Anyone else with CRF cat?

For those seeking advice on caring for incontinent pets and animals with kidney-related problems.
Post Reply
User avatar
LisainCAN
Moderator
Posts: 568
Joined: Mon Jul 05, 2004 7:00 pm
Location: Canada

Anyone else with CRF cat?

Post by LisainCAN »

Hi there,

My beautiful Agnes, 1.5 yrs., has just been diagnosed with CRF, likely due to FIP. I lost Holly two years ago at the same age from the same thing so I know that it is a death sentence. For Holly, I chose heroic measures. For Agnes, I am choosing quality of life and holistic treatments. Any advice on diet? I am fully prepared to make her meals. Any supplements or herbs I can give her?

Thank you,
Lisa.
User avatar
critters
Founding Member
Posts: 14368
Joined: Sat Apr 28, 2001 7:00 pm

Re: Anyone else with CRF cat?

Post by critters »

There are a number of CRF parents at CIC; in fact, Victoria and Clay just PTS their boy Indy a few days ago. http://catsincrisis.org/phpBB/index.php
User avatar
CarolC
Moderator
Posts: 13708
Joined: Wed Dec 31, 2003 7:00 pm
Contact:

Re: Anyone else with CRF cat?

Post by CarolC »

Hi Lisa,

Yes, my wonderful Betsy has CRF.

http://www.handicappedpets.com/help/vie ... php?t=6590

I give her 75 ml. fluids twice a day and she is on Science Diet k/d dry. They did x-rays and one of her kidneys is shrunken and nonfunctioning and the other is simply declining with extreme old age. I remember you mentioned being a distance from the vet and wanting to do fluids. Some people do fluids once a day, or twice a week, it depends on your cat's needs.

Big bags of LRS are about $6 each from my vet and last about a week, but I think they are cheaper by half online. If you stock up, storage is no problem, the bags I am getting now have expiration dates in 2008 so you could buy by the case. Needles are $21/100 through my vet, probably cheaper online. Hope this helps!

____________________________________________________

EDIT--I gave the wrong information, I am sorry. Betsy should be on k/d for her kidney(s) but is actually on w/d because she got pancreatitis and a lower fat diet is recommended and working. I am scared the k/d may set it off again, therefore she remains on w/d. Teddy is on k/d and loves it--that part was correct.
Last edited by Anonymous on Mon Nov 13, 2006 11:25 pm, edited 1 time in total.
User avatar
Barbara Boehmer
Posts: 211
Joined: Fri Dec 16, 2005 7:39 pm

Re: Anyone else with CRF cat?

Post by Barbara Boehmer »

I currently have two cats with CRF. One is 21 years old (Rowdy) and the other is 16 years old (Tuxedo). Both also have anemia. Rowdy is also hyperthryoid and Tuxedo is a former diabetic. Both are still enjoying a good quality of life. They are able to eat and drink and use the litter box on their own and get around well enough to get to and from the food, water, litter, and their favorite resting spots. I have provided extra food and water dishes close to their favorite spots, so they don't have to go far. They both still enjoy interacting with the other cats and purr when I pick them up or sit them in my lap or brush them or pet them. They do a little self-grooming and the other cats and I do the rest for them. I have had them since they were kittens. Tuxedo did have a bad period of time where it looked like he might not last for more than a few days, but with fluids and medicines, he got better.

I am not sure what you consider heroic measures. I try to avoid anything that might do more harm than good or decreases their quality of life. I have had unsuccessful experiences in the past with surgeries and tests like a bone marrow aspirate, so I tend to avoid that kind of thing. Anything that requires withholding food and water and sedation is risky with an elderly cat with such major problems. I did hospitalize Tuxedo for a couple of days, so he could have continuous i.v. fluids and get stabilized. I try to do as much at home as possible and only take short trips to the vet to do minimal testing. Rowdy gets her thyroid levels checked every so often and Tuxedo gets his packed cell volume checked to see if his anmeia has reached a point yet where he needs a transfusion and/or oxyglobin synthetic blood. We already know that he is a rare type B. Neither of them needs to go to the vet for anything for their CRF; I do all of that at home and just stop in for refills on the supplies.

