CKD - I'm so confused!

[LadyJ]

Bringing her home tomorrow, couldn't get anywhere feliway spray I worry as it will be 30-40 min  drive in car back home which will stress her:(



Other than that I just bought everything for her and cat wait to have her home ❤️

[jezebel]

LadyJ, it's wonderful that you want to adopt an elderly cat with health issues - not many people would! Just being adopted will probably improve her health and prognosis (no criticism towards rescues, but I'm sure cats are healthier in their own home).

[LadyJ]

Hi! I am in similar situation.
I wanted to adopt cat and I fell in love with cat which is 14years old and has thyroid gland removed (one removed one left) and she has also CRF. She is stable now though and all ok. Just on vet prescription diet Royal cabin renal and they told me to do regular check ups on urine and blood at vet's every 3/6 months.

I am worried cause I want her to live as long as she can but just want her to be happy, hopefully we will make her happy very soon.

I dont think there is anything you can do if the vet cant.

I would let her enjoy her life and food, quality of life to me is the most important.

I have lost all 3 cats to kidney probs, none were medicated because they couldnt be and they ate what ever they wanted and lived until 17, 18 and 20.

that makes me  feel bit more positive knowing your cats  lived long after 

[jezebel]

Totally agree, Susanne. Drum is a stress-pot at the best of times so the less I need to "administer" to her, the better!

All I really want to know is if there's anything I should be giving her in terms of food or supplements to slow the kidney disease down - or at least get her as healthy and strong as possible. As I said at the beginning of the thread, there's so much conflicting information around that it's difficult to know what's best.

[Susanne (urbantigers)]

Getting more water into them isn't always the answer.  They drink more because they are dehydrated and despite drinking lots they are not getting the benefit because the kidneys do not work efficiently to filter out waste products (so they build up and cause nausea) or to utilise the  water for hydration.  That's why they pee a lot - the water essentially goes straight through them.  Subcutaneous fluids can help with hydration but that's not a practical option for all cats (I would not even have attempted that with Jaffa and the vet did not recommend leaving him there on a drip because he would have hated it and any benefit would have been temporary). Towards the end Jaffa would drink so much he would regurgitate water because his stomach was so full of it.  He just couldn't drink enough to stay hydrated.  However, Drum is not at that stage so I would just provide plenty of water (adding a bit to food is a good idea - I do that routinely even with Mosi) and keep an eye on her.

Jaffa was given nelio tablets which are ACE inhibitors and dilate the blood vessels with the aim of maximising what kidney function remains.  I forget the name of the one that's more commonly used (it's the same drug just a different brand).  You could ask the vet whether he thinks that would  help but I would assume he considers that not to be necessary at this stage and there's no point in trying to get tablets down a cat when you don't need to.  It sounds as though Drum is doing fine and is a happy cat and she may stay like that for years.  Having routine tests is good to know what is going on inside but I think it's also important to remember to treat the cat and not the numbers.

[Gill (sneakiefeline)]

So agree with you BCL and exactly what I did.

Cats usually start drinking more all by them selves but I also use to add water to the food.

[jezebel]

Phosphorous was 1.46 (range 0.90 - 2.20) so not a problem yet, which is why the vet said there was nothing to do at the moment.

Drum had a urine test at the same time as the blood test, and she will have a repeat of those in May.

The scan showed her kidneys are shrunken (not sure by how much!) and she's been drinking a lot for several months  now but apart from that, she seems fine - her appetite certainly isn't affected! I've started adding a little water to her food, which seems to be going down well.

[Tiggy's Mum]

Those results don't sound too bad at all, Urea can be affected by dehydration and the creatinine (which is a more reliable indicator of kidney function) is within range! What was the phosphorous? That's another key reading.

If she uses a tray can you use those special beads and get a urine sample to take in to test for urine specific gravity - it's a 10 second test that shows how dilute the urine is which is another indicator of kidney function. Costs less than a tenner.

For comparison Lu's creatinine is 195 (was higher on the inhouse test) and his urea is 10.3 - same ranges as possibly the same lab (IDEXX)?

[Lyn (Slugsta)]

BCL, I don't think that sounds irresponsible at all! It sounds as if you are putting the needs of your cat before your desire to keep her with you, who could object to that?!

[jezebel]

Thanks BCL!

Rosella, Drum's creatinine is 156 (range: 20-177) and urea is 12.6 (range: 2.5-9.9).

