After being cured from Chronic Renal Failure - convalescence and related problems

[francoise_peace]

Discuss about cat convalescence after having being cured from CRF.

Hello, my 19yo cat cured from CRF, but I'll have to continue treatment. And I don't know if after being cured, if she shall continue treatment or not, because usually cats don't get cured of CRF.

She'll soon re-start her treatment: Renalzin + Probiavi probiotics, Renalzin made her Phosphorus get lower and the probiotics made her Urea get lower, and both made the Creatinine get back to normal levels:
http://www.flickr.com/photos/waterreedshimmer/4970322673/

- I don't know if it's good to wait for her probiotics to arrive before re-start ?
- I don't know if low urea is dangerous ?
- I don't know if low phosphorus is dangerous ?
- I don't know if there is something in her kidney that didn't cure ?

Renalzin = Lanthanum carbonate (Human Renalzin in France is called Fosrenol, but you must have the same medicine with another name in UK and USA)

Probiavi contains =

Pediococcus Acidophilus
Bifido lactis
Bifido Longdum
Lactobacillus Acidophillus
Streptococcus Thermophilus
S.Cervisiae (yeast)
FOS (Fructo oligo sacharide)
And a little dextrose (food grade)

And there is also another problem, I pass my time trying to contact a researcher that can tell me if it is possible that one of her probiotics bacteria has mutated into one that can cure cat kidney cancer or contains a new virus that can cure CRF ? And I also think that if such bacteria or virus exists, it comes from Canada and it travels in USA through Psyllium Husk that are prebiotics, that means food for bacteria. But I still did not have a positive answer from any researcher. It is important because cure for CRF, or at least mega toxin eater that lowers Urea, cannot be into a volatil compound that has not been identified and whose presence depends on luck.

If there isn't such mutated bacteria nor virus, it's only the treatment that worked. Some humans also can cure from it.

I also have no vet knowledge and am a simple pet owner.

[dmr111]

do you know if ash , taurine and magnesium are bad for cats with rf?

[francoise_peace]

Hello, I close the topic. It's already too long:

New topic:
CRF with anemia - end of life
http://www.medhelp.org/posts/Cats/CRF-with-anemia---end-of-life/show/1416438

So you are welcome to follow new topic and to give me your advices :)

[francoise_peace]

Hey big idea this morning: colostrum for anemia ?

[francoise_peace]

She went today to the vet. She is having anemia with CRF :(
The vet saved her again by de-constipating her with his hands.
I don't know what to do about anemia ?
He gave her an injection for eating, but I don't see the use since it's me who is feeding her - and it didn't make her more hungry.
For constipation he said to give her Hills 7+ instead of Hills i/d with Hills k/d because before Hills 7+ was giving her diarrhea.
I'll post a new topic but I'm not sure I can save her again. But situation is still not dramatic.

CRF + Anemia:

Urea: 0,789 g/L max is 0,756
Crea: 33,6 mg/L max is 24
GR HCT and HGB very very low - because of constipation she didn't want to eat, and she wasn't eating much although she eats 20ml * 3 times + 10ml of water.
Problem: Can't put at once 40ml of wet food in a cat stomach !!!

And she'll have Nelio 2,5 instead of Fortekor because clinic changed medication partnership because Fortekor is sold to us (and probably to them) very expensive (yes, it's about 1/2 of the price of Mercola Probiotics).

Do you think if I found a Sheba that isn't only protein (sheba tuna, sheba chicken), a wet one with fish and vegetables (sheba ocean i don't know what), she can have some ? I'll see this now. At list CRF cats who eats holistic don't have this anemia problem. But I think anemia is more serious than CRF because if she can't get her strength back, she can't fight CRF.
And vet said to avoid vitamins to treat anemia because it isn't good to kidney.

I think it's really a food dosage problem mixed with CRF and constipation and past diarrhea problem.

If someone can invent 20ml nutritional equilibrated food for cats that eat only with syringe ?

Please !!!

[francoise_peace]

Correction:

100 - (60/234 * 100) = 100 - 25,64 = 74,36%


So she is allowed to eat:
8,4 + (8,4x74,36)/100 = 14,65% of proteins

--
Explanation:

Hypothesis:
For a 3,5kg cat, 1 can and 1/4 = 156g + 39g = 195g
For a 4kg cat, 1 can and 1/2 = 156 + 78 = 234g
You give E(g) of food a day to your cat.

