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Cat has CRF



 
 
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  #11  
Old April 23rd 09, 03:21 AM posted to rec.pets.cats.health+behav
Kolbard
external usenet poster
 
Posts: 24
Default Cat has CRF

On Wed, 22 Apr 2009 16:51:36 -0700 (PDT), cindys
wrote:

On Apr 22, 6:24*pm, Kolbard wrote:
I was unable to go today, but my mother took her to another vet today,
in the hopes of getting her on an IV again, to see if it helped. *The
vet took one look at her numbers and said, "Short answer, no, I can't
do anything." *I've read of cats with numbers higher than these who
survived; should I try every damned vet in town until I find one who's
competant?

------------
BTW, I think your cat should have IV fluids ASAP since she is
dehydrated. The cat will feel MUCH better once she is rehydrated. You
can even be taught to do this yourself at home. I can't believe a vet
would refuse to do this, no matter how grave the cat's condition.
Best regards,
---Cindy S.


She had IV fluids last week, but it didn't seem to help her more than
a day.

My mother decided to take her back to the vet who didn't want to treat
her after seeing the numbers, and told him she wanted him to go ahead
and do it anyway. He was hard-line negative. So, she took her back
to the original vet and apparently she does know about phosphorus
binders, she just didn't mention them before (???). I was she'd get
her back on IV, but she gave her a SubQ and sent her home. She
mentioned Maalox and Tums (!!) as P inhibitors, but I'm not sure if I
want to try those. Someone somewhere, possibly here, mentioned Pepcid
as an anti-nausea measure, but I don't know how much to give.

Kolbard
  #12  
Old April 23rd 09, 04:47 AM posted to rec.pets.cats.health+behav
Phil P.
external usenet poster
 
Posts: 1,027
Default Cat has CRF


"Kolbard" wrote in message
...

She had IV fluids last week, but it didn't seem to help her more than
a day.


....because she probably didn't get enough fluids or for long enough. Once
your cat is adequately hydrated, you should concentrate on increasing the
excretion of the uremic toxins in her blood by increasing her urine output.
Fluids alone are usually enough to cause mild diuresis (fluid diuresis) and
flush out most of the uremic toxins- enough to shut down a uremic crisis.
But since your cat's BUN/Cr/and/P are so high, fluids alone probably aren't
enough. She probably needs a diuretic with the fluids (intense diuresis).
Intesnse diuresis removes uremic toxins *much* faster. With fluids alone
diruesis can take several hours to begin. As long as your cat doesn't have
heart disease or hypertension, ID will probably shut down her uremic crisis
fairly quickly.

Her K+ is already way too low as it is- even without fluid therapy she
urgently needs a K+ supplement. Fluid diuresis and especially intense
diuresis will increase K+ excretion and depletion even further, so she
*definitely* needs a K+ supplement *urgently*.


My mother decided to take her back to the vet who didn't want to treat
her after seeing the numbers, and told him she wanted him to go ahead
and do it anyway. He was hard-line negative.


That's probably because he has little or experience treating CRF in cats. A
vet who knows anything about CRF in cats knows he should treat the ***cat***
not the numbers!


So, she took her back
to the original vet and apparently she does know about phosphorus
binders, she just didn't mention them before (???). I was she'd get
her back on IV, but she gave her a SubQ and sent her home. She
mentioned Maalox and Tums (!!) as P inhibitors, but I'm not sure if I
want to try those. Someone somewhere, possibly here, mentioned


Pepcid
as an anti-nausea measure, but I don't know how much to give.


The usual dose is 1/4 of a 10 mg tab of Pepcid *AC Original Strength* every
other day (don't use any other formulation). If that doesn't help, the dose
is usually increased to 1/4 tab every day. The maximum dose should not
exceed 1/4 tab twice a day (5 mg/day/cat) max. You might want to put the
1/4 tab(s) in a #4 gelcap before giving it to your cat to prevent her from
tasting it. Pepcid is very bitter- if your cat ever gets a taste of it -
pilling will be a nightmare. I'm not a vet- I'm just relaying what worked
for our CRF cats that were in a uremic crisis, so run this by a vet first.

