Just diagnosed with Kidney Failure, etc...

stephanietx

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It's important to keep a CRF kitty's weight up.  It's so hard for them to maintain their weight, though my Callie had no problems.  She loved her carbs, though, and seldom relished eating wet food!  LOL  Wet food is really best for your kitty, though.  You want your kitty at a healthy weight, not too round and not skin & bones.  I think the most important thing is for the kitty to eat, even if it's Fancy Feast or Friskies.  I know many folks on the Yahoo CRF group feed their kitties Fancy Feast.
 

otto

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It's the diarrhea draining away his weight and hydration. Get him on a probiotic, yogurt isn't enough. I recommend ProViable DC, it's done wonders for Queen Eva.

The initial weight loss when you switched to canned could have been from the kidney disease, and have nothing to do with canned food. Carbohydrates can make a healthy cat too fat, but they are not all that good for a sick cat. Sick cats need lots healthy proteins to gain weight.

Glad you have stopped feeding moistened wet food, especially left over! Feed warmed up canned food in small portions as often as possible.

Sometimes when cats don't feel good, too much food in the dish will cause them to turn away and not eat at all. Small portions, like a tablespoon at a time, warmed up either by adding a little warm water to it, or letting the dish sit in a dish of warm water for a few minutes, makes it even more appealing.

Hand (or spoon) feeding is good too, and helps you bond together.

Do not ever let your cat be put on clavamox again. There are other antibiotics available. None of my cats can tolerate clavamox.

:vibes::vibes::vibes::heart3:
 
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carolina

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Do not ever let your cat be put on clavamox again. There are other antibiotics available. None of my cats can tolerate clavamox.
:vibes::vibes::vibes::heart3:
:yeah: Clavamox has joined my "Do NOT give list in all my kitties files - I will not give it, no matter what. I have a fear Bugsy will never be the same afer that very first pill :(

As Otto said - get Proviable-DC - det it on AMAzon - you will get it for the best price...... the box comes with 80 pills, for about $37. It is the cheapest place you can get..... I believe you can get around the same at entirely pets.
Proviable-DC is bar none the Best Probiotic for animals, IMHO.

Good luck hun! :vibes::vibes::vibes::vibes::vibes::vibes::vibes:
 
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sweetpea24

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First of all, I don't know why clavamox would be prescribed for anemia but if your cat has diarrhea and vomiting, ask your vet for another suitable antibiotic. I would also ask him why he prescribed an antibiotic. 

With CRF it is important, I think, to figure out what stage of kidney failure your cat is at. Usually, when it is diagnosed, a cat's kidneys have already lost 75 % of its function. So regular monitoring and proper treatment are of the utmost importance in ensuring that the remaining 25% function as best as it can.  I'm also interested in why your vet prescribed Epakitin so soon. Usually, a phosphorus binder is prescribed later in the disease - I can't recall exactly why but there are side effects to these phosphorus binders. There are others such as calcium carbonate or aluminum hydroxide, the latter of which is no longer used in humans.  Again, I can't recall (damn my age) why but at the clinic where I work, it is used more than Epakitin.  I think, from what I've read, there are pros and cons to both.  I have never given calcium carbonate to a cat with CRF so I am not aware of its effectiveness or side effects.

I cannot emphasize more than the other posters about the importance of feeding canned food. It provides the moisture your cat needs, it is more digestible (which is important for CRF kitties as sometimes their tummies don't feel so good), and is generally better for cats.  I know that a lot of people are dry feeders some for financial reasons and others just because they have always fed it and their cats are doing fine. However, with CRF, if you want your cat to live a quality life during the progression of this disease, then canned food is the key.  i feed my 4.5 kg CRF cat 1.5 cans a day (half a can three times a day - again, smaller meals more often will not overtax his digestive system and thus, his kidneys).  However, if financial reasons prohibit a full canned diet, then try to feed as much canned as possible. 

