Taking clapton off fortekor

[Tiggy's Mum]

I know exactly what you mean Mark, for me it was like living with a fussy toddler!  I was always trying to persuade her to eat, chicken breast was her favourite and sometimes I'm sure she held out for some chicken breast knowing if she didn't eat her dinner she would get some.  She would be very jealous of Clapton's tea tonoight, free range aswell!

[Mark]

I need to ge more organised. I have claptons results "somewhere" - Iam the most disorganised person going. Clapton's weight is pretty stable but it takes a lot of effort.  I know what you mean lynn about not trying so hard but I'm scared that unless I cajole him, he won't eat enough. I sit on the basement stairs with him on my lap and let him eat from my hand. Once he gets into t, he will eat more. Anyway, I got some free range west country chicken breasts from the clearance counter in sainsburys today so I think he will make up for lost time later 

[Tiggy's Mum]

Clapton clearly has Fortekor side effects; anyone else?  My 2 were playing like loonies today and eating well and I'm torn between medicating and not, like Mark and others. I don't want to ruin his current good spell, nor to leave it untreated for too long. Vet told me Istin wouldn't cause any probs and it did.  I suppose could try - how long are cats on it for before you can tell if it's working or not?

Tiggy was on Fortekor for almost 20 months and had no side effects whatsoever.  When she was diagnosed the vet initially gave the prognosis of 5 - 7 months given her age, I honestly believe that the Fortekor gave her the extra time with me and in the end her CRF was still well managed it was the cancer that took her 

Here are Tiggy's blood test results, Fortekor was started immediately after the first test in July 2005...  As you can see her results improved at every test, the last test taken just 4 months before she died her kidney levels were actually within normal range - not bad for an 18 year old cat diagnosed with a terminal condition 20 months earlier!

Here's a really good link to info on Fortekor, it mentions that Fortekor is primarily excreted by the liver so may not be suitable for Swampy after all?  There are also links to studies, trials and other articles.  http://www.felinecrf.org/treatments.htm#ACEI


July 05

Urea       35.3      Normal range     2.5 - 9.9
Creat       312.2     Normal range     20 - 177
Phos       2.24      Normal range     0.9 - 2.2



October 05

Urea       16.5      Normal range     2.5 - 9.9
Creat       233      Normal range     20 - 177
Phos       1.68      Normal range     0.9 - 2.2



January 06

Urea       20           Normal range     2.5 - 9.9
Creat       165      Normal range    20 - 177
Phos       2.06      Normal range    0.9 - 2.2



April 06

Urea       18.5           Normal range     2.5 - 9.9
Creat       150      Normal range     20 - 177
Phos       1.5       Normal range    0.9 - 2.2



October 06

Urea      9.8               Normal range    2.5 - 9.9
Creat      97.4             Normal range    20 - 177
Phos      1.7               Normal range    0.9 - 2.2

[CurlyCatz]

Mark i dont think stop / start is a good idea if it were to happen too often.
One thing ive realised i havent asked you is regarding claptons weight (quite silly i havent asked actually)  how is this going, i'm thinking if its fairly stable then perhaps you should just stop trying to hard if that makes sense.
if you are convinced that its the fortekor making him like this then i would make a decision if it were me and following speaking to the vet to stop it completely for 1 month then reavaluate.

s & m mum..i think the fortekor might be worth a try tbh esp if there is a heart murmer etc aswell since fortekor was originally made for dogs with heart problems, the fact it helps cat with kidney problems has been an added bonus so to speak.  RE the urine sample...i in all honestly couldnt tell you exactly how many hours they are ok for, fresh is always best but i think many urine samples are up to 12 hrs old by the time we probably get them...always store in the fridge though.

[Mark]

Keeping it on this thread is fine. We're both trying to get the same info 

Well I have been out for a few hours (fruitless trip - on a separate thread)  and he is sleeping. He Still hasn't eaten. He doesn't seem "ill" ie his eyes don't have that look but he is being very needy today. Licking hands and whimpering at me (he doesn't really meow). I wonder if its because I started him back on Fortekor yesterday (maybe its not a good idea to "stop start") I will seak to the vet again next week. I am probably going to speak to the vet next door and I may have to ask them the retest and get a 2nd opinion.

[swampmaxmum]

Blimey, vet already thinks I'm a neurotic know-it- all because of the info I pass on from all the knowledgeable kittybods on this forum. I'm wondering how to broach the subject of dipstick vs refractometer without him going ballistic.....I know his nurse does the testing cos she mentioned the dipstick.
Lynn, how many hours old can a urine sample be and still be ok to test? Max will only pee at night when vet is closed.
He's going on urine concentration as the bloods aren't too bad (183 and 9.2), but he's concerned that there is kidney deterioration in a cat with a small heart murmur and having had liver disease.
The latter makes me petrified about Fortekor although I can't see it contra-indicated (like Istin).

Clapton clearly has Fortekor side effects; anyone else?  My 2 were playing like loonies today and eating well and I'm torn between medicating and not, like Mark and others. I don't want to ruin his current good spell, nor to leave it untreated for too long. Vet told me Istin wouldn't cause any probs and it did.  I suppose could try - how long are cats on it for before you can tell if it's working or not?

