Hi there,
I have a 16-year old female cat domestic shorthair that has heart and now kidney issues. Fair warning LONG...
About a year and a half ago (July 2020), she briefly lost function of her hind legs; she was diagnosed with hypertension and advanced heart disease possibly CHF (Nt-proBNP levels at 400 pmol/L, blood pressure 280/206). We started her on 0.625 mg amlopidine, Semintra (dosage for weight) and 18.75 mg of clopidrogrel. She slowly recovered over the next few weeks and apart some weakness in her hind legs and hips, returned for the most part to her old self. In January 2021, her blood tests were fairly normal. Over the last couple of months, we noticed a drop in appetite and that she was licking her lips a lot - brought her for a vet visit in January 2022, and her creatinine was way high (497 umol/L when it was 160 umol/L the previous year). See a copy of the last three bloowork results here ). This sharp and rapid rise was a little surprising, but there is nothing in her environement that could support acute kidney injury, so the best guess was that perhaps her heart issues caused the kidney's function to degrade at a unusually fast rate over the last year. I am absolutely eaten up by guilt that I didn't bring her in 6 months ago since perhaps we could have caught it at an earlier level and been able to treat it then. I feel this stage 4 is a lost cause and it's mostly my fault; every time I think about it it makes me feel sick.
We were sent home with k/d food and subQ fluids, as well as potassium gluconate (her levels were a little low, and we're also hoping it will help her hind legs and colon). Initial prescription for subQ fluids was between 100-200 mL every two days but after reading that subQ fluids in cats with heart disease could make matters worse and discussing it with the vet, we took it back to 75 mL every two days (asked about smaller doses more frequently, but was told it would have the same effect if not worse?). It is my understanding that this may still be a dangerous thing to do given her heart issues? We are using lactated ringers; I did bring up the possibility of using another fluid lower in sodium but the vet said lactated ringers what they generally used and since her blood pressure and sodium levels were currently under control. We have had an insane amount of trouble trying to get her to eat over the last week-end - she was not a fan of the k/d food, despite using Fortiflora and trying to introduce it slowly. Her previous diet was Royal Canin weight loss dry food and half-to-three-quarters of a can of Fancy Feast at night (whatever she would eat). On Monday, she threw up four times and it became clear she was constipated (straining, not pooping) - we switched her back Fancy Feast with Miralax and added Cerenia for a couple of days following the vet's advice. She started eating more on Tuesday and then eating a normal amount on Wednesday and Thursday (just the Fancy Feast, tuna water, or Churu's - nothing else she would touch) but she still had not pooped by Friday morning. Brought her to the vet again and he said there was a decent amount in her colon that were probably too big and dry so he manually broke them up through palpation and was able to get a bit out manually (she was in there maybe 15 minutes; no sedative or anasthesia was used so I assume what he did couldn't have been that drastic?). He told us this may keep happening and that the general solution would be to up the subQ fluids but that we should do an ultrasound to assess her heart condition beforehand to see if it is safe to do. She pooped some more throughout the day and had diarrhea this morning - her back area seems quite swollen, almost like there are two lumps just below? I'm not sure if this is normal and/or if I should be concerned that something went wrong during the procedure, especially given the fact that she was still 'leaking' this morning (although maybe that's from all the Miralax we gave her finally making its way through?)
Thank you.
I have a 16-year old female cat domestic shorthair that has heart and now kidney issues. Fair warning LONG...
About a year and a half ago (July 2020), she briefly lost function of her hind legs; she was diagnosed with hypertension and advanced heart disease possibly CHF (Nt-proBNP levels at 400 pmol/L, blood pressure 280/206). We started her on 0.625 mg amlopidine, Semintra (dosage for weight) and 18.75 mg of clopidrogrel. She slowly recovered over the next few weeks and apart some weakness in her hind legs and hips, returned for the most part to her old self. In January 2021, her blood tests were fairly normal. Over the last couple of months, we noticed a drop in appetite and that she was licking her lips a lot - brought her for a vet visit in January 2022, and her creatinine was way high (497 umol/L when it was 160 umol/L the previous year). See a copy of the last three bloowork results here ). This sharp and rapid rise was a little surprising, but there is nothing in her environement that could support acute kidney injury, so the best guess was that perhaps her heart issues caused the kidney's function to degrade at a unusually fast rate over the last year. I am absolutely eaten up by guilt that I didn't bring her in 6 months ago since perhaps we could have caught it at an earlier level and been able to treat it then. I feel this stage 4 is a lost cause and it's mostly my fault; every time I think about it it makes me feel sick.
We were sent home with k/d food and subQ fluids, as well as potassium gluconate (her levels were a little low, and we're also hoping it will help her hind legs and colon). Initial prescription for subQ fluids was between 100-200 mL every two days but after reading that subQ fluids in cats with heart disease could make matters worse and discussing it with the vet, we took it back to 75 mL every two days (asked about smaller doses more frequently, but was told it would have the same effect if not worse?). It is my understanding that this may still be a dangerous thing to do given her heart issues? We are using lactated ringers; I did bring up the possibility of using another fluid lower in sodium but the vet said lactated ringers what they generally used and since her blood pressure and sodium levels were currently under control. We have had an insane amount of trouble trying to get her to eat over the last week-end - she was not a fan of the k/d food, despite using Fortiflora and trying to introduce it slowly. Her previous diet was Royal Canin weight loss dry food and half-to-three-quarters of a can of Fancy Feast at night (whatever she would eat). On Monday, she threw up four times and it became clear she was constipated (straining, not pooping) - we switched her back Fancy Feast with Miralax and added Cerenia for a couple of days following the vet's advice. She started eating more on Tuesday and then eating a normal amount on Wednesday and Thursday (just the Fancy Feast, tuna water, or Churu's - nothing else she would touch) but she still had not pooped by Friday morning. Brought her to the vet again and he said there was a decent amount in her colon that were probably too big and dry so he manually broke them up through palpation and was able to get a bit out manually (she was in there maybe 15 minutes; no sedative or anasthesia was used so I assume what he did couldn't have been that drastic?). He told us this may keep happening and that the general solution would be to up the subQ fluids but that we should do an ultrasound to assess her heart condition beforehand to see if it is safe to do. She pooped some more throughout the day and had diarrhea this morning - her back area seems quite swollen, almost like there are two lumps just below? I'm not sure if this is normal and/or if I should be concerned that something went wrong during the procedure, especially given the fact that she was still 'leaking' this morning (although maybe that's from all the Miralax we gave her finally making its way through?)
- Anyone have more information about subQ fluids and heart disease, and the type of subQ fluid that would be best?
- I'm not sure I understand how an ultrasound will tell us whether we can use more subQ fluids or not - I did not know that the type of heart disease could be diagnosed this way and I also did not know that some of the types of heart disease could handle more subQ fluids? Would an echocardiogram be superior to an ultrasound if not performed by a cardiologist (
- Any tips to try and get her to eat the stupid k/d food? We have tried a few of them, and even gotten a couple off of Tanya's list but she is being awfully picky.
- Is tuna water (the water from low-salt canned tuna packed in water only) bad for her? What about Churus and cat milk? We also use Temptations treats to give her some meds, although we know those are not recommended, we have yet to find treats low in protein and phosphorus... We have also used the Fancy Feast broths - she mostly just eats the broth so we assume it can't be too bad despite the high protein content of those?
Thank you.