High Creatine and the kidneys

CakesCats

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Hi all! I'm new here and was hoping for some advice/input for my boy.
Petey is 13/14 domestic short hair. He's a pretty large boy most recently weighing in at 12lbs.
He has been with us since he was a kitten and has had an array of health issues. Mostly bladder and stress related despite us trying to provide him with the best life.
He is currently prescribed amitriptyline to combat the anxiety he has and he has done well with it. Since being prescribed this he has had consiptation issues (The vet says he has a large colon, but he never had an issue until amitriptyline) so he was prescribed lactulose, which didn't work and is now on Miralax (1/4tsp twice daily).

3 weeks ago I noticed vomit (clear liquid) in the bathroom with a small amount of blood. At the time I couldn't pinpoint which cat it was. Two weeks later the same thing happened again with a few small flecks of blood and I was able to 99% say it was Petey.

I took him to the vet Friday and the vet said he has lost 2lbs in 3 months (I thought he looked like he lost a little, but I attributed it to feeding him majority soft food to help the consitpation instead of his normal hard food). 3 months ago when I took him to the vet he had GAINED 1 lb since the month prior when he first started amitiptyline, so I was shocked that he now had lost 2 lbs).
Anyways, they did blood work and took a urine sample.
His white blood count came back high. His creatine was slightly elevated (not sure the exact number), but not cause for alarm just yet and his thyroid value was 3.6 (the 4.5 is when they start treatment).
The vet was not super concerned about his kidneys just yet. He did mention the Hill's K/D food, but said that it wasn't necessary since Petey refused both the C/D and C/D stress formulas and that we have multiple cats of differing ages who we free feed.
He just wants us to follow up in 6 months to check the kidneys again and to check the thyroid as we may be looking at both the kidneys declining and hyperthroidism.
My questions are:

Besides the K/D food, are there any other foods that I can try that are good for the kidneys that ALL my cats can eat (ages 6-14)?
Do you have any suggested probiotics or foods that can help the constipation? The vet did suggest we continue the anxiety meds for now as it does help reduce his stress levels which keeps the bladder inflammation at bay (usually).
Any other helpful thoughts/tips/tricks/suggestions??
 
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Maurey

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I’d transition to feeding all wet, or at least majority wet, in your position. High protein, low carb, with lower phos foods for the seniors. Wet food is the best thing for pre-kidney/kidney cats as it provides adequate moisture and the high protein helps prevent muscle wasting. It may be worth discussing phos binders with your vet.
 

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Hi. What did the vet say about the possible flecks of blood in Petey's vomit? Could those flecks have been food remnants? How is he eating? I have heard that some of the possible side effects of amitriptyline can be constipation as well as poor appetite.

As far as the K/D food - forget it, even if Petey shows signs down the road of kidney issues. The food is lower in protein, and more recent research is suggesting that it is not as beneficial as once thought to lower protein to help with kidney issues - mostly due to the fact that cats, especially older ones, need high protein foods to help reduce the chance of muscle mass loss which is common as cats age. There might be some muscle mass loss in Petey, contributing to his weight loss.

If Petey's thyroid level were to elevate in the future and he needs treatment for that, know that stabilizing the thyroid hormones can end up revealing a kidney issue as an over productive thyroid tends to mask kidney problems. So, heading in the direction of a good protein food with a lower phosphorus is a good idea even now before his blood work shows any trouble. You can check out a chart of foods (canned) that are lower in phosphorus on this web site: Tanya's Comprehensive Guide to Feline Chronic Kidney Disease- Canned Food Data USA (felinecrf.org). You can also contact the food companies and ask for phosphorus levels - as well as protein content - in their foods (on a dry matter basis, which is the most accurate; most don't provide this information on their cans/websites). I have found the ones I contacted to be very accommodating. Phosphorus binders aren't generally introduced into a cat's diet until the phosphorus levels are high in the blood work you have done. There is a ton of information on the above noted web site about this and many, many other issues associated with kidney disease.

If the Miralax is working, I am not sure there is much reason to try to find alternatives. A lot of the other options are all about adding fiber to a cat's diet, but unless you know of a particular cause for Petey's tendency to lean toward constipation, the fiber may not be a beneficial choice. Adding more moisture to his diet - through canned foods is the best approach. Getting him to drink more water - through enticements like a water fountain and/or simply mixing a bit of water to his canned food is another way to get more moisture in his diet.
 

kittyprincesss

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Everyone here has already beat me to giving wonderful suggestions! As a fellow CKD momma, just want to lend a big hug and say that Tania's Comphrensive guide saved my butt when I was first faced with kidney problems. Like everyone is saying, moisture is the biggest key for these little beans, by whatever means necessary to prevent the possible future of Sub-Q fluids for as long as possible.