What is missing ?
For a 3,5kg cat, 100 - (E/195 * 100) = A%
For a 4kg cat, 100 - (E/234 * 100) = A%

If:
K/D label: proteins8,4 fat7,9 carboh11  fibre0,7 Pho0,1   Ca0,18 K0,3    Na0,09 tau0,11

Than:
Suppose that E = 60g
For a 4kg cat, 100 - (E/234 * 100) = A%
So 100 - (60/234 * 100) = 100 - 25,64 = 74,36%
So max proteins = (8,4xA)/100 + 8,4 = 14,65%

[francoise_peace]

Explanation:

Hypothesis:
For a 3,5kg cat, 1 can and 1/4 = 156g + 39g = 195g
For a 4kg cat, 1 can and 1/2 = 156 + 78 = 234g
You give E(g) of food a day to your cat.

What is missing ?
For a 3,5kg cat, 100 - (E/195 * 100) = A%
For a 4kg cat, 100 - (E/234 * 100) = A%

If:
K/D label: proteins8,4 fat7,9 carboh11  fibre0,7 Pho0,1   Ca0,18 K0,3    Na0,09 tau0,11

Than:
Suppose that E = 60g
For a 4kg cat, 100 - (E/234 * 100) = A%
So 100 - (60/234 * 100) = 100 - 25,64 = 74,36%
So max proteins = (8,4xA)/100 + 8,4 = 14,65%

And there, you can give other food to your cat along with its renal food if he/she eats less than supposed, but there must be limits to proteins intake in CRF cats.

[francoise_peace]

I'm happy that my cat is still alive.

Now days she is having a lot of constipation, the cause is rather not enough strength.

She is doing well with K/D mixed with I/D.

Thinking maths:
3 x 2 syringes a day = 3*(2 x 10ml) = 60 ml a day - the water added.

1 can of K/D = 156g
For a 4kg cat, 1 can and 1/2 = 156 + 78 = 234g

So the quantity she must eat is:
ex:
K/D proteins: 8,4%
I/D proteins: 9,9%

60/234 * 100 = 25,64%

So she is allowed to eat:
(8,4+25,64)/100 + 8,4 = 10,55% of proteins

(if someone can advice better calculus than me for everyone... ?)

So I/D is OK.

[francoise_peace]

I am the happiest cat-mother that exists over the world.

And I am very sad about the thousand of people who thinks I feel frustrated when grooming my sick cat. I love my cat. So I love to take care of her. And I have hope. As I will always have hope in sickness with everyone. You can only kill someone if you lost your hope about him/her. Because love is an essencial ingredient for cure.

We live in a very dangerous society. People who don't have hope and who think you are frustrated are dangerous for society. I don't like you.

I am as happy as when I did the Master 1 and succeeded, it were the happiest days of my life, and professors didn't have to tell me they are in depression because I should be feeling frustrated because I am old (???) and as most of their students they don't like, I dream about finding my first job, but unfortunately Linguistics field is not associated with the world of employment (???). Those people who don't believe in you, don't believe in their own future. They are all wrong. I passed 10years without being told Linguistics isn't associated with a job. But I'm not as lunatic as professors, I have ambitions in Geology field, and I'll take the 70years left for me to live, to become Geologist. I also have ambition of working even if I'll have to say: "I did no studies and passed 10years in vidéo games", because you can't find a job with a human science diploma, may it be linguistics or psychology or sociology or ethnology. But before all, I'll take care of my cat.

I'm very happy with my vet, because he has hope. And I wouldn't stay with a vet that don't believe the cat can live.

So the thousand of people who told me they are frustrated when their car is sick so I must feel frustrated with mine. You are wrong and dangerous for society! Sickness is the same thing then fairies, if you don't believe in them, they die.

[francoise_peace]

Minou had a more than 7days constipation, she went to the vet and he took out the #### that was huge. I'm glad the vet has a cat, you must have some courage to help a constipated cat, and taking the #### out is a very personnal intervention !
But Minou is calm, that might have helped, he said he used a lubrificator, and it hurted her anus a little, but very small blood from mucosa.
I have the same problem then her because I am vegetarian. I am sure K/D without proteins can't help. I don't know if the i/d will help for this in the future. I hope she recovers because her skin is full of dandruff because of constipation.
She had 2 syringues (of 10mm) of water plus one with water + vitamin gel paste from Virback, before going to the vet, so that she won't faint. And when we arrived she had her food with her probiotics and her Renalzin. Because I always eat after constipation.