Best of luck

Phil




  #13  
Old April 23rd 09, 05:37 AM posted to rec.pets.cats.health+behav
Kolbard
external usenet poster
 
Posts: 24
Default Cat has CRF

Thanks for the advice, Phil. My biggest concern here is how can I get
the vet to do all these things? She was on the IV last Monday through
last Wednesday, but I was hoping they'd keep her longer. I wasn't
even aware her potassium was low. I was hoping she'd be back on the
IV tonight, but they just gave her a SubQ instead.

I tried syringing some food and AlternaGel, someone successfully.
Unfortunately, I tried to syringe some more food a short while later
and she threw it all up. She's so thin, I'm not sure she'll last much
longer without nourishment.

On Thu, 23 Apr 2009 03:47:18 GMT, "Phil P."
wrote:


"Kolbard" wrote in message
.. .

She had IV fluids last week, but it didn't seem to help her more than
a day.


...because she probably didn't get enough fluids or for long enough. Once
your cat is adequately hydrated, you should concentrate on increasing the
excretion of the uremic toxins in her blood by increasing her urine output.
Fluids alone are usually enough to cause mild diuresis (fluid diuresis) and
flush out most of the uremic toxins- enough to shut down a uremic crisis.
But since your cat's BUN/Cr/and/P are so high, fluids alone probably aren't
enough. She probably needs a diuretic with the fluids (intense diuresis).
Intesnse diuresis removes uremic toxins *much* faster. With fluids alone
diruesis can take several hours to begin. As long as your cat doesn't have
heart disease or hypertension, ID will probably shut down her uremic crisis
fairly quickly.

Her K+ is already way too low as it is- even without fluid therapy she
urgently needs a K+ supplement. Fluid diuresis and especially intense
diuresis will increase K+ excretion and depletion even further, so she
*definitely* needs a K+ supplement *urgently*.


My mother decided to take her back to the vet who didn't want to treat
her after seeing the numbers, and told him she wanted him to go ahead
and do it anyway. He was hard-line negative.


That's probably because he has little or experience treating CRF in cats. A
vet who knows anything about CRF in cats knows he should treat the ***cat***
not the numbers!


So, she took her back
to the original vet and apparently she does know about phosphorus
binders, she just didn't mention them before (???). I was she'd get
her back on IV, but she gave her a SubQ and sent her home. She
mentioned Maalox and Tums (!!) as P inhibitors, but I'm not sure if I
want to try those. Someone somewhere, possibly here, mentioned


Pepcid
as an anti-nausea measure, but I don't know how much to give.


The usual dose is 1/4 of a 10 mg tab of Pepcid *AC Original Strength* every
other day (don't use any other formulation). If that doesn't help, the dose
is usually increased to 1/4 tab every day. The maximum dose should not
exceed 1/4 tab twice a day (5 mg/day/cat) max. You might want to put the
1/4 tab(s) in a #4 gelcap before giving it to your cat to prevent her from
tasting it. Pepcid is very bitter- if your cat ever gets a taste of it -
pilling will be a nightmare. I'm not a vet- I'm just relaying what worked
for our CRF cats that were in a uremic crisis, so run this by a vet first.

Best of luck

Phil





Kolbard
  #14  
Old April 23rd 09, 06:18 AM posted to rec.pets.cats.health+behav
Kolbard
external usenet poster
 
Posts: 24
Default Cat has CRF

On Thu, 23 Apr 2009 03:47:18 GMT, "Phil P."
wrote:
Her K+ is already way too low as it is- even without fluid therapy she
urgently needs a K+ supplement. Fluid diuresis and especially intense
diuresis will increase K+ excretion and depletion even further, so she
*definitely* needs a K+ supplement *urgently*.


I just checked the test results page, and the listed normal range for
K+ is 3.7-5.8. Hers was 3.8 at last test. Are these supplements
readily available from vet clinics?

Kolbard
  #15  
Old April 23rd 09, 06:44 AM posted to rec.pets.cats.health+behav
cindys
external usenet poster
 
Posts: 592
Default Cat has CRF

On Apr 23, 1:18*am, Kolbard wrote:
On Thu, 23 Apr 2009 03:47:18 GMT, "Phil P."
wrote:

Her K+ is already way too low as it is- even without fluid therapy she
urgently needs a K+ supplement. *Fluid diuresis and especially intense
diuresis will increase K+ excretion and depletion even further, so she
*definitely* needs a K+ supplement *urgently*.


