A Second Guess… Kidney Treatment Tips

Kisses

Since the pet food recall introduced feline kidney failure into our household, friends with cats recently diagnosed with Chronic Renal Disease (CRD, or CRF for Chronic Renal Failure) have asked for suggestions. I’m offering some favorite shortcuts to anyone struggling to help a pet with CRF, and I hope CRF veterans will add even more tips and resources in the comments.

Internet searches may show one person’s favorite treatment included in someone else’s warning. This seems particularly true with regard to some pre-mixed herbal treatments labeled “kidney” this or that. I am not an expert, so I took warnings about certain herbal ingredients as harsh, quite seriously. We all want a quick fix, and maybe some of these treatments have worked for you; I’m just recommending using the Internet or other resources to generate a second opinion for any ingredients.

Of course, please discuss any treatments with your veterinarian.

The CRF sites I visited most often were:
• Feline CRF Information Center
• Holisticat including this article (Holisticat founder Sandy Arora also released a book, Whole Health for Happy Cats, in 2006 )
• Tanya’s Feline CRF Information Centre, a UK site

Subcutaneous fluids seem to enter all treatment regimens eventually. Your vet can administer them, or you can give these at home. Do not feel like a failure if you cannot do this, depending on the squirminess of your cat or your own squeamishness.

My vet recommended setting my cat, Kisses, on something like a washing machine since elevation makes the cat more likely to be still and puts her in your reach, and I found a TV tray worked best for this purpose. I kept the IV bag hanging from a hook on the back of a bedroom door. When it was time for her fluids, I could take her into the room, shut the door and move the TV tray into the corner next to the door. When I placed her on the TV tray and stood next to it, she was boxed in on three sides. Kisses preferred to face the open side, lying down during the injection. Some resources recommend gently warming the fluids for the cat’s comfort.

I enjoyed Dr. Elizabeth Hodgkins’ recently released book, Your Cat… Simple New Secrets to a Longer, Stronger Life. In her chapter on kidney disease, she discusses more than the controversy over low-protein diets; Hodgkins introduces readers to her use of benazepril (an ACE inhibitor) to treat CRD patients. Read her book for other ideas, such as low-dose calcitriol supplementation for some patients.

Hodgkins and others mention cooked egg white can dilute the phosphorus in a meal. (Although I’ve seen mixed opinions on low protein vs. moderate protein, limiting phosphorus intake appears universally accepted.) I did this late in my cat’s illness, and I found she was excited to eat for a few minutes and seemed to keep it down.

Do not hesitate to explore cooking for your pet. You’ve learned how to meet the dietary demands of a human animal, so why not a pet’s? This is not a blanket endorsement of all table foods –- some items such as onion powder can harm cats. You can find feline nutrition information including “dos and don’ts” online or in books.

Here are a few books with specific kidney recipes.
• The New Natural Cat by Anitra Frazier
• Dr. Pitcairn’s Complete Guide to Natural Health for Dogs and Cats
• Home Prepared Dog and Cat Diets, the Healthful Alternative by Donald Strombeck, DVM

Not all cats accept home-prepared meals; some accept them only part of the time. This article from the Feline CRF Information Center mentions some commercial diets; most manufacturers can be found on the Pet Food List.

You can e-mail specific companies to ask about phosphorus content and other ingredients, and Ohio State University’s College of Veterinary Medicine offers an online resource which displays phosphorus, calcium and other ratios within “prescription” brands for comparison. (Click Diet Search, select a brand or brands, and check Reduced phosphorus/protein. And again, not everyone agrees regarding low vs. moderate protein.)

Other books I’ve read recently with portions dedicated to kidney issues include
• Homeopathic Care for Cats and Dogs by Don Hamilton, DVM
• Four Paws, Five Directions by Cheryl Schwartz, DVM

Hamilton’s book goes beyond homeopathic treatments, while Schwartz covers acupressure points and other aspects of Eastern medicine. Her thoroughness makes the book a bit complex but potentially rewarding.

Several resources mention Vitamin C and other supplements. Recommendations on which form (or brand) of supplement vary; try some of the resources above or The Veterinarian’s Guide to Natural Remedies for Cats, a book edited by Martin Zucker. Anemia hit Kisses really fast, not long after a decent blood test. I thought I would notice pale gums when this condition hit, but I did not. At that point, we started her on a liquid Vitamin B/Iron supplement, but I wonder now if we could have tried that earlier. Talk to your vet.

I remain curious about “glandular” supplementation mentioned by Bob Goldstein in The Goldsteins’ Wellness and Longevity Program for Dogs and Cats, as well as his brother Marty Goldstein in The Nature of Animal Healing. (From what I understand, glandulars contain materials from other animals which may function as “decoys” for a pet’s immune system to stop attacking an already affected organ.)