[francoise_peace]

Looking at i/d vs k/d (vet said to mix both), they are quiet similar in % for one can:

i/d:  proteins9,9 fat6,3 carboh7,1 fibre0,4 Pho0,21 Ca0,31 K0,27  Na0,09 tau0,14
k/d: proteins8,4 fat7,9 carboh11  fibre0,7 Pho0,1   Ca0,18 K0,3    Na0,09 tau0,11

i/d: kcal/100g 110 target-ph 6.2-6.4  disgestibility:proteins:91%
k/d: kcal/100g 136 target-ph 6.6-6.9 non-protein-calories 78%

ingredients i/d: Turkey, turkey liver, maize flour, rice flour, Fibrim® 1260 (soluble fibre source), dicalcium phosphate, calcium sulphate, potassium chloride, edible gums, calcium carbonate, taurine, iodised salt, vitamins and trace elements.

ingredients k/d: Liver, chicken (minimum 14%), pork, ground rice, oat fibre, maize starch, glucose, animal fat, potassium citrate, psyllium, edible gums, calcium carbonate, calcium sulphate, menhaden oil, taurine, DL-methionine, iodised
salt, vitamins and trace elements.

Fibrim is soy fiber. Hope it's not dangerous since soy contains hormones and that could give thyrroid problems, but maybe fiber isn't grain ?

But I think the protein level of i/d is OK for CRF, moreover if it's mixed with k/d.

[francoise_peace]

She is 2,400 Kgs, so she lost weight although she kept very big belly (ventre) but we see she is bony.

She did blood analysis + echography.

All organs were OK (bowel, kidney - 1 kidney had a kyst, bladder etc.) but she has hard stools (selles dures) waiting in bowel. I spoke about her always go: 1st) big and hard 2nd) diarrhea-like.
Mother asked if could be: hemorroids ?
Vet answered: Cats can't have hemorroids. But she can't also have laxatives because of the diarrhea problems.

I said I give cooked zucchini with her food for her PH and for her gastro-intestinal problems (fibers).

About her PH, I mesured yesterday, it was 5.8. So a little bit of zucchini is good for correcting acid urine problems, thanks to its alkalinity properties, I confirm. But echography said: no visible crystals.

Vet said to mix Sciences Hills i/d (gastro-intestinal wet food) with k/d (renal wet food). But I am a little afraid for creatinine. Because the kidney in sick cats don't synthetise proteins as well as for normal cats. But on the other hand she is still loosing weight and she has this intestinal problem with heavy #### followed by water-like-#### (that dirties everything).

He didn't gave any opinion about zucchini (courgette) because vets in France don't have nutritional formation, but mother said previous vet had advised it for her cat (my cat was her grandmother when her cat was alive) when she had constipation issues and said it was also good without constipation.

He also said I could go on with Mercola Probiotics. I showed him the bottle. Although I had stopped it.

About her blood analysis. He thinks it's because she is old and her kidney is old that it is getting worse. But he don't think there is a pathology associated with it and he thinks she is not going to die now (mother asked).

UREA: 0,526 g/L (past Probiotics for uremia + Renalzin phosphorus blinder + actually zucchini for acidity) -> normal - we are in the middle of the normal.
CREA: 28,8 mg/L high, max is 24.
Other levels: normal.
Na - K - Cl: normal.
He didn't measure phosphorus.

[francoise_peace]

I tried to put something on wikipedia related to what I've found on the net, don't know if it'll stay:

==Dietetics==

For humans: Drink low mineralized water, avoid tap water even for cooking, eat less meat, and add alkaline vegetables on your plate like fresh cucumber, zucchini, fresh endive, alfafa grass, onion and garlic.
*[http://www.naturalhealthcarestore.com/phdiet.htm Adjust Your Bodies pH Level With an Acid and Alkaline Balanced Diet]
*[http://www.balance-ph-diet.com/acid_alkaline_food_chart.html Acid Alkaline Food Chart]  

For animals: Offer low mineralized water several times a day. Cook in low mineralized water zucchini slices, pass a few through a small strainer along with its wet food diet, to have a more alkaline pet food.