The old diet recommendation for CRF cats was low sodium and low protein. It is currently thought that low phosphorus is also important and that the quality of protein is more important than the quantity of protein. Good quality protein comes from things like egg and liver and muscle meats, not by-products that include things like bones and beaks and claws and feathers. The object is to reduce the things that the kidneys have to filter out, while still providing sufficient nutrition. Here are some links to websites that show protein, phosphorus, and sodium content for various canned and dry cat foods.

http://webpages.charter.net/katkarma/canned.htm
http://webpages.charter.net/katkarma/canfood.htm
http://webpages.charter.net/katkarma/dry.htm
http://webpages.charter.net/katkarma/dryfood.htm

It is more important that CRF cats get enough of something to eat than it is that they be fed what is theoretically best for their condition. Some cats will eat the prescription diets, like Science Diet K/D and Eukenuba Multi-Stage Renal and some won't. If you are feeding a multi-cat household, you may need to feed something they all can eat. Royal Canin Mature 27 dry cat food (made in Canada) is very popular for CRF cats. Some people have success at mixing appealing foods with healthier ones and compromising. When they are sick, they seem to loose some of their sense of smell and taste and anything with fish and/or liver tends to be more appealing. Fancy Feast canned cat food is well-known as being appealing to the most finicky picky eaters. I usually start each morning and each evening by offering some Science Diet K/D to my two CRF cats. Sometimes they eat some and sometimes they don't. Then I offer some Iam's ocean fish canned cat food or Nutro MaxCat senior chicken and lamb canned cat food or Dick Van Patten's Natural Balance venison and green pea canned cat food. If they don't eat that, then I give them Fancy Feast canned cat food (ocean fish and tuna flavor, or salmon flavor, or cod sole and shrimp flavor, or liver and chicken flavor). The CRF cats usually don't eat each very much at one time, but nibble throughout the day. I keep canned and dry food available at all times. I have one bowl of Iam's dry food and one bowl of Royal Canin dry food. I tried mixing them, but those that ony like the Iam's would not eat it.

In addition to diet, I also give subcutaneous fluids daily. Tuxedo is a big cat and is in a more advanced stage and gets 100 mililiters per day. Rowdy is smaller and hers is less severe. I started her on 75 mililiters per day, then reduced it to 50 mililiters per day, then 25 mililiters per day. You have to check to see how fast they are absorbing the fluids and make sure that you do not over-hydrate. My cats tolerate the fluids very well. I groom them first and provide a dish of food and water in front of them while I do it. They actually look forward to it and purr when I pick them up to take them to the bathroom and they know it is their turn. I hang the bag from a coat hanger bent over the shower door and put the cat on the floor, so gravity helps it flow faster and it only takes a couple of minutes.

Although Rowdy is five years older than Tuxedo, and a 21-year-old cat is comparable to a 100-year-old human, her CRF is less severe, possibly due to her hyperthyroidism increasing the blood supply to the kidneys. So, diet and fluids and tapazole pills twice a day for her hyperthyroidism are all she needs. Tuxedo's problem is more severe. For a while, he kept vomiting, so he gets pepcid antacid and reglan anti-nausea syrup, both twice per day, and has not vomited in a few weeks now. Some people use pepcid and some use tagamet. Some cats only need 1/4 pepcid tablet (2.5 mg) every other day and some need 1/4 tablet twice per day. I put the 1/4 pill in a pill pocket (a soft tasty cat treat made for sticking a pill in and feeding to a cat) and he eats it out of my hand. Except for the subcutaneous fluids, my cats don't know they are getting medicines; they just think they are getting treats. The pill pockets are made with chicken liver and even have some probiotics in them. I get them cheaply from http://www.discountpetdrugs.com. They come in chicken flavor or salmon flavor. I used to wrap pills in a bit of american cheese and a thin slice of roast beef, but my cats like the pill pockets better and they are good for them. There is no prescription required for pepcid or pill pockets.

If you are going to cook for your cat, you have to be careful what ingredients you use. Onions can cause anemia in cats. Boiled chicken is safe, but may be too bland. I have found that my cats would rather have fishy cat food. Most people food may be too salty for a CRF cat or have other harmful ingredients.

I belong to the following very active Yahoo group for CRF cats:

http://pets.groups.yahoo.com/group/Feline-CRF-Support/

You will find about 100 messages per day, solely about CRF cats there. I am not much into cooking or holistic remedies, but you will find others there with recipes and everything from acupuncture to slippery elm bark.
Barbara Boehmer (not a veterinarian, just a fellow pet owner)
User avatar
CarolC
Moderator
Posts: 13708
Joined: Wed Dec 31, 2003 7:00 pm
Contact:

Re: Anyone else with CRF cat?

