When people have severe kidney problems, they often receive dialysis treatment. Dialysis is a medical process by which a person's blood is cleansed of toxins that would normally be flushed out by the kidneys. It generally requires sophisticated equipment, and is often done at the hospital.
While giving a cat kidney dialysis isn't unheard of, we can all appreciate that the expense and trauma of doing this on an ongoing basis make this difficult, if not impossible for most pet owners.
There is, however, a form of "mini dialysis" you can learn to do at home that is both easy and affordable. And that's to give your cat extra fluids (sterile, saline solution) "subcutaneously" – which means just under the skin and not into a vein).
Fluid therapy can be very beneficial to dehydrated pets with limited kidney function. Cats with kidney failure drink a lot of water. But they can't drink enough water to compensate for the reduced filtering function of their kidneys. But by adding even more fluid (water) to their system, you can help them flush out more toxins from their body and help them feel better.
Chances are your vet may have given your cat subcutaneous fluids shortly after your cat was diagnosed with kidney failure. The staff at your vet's office can show you how to do it, and provide all the equipment you need, which is:
A 1000 cc bag of sterile fluid (a Lactated Ringer).
A supply of disposable needles (probably 18 gauge with a pink plastic base)
A sterile tube that connects the needle to the bag of saline fluid
You can use a wire coat hanger and a string or shoelace to attach the bag of fluid to the hanger. You then hang the whole thing from a door or any other secure, high object. It looks like the "mash" unit you see on TV medical shows.
Administering the Fluids
There are two important tricks to giving your cat fluids:
1) Inserting the needle well. Your vet's staff will show you how to make a little "tent" of the loose skin on the scruff of your cat's neck or upper back. You then poke the needle parallel to your cat's back, into this little pouch of skin you've created by "tenting" it. In other words, the needle goes sideways and flush with your cat's back. NOT straight into your cat!
It's interesting to note that you can tell how dehydrated you cat is by how easily you can make this tent of skin. If the skin pulls up easily, your cat is still fairly hydrated. If there is very little elasticity in the skin, it could be a sign that your cat is somewhat dehydrated.
2) Stay on schedule. Shortly after diagnosis, you may be on a very frequent hydration schedule, say, every two days (or even every day), to help flush toxins out of your cat and bring her blood levels back to normal.
As time goes on and she appears to respond to the treatment, you may dial back to every two or three days. By mistake, we have gone four days between treatments. Michou seemed to be a little out of sorts after waiting that long. Now, we stick to every two-and-a-half days. I use an "appointment alert" in my Outlook calendar, on my computer's desktop.
I also keep a paper diary of her treatments. I record the date, time of treatment, level of fluids left in the bag, and whether or not I used a new needle last time.
Our vet recommended changing the needle each time, and changing the "line" – the plastic tubing – every week. We felt that was an unnecessary expense. Instead, we use a sterile needle for two treatments, and then throw it a way. We use the sterile plastic tubing for weeks, if not months at a time, before getting a new one. We have not seen any detrimental results.
Since you're dripping 200 ml of fluid with each treatment, each 1,000 ml bag will last for 5 treatments or roughly 10 days to two weeks.
The Feline CRF Foundation website has a handy step-by-step illustrated guide for administering fluids to your cat, which you may find helpful.
You can also get more information about administering subcutaneous fluids in cats at Washington State University's College of Veterinary Medicine. Although you will probably learn everything you need to know from your vet's office.
Wednesday, December 8, 2010
Saturday, December 4, 2010
Low Protein Diets for Cats with Kidney Disease
When your cat has kidney failure, one of the first things you need to do is get very involved with his or her diet.
Many vets recommend switching to a special canned low-protein diet. A low-protein, low salt, low phosphorus diet will help reduce the amount of waste products that your cat's kidneys will have to filter out. The lower salt and lower phosphorus may also help control the electrolyte balance in your cat's body, which is good for muscle and nerve function.
Since meat is especially high in phosphorus, low-protein diets will have less meat, and more fat. Reducing the level of highly digestible protein decreases the demand on your cat's kidneys and liver.
