Tiger's kidneys

Tiger went to the vet on Sunday. She had peed in several places that
were not her litterbox, and her skanky ears were bothering her again.

I called just now to see if her test results were back. The vet said
the urine culture wasn't done, so I don't know about that yet. She
said that her urine had a low concentration(?) and that her creatinine
was slightly elevated. She said the normal range is .8 - 2.3 and
Tiger's was 2.4. On Sunday, she said that her left kidney felt really
small. So, it looks like Tiger is heading for kidney failure.

The vet suggested giving her extra fluids 2-3 times a week, so I'm
going to bring her in next week to learn how to do that. She also
suggested putting her on a prescription diet. She said they carry
Eukanuba and Science Diet prescription foods for kidney problems. Does
anyone have an opinion about them, which is better? Tiger has been
eating only canned food for the last couple of years and I'd like to
stay with that. Also, I have another cat and forgot to ask if he would
be able to eat the prescription food as well. I know that no matter
how hard I try, they will end up getting into each other's bowls.

Currently Tiger is eating & drinking well. She actually seems to be
eating more, or at least cleaning her bowl faster. She's always been a
good drinker. I had her shut in the bathroom for a couple of days
before her appointment while I was at work, and had a bowl of water in
there for her. One day after I let her out I forgot to remove the
bowl, and she kept making special trips into the bathroom to drink from
it, as well as the Drinkwell in the kitchen.

I'm hoping that we caught this early and Tiger will be around for
awhile, but she is already 15 1/2 years old. She had a tumor removed
last year. Other than that, she's been a healthy cat except for the
skanky, waxy buildup that tends to form in her ears. I have some
medication for that from the new vet.

--
Liz

Is the skanky stuff fungal? My cat that passed away recently had a
fungal problem with his ears. Brown waxy stuff - the vet had him on a
medicine in a tube,,, sorry but the name escapes me.

"Elizabeth Blake" wrote in message
oups.com...
Tiger went to the vet on Sunday. She had peed in several places that
were not her litterbox, and her skanky ears were bothering her again.

I called just now to see if her test results were back. The vet said
the urine culture wasn't done, so I don't know about that yet.

It was a wise decision for your vet to run a urine culture. Cats with
kidney disease are more predisposed to urinary tract infections and if the
infection spreads to the kidneys it can accelerate progression of kidney
disease.


She
said that her urine had a low concentration(?) and that her creatinine
was slightly elevated. She said the normal range is .8 - 2.3 and
Tiger's was 2.4. On Sunday, she said that her left kidney felt really
small. So, it looks like Tiger is heading for kidney failure.


She is just in the early stages of kidney disease, she could still have
years of life left.


The vet suggested giving her extra fluids 2-3 times a week, so I'm
going to bring her in next week to learn how to do that.

Seems like fairly aggressive treatment for early kidney disease. The
purpose of subcutaneous fluids is to ensure she is taking in enough fluids
to compensate for extra fluid loss in her urine. Thus SQ fluids are
important for cats that are not taking in enough fluids from eating and
drinking. I recommend adding extra water to canned food to increase fluid
intake and make sure you have multiple large water bowls with fresh water
available throughout the house. The drinkwell water fountain is a great
idea too.



She also
suggested putting her on a prescription diet. She said they carry
Eukanuba and Science Diet prescription foods for kidney problems. Does
anyone have an opinion about them, which is better?


Science diet G/D is a good food for this stage of kidney disease. Most
premium senior diets would be appropriate as well. Diets specifically
designed for kidney disease (e.g. K/D or Euk Multistage Renal) are too
protein restricted for cats with early kidney disease. I usually don't
recommend them until BUN values are significantly elevated.



Tiger has been
eating only canned food for the last couple of years and I'd like to
stay with that.

Good idea

Also, I have another cat and forgot to ask if he would
be able to eat the prescription food as well.

Your other cat shouldn't be fed a kidney diet, but neither should Tiger at
this point.

Ask if her blood potassium level was tested. Potassium supplementation
should be started if potassium levels are in the low end of normal range.
There is evidence that potassium supplementation at this stage will prolong
kidney function. I find the powdered potassium supplements are the easiest
to give.


J. dvm

wrote in message
oups.com...
Is the skanky stuff fungal? My cat that passed away recently had a
fungal problem with his ears. Brown waxy stuff - the vet had him on a
medicine in a tube,,, sorry but the name escapes me.

I'm not sure. I know it's been tested for various things in the past but I
don't know what. I was just always told that it's "nothing". It's thick,
brown & waxy and drives her crazy. When pressed, a couple of vets had given
me medication in the past (Animax? and something else) but the stuff always
returned. I have to say that after the last deep cleaning (October 2004)
until now, her ears have stayed cleanest the longest. The stuff still came
back but not as much, and one ear stayed almost completely clear until just
recently, when she began scratching it again. The medication this new vet
gave me is for mites, I think - Tresaderm.

