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Kidney Failure - Recently Diagnosed
I recently inherited an 18.5 year old cat, Muffy from my mother in-law who just passed away 4-weeks ado. Muffy is actually my cats (Munchkin) daughter and has just been diagnosed with the same disease her dad had, Kidney Failure (he passed away in Jan'08). We undertook the approach of Holistic as most Doctor's we took Munchkin too had minimal to no options, where Holistic approach has many options available. I am currently feeding Muffy Merrick wet cat food, but concerned about the possible levels of phosphorus and containing cranberries. I have used the felinecrg.org website as my key resource for assisting with symptoms and possible solutions.
I am not sure that the low protein is the best direction as there is so much controversy in animals and feel this is the right path for us. Any ideas on food types that would ensure proper health and restricting phosphorus levels? |
#2
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Here is an excellent thread that covers absoutely everything regarding kidney failure in cats....The low protein diet is debunked, a worthwhile read http://www.pets.ca/forum/showthread....y+failure+cats
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Thank you for the information! it's hard to balance all the information. No cranberries, low vitamin C. Is it really important to stay away from Fish? i moved Muffy off of Fancy Feast to a better grade food, but now seems to have stomach acid issues. I moved her to Merrick, but fish, i guess i need to move off of that quickly.
Last edited by m.scott; May 11th, 2009 at 11:45 AM. |
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Hi m.scott sorry to hear about your family's loss and the CRF diagnosis
I see Chris already gave you the link to my thread and you have seen felinecrf.org Re the fish - yes removing it is best, you can feed just 1 or 2 times a month for variety or if at all possible eliminate it totally. CRF cats become very picky eaters - when they do eat - and you need to ensure balanced food (fish, esp tuna, causes a Vit E deficiancy) that they will not refuse because they are holding out for fish, plus fish tends to be higher in phos. Wellness grain free canned Turkey, Chicken, Chicken & Beef, Kitten all have lower phos levels, when Duffy was on canned (she's raw fed) she quite enjoyed the Wellness The low protein theory is old thinking, low phosphorus is what needs to be looked at. Stomach acid - raise the food & water dishes up between 2-4 inches off the ground it will help with the nausea associated with excess stomach acid by keeping it in the stomach. Smaller more frequent meals, one especially before you go to bed - long wait till breakfast - will also help as it keeps the amount of acid produced lower. There is a summary of that thread here: http://www.pets.ca/forum/showpost.ph...&postcount=220 I'm treating my 18yr old CRF cat Homeopathically (diagnosed ~2 years ago), if you have any questions about homeopathy, CRF, reading test results etc let me know I'm happy to help
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Avoid biting when a simple growl will do The Spirit Lives As Long As Someone Who Lives Remembers You - Navaho Saying |
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Hi Growler Thank you for the information and glad to hear that someone else is taking the Holistic approach.
So since I am feeding Merrick, Grammy's Pot Pie (got rid of the fish yesterday). i am trying to calculate the Phos. levels in the food. The website states their food ranges from .18% to .25% as fed, so if i convert to dry matter, is this correct. 78% moisture 10% protein 22% DM value 10/22=45.4% protein DM? if this brand is the highest Phos. level at .25% as-fed (.25%) .25/22=1.13% Phos. level? Not sure if that is correct. As well do you need to stay away from cranberries and Vit C. Poor Muffy also has a heart murmur, so have started ACE inhibitors already and needed to start low dose aspirin, she passed a clot last week and lost the use of her left side. She has recovered mostly, only damage that we can tell is to her back left leg, but it's about 90% now, she can still get up and down the stairs. Her current full list of daily meds are: ACE inhibitors Aspirin (low Dose 1/4 tab every other day) Co Q10 Digestive aid, with food B-Plex vitamins (liquid wtih food) Kidney Tone - 1/2 tsp daily Reneel tablets, but have not started this one yet. The vet says that you need to crush and tip into the mouth, rather than give as a treat and not sure how i'm going to do that. any other suggestions? I have decided not to start Sub-Q yet as she is drinking ok right now and wtih Munchkin (her dad) we had a really hard time with fluids after a while, really started to flight it, didn't matter on the temp. Still waiting for the vet to email over the blood work, but she said she is in stage 1 at this point. |
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m.scott, Growler won't be logging in until tonight, I'm pretty sure she will touch base with you then
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"To close your eyes will not ease another's pain." ~ Chinese Proverb “We must not refuse to see with our eyes what they must endure with their bodies.” ~ Gretchen Wyler |
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Thank you for the site, I must have come across it and missed the calculation based on 100Kcal. Cranberries seems to be an issue per the felinecrf.org site, is that correct? it's hard to find good food without it. It seems that most Merrick has it other than the Grammy's pot pie, but Muffy really likes the ones with crab, lobster, salmon and tuna, but I guess that is a no no for CRF cats.
