12 Year Old Cat with Chronic Renal Failure

[sweetnothin]

Hello! My 12 year old female cat had a blood test & urinalysis done a few days ago that indicated she has chronic renal failure. This is her only medical condition and has been showing signs of renal failure for approx. 2-3 years (drinking alot, occasionally peeing somewhere she shouldn't) I really need some advice on treatment.

Her levels that were too high:
BUN: 92 MG
CREA: 4.2 MG
PHOS: 7.9 MG
CA: 11.7 MG
pH(ven): 7.60

Her levels that were too low:
PCO2(ven) 25 mmHg
tCO2(ven): 23.5 mmol/L

The urinalysis confirmed that her urine was diluted and unconcentrated.

My vet decided to put her on Epakitin (3/4 a gram twice a day) to absorb excess phosphate and Rehmannia 14 to stabilize kidney function
I don't really know if Rehmannia 14 is a good idea or not. After a lot of research I've only found that it is commonly used for Cushing's Disease (which my cat doesn't have) & a kidney disorder that involves heating and cooling of the kidneys (which also isn't what my cat has). I don't see how it will stabilize her kidneys...
I've also read that Epakitin has side effects because of it's high amount of calcium, which would be bad for CRF cats.

I personally believe my cat should be on Rehmannia 8, Shut the Sluice Pill, or Azodyl instead of Rehmannia 14. And Aluminum Hydroxide instead of Epakitin. Then again, I'm not a vet, I don't know these things. I really need advice on what I should do... :(

Thank you for any advice, I really appreciate it.

[Dr. Carol Osborne, DVM]

Daily fluids are the most critical part of restoring kidney function!. Aluminum hydroxide is the correct choice to remove the excess phosphorus and would replace the epikacin. B-Vitamins will boost red blood cell production and combat the anemia associated with chronic feline kidney failure. A home made diet with high quality, low residue protein would also be a valid consideration. Azodyl is a probiotic supplement. Probiotics are wonderful for digestion support but have no actual effect on kidney function at all. There are also many full spectrum probiotic supplements available to you that are not only effective for digestrion and absorption of nutrients but also much less expensive. Should you want to follow up on this with me, that would be fine.
Best Wishes,
Dr Carol Osborne, DVM

[sweetnothin]

Thank you so much for your response! I appreciate it so much more than you think! At first my vet told me she had months to live & didn't even suggest supplements/medicines. I really appreciate having advice I can trust.

I'm going to follow your plan, but the only problem I see is with the daily injection of fluids. My cat isn't the calmest in the world and would never let me put a needle in her. Is there something else in powder/pill form that could do a similar job?

Would probiotics or Azodyl be more effective in helping absorb nutrients? If you think Azodyl would be better I'll spend the extra money, I'm willing to do anything at this point, especially because things like the injection of fluids, or anything that has to do with the vet's office are out of the question due to her personality.

Thank you for help!!!

[Dr. Carol Osborne, DVM]

I recommend aluminum hydroxide to remove the excess phosphorus, daily subcutaneous fluids and B-Vitamins to build red blood cells and combat the anemia that occurs secondarily to chronic feline kidney failure.

Probiotics are helpful to promote absorption of digested dietary nutrients. Understand that probiotics are wonderful but have no direct effect on actual kidney function. Many probiotic supplements are available online, through your veterinarian and at retail that are broad spectrum and far more cost effective than azodyl.

A good home made diet with high quality, low residue protein would also be very helpful. If you'f like to follow up on this that would be my pleasure.

Best Wishes,
Dr Carol Osborne, DVM