A cat's urine PH should be between 6.1 and 6.6 and a dog's PH should be between 5.2 to 6.8, if it is less there is a risk of high uric acid, cystine, and calcium oxalate crystals. Acidic urine can be the consequence of meat diet, low chloride or acidoses. On the other hand, alkaline urine can cause struvite, calcium carbonate, calcium phosphate, and can be the consequence of alkaline vegetable diet, high phosphate or bacterial infection. PH paper strips can be bought at aquarium stores for personal use. Avoid contact with litter when mesuring, and results must be checked instantaneously.

========

References (as above):
http://adam.about.com/reports/000081_7.htm
http://www.vet.uga.edu/vpp/clerk/sine/index.php (good PH explanation)
http://loudoun.nvcc.edu/vetonline/vet131/urinalysis.htm (more exact PH of cats and dogs)
But there is a chance that for dogs there is variations according to breed. But I don't know.

[francoise_peace]

Yes, I'm worried:

http://adam.about.com/reports/000081_7.htm :
Kidney Stones

- Water. Although water is best, it may vary depending on its source. Variations in water itself may have different impacts. One study reported that drinking hard tap water increased urinary calcium concentration by 50% compared to soft bottled water. On the other hand, mineral water containing both calcium and magnesium may reduce several risk factors for both calcium and uric acid stone formation.

- The most important dietary recommendations for reducing the risk for calcium stones are increasing fluid intake, restricting sodium, and reducing protein intake. A lower risk for calcium stones is also associated with higher potassium intake.

- Fiber may be beneficial for people with kidney stones. In addition, some fiber-rich foods may contain compounds that help protect against kidney stones. A wide variety of high-fiber plant foods contain a compound called phytate (also called inositol hexaphosphate, InsP6, or IP6), which appears to help prevent crystallization of calcium salts, both oxalate and phosphate. Phytate is found in legumes and wheat and rice bran. (Soybeans are also rich in phytate but they are also very high in oxalates, so the overall effects of soy on kidney stones are not clear.)

http://www.catfoodguide.com/long-guide/ :
- Avoid: Soy (along with most legumes and grains) contains large amounts of phytic acid. In fact, soy contains more phytic acid than any other legume or food plant studied. Phytic acid combines with minerals in the cat’s digestive tract, thereby inhibiting their absorption. Again, normal heat processing doesn’t destroy phytic acid.Soy contains phytoestrogens which have been known to cause damage to cheetah livers and reproductive systems. Yes, cheetahs are especially sensitive because they’re notoriously inbred and fragile. However, the soy that caused problems in the studied cheetahs made up a fairly small proportion of their food, and cats in general are pretty sensitive to all sorts of wacky chemicals, up to and including estrogens.

- But try: oats and rice ?

- Didn't found nothing about zucchini (pumpkin, courgette) ?

http://www.vet.uga.edu/vpp/clerk/sine/index.php :

"                                                               pH

The pH of urine can vary depending on an animal’s diet as well as its acid-base status. For example, animals that primarily eat high protein meat-based diets will have acidic urine. On the other hand, animals that eat more vegetable-based diets will have an alkaline urine.1,5

Dipsticks measure pH using methyl red, bromthymol blue or phenolphathalein indicator dyes. These reagents react rapidly and result in a color change. pH can be approximated within 0.5 units using a dipstick. The urine sample should be fresh as urine becomes more alkaline on standing due to the conversion of urea to ammonia by bacteria (if present), and loss of CO2.1

Causes of acidic urine include: meat diet, systemic acidosis, hypochloridemia, and administration of acidifying agents such as d,l-methionine or NH4Cl. 4,5 Urine with high concentrations of glucose may have a lower pH.6 This is due to bacterial metabolism of glucose and and production of ammonia which lowers pH.1

Causes of alkaline urine include: vegetable based diet, bacterial infection of urease-producing bacteria, systemic alkalosis, urine exposed to room air for an extended time (loss of CO2), and administration of alkalinizing agents including citrate or NaHCO3.1,4,5

Urine pH also may provide good predictive assessment of crystal and stone morphology as certain crystals and stones form in either acidic or alkaline environments. Uric acid, cystine, and calcium oxalate crystals are found in acidic urine. On the other hand, struvite, calcium carbonate, calcium phosphate, ammonium biurate, and amorphous phosphate crystals are found in alkaline urine.5