Sorry, Mark, would you prefer it if this all got moved to a dedicated Fortekor thread? I only started the mini hijack here because my qs were so similar to your's ie Fortekor and side effects vs benefits.

[CurlyCatz]

s & m mum... sorry i didnt realise the reasons you were feeding i/d but i do now thanks....I'm sure if given a choice of i/d over some commercial foods the i/d would be much better.
I am very concerned though about what you said on the blood tests.  On a previous post you gave latest urea and creat results so why did you mention your vet goes on the specific gravity (concentration) of urine rather than bloods ??  If your vet is doing bloods every 3-6 months i'd say that was adequeate and testing the sg inbetween is fine.

also i would like to inform you guys that dipsticks to test for the specific gravity of urine but please know that these are well known for being quite inaccurate for that indicator (they are far more accurate on the protein, glucose etc etc)   Lots of vets have a little peice of equipment called a " refractometer" which you put a drop of urine in, look through an eye piece and it gives you an exact and more accurate SG reading. At no time did we ever use the dipsticks reading for SG and always used the refractometer with every  urine test.

[Gillian Harvey]

Plus is it true that to have even slightly above normal urea and creatinine, at least 70% of kidney function is really already gone?

Like you, what is 'mild', 'early' or 'moderate' then?

This gives you an idea here about how bad it is http://felinecrf.org/how_bad_is_it.htm

My Suzie's creatinine was 359 and urea 26.5 so she is definitely in kidney failure, as opposed to having kidney insufficiency. That was in November last year, she's not on fortekor, and I'm just feeding her her normal diet and she's still got a good appetite thankfully. I havent had further blood tests done, but am planning to soon (when I've save up enough LOL!) Suzie is 14.

[swampmaxmum]

that's young for kidney disease. I'm so sorry. Hope he has a good weekend with you, even if he's trying to stop you using the laptop 

[Mark]

Clapton is only 7. Willow is 8 and like a kitten 

[swampmaxmum]

he's just getting older Mark.  Swampy's a lot more clingy too.  They seem to need more reassurance.  It's hard when a robust, mad cat turns into a little old man, but I love spending quiet time with the little guy. I think about the phases of his life and how in each one, he's wanted a different type of attention. It's rather wonderful. Purrs to Clapton. Hope he wants to nosh later.
Have you tried any appetite stimulants or antacids with him or is he doing just fine as he is?

[Mark]

He hasn't eaten  yet and just wants to curl up on my lap - laptop is perched on my knees 

He let me cover him up with a jumper this morning to keep him warm - he used to hate that kind of thing

[swampmaxmum]

i/d is less suitable but it's not junk food either or so we hope !

the only k/d that doesn't make Max vomit is the minced chicken. If I feed him that, Swampy wants it and leaves his l/d and heads off in the direction of M's plate (aka the Ominous Waddle lol). Swampy then eats it and...usually vomits it. Plus then starts to refuse l/d. So all in all, right now with only mild problems, it's just easier to feed i/d (which Swamp fancies but doesn't cause him to start the OW). Plus Max had a vomiting spree in Feb which has calmed down on i/d.

Sorry, Mark! Thanks Lynn for the licensing info. I think they will both be on Fortekor. Did your vet do a urinalysis Mark? I don't know how the vets can prescribe strong drugs based on a non sterile sample tested on a dipstick, but he's fixating on the concentration of the sample rather than on the bloods. Plus is it true that to have even slightly above normal urea and creatinine, at least 70% of kidney function is really already gone?

Like you, what is 'mild', 'early' or 'moderate' then? Maybe we should stick to Fortekor if it makes them live longer - as long as it's not what's making Clapton feel yuk. Wondered how long after starting to take it that he showed the side effects? Do you know if it lowered his blood pressure?
hope he's having a good day. Mine started at 6am by knocking over a pile of books, then yelling, then ate 1/2 can of nosh each. Hope Clapton's having a good kip 'n nosh day too :-)

[CurlyCatz]

re the licensing thing thats pretty easy..the company will have paid for it to be licensed in britain but not america, licensing will only be given once it has passed a few years of testing and case studies, so dont worry about that at all...it IS licensed for cats. 

I dont think it is preventative and its certainly not curative as there is no cure for crf as far as i am aware.  Fortekor for cats with crf wasnt used when i last worked so i cant claim to know all about it for this but as far as i can gather it  works by reducing work load on the kidneys for a very simplified explanation and therefore the kidneys will keep on going longer and deterioration will take longer if they are not having to work so hard.

Have you looked into the differences between i/d and k/d properly ??  if your cat has a degree of crf im puzzled as to why you would feed i/d and not k/d or other prescrip diets specifically for crf.  I do know that the prescrip diets can play a big role in this condition and have seen many times moderate crf levels come back within normal ranges through diet alone. (great if the cat is happy to eat them.)

