CKD diagnosis - what to expect

Nan68

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Not sure anyone mentioned yet not read all replies but I had 20 yo cat with kidney disease and epakitin supplement really kept her going she has since passed but I found it bought her more time.
 
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blumarine916

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Not sure anyone mentioned yet not read all replies but I had 20 yo cat with kidney disease and epakitin supplement really kept her going she has since passed but I found it bought her more time.
Thanks. I will check that out.
 

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Is it normal for CKD cats to still drink water even if we are giving SubQ once a day? I keep thinking was it because the SubQ is not enough.
Yes, for my cat it was normal,...since I figure that our cats still need the moisture in the water, or wet cat food, to feel their mouths, throats, throat linings to feel well hydrated.
The sub-q's go into the 'interstitial spaces'...and are absorbed differently...than taking in water from drinking.
Body Fluid Compartments and Fluid Dynamics in Animals - Emergency Medicine and Critical Care - Merck Veterinary Manual

Not sure, if your Meffy needs more Sub-q fluid, though?
Do you know her present weight,...or the weight that the Vet last did, at the clinic?

If you can find that out, then you could do a simple calculation, which the 'iwillhelpyourcat' vet did, and get a good safe number, to know approximately what is useful to give.
The formula he used is on his website, too.
Videos & Tutorials — I Will Help Your Cat

Meimey threw up her food last night. She has a habit of eating too fast sometimes and running around immediately after eatinf. After throwing up, she came back for more, threw that up too. So I removed all the food last night. This morning, again regurgitating minutes after eating and coming back for seconds. This is beginning to worry me. I didn’t see anymore incidents before I left the house so I’m hoping she calmed down. She’s been so nervous/scared ever since Meffy was diagnosed and Meffy going back and forth to the vet. I wonder if this is stress triggered. Usually Meimey vomits 1-2 times a month. Last month was good, no incidents until Meffy got sick.
Hmm...that is a bit worrisome.
Could you try placing her food, higher up, on some books, or a box, so that she does not have to bend over to eat.
18 Awesome Cat Feeding Tips By Thecatsite Staff Members – TheCatSite Articles

Even some puzzle games may help:
Homemade Puzzles - Food Puzzles for Cats
Unless she eats the actual puzzle, or cannot figure it out.

(you have to supervise them, and my female cat just gives up, but goes back to the treats later, while my male cat enjoys the challenge, for awhile. Basically, both my cats get me to show them over and over how it's done, and get the food/treats out for them. ahhhh...my cats are way smarter than their human. The cats are probably laughing inside, on how easy I am.)

Also, maybe trying some of those 'online licky mats'...or other online products...which could 'slow down a cat's eating'.
**Google:..."how to slow down a cat that eats too fast"...and you will get a lot of suggestions.

*Is the food that you are feeding Meimey...also been changed from her usual food?
She might be having some sort of 'sensitivity'...or slight allergic reaction to something in the food, too.

And check any of the food, in case they made some 'ingredient changes', or 'supply chain changes'..from where they source their products. If it's the same food, but a 'new batch'...then sometimes even 'small changes' are totally noticed by our cats.
Check for recalls on any batches.

Sometimes a food will go bad, once in the fridge,...I've seen that happen.
Or or with dry food, if it's left in a bag, and not in one of those see through, sealed containers, where heat, or moisture, humidity, can affect it..it could also go bad.
Even some you buy from the store, and open them, will sometimes have an awful smell, and then you know that it must have been bad to start off with.

Thankfully, this happens rarely, but still it does happen.
(same with food for us humans, too, since we really don't know how long they froze it, or let it sit on a shelf. Sure, they put on a date, but sometimes it goes bad fast.)

Members, here, have mentioned this site, for some more useful info to read:
Feeding Your Cat: Know the Basics of Feline Nutrition – Common Sense. Healthy Cats.
(I've only browsed it, so cannot really say.)