As her illness progressed, my cat began grooming frequently, a sign of stress. Frazier’s book mentions an interesting concept: kidney patients recycle their own wastes during this grooming process, licking dander back into their systems to be digested. Kisses hated baths, so I’m not sure whether I would have bathed her with a castile soap as suggested in the book, or tried using finer brushes to catch and remove more of the dander.

After Kisses was gone, I flinched every time I read about kidney disease, worried a new idea or treatment would plunge me into what-ifs. But with so many treatment options, each person must choose a particular path or method, and make adjustments when needed –- in short, do the best you can. A little internal kindness for the caregiver is important. If we are depleted, how can we have the strength needed to help our pets?

Best wishes to those currently battling a pet’s kidney issue or other health-related demons. You are not alone.

Photo: Candace Schilling

15 Responses to “A Second Guess… Kidney Treatment Tips”

  1. kathy says:

    Thank you!

  2. pat says:

    another great article from Candace. i have a crf cat in residence, and found a lot of good advice and support from the yahoo group feline-crf-support. this very active group has a core of contributors that are knowledgable and responsive to specific questions about interpreting lab test results, treatment options, dietary considerations, etc, in a caring environment. you have to sign up, but if your cat has been diagnosed with crf it’s really worth the effort:

    http://pets.groups.yahoo.com/g.....F-Support/

    as Candace pointed out, there are several treatment options out there and doing research is necessary to find the best regimen for your crf kitty. my little guy has responded well to probiotic treatment… that is, we give him a product called azodyl that sets up a bacterial flora in the intestinal tract that helps to filter toxins, lessening stress on the kidneys. we also encourage him to drink a lot of water to stay well hydrated. this combination has worked well for 14 months, but we know that the situation can change at any time and will ultimately require more aggressive therapies. we’re glad that we’ve been able to give him 14 months (so far) of relatively normal life without sub-q, extra medications and dietary supplements, etc.

  3. Anonymous says:

    Good article. Good resources. My personal experience is that an online support community is a necessity when addressing an ongoing challenge like this. Holisticat is certainly an excellent one. Thanks itchmo and like to see more articles like this.

  4. Gary says:

    Yes, the Yahoo groups are about the best right-now, hands on help groups one can find. With their help, my kitty lived 3 years longer. This was after the vet recommended to “put to sleep within a week”.

    Helen of Tanya’s site also has a Yahoo Group:

    http://pets.groups.yahoo.com/g.....-crf-info/

  5. Gary says:

    One tip I have to make giving subcutaneous fluids (sub-q) a lot easier is to shave the injection area with a electric hair clipper (your vet can do this if you ask). Shave perhaps a 2-3″ area.

    This is especially useful when kitty is very thin and finding the skin fold is difficult. Kitty won’t like it either with someone making multiple needle sticks trying to get it right.

    Some owners do not like the shaved area appearance but the ease of injecting more than makes up for any appearance worries. It’s well worth it.

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  7. NH says:

    Warming the fluid helps too. If it’s too cold, it will freak the cat out. My kitty died 1 year after being diagnosed with kidney disease.

    The Yahoo group mentioned was a very big help.

  8. mittens says:

    now that cats are living longer then they ever had-especially by being kept indoors( wild cats barely live 10 years)- we’re discovering that their unique renal systems very very often break down severely with age alone despite any outside unnatural influences. it’s one of the main reasons you shouldn’t fed your cat only dry food- not getting enough water compromises their kidneys. lifelong the damage can be fatal. cats are particularly susecptable to things like the poison pet food because of their relatively delicate renal systems which in fact evolved in the desert.

    i found Tanya’s CRF site very helpful as well as my vets startlingly truthful assessment of cat food vis a vis their renal systems. i decided in the end it was completely unfair of me to have the treatments descend into torture of a cat whose time had come- she was 18 and the fact is once the kidneys functioning is cut by a certain percentage it does not come back and herbs and pills and sub qs arent helping but prolonging a life whose natural end has arrived. but this is a personal decision and depends on the animal and it’’s will and the physical realities of the amount of loss of functioning. i find my cats have told me when it was their’ time’ and i could never explain that feeling- you just know.i never thought i’d be able to jab any of my cats with a large bore needle and now i know i am capable of much more then i ever expected.

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  14. stefani says:

    My experience has shown that fluids twice a day (half the daily amount in each sitting) works even better than fluids once a day. Keeps the hydration more consistent. Just a thought . . .

  15. Anonymous says:

    Interesting article. Two corrections:

    Tanya’s site is not a UK site. Its owner, Helen, is English but she lives in the USA. Tanya’s site is actually suitable for people all over the world, because she gives bloodwork details for both US and international measurements - no other site does this.

    Excessive grooming may be caused by itching. Dander is also common in CRF. Tanya’s Index of Symptoms and Treatments provides good, proven treatments for these symptoms which work far better than a bath.


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