Linda's Feline CRF Hints
This section is mainly for those of you facing CRF for the first time. It tries to answer some of your initial questions. I have made editing changes, as Cynthia requested.
Cynthia compiled this information, which was written by Lynn T, Cindy G, Jim Hayes, and Saundra. All are members of the CRF-Support group. Elizabeth created the free record book
Your kitty has just been diagnosed, and you have many questions. This is a disease, but there is good news; it's treatable. There is no cure at this time, but many kitties can live and feel well with this disease for years.
I think one of the most important things to do is to learn as much as you can, so that you will be able to help your kitty to be as comfortable as possible for the rest of their life.
The learning will also help you come to terms with the disease and help you deal with problems that can arise so you will be better equipped to handle the emotional roller coaster.
It's up to you to overcome the fears of treating this disease. KNOW that what ever you are doing for your kitty is helping your kitty not hurting him/her.
Making sure you understand that your vet is really important. You may want to ask your vet if they are up to date on the latest treatments and medications. How many kitties do they see a year that have renal failure and what is their survival rate? You may want to look for a specialist in this field.
When your vet prescribes a medication, he/she (or the pharmacy) should give you a fact sheet on the medication, so you will know what to watch for if your kitty seems to be having a reaction/side effect to it. Will it cause nausea, vomiting, loss of appetite etc?
You may want to take a tape recording to each vet visit, so that you can play back the information later. You will receive information and answers to your many questions and sometimes it's just too much to remember.
Fluid therapy will be required at some point; this will be your choice and a decision between you and your vet. Dehydration is the primary reason for
fluids/Sub-q's. The simple fact is that when water is lost, it needs to be replaced. Since the kidneys lose their concentrating ability, more liquids are required. There will come a time when a kitty simply cannot drink enough water to stay hydrated.
Understanding Secondary diseases, problems that come with CRF.
Learn about Fluids and Hypertropic Cardiomopathy and its dangers. The beginning stages of cardiomyopathy occurs when the left ventricle heart muscle begins to thicken causing less blood to pump to the body and other organs. This is not good for the kidneys since they need as much blood flow as possible so they do not have to work as hard, thereby, helping the remaining functioning parts of the kidney to stay as healthy as long as possible.
Checking kitty's blood pressure. Retinal tearing (or detachment ) is usually thought to result from long-term elevated blood pressure. Pupils that are different in size or don't respond equally to light increase/decrease are both indicators of high blood pressure.
A cat's heart normally beats from 120 to 240 times per minute,120 to 160 would be in normal range. This can be checked at the vets, or you could check with a stethoscope.
Heart murmurs -- you need to get to the bottom of the cause of the murmur by having an ultrasound (sometimes called echocardiogram) of the heart to see if there are any abnormalities that can and should be treated with heart medication.
The above information is important to know and be diagnosed properly before giving high volume fluids/Sub-q's. Fluids can be dangerous if too much is given when heart complications are present.
Know about Blood Values and their meanings; for what should your vet check. Blood values are one of the best indicators of how well your kitty is doing.
A full blood panel is usually is done only every two to four months, unless there is a problem. For a little extra cost a full blood panel can be done more often, and you can save the stress of having to take your kitty back to the vets.
For example, high liver values might have something to do with Hyperthyroidism. If blood for the T4/T3 test was not taken at the same time, you would have to have another blood sample drawn. Also ask your
vet to freeze it any blood that is left over, this way if they need to double check a blood value they will already have the blood, giving your kitty a big break.
If you are taking your kitty in weekly for a certain test make sure your vet takes a little blood as possible, too many blood draws can make a kitty anemic.
Here's a list of the most important blood values: Ranges may vary from lab to lab.