--
Liz

"J. Martin" wrote in message
.. .

"Elizabeth Blake" wrote in message
oups.com...
Tiger went to the vet on Sunday. She had peed in several places that
were not her litterbox, and her skanky ears were bothering her again.

I called just now to see if her test results were back. The vet said
the urine culture wasn't done, so I don't know about that yet.

It was a wise decision for your vet to run a urine culture. Cats with
kidney disease are more predisposed to urinary tract infections and if the
infection spreads to the kidneys it can accelerate progression of kidney
disease.

She said that there doesn't seem to any infection but I guess I'll find out
for sure when the culture is completed. I forgot to ask when that would be.
When she had urination problems in the past (starting when she was young) I
was always told she didn't have an infection.


The vet suggested giving her extra fluids 2-3 times a week, so I'm
going to bring her in next week to learn how to do that.

Seems like fairly aggressive treatment for early kidney disease. The
purpose of subcutaneous fluids is to ensure she is taking in enough fluids
to compensate for extra fluid loss in her urine. Thus SQ fluids are
important for cats that are not taking in enough fluids from eating and
drinking. I recommend adding extra water to canned food to increase fluid
intake and make sure you have multiple large water bowls with fresh water
available throughout the house. The drinkwell water fountain is a great
idea too.

The vet said it was up to me. She said that Tiger's skin was "tenting" when
I had her in. When they pull up on the skin, it remians that way for a few
seconds before returning to normal. I just pulled her skin myself, and it
doesn't stay that way for more than a second or so. I'm still going to
bring her in on Tuesday to learn how to give her fluids, because I'm sure I
will eventually need to know and I might as well learn now. It will be up
to me to decide if I want to give them to her or not. I have a feeling I
will put it off for now. Tiger does get plenty of fluids. She *loves* to
drink and she eats wet food. I'm going to put a bowl of water back in the
bathroom, since she was also going in there to drink when I left it down. I
think my other cat, Otto, prefers a bowl over the Drinkwell. I rarely see
him drinking. Before I got the fountain, I'd see a lot of fur at the bottom
of the water bowls because he would stick his paw in and then lick the water
off his paw. When I open a can of food in the morning, I leave it in the
sink full of water because he likes drinking water out of the dirty dishes
in the sink. But I have never had to worry about Tiger getting enough.
Recently, even before she began peeing outside the box, I've noticed the
reservoir in the fountain was emptying faster.

She also
suggested putting her on a prescription diet. She said they carry
Eukanuba and Science Diet prescription foods for kidney problems. Does
anyone have an opinion about them, which is better?


Science diet G/D is a good food for this stage of kidney disease. Most
premium senior diets would be appropriate as well. Diets specifically
designed for kidney disease (e.g. K/D or Euk Multistage Renal) are too
protein restricted for cats with early kidney disease. I usually don't
recommend them until BUN values are significantly elevated.

Right now she's eating regular (adult, not senior) Wellness, Petguard &
Science Diet. Chicken, turkey, beef combinations mostly. She's never been
a picky eater and as long as the canned food is pate style, she's eaten it.
She's also become a treat fanatic, running over every time she hears a bag,
or what she thinks is a bag or treats getting rattled. Tonight she came
running as I was testing my blood sugar, because she thought the vial of
strips sounded like treats. She's always liked treats but has never been
pushy about it. Is her increased appetite related to her kidneys? She's
even eating more at regular mealtimes.


Also, I have another cat and forgot to ask if he would
be able to eat the prescription food as well.

Your other cat shouldn't be fed a kidney diet, but neither should Tiger at
this point.

Ask if her blood potassium level was tested. Potassium supplementation
should be started if potassium levels are in the low end of normal range.
There is evidence that potassium supplementation at this stage will
prolong kidney function. I find the powdered potassium supplements are
the easiest to give.


J. dvm

I can put her in the bedroom or bathroom at mealtime. I had her in the
bathroom for several days last week and that's when I realized how quickly
she emptied her bowl. I'll ask about the rest of her blood test results
when I go next week, and will also ask about her potassium levels.

--
Liz

"Elizabeth Blake" wrote in message
.net...
"J. Martin" wrote in message
.. .

"Elizabeth Blake" wrote in message
oups.com...
Tiger went to the vet on Sunday. She had peed in several places that
were not her litterbox, and her skanky ears were bothering her again.

I called just now to see if her test results were back. The vet said
the urine culture wasn't done, so I don't know about that yet.

It was a wise decision for your vet to run a urine culture. Cats with
kidney disease are more predisposed to urinary tract infections and if
the infection spreads to the kidneys it can accelerate progression of
kidney disease.

She said that there doesn't seem to any infection but I guess I'll find
out for sure when the culture is completed. I forgot to ask when that
would be.

Results usually take about 3 days.

SNIP

pushy about it. Is her increased appetite related to her kidneys?