I just checked the test results page, and the listed normal range for
K+ is 3.7-5.8. *Hers was 3.8 at last test. *Are these supplements
readily available from vet clinics?

Kolbard

----------------
Yes. You can get the potassium supplement in the form of Tumil K
(which is a pill), a powder (Vet Solutions Renal K+ plus, which
supposedly has a beef flavor, but my cats hated it), or as a gel
(don't get any gel other than Vet Solutions Renal K+ - there is a
different gel which has a horrible smell and flavor). If your vet
doesn't carry any of these, they are easily accessible on the internet
from any number of sources.

http://www.amazon.com/Renal-K-Potass..._bxgy_k_text_b

Under the circumstances, I would have them shipped next-day air. If I
were you, I would go with the Vet Solutions Renal K+ gel. I used to
use this gel, and it worked out well. I currently use the Tumil K
pills for my cats only because the pills are cheaper, and I don't have
a problem pilling my cats. You can put the gel on your cat's paw, and
she will hopefully lick it off. If she doesn't, you can measure it
into a large oral syringe and squirt it in her mouth. The normal dose
is 2.5 mL (1/2 teaspoon) twice daily.

BTW, I am stunned that the price is only $7.99 + 6.16 shipping
(regular ground) from Medivet (sold through Amazon.com). My vet used
to charge me $21 for the same thing! At this price, I may return to
the gel.
Best regards,
---Cindy S.
  #16  
Old April 23rd 09, 11:13 AM posted to rec.pets.cats.health+behav
Phil P.
external usenet poster
 
Posts: 1,027
Default Cat has CRF


"Kolbard" wrote in message
...
Thanks for the advice, Phil. My biggest concern here is how can I get
the vet to do all these things?


At this point, I wouldn't waste time trying to find a general practitioner
that's experienced in treating CRF. I think you should consult a an ABVP or
ACVIM specialist ASAP-- if not sooner. I don't think you should wait another
second. If you live within range of a veterinary school, you should give
them a call. Most veterinary colleges have nephrologists and urologists on
staff and are fully equipped to handle uremic crises.

If not, do a search for an ABVP feline specialist in your area:
http://www.abvp.com/FindDiplomate.aspx

If you can't find an ABVP Diplomate in your area try:
ACVIM Board-certified Veterinary Specialist in Your Area
http://www.acvim.org/websites/acvim/index.php?p=3


She was on the IV last Monday through
last Wednesday, but I was hoping they'd keep her longer. I wasn't
even aware her potassium was low.


(From a recent post)
"Serum potassium levels are a poor indicator of total body stores of K+
since
95% of the total body stores of K+ are contained in the cells

(intracellular fluid- [ICF]). If the K+ level is low in the blood
(extracellular fluid [ECF]- its *definitely* low in the cells. Your cat is
borderline hypokalemic. When serum K+ is low the body will draw K from the
cells to maintain adequate serum K+ levels. This is why potassium depletion
in the cells can occur long before the onset of hypokalemia. Serum K+ levels
should be kept in the upper half of the normal range because the ECF K+ pool
is so much smaller, tiny shifts between ICF and ECF can affect serum K+
levels tremendously."

If your email is a working address, I'd be happy to send you a paper on the
importance of K+ in cats with CRF. Its called "Renal Disease in Cats" The
Potassium Connection" by Steven Dow and Martin Fettman.


I was hoping she'd be back on the
IV tonight, but they just gave her a SubQ instead.

I tried syringing some food and AlternaGel, someone successfully.
Unfortunately, I tried to syringe some more food a short while later
and she threw it all up. She's so thin, I'm not sure she'll last much
longer without nourishment.


Pepcid should help control nausea- although she'll probably need the
high-end dose, and/or metoclopramide (Reglan) which also controls nausea-
its a little stronger than Pepcid and works a little differently.

Along with the 1/4 tab of Pepcid, I include 1/4 tab of cyproheptadine in a
#4 gelcap (they fit). Cyproheptadine (Periactin), is an antihistamine which
acts like an appetite stimulant in cats.