It used to be thought that CRF cats needed a reduced protein diet but current research has pointed to reduced phosphorus as being key to prolonging the life of a CRF cat. Your vet will tell you that studies have shown that the rx kidney diets have proved to prolong a CRF cat's life as compared to a regular maintenance diet. I am not doubting it but as these diets are not as palatable, your cat may not eat them. So if your catis like mine, you'll have to find foods that may appeal to him but with a relatively low phosphorus content (<0.5-0.1 %). I feed Natural Balance's limited ingredient foods (all flavours), Wellness Turkey and Chicken (not the best choice but one he will eat in the middle of the rotation), Holistic Selects (Chicken and Lamb, Duck and Chicken? & Salmon & Shrimp), the occasional Almo Nature (not good for CRF but when he refuses all other foods, this has to do), and the occasional Hills k/d, Medi-cal Reduced Protein, Medi-cal Mature, and Hills g/d.  Senior diets like the Mature and g/d can be fed to cats at the early stages of CRF.  My cat usually refuses them but he will eat them on the rare occasion.  I also give him 75 mls of subcutaneous fluids per day and the occasional famotidine (Pepcid AC) when his appetite wanes (meaning his tummy is not feeling well and thankfully, his appetite doesn't wane too often).

I don't know if your vet has a different approach to treating CRF - I am not saying what he is prescribing is wrong - who am I to say?  There are different approaches.  Some vets will prescribe Benazepril immediately after diagnosis.  This is typically given to cats with heart issues but it is thought to help prolong the life of cats with CRF.  however, studies have shown that this is true under certain conditions.  One is the urine-protein-creatinine ratio (UPC ratio) which is basically a measure of the protein in the urine. It is also a measure of the damage to the kidneys and blood pressure and something called secondary parathyroidism. I don't understand this enough to explain it but it has to do something with calcium, vitamin D and its progression results in bone density loss and other things.  Calcitriol is often prescribed either immediately or at a certain point of CRF - many approaches to this as well.  If the UPC ratio was >0.1, then CRF cats given benazepril had a longer survival time.  UPC ratios <0.1 did not show any significant difference between cats given benazepril and those not given benazepril.  At my clinic, (again, not saying this is the right and only way, just one approach) they prescribe benazepril when the UPC ratio is <0.4.  that is the dangerous level for cats (for dogs it's 0.5 and over).  So once the UPC ratio is >0.4, the cat is at risk.  So I would suggest having your cat's UPC ratio monitored regularly.  Some vets believe that benazepril can reduce the survival time of a CRF cat or at the very least, increase the clinical signs of CRF so these vets probably only prescribe it when the UPC >0.4.

Also, a urinalysis and a culture and sensitivity should be done regularly as well.  If the kidneys are filtering and concentrating urine properly, then the urinary tract is protected from infection. However, if the kidneys are not concentrating urine properly, then the urinary tract is not protected from infection.  Doing the urinalysis and culture will determine if there is an infection - they will also determine the urine's specific gravity which determines how the urine is concentrating.  Usually, it's low in CRF cats so the kidneys are basically retaining the toxins as opposed to excreting them into the urine.  Regular urinalyses and cultures will detect infection which can be treated so no further damage can be done to the urinary tract.

Usually, an xray and/or ultrasound is done to see the size of the kidneys (i.e. the amount of damage done - if they are smaller than normal, that means damage has been done) and the texture of the kidneys. 

Regular bloodwork, urinalysis cultures and UPC ratios to monitor your cat's CRF are usually done every three months, longer if his values are stable. My cat's values are now stable and have actually reduced somewhat (knock on wood). 

There are many supplements out there that purport to support the kidneys.  A popular one is Azodyl.  it is a probiotic which purports to reduce the BUN (blood urea nitrogen) and creatinine going through the kidneys.  As these are both markers on the bloodwork on which vets base the progression of CRF, this on the surface sounds like a good idea.  However, BUN and creatinine are not the only factors that are involved in kidney disease so you may be given false hope.  I used to give it to my cat but stopped it as I didn't want to give a huge pill for nothing.  I have read and spoke to many vets about Azodyl and all of them said that it doesn't make much of a difference.  Just giving that example to be aware.  As CRF progresses, you will have to give more meds so why stress your cat out for nothing?