Only small tip I could give is with his WBC being elevated, maybe he could be a good candidate for some Clavamox. That was what they prescribed my girl who was a CKD baby with high WBC. It was always safe (for her, double check with vet!) and gentle enough to where it didn't hurt her tummy too much. They can also compound Omeprazole in a liquid for him if his stomach acid is too high causing some nausea. Good luck Petey!! We are rooting for ya!! :rbheart: :rbheart: :grouphug:
 
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CakesCats

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Hi. What did the vet say about the possible flecks of blood in Petey's vomit? Could those flecks have been food remnants? How is he eating? I have heard that some of the possible side effects of amitriptyline can be constipation as well as poor appetite.

As far as the K/D food - forget it, even if Petey shows signs down the road of kidney issues. The food is lower in protein, and more recent research is suggesting that it is not as beneficial as once thought to lower protein to help with kidney issues - mostly due to the fact that cats, especially older ones, need high protein foods to help reduce the chance of muscle mass loss which is common as cats age. There might be some muscle mass loss in Petey, contributing to his weight loss.

If Petey's thyroid level were to elevate in the future and he needs treatment for that, know that stabilizing the thyroid hormones can end up revealing a kidney issue as an over productive thyroid tends to mask kidney problems. So, heading in the direction of a good protein food with a lower phosphorus is a good idea even now before his blood work shows any trouble. You can check out a chart of foods (canned) that are lower in phosphorus on this web site: Tanya's Comprehensive Guide to Feline Chronic Kidney Disease- Canned Food Data USA (felinecrf.org). You can also contact the food companies and ask for phosphorus levels - as well as protein content - in their foods (on a dry matter basis, which is the most accurate; most don't provide this information on their cans/websites). I have found the ones I contacted to be very accommodating. Phosphorus binders aren't generally introduced into a cat's diet until the phosphorus levels are high in the blood work you have done. There is a ton of information on the above noted web site about this and many, many other issues associated with kidney disease.

If the Miralax is working, I am not sure there is much reason to try to find alternatives. A lot of the other options are all about adding fiber to a cat's diet, but unless you know of a particular cause for Petey's tendency to lean toward constipation, the fiber may not be a beneficial choice. Adding more moisture to his diet - through canned foods is the best approach. Getting him to drink more water - through enticements like a water fountain and/or simply mixing a bit of water to his canned food is another way to get more moisture in his diet.

Thank you for the response. The vet actually didn't say much about the blood specks. He did take some X-rays and didn't say anything besides he still had some stool in there. He went back today for an antibiotic shot since his WBC was a little high. Luckily, he hasn't thrown up any more since last Thursday (knock on wood and fingers crossed!!) and his appetite has been normal. Petey eats a majority wet food, but we do leave dry food out as one of our others refuses wet food of all types (I'm still working on him!). He may nibble some while we are at work, but I rarely see him eat any of the hard when we are home. I looked at that website (awesome resource!) and have ordered some of the BFF brands to try to transition him to(It seemed like a good choice??). I'd like to find a dry to switch to as well for any time he does eat it. We have two cats on the large side and two on the smaller side so I'm having a hard time finding a dry cat food that works for overweight, normal size, kidney issues, urinary issues, thyroid issues and constipation issues all rolled into one. UGH!
Thank you for the heads up about the thyroid issues possibly masking kidney issues. He wants us to retest in 6 months, but I may do it sooner because I'm a paranoid momma lol.
 
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CakesCats

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Everyone here has already beat me to giving wonderful suggestions! As a fellow CKD momma, just want to lend a big hug and say that Tania's Comphrensive guide saved my butt when I was first faced with kidney problems. Like everyone is saying, moisture is the biggest key for these little beans, by whatever means necessary to prevent the possible future of Sub-Q fluids for as long as possible.

Only small tip I could give is with his WBC being elevated, maybe he could be a good candidate for some Clavamox. That was what they prescribed my girl who was a CKD baby with high WBC. It was always safe (for her, double check with vet!) and gentle enough to where it didn't hurt her tummy too much. They can also compound Omeprazole in a liquid for him if his stomach acid is too high causing some nausea. Good luck Petey!! We are rooting for ya!! :rbheart: :rbheart: :grouphug:

Hi there!! Hope your kitty(s) are doing well! :)
He went back today for an antibiotic shot (I'm at work right now((clearly working hard, lol)) and can't remember the name), so hopefully it will will knock out whatever caused the WBC to rise. I've been texting my husband through the day to make sure Pete is doing okay and so far he has been his normal self.
That website seems to have a lot of really wonderful information! Thank you for also suggesting it. I have been adding more water to Petey's food and am going to get an additional fountain to add to a different room.

Thank you so much for the suggestions!!!
 
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CakesCats

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I’d transition to feeding all wet, or at least majority wet, in your position. High protein, low carb, with lower phos foods for the seniors. Wet food is the best thing for pre-kidney/kidney cats as it provides adequate moisture and the high protein helps prevent muscle wasting. It may be worth discussing phos binders with your vet.
He currently eats a majority wet food (
I’d transition to feeding all wet, or at least majority wet, in your position. High protein, low carb, with lower phos foods for the seniors. Wet food is the best thing for pre-kidney/kidney cats as it provides adequate moisture and the high protein helps prevent muscle wasting. It may be worth discussing phos binders with your vet.

