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    Posts Tagged ‘chronic renal failure’

    Treatment for Feline Renal Failure


     Providing Treatment and Comfort for your Cat with CRF


    Four little letters - HUGE imapact on Feline Treatment for CRF or any malady!Learning that your cat has kidney disease can be devastating.  There is no cure, other than for a successful kidney transplant.  The diagnosis of feline renal failure is not an immediate death sentence, however.  Unless a cat is suffering from dire pain with no hope of relief or has lost all kidney function, we can usually help our sweet feline friends to  extend their days with us and enjoy some quality time basking in attention and love.


    Usually, a cat with kidney disease becomes dehydrated from increased urination and its system requires a cleansing from toxins with rehydration, which the vet will do at the clinic or hospital.  Subsequently, to keep your cat comfortable, additional hydration via a subcutaneous IV drip will likely be necessary. This often can be handled at home with proper training by your vet. We have become adept at this procedure, which can be learned easily, and has proven very helpful in the treatment of our special furry patients. Antibiotics were also usually part of the feline renal treatment regimen to fight concurrent infections that developed. Additional medications are available to help reduce nausea and encourage appetite.


    In addition to fluid therapy, the likelihood of anemia is addressed, along with additional feline treatment procedures for modification of phosphorus and calcium, the management of hypertension, any nausea and diet therapy.


    CRF Requires Increased Amount of High Quality Protein for your Cat – Newest Vet Advice


    A high quality low protein prescription diet has been a standard recommendation by most vets for CRF.   Such prescription diets can be obtained from your vet  (other high quality protein canned cat food can also be used…read labels!) and it is still a standard  recommendation by many vets.  Low protein diets have been thought to put less strain on the kidneys, which  have to filter the acids and residue of protein breakdown from the cat’s systems.


    However — Note that reducing the intake of  protein is increasingly NOT considered a good thing by more and more cat care experts. 

    They recommend the exact opposite —  (More) high quality, human grade protein  not less protein… but with  lower than normal levels of phosphorus and sodium …as essential to your cat’s health and extended life.  Be sure that the protein is of prime quality. Low protein nutrition is now even viewed as detrimental to the further well-being of an ailing CRF cat.   Further recommended for optimal health, whether healthy or sick, is a raw food diet, which is closer to a natural, ancestral diet.  This option may be difficult for most, and when providing homemade fare, we must be very careful to include all the necessary vitamins and nutrients required for a balanced diet, as missing even one essential component can spell big troubles.  Without exact recipes, it is safest to purchase commercially produced raw food from a specialty pet food store.


    When we are steeped in the new routines of care for our sick animal, preparing food each day may be the last thing we are able to consider.  Thus, finding premium moist canned food at your specialty pet store  may be the best solution.  Also, if your pet is not used to raw food, it may be an inopportune time to introduce it, although it is held to be so highly beneficial.


    Always Read Labels


    High quality protein in premium catfood is essential to your cat's health.When purchasing high quality protein canned cat food,  look for the first ingredient on the label to be ‘real’ meat, specifically stated as ‘chicken’,’ turkey’, or ‘salmon’,  for instance, on the label…and not a more generic ‘meat’, meat byproducts (horrid!), or even just ‘poultry’. These terms indicate quality far less than high grade. (Higher quality foods may also have turkey or chicken meal  listed on the label,  for instance, often found as a second or third listing ) And look for grain free components, no preservatives, colorings or additives.  This is ‘high quality’,  high protein fare recommended in the newest veterinarian advisements based on good research. Check for the percentage of protein on the can as well – although this can be deceiving to calculate.


    Here is an excerpt from an article by Dr. Karen Becker DVM –  Integrative Animal Care  Expert –  concerning the need for more  (high quality) proteinnot less – for cats as they age,  as well as focus on problems created by  low protein diets for cats with CRF suffering decreased kidney function:

    … in 1992 Dr. Delmar Finco, a veterinary nutritionist, discovered protein requirements actually increase as pets age. Even in animals with kidney failure, restricting protein didn’t improve their health or longevity.

    In fact, Dr. Finco’s research proved cats on low protein diets developed hypoproteinemia. They had muscle wasting, became catabolic, and lost weight. The more protein was restricted, the more ill these kitties became. Fortunately, Dr. Finco discovered it was the level of phosphorus in foods, not necessarily the amount of protein that exacerbated kidney disease.

