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Options for Treatment - CRF??
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Options for Treatment - CRF??

Everyone on the yahoo support group tells me that my vet should have reccomended SubQ fluds for Rascal and should also have given him something for anemia due to his lab results (hct). I read about Azodyl and epakitin via a post that you made for someone else and am very inerested.   I called my vet and expressed my concerns and she was willing to move his next blood check up to one week because I was concerned that I was not doing everything possible for him.  I was worried that his condition could get really bad in 2 weeks if he did need fluids and I was not giving them.  I have been trying to check for dehydration by pulling up his skin and also his gums and nose...but he seems to be wet etc.  He has been eating almost a full can of food, drinking regularly (he has always loved water) He has 2 large fountains.  He has been peeing a regular amount as far as I can tell (nothing unusual) and his stool is formed and regular as far as I can tell.  he is bathing himself, seeking attention and playing....he does not seem sick in action or appearance right now.  Any suggestions that you would have for how i should proceed would be greatly appreciated!  This cat has been my best friend and constant companion for the past 13 years and I am not ready to give up on him.  He is too special to me and I want to make sure I am doing everything that can be done to keep him healthy!
Thanks in advance for you help.  Trish & her best Buddy Rascal!
Type of Animal
:  
Cat - Feline
Age of Animal
:  
13
Sex of Animal
:  
Female
Breed of Animal
:  
Mackeral Tabby
Last date your pet was examined by a vet?
:  
February 15, 2010
City
:  
Ligonier
State/Province
:  
PA
Blood Test Results
:  

2/15/2010 10:33am - LaserCyte
RBC * 4.89 M/ul LOW (5.00 - 10.00)  HCT * 24.7% LOW (30.0 - 45.00)
HGB 10.5 g/dL (9.0 - 15.1)   MCV * 50.5 fL (41.0 - 58.0)
MCH 21.44 pg HIGH (12.00 - 20.00)   MCHC --.-- g/dL
RDW 20.6% (17.3 - 22.0)   %RETIC 0.4%
RETIC 21.6 K/uL  WBC 8.87 K/uL (5.50 - 19.50)
%NEU * 78.8%   %LYM 10.3%
%MONO * 6.5%   %EOS 4.2%
%BASo 0.25  NEU * 6.99 K/uL (2.50 - 12.50)
LYM 0.91 K/uL (0.40 - 6.80)   MONO * 0.58 K/uL (0.15 - 1.70)
EOS 0.37 K/uL (0.10 - 0.79)   BASO 0.02 K/uL (0.00 - 0.10)
PLT * 289. K/uL (175 - 600)   MPV * 11.22 fL
PDW 18.4%  PCT * 0.3%
ALP 24 (10-90) U/L  ALT 47 (20-100) U/L
BUN 94 * (10 - 30) HG/DL  CRE 6.4 * (0.3 - 2.1) HG/DL
GLU 101 (70 - 160) HG/DL   TP 8.8 * (5.4 - 8.2) G/DL
QC ok  HEM 0   LIP 0   ICT 0

> 2/16/2010 9:34am VetTest
BUN 78 mg/dL HIGH (16 - 36)  CRE 7.7 mg/dL HIGH (0.8 - 2.4)
X-Ray Results
:  
N/A - None Taken
Other pertinent test results
:  
Rascal was seen on 2/15 for an ear cleaning but ended up being diagnosed with CRF.  He was kept overnight to get IV fluids to flush his kidneys to attempt to bring his BUN and Creatinine down.  He was released the next day but his BUN decreased and his Creatinine was slightly higher.  The vet basically told me it was terminal illness and recommended changing his diet to Hills k/d and gave me epakitin powder to mix with his food b.i.d.  No SubQ fluids were recommended or anything else...She scheduled him to be rechecked in 2 weeks.
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I am sorry that your cat has developed kidney insufficiency but it is very common in the older cat.  

I will discuss a protocol that may help your cat to be able to live happily for the rest of his life.  

Sadly, your vet is correct in stating that the kidney disease is terminal, but , although there is no guarantee,   many cats have survived for years after the diagnosis of kidney disease with rigorous integrative treatment.