Not sure anyone mentioned yet not read all replies but I had 20 yo cat with kidney disease and epakitin supplement really kept her going she has since passed but I found it bought her more time.
Thank you so much Nan68 Nan68 . This is very helpful info to know.
Ipakitine/Epakitin Powder For Dogs Cats – The Veterinary Medicine
Why Try All Natural Epakitin For Cat Kidney Disease?

blumarine916 blumarine916 ..maybe there is a substitute version in Malaysia, which would be lesser in cost, too,..so you would not have to import so far.
Vetoquinol Epakitin: Buy Online in Malaysia at desertcart
 
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michelle3370

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Will Meffy ever be back to cheerful, playful herself despite being sick? Or have I lost this forever?
Did you vet give her subcutaneous fluids? It is done via IV. I had 2 kidney disease cats that I gave the fluids myself. I have another that hasnt gotten to that point yet. I would give it a little time for her to perk up. My cats did better on the fluids and with their CKD diet.
 
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blumarine916

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Yes, for my cat it was normal,...since I figure that our cats still need the moisture in the water, or wet cat food, to feel their mouths, throats, throat linings to feel well hydrated.
The sub-q's go into the 'interstitial spaces'...and are absorbed differently...than taking in water from drinking.
Body Fluid Compartments and Fluid Dynamics in Animals - Emergency Medicine and Critical Care - Merck Veterinary Manual

Not sure, if your Meffy needs more Sub-q fluid, though?
Do you know her present weight,...or the weight that the Vet last did, at the clinic?

If you can find that out, then you could do a simple calculation, which the 'iwillhelpyourcat' vet did, and get a good safe number, to know approximately what is useful to give.
The formula he used is on his website, too.
Videos & Tutorials — I Will Help Your Cat


Hmm...that is a bit worrisome.
Could you try placing her food, higher up, on some books, or a box, so that she does not have to bend over to eat.
18 Awesome Cat Feeding Tips By Thecatsite Staff Members – TheCatSite Articles

Even some puzzle games may help:
Homemade Puzzles - Food Puzzles for Cats
Unless she eats the actual puzzle, or cannot figure it out.

(you have to supervise them, and my female cat just gives up, but goes back to the treats later, while my male cat enjoys the challenge, for awhile. Basically, both my cats get me to show them over and over how it's done, and get the food/treats out for them. ahhhh...my cats are way smarter than their human. The cats are probably laughing inside, on how easy I am.)

Also, maybe trying some of those 'online licky mats'...or other online products...which could 'slow down a cat's eating'.
**Google:..."how to slow down a cat that eats too fast"...and you will get a lot of suggestions.

*Is the food that you are feeding Meimey...also been changed from her usual food?
She might be having some sort of 'sensitivity'...or slight allergic reaction to something in the food, too.

And check any of the food, in case they made some 'ingredient changes', or 'supply chain changes'..from where they source their products. If it's the same food, but a 'new batch'...then sometimes even 'small changes' are totally noticed by our cats.
Check for recalls on any batches.

Sometimes a food will go bad, once in the fridge,...I've seen that happen.
Or or with dry food, if it's left in a bag, and not in one of those see through, sealed containers, where heat, or moisture, humidity, can affect it..it could also go bad.
Even some you buy from the store, and open them, will sometimes have an awful smell, and then you know that it must have been bad to start off with.

Thankfully, this happens rarely, but still it does happen.
(same with food for us humans, too, since we really don't know how long they froze it, or let it sit on a shelf. Sure, they put on a date, but sometimes it goes bad fast.)

Members, here, have mentioned this site, for some more useful info to read:
Feeding Your Cat: Know the Basics of Feline Nutrition – Common Sense. Healthy Cats.
(I've only browsed it, so cannot really say.)


