Oliver is a 14yo orange tabby that has had minor struggles along the way with a heart murmur (now a 2/6) and kidney issues. We have been supporting him for several years, esp since he was having some vomiting issues to try to balance and support whatever we could do. Yesterday, on his checkup (we go every 3 mos) we told the internist we were very concerned with weight loss and his kidneys, but he has been eating and social (pretty normal BEAM). We were not expecting the urine/blood results that we have gotten back which are very concerning. We want the best quality of life and support for him at any measure. The internist suggested putting him into the hospital for days to administer fluids to see if they could better values. The concern is also monitoring his heart as well. They don't know the likely outcome, but we know that we have to do something. The 2nd option is dialysis (if he is a candidate with the heart issue) and they want the vet to talk to them about that, so we have put that in motion to see. We could do and are asking for an ultrasound of heart/kidneys to see what add'l info that can get the vet on picking a path. I can't seem to get them to move fast enough to try to get as much info to make the best decision. I am enclosing the most recent para on their concerns and his bloodwork for help on what we know as of yesterday. Sorry for the long post....
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Cat with urgent concerns on CKD issues
- Thread starter TerriH
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Welcome to HA! Terri. Thanks for making your first awe-some post!
I'm really sorry to hear about Oliver's kidney, heart and thyroid challenges.
You have an amazingly thorough internist! That 4 page detailed case summary is wonderful.
You've got lots of things to consider, but we can summarize them by the one thing that unites the functioning of his kidneys, heart and thyroid. And that is cellular energy.
IMHO, everything you do right now should be to build and preserve Oliver's energy/vitality.
There are many ways to do the energy building part, but I wonder first about Oliver's BEAM (behavior, energy, appetite, mood).
Is he living a happy life despite the test results?
What's he eating?
Is he currently still on the anti-biotic/anti-inflammatory metronidazole (Flagyl)?
Any other medications aside from atenolol?
I have a consult right now so have to end this post, but will look for your reply after getting off the phone.
In the meantime, here's a few of the simple strategies of the Terrain Optimizing Protocol (TOP).
I'm really sorry to hear about Oliver's kidney, heart and thyroid challenges.
You have an amazingly thorough internist! That 4 page detailed case summary is wonderful.
You've got lots of things to consider, but we can summarize them by the one thing that unites the functioning of his kidneys, heart and thyroid. And that is cellular energy.
IMHO, everything you do right now should be to build and preserve Oliver's energy/vitality.
There are many ways to do the energy building part, but I wonder first about Oliver's BEAM (behavior, energy, appetite, mood).
Is he living a happy life despite the test results?
What's he eating?
Is he currently still on the anti-biotic/anti-inflammatory metronidazole (Flagyl)?
Any other medications aside from atenolol?
I have a consult right now so have to end this post, but will look for your reply after getting off the phone.
In the meantime, here's a few of the simple strategies of the Terrain Optimizing Protocol (TOP).
He is doing reasonably well, but noticed him not quite himself the past week and was anxious to get him in to see what may be going on. I have been trying to put weight on him, and yes - he is still on the niacinamide and the metronadizole. Any attempts to try to wean it back have not been with good results. He eats wet food (Wellness and Weruva wet) and he won't eat the CKD diets (Hills). He will eat Royal Canin dry for CKD, but I am limiting the dry because of the concerns with feeding dry (even though the local vet encouraged it). So I look for lower protein and measure the moisture against the protein values. But then he loses weight, so that is a concern. He will not eat what he does not like...he is finicky in that manner. He does get a lot of liquid in the canned foods. He gets 125mg of Niacinamide a day.
Right now the internist called and wants me to run him up to DC to the kidney specialists that do dialysis and do a thorough review of his functions (heart/kidneys) there to see where we are and then to be able to make decisions from there. He mentioned even heading to Penn, but I think dialysis would be the first step (and getting all of the eval info) before going to that option realistically. So I am headed there at least to know more on what they recommend now with him and family.
Right now the internist called and wants me to run him up to DC to the kidney specialists that do dialysis and do a thorough review of his functions (heart/kidneys) there to see where we are and then to be able to make decisions from there. He mentioned even heading to Penn, but I think dialysis would be the first step (and getting all of the eval info) before going to that option realistically. So I am headed there at least to know more on what they recommend now with him and family.
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Wonderful that his BEAM is OK. In what way is he not himself?
What happens when you try to wean the metronidazole?
Have you tried any fresh food like chicken, beef, eggs, etc?
Yes, the weight loss and sarcopenia (muscle loss) is a big problem especially when they are on a low protein diet.
Do you use an omega-3 (fish oil)? SmartZyme algae-derived DHA is another great option.
www.phytosmart.com
BTW-Protein is a problem because higher protein foods also have higher phosphorus levels. Phosphorus is toxic to the kidneys.
Which phosphorus binder?
Good luck at Penn. Which internist are you seeing today (some of my vet school professors are still there)?
I look forward to reading their report when you receive it.