For a more accurate assessment of urine pH, a pH meter may be used. However, for most routine veterinary analyses a dipstick pH reading is sufficient.5
"

http://www.naturalhealthcarestore.com/phdiet.htm :

High Alkaline: Onions
Alkaline: Zucchini
Low alkaline: Soy beans

Low acid: Spinach, Pumpkin
Acid: Potatoes, Corn
High acid: Blackberries*, Milk
(although the other website says blackberries is good against acid ?)

http://www.balance-ph-diet.com/acid_alkaline_food_chart.html :
Each one is assigned a number which mirrors its approximate relative potential of alkalinity (+) or acidity (-) existent in one ounce (28.35g) of food. The higher the number, the better it is for you to eat.
(-> it isn't the PH)

Healthy Alkaline Foods: Eat lots of them!
(...)
Straw Grass +21.4
Watercress +7.7
Wheat Grass +33.8
White Cabbage +3.3
Zucchini +5.7

**
So zucchini (la courgette) is safe because it doesn't contains phytic acid although phytic acid may help, but may cause problems also. And it is a little alkalin.

************************************************************************************************
************************************************************************************************
So zucchini (courgette) cooked in low mineralized water mixed with Science Hills K/D will be fine. Because it will higher PH alkalinity a little and therefore lower urine acidity.
And drinking a lot / for a cat is several times a little / water is also good.
************************************************************************************************
************************************************************************************************

[opus88]

after doing more reading I realize the info I gave you is wrong!!! a normal ph level should be 6.1-6.6 (sited from wellness diet site)....therefor if your kitties is reading 5.5 the urine is already acidic so you don't want to lower this any further....speak with your Vet.

[francoise_peace]

Thanks Opus, my PH paper goes only until 5.5, so I can't know if it is worse. Before she was 6 or 6.2.
Friday morning I'll go to the vet.

[francoise_peace]

For stomach acidity, I'm feeding her little food (case: 1 syringue) 5 or 6 times a day instead of 2 three times a day. Because the cat has little stomach and that makes food calm down stomach without beeing too full or too empty.

For urinary acidity, I just found this night that adding a little cooked pumpkin (courgette / green vegetable) in her food will high alkalinity and lower acidity. Because cats who only eat meat have calcium oxalate problems (acid side) and cats who only eats vegetarian have struvite problems (alkalin side). So a little pumpkin or peas will lower acidity.

[opus88]

hi Franc. a PH of 5.5 is in normal range, but I would watch as you are doing not to let this get any lower...as you say you need to be careful of too acidic a urine and oxolate crystals.
I am glad you've stopped the whiskas cat milk, god only knows what they add to that stuff and any milk product isn't good for kitties digestive system.
You are doing a good job....frustrating tho it is...
♥Opus

[francoise_peace]

I think she is having high creatinine now days because of gastro, because today PH paper was 5.5.
I'm going to keep on K/D wet, although I've ordered Renal Special, but she isn't eating her dry food from long.
I'm going to stop Mercola Complete Probiotics and Whiskas Cat Milk, although I have some at home. Mercola because it was good on #### but it didn't improve her gastro-intestinal problems. Cat Milk, because of risk of Oxalate crystals.
As soon as I can I'll try iFlora Healthy Pets wich is lighter then Mercola 5billions * more than 10 bacterias * 2mg / 2,2. And it is written "Balanced Digestion" on it.
Cellulose isn't only in Mercola, it's also on K/D and plenty of cat foods. I don't trust the ingredient, but I can't say it's the cellulose in Mercola that isn't helping because the cellulose is everywhere. But cellulose might have a negative effect on crystal oxalate.
Really worried.

I'll buy some K/D at the vet for waiting. I don't know what to do about her gastric problems. I can't give her Gastro-Intestinal Moderate because family is right, it isn't appropriate.

[francoise_peace]

http://www.royalcanin.co.uk/vet/clinical_diets/feline_clinical_diets/gastro-intestinal_mod_cal_wet.aspx

So I bought the Science Hills K/D thanks to family participation. But I've also ordered on my side Gastro-Intestinal Moderate Calorie Wet, it should arrive tomorrow. I'll try to convince family to give it to her during a week, so that I hope her gastro-intestinal problems will decrease. I don't want her to die of colitis, it'll be absurde.

