Well, we got the word from the vet today - the 3+ protein in her urine is definitely from her kidneys, not a urinary tract infection.
My husband picked up the reduced-protein dry kibble for Max - he says that there was low-protein wet food there, too - I think we’ll pick some of that up.
Damn, figuring out two cats on two special diets is frigging hard. We’re reading websites and doing research on foods now, and I’m getting more confused all the time. One site says that the best food for a Chronic Kidney Disease (CKD) cat is any food she’ll eat, since they tend to die of starvation. Another site says that phosphorus is the issue, not the protein. Another one says that feeding high-quality protein is more important than reducing protein overall. We have thyroid dry and wet food, regular dry food, and kidney dry food at home, and I’m comparing the labels - there doesn’t seem to be a huge difference between the thyroid food and the kidney food. So confusing!
First, I don’t know anything about any special hyperthyroid food, so my comments might be borne of ignorance, but…
Kidney disease causes nausea and dehydration, so that’s why cats stop eating. So wet food that they will eat always ended up being what we did so that we could keep their weight up and their bodies hydrated.
(I’ve dealt with way too many kidney failure cats.)
Both phosphorus and protein are elevated in kidney failure because the kidneys are working much more slower than usual. Renal diets are usually low in both phosphorus and protein. The idea is to decrease the amount of work the remaining kidneys have to do (make it easier for them), while still meeting most of the health requirements for the animal.
5am was way too early for that first sentence. Phosphorus is elevated in the blood (because it is not cleared out by the filtrating kidneys fast enough), and protein is elevated in the urine (due to a problem in either dumping protein that shouldn’t be dumped to what will become urine, or by lack of reabsorption from the urine).
Update: Max doesn’t seem to be eating today except for drinking a little milk. Then she goes right back into her room and sleeps on the bed. That isn’t good, is it?
We have a vet appointment for tomorrow after work.
No, not good. I’m glad you have the appointment. I’m sure your vet will want to do blood work to get to the bottom of it. How is she drinking? If her gums feel tacky and not smooth, you have an emergency and should head to the ER clinic or at the very least get her to the vet early in the AM.
If you think she’s hydrated, in the meantime she’s got to eat something. If cats don’t eat they don’t feel well, and if they don’t feel well they don’t eat. Vicious circle! Cats aren’t like us where they can tolerate fasting-they start using their muscle mass for energy and drop weight very quickly.
Can you try to tempt her with her favorites? Maybe some stinky Fancy Feast or tuna? Not the best foods, but any food is better than no food.
We’ve been on the “whatever she’ll actually eat” diet for a while now (she’s gotten very picky lately). She has been drinking well until today - today, she isn’t drinking much either.
Hey, I haven’t tried tuna yet! I’ll try it next time she’s up.
Another update: Max is spending the night at the vet’s, getting re-hydrated and having her blood tested to see what all her biochemistry levels are at. Hopefully we’ll have some better news tomorrow, but the vet didn’t seem very optimistic.
Latest update: Blood work last night and this morning was slightly more encouraging than expected, but not exactly good news. Max’s kidneys are enlarged, her renal values are worse than they were a month ago. On the plus side, apparently her electrolytes are in the normal range, so that’s good.
She’s going through one more round of blood tests and a urinalysis today and we’re planning on bringing her home after that. I don’t see the point of keeping her in the scary, strange place for any longer than absolutely necessary.
Hopefully she has had a positive response to the IV fluids they’re giving her and she feels a little more perked up…
Have they showed you how to inject fluids under the skin? If she’s otherwise hanging in there but getting dehydrated, that may be an option. It’s easy, even at home, though a bit daunting at first.
Cat Whisperer - I had a cat with chronic renal failure and did the at-home sub-q fluids. My cat didn’t mind it at all. In fact, she was much worse about taking her meds than she was about having a needle stuck in her side and 200 ml of fluid inserted. It’s easy to do, too.
Okay, Max is at home and resting in the bedroom now. She seems to tolerate the sub-q treatment okay - we’ll see how she does at home. It looks like it shouldn’t be too difficult.