Any recommendations on wet foods? I see that Growler talks about Wellness, but most have cranberries in it. THX! |
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m.scott,I just want to say thank you,for caring for your MIL's 18yr old cat,where many would have just dumped her at a shelter
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"The cruelest animal is the Human animal" 3 kitties,Rocky(r.i.p my boy),Chico,Vinnie |
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Honestly, the amount of cranberries in canned cat food is negligible. It's really just there to appeal to the humans buying it. I understand that the reason it's a potential concern is because cranberries are acidifying, and CRF cats are prone to acidosis, but I think the issue is overstated. It's not something you should worry about this early. Wellness really is a good food for CRF cats and many do quite well on it.
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"To close your eyes will not ease another's pain." ~ Chinese Proverb “We must not refuse to see with our eyes what they must endure with their bodies.” ~ Gretchen Wyler |
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Hi Chico2, Her last wish was to bring her home. She knew that we would take good care of her. There is no way that an animal is going to be put down unnecessarily
Sugarcatmom. here is what the blood work looks like, let me know what you think. Urea: 29.5 Creatine: 316 Calcium: 2.63 Potassium: 4.6 Phos. 2.5 I just started the Reneel today (1/2 tab) and started the Kidney Tone (by Omega Alpha. Poor thing, she is only 5.8Lbs! we just spent the last few weeks working out all the matts, some were 7" long, 4" wide and 3" deep. I will pickup some of the wellness based on your reommedation, but the felinecrf.org site levels would way Muffy is stage 3 already. Any ideas on what else we can try? she seems to be having regular BM's and urinating frequently. now that she knows the bathtub has running water she dosen't want to drink from anyting else, including the flown water fountains we have bought. THX! |
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How severe is the heart murmur? With the cre in the 300s I would consider starting subq fluids especially if your vet has recommended it. Fluid therapy will help to flush out the Urea & lower both cre & BUN/Urea. The levels will all fluctuate in & out of the different stages so you will likely have highs & lows. My Duffy's cre peaked at 322 & her BUN was 20.9 (later it peaked at 25.1), a month or so later the cre dropped back to 218, it rose again then dropped, shortly after that I started fluid therapy partly cuz her water intake had increased. As of Feb her Cre is 216 & BUN 15 not far from the high end of normal With the numbers you've posted, every lab has their own reference range for normal values, those are important for determining where Muffy's numbers sit. Using the ref range from my lab Muffy's potassium & calcuim are within normal but the phos level is higher than normal. You may wish to speak to your vet about starting a phosphorus binder * this should be given at least 2 hours apart from the ACE inhibitor. Speaking of the ACE Inhibitor, have you had Muffy's blood pressure checked? I ask because not all vets have a bp monitor. Co Q10 may increase blood pressure & if that is already an issue you might need to find an alternative.