I hope they pick the one for the cat, and I hope not to get stolen, and I hope it'll really arrive tomorrow morning.

I had enough of not being able to do something for her !

America is right: you have money, you have health, you have a bank account, you have money ! Really #### !!!

[francoise_peace]

Finally she'll stay with Science Hills K/D wet, family is agains't trying another food. I would have tried Royal Canin Renal with Beef.

It's such a worry when they have diarrhea. But it passed. She ate, she's OK.

[francoise_peace]

Compared with mature:

http://www.royalcanin.co.uk/PDF/neutered_mature.pdf
10+ Protein - FAT = 25
http://www.hillspet.com/products/sd-feline-minced-gourmet-turkey-entree-mature-adult-7plus-canned.html
7+ Protein - FAT = 14,4

Compared with other condition:

http://www.hillspet.com/products/pd-feline-dd-feline-skin-support-duck-formula-canned.html
d/d Protein - FAT = 9
http://www.hillspet.com/products/pd-feline-ld-feline-hepatic-health-canned.html
l/d Protein - FAT = 8,4
http://www.hillspet.com/products/pd-feline-zd-feline-ultra-allergen-free-canned.html
z/d Protein - FAT = 15,5

Relativity in all :)

[francoise_peace]

Hypothesis: High Fat causes diarrhea

Fat comparision for wet:

Protein -minus(-)- FAT % =
K/D can (actual) = 1,9
K/D Pouches = 1,5
Royal Canin Tuna Pouch = 3,8
Royal Canin Beef Pouch = 4,1
Royal Canin Chicken Pouch = -6
Royal Canin Alutray = 4,4
Integra Protect Renal = -4,72
Eukanuba Renal = -24 ?!

So the best is:
Royal Canin Alutray = 4,4
Royal Canin Beef Pouch = 4,1
Royal Canin Tuna Pouch = 3,8
http://www.royalcanin.co.uk/PDF/renal_with_tuna_and_beef_feline.pdf

And avoid negatives:
Royal Canin Chicken Pouch = -6
Integra Protect Renal = -4,72
Eukanuba Renal = -24 ?! (Protein 25% Fat 49% Carbohydrate 26%)

(OK this is really bad publicity........)

[francoise_peace]

3 november 2010, she did 2 big, hard, brown, consistent, with no smell, normal looking (====) and one small, then diarrhea. I think it is IBS because she forced for the 2 first ones.

[francoise_peace]

I'll post a new post on december, when I'll have her new blood analysis. Target is still: get levels back to normal. But even if CRF levels get back to normal, damages are there, and can't get back to normal.

This is relativity. Blood levels says if treatment is treating symptoms. If treatment is treating disease, this we cannot know. All CRF symptoms can be treated. But disease can't be treated yet. CRF BUN blood levels are tricky, if treatment isn't working, you have the actual state of the cat's kidney, if treatment is working on symptoms, it only says symptoms aren't there, but the disease is there, and requires a medicine that treats it without only treating the symptoms.

Probiotics can lower UREA if they contain Kibow Biotics:
S.thermophilus(KB19), L.acidophilus (KB27) and B.longum (KB31)
http://www.kibowbiotech.com/biotics.php

But we don't need to have the trademark Kibow Biotics to have the good bacterias. Plenty of probiotics trademarks contains them like Probiavi, Mercola, Sedona... Cat can be given human or pet probiotics. Just make sure the probiotics trademark is known so it isn't junk. And it is very good when you have CFU/g per spoon or per powder bottle. It is important to have above 2 billion.

Probiotics are safe because they don't have side effects. But giving too much can cause constipation, in my own pet owner opinion. And it can contains extra substances that might not be good for your car, like mold when it is refrigerated or additives. I think FOS is safer then microcrystalline cellulose (plant extract). Psyllium Husk additive is considered by vets as safe also, but it isn't considered that safe for human. FOS, cellulose and Psyllium are prebiotics wich is food for Probiotics that are alive bacterias that need food for not starving.

Phosphate binder like RENALZIN can lower phosphorus wich lowers Kidney function wich lowers UREA.

By lowering UREA, CREATININE gets lower and can get back to normal. If CREATININE in CRF cat is normal, than must be seen as a relativity phenomenon. CREATININE can be normal but Kidney is still damaged and is still necrosing. Only process of necrosing is very very small OR is occuring at normal speed but is related to something else than CREATININE. So blood levels aren't true test.

