Please talk to me about CKD

[PinkSparklyPussyCat]

We found out yesterday that Harry has early kidney disease. The vet isn't too worried at the moment as, if he hadn't had bloods done when they x rayed his jaw we would never have known.

The vet suggested we change him to a renal diet (which they sell, surprise surprise) and we will try it. We're thinking of starting with Royal Canin as they do a tuna variety! My main reservation is all the renal diets contain sugars and God knows what else.

She also mentioned phosphate binders in his normal food, although apparently it's not as effective. Has anyone got any experience with this? We're may well start with this as we've got a stash of his normal food that cost a fortune. (The vet is ok with that, we wouldn't not treat him just to save money!)

I'm not convinced he'll like the food and I'm worried he'll taste the phosphate binders. Has anyone not treated CKD and just gone with 'watch and wait' and giving the cat a shorter but happy life? I'm not prepared to make him miserable by making him eat food he doesn't want. It would break my heart but I'd rather have a couple more years with him than prolong his life for me.

Sorry this is long and thanks in advance for any advice.

[Fluffycloudland77]

I would buy a sample pack. Do they think he feels unwell?.

I'm sorry, I know how much you love Harry. He has had some awful luck.

[PinkSparklyPussyCat]

Thanks Fluffy.

Apparently if he hadn't had the blood tests when he had the last lot of x rays no one would have known for at least another couple of years. He has no symptoms at all - DH sniggered when I mentioned anorexia is one as Harry isn't, shall we say, skinny?!

[knockknockknock]

I have no experience of the disease or cats BUT have a look at a raw feeding website. I know many people swear by raw for kidney problems with their dogs and there's many people who raw feed cats as well.

Worth a look - this is one I use on Facebook. You do have to ask to join (no fees or anything like that though!!)

Worldwide raw feeding advice and support

Good luck 🐾

[PinkSparklyPussyCat]

Thanks knock, definitely something to look into. I did try it once before and he looked at me as though I was mad but I'm definitely willing to try again!

[ifonly4]

My CKD eat the renal food for about three weeks and then flatly refused after I'd put in a bulk order for all Royal Canin flavours. Luckily his sister did like it and the vet said short term it wouldn't do her any harm. Neither of them were fussed about the tuna though, which is funny as they wouldn't eat the beef in other brands but I think that was the most popular. If he does eat it, you can order online a lot cheaper than getting it through the vet. I did buy a phosphorus binder, Ipakitine, online which I gave to my boy.

Losing weight and drinking more where the first signs I picked up when my lad had CKD, so it's positive that Harry hasn't got to that stage. I do agree with you, life is about quality not quantity. If he really won't eat the renal food, he still has to eat otherwise he'll be ill from other things before the CKD totally kicks in.

[PinkSparklyPussyCat]

Thanks ifonly. DH is going to the vet today to have a word and pick up phosphate binder so we can start when the weather cools down - the vet agreed it's better to wait as he's not eating much at the moment and we won't know if he's not eating because he doesn't like it or if he's too hot!

I spoke to one of the nurses last night and she was lovely and agreed he has to eat something! We'll try everything, but I'm not prepared to starve him into submission!

[ifonly4]

I think a lot of cats aren't eating that well at the moment with the heat. It might be worth trying to feed him really early or late at night when it's cooler. Also, it won't hurt him to have his usual food for a couple of days, it's more important that he doesn't get dehydrated at the moment. You can try the renal food again at the end of the week when it's meant to be cooler.

[PinkSparklyPussyCat]

The vet was quite happy for us to do that, she actually said we can keep him on his current food until he's eaten the stash I've got in the living room, preferably with the phosphate binders. She probably didn't realise just how much I've got though!

DH is sorting the phosphate binder and I've got some renal food being delivered by Fetch on Friday as it was the only place I could find a small box. I really don't need 48 pouches to start with! I'm worried about the food containing sugar as Harry's teeth aren't that special and I don't want him having to have a dental if we can avoid it as he had such a bad reaction to the sedation last time.

I think it's going to be about getting the balance right

[PinkSparklyPussyCat]

Right, update from the vet via DH.

As the kidney disease has been discovered so early she's happy for him to have the phosphate binders and have another blood test in 3 months time and then 6 monthly after that. Thankfully he won't need to be sedated for that.

He has been prescribed a liquid phosphate binder that is newer than Ipakitine and has been formulated to taste better. We're going to start that tonight rather than wait. The bad news is it's £30 for 60ml and £70 for 180ml. The good news is the insurance should cover it, whereas they won't cover food.

The vet is happy for him to stay on his Natures Menu as the prescription diet has a protein level of 7.5 whereas NM is 10 (not sure what that means) so there's not a huge difference.

[Fluffycloudland77]

Would it be cheaper to buy it via a private prescription online? Rather than pay the excess?

[PinkSparklyPussyCat]

Thanks for the suggestion, we're going to have to work that one out. We're going to be claiming for blood and urine tests anyway so we're going to have to pay the excess for those. The excess is £125 plus 20% of treatment so I'll be claiming for as much as I can!

