My little one with CKD stopped eating and seems lost..

[EllaKen]

Hi there,

I've got an almost 15yo siamese girl with CKD for around 6 months now (from what we've known) and since last Monday she stopped eating all together and she is not drinking a lot of water and she seems a bit lost (looks in the void etc). She has lost almost half a kilo too..

We have given her iv fluids and a lot of different foods to try but things don't look great

She is currently on Pronefra and her values are the following:
Creatine: 180
BUN: 23.4
Urea: 23.4

I am not sure what is going on, my vet told me it's probably due to CKD but the values are not that bad. Am I wrong?

The only difference I've noticed is that the last couple of weeks (before this happen) she started leaving little food pieces outside the bowl which might be an oral problem? My vet checked it out and said there seems to be no oral problem whatsoever. She also keeps doing this: IMG_3777.mp4 (didn't know how else to upload the video)

Any ideas/suggestions would be appreciated
If she keeps going like this, I've been told it is best to rest her, but..

 

[Furballsmom]

Hi, can you find a different vet? Will she eat at all if you handfeed her? I could see the video, it's almost as though something is stuck in her mouth or throat ... ?

 

[FeebysOwner]

Hi. Just based on her creatinine level (180 mmol/L), she would be considered Stage 2 - not time to consider that this is near her end.
What else is she getting - appetite stimulant, anti-nausea meds, phosphorus binder? How much sub-Q fluids does she get and how often? Most CKD cats need all of the above.

What is her phosphorus level? I don't know anything about Pronefra, but I think that is a phosphorus binder, so that is good that she is getting that. But that product tells me you are probably not in the USA, correct? That being the case, you probably can't use baby food meat (Gerber Stage 2 or Beechnut) to help with her eating. Many CKD cats, including mine, seem to like it especially when they are off of their own food. There are ways to make most of them nutritionally complete for a cat too.

Are you aware of this web site - Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Everything You Need to Know to Help Your Cat (felinecrf.org). It is very comprehensive, but it is the best reference for all things CKD. I would strongly suggest you start looking through the sections and read what interests you most, and then you can move on from there. I use this web site all the time.

Ask all the questions you want; we will help navigate through this with you. (Sorry, but I wasn't able to view your video. Hopefully others can.)

 

[Furballsmom]

There's an easier website page for starters for felinecrf, otherwise known as Tanya's site, since it is so extremely comprehensive it can be overwhelming.

Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - What You Need to Know First

 

[EllaKen]

Hi, can you find a different vet? Will she eat at all if you handfeed her? I could see the video, it's almost as though something is stuck in her mouth or throat ... ?

Hi there, this is my 3rd vet.. Which seems to be the best one of them. I am trying to handfeed her but she barely eats. Today she managed to eat some tuna, which is something.. That's what I thought, it seems like something is stuck in her mouth/throat :/

Hi. Just based on her creatinine level (180 mmol/L), she would be considered Stage 2 - not time to consider that this is near her end.
What else is she getting - appetite stimulant, anti-nausea meds, phosphorus binder? How much sub-Q fluids does she get and how often? Most CKD cats need all of the above.

What is her phosphorus level? I don't know anything about Pronefra, but I think that is a phosphorus binder, so that is good that she is getting that. But that product tells me you are probably not in the USA, correct? That being the case, you probably can't use baby food meat (Gerber Stage 2 or Beechnut) to help with her eating. Many CKD cats, including mine, seem to like it especially when they are off of their own food. There are ways to make most of them nutritionally complete for a cat too.

Are you aware of this web site - Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Everything You Need to Know to Help Your Cat (felinecrf.org). It is very comprehensive, but it is the best reference for all things CKD. I would strongly suggest you start looking through the sections and read what interests you most, and then you can move on from there. I use this web site all the time.

Ask all the questions you want; we will help navigate through this with you. (Sorry, but I wasn't able to view your video. Hopefully others can.)

Hi there, I was not given any appetite stimulant or anti-nausea meds (although today she got a anti-nausea vaccine or something). I think Pronefra is a phosphorus binder. Right now she gets around 15ml of IV fluids/day (today was our first day.. she is also under 2kg right now.. Used to be around 3kg a few months ago)

Phosphorus is at 1.52. I am not in the USA, no.. I am in Europe though. I thought about baby food so I bought yesterday Nestle's baby food chicken with vegetables (no idea if that was the best choice but seemed to be the safest of them all) but I haven't tried feeding her yet..