What happens when you try to wean the metronidazole?
Have you tried any fresh food like chicken, beef, eggs, etc?
Yes, the weight loss and sarcopenia (muscle loss) is a big problem especially when they are on a low protein diet.
Do you use an omega-3 (fish oil)? SmartZyme algae-derived DHA is another great option.
PhytoSmart – Have a Happier Healthier Pet
www.phytosmart.com
BTW-Protein is a problem because higher protein foods also have higher phosphorus levels. Phosphorus is toxic to the kidneys.
Which phosphorus binder?
Good luck at Penn. Which internist are you seeing today (some of my vet school professors are still there)?
I look forward to reading their report when you receive it.
Oliver is at the hospital in DC now to evaluate and see about fluids while they monitor him around the clock. They expect to have him there 24-48 hours but seem optimistic in finding some improvement. I hope so. I can post more later when I know more. Get your input and feedback and what has worked for other CKD cats to consider.
Sorry to take so long...crazy day. Worried about his weight loss and just seeming not quite himself. I wish I could have gotten the internist earlier, especially now. He eats but has lost a pound in the last 3-4 mos. If I cut back on the metranadizole (liquid), he does ok for a day or so but will then vomit. It seems to happen most often in the morning. I am reading on here and other areas that trying to feed more before bedtime may help this also because of what I am dealing with. Niacinamide for the binder (although the vet internist acted like that was crazy). Confident with that as Dr. Sara C had suggested it for him earlier and it isn't the first time to get crossed eyes on diet/supplements. The internist seemed to think that the hyperthyroidism may have been assisting how he has been feeling. He was good today on way to DC. Will post more info as I check in on him and what they are doing and recommend. I know it will be fluids and monitoring. To be clear, he is at the kidney dialysis center (kidney specialist) in DC. They want to see what they can do before they would refer him on to Penn if they thought a transplant was the way to go. Too soon to know -- just praying for good updates. Thank you!!Wonderful that his BEAM is OK. In what way is he not himself?
What happens when you try to wean the metronidazole?
Have you tried any fresh food like chicken, beef, eggs, etc?
Yes, the weight loss and sarcopenia (muscle loss) is a big problem especially when they are on a low protein diet.
Do you use an omega-3 (fish oil)? SmartZyme algae-derived DHA is another great option.
PhytoSmart – Have a Happier Healthier Pet
BTW-Protein is a problem because higher protein foods also have higher phosphorus levels. Phosphorus is toxic to the kidneys.
Which phosphorus binder?
Good luck at Penn. Which internist are you seeing today (some of my vet school professors are still there)?
I look forward to reading their report when you receive it.
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You're welcome, Terri!
Sorry to have mixed up PA and DC (I guess too many initials for me).
Yes, I think you'll see some kidney value improvement no matter how they give the fluids (intravenous or subcutaneous).
When he gets home, he will probably still need additional fluid support from you or your local vet.
Also, when he gets home he will probably need addition phosphorus binders such as Phos Bind from Rx Vitamins, Aventi or Renagel (which is very effective but is also very pricey).
His mild anemia will probably worsen which could make it harder to get him to eat. However, getting any calories into him is super important. Try anything he loves and if he eats, fantastic! If he doesn't eat, try a variety of foods including ones that are sweet, salty, savory, hot, cool, watery, chunky...
Along with all of your nursing support and @Dr. Sara's excellent homeopathic prescribing, you can try these:
www.homevet.com
Rx Renal Feline-#120 - HomeVet (this one also contains Rehmannia, so ask Dr. Sara if it is OK to use without a dose modification)
Please post the test results and your update when you hear more.
Sorry to have mixed up PA and DC (I guess too many initials for me).
Yes, I think you'll see some kidney value improvement no matter how they give the fluids (intravenous or subcutaneous).
When he gets home, he will probably still need additional fluid support from you or your local vet.
Also, when he gets home he will probably need addition phosphorus binders such as Phos Bind from Rx Vitamins, Aventi or Renagel (which is very effective but is also very pricey).
His mild anemia will probably worsen which could make it harder to get him to eat. However, getting any calories into him is super important. Try anything he loves and if he eats, fantastic! If he doesn't eat, try a variety of foods including ones that are sweet, salty, savory, hot, cool, watery, chunky...
Along with all of your nursing support and @Dr. Sara's excellent homeopathic prescribing, you can try these:
AminAvast Feline #60 - HomeVet
RenAvast™ is may help halt the progression of Chronic Renal Failure (CRF) in cats and improve overall kidney function.
www.homevet.com
Rx Renal Feline-#120 - HomeVet (this one also contains Rehmannia, so ask Dr. Sara if it is OK to use without a dose modification)
Please post the test results and your update when you hear more.
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- Dec 30, 2018
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These supplements may well help Oliver. When starting any new supplements, I begin with a quarter to a half of the dose and slowly work up. We don't want cats to stop eating, and any animal could get an upset stomach from a new supplement.
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