Best of luck,

Phil


On Thu, 23 Apr 2009 03:47:18 GMT, "Phil P."
wrote:


"Kolbard" wrote in message
.. .

She had IV fluids last week, but it didn't seem to help her more than
a day.


...because she probably didn't get enough fluids or for long enough.

Once
your cat is adequately hydrated, you should concentrate on increasing the
excretion of the uremic toxins in her blood by increasing her urine

output.
Fluids alone are usually enough to cause mild diuresis (fluid diuresis)

and
flush out most of the uremic toxins- enough to shut down a uremic crisis.
But since your cat's BUN/Cr/and/P are so high, fluids alone probably

aren't
enough. She probably needs a diuretic with the fluids (intense diuresis).
Intesnse diuresis removes uremic toxins *much* faster. With fluids alone
diruesis can take several hours to begin. As long as your cat doesn't

have
heart disease or hypertension, ID will probably shut down her uremic

crisis
fairly quickly.

Her K+ is already way too low as it is- even without fluid therapy she
urgently needs a K+ supplement. Fluid diuresis and especially intense
diuresis will increase K+ excretion and depletion even further, so she
*definitely* needs a K+ supplement *urgently*.


My mother decided to take her back to the vet who didn't want to treat
her after seeing the numbers, and told him she wanted him to go ahead
and do it anyway. He was hard-line negative.


That's probably because he has little or experience treating CRF in cats.

A
vet who knows anything about CRF in cats knows he should treat the

***cat***
not the numbers!


So, she took her back
to the original vet and apparently she does know about phosphorus
binders, she just didn't mention them before (???). I was she'd get
her back on IV, but she gave her a SubQ and sent her home. She
mentioned Maalox and Tums (!!) as P inhibitors, but I'm not sure if I
want to try those. Someone somewhere, possibly here, mentioned


Pepcid
as an anti-nausea measure, but I don't know how much to give.


The usual dose is 1/4 of a 10 mg tab of Pepcid *AC Original Strength*

every
other day (don't use any other formulation). If that doesn't help, the

dose
is usually increased to 1/4 tab every day. The maximum dose should not
exceed 1/4 tab twice a day (5 mg/day/cat) max. You might want to put the
1/4 tab(s) in a #4 gelcap before giving it to your cat to prevent her

from
tasting it. Pepcid is very bitter- if your cat ever gets a taste of it -
pilling will be a nightmare. I'm not a vet- I'm just relaying what worked
for our CRF cats that were in a uremic crisis, so run this by a vet

first.

Best of luck

Phil





Kolbard




  #17  
Old April 23rd 09, 11:30 AM posted to rec.pets.cats.health+behav
Kolbard
external usenet poster
 
Posts: 24
Default Cat has CRF

On Thu, 23 Apr 2009 10:13:15 GMT, "Phil P."
wrote:


"Kolbard" wrote in message
.. .
Thanks for the advice, Phil. My biggest concern here is how can I get
the vet to do all these things?


At this point, I wouldn't waste time trying to find a general practitioner
that's experienced in treating CRF. I think you should consult a an ABVP or
ACVIM specialist ASAP-- if not sooner. I don't think you should wait another
second. If you live within range of a veterinary school, you should give
them a call. Most veterinary colleges have nephrologists and urologists on
staff and are fully equipped to handle uremic crises.

If not, do a search for an ABVP feline specialist in your area:
http://www.abvp.com/FindDiplomate.aspx

If you can't find an ABVP Diplomate in your area try:
ACVIM Board-certified Veterinary Specialist in Your Area
http://www.acvim.org/websites/acvim/index.php?p=3


I just checked and there aren't any close to me. The closest is maybe
5 hours away.

All I can hope for is that the vet agrees to put her back on IV. I
hate feeling so helpless, being at the mercy of the vets here.

Kolbard
  #18  
Old April 23rd 09, 04:23 PM posted to rec.pets.cats.health+behav
cindys
external usenet poster
 
Posts: 592
Default Cat has CRF

On Apr 23, 6:30*am, Kolbard wrote:
On Thu, 23 Apr 2009 10:13:15 GMT, "Phil P."
wrote:





"Kolbard" wrote in message
.. .
Thanks for the advice, Phil. *My biggest concern here is how can I get
the vet to do all these things?