[PinkSparklyPussyCat]

We put the phosphate binder in his food tonight and a third of the bowl has gone already so it doesn't seem to be putting him off. Fingers crossed he carries on like this! If he does, hopefully we can put off the prescription diet for a while.

Does anyone know what happens if he doesn't eat the whole bowl of food so doesn't get his full dose? I'm presuming it won't make a huge difference at this stage and I'm obviously hoping he takes as much as possible.

[NecklessMumster]

Mine ears the renal diet food ok. Vet also said leave extra bowls of water around so she has one in the bathroom too, and drinks a lot. We didn't bother with the phosphate binders and haven't been back to vet again yet

[Fluffycloudland77]

He's not a cheap date is he? We say our initial outlay on the cat was just the down payment.

[PinkSparklyPussyCat]

Harry is so fussy which is why we thought we'd try the phosphate binders first. We had to change his food from dry to wet last year when he fractured his jaw and it took a long find something he was really happy with. He can't eat dry food at all now as his jaw is still unstable so that limits the choice even further.

He's got two bowls of water, a large one in the living room and a smaller one the kitchen as well as a tray of water in the garden so hopefully that will be enough.

I'm glad your cat is doing well Neckless

[PinkSparklyPussyCat]

Exactly Fluffy - DH refers to him as the gift that keeps on taking!

I popped in the vets tonight to sign the insurance paperwork (Petplan must love us!) and before they even said hello to me they were asking how Harry is. I think they have a soft spot for him!

[Fluffycloudland77]

I'm mixing water in every meal now it's hot. He doesn't seem to mind & they don't need lots.

[PinkSparklyPussyCat]

Harry doesn't like anything being done to his food or water!

Suprisingly he ate his dinner last night and two thirds of his breakfast this morning containing the phosphate binder. I'm hoping that's a good sign!

He's due to go for another blood test at the end of September so the plan is to stay on the phosphate binders and then review after that. If there's little or no change we'll carry on and review every six months and move him onto the food if things start to change.

[stressystressy]

My experience with CKD, consultation with a specialist cat vet, and a long time managing the condition in several cats.

• a phosphate binder is far superior to the renal food. It is the phosphorous in food which damages the kidneys so by keeping that to a minimum you slow the progress of the disease.
  
• Renal food is not required (and even then is debatable) until your cat is in Stage 3. By which time you would definitely see symptoms.
  
• the important thing is to keep him hydrated. Add water to meals, have multiple water sources (we bought a fountain), and no dry food at all.
  
• lots of people give subcutaneous fluids under the direction of their vet. I have seen this keep a CKD cat healthy for a LONG time. Only you know if you are comfortable to administer this at home and if your cat has a temperament that will allow you to do it.
  
• as the disease progresses your cat will start to drink more and urinate more.
  

Two of the best resources I found were:
www.felinecrf.org
Facebook group FELINE CHRONIC KIDNEY DISEASE (get a copy of your cat's blood work if you join this group)

[PinkSparklyPussyCat]

Thanks Stressy

That's interesting about the phosphate binder, he's such a fussy eater that I want to keep him on his normal food for as long as possible. DH tried him on a pouch of renal food yesterday and he approached it cautiously, took one look in the bowl, jumped back and walked off and wouldn't go back until his tuna Hi Life went down!

We've got water bowls in the kitchen and living room and a tray of water in the garden. We bought a water fountain a couple of years ago and he refused to go in the kitchen while it was there. (You're probably getting the idea by now that he's a little odd!)

He can't eat dried food which is something, but I will try adding a little bit of water to his food. His food is quite wet anyway so I know he gets fluid from that.

Thank you again

[PinkSparklyPussyCat]

I've just got back from the vets with Harry after taking him for his injections - far more traumatic for me than him due to my needle phobia! He's had a clean bill of health, or as clean as he's going to get now. His jaw is reasonably stable, his mouth and teeth are fine and he's only lost 300g in the last 13 months, during which we've changed his diet and he didn't eat much when it was hot.

I spoke to the vet about the renal diet and she agrees that there's no point keep trying him on it, we're better off giving him his normal diet with Pronefra twice a day. Someone told me today that they would force him to eat it if he was their cat but there's no way you can force Harry to do anything!

He's back in 3 months for blood tests and we'll see what happens then. As the vet said there's no way of knowing how fast it will progress but the main thing is keeping him happy.

[Fluffycloudland77]

I would like to know how you force a cat to do anything too! 😹

Harry's his own man.

[villainousbroodmare]

Sometimes we put feeding tubes in cats. It's a soft rubber tube that goes through the skin straight into the esophagus and stays in place. The cat eats normally, as much as he wants, and if it's not enough, his daily ration is supplemented via the tube. It helps to maintain weight and ensures that they are taking an appropriate food even if it is not exactly to their liking. It wouldn't be my personal choice and doesn't suit every cat or owner, but I know a cat who had one for 6 years and remained in very good and comfortable condition until he developed unrelated issues at the grand old age of 21.

[PinkSparklyPussyCat]

I just looked at her Fluffy and wondered if this was her first cat!

That's interesting villainous. I'm not sure I could do that to Harry as I don't think he's got the temperament - his vets notes say he's fractious - but I'm interested in every option so we can make the right decisions for him.