Thank you so much Nan68 Nan68 . This is very helpful info to know.
Ipakitine/Epakitin Powder For Dogs Cats – The Veterinary Medicine
Why Try All Natural Epakitin For Cat Kidney Disease?

blumarine916 blumarine916 ..maybe there is a substitute version in Malaysia, which would be lesser in cost, too,..so you would not have to import so far.
Vetoquinol Epakitin: Buy Online in Malaysia at desertcart
I just ordered Epatikin. I hope the cats will accept it being in their food.
Did you vet give her subcutaneous fluids? It is done via IV. I had 2 kidney disease cats that I gave the fluids myself. I have another that hasnt gotten to that point yet. I would give it a little time for her to perk up. My cats did better on the fluids and with their CKD diet.
Yes she was at the clinic where the vet gave her too much SubQ fluids (300ml a day!) to the point that she can’t even eat. Now that she’s home all week I’ve been giving the SubQ myself and reduced it to 100ml a day. She’s doing great so far, eating normally too. I’m so relieved for that.
 
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blumarine916

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Update :
Meffy is doing great so far. Her appetite is back to normal or it seems like she’s eating more than before. Maybe it’s because I’m feeding her cooked food instead of canned in addition to her usual kibbles. Thankfully she’s not constipated either. The RC renal kibbles should arrive soon so I’ll be slowly transitioning them to this new food.

She’s also grooming and playing more now. I’m still giving her 100ml of subQ daily, not sure if I can reduce to 80ml or skip a day. The vet isn’t helpful on this because they are still telling me 150ml 2x a day. I feel like they are just using standard book procedure to handle this. I’ve managed to switch to giving her during pm so I don’t have to it during the morning rush.
 
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blumarine916

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How is your Meffy doing, blumarine916 blumarine916 ?
Still sending Mega Health Thoughts for your Meffy. :vibes::vibes::tabbycat:
I Hope she is doing well.
Hii
She’s doing pretty well. She’s got her energy back and is chasing Meimey around now. Her appetite is also normal but I can‘t seem to get her to drink water. She’s also used to the daily fluid treatment by now and voluntarily with a reluctant face lol. So I don’t have to chase her around the house.

I tried putting Epatikin in her food but she seems to notice it. Hm…
 

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Hii
She’s doing pretty well. She’s got her energy back and is chasing Meimey around now.
Wow, that sounds great.! :)
Meffy chasing Meimey around...that sounds funny. :blush:
Probably not to Meimey, though,...but it's still a good thing to see. :D;):yess::jive:
Her appetite is also normal but I can‘t seem to get her to drink water.
Hmm...and you've tried all the 'usual tricks'...of placing the water...in different bowls, dishes, throughout the home.
Seeing if your Meffy will drink out of a slowly dripping tap...meaning...she might like a water fountain....(though, I have never used one, and just keep changing the water, in various locations),...plus using larger stainless steel salad bowls...for water.

Perhaps due to her getting sub-q's daily, and her eating wet food, then she does not feel thirsty...but it would be good to see her drink some water, from time to time.

If she likes to 'copy what Meimey does'...like with the food...then try to get her to see when Meimey is drinking...so that she gets the idea...to drink, too. :greenpaw:
(I don't know, it may not work, and might just cause Meffy to chase Meimey some more.) 🤔 😼 😺
She’s also used to the daily fluid treatment by now and voluntarily with a reluctant face lol. So I don’t have to chase her around the house.
Lol.. now that is a positive.
Chasing Meffy around the house sounds like a good work-out...but yeah...it must have gotten tiring...doing it everyday.
Your Meffy keeps you in good shape...as do all our cats...I think. :lol: :thumbsup:
I tried putting Epatikin in her food but she seems to notice it. Hm…
Hmm...this website...says to try putting it into a syringe...with some water to mix it...into a suspension...and then squirt it immediately...after eating.
Vetoquinol Epakitin Powder Urinary Supplement for Cats & Dogs - Customer Questions & Answers - Chewy.com
"Epakitin needs to be in contact with the food for it to work. If the pet refuses to eat if it is mixed with the food, then the owner can mix the Epakitin with water in a small syringe and squirt it down the throat immediately after they eat. They will need to shake the syringe vigorously because Epakitin will not go into solution. It will only be a suspension and will settle out again."

Another answer was to: "I found that I can add this powder on her renal dry food. I put dry food in a plastic bag and spread powder evenly and shake it well. As dry food has fat in it, powders are well coated and hard to recognize by my cat. ..quote by Maru."