While there's no actual "cure" for chronic kidney failure, a low protein, low phosphorus diet may be able to slow the progression of the disease. It can ease the burden on your cat's kidneys, and may help you cat feel better, too.
Some popular low-protein, CRF cat foods include:
Hills Prescription Diet Feline - K/D canned
Royal Canin Veterinary Diet – Renal Medi-Cal® Feline Reduced Protein
Eukanuba Veterinary Diet Multi-Stage Renal Formula (Canned)
Iams® Veterinary Formulas Renal Multi-Stage Renal™/Feline Canned Formula
Purina NF Kidney Function Brand™ FORMULA (canned and dry) - Purina Pet Food
Many of these brands have both canned and dry varieties. At this point, I believe that cats with kidney problems should only eat canned cat food. Dry cat food can dehydrate your cat at a time when they need more fluids, not less, to flush out toxins from their bodies. (I'd be interested in your opinion on this, especially if you are a vet or have been treating a cat with kidney disease. Add your comments below.)
After our cat, Michou, developed her kidney problems, I felt guilty at having fed her dry cat food for so many years. It was easy and convenient and she liked it. Plus, it naturally made it easier to leave her some food if we went away for a day or two. But today, the folly of that diet seems obvious. Just think of cats in the wild. Do lions and tigers eat grains? Vegetables? No, they hunt other animals. They eat meat. It just seems obvious today that we should have been feeding her wet or canned cat food all along.
Some studies have questioned whether restricting protein (and therefore reduced phosphorus) is good for a cat, in that it may not give the cat enough protein for other normal body functions. One expert is quoted as saying low-protein diets are not appropriate until your cat's Blood Urea Nitrogen (BUN) levels are double the normal reading (roughly 60-80 mg/dl).
All I can say is that we switched to this diet immediately after Michou's diagnosis and have been on it for over three years. There is one thing to watch out for, though...
And that's weight loss and loss of appetite. Michou was a heavy cat to begin with so the weight she initially lost brought her into the normal range. She is now a bit skinnier, even a bit bony, which is cause for concern.
But as you'll read in "Does My Cat Feel Pain," nausea and lack of appetite is a big problem in cats with kidney disease. You have to continually make sure they are eating, even if it means hand-feeding or spoon-feeding them at times.
And the biggest problem with switching a cat's diet, as you may know, is that the finicky little critters won't eat the stuff!
We experimented at first with 3-4 brands until Michou found one she seemed to like, which was the KD Chicken brand. But after about two-and-a-half years, as her appetite seemed to wane and she got thinner, we tried a few other brands. Lately, she's been on Royal Canin's Medi-Cal® for cats.
What NOT to Do With a Low-Protein Diet
Veterinarians warn not to supplement your cat's low protein, low phosphorus diet with any foods that are high in protein. This can cancel out the positive effects of the diet.
Foods to avoid include meat and milk, which is surprisingly high in phosphorus. Also avoid ever feeding your cat onions, which can lead to anemia, which is especially dangerous for cats with kidney failure.
There are more things you can do, as you'll see in "Appetite Boosters for Cats with Kidney Disease."
Many vets recommend switching to a special canned low-protein diet. A low-protein, low salt, low phosphorus diet will help reduce the amount of waste products that your cat's kidneys will have to filter out. The lower salt and lower phosphorus may also help control the electrolyte balance in your cat's body, which is good for muscle and nerve function.
Since meat is especially high in phosphorus, low-protein diets will have less meat, and more fat. Reducing the level of highly digestible protein decreases the demand on your cat's kidneys and liver.
While there's no actual "cure" for chronic kidney failure, a low protein, low phosphorus diet may be able to slow the progression of the disease. It can ease the burden on your cat's kidneys, and may help you cat feel better, too.
Some popular low-protein, CRF cat foods include:
Hills Prescription Diet Feline - K/D canned
Royal Canin Veterinary Diet – Renal Medi-Cal® Feline Reduced Protein
Eukanuba Veterinary Diet Multi-Stage Renal Formula (Canned)
Iams® Veterinary Formulas Renal Multi-Stage Renal™/Feline Canned Formula
Purina NF Kidney Function Brand™ FORMULA (canned and dry) - Purina Pet Food
Many of these brands have both canned and dry varieties. At this point, I believe that cats with kidney problems should only eat canned cat food. Dry cat food can dehydrate your cat at a time when they need more fluids, not less, to flush out toxins from their bodies. (I'd be interested in your opinion on this, especially if you are a vet or have been treating a cat with kidney disease. Add your comments below.)