Post by CarolC »

Barbara Boehmer wrote: Tuxedo gets his packed cell volume checked to see if his anmeia has reached a point yet where he needs a transfusion and/or oxyglobin synthetic blood.
Barbara, I have not heard of oxyglobin, can you explain?

My cat also gets mixed food. She gets a bowl of k/d dry in the morning, which she loves. At night she either gets a jar of Gerber turkey baby food with 250 mg taurine mixed in, or a small dish of tuna. I was scared of the tuna and am still a little hesitant because it can cause steatitis, however she has been having a dish of tuna every second or third day for a couple of months with no problems so far, fingers crossed. She quit eating regular canned food when she got pancreatitis in April.

My other cat who was hyperthyroid and had iodine treatment (he was only about 12 at the time of treatment) is also early CRF and is on k/d. He eats k/d dry in the morning, and at night he gets more k/d dry with a blop of canned food on top.

Betsy was also on B-12 injections, but they seemed to cause diarrhea unfortunately so I reduced them and then quit.

Barbara, I didn't see you mention Tumil-K. I have had 2 cats with kidney problems on Tumil-K but neither of mine now are. Both of my previous cats really disliked it, and the vet hasn't really mentioned it this time. Both of my cats also don't like k/d canned.
_____________________________________

EDIT--Betsy is on w/d due to pancreatis in addition to kidney trouble, and Teddy is on k/d as he should be.
Last edited by Anonymous on Mon Nov 13, 2006 11:29 pm, edited 1 time in total.
User avatar
Barbara Boehmer
Posts: 211
Joined: Fri Dec 16, 2005 7:39 pm

Re: Anyone else with CRF cat?

Post by Barbara Boehmer »

Oxyglobin is a blood substitute that stores well and can be given to a cat with any blood type. My local emergency vet keeps it in stock and can give some as a temporary measure until they order some of his rare type B blood shipped from Sacramento. Local blood banks do not carry type B feline blood. 90% of cats are type A. Here is a link regarding oxyglobin:

http://www.biopure.com/shared/home.cfm?CDID=2&CPgID=54

My day vet told me that the hyperthyroidism frequently masks kidney problems, because it increases the blood supply to the kidneys. Once the hyperthyroidism is treated, the kidney problem emerges. This is one of the reasons that I chose twice daily medication with tapazole, rather than radioactive iodine treatment. If the kidney problem in a hyperthyroid cat on tapazole gets worse, I can reduce the tapazole dosage, whereas once iodine treatment is done, you can't reverse that. I have one cat (Rowdy) who is hyperthyroid with kidney failure and anemia. I also have a younger cat (Gertie) who is only hyperthyroid (so far) and is also on tapazole. I also have two other cats on medications for other problems, so I am currently medicating/treating 5 cats, which keeps me quite busy.

I give Tuxedo Pet Tabs Iron Plus, which is a liquid supplement. It is an Iron and B vitamin supplement intended for anemic cats. It does not have the fat-soluble vitamins that can accumulate. It is in a base of mostly corn syrup flavored for cats. Tuxedo has not had a diarrhea problem, but he eats some of the Iam's hairball formula dry cat food and the fiber helps prevent diarrhea. The pill pockets also have probiotics that help prevent diarrhea. Since Tuxedo is on multiple medicatoins, I space them out in order to avoid conflicts. He gets reglan at 6 am and 6 pm, pepcid in a pill pocket at 9 am and 9 pm, fluids at 7 am, and Pet Tabs Iron Plus at 1 pm. He just finished a course of doxycycline antibiotic that I was giving at 7 am and 7 pm. I have established a pretty smoothe, peaceful routine that we have all gotten used to, with multiple alarms set as reminders.

I have not used tumil-k or any phosphorus binders or some of the other things that I have heard others on the CRF forums using. Because his pcv is so low, Tuxedo cannot spare a sufficient quanitity of blood to test to see what the current potassium and phosphorus and calcium levels are to determine if he might benefit from such things. Right now, what I am doing is working, so I am not changing anything. Tuxedo is eating better, not vomiting, slowly gaining weight, and his pcv has gradually increased to 15. The vet thinks his anemia is probably caused by some sort of bone marrow leukemia. I have not put him through a bone marrow biopsy to confirm this, because if it does confirm it, he could not be treated for it, due to his kidney problem. Additionally, I have had past experience with a similar situation with another cat where the bone marrow biopsy came back negative, so they still did not now what the cat had, and it was so weakened by the procedure, that it died a few days later. I have heard that some things, like hemobartonella are easy to miss in lab tests, due to the dormant cycles where only 1% may be present at time of testing. So, I have been trying to provide all treatments that can't hurt and might help. He improved after a course of doxycycline, so I still suspect that hemobartonella or some such thing may have been at least part of the problem. It has only been a week since he finished that and it takes red blood cells a few weeks to mature. His pcv was 15 yesterday. I am hoping that in a few weeks it may be even better.
Barbara Boehmer (not a veterinarian, just a fellow pet owner)
User avatar
critters
Founding Member
Posts: 14368
Joined: Sat Apr 28, 2001 7:00 pm