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Avoid biting when a simple growl will do The Spirit Lives As Long As Someone Who Lives Remembers You - Navaho Saying |
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Hi Growler,
Here are the reference ranges: Urea: 5.0 - 13.0 (Actual 29.5) Creatine: 50-177 (Actual 316) Calcium: 2.00 - 2.90 (actual 2.63) Posassium: 3.7 - 5.8 (Actual 4.6) Phosphorus: 0.8 - 2.5 - (Actual 2.5) I am not sure how bad the murmur is, but our vet said it was very pronounced. I also don't beleive that her blood pressure was checked. I am concerned with the fluids that it might stress her heart too much. I will call my vet (she is mobile and comes to the house) and see how bad the murmur is (compared to how her dad's was) and see if we can check her Bp. With the merrick over 1% phos. i think i will try your recommendations on the wellness and see what happens. I have lifted up the food, Muffy was sick this morning, but only clear. I have also measured out the water in her bowl to see what she is eating and I will aks out vet for a sub-q kit (she comes on Friday). Quick question (Not! LOL!) on the wellness food the Phos levels seem to be similar to the Merrick (Grammy's pot pie) at 1.13% and the wellness is between 1.05 and 1.15, do you think i can stay with the merrick and introduce the lower phos wellness (Turkey seems to be the lowest). Last edited by m.scott; May 13th, 2009 at 07:44 AM. |
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Update on food
Hi Growler and Sugarcatmom. I decided to try the EVO venison today since the Phos. levels are really low. Muffy perked up and inhaled it today, but should i be concerned on the protein levels and her age, Bun and Creatine levels? i requested from my vet today a sub-q kit (I have done that before) and book marked a website that I saw in a thread. We had a hard time with Muffy's dad with sub'q. I also have inquired about Phos. binders and to see if we can do a BP test. I would think that Muffy's BP would be lower with taking the asprin, but it's better to check. she has perked up today since giving her the Kidney Tone and the Reneel (Kidney Tone 2-days now and Reneel just yesterday).
I would like to see about moving her to a raw food diet as I think that might be best, any suggestions? Thank you! |
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Many of the pre-made raw diets are quite high in phosphorus, so it's a good idea to find out what the values are before picking one (some are listed at the bottom of that link I gave you). If you intend to make your own, you can replace some of the bone with a calcium substitute to lessen the amount of phosphorus, but make sure you maintain the correct calcium/phosphorus ratio of 1.4-1.2 to 1.
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"To close your eyes will not ease another's pain." ~ Chinese Proverb “We must not refuse to see with our eyes what they must endure with their bodies.” ~ Gretchen Wyler |
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She seems to be a bit picky with her food right now, right? I would feed a variety of the lower phos foods from Merrick, Wellness, Evo, Felidae Chicken & Rice is low phos. The last thing that you want is for her to get bored with one food & refuse to eat just cuz she doesn't want it anymore trust me Quote:
Try not to think about how it was with Munchkin or how he reacted to the fluids - part of that could have been the type of fluids too - ie Saline Soluition can sting - Lactated Ringers Solution is the better choice. If you are calm & relaxed and Muffy is calm & not startled or stressed at the time you start it will make for a better experience. This is probably the one you mean: Sophia gets her sub q fluids One thing I do differently from their method is I leave the old needle on the line & don't replace it with a new one until the next injection - keep the entire the needle more sterile that way. Raw is a great way to go - if she'll eat it. Try her out with a small piece of raw chicken (usually the easiest for them to accept first) meat the next time you are cooking, you can gauge her willingness first. There is a site here that you can see the various vit/mineral etc levels in diffrent types of meat especially helpful if you are using a raw company not on that list or making your own: http://www.nal.usda.gov/fnic/foodcomp/search/index.html For example: In Keyword type: chicken raw In Food Group select: poulty products From the list select: chicken raw ground Click to accept: per 100 grams Then it lists all the nutrient amounts per 100 grams of ground raw chicken. 178 mg of Phos in 100 grams of ground raw chicken
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Avoid biting when a simple growl will do The Spirit Lives As Long As Someone Who Lives Remembers You - Navaho Saying |
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So far so good
Muffy seems to really like the EVO, i put a bit down as a "treat" and she gobbled it up good choice. We have been able to shave off most of the matts as of tonight, so tomorrow Muffy gets a bath. I will send an email to my vet as she comes this Friday about the sub-q you recommended as well the Phos binders. Thinking that lower amounts of sub-q is going to be the best bet, at first. We really need to get the BUN levels down as I am concerned about all the spin-offs with high BUN. We are also going to try acupuncture, it worked well on munchkin for the longest time
I really appriciate all the good advise and I will keep you posted on the outcome. I can't believe I left out the best part. not sure what's working, but Muffy had a GREAT day today! she was up for 4-hours and talked up a storm. She also drank 1-cup of water today, best she has done this week. I am now measuring the water daily to see what her intake is. What should I be trying to maintain? is a cup per day enough?. THX Last edited by m.scott; May 13th, 2009 at 08:25 PM. Reason: Additional update/question |
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Great news on the Evo love and getting rid of the mats I'm sure she feels much better with them gone.
