Help from those who have dealt with kidney failure

[jenluckenbach]

I never (up to now) had a cat in kidney failure. I never had to deal with it. But now I have BraveHeart. And while most of my info will come from my vet, I would LOVE input from those who have lived through it. (I hate to ask the vet every teeny, tiny question. )

So, any hints, symptoms to watch out for, suggestions that have worked, do and don'ts, food suggestions, meds ANYTHING!!

For example, his new problem is vomitting. I know cats throw up (trust me, everyone in the house has been throwing up lately) but 4 days in a row!!?? I will be calling the vet tomorrow to update them on this.

HOW important are the sub-Q fluids?? (He really gives me a hard time any more. )

[Freedom]

My RB Amber had kidney failure.

The sub Q fluids are to maintain hydration. In kidney failure, the kidneys over act and deplete the needed moisture in the body. The fluids help keep up the body's other systems by holding the fluid level stable. If you stop it completely, then the slide down hill is quicker and more difficult to reverse; and other systems are affected. You can test for the hydration level by pinching a bit of skin on the side. It should bounce right back to normal. If it holds for a second then slowly releases and drops, there is not enough fluid in the body.

Hope that helps!

Here is one site (of many) with info.
http://www.felinecrf.org/symptoms.htm

[Emeraldgreen]

Hi Jen, thanks for your post in my thread. My turn to return the favor!

My cat Jade lived to age 20 and is now at the RB. But, she was diagnosed with kidney failure 4 years earlier. My vet at that time didn't think she'd have that long after he diagnosed her. He prescribed so many things that I can't remember the name of but had to do with blood pressure and organs. She hated them and they were expensive. She didn't want to eat any of the low protein foods that my vet prescribed and ultimately started losing weight. He finally told me that feeding her whatever she wanted to eat would be better than not eating at all and at that time, he thought she didn't have long anyway. So, I went out and bought all her previous favourites, friskies wet food and fancy feast and she ate it up. She put the weight back on and looked good.
I also gave her fluids at home for the last 2 years of her life and it made such an incredible difference. I gave her 100cc's of lactated ringers once a week, sometimes twice and after the big hump on her back soaked into her within the hour, she was rejuvinated. She played and raced up and down the stairs, where the day before, she wasn't much ready for anything. I always put the needle between her shoulder blades and a few inches higher up towards her neck. Each week, I'd choose a place that was an inch or so away from the week before. I found that using a smaller 22 gauged needle (the plastic base was pink in colour) helped. The vet and tech told me to use a larger one because then it wouldn't take so long but she found it so uncomfortable. The smaller one took maybe 5 minutes longer but I set up a routine that she seemed to enjoy. Each time, I'd get everything set up in advance so she wouldn't see what I was up to. I'd hang the bag from a hook in the ceiling above my bed and get the new needle put on and then I'd get her and put her on the bed and start massaging her. I'd have the tv on for distraction (animal planet of course!) and then I'd get the needle in and keep massaging in different areas to create more distraction.
In her last year, I went up to 150 cc's or 200 if I could get her to sit still long enough for that much fluid. In the end, she ended up catching a respiratory illness from one of my other cats who had the herpes virus and because were were in the middle of moving into a new house, it was a very stressful enviroment and the virus which is normally dormant, flared up. By the time we got settled in our new home it was evident that Jade had come down with it as well and by then her immune system just wasn't up to fighting it. I was so sad to lose her but finally had to make the decision to have her put down.
But, that was 4 years after my vet told me she didn't have long so in my opinion, fluids are key and so is feeding whatever you can get into them, especially if they are not eager to eat specialized foods. Hope some of this helps. Please give beautiful Braveheart a hug for me. He really is so brave.