I think my biggest concern is that it seems like we’re supposed to overmedicate her - they’ve sent us home with six medications, some of which have side-effects that make her condition worse or are counter-indicated in cats with renal failure. They also want her back into the office next week for more follow-up bloodwork. She’s 16 years old and she has renal failure (from the looks of her bloodwork, her kidneys are very close to shutting down) - I think we’re on a different page than the vets. We want to make her comfortable the time that she has left - the vets seem to want to fix her.
Cat Whisperer, thank you so much for this thread. My 15 y.o. Mia is experiencing much of the same thing. She has become underweight, eats like a champion, pees like a racehorse and has me very worried. I was pretty sure that kidneys and possibly hyperthyroidism were her issues. I’ve upped her food intake and I try to keep her hydrated.
Unfortunately, I’m skint right now (laid off) or I’d take her to the vet. I already know I will just do what I can for her until she has lost her ability to jump up on the counter when I’m not around. I don’t want her to suffer, but other than hunger and thirst and a stronger desire to cuddle, she seems to be doing fine.
Some vets will be really tentative about how they treat end of life issues. They don’t want to offend you, basically, so if you don’t broach the subject, they might not. So, try to be as clear as possible about what your expectations are and how you want to handle end of life for your animals. Most vets will do their best to be supportive and to give you really good advice if they know you want it.
I’m sorry she’s doing so poorly.
Our Bertram was really clingy earlier today, and tonight felt like he had a fever and didn’t want anything to do with us, so I’m worried, too. Little fuzzballs know how to make us worry, huh?
That does sound an awful lot like kidney failure. I wish you and your Mia all the best.
That’s what is probably happening. It seems awfully callous to just say flat out that you don’t want to treat your cat (or that you can’t afford to), but prolonging what is obviously a terminal illness is not what we want to do. I’d rather she had a month of good days than two months of being miserable.
She seems a lot better now that she’s been re-hydrated and is back home. She’s still not eating great, but we’ll see how she comes around in the next few days.
Hey, carnut, doing some research, I found out about Slippery Elm herbal for cats. We’ve started adding it to Max’s food, and she seems to be tolerating it very well. It’s supposed to help for digestive problems (nausea, diarrhea, constipation, vomiting), and all kinds of issues, including kidney failure. It has very little smell, and almost no taste - we mix it into some wet food, and I don’t even think she knows it’s there. It’s not terribly expensive, either - I just bought it at a local herbal store. The only downside of it is that is might interfere with the absorption of other medications, but the Slippery Elm is treating all the things she’s having problems with, so I’m not too worried about that.
CW, I’m glad Max is home and the slippery elm is helping. As far as her numbers, they don’t come down right away after being on fluids-it can take days or even a week or two as things get going again. So I wouldn’t worry too much that there wasn’t immediate improvement. You’ll get a better picture with her next blood tests.
I’ve had two CRF cats, one still living. Around the time the first one was diagnosed I found out a third one had diabetes. Their prescribed diets were about as opposite as they could get, and the CRF cat wanted the diabetic’s food, and the diabetic wanted the CRF food. It was a constant struggle. I ended up ditching the CRF food entirely after reading the ingredients. I read that (as you’ve mentioned above) the quality of the protein is more important than the quantity, and I figured high quality protein had to be better than the corn and feathers that were in the prescription foods. Both CRF cats continued to eat rather well.
Sub-Qs are important and easy. Pepcid AC (regular strength & quartered) is very helpful. Watch for constipation issues, my deceased cat had horrible problems and had to be closely monitored.
I think the thing about dry food being better for teeth is complete bunk. Eat a bunch of crackers and look closely at your teeth. As someone else mentioned it’s also harder to digest. Cats get most of their moisture from their food in the wild, and most kibble-eating house cats are some degree of dehydrated. Wet food is best.
Often hyperthyroid issues in cats helps to mask the kidney failure. Be aware that medicating for the thyroid can cause the kidneys to crash. Here is a good link; scroll down to ‘Treatment Cautions.’