Anything is worth a try, I think,...but only if you use 'another new food'...so that Meffy does NOT go off the food that she now likes.
It's to avoid 'food aversion in cats'
.
No matter what,...the main point...is that your Meffy is eating...and has energy. :) :thumbsup:

You could always ask your Vet for another 'phosphorus binder'...in case there are some that cats would like more.
I cannot remember, though, if you actually said...what Meffy's phosphorus levels were? in the bloodwork?
It would be on her last bloodwork report.


Try doing the 'parfait trick'...from this video...using another 'new wet food'...or some tuna juice,...baby food with meat only, (no onions or garlic):...starts at 4:48
 
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blumarine916

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I have managed to "sneak in" some of the phos binder into her food at least one meal a day. Will it be a problem if the other cat eats this too? They don't always finish their food at one go so sometimes my other cat also eats from the same bowl. I feel them together but still in the same location.

Now that Meffy is no longer in crisis mode, how do I know if I can reduce her fluids? Or maybe skip a day? I've been giving her 100ml everyday without fail for about a month now. Sometimes the amount is lesser because she's squirmy and manage to escape halfway. If she escapes too early, I have to poke her again. I try to make it to at least 50ml. I always get so paranoid like she's just going to faint if don't give enough or if I try to skip a day but I'm really that worried. The vet that I sent her last month wasn't helpful as they told me Meffy would probably live a month :( I don't want to believe that as I believe this fluid treatment really helped.
 

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I have managed to "sneak in" some of the phos binder into her food at least one meal a day. Will it be a problem if the other cat eats this too? They don't always finish their food at one go so sometimes my other cat also eats from the same bowl. I feel them together but still in the same location.
I would not let your Meimey eat the phosphorus binder.
Not only because it might cause constipation, but I would be worried about restricting a healthy cat's phosphorus levels, and really don't know what that would do to a health cat's system.
StackPath
Tanya's Comprehensive Guide to Feline Chronic Kidney Disease -All About Phosphorus Binders

If you could feed them, but in separate locations, and then take away the food bowl with the phos binder in it, it would be better for Meimey.

This question would be good to Ask about, and 'start another thread'...so that you get more input,...on how people with multi cat households...feed their cats...that require different medicated diets.🤔
Now that Meffy is no longer in crisis mode, how do I know if I can reduce her fluids? Or maybe skip a day? I've been giving her 100ml everyday without fail for about a month now. Sometimes the amount is lesser because she's squirmy and manage to escape halfway. If she escapes too early, I have to poke her again. I try to make it to at least 50ml. I always get so paranoid like she's just going to faint if don't give enough or if I try to skip a day but I'm really that worried. The vet that I sent her last month wasn't helpful as they told me Meffy would probably live a month :( I don't want to believe that as I believe this fluid treatment really helped.
Is there any way that you can get a second opinion from a different Vet?

Because I really don't want to believe that either, but sadly, that is what I have also read...that it's usually one to 1.5 months for end stage. (even writing this down, makes me sad, and wanting to cry,...but I won't because your Meffy is still here, and sounds like she is doing well.):touched:(I hate these diseases, though,...because I always want things to be fixable.)

My Hope is that somehow your Vet's machine was wrong...in those numbers...on bloodwork,...or that Meffy was not in end stage...but rather in "acute crisis"...like FeebysOwner FeebysOwner ...had mentioned about, in the beginning of this thread.
If it was 'acute crisis', then my hope is that your Meffy's kidneys are not all damaged, and that somehow she can maintain any function she has left...with your help, and sub-q fluids, of course.

I really think that it would be wise to get a second opinion,...from another Vet...who can look at your Meffy with 'new eyes'.

You can still bring all the reports, that you have from Meffy, to the new Vet,..since you paid for them, and they are yours.
Even if you decide to not bring Meffy back in, physically,... and just bring the reports...and ask a different Vet, (totally not related to the other Vet's practice),...to go over the information with you...and then describe what this last month has been like...then you can at least get more insight into what they professionally think...and also what to expect.