[IMG]

[Barbara]

http://www.felinecrf.com/

This is the best website for cats with chronical renal failure.
Of course no story is like the others.
Vomiting is a bad sign and does not occur in the earlier stages. But subcutaneous fluids can change a lot.
Filou goes to see the vet for his sub-qs as he is by far too wiggly a little worm to get them from me. But I know that many Pettalkers administer them themselves.
Another important thing: they shouldn't lose weight. They rather can have the most yummy food even if it contains too much protein- but if they lose weight they are using their own protein
So all nice things like cream, egg yolk etc. are good to help them keep their weight (just opposite to us ).
All the best for Braveheart.

[kb2yjx]

Jen!! I had a big reply and was reveiwing it and it suddenly disappeared!!! I will try again!!!
This is the hard time in a cat owner's life(or in your case, a foster cat that you LOVE as your own). But, please remember, we are here for you and BraveHeart. I like the www.felinecrf.org, which is Tanya renal site. It is maintained by Helen, who is just wonderful. She does answer questions. I had no idea that if you put the needle that you were going to use to give sub q's in the FREEZER, the needle in easier to insert into the cat!! Spunky was the absolute PITS when it was sub q time. I ended up putting a dish of baby food with some chicken in it, get him to eat, so I could put in the needle and prayer that the 100 cc's went in quickly!!. There comes a time that it is best to let the cat eat what it wants. I still cringe when I think about Molly eating Nine Lives and Fancy Feast!! I would cook up chicken, turkey, liver, the ultimate bribe food, baby food. And it is OK if the cat eats, and it is still OK, if the cat does not eat. Keeping oneself calm, is the key to not stressing out the cat. Keep giving BraveHeart the pepcid, at least 20 minutes before he eats. It really does help with the nausea feeling. I remember giving Boo her fluids, she looked up at me, I petted her and told her, You are not going to get better, I cannot make you better, you are not going to live forever, BUT I promise you your dignity, comfort, quality of life, and no pain. I kept that promise to Boo and to all the other cats that have gone to the Bridge. I was once a member of a Yahoo renal group. As a nurse, I thought what are these people doing, why are they so concerned about giving the cat all sorts of pills, having procedures done, and they were nuts about the lab values. And for what, they were just causing the cat so much stress and pain. There comes to a point when that is it, nothing more can be done(BraveHeart is not there yet, is he??). I know that BraveHeart is in the BEST of loving hands with you caring for him. HUGS FOR JEN and MANY PRAYERS FOR DEAR BRAVE BRAVEHEART......Sandra

[Freedom]

Me again.

I saw that Emerald green explained how she worked the bag, so thought I'd post how I did that also.

Take a piece of twine, tie in a loop about 4 inches long, knot it well. Open cupboard door, TOP cupboard is what I did, and loop this over the top hinge. Get a small "S" hook and slip it over the twine. This all stays put. The door will open and close fine.

When it is time to administer the fluids, hang the bag off of the hook. I had Amber up on the kitchen counter.

But I bet you can use a lower cabinet and sit on the floor, as well.

Just one more idea.

Oh, and I suppose it is a GOOD that that 3 of us referred you to the same site!

[Catty1]

The ideas about a smaller needle and freezing it sound good, as well as changing the inject sites...if BraveHeart learned it hurts way less, he might not object to it so much.

{{{hugs}}} and good luck with that baby. He could be around a long time yet...what with working up an appetite on his social outings and all!

[nepeta]

I agree with what all the others have said; the sub-q's made a huge difference for Sammy, and the Pepcid helped her want to eat.

She ate renal diet for about 3 years after initial diagnosis, and then decided she didn't like it. Someone posted this link that gives protein, sodium, and phosphorous levels for other commercial foods and I found senior foods that she liked that weren't as far off a renal diet as some other foods:
http://webpages.charter.net/katkarma/canfood.htm
Hunt around for links from this site - they also have dry food ratings.

And, as the others have said, eating is more important than eating a specific diet.

I also used the felinecrf.org site that the others have mentioned.