Re: Anyone else with CRF cat?

Post by critters »

That's certainly true about Hemobart. What a busy schedule you have!! :shock:
User avatar
LisainCAN
Moderator
Posts: 568
Joined: Mon Jul 05, 2004 7:00 pm
Location: Canada

Re: Anyone else with CRF cat?

Post by LisainCAN »

Thank you so much Barbara and CarolC. These are exactly the responses I was looking for. I did post on the CRF-Yahoo site but I think that my post got lost in the high volume since I didn't really have any responses.

So far, Agnes is still eating Nutro dry adult cat food with the others. She doesn't appear to be vomiting and her water intake is rather moderate for a CRF kitty. She grooms herself occasionally and Sara, my 8 yr. old dog, does the rest. She has a secondary URI infection common to CRF so she is on Clavamox and it is actually clearing up. Of course, she gets a lot of TLC and she sleeps either on me or on my husband's pillow. [I told him that when he comes home, he's going to have to battle the animals for his spot back in the bed!]

I am watching her carefully. According to the vet, her levels are still "not that bad," so she doesn't need fluids. Her hematocrit was low (I forget the number) so I am checking her gums carefully. I have a donor cat, Harry, my huge Maine Coon-manx mix and he is ready to the job when she needs blood.

The problem though with Agnes is that she likely has FIP which is what is causing the CRF. The vet found evidence of it in the her bloodwork because her globulin? (I think it is) levels were high.

I will keep you all posted. My husband is also very sad about Agnes and asks about her every day, even if he doesn't remember her specifically (as he's lost a about a year of memories from before the accident).

Lisa.
User avatar
GabrielDeafBlindPupFamily
Posts: 5011
Joined: Thu Dec 11, 2003 7:00 pm
Location: St. Helena Island, SC

Re: Anyone else with CRF cat?-OT Lisa

Post by GabrielDeafBlindPupFamily »

Lisa, OT, so glad to hear word of your husband... So very very glad.
Karen, Andy's ^i^ mom
Lethal White Aussies Rule!
INTERACTIVE RESCUE SITE!
http://www.s8.createphpbb.com/lethalwhiteauss/
http://groups.yahoo.com/group/LethalWhiteAussieRescue/
User avatar
Barbara Boehmer
Posts: 211
Joined: Fri Dec 16, 2005 7:39 pm

Re: Anyone else with CRF cat?

Post by Barbara Boehmer »

I don't know whether you saw it yet or not, but you got a response from Lynn on the Yahoo feline CRF group:


http://pets.groups.yahoo.com/group/Feli ... age/162779


I think anyone else is probably waiting for you to answer her questions before they respond. Sometimes people just post responses to the group board and don't email the individual separately, so you may not see it unless you check the board or have your profile set to send an immediate email of every post. There is also sometimes a time delay between posting and when it becomes visible.
Barbara Boehmer (not a veterinarian, just a fellow pet owner)
User avatar
LisainCAN
Moderator
Posts: 568
Joined: Mon Jul 05, 2004 7:00 pm
Location: Canada

Re: Anyone else with CRF cat?

Post by LisainCAN »

Thanks Barbara. I had seen it and I emailed her with some very specific diet questions but she has yet to respond. When my vet opens tomorrow I am going to call and get Agnes' numbers so that I can post them on the board.

Agnes is such a gentle, loving cat soul that I am hoping that we still have some time together. I absolutely hate it when my creatures get sick but I take all the "throw aways" so I should expect early illnesses or problems. I will always take these kinds of cats though over any other. My vet always remarks on how freakishly affectionate and sweet all my cats are but I think that it is just gratitude for having been given a chance in life when no one else wanted them. I cherish my creatures.

OT, Karen, my husband is truly a miracle. PM me for more details!

Lisa.
Post Reply