I don't think you should skip days, either, if Meffy is truly in end stage,..since the sub-q fluids would be doing the work of the non functioning parts of the kidneys.:frown: :hugs::grouphug:
A second Vet opinion, would also better be able to answer this question for you,...since they have seen more cases.

I'm still so glad for this update, blumarine916 blumarine916 ...since I often think of your Meffy, and wonder how she is doing.
It's good to hear that she is still eating, and holding on well. :heartshape::touched::wave3: :bicolorcat::catrub::bluepaw:
 
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FeebysOwner

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How much phosphorus binder are you 'sneaking in' her food? Would it be possible to serve half of her food with the binder in it, and then the other half once she is done with the first? That way any leftovers from the remaining portion would not contain the binder and would be no issue for your other cat. Btw, you could try Phos-Bind instead of Epakitin, as I am pretty sure it is tasteless and odorless. Works in the same manner as Epakitin, as far as I know.

Also, if you are getting her to take the binder regularly, you should have her phosphorus level retested after about 30 days, just to see where it is at. And, whatever you do, DO NOT give her a phosphorus binder if you feed her the kidney care food.

And, cat nap cat nap brings up a good point - depending on how much binder and how often you give it to Meffy, keep an eye out on her stool to ensure they don't become too hard. 1/8 tsp of Miralax mixed with water and added to a meal later in the day should help with any hardening. If you are not getting a lot of binder down her, especially if not every day, then the Miralax might likely only be needed intermittently.

Do you check her hydration level with the scruff test? Gently pull up her skin at the base of her neck and let go. If she is not dehydrated the skin will fall back into place pretty quickly. If it tents and/or is slow to fall back, then there is a level of dehydration going on. This can be tricky and took me a while to get it right for Feeby. The vet techs would tell me she was slightly dehydrated, and yet I couldn't see it. I ended up sending a video of it to numerous people - and all told me she wasn't dehydrated.

I do think that the amount of fluids she is getting could be too much, especially if - also as mentioned above - she really isn't in end stage.

Which leads me to my next question - did you ever share her blood work results here on this site? I somehow lost track of this thread and have not gone back to read the posts I missed. And, given that I did miss some posts, forgive me if I am repeating information you have received before.
 
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blumarine916

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I do the scruff test many times to check her hydration levels. Right after the SubQ, it springs back into place. One day later, it still goes back but at a slower rate. It doesn’t stay tented.

What size needles are you using for the SubQ treatments? I started with 18G needles given by the vet. I found them too big and looked painful so I changed it to 21G. However, 21G flows really slowly and Meffy gets impatient after 1 minute. With 18G, I see a line of flow in the drip chamber while 21G is showing me lots of drops. Also, is all this poking going to damage her skin badly? There is no blood and I change sides and needles everyday but I’m just wondering if the skin closes back after the needle is removed. Last thing I want is to get an infection there.
 

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I haven't had the misfortune of needing to give Feeby sub-Q fuids yet, so I don't know about the needle gauges. My gut would tell me to use the smaller gauge since you are doing the fluids so frequently - much less of a 'puncture' wound and quicker to close up - despite the impatience by Meffy.

I hope others come along and tell you what they do, and what kind of distraction techniques they use to help to reduce the impatience level in their cats.

I know you were a bit taken aback by the CKD forum, but they have enough collective experience that I am sure they could help immensely in giving you some answers to your questions. Maybe just start a new post on their site asking for assistance in just this one area.
 

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You answered your own question about the needles. The catch, even with cats, is that any of the smaller needles flow so slowly that it becomes more stressful. I always used 18G personally. There is a 20G which might flow a little faster, although I always found that one to be much slower than 18. I have never had an animal get an infection from doing subQ fluids. You were shown how to do this with tenting the skin, etc?
 