Weird how the ranges vary so much between your results and mine!

[Big Cat Lover]

Hi Jezebel, sorry to hear Drum has been diagnosed with CKD.  My Lucky got diagnosed with this back in September; she's at Stage 2.  She doesn't need medication, but my vet gave me some phosphate binder to put in her food.  Lucky wouldn't touch the renal food I got her, but as she's 16, all I care about is her quality of life.  I'd rather let her eat what she likes (within reason!) than to try and make her eat something she doesn't like. I know that probably sounds irresponsible, but as I said, all I really care about is making my Lucky happy and comfortable.

Give Drum lots and lots of kisses from me - Lucky sends lots of furry headbutts as well!      

[Rosella moggy]

Oh and subcutaneous fluids are more relevant to end stage I think  but we decided against that sort of intervention as Fred would have hated it.

[Rosella moggy]

All blood results I have had showed "normal" range so you can determine which end of normal range test falls into and, if over or under "normal" range, by how much. 

I kept a record with Fred so I could keep an eye on how his results altered after each blood test. Maybe this will give you a flavour (I understand createnine is the more important and we only started testing for hyper thyroid -T4 when other symptoms showed up)  .........

                              Urea             Createnine                   T4
(normal range)         (5.7-12.9)   (71-212)      (25 norm-60 high)   
Date of test
6 Apr 2010         15.5                242
7 Jul 2010         19.1                294
21 Sept 2010         23.4                314             46.3

Sorry it's a bit scuwiff but tabs don't work.........

It is soo easy to make generalisations but all cats have there own "normal" range and "normal" for T4 results gets lower as a cat gets older ........ or so I understand.

I used to keep a detailed diary for my boy as I loved my piddle pot very dearly.

Best of luck 

[maddercow]

Ah, maybe not then...Holly was a very docile wee thing so it was easy with her. X

[jezebel]

Subcutanous fluids? This is the cat that sulks for three days after Frontline!

I don't know if she's dehydrated. She both drinks and pees a lot but doesn't seem ill or tired. I've started adding water to her food so that might help if she is.

I now have her test results - all five pages! Not sure what I'm looking for. Some results are marked high, others low but I don't know if any of them are worryingly high/low.

[maddercow]

Is Drum dehydrated? If so has your vet recommended sub-cutaneous fluids?  That really helped my Holly when she was diagnosed, perked her up no end. I gather that CRF feels a bit like a hangover and so hydration is really important, I know you said Drum is drinking well but she may be weeing rather alot as well. You can also learn to do them yourself if your vet is ok with that, it saves a trip.

As has been said, although there are various recommendations about foods it is most important that Drum continues to eat and enjoy it. 

Royal Canin renal food went down pretty well with Holly too. I got some of the phosphorus binder powder on tinternet, was quite reasonably priced and certainly did no harm.

It certainly sounds as though you have caught it nice and early which is good.

[Susanne (urbantigers)]

What Gill says - you are entitled to a copy of the test results so don't let them fob you off. 

[Gill (sneakiefeline)]

Dont let them fob you off about a copy of the test results..............you paid for them!

[jezebel]

Thanks Susanne. I've joined Tanya's CKD forum and have been reading about phosphorus binders (which I'd never heard of until today!) and lots of useful information and advice.

I rang the vet earlier to ask for a copy of Drum's test results but whoever I spoke to was really hesitant and said she would have to ask someone whether this was okay.

I read about the stomach acid thing a while ago, so we now put her dishes on a raised platform (it's amazing what you can make with a cheap shelf and a couple of bits of old wood!) and I think she's actually eating more now. There's certainly nothing wrong with her appetite anyway, bless her, and she's still very active so I don't think she's feeling too bad at the moment. Fortunately she's not as fussy as her sister when it comes to food and will happily eat good quality stuff - for a while, anyway.

Sadly, I read that prawns are high in phosphates so she will be having less of her favourite treat.

[Susanne (urbantigers)]

There is so much conflicting advice out there but Tanya's site is excellent so worth dipping in to now and again to read a bit more.