After our cat, Michou, developed her kidney problems, I felt guilty at having fed her dry cat food for so many years. It was easy and convenient and she liked it. Plus, it naturally made it easier to leave her some food if we went away for a day or two. But today, the folly of that diet seems obvious. Just think of cats in the wild. Do lions and tigers eat grains? Vegetables? No, they hunt other animals. They eat meat. It just seems obvious today that we should have been feeding her wet or canned cat food all along.
Some studies have questioned whether restricting protein (and therefore reduced phosphorus) is good for a cat, in that it may not give the cat enough protein for other normal body functions. One expert is quoted as saying low-protein diets are not appropriate until your cat's Blood Urea Nitrogen (BUN) levels are double the normal reading (roughly 60-80 mg/dl).
All I can say is that we switched to this diet immediately after Michou's diagnosis and have been on it for over three years. There is one thing to watch out for, though...
And that's weight loss and loss of appetite. Michou was a heavy cat to begin with so the weight she initially lost brought her into the normal range. She is now a bit skinnier, even a bit bony, which is cause for concern.
But as you'll read in "Does My Cat Feel Pain," nausea and lack of appetite is a big problem in cats with kidney disease. You have to continually make sure they are eating, even if it means hand-feeding or spoon-feeding them at times.
And the biggest problem with switching a cat's diet, as you may know, is that the finicky little critters won't eat the stuff!
We experimented at first with 3-4 brands until Michou found one she seemed to like, which was the KD Chicken brand. But after about two-and-a-half years, as her appetite seemed to wane and she got thinner, we tried a few other brands. Lately, she's been on Royal Canin's Medi-Cal® for cats.
What NOT to Do With a Low-Protein Diet
Veterinarians warn not to supplement your cat's low protein, low phosphorus diet with any foods that are high in protein. This can cancel out the positive effects of the diet.
Foods to avoid include meat and milk, which is surprisingly high in phosphorus. Also avoid ever feeding your cat onions, which can lead to anemia, which is especially dangerous for cats with kidney failure.
There are more things you can do, as you'll see in "Appetite Boosters for Cats with Kidney Disease."
Monday, November 29, 2010
What Are the Treatments for Cats with Kidney Disease?
People will tell you that Chronic Renal Failure (CRF) is both progressive and incurable. And tell you that there's no conventional or alternative treatment that can stop it, since the disease destroys kidney cells, and the dead kidney cells then turn into scar tissue.
While all this may be true, the diagnosis of CRF in your cat is NOT an immediate death sentence. Of course, every cat and every case will be different. And you have to rely on your vet's advice.
But there is a lot you can do to comfort your cat, and perhaps even enjoy many more months and even years of love and time together. Our cat, Michou, is proof of that. She is still functioning fine with all her cat-habits more than 3 ½ years after being diagnosed.
There are 3 things you need to do immediately:
1) Let your vet know you want to be as aggressive as possible in treating your cat. Some vets or clinic staff will assume you think that "it's time" and you just want to let your cat go, in as peaceful and humane a way as possible. But if not, then you need to let them know right away and begin treatments. Your vet may not tell you about all the things you can do, unless you ask.
2) Educate yourself. Read all you can about taking care of cats with kidney disease. There are a number of treatments listed on this blog. And I've included some other helpful links on this site.
2) Get a second opinion. We were fortunate to have a close friend who was a vet. Although he wasn't our regular vet for Michou, he gave us a number of good suggestions for treating her kidney disease that our regular vet and his staff never brought up. This included ways to cope with the nausea that cats with kidney disease experience, and he was the one who suggested hydration treatments.