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blumarine916

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You answered your own question about the needles. The catch, even with cats, is that any of the smaller needles flow so slowly that it becomes more stressful. I always used 18G personally. There is a 20G which might flow a little faster, although I always found that one to be much slower than 18. I have never had an animal get an infection from doing subQ fluids. You were shown how to do this with tenting the skin, etc?
Yes I do it with the tenting then poke between. I’m just concern that her skin would be badly scarred with this as time goes by.
 

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Jessie (age 7, female) was diagnosed with CKD about 6 months ago. She went in for a routine appointment and ended up having labwork because she'd lost weight. So far her numbers have been in the 'high normal' range. We switched her to prescription food and she hated it. She reluctantly ate the canned but refused to touch the dry. She wasn't getting enough calories no matter how much wet food I gave her. She lost weight and was starving all the time. The day she tried to climb into a hot frying pan to eat the butter I was melting was the day I said, "Enough is enough!" and switched her to Purina One Urinary Tract. She's been much happier and steadily gaining weight. Last week, she developed a bladder infection and had to spend two days in the hospital. She's recovering well and off all her meds. But now she doesn't want to eat the prescription wet food at all. Sigh! Her appetite is decent if I give her something other than the prescription food. She's got me at my wit's end! Are there other options if they simply will not eat the prescription food? It's so expensive that I can't keep buying it if she won't eat it. I've tried talking to the vet about it and they just keep saying that the prescription food is best. Yeah, I get that. But Jessie doesn't care! Lol.
 

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Are there other options if they simply will not eat the prescription food?
Take a look at the food options on this web site (link below) - these are commercial foods that are lower in phosphorus, which is the intent with the prescription foods. When you get a chance, spend some time looking around the entire web site - a wealth of information for those of us who have CKD cats.
Tanya's Comprehensive Guide to Feline Chronic Kidney Disease- Canned Food Data USA (felinecrf.org)
 

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Jessie (age 7, female) was diagnosed with CKD about 6 months ago. She went in for a routine appointment and ended up having labwork because she'd lost weight. So far her numbers have been in the 'high normal' range. We switched her to prescription food and she hated it. She reluctantly ate the canned but refused to touch the dry. She wasn't getting enough calories no matter how much wet food I gave her. She lost weight and was starving all the time. The day she tried to climb into a hot frying pan to eat the butter I was melting was the day I said, "Enough is enough!" and switched her to Purina One Urinary Tract. She's been much happier and steadily gaining weight. Last week, she developed a bladder infection and had to spend two days in the hospital. She's recovering well and off all her meds. But now she doesn't want to eat the prescription wet food at all. Sigh! Her appetite is decent if I give her something other than the prescription food. She's got me at my wit's end! Are there other options if they simply will not eat the prescription food? It's so expensive that I can't keep buying it if she won't eat it. I've tried talking to the vet about it and they just keep saying that the prescription food is best. Yeah, I get that. But Jessie doesn't care! Lol.
Take a look at the food options on this web site (link below) - these are commercial foods that are lower in phosphorus, which is the intent with the prescription foods. When you get a chance, spend some time looking around the entire web site - a wealth of information for those of us who have CKD cats.
Tanya's Comprehensive Guide to Feline Chronic Kidney Disease- Canned Food Data USA (felinecrf.org)
:yeah:
Hi, C Chloe Minerva ...definitely take a look at the above site, that FeebysOwner FeebysOwner posted.
The data food tables have been so extremely helpful, and also learning more about CKD, and the different stages and treatments, is so valuable, too,...in order to know what to expect.

Your Jessie seems very young to have developed ckd...but it's not unheard of.
Did they also do complete bloodwork, and look at her thyroid levels?
(I think the thyroid is an added-on test, but it would be worth doing if she has lost a lot of weight).

You might also want to read through this member's thread: Am I overreacting?
I think post #26 and post #72...mention actual foods,...so that might be helpful for you to try...depending on what type of texture and flavour your Jessie likes.

Sending you Loads of Luck...that you find something that your Jessie will like...and that will help her kidneys, bladder, and any urinary issues. :vibes::vibes::caticon: :crossfingers: :grouphug: :goodluck:
 
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