At this point, I wouldn't waste time trying to find a general practitioner
that's experienced in treating CRF. *I think you should consult a an ABVP or
ACVIM specialist ASAP-- if not sooner. I don't think you should wait another
second. If you live within range of a veterinary school, you should give
them a call. *Most veterinary colleges have nephrologists and urologists on
staff and are fully equipped to handle uremic crises.


If not, do a search for an ABVP feline specialist in your area:
http://www.abvp.com/FindDiplomate.aspx


If you can't find an ABVP Diplomate in your area try:
ACVIM Board-certified Veterinary Specialist in Your Area
http://www.acvim.org/websites/acvim/index.php?p=3


I just checked and there aren't any close to me. *The closest is maybe
5 hours away.

All I can hope for is that the vet agrees to put her back on IV. *I
hate feeling so helpless, being at the mercy of the vets here.

---------
I don't understand why they would refuse. If nothing else, it's money
in their pockets to treat your cat. Please continue to keep us
updated.
Best regards,
---Cindy S.

  #19  
Old April 23rd 09, 07:07 PM posted to rec.pets.cats.health+behav
Phil P.
external usenet poster
 
Posts: 1,027
Default Cat has CRF


"Kolbard" wrote in message
...
On Thu, 23 Apr 2009 10:13:15 GMT, "Phil P."
wrote:


"Kolbard" wrote in message
.. .
Thanks for the advice, Phil. My biggest concern here is how can I get
the vet to do all these things?


At this point, I wouldn't waste time trying to find a general

practitioner
that's experienced in treating CRF. I think you should consult a an ABVP

or
ACVIM specialist ASAP-- if not sooner. I don't think you should wait

another
second. If you live within range of a veterinary school, you should give
them a call. Most veterinary colleges have nephrologists and urologists

on
staff and are fully equipped to handle uremic crises.

If not, do a search for an ABVP feline specialist in your area:
http://www.abvp.com/FindDiplomate.aspx

If you can't find an ABVP Diplomate in your area try:
ACVIM Board-certified Veterinary Specialist in Your Area
http://www.acvim.org/websites/acvim/index.php?p=3


I just checked and there aren't any close to me. The closest is maybe
5 hours away.



That's not that far under the circumstances- considering your cat urgently
needs correct and immediate treatment.



All I can hope for is that the vet agrees to put her back on IV. I
hate feeling so helpless, being at the mercy of the vets here.



Do you have a car? How far do you live from the nearest vet college?


Phil


  #20  
Old April 23rd 09, 10:21 PM posted to rec.pets.cats.health+behav
Kolbard
external usenet poster
 
Posts: 24
Default Cat has CRF

On Thu, 23 Apr 2009 18:07:10 GMT, "Phil P."
wrote:


"Kolbard" wrote in message
.. .
On Thu, 23 Apr 2009 10:13:15 GMT, "Phil P."
wrote:


"Kolbard" wrote in message
.. .
Thanks for the advice, Phil. My biggest concern here is how can I get
the vet to do all these things?

At this point, I wouldn't waste time trying to find a general

practitioner
that's experienced in treating CRF. I think you should consult a an ABVP

or
ACVIM specialist ASAP-- if not sooner. I don't think you should wait

another
second. If you live within range of a veterinary school, you should give
them a call. Most veterinary colleges have nephrologists and urologists

on
staff and are fully equipped to handle uremic crises.

If not, do a search for an ABVP feline specialist in your area:
http://www.abvp.com/FindDiplomate.aspx

If you can't find an ABVP Diplomate in your area try:
ACVIM Board-certified Veterinary Specialist in Your Area
http://www.acvim.org/websites/acvim/index.php?p=3


I just checked and there aren't any close to me. The closest is maybe
5 hours away.



That's not that far under the circumstances- considering your cat urgently
needs correct and immediate treatment.



All I can hope for is that the vet agrees to put her back on IV. I
hate feeling so helpless, being at the mercy of the vets here.



Do you have a car? How far do you live from the nearest vet college?


Phil


We took her back to the vet to get her back on IV (and mention the
diuretic), but they couldn't IV her because she's still swollen from
the SubQ shot yesterday.

Kolbard
 




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