In the next few posts, I'll describe the key things you can do to help make your cat more comfortable and perhaps help her enjoy life much longer. These are not "heroic" measures that costs thousands of dollars, such as a kidney transplant or feline dialysis. Instead, they are fairly affordable and simple things you can do at home to give your CRF cat a normal life. They include:
Low Protein Diets for Cats with Kidney Disease
Fluid Treatments for Cats with Kidney Disease
Watching the Weight of Cats with Kidney Disease
Appetite Boosters for Cats with Kidney Disease
Nutritional Supplements for Cats with Kidney Disease
Medications for Cats with Kidney Disease
Advanced Treatments for Cats with Kidney Disease
The first steps in treating your cat will probably involve getting more fluids into her to relieve any dehydration and to help flush out toxins that may have built up in the bloodstream.
While all this may be true, the diagnosis of CRF in your cat is NOT an immediate death sentence. Of course, every cat and every case will be different. And you have to rely on your vet's advice.
But there is a lot you can do to comfort your cat, and perhaps even enjoy many more months and even years of love and time together. Our cat, Michou, is proof of that. She is still functioning fine with all her cat-habits more than 3 ½ years after being diagnosed.
There are 3 things you need to do immediately:
1) Let your vet know you want to be as aggressive as possible in treating your cat. Some vets or clinic staff will assume you think that "it's time" and you just want to let your cat go, in as peaceful and humane a way as possible. But if not, then you need to let them know right away and begin treatments. Your vet may not tell you about all the things you can do, unless you ask.
2) Educate yourself. Read all you can about taking care of cats with kidney disease. There are a number of treatments listed on this blog. And I've included some other helpful links on this site.
2) Get a second opinion. We were fortunate to have a close friend who was a vet. Although he wasn't our regular vet for Michou, he gave us a number of good suggestions for treating her kidney disease that our regular vet and his staff never brought up. This included ways to cope with the nausea that cats with kidney disease experience, and he was the one who suggested hydration treatments.
In the next few posts, I'll describe the key things you can do to help make your cat more comfortable and perhaps help her enjoy life much longer. These are not "heroic" measures that costs thousands of dollars, such as a kidney transplant or feline dialysis. Instead, they are fairly affordable and simple things you can do at home to give your CRF cat a normal life. They include:
Low Protein Diets for Cats with Kidney Disease
Fluid Treatments for Cats with Kidney Disease
Watching the Weight of Cats with Kidney Disease
Appetite Boosters for Cats with Kidney Disease
Nutritional Supplements for Cats with Kidney Disease
Medications for Cats with Kidney Disease
Advanced Treatments for Cats with Kidney Disease
The first steps in treating your cat will probably involve getting more fluids into her to relieve any dehydration and to help flush out toxins that may have built up in the bloodstream.
Thursday, November 25, 2010
What Tests Are Needed For Cats with Kidney Disease?
If you've spotted the symptoms for what you think is kidney failure, bring your cat to your vet right away.
Your vet will likely run a Complete Blood Count to confirm whether or not your cat has kidney failure. He will draw some blood from a vein in your cat's neck using a needle and syringe. Once they have a sample, they will run the following tests:
Blood Urea Nitrogen (BUN) – which measures the level of a waste product excreted by the kidneys. Normal BUN levels are between 14 – 36 mg/dl.
Creatinine – is another waste product excreted through by the kidneys that is thought to indicate overall kidney function. Normal levels: .6 – 2.4 mg/dl.
Calcium – healthy cats have a calcium-to-phosphorus ratio of 1:1 to 2:1. If your cat's kidneys are not functioning properly, blood tests will indicate a rise in the levels of calcium. Normal levels: 8.2 – 10.8 mg/dl.
Phosphorus – cats with kidney failure have higher levels of phosphorus in their blood because their kidneys can no longer excrete it as efficiently. This excess phosphorus can make their condition worse. As you'll see when we get to special diets for cats with kidney failure, a low-phosphorus diet is crucial. Normal reading for phosphorus: 2.4 – 8.2 mg/dl.
These are the main blood tests for kidney disease. When BUN and creatinine are elevated, there's a good chance your cat's kidneys are compromised.
