try and fight this, even with chances for him getting better are very slim

 

[Antonio65]

Thank you all, I just ordered Royal Canin renal food and I will start with that tomorrow. Today I gave him some medical food with low protein and he didn't vomit food, just some yellow foam later. Vet said that I give him some more time and try with food. Maybe my mistake was that during IV treatments last week when he got better I gave him meat (beef) to eat and he eat a lot, so that might got him little worse.

Yes, treats and food different from the diet one must be avoided, at least in the acute moments of the disease.
Hasn't your vet prescribed a med for your cat? Usually vets prescribe an ACE inhibitor to CKD cats, namely Fortekor.
This can be of great help and benefit.
Do not give your cat anything different from his diet food.

 

[cat princesses]

I know mixing B complex I think it was into the sub q fluids was really good as well. I did that for my CKD cat and also gave her b12 shots separately.

 

[Boban]

Yes, treats and food different from the diet one must be avoided, at least in the acute moments of the disease.
Hasn't your vet prescribed a med for your cat? Usually vets prescribe an ACE inhibitor to CKD cats, namely Fortekor.
This can be of great help and benefit.
Do not give your cat anything different from his diet food.

I asked him about fortekor today when he received treatment and he gave him enalapril, which is same medication but different name. For now vet gave him everything he need during therapy, but if vet decide to stop with therapy then I will ask him for medication that I might give him at home

 

[Antonio65]

Please, follow C cat princesses 's advice about vit B complex. Also probiotics can be of great help!