Woah thanks! I'll need to start reading tomorrow. It is almost 4 am now.. I've also uploaded the video here maybe it will work now for you: VEED - IMG_3777.mp4

Thank you both for your time and help!

 

[Furballsmom]

If you haven't already, I think it would help the vet to see what she's doing. My guess is, (I'm not a vet) whatever is causing her to do that is keeping her from eating normally.

 

[Twylasmom]

Hi there, this is my 3rd vet.. Which seems to be the best one of them. I am trying to handfeed her but she barely eats. Today she managed to eat some tuna, which is something.. That's what I thought, it seems like something is stuck in her mouth/throat :/




Hi there, I was not given any appetite stimulant or anti-nausea meds (although today she got a anti-nausea vaccine or something). I think Pronefra is a phosphorus binder. Right now she gets around 15ml of IV fluids/day (today was our first day.. she is also under 2kg right now.. Used to be around 3kg a few months ago)

Phosphorus is at 1.52. I am not in the USA, no.. I am in Europe though. I thought about baby food so I bought yesterday Nestle's baby food chicken with vegetables (no idea if that was the best choice but seemed to be the safest of them all) but I haven't tried feeding her yet..

Woah thanks! I'll need to start reading tomorrow. It is almost 4 am now.. I've also uploaded the video here maybe it will work now for you: VEED - IMG_3777.mp4

Thank you both for your time and help!

Before you try the baby food make sure it doesn’t contain any garlic or onion, which are toxic to cats. Ideally it would be puréed meat only.

 

[EllaKen]

If you haven't already, I think it would help the vet to see what she's doing. My guess is, (I'm not a vet) whatever is causing her to do that is keeping her from eating normally.

I showed the video to the vet today and then he examined her and said the mouth/teeth looks fine. It doesn't seem fine though. Unless this is something related to nausea?

Before you try the baby food make sure it doesn’t contain any garlic or onion, which are toxic to cats. Ideally it would be puréed meat only.

I read all the ingredients to avoid the garlic and onion before buying it. I didn't find any meat only baby food though. Will search for more tomorrow.

 

[Furballsmom]

Unless this is something related to nausea?

Hopefully the anti nausea medicine has an effect

 

[stephanietx]

Is she pooping? She could be constipated, which can cause nausea. Many CKD owners will put their kitty on a daily dose of Pepcid or Ondansetron to help with nausea. Have you tried feeding plain meat baby food, chicken or turkey? In a worst case scenario, try getting some Science Diet a/d from the vet and offering that. That stuff's like kitty crack.

 

[FeebysOwner]

Her phosphorus level is pretty good for Stage 2 CKD. I don't know about an anti-nausea vaccine - here in the states, that might be Cerenia, which is really only effective for 24 hours. You need an ongoing anti-nausea med. And, an appetite stimulant would be good too. Again, here, that would be Mirtazapine or the transdermal form for the ear called Mirataz.

I was able to see that video, and I am not sure it really means anything, tbh. My cat does some funny things when eating too. It looks similar to when Feeby tries to eat more solid foods, or hard treats. It might be possible that it correlates with nausea - that I don't know for sure.

 

[EllaKen]

Is she pooping? She could be constipated, which can cause nausea. Many CKD owners will put their kitty on a daily dose of Pepcid or Ondansetron to help with nausea. Have you tried feeding plain meat baby food, chicken or turkey? In a worst case scenario, try getting some Science Diet a/d from the vet and offering that. That stuff's like kitty crack.

She was doing a bit of diarrhea (almost every day/other day) but today had some normal stool. I will look into meds about nausea. Will also look tomorrow for plan meat baby foods. Didn't find any last time I went to the super market. I've never heard of Science Diet either :/ So many things I didn't know..

Her phosphorus level is pretty good for Stage 2 CKD. I don't know about an anti-nausea vaccine - here in the states, that might be Cerenia, which is really only effective for 24 hours. You need an ongoing anti-nausea med. And, an appetite stimulant would be good too. Again, here, that would be Mirtazapine or the transdermal form for the ear called Mirataz.

I was able to see that video, and I am not sure it really means anything, tbh. My cat does some funny things when eating too. It looks similar to when Feeby tries to eat more solid foods, or hard treats. It might be possible that it correlates with nausea - that I don't know for sure.