In addition, some vets may check for elevated levels of an enzyme called Amylase, which may be a warning signal of kidney disease. He may check cholesterol levels, which can increase with kidney disease. He may check Potassium levels which can be dangerously low, because of more frequent urination or vomiting in a sick cat. Some cats with kidney problems need potassium supplements to raise their levels. And your vet may check sodium levels, which can rise, since your cat is unable to excrete it. Too much sodium can lead to high blood pressure.
You will receive a detailed printout of you cat's blood tests. More importantly, you should have a consultation with the vet about what the numbers mean, and what to do next.
Your vet will likely run a Complete Blood Count to confirm whether or not your cat has kidney failure. He will draw some blood from a vein in your cat's neck using a needle and syringe. Once they have a sample, they will run the following tests:
Blood Urea Nitrogen (BUN) – which measures the level of a waste product excreted by the kidneys. Normal BUN levels are between 14 – 36 mg/dl.
Creatinine – is another waste product excreted through by the kidneys that is thought to indicate overall kidney function. Normal levels: .6 – 2.4 mg/dl.
Calcium – healthy cats have a calcium-to-phosphorus ratio of 1:1 to 2:1. If your cat's kidneys are not functioning properly, blood tests will indicate a rise in the levels of calcium. Normal levels: 8.2 – 10.8 mg/dl.
Phosphorus – cats with kidney failure have higher levels of phosphorus in their blood because their kidneys can no longer excrete it as efficiently. This excess phosphorus can make their condition worse. As you'll see when we get to special diets for cats with kidney failure, a low-phosphorus diet is crucial. Normal reading for phosphorus: 2.4 – 8.2 mg/dl.
These are the main blood tests for kidney disease. When BUN and creatinine are elevated, there's a good chance your cat's kidneys are compromised.
In addition, some vets may check for elevated levels of an enzyme called Amylase, which may be a warning signal of kidney disease. He may check cholesterol levels, which can increase with kidney disease. He may check Potassium levels which can be dangerously low, because of more frequent urination or vomiting in a sick cat. Some cats with kidney problems need potassium supplements to raise their levels. And your vet may check sodium levels, which can rise, since your cat is unable to excrete it. Too much sodium can lead to high blood pressure.
You will receive a detailed printout of you cat's blood tests. More importantly, you should have a consultation with the vet about what the numbers mean, and what to do next.
Wednesday, November 24, 2010
What Are the Symptoms of Kidney Failure in Cats?
Today it's not unusual for domesticated house cats to live to 12-14 years of age or longer, especially when they are kept indoors in comfortable surroundings. However, the downside of cats living longer is that many develop chronic health problems as they get older, kidney disease being one of them.
The kidneys are usually one of the first organs to show signs of deterioration. So cats suffering from kidney failure is now a fairly common veterinary condition, particularly with older cats.
If your cat is starting to have kidney problem, you may notice an increase in drinking water and more frequent urination. The increase in drinking and peeing is because the cat's kidneys are having a harder time concentrating the urine and getting rid of toxins from the body. Other symptoms you might notice include:
Loss of appetite
Lethargy
Weight loss
Vomiting, both clear and food
Dehydration
Poor grooming
Drooling
Weakness
Ulcers on tongue and gums
A peculiar or ammonia-like smell on the breath
Shortness of breath
Itching/scratching
Also, because kidney failure sometimes triggers high blood pressure, a frightening symptom can be the dilation (widening) of your cat's pupils, even in bright light, which can lead to permanent blindness.
If left untreated, kidney failure will cause toxins to build up in your cat's body and eventually, she will suffer from uremia – which is such a high build-up of toxins that it can lead to coma or death.
However, a diagnosis of Chronic Renal Failure (CRF) can only be properly diagnosed with a series of blood tests. So if you notice any of these symptoms, take your cat to the vet immediately.
The kidneys have a large reserve capacity. Symptoms of kidney failure often do not even show up until about 75% of the kidneys are no longer working. This was the case with our cat, Michou.
Kidney failure is also the most common cause of death among older cats.
The kidneys are usually one of the first organs to show signs of deterioration. So cats suffering from kidney failure is now a fairly common veterinary condition, particularly with older cats.