NAME NORMAL RANGE
ALBUMIN 2.50 - 3.50 U/L
HEMOGLOBIN 8.0 - 15.0 g/dl
ALKALINE PHOS 6 - 111 U/L
OSMALITY 299 - 330
ALT/SGPT 10 - 130 U/L
PACK CELL VOL 24% - 48%
ONION GAP 13 - 27
PHOSPHOROUS 2.40 - 8.20 mg/dl
AMYLASE 100 - 1500 U/L
POTASSIUM 3.40 - 5.80 mmol/l
AST 10 - 100
RED BLOOD CEL 5.92- 9.93
BUN 14.0 - 36.0 mg/dl
SODIUM 145.0 - 165.0 mmol/l
CALCIUM 7.80 - 11.30 mg/dl
T BILIRUBIN 0.10 - 0.50 mg/dl
CHLORIDE 104.0 - 129.0 mmol/l
TOTAL PROTEIN 5.20 - 8.90 g/dl
CHOLESTEROL 65.0 - 225.0 mg/dl
T4 0.8 - 4.0
CPK 56 - 529
TRIGYLCERIDES 25 - 160
CREATININE 0.60 - 2.40 mg/dl
WBC 3.5 - 16.0
GLOBULINS 2.30 - 5.30 g/dl
GLUCOSE 64.0 - 170.0 mg/dl
URINALYSIS - USG Urine Spacific Gravity - Concentration Ability
Knowing about Food Aversion, Vomiting and Gastric Ulcers.
If your cat doesn't eat for a period of 12 to 48 hours there is a danger of Hepatic Lipodosis. It is extremely important to make sure your kitty is eating something, even if it is not always possible to have them eat "good CRF" food. If they are rejecting all foods you should talk to your vet immediately.
There are several reasons why a kitty is not eating. Nausea is a main one; reasons for nausea may be dehydration, constipation, gastric ulcers, or medications.
There are a number of treatments that can be used to treat nausea. Pepcid a.c helps eliminate acids, Periactin is an appetite stimulant. Slippery Elm Bark a supplement is known to have soothing abilities.
Dehydration, can make a kitty feel very ill and nauseated. It's important
to learn how to tell if your kitty is dehydrated. Pulling up the fur alone will not give an accurate idea if your kitty is dehydrated. Run your finger across your kitty's gums; they should feel slick and slippery. If the gums are dry or tacky (sticky) your kitty need fluids right away; contact your vet immediately if you do not have supplies at home for hydration.
Constipation is also very serious and must be looked into right away. Most kitties will go to the litter box at least once a day. It's important to keep track of this. Straining and vomiting can occur with constipation, which is very hard on all organs. There are several treatments for constipation. Adding fiber such as babyfood peas, carrots, squash etc. Lactulose is a prescription medication that you can ask your vet about. Supplements like Slippery Elm Bark have been known to help with both Constipation and Diarrhea.
High Blood levels of Phosphorus can be a cause of nausea; this is one reason why our vets encourage us to feed lower protein foods. Its important
to maintain phosphorous levels in CRF cats in the middle of the normal range which would be around 4.0. If the number rises you should ask your vet for a Phosphorus Binder, to help lower the levels. Some known phosphorus binder are; Basaljel, Alternagel and Phoslo.
Making sure your kitty is absorbing fluids and urinating; this is really
important. If your kitty is urinating out of the litter box, a urine sample should be taken to make sure there is not an infection.
Its important to know that your vet is made aware of how you want to treat your kitty with this disease. And how far you are willing to go. Unfortunately there are vets out there who are not up to date on the latest treatments. This is why its important to know and learn everything you can.
Remember, equal time for your other pets too.
And remember that animals have a unique way of hiding their illnesses, and it would not be a bad idea if you keep a record book of your kitty's progress each day.
Controlling Phosphorus is 100% necessary for maintaining life.
Check blood pressure. Basic testing for people, but too often ignored for cats.
Elizabeth has created a free record book (PDF format); you need Adobe Acrobat to download the PDF file. There are instructions for putting together a book, transferring labwork results to the charts, etc. Make pockets for copies of labwork. For some reason I can't link this to my website, so you'll have to cut and paste.to your browser. http://www.geocities.com/~pawsplus/vetrec.pdf