If you manage to lower UREA and CREATININE at normal levels, you won't know what is going on.

Vet can also lower other symptoms like nausea wich is caused by uremia even if UREA is normal, and stimulate cat's appetite. And neutralise all of the CRF symptoms like CONSTIPATION, DIARRHEA, HUNGER, THIRST, VOMITING, NAUSEA, etc... But even if symptoms are neutralised, the disease is there, and TREATMENT MUST CONTINUE THE SAME AS IF CAT HAD NOT CURED.

A lot of people can make there cat stay alive with junk food that contains by-products like Fancy Feast, for over 3-4 years. Some people can also, if cat eats, make CRF cat stay alive for 1-5 years with specific renal food like Science Hills K/D. And some people have the same results with natural balanced food without by-products and with plenty of innovative ecological food ideas.

Food choice influence 2 things: 1) Health 2) Kidney condition. If food acts very well on Health or on Kidney, than your cat will live longer. But food cannot help both Health or Kidney. I'll advise:
Science Hills K/D wet for old cats. Because they don't move that much and they don't need so much proteins. But the cat must eat at normal quantities. CRF food is often related with ANOREXIA.
I never tried, but since high quality food seems to stimulate health and long living in younger cats that need proteins, I think healthy food would be advised for young cats with CRF. But high quality food might DAMAGE more kidney than CRF food because of digestibility, phosphorus and proteins.

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About stimulating apetite, I have bought all of this:
- a small strainer (passoire in French /  ment for cooking)
- a mini-casserole in the pan (ment for human cooking)
- a hard iron spoon (ment for human eating with it)
- a baby plate (ment for human eating on it)
- a baby bowl (ment for human eating on it)
- empty biggest size syringues (vet or pharmacy sells them, ask a pack of 10 syringues)
- aluminium paper (ment for human food)
- low mineralized water (written: advised for kidney function and seniors)
- CRF food (or a trusted high quality food if you think your cat kidney can handdle it)
- paper towels / or tissue towels for frequent use

The wet canned food is kept in the refrigerator OUTSIDE can, in the BABY BOWL covered with ALUMINIUM PAPER. It is dangerous to keep canned food inside CANS because can gives bacterias that can kill in a day like BOTULISM.

As CRF food my cat takes tree times a day a big SPOON of Science Hills K/D wet mixed with water.

So I take the K/D wet out of fridge, I put it in a mini-casserole, I add LOW-MINERALIZED WATER in the food, and TAP WATER for bain-marie in the pan, at a level where I can take out the miini-casserole.

Heating food in bain-marie is safe and stimulate cat's appetite because it's hotter and it smells better.

Than I pass the food with the HARD IRON SPOON in the SMALL STRAINER, so that the food will be liquid. It all falls in the baby plate.

It is important that wet food becomes liquid, with STRAINER or ROBOT, so that it doesn't SPLASH  on the cat and on the walls when you give her/him the food syringue.

Than I put the medicine in food:
- Morning: probiotics 1/8 to 1/4 of Mercola's Spoon, I suppose it is 0,6 to 2mg, anyway it's less than a pinch to a pinch.
- Noon: 2 pomps of Renalzin (you can also give 2*2 Renalzin in a day if cat is in bad condition with phosphorus)
- Night: 1/2 Fortekor.
Cat medication can change, according to what vet prescribes and to what you think it's better to him. But please always check each molecule in a bottle.

Make sure with SPOON everything is liquid and put in the EMPTY SYRINGUE (without the nail of course, because the syringue is like a baby bottle).

You can give 1 to 3 syringues of food (8-24mg) mixed with water. I'll recommend 2 syringues (16mg) per meal three times a day, but it depends on the cat size. And it will be so good if vets could give us the REAL FOOD AND WATER QUANTITY IN SYRINGUE that a CRF cat that doesn't eat should be GIVEN ?

Put two paper towels under the cat, the syringue on the left or right side of the cat's mouth, and give slowly the food, for th cat to eat while breathing. If the food is liquid enough, there won't be big splashes, and the cat will be less dirty.

Then clean the cat's mouth with humid towel.

I really think the small strainer will have a future in cleaning issues with feedind cat with syringue-bottle.