The following is an integrative protocol for feline renal disease:

1.  Daily Sub-Cutaneous Fluid therapy

This is either performed at your vet's office, or to be given at home (your vet or veterinary nurse can instruct you how to perform this).  50 to 100 milliliters (depending on your cat’s size) of Lactated Ringers Solution or Normosol Solution.

2.  Azodyl

This is available by prescription from your vet.  

3.  Chinese herbal formula’s for kidney disease

These include: *Rehmannia 8 (also know as: Jin Gui Shen Qi Wan), and/or: *You Gui Wan.  Use  1/8 of a human adult dose.  Since these are common herbal formula's and you may be able to find one specifically for pets, or from the Jing Tang Herbal Company.  The Jing Tang herbal company has these and other veterinary Chinese herbal formula’s for pets.  Your vet should be able to write you prescriptions and you can purchase directly from the company.  Jing Tang‘s web site: tcvmherbal.com.  

4.  Cosequin or other glucosamine/chondroitin supplement.

5.  PhosLo, or Epakitin  

These are phosphorus binder to be used when/if phosphorus becomes elevated in the blood. These should be available at your veterinarian's.

6.  B-complex vitamins, vitamin C and D, and antioxidants.    

1000 mg of Vitamin B-12 should be administered by injection once weekly or lesser amounts more frequently.  If you feed your cat liver, the injections are not necessary.  For the other vitamin supplements,  use over the counter infant or children’s formulas if not available at your vets.

7.  Enalapril

This is an Ace Inhibitor medication, to be used as an adjunct, since it helps to aid in perfusion of the kidneys.  This is available at your veterinarian's

8.  Omega 3 fatty acids

Available over the counter as fish oils.  Carlson’s  is an excellent brand and is a liquid.  Use ½ tsp on food twice daily.

9.  Renal tissue complex

Available in tablet or capsule form from health food stores or online.  Or, you could feed your cat beef , pork or chicken kidney’s.

10.  Epogen

This is an injectable medication for anemia.  It may only help temporarily, however;  40% of cats eventually develop antibodies against Epogen and it loses it’s effectiveness.  There are holistic ways to treat anemia, though.  You could give your cat the Chinese herbal anemia formulas: Si Wu Tang or 8 Treasures.  These are also available at Jing Tang Herbal Company; or, you could feed your cat  beef, pork or chicken liver along with the kidneys.

11.  Keep your cat eating!  

Your cat is eating now which is great, but anorexia and decreased eating are very common in kidney disease at times.  If your cat does becomes anorexic ask your vet for a prescription for either  Periactin or Remeron, which are both good prescription appetite stimulants.  

The Chinese herbal formula‘s: Xiang Sha Liu Jun Zi Tang (also known as Eight Gentleman), or Yu Nu Jian are also very helpful appetite stimulants, especially if the prescriptions are ineffective.  Doses for the Chinese Formula's if only a human formula is available would be 1/8 to 1/4 of a human dose.    And, Jing Tang herbal company has pet versions.

12.  Have frequent urinalysis performed.

Have urine samples checked frequently and treat any urinary tract infection immediately.

13.  Feed your cat high quality, grain free canned or homemade food.  

It has been proven that Hill’s Prescription K/D diet DOES NOT help to slow the progression of kidney disease in cats.  (K/D is helpful for dog’s with kidney disease, however)

As an aside, I will say that the only cure for kidney disease is a kidney transplant.  Specialty veterinary teaching hospitals who perform kidney transplants require that the cat who donates one of it’s kidney’s must be adopted by the recipients household.  The procedure is very expensive and would require long term to life long anti-rejection medication.  

2 Comments
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My homeopathic vet prescribed Detoxosode and some compound formula, bucco/soligar (the latter of which is very distasteful to my cat!)  I also found a website with a formula called Tripsy.  My CRF cat is 20 years old and only developed CRF after his companion, Kittle passed away after having CRF since 2007.  He is receiving SubQ 1.5 ml once a day for dehydration and I am currently hand feeding him with cat milk plus either Nutrical or Felovite, sometimes adding chicken or lamb baby food.  Yesterday, he actually ate a few kibbles from the bowl!  He has regained mobility after being on IV for 48 hours at the vet (non homeopathic) who recommended euthanasia.  I was very surprised to read the vet's comment about K/D NOT HELPING cats!  We have been feeding that since 2007 along with some canned food.  But both cats have been dry food eaters since kittens.
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