He currently eats a majority of wet, but I'm going to start adding in more water and have ordered some low phosphorous foods to try to transition him to. Thank you for the suggestions!!
 
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CakesCats

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Does anyone have cats that have kidney disease that are currently taking medications (not related to the kidneys)? Has that medication seemed to have any impact on their kidneys after diagnosis? As I mentioned, Petey is currently on Amitriptyline. When I asked the vet if he should continue this medicine with his current levels the vet said "You know, I don't really have an exact answer for that". He thought about it for a moment and then suggested that for now we continue it since it has seemed to reduce Petey's stress and the bladder issues that arise from it, but I'm worried that it is going to just make the kidney issues worse much faster. I guess we will see at the next bloodwork if anything has changed, but just looking to see other's experiences.
 

kittyprincesss

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Does anyone have cats that have kidney disease that are currently taking medications (not related to the kidneys)? Has that medication seemed to have any impact on their kidneys after diagnosis? As I mentioned, Petey is currently on Amitriptyline. When I asked the vet if he should continue this medicine with his current levels the vet said "You know, I don't really have an exact answer for that". He thought about it for a moment and then suggested that for now we continue it since it has seemed to reduce Petey's stress and the bladder issues that arise from it, but I'm worried that it is going to just make the kidney issues worse much faster. I guess we will see at the next bloodwork if anything has changed, but just looking to see other's experiences.
Methimazole was a hard knocker on my girls kidneys. This was her thyroid medication, so it was to be expected that it would hurt her kidneys. To put it simply, my choice was to help her thyroid and risk her kidneys or do nothing about her thyroid and risk her health still. I chose the later and closely monitored both values with frequent bloodwork to see how much it was impacting kidney function. She was also on Prednisolone...which sadly did not help her kidneys either but she still fought through it for 3 years.

Its all about watching those numbers, watching behavior, and being a good parent (which you already are doing)! Sweet wishes and healthy purrs.
 

pearl99

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I had the opposite with methimazole, Gracie's hyperthyroidism was masking her kidney disease by causing higher blood pressure and elevated heart rate which pushed more fluid through her kidneys and helped them function better. After 2 weeks on methimazole her kidney values showed kidney disease, and now they are within normal.
Methimazole has side effects, but she hasn't had any yet luckily.
She's 14 years old so I wasn't surprised by either, and had to have a dental a year ago for a resorbing tooth and other teeth needing to be removed- so I wonder too if the anesthesia helped the kidney disease along.
 

mrsgreenjeens

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Does anyone have cats that have kidney disease that are currently taking medications (not related to the kidneys)? Has that medication seemed to have any impact on their kidneys after diagnosis? As I mentioned, Petey is currently on Amitriptyline. When I asked the vet if he should continue this medicine with his current levels the vet said "You know, I don't really have an exact answer for that". He thought about it for a moment and then suggested that for now we continue it since it has seemed to reduce Petey's stress and the bladder issues that arise from it, but I'm worried that it is going to just make the kidney issues worse much faster. I guess we will see at the next bloodwork if anything has changed, but just looking to see other's experiences.
I didn't have any of my kidney cats taking Amitriptyline, but did find this link off of Tanya's website about it: AMITRIPTYLINE - Mar Vista Animal Medical Center. It talks about what other drugs are issues, etc. and how liver issues and diabetes, but nothing specifically about the kidneys.
 
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CakesCats

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Methimazole was a hard knocker on my girls kidneys. This was her thyroid medication, so it was to be expected that it would hurt her kidneys. To put it simply, my choice was to help her thyroid and risk her kidneys or do nothing about her thyroid and risk her health still. I chose the later and closely monitored both values with frequent bloodwork to see how much it was impacting kidney function. She was also on Prednisolone...which sadly did not help her kidneys either but she still fought through it for 3 years.

Its all about watching those numbers, watching behavior, and being a good parent (which you already are doing)! Sweet wishes and healthy purrs.
Thank you! I was worried about methimazole as the vet did suggest this at a later date if needed.
 
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CakesCats

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I had the opposite with methimazole, Gracie's hyperthyroidism was masking her kidney disease by causing higher blood pressure and elevated heart rate which pushed more fluid through her kidneys and helped them function better. After 2 weeks on methimazole her kidney values showed kidney disease, and now they are within normal.
Methimazole has side effects, but she hasn't had any yet luckily.
She's 14 years old so I wasn't surprised by either, and had to have a dental a year ago for a resorbing tooth and other teeth needing to be removed- so I wonder too if the anesthesia helped the kidney disease along.
Oh wow, I'm glad to hear that her kidney values are normal! Hope that keeps up! Your Ziggy looks like a twin to our girl Ki :)
 
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Oh wow, I'm glad to hear that her kidney values are normal! Hope that keeps up! Your Ziggy looks like a twin to our girl Ki :)
I think I meant her thyroid values are normal, duh. Still has the kidney disease that was masked :doh2: .
Cool that Ziggy has a twin!
 
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