[Mark]

Apparently he only has "moderate" CRF -which I suppose is like "how long is a piece of string' - he doesn't vomit, he gurgles sometimes, not as active as he used to be and more of a daddies boy every day. He wants to sleep on my lap every time I sit down (which isn't often as I am hyper  )

[swampmaxmum]

He gets Hills l/d and some i/d. I gather l/d is very similar to k/d.
Vet says he has early kidney dysfunction and his urine is too dilute so wants to start him on treatment now. Max possibly also - vague vet is checking, but Max's blood kidney results were worse than Swamp's....so they may both be on it quite soon. Swamp's results were within normal range in January; now just above.
One thing: Novartis claim that it works best in chronic renal insufficiency that's advanced - is it protective or curative then?

Plus why isn't it licensed for cats in America (dogs only)? I am so scared of these big intl conglomaterates. Swampy's doing well as is Max right now and I don't want to be overmedicating.

How bad is Clapton, Mark? I guess the CFS is what's probably making him feel very sick. My vet said that the Fortekor actually should help to reduce nausea. Blimey, it's difficult trying to do the right thing.

[CurlyCatz]

here you guys if you havent already read this

http://www.noahcompendium.co.uk/Compendium/Overview/search.asp?search=fortekor

Swampmax..note in contras it says fortekor can cause a rise of plasma urea initially !  (what type of hills are you feeding btw)

[swampmaxmum]

http://www.ah.novartis.com/products/en/cab/fortekor.shtml

from the drug co...claims it puts on weight. There are some precautions and contra-indications which you might want to chat to with the vet (lethargy etc bit if you scroll down).
Nausea's not listed. That doesn't mean it isn't making him nauseous. Try an antacid?

good luck with Clapton.

[swampmaxmum]

This is really interesting Mark as sometimes the vets insist there are no 'side effects' whereas owners who live with the cats can see that they are feeling better/worse etc on a pill or off it. My vet insisted Istin (bp) wouldn't affect Swamp's liver whereas it did.  His kidney results have just shown the beginnings of deterioration so the vet's talking Fortekor - something to do with cos he has a heart murmur too?! (no time to explain either and very vague, if good, vet).
Can you get hold of the drug insert online to look for side effects? Like Helen says, it could be that he's got too much acid so fortekor with an antacid may help (?).
I'm going to have a look-see myself as can see both of mine being put on it.

Just how much difference does Fortekor make in keeping kidney deterioration at bay? Sorry to hijack your thread, but was just going to open up another on on Fortekor when I read this. I'll do so if you prefer?  Swampy's readings are 182 creatinine and 9.2 urea; higher than 3 months ago (please don't let it be the Hills food!).

I'll post anything I see about Fortekor and nausea.  Hope Clapton's enjoying his nosh today.

[CurlyCatz]

you should write down your questions you want answers to mark and speak to the vet.  perhaps get together with him and have 2 or 3 plans of action ie carry on fortekor but as helen suggested have him take some sort of antacids aswell for say a 1 mnth trial and if things are still the same discuss with the vet stopping fortekor but perhaps have him blood tested every 12-16 wks for kidney function.

You know ive said before whats the point of adding quantity of life if the quality is greatly reduced.

Let us know how you get on 

[Mark]

I wish my vet wasn't so cut & dried about things. When I tried to discuss binders with him, he just dismissed it. Its not just the appetite, clapton's whole demenour  changes, he seems a lot happier when he isn't on the fortekor . He did have a gurgly stomach but I have been giving him slippery elm which seems to help a bit and he eats it no problem. I will try puting him back on them and speak to the vet (hopefully without having to take clapton with me)

He is fast asleep on my bed at the moment  (kylie isn 't too pleased but she has accepted it  )

[Desley (booktigger)]

I would discuss this with your vet before making any decisions, but good luck.

[Tiggy's Mum]

I can only go on my experiences but I have a lot of time for Fortekor.  Tiggy's inappetance was due to excess stomach acid and once that problem was under control then that was half the battle of CRF won. 

Does Clapton's stomach gurgle? Or does he sometimes vomit clear foamy patches?  If he does then he very likely has excess stomach acid/nausea, that will undoubtedly cause a lack of appetite or sometimes an interest in food but when it comes to the crunch getting to the bowl and not eating.  Obviously you should discuss any new treatments with your vet but there are several remedies for excess acid available that really do work.  If you or your vet don't think that he is suffering from excess stomach acid/nausea then I think you have to consider taking him off it if is really affecting his appetite that badly.  It's so hard to know what to do for the best, I'm sure you'll make the right decision for him 

[Mark]

A few weeks when I ran out over easter, clapton was 5 days without and his appetite improved. Also he was a lot livlier. I have had a lot of trouble feeding him this week. He often only eats in the evening but on  day one without a pill he wanted food during the day and this morning actually wanted breakfast for the first time in ages. I am still struggling to get him to eat senior but he has had 2 trays of sheba terrine, one pouch of whiskas senior, a coley steak and a small amount of co-op terrine today which is the most he has eaten in a day in some time. He has been playing in the garden and even jumped on my lap for a cuddle in the garden. I really don't know what to do for the best. As I type this, he has polished off the tray in less than 2 minutes - instead of nibbling, he is doing his old trick of dragging it across the floor and devouring it with gusto