[Medusa]

Jen, my Puddy has been on subQ's for a couple of years now and it's made quite a difference in how she feels and acts. As others have mentioned, my vet recommended using a larger gauge needle in order for the treatments to go faster and, although it is a little more uncomfortable upon insertion, the treatment goes so fast that I feel it's worth it. Puddy has always been a very impatient and aggressive cat and to have a treatment take longer than it has to just isn't worth it to either of us. I also move the needle to a different spot each time so that the area doesn't become sore. It's also important to use a new needle each time or at least every other time so that it's more comfortable. Puddy gets 150 cc's and I use my judgment as to how often. In the beginning, she was getting 2 treatments a day, then I backed off to 1 a day for a while, then 1 every other day, then every two days, etc. If she looks scruffy ie. somewhat dehydrated, she gets a treatment.

As for vomiting, my vet said that if she throws up once, not to worry but if she throws up twice in one day, to call him, especially if it's bile and not food. Believe it or not, Puddy actually likes canned KD now, which is especially for cats in renal failure and it also comes in dry form but she isn't too hot on that. I also sprinkle Forti Flora on her food; it's a pro-biotic that's quite palatable and it helps her w/bowel movements. It's great for cats who get diarrhea often or who, like Puddy, tend to have mushy stools.

Trust your judgment as to how often to give the subQ's unless your vet told you specifically how often to give them. Puddy always perks up after one. You can't hurt Braveheart by giving him too much. He may get a little pocket of fluid, though. Puddy gets an accumulation right under her front right leg but, after a while, it goes down. It doesn't harm them in any way. And when you first administer the subQ, Braveheart may squeal a little and that's because it feels funny when it first goes in.

Braveheart will get used to his treatments and so will you. It'll become so easy that you won't think anything of it after a short while.

[jenluckenbach]

Thanks everyone.

I knew the sub-q's were important. And shall continue to try.

BraveHeart doesn't mind the needle going in (too much) but actually getting it in is difficult. It is not difficult because of the original "stick" but because he is SOOOOOOOOO skinny. No matter where you attempt to make "the tent" there is absolutely no thickness to the skin. I have, all too often, had it go in one side and out the other without even realizing it. so, even though I attempt to use a different spot each time, there is just not enough thickness to keep the needle in.

As for using a smalle needle, I'd love to, but BraveHeart's biggest grief with me is not having enough patience to get the fluids in (so we don't want it to take LONGER!) He gets agitated and squirms and wiggles and I can't keep the needle from coming out. If he was a heavier cat, it might stay in better.

[kb2yjx]

Jen, the same thing happens to Raven when she get her fluids!!! She is only 4.9 pounds, and the needle goes in and out. Then I see the LR coming out of her!!!! She does not like the restick and is a real wiggle worm!!! Since I have several cats that get fluids, I invested in an IV pole. Brico is the site where I get my fluids and supplies, they are very good and helpful. FAST delivery, too!
www.bricomedicalsupplies.com/CRFpage

[kb2yjx]

If that address does not come up, put Brico Medical Supplies in your search engine. The site you need will come up!!!

[Emeraldgreen]

At first, I used to have a similar problem with the needle going in one side and out the other when Jade was at her skinniest and wasn't eating the prescribed food. Once I got her to get eating again with other foods, and got some meat on her bones, it became ALOT easier.
As gruesome as it sounds, if the needle is out through the other side, sometimes you can back it up slightly just enough so that you are where you are supposed to be rather than having to re-stick him.
As was mentioned in an earlier post, it's good to change the needle each time to make it easier and because bacteria can grow in the needle that is left on from the previous treatment.
Medusa mentioned canned K/D and while Jade didn't like the canned version, she really liked the K/D kibble. I don't know if you've bought some yet but the kibbles are really small and greasy and my other cats kept trying to get some for themselves. Of all the reduced protein diets, that is the only one she ever ate.
I remember you mentioning in a few of your previous posts on the other thread that Braveheart loves his kibbles. I was thinking that maybe he might like something in between wetfood and dry kibbles like Tender Vittles? That way it would be soft on his mouth but still in kibble form. I know it's not ideal food but if he liked it, it might help get him 'filled' out a little more and hopefully a bit easier for you to work with the needle.