Do you have a copy of the test results?  As Helen says, always good to have that as reference even if you don't understand them all.  If the vet doesn't feel she needs medication then that implies that the disease is not too far advanced.  worth looking at the phosphorus levels in the test results - if they are normal I wouldn't worry too much about a low quality phosphorus food but if that is higher than normal then paying attention to the amount of phosphorus in the food and feeding either a renal food or adding a phosphorus binder to her normal food might be a good idea.  I think good quality protein is better than low protein levels per se so I wouldn't worry too much about the amount of protein.  I think the traditional approach has been to feed a food low in protein but these days I think more people are recommending just good quality protein.  If you need or want to feed foods low in phosphorus, zooplus is one place that does list the amount of phosphorus in a lot of their foods (although you have to calculate how much on a dry matter basis).  If she is in the early stages and does not have low phosphorus levels I would keep feeding her what she's used to and try not to worry too much.

One of problems with cats with kidney disease is that they often feel nauseous due to excess stomach acid and therefore are reluctant to eat just at the point where you want them to eat a specific food.  If Drum is eating ok it sounds as though she's not at that stage yet so I would try not to worry too much at this point.  There are meds and supplements you can give them to help with nausea etc.

[Frances]

From what I've read the kidney diets are very effective . . .

My late mum’s cat Georgie, a Posh Persian , had chronic kidney problems – not exactly sure what but one of her kidneys was all but defunct – and did very well on Royal Canin renal food, both wet and dry. Her daily special treat was a small amount of cooked chicken which didn’t appear to do her any harm (that’s Georgie, not my mum ).

[Tiggy's Mum]

I always get a copy of blood results now, at first they're gobbledegook but when you get to know what means what it really helps me to not worry, or vice versa! Lu has recently been diagnosed with CKD (he's only 7  ) so I've been reading up on it. It seems we've caught his early on and I'm sort of hoping there's something odd going on as he's 100% his normal happy/healthy self and there was an anomaly with one of his urine specific gravity tests that showed his kidneys can still concentrate urine ie they're able to function normally whereas the first test suggested otherwise.

[jezebel]

Thanks TM.

I don't know Drum's test results but I can ask the vet for a copy - not sure how much sense they will make to me though!

She didn't have her blood pressure checked - unless they did it when I left her there for her ultrasound.

[Tiggy's Mum]

My vet recommended this website: http://www.iris-kidney.com/guidelines/ with lots more info here: http://www.iris-kidney.com/education/

Do you know the figures for Drum's blood results? The main figures to look for are creatinine, urea and phosphorous. It really depends on the results as to what/if any treatments you decide to go for at this stage. From what I've read the kidney diets are very effective, whether or not she'd eat it is another matter though! Did she have a urine specific gravity test (this doesn't need sending away, takes two seconds) or blood pressure taken?

[Kay and Penny]

I've not had (yet) a cat with renal impairment, but as I understand it,  it's advisable to feed foods low in phosphorus, and because one of mine is over 12 I have been giving my two low phosphoros biscuits to balance out ordinary wet

they both like the two varieties of  RC 12+ biscuits, and Josera Carisimo - all sold by Zooplus

if I am right, and phosphorus is the main thing to avoid, there are probably web sites which advise on the phosphorus content of stuff like chicken 

[jezebel]

Thanks Gill. I just don't want to be doing anything that will make her condition worse.

[Gill (sneakiefeline)]

I dont think there is anything you can do if the vet cant.

I would let her enjoy her life and food, quality of life to me is the most important.

I have lost all 3 cats to kidney probs, none were medicated because they couldnt be and they ate what ever they wanted and lived until 17, 18 and 20.

[jezebel]

Since Drum was diagnosed with chronic kidney disease a few weeks ago I've been trying to find out if there's anything I can do for her in terms of diet and supplements, but I'm so confused by all the information (including Tanya's site, which is great if you've got a spare few hours!) that I now have even more questions than before.
Low protein or high protein? Grain or no grain? Does she need extra essential fatty acids?  Do I stop giving her her favourite treat of roast chicken? Should she be on a special renal diet yet? Just before she was diagnosed, I bought some good quality food from Zooplus but it was very high protein so I'm worried that she shouldn't have had it!

So far her only symptom is drinking a lot. She's eating (very!) well, is playful and affectionate and still goes bonkers when she feels like it! She might have lost a little weight but it's nothing drastic, and occasionally her fur looks a bit "spikey" and dull. For 14, I think she's doing okay.

The vet said there was nothing much they could do for her at the moment, just give her regular blood tests to monitor her levels which would indicate when she needs a special diet or medication.

But I don't want to wait till her health deteriorates. Is there anything I should be giving her/not giving her, or doing/not doing?