I know this is a lot to digest and I'm sorry if I have confused and overwhelmed you. That is not my intent.  My intent was to further inform you so that you can make sure your cat gets the best care you can give him.  The more knowledge you have, the better your cat will be.  IMHO, I would get a second opinion.  I'm sorry about your cat's diagnosis, but she can live a quality life if treated properly and conscientiously.  Vibes to you and your cat...
 
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lovemykittehs

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My cat got Clavamox 13 months ago for an UTI..... got horrible diarrhea from it..... while he got somewhat better - after a LOT of treatments - so many treatments that actually affected hi liver, his digestive tract never wen back to normal. He still has soft poop. Not diarrhea, as he only poops once..... but still gelly like. And again - we are talking 13 months here..... and he is only 4.
P.S. - take care of that tooth - having those disease pieces broken inside of his bone is absolutely not a good thing..... Whenever giving him antibiotics (like for the dental, for example), get injections as oppose of pills - it is much easier on their bodies..... easy to give at home too, don't worry.....
Make sure to do a full blood test prior to the dental and TELL the dentist about the murmur - get an IV for emergencies. If you have all these things in place, your kitty will be fine.....
Is this common?? Clavamox is really that harmful to cats?? I'm mad that the vet even prescribed this in the first place... It's been about 1.5 months of straight diarrhea now and the Metronidazole that was prescribed has done nothing... he just finished his last dose this morning. There has been no improvement. I really hope this isn't permanent all because of a drug that didn't even help him to begin with :(
 
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lovemykittehs

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It's the diarrhea draining away his weight and hydration. Get him on a probiotic, yogurt isn't enough. I recommend ProViable DC, it's done wonders for Queen Eva.
The initial weight loss when you switched to canned could have been from the kidney disease, and have nothing to do with canned food. Carbohydrates can make a healthy cat too fat, but they are not all that good for a sick cat. Sick cats need lots healthy proteins to gain weight.
Glad you have stopped feeding moistened wet food, especially left over! Feed warmed up canned food in small portions as often as possible.
Sometimes when cats don't feel good, too much food in the dish will cause them to turn away and not eat at all. Small portions, like a tablespoon at a time, warmed up either by adding a little warm water to it, or letting the dish sit in a dish of warm water for a few minutes, makes it even more appealing.
Hand (or spoon) feeding is good too, and helps you bond together.
Do not ever let your cat be put on clavamox again. There are other antibiotics available. None of my cats can tolerate clavamox.
Thank you :)  He actually has a very healthy appetite.  It's just hard for him to eat now because of the rotting teeth on one side...
 
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lovemykittehs

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@ sweetpea24;

I did correct myself on that - clavamox was not prescribed for the anemia, but because he has an infection in his blood (likely due to the rotten teeth).

I was told that when cats show signs of kidney failure, the kidneys have already lost 75% of their function.  I confirmed with the vet that this was the same with my cat's case.  I was told that the Epakitin does not give any side effects and my cat didn't show any while taking it.

I have tried the Hill's K/D canned and my cat does not like it.  It is also a rip off and does not have the best ingrediants anyway.

I have been strapped financially for quite some time now, so regular urine and blood testing is not possible at this point. I will try my best to get his kidney levels tested every few months or so though.  He has had an x-ray at the initial visit and it shows that one of his kidneys is quite enlarged.

On his second blood panel, the vet told me that my cat has shown significant improvement and that improvement is usually slow, but not in my case. His urea was 31.5, now it is 15.7 and normal range is 12.  His creatinine went from 440 to 256. I take some comfort in knowing that.