He told me the shot will help her for around 24 hours so might be the same. Will look into anti-nausea med for sure. No one told me she needs one. She occasionally vomit (like once every month or 2 months) but from my understanding it was due to the toilet. Because she would go to the toilet, and if she couldn't poop she would vomit.. Will also need to check appetite stimulant..

 

[Furballsmom]

It doesn't seem fine though.

She's doing this whether she's eating or not, is that correct?

The science diet, or another brand is Royal Canin, here in the US are foods specifically manufactured to help cats with health issues. Hopefully your vet has something that they can provide, or even kitten food in a soft mousse or pre style can be helpful, if she will eat it.

I really wish your vet would pay more attention to that video.

 

[EllaKen]

Ohhh I also forgot to mention (this could be important too..) the CKD started after going to the old vet for around 1 1/2 - 2 years thinking (at least that what he was telling us) that she has FIP since we would need to remove fluids from her belly every week or bi-weekly or monthly.

We were getting ready to grab a black market vaccine that supposingly works for FIP but the seller told us to check her again because it is highly unlikely to have FIP for so long. So we changed vet, and we did send the fluids to a lab to another city which pointed out that she doesn't have FIP.

Even though we did a bunch of blood tests/ultrasounds etc we still have no idea what is causing this (we did discover though that she has 1 small kidney and a normal one). The only solution was to cut her open and grab samples from every organ. Due to her age though our vet told us to not risk it and we agreed. So we are still going once every X week/s to remove that belly fluids which we have no idea what is causing it..

She's doing this whether she's eating or not, is that correct?

The science diet, or another brand is Royal Canin, here in the US are foods specifically manufactured to help cats with health issues. Hopefully your vet has something that they can provide, or even kitten food in a soft mousse or pre style can be helpful, if she will eat it.

I really wish your vet would pay more attention to that video.

Yeah she does this randomly, sometimes a lot of times within a few minutes..

 

[FeebysOwner]

Because she would go to the toilet, and if she couldn't poop she would vomit..

Phosphorus binders can cause constipation in some cats and can require something like Miralax (Polyethylene glycol 3350) to be used, as needed. Miralax is a powder that can be mixed with a tiny amount of water and then added to her food. But, if she intermittently has diarrhea too, then Miralax should only be given when you know she is actually constipated or passing hard stools.

So we are still going once every X week/s to remove that belly fluids which we have no idea what is causing it.

I have no idea what is behind that, but draining fluids from her belly could possibly cause electrolyte imbalances, depending on how much and how often. So, sorry another thing to ask your vet about. What do her liver levels look like? Has her blood pressure been checked?

I am sorry, I didn't understand the motions she makes with her mouth weren't just when she is eating something. I would bug the vet about that again, as noted above. But I do wonder if it is related to nausea/stomach acids/acid reflux.

Take a deep breath - we are throwing a lot of stuff at you, and you don't need to try to absorb it all at once.

 

[Norachan]

I have a cat with CKD too. Albert, in my banner below, is FIV+ and at stage 4. He's doing much better since we got him on medication, but he will occasionally stop eating for a few days.

If nothing I offer him seems appealing I resort to syringe feeding him. Hills A/D is excellent, but even if you can syringe a couple of Churu treats or regular wet food mixed with warm water into them it seems to help. I think having a completely empty stomach makes them feel nauseous and then they want to eat even less. It's a vicious cycle, but if you can get a little something into them it helps. Albert usually starts eating again after 2 or 3 days of syringe feeding.

I wrap him in a towel, kneel on the floor with him between my knees (Tail in, head out) and syringe food into the corner of his mouth, just a little at a time.

It does look like she has some mouth pain. I would get the vet to do a proper dental check because even a slight gum infection can cause enough pain to make them stop eating.

Good luck, please keep us posted

 

[stephanietx]

The mouth chewing is what my kitty does when his tummy is upset and he's nauseous.

 

[EllaKen]

Phosphorus binders can cause constipation in some cats and can require something like Miralax (Polyethylene glycol 3350) to be used, as needed. Miralax is a powder that can be mixed with a tiny amount of water and then added to her food. But, if she intermittently has diarrhea too, then Miralax should only be given when you know she is actually constipated or passing hard stools.

I have no idea what is behind that, but draining fluids from her belly could possibly cause electrolyte imbalances, depending on how much and how often. So, sorry another thing to ask your vet about. What do her liver levels look like? Has her blood pressure been checked?