Accupuncture is a good idea My grrl Duffy goes for a similiar treatment called IntraMuscular Stimulation or GUNN IMS & it's been a great help. When I mentioned measuring the amount of water that is just as a guide to mention to your vet so they can determine how much fluids Muffy will need. I mean if you tell the vet Muffy is drinking X amount of water per day they many say okay we'll give C amount of fluids, but if she's drinking Z amount of water we'll would give G amount of fluids. Do you see where I'm going with that? If she's drinking a large volume of water per day/week her sub q fluid amount would be higher or more frequent than a cat is isn't drinking as much. Let her drink as much as she wants/needs, she needs it to flush out the toxins from her kidneys and because she can't concentrate her urine as per normal she needs the extra water to do so. Seriously 1 cup though, is that a baking measure 1 cup? wow. My Duffy prior to starting fluids was drinking 2 cups of water over a 5 day period that works out to 0.4 cup per day, although her Cre & BUN weren't as high as Muffy's right now. Quote:
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Avoid biting when a simple growl will do The Spirit Lives As Long As Someone Who Lives Remembers You - Navaho Saying |
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Hi Growler,
[QUOTE] Quote:
Since I started the Omega Alpha - Kidney Tone and the Reneel (as well got away from the fish) each day has been getting better. Muffy drank a full 1-cup in baking measure yesterday, I measured it out in the AM and measured what was left in the evening We were not able to get a urinalysis, but close. I am not interested in sticking a needle into her bladder as suggested by one vet I took Munchkin too I also tried the vet's office that my mobile vet works from to see about a BP reading, but no luck, they don't have one. I called around to another Animal Hospital up the road, but they want to do a full work-up on Muffy, which I am not interested in I called the emergency hospital, but they will only do it on a referral and it's 160 bucks! WOW i need to get into that business. I think with the Aspirin that if there was high BP it would help and I checked the symptoms listed in felineCRF.org and she does not have any Tonight is the first time that she has been out of the bathtub and walking around, usually just in and out, in and out... so I suspect with all the assistance I am getting here is working Will let you know what the vet says tomorrow and I am going to check on the Lactated Ringers Solutions you recommended. |
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Actually, extracting urine via cystocentisis is the best, least contaminated method. It truly does not hurt the cat, the worst part about it for them is being restrained for the procedure. In fact, if you were ever to require a culture and sensitivity to check for a urinary tract infection, the only acceptable way to get a urine sample is from cystocentisis. For just an ordinary urinalysis, a free catch sample from home is fine. I have tips on how to get that if you need them.
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"To close your eyes will not ease another's pain." ~ Chinese Proverb “We must not refuse to see with our eyes what they must endure with their bodies.” ~ Gretchen Wyler |
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Hi Sugarcatmom.
Free flow catch at home would be best. Any tips you can provide would be great. We had to give Muffy a bath after cutting out all the matts....she seems to be trembling now, so we are just keeping he warm and calm, a bit of rescue remedy as well. She is cleaning herself now, so a bit better. I made sure that th bedroom was really warm, so she wouldn't get cold. Not what what happened after that, she went to use the litter box and seemed to be pushing hard for a BM and she ended up vomiting in the litter box...all that water she just drank. I looked at the FelineCRF site and it said to see if her BM was hard (and it's very hard). I assume that we will start the fluid therapy tomorrow (based on what the vets has to say). I am not sure if she is constipated, but based on the hardness of the BM, i would think so. She was able to get some out before vomiting. I have lactulose that i can give her until we start fluid therapy. Do you think that's a good idea for the night? just not sure if it will cause her to loose more water. I guess a quick switch to the EVO may not have been a good idea... |
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Ok, never mind on the BM, she just went and all seems OK and the shaking as completly stopped and is happy again.