No, appetite decreases as kidney disease advances, so a good appetite is a
good sign.

"Elizabeth Blake" wrote in message
.net...

The vet said it was up to me. She said that Tiger's skin was "tenting"
when
I had her in. When they pull up on the skin, it remians that way for a
few
seconds before returning to normal.

She's a 15 year-old cat! What does he expect? Older cats often have reduced
skin turgor and delayed skin return even without dehydration because their
skin losses elasticity with age. A 15-year-old cat is physiologically
equivalent to a 76-year-old person. Hasn't he ever noticed the flaccid
"chicken skin" on elderly people? Its like Silly Putty. Same principal
applies to elderly cats.

Fluid therapy should only be used to prevent dehydration in cats that aren't
getting enough water from food and drinking to keep up their urinary losses,
or on a *short-term* basis to promote diuresis to lower uremic
toxins in the blood during acute decompensation. Chronic fluid therapy
actually promotes the progression of CRF because it makes the kidneys work
harder and also increases single-nephron GFR and promotes glomerular
hyperfiltration- which can also promote progression.

If she's eating canned food, she's meeting almost her entire daily water
requirement from her food and only needs to drink a little extra water.




She also
suggested putting her on a prescription diet. She said they carry
Eukanuba and Science Diet prescription foods for kidney problems. Does
anyone have an opinion about them, which is better?

Her kidney values are *far* too low to begin protein restriction. All she
needs right now is a canned senior diet that's low in phosphorus and a
potassium and an omega-3 supplement. Protein restriction shouldn't begin
until her BUN is at least 60-80 mg/dl or if she develops clinical signs of
uremia.

Between premature protein restriction and unnecessary fluid therapy, some
vets are actually hastening CRF cats' premature demise.

How's Harriet?

Phil

"J. Martin" wrote in message
.. .

Ask if her blood potassium level was tested. Potassium supplementation
should be started if potassium levels are in the low end of normal range.
There is evidence that potassium supplementation at this stage will
prolong
kidney function. I find the powdered potassium supplements are the
easiest
to give.

Hi Doc,

I'm glad to see you back! You've been sorely missed.

I have an excellent paper by Drs. Steven Dow and Martin Fettman on the
benefits of potassium supplementation in renal cats: "RENAL DISEASE IN CATS:
THE POTASSIUM CONNECTION". I'd be happy to send it to you if you'd like to
read it.

Phil

"Phil P." wrote in message
k.net...

"J. Martin" wrote in message
.. .

Ask if her blood potassium level was tested. Potassium supplementation
should be started if potassium levels are in the low end of normal range.
There is evidence that potassium supplementation at this stage will
prolong
kidney function. I find the powdered potassium supplements are the
easiest
to give.

Hi Doc,

I'm glad to see you back! You've been sorely missed.

I have an excellent paper by Drs. Steven Dow and Martin Fettman on the
benefits of potassium supplementation in renal cats: "RENAL DISEASE IN
CATS:
THE POTASSIUM CONNECTION". I'd be happy to send it to you if you'd like
to
read it.

Phil


Thanks Phil, I'd like to read that. I'll send you my email address
privately

"Phil P." wrote in message
k.net...

Fluid therapy should only be used to prevent dehydration in cats that
aren't
getting enough water from food and drinking to keep up their urinary
losses,
or on a *short-term* basis to promote diuresis to lower uremic
toxins in the blood during acute decompensation. Chronic fluid therapy
actually promotes the progression of CRF because it makes the kidneys work
harder and also increases single-nephron GFR and promotes glomerular
hyperfiltration- which can also promote progression.

If she's eating canned food, she's meeting almost her entire daily water
requirement from her food and only needs to drink a little extra water.

I'm still going to bring her in next week to learn how to give her fluids,
but won't actually start doing so until she needs it. She always has liked
water so I was surprised when they said she was a little dehydrated. Like
you said, it's probably not dehydration but just normal aging.

She also
suggested putting her on a prescription diet. She said they carry
Eukanuba and Science Diet prescription foods for kidney problems.
Does
anyone have an opinion about them, which is better?

Her kidney values are *far* too low to begin protein restriction. All she
needs right now is a canned senior diet that's low in phosphorus and a
potassium and an omega-3 supplement. Protein restriction shouldn't begin
until her BUN is at least 60-80 mg/dl or if she develops clinical signs of
uremia.

I started buying some senior cat food for her before Otto showed up,
probably when she was around 9 years old. She began to lose weight rapidly
with it, so I put her back on her regular foods. I'm willing to try it
again. Any brand(s) you recommend? Right now she's getting adult Petguard,
Wellness & Science Diet.


How's Harriet?

Phil

Harriet is doing much better, although today I caught her in one of the
rooms burying something. I found a couple of turds on the floor but don't
know how long they had been there. They weren't fresh. She has been going
regularly in the box, is eating better and hasn't been attacking anyone for
several weeks.

--
Liz