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Hi everyone, I thought I'd post here since this seems to be a general "CRF cat" thread, I hope that's ok. My cat Smokey was diagnosed with CRF back in mid-July. He's doing fairly well right now with the treatment, but I want to make sure I do everything possible for him and so I wanted to see what other people's experiences are like, etc. I'm just starting to educate myself about these issues, but I will try to contribute and be helpful as much as I can.
Basically back in July Smokey "crashed". Over the course of a week or so he gradually lost his appetite until he refused to eat at all and spent all the time hiding under the bed, not relaxing like he sometimes does, but refusing to come out at all. He was taken to the vet and diagnosed with CRF after urine tests, bloodwork, ultrasound, etc.
On July 17th his BUN was 40.5 and his Creatinine was 783, with slightly elevated phosphorus. He was put on IV fluids for a few days, and then started a regime of:
-150 ml of subQ fluids every other day,
-Fortekor once a day
-antacid once a day
-Azodyl twice a day
-Rubenal and Renal Essentials twice a day each (these are vitamin/supplements)
He was also given renal prescription dry food and wet food. He quite liked the dry food but wouldn't touch the wet food, so we resorted to Fancy Feast, which I know isn't very good but the main thing was getting him to eat that point, and that was all that he was interested in.
On July 22, he was tested again, and this time his results showed a BUN of 13.5, Creatinine of 200, and normal Phosphorus levels (1.54, normal range 1.10-2.74 according to this lab). Still not quite right, but a significant improvement.
After this, the vet changed his regimen to 150 ml SubQ's twice a week, with everything else the same, except that we stopped the antacid. Giving him the pills every day was ridiculously difficult at first but we are much, much better at it now, although he still tries to outsmart us from time to time. We have been doing the SubQ at the vet but are psyching ourselves up to do it at home, and after having gotten a couple of "lessons", will be doing the procedure next week at the vet myself before trying to do it all at home.
He was tested again on August 13th. His BUN was 12.9, Creatinine 204, and Phosphorus 1.44. Our vet was quite pleased with the results, saying that he seemed to be stable, and that we should continue giving the SubQ's twice a week and the pills, with the exception that we could try reducing the Azodyl to once a day. Her reasoning is that we should try to find the most conservative therapy that can keep him stable, which makes sense to me.
About 3 weeks have passed since then, and I am trying to evaluate his current state and make sure I am doing everything I can. There are a few things I'm wondering about.
1) Being quite pleased with his Aug 13 results, the vet thinks we should do the next testing in 4 months. Now, I've read up on this a bit, and it seems to be a roughly standard amount of time, but I confess to being a bit paranoid about waiting that long to monitor how he's doing. On the other hand, I have read that testing too often could be counterproductive and obviously stressful for the cat. I don't want to give the impression that I don't trust my vet either, since as far as I can tell, she has saved my cat's life. But I also don't want to be passive or complacent. Does waiting that long seem like a reasonable idea, and I should just relax?
2) I am wondering if you guys had any ideas about what it means that his numbers were so high, and then suddenly went down so low again, to where they are *almost* brushing up against normal. One reason I wonder about this is that I've heard that cats with low values shouldn't be put on SubQ's prematurely, but then, it's a bit different for him since he *started out* with much higher results.
3) The dosage for Azodyl is 1 pill for cats 5 pounds and less, and two for cats that are over 5. My cat is just over 5 at the moment, as he is regaining weight he lost when he wasn't eating. His normal weight is around 5.5 or so. So would it be a good idea to give him one Azodyl a day instead of 2, as the vet recommended? As far as I can tell, there's no pressing reason to reduce the dose of a probiotic, as opposed to a "drug" that can have side effects. However, it would certainly be easier to pill him only once a day (and he'd be happier as well I expect).
4) Since I've been lurking this forum for a while, I'm much more educated about cat food than I was before. Unfortunately the result is that I'm kind of appalled by the pseudoscientific and dishonest practices of the pet food industry and the collusion of many vets with these practices. It's really disappointing. Silly me to trust a prescription product sold by medical doctors! That being said, I'm considering moving Smokey off dry food completely, and off the prescription food as well, wet or dry. Does this seem like a good idea, and do you have any advice for making the transition? For example, would it be a good idea to mix some new, better wet food in with his Fancy Feast at first in order to get him to try it, and then gradually change the ratios? Or will this upset his stomach?
5) Finally, is there anything I should watch out for that I haven't mentioned? If we keep going with this regimen, and don't get him tested again for a few months, are there any signs or warnings I should be looking for, beyond the obvious? I realize I sound like a paranoid lunatic, but I want to do right by Smokey because he's a good cat and an excellent companion, and cats can be so frustratingly stealthy about their health. Again I apologize for asking so many questions, any advice, big or small, you could give at all would be greatly appreciated. I'll try my best to return the favour.
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