I thank everyone for the recommendations - I'll look into it and ask vet's opinion.
 

carolina

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Is this common?? Clavamox is really that harmful to cats?? I'm mad that the vet even prescribed this in the first place... It's been about 1.5 months of straight diarrhea now and the Metronidazole that was prescribed has done nothing... he just finished his last dose this morning. There has been no improvement. I really hope this isn't permanent all because of a drug that didn't even help him to begin with :(
Bugsy's case is not common, I don't think.... However, yes - Clavamox can be very harmful for a lot of cats. It is unfortunately, the first prescribed antibiotic for UTI, usually.... Then if it doesn't work vet move on to other ones. There has been kitties who have died to a reaction to it.
Now.... the majority of cats do just fine on it - with diarrhea and vomiting during treatment as side effects..... But others can not tolerate, and some, like my Bugsy, have awful, potentially life-long lasting effects from it. Because of that, I do not risk it with any of my cats - I do don't want to ever have even the slightest risk of going through that again.
 

feralvr

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Just sending along :hugs: and :vibes: your way. The vet's usually do start with Clavamox for UTI's. I have used Clavamox over the years for my cat's and have never had a problem, vomiting or diarrhea with that antibiotic. But some cat's certainly do. I will usually start them on a Probiotic before, during and after the antibiotics. Try not to worry so, I know it is hard with all that is going on. Good luck with everything :D!!!! :vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes:
 
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sweetpea24

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@luvmykittens, sorry must have missed some info.

I wasn't suggesting that you feed k/d, just giving an option. From your original post it didn't sound like your vet gave you a lot of info but apparently, I missed that post.

Glad to hear your cat's numbers are improving.
 
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lovemykittehs

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Can anyone suggest what I should be doing for him from here on out? In regards to the kidney failure, heart murmur, rotten teeth/periodontal disease and constant diarrhea...

As I stated before I was giving him Epakitin for kidney fuction for the first month, but now that his phosphorus levels have improved the vet suggested I stop, whereas another vet said he needs it for the rest of his life.

Other than the 150 mls of fluids every other day- Any meds I should have him on, precautions, etc...

Can I still give him treats? Temptations, etc... And yogourt is ok to give daily right? He loves his yogourt :)

I plan to feed him canned Friskies from here on out..even though it is not the most nutritious, but it is what I can afford at this point... and I will always leave some dry food out as well if he's hungry in between feedings, even though most of you have advised me not to.

I also had a second opinion of another vet when I first got the numbers from his initial blood panel, and she suggested that I put him down.  I refuse to put him down until he tells me it's time. But I find it crazy that's what she suggested right away though, judging from his numbers alone.  He's still a very hyper, crazy 13 yr old cat who runs around the house like a kitten.
 

stephanietx

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otto

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Awww.....what a sweet boy!

I've never used the epakitin so can't comment on it. Ootay :rbheart: :angel: got 150 ml fluids four times a week for three years, and was fed what she wanted to eat, as often as I could get her to eat it. I did not free feed dry food, she wouldn't have gotten it anyway, since the other cats would eat it. Instead I arranged my day, actually my LIFE, around being able to come home every 3-4 hours, six at the very most, to feed her.

She would only eat very small amounts at a time. A teaspoonful of canned food. 8 pieces of kibble. Then if I waited 15 minutes and offered her another teaspoonful she would usually eat that, too. And so on.

Ootay loved yogurt and would lick out my yogurt cup every day. Don't give him yogurt with artificial sweeteners in it, is all.

Ootay also had high blood pressure and hyperthyroid disease, but they were un-treated as she couldn't tolerate the medicines. All forms of methimazole were tried, over a period of 18 months. The Norvasc (for HBP) gave her fainting spells even at the lowest possible dose. Ootay had megacolon and took cisapride three times a day, psyllium once a day, and mineral oil twice a day. And Cosequin for arthritis. She had a heart murmur too. Her little body just couldn't tolerate anything else. I've forgotten why I was writing this. :lol3:

Oh yeah....I was going to post some links

Many people recommend Tanya's website and it's a good one, but during Ootay's time I was relying heavily on this one:

www.felincecrf.com

And if friskies is what he wants, let him have it. :)
 
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otto

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I would have the dental done. Dental disease causes kidney disease, or in his case will make it worse. It also affects the heart.

It also greatly lessens quality of life.

Ootay had a dental at 17 1/2 years old, with all of the above listed ailments, including one stroke. She did fine, and felt so much better after. She ate better, too. Insist your vet use sevoflourane gas anesthesia only. It is the safest, and fast acting. If you harbor doubts about your vets dental abilities, take him to a specialist to have it done. He should, of course be hooked up to an IV catheter for the entire procedure, and put on clindamycin (antirobe) antibiotic.

Anesthesia can be rough on the kidneys, but dental disease is rougher. And..it is a quality of life issue. When I made the decision to go ahead with Ootay, it was with the thought that, even if the procedure shortened her life by a couple months (by advancing the kidney disease).....at least those remaining months would be mouth-pain free. I had nine more months with her after the dental (she also had one extraction). And it's a great comfort knowing those nine months were free of mouth pain.

The diarrhea: it could be the epakitin. But if your vet wants him on it, put him on a probiotic. I recommend ProViable DC made by NutraMax. This is an excellent product, and it's not full of junk or sugar like some others. The capsule contains nothing but the probiotic cultures. And cats like it.

Forti Flora, made by Purina, is an effective probiotic, and cats love it, but it does have some icky things in it, such as animal digest. However it has made many a reluctant eater gobble his food.

So I would recommend you get him on either of those. Or both. A little forti flora sprinkled over every meal (just a tiny bit) to encourage appetite and a capsule of ProViable mixed in once a day.

Discuss it with your vet first of course. But he really should be on a probiotic.
 
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dusty's mom

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My CRF kitty has really rallied from near death last year to gaining over a pound, anemia improved (based on visual appearance of gums that used to be pale and are now healthy pink), coat nice and thick (compared to fur loss last year).  I'm not medicating her.  I just changed her food to Paws canned, which she absolutely loves.  It is reasonably priced ($0.50 per can) and seems to be grain free - no corn anyway.  It's hard to find as it has limited distribution to member stores only, but here's where you can find it:

http://www.pawsforpets.com/StoreLocations.aspx

I'm not saying this is a cure-all.  I can just say that my cat's health has greatly improved.
 

feralvr

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AWWW he really is a handsome boy :love:..... Just sending along more vibes and hope you boy is feeling good today :vibes::vibes::vibes::vibes::vibes::vibes::vibes:
 

mrsgreenjeens

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For what it's worth, my 16 year old CRF kitty no longer even gets tested for BUN or createnine or anything else because it wouldn't matter.  We base everything we do by how he acts, and that is mainly adjusting how much fluid and how often we do it (sub-q's)  We also feed him HIGH protein food, and that is mostly dry food, because that's what he really likes, and he needs to eat!  I try to get him to eat wet food, even follow him around with his bowl encouraging him to eat a little several times a day...sometimes he does, sometimes he doesn't.  We still give him Temptations, Greenies, Whiska Lickins, basically anything he will eat.  (I WISH he would eat yogurt, because he has an upset stomach often, for which I give him Pepcid AC - when he'll let me 
)

You mentioned money is tight.  Are YOU giving him his sub-qs?  If not, you should probably learn how.  It's really easy, and really inexpensive to do it yourself, especially if you order all your supplies over the internet.  (Sorry if you already mentioned that...I read in kind of a hurry)

As far as the dental, I'm with Otto in that quality of life is far better than quantity, and the poor guy must be suffering at the moment.  As for the diarrhea, I will have to defer to the other experts in that area, as my Sven has the opposite problem
, but someone mentioned that thought it might be the Epakitin, and if your Vet suggested he no longer needs it, that might just solve that problem.

BTW, he certainly looks like a sweet little boy!
 
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