    Since that research was published, veterinary recommendations have changed. What we’re recommending for animals struggling with under-functioning kidneys and livers is that you feed really good quality protein that is highly digestible and assimilable.

    We also recommend you restrict phosphorus in the diet, but not necessarily protein.

    We know that cats and dogs, as carnivores, require lots of high quality protein not only to maintain good organ and immune function, but also to maintain healthy muscle mass as they go through life and the aging process.


    Your vet can prescibe and provide the needed Phosphorus binders  for the essential reduction needed in feline renal failure treatment and you can buy them online.


     Cats with CRF May Reject Food

    Here at the Sanctuary, in most cases, as the disease progressed,  I had to hand feed after certain stages, since the cats were willing to eat, but lacked the interest or energy to do so on their own.  The use of some food or larger syringes obtainable from your vet or pharmacy makes this process simpler. Some wavered back and forth from acceptance to rejection at times on different days.


    • Diluting the canned food with additional water or broth will make the use of the syringe easier, and the additional fluids are beneficial to a cat with CRF.

     I recommend it.  None of my cats with kidney disease were interested in –  nor could they really even eat on their own – food that was not additionally moistened to a  thin pudding-like or even  soupy consistency.  The more you dilute, the more feedings you will have to give to get a full day’s ration down, or as close to it as your cat will accept.  But again, the fluids are needed and helpful.  So feeding more times a day, smaller feedings should be planned out.  The need to balance the liquids with the additional “bulk” of  food it produces has to be balanced so that your cat can manage a full day’s ration, or as close as you can get.

    If your cat refuses or rejects your attempts to feed, please stop and try later.  If they continue to refuse food, or you’re only able to get a couple of tablespoons down for the day, try again the next.  But it is essential that your cat  receive enough nutrition to go on. At first they may feel too unwell to take in more.  But if you cannot get more into them in two days, consult your vet.  Your cat may be nauseated and require something to alleviate it.  Meanwhile, if they won’t eat food,  try  syringing broth and even diluted high quality yoghurt.  Anything you can get them to eat at this stage and not vomit is good calories. If you need to entice them with some lessor quality store-shelf type catfood, and they accept it, consider it success for the day.  But work up to the quality food and try to increase their intake a little every day if possible.


    High quality protein is now increasingly deemed essential protocol by cat nutrition experts for the health of your cat with CRF.It may take a few days before you can get a decent portion consumed.  You need to balance the food intake with the meds as well and be creative if needed about keeping them both from being vomited.  But with patience and some time, assuming your cat is not checking out, it will improve.


    • Take the day’s ration for your cat divide it into 4 – 6 portions or more as needed and dilute it as you go.  You will also be able to monitor how much of the ration your cat has eaten by keeping it separate.  You can rank each day against the next to determine progress or possible decline.  But sometimes they will eat more, sometimes less, depending on how they feel that day.  Or if they become constipated for some reason, whether lack of fluids, less activity or some other reason, they will not likely want to or be able to eat as much.


    For that reason, observe your cats’ toilet habits and watch that they ARE eliminating.  Not only urine, which will likely be profuse, but also solid waste. If your cat is not eliminating solid waste every day, contact your vet for something that will help them.  Here, I’ve used up to a tsp. or more of pure virgin olive oil mixed into their food, or a tsp. or so of pumpkin or even  a finger full of some white petroleum jelly (be sure it is unadulterated WHITE petroleum jelly.  Don’t use if in doubt!)  if nothing else was available.  There are also some herbs that can be used, but I prefer olive oil or pumpkin. Herbs can be quite strong tasting and a challenge to use with your cat, but they can be effective.


    If you aren’t able to facilitate a bowel movement in a day or two, call your vet!  There may be blockage that will need to be addressed.  And perhaps more fluids are in order – or more often.


     The Only Current Cure for Feline Renal Disease / CRF


    Recently, kidney transplants have been successfully accomplished in cats with feline renal disease. The procedure is not common, is expensive, and post opertative care requires  significant commitment from the caretaker. But it does offer hope.  A big question of consideration is the ethics and procedures of how and where donor kidneys may be accessed….a topic for further review. ( Some Further resources for your consideration of feline kidney transplants are available here.)


    Am I Making My Cat Suffer by Extending its Life with CRF?