If your cat is starting to have kidney problem, you may notice an increase in drinking water and more frequent urination. The increase in drinking and peeing is because the cat's kidneys are having a harder time concentrating the urine and getting rid of toxins from the body. Other symptoms you might notice include:
Loss of appetite
Lethargy
Weight loss
Vomiting, both clear and food
Dehydration
Poor grooming
Drooling
Weakness
Ulcers on tongue and gums
A peculiar or ammonia-like smell on the breath
Shortness of breath
Itching/scratching
Also, because kidney failure sometimes triggers high blood pressure, a frightening symptom can be the dilation (widening) of your cat's pupils, even in bright light, which can lead to permanent blindness.
If left untreated, kidney failure will cause toxins to build up in your cat's body and eventually, she will suffer from uremia – which is such a high build-up of toxins that it can lead to coma or death.
However, a diagnosis of Chronic Renal Failure (CRF) can only be properly diagnosed with a series of blood tests. So if you notice any of these symptoms, take your cat to the vet immediately.
The kidneys have a large reserve capacity. Symptoms of kidney failure often do not even show up until about 75% of the kidneys are no longer working. This was the case with our cat, Michou.
Kidney failure is also the most common cause of death among older cats.
Monday, November 22, 2010
Welcome
Our story began just over three years ago. My wife noticed that our 14-year-old Calico, Michou, was going over to her water bowl more frequently and drinking often. My wife also just had a feeling that something was different about Michou's behavior.
We waited a few days and then saw the vet. They took blood tests and within a day we were back for the results: Her blood tests showed a creatinine level of 4.38 mg/dl. Creatinine is a waste product that is excreted through the kidneys. A normal creatinine reading would be between 0.6-2.4 mg/dl.
Michou's "BUN" levels (blood urea nitrogen) was 31. BUN is another waste product excreted through the kidneys. A normal reading would be in the 14 mg/dl range.
These high readings show up when a cat's kidneys are nearly 70% destroyed. Michou had severe kidney failure. The vet estimated that she only had about 25% of the function left in her kidneys.
We asked what we could do. The staff gave us a sad and "understanding" look, as if to say, "There isn't much you can do. Prepare for the inevitable."
Well I'm here to tell you that there is a lot you can do.
It has been 3 ½ years since that day and I'm happy to say that we have enjoyed many wonderful moments with our little Michou. She is now 17 ½ years old. And although she is nearly 100 years old in human years, she still does many of her old familiar activities: wander outside into our fenced-in back yard to nibble on grass and relax in the sun; sleep next to us at night with her head on a pillow; and meow loudly when she wants food or to be gently lifted onto a chair.
We love her and are so grateful to those who have helped us keep her going.
It is my hope that the information in this website can help you enjoy many more years together with your little cat, too. There are many things you can do to help a cat even with a highly compromised kidneys enjoy the life and love you have to give. Here's how...
We waited a few days and then saw the vet. They took blood tests and within a day we were back for the results: Her blood tests showed a creatinine level of 4.38 mg/dl. Creatinine is a waste product that is excreted through the kidneys. A normal creatinine reading would be between 0.6-2.4 mg/dl.
Michou's "BUN" levels (blood urea nitrogen) was 31. BUN is another waste product excreted through the kidneys. A normal reading would be in the 14 mg/dl range.
These high readings show up when a cat's kidneys are nearly 70% destroyed. Michou had severe kidney failure. The vet estimated that she only had about 25% of the function left in her kidneys.
We asked what we could do. The staff gave us a sad and "understanding" look, as if to say, "There isn't much you can do. Prepare for the inevitable."
Well I'm here to tell you that there is a lot you can do.
It has been 3 ½ years since that day and I'm happy to say that we have enjoyed many wonderful moments with our little Michou. She is now 17 ½ years old. And although she is nearly 100 years old in human years, she still does many of her old familiar activities: wander outside into our fenced-in back yard to nibble on grass and relax in the sun; sleep next to us at night with her head on a pillow; and meow loudly when she wants food or to be gently lifted onto a chair.
We love her and are so grateful to those who have helped us keep her going.
It is my hope that the information in this website can help you enjoy many more years together with your little cat, too. There are many things you can do to help a cat even with a highly compromised kidneys enjoy the life and love you have to give. Here's how...
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