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You don't need a huge amount of urine, even just a couple teaspoons will do. Quote:
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__________________
"To close your eyes will not ease another's pain." ~ Chinese Proverb “We must not refuse to see with our eyes what they must endure with their bodies.” ~ Gretchen Wyler |
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Phew! Maybe she was just stressed out from the bath and stuff.
__________________
"To close your eyes will not ease another's pain." ~ Chinese Proverb “We must not refuse to see with our eyes what they must endure with their bodies.” ~ Gretchen Wyler |
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I sure hope so, the BM was a bit more moist when i pulled it apart (wtih kleenex)! what we do for our babies! I have a launrdy list for the vet tomorrow, I hope she got it intime as I would like to try the Lactated Ringers Solution. That may have been the issue wtih Munchkin, it was stinging
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You can ask your vet if she has an affiliation with one of the clinics so you can have it checked without the full work up. Some vets have a working relationship with another clinic to provide services they don't have available in their own offices. Quote:
If you can add 1-2 teaspoons of water to the canned food that allows the stomach to retain a bit of water a little longer while the food is digesting. I found adding a pump of Grizzly Salmon oil to the food twice a day, plus her fluids has eliminated this issue for Duffy. You can also the Slippery Elm Bark that SCM mentions or try 1/2 teaspoon Butternut squash (Heinz Organics Babyfood is easiest way to get it) twice a day with food will help to balance the water in the bowels. I wouldn't think the food switch would have that effect, generally you get diarreah of there is an issues with food for the visit
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Avoid biting when a simple growl will do The Spirit Lives As Long As Someone Who Lives Remembers You - Navaho Saying |
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Vet's Update
Hi Growler,
Lisa (our vet) was here yesterday and did not seem too concerned about the Phos. levels. She wants to see if we can get it under control with the remedies that we are trying and now the low Phos food. i as well asked about the BP test, but she does not believe that Muffy has high BP (no symptoms) and the aspirin should help with that. She really didn't think that the COQ10 would cause elevated BP, so i guess i will have to look into that myself further. She brought the Lactated Ringer's Solution to try and see what happens. she said not to be too concerned over the heart murmur, but go easy on the Sub-Q (only 50ml's) every 3-days to start and see how it goes. Muffy didn't really like the acupuncture, but i think overtime she will be ok. i think too much fussing this week with clipping matts every night and the bath on Thursday, she is saying "leave me alone for now!" Lisa suggested the salmon oil for lubrication and to give her 1/4 capsule in each meal and I have been adding 2-tbsp of water to each meal now. I will see if I can find the Grizzly brand, but seems to be online in Western Canada. I will see what my pet food store carries. I also will try and obtain a urine sample this weekend from Muffy so we can run the test. Lisa also advised that a vet in the next town will do a BP test for her at a much lower amount I could find. 2 vets wanted $150+ for the test |
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You can also just get wild salmon oil (or sardine/anchovy or krill) capsules from a health food store (puncture the end with a pin and squeeze into food). I know growler has good success with the Grizzly one but I tend to think the capsules stay fresher longer. If you do get an oil in a pump bottle, get the smallest bottle you can find and keep it refrigerated. Oils can go rancid the longer they're exposed to air.
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"To close your eyes will not ease another's pain." ~ Chinese Proverb “We must not refuse to see with our eyes what they must endure with their bodies.” ~ Gretchen Wyler |
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Got a free flow urine sample today, so it's now in for testing |
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just wanted to let you know that the salmon oil is goin down well, so far!
We are goi to do sub-a tomorrow and will re-read the info you provided in the Thread.only 50ml so that will go fast rather than 10ml that Munch use to get |
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