    Proper management of feline kidney disease symptoms will help to lengthen the number of days, months or years you can enjoy your beloved cat – and your cat can enjoy you with far more comfort to truly appreciate their extended days.   The disease will progress faster in some cats, slower in others, but the help you give,  along with informed management of the symptoms and condition will certainly go far in providing a longer, quality life with your cat.


    I’ve  put forth the efforts more than once, and although it can take some good effort and  work, I have NEVER regretted it  – and our cats have shown over and over their definite affection, and I believe without wisp of doubt, their appreciation for our extended love.


    Please understand that prolonging the  life of your cat with feline renal failure is not prolonging pain or agony! 


    To get a handle on what my cats might be feeling in order to make a decision the first time CRF was encountered, I looked for information about what a human patient experiences with kidney disease.  Based on reports from human victims of this diease, they cite experiencing a general ‘out-of-sorts’ or ‘unwell’ feeling.  Feeling under par — but not pain.Dehydration contributes to an overall unwell feeling for your cat.Dehydration is often a symtptom of feline renal failure.As anyone who has experienced dehydration can attest, it makes you feel ‘uncomfortable’ with an overall spacey or headachey feeling and sometimes nauseated.  That’s also why treating your cats regularly with sub-Q fluids is important to their comfort, and which alone has been observed over and over in our Sanctuary to make significant improvement in our cat patients.  It is relatively simple to do and one of the most cost-effective and less expensive therapies that make a difference in the well-being of your cat. (You can obtain fluids and needles with a prescription from your vet from certain ‘membership’ shopping clubs like Sams at big savings.  The set up I purchased from my vet.)


    Even though cats are good at hiding illnesses, none of our cats ever showed any level of pain during the course of their kidney disease, except if they had become constipated.  And that was a function of constipation, not other  feline CRF symptoms, and could be addressed easily.  On the contrary, they responded normally to stroking, cuddles and other normal affection. they slept more than usual, which is common, but they never winced or cried when probed or checked by the vet or picked up by us or anyone.


    There is no dire pain involved with CRF per all resources and face-to-face experience.   A cat patient with kidney disease may experience weakness, nausea and general discomfort or lethargy, but in no way are we subjecting them to undue agony or painful sensation. At the very end stages, should complications or convulsive behavior arise, there may be some pain sensation.  But my cats have all died in my arms basically, and there was no undue pain observed or anything abnormal or over and above the ‘normal’ dying process.


    Old Attitudes Die Hard

    It can be quite distressing to hear someone comment to others that  ‘that animal should be put down…it’s dying..or in pain..and… ‘this is cruel’! I’ve overhead this said about others in vet waiting rooms, as pet guardians struggled in the treatment rooms with dark emotions, warring with themselves about the ‘right’ thing to do..and not wanting to let their pet ‘suffer’ while  questioning ‘selfishness’…etc.


    It is a nerve-wracking, devastating emotional upheaval and such uninformed comments may be based on years of ‘conditioning’ in  sometimes all too ‘needle happy’ environment. Such attitudes are perpeutated, perhaps, as leftovers from times when helpful protocols weren’t as possible or available as they are today with the advancement of medicine and a host of other holistic treatments we can access.  Along with additional means to treat our pets at home.  Once an ‘idea’ or ‘attitude’ or ‘perspective’ becomes established and status quo,  underscored by vet recommendations, it is hard to eradicate if and when something comes along that trounces it.


    One can imagine that some vets might recommend euthanasia due to belief that a pet custodian won’t or cannot care for the animal properly to assure its comfort…and to possibly curtail such ‘suffering’ on the animal’s behalf.   At other times, instances have been witnessed and comments overheard, that a companion animal (that was definitely a candidate for some simple at home care) was ‘put down’ simply because the guardian didn’t want to deal with the ‘effort’ or ‘ mess’ that might be involved.


    Take  Some Time  – Don’t Be Pressured into Life-Death Decision

    Providing hospice care for your beloved cat with feline renal disease is a noble act of Love.Hopefully these resources will help you to understand that your desire to help your pet continue its days is not a selfish thing – but a noble act of love – all things considered for each individual animal and their stage of kidney disease or of any condition.

    Don’t beat yourself up.  Stop – Breathe – Take Some Time

    Don’t be pressured into making a hasty decision that cannot be undone.


    Unless your pet is writhing in pain or other serious forms of