I am sorry, I didn't understand the motions she makes with her mouth weren't just when she is eating something. I would bug the vet about that again, as noted above. But I do wonder if it is related to nausea/stomach acids/acid reflux.

Take a deep breath - we are throwing a lot of stuff at you, and you don't need to try to absorb it all at once.

Thank you for the info! I will keep that in mind in case of emergency (Miralax that is)

She was also (she currently doesn't take it) on Hepatiale Forte for her liver, but I am not sure we did any liver related test on her latest blood tests (unless it is ALB?) and I doubt we have ever checked her blood pressure hmm

I am still reading..

I have a cat with CKD too. Albert, in my banner below, is FIV+ and at stage 4. He's doing much better since we got him on medication, but he will occasionally stop eating for a few days.

If nothing I offer him seems appealing I resort to syringe feeding him. Hills A/D is excellent, but even if you can syringe a couple of Churu treats or regular wet food mixed with warm water into them it seems to help. I think having a completely empty stomach makes them feel nauseous and then they want to eat even less. It's a vicious cycle, but if you can get a little something into them it helps. Albert usually starts eating again after 2 or 3 days of syringe feeding.

I wrap him in a towel, kneel on the floor with him between my knees (Tail in, head out) and syringe food into the corner of his mouth, just a little at a time.

It does look like she has some mouth pain. I would get the vet to do a proper dental check because even a slight gum infection can cause enough pain to make them stop eating.

Good luck, please keep us posted

Thank you for the information and tips!

The mouth chewing is what my kitty does when his tummy is upset and he's nauseous.

That makes sense.. Thank you for verifying.


-----

A small update, the little one has started eating (well not a lot but I'm happy she started) some tuna and a little chicken, will try some other foods later on today. She also didn't do that thing with her mouth that much (almost none at all) after the anti-nausea med on Friday so that could probably be the cause.

Now I have to look if I can find a non-pill solution for anti-nausea + appetite stimulant since in case of pills she hates us all and goes into depression mode.

The only thing that still worries me is that she is still down, no wing tail when I pet her or am around and she barely looks at me. She is mainly looking in the void/ignoring me or she is in some other place altogether

 

[FeebysOwner]

ALB is one of a few liver values that are typically part of Chemistry panel that also reflects kidney values. Other liver values are ALT, AST, ALP, GGT, and Bilirubin. Each has varying degrees of relativity to liver function. High BP is more common in older cats, ones with CKD, and hyperthyroidism, to name a few. Liver function and high BP can, in some cases, cause fluid buildup in either the abdominal or chest cavities. That is why I asked about them. But, I suspect there would be other signs in addition to fluid buildup.

The appetite stimulant known as Mirtazapine/Remeron can be given transdermally (rubbed into the pinnae of the ear) - and MIrataz is what it is labeled as here. It is specifically for cats. Maropitant citrate/Cerena and ondansetron/Zofran (anti-nausea meds) can be compounded into a transdermal for the ear as well. I am sure there are others. If your cat doesn't mind her ear being touched, these could be options. The ears need to be cleaned (soft, damp cloth) after every application or two, to reduce med buildup which can interfere with their effectiveness.

 

[EllaKen]

ALB is one of a few liver values that are typically part of Chemistry panel that also reflects kidney values. Other liver values are ALT, AST, ALP, GGT, and Bilirubin. Each has varying degrees of relativity to liver function. High BP is more common in older cats, ones with CKD, and hyperthyroidism, to name a few. Liver function and high BP can, in some cases, cause fluid buildup in either the abdominal or chest cavities. That is why I asked about them. But, I suspect there would be other signs in addition to fluid buildup.

The appetite stimulant known as Mirtazapine/Remeron can be given transdermally (rubbed into the pinnae of the ear) - and MIrataz is what it is labeled as here. It is specifically for cats. Maropitant citrate/Cerena and ondansetron/Zofran (anti-nausea meds) can be compounded into a transdermal for the ear as well. I am sure there are others. If your cat doesn't mind her ear being touched, these could be options. The ears need to be cleaned (soft, damp cloth) after every application or two, to reduce med buildup which can interfere with their effectiveness.

Thank you sooo much! Will call the vet tomorrow to get some Mirataz (we've got that here) and ask about the anti-nausea too. She has no problem touching her ears (thank god) so I can work with that!

Will also get do full blood tests next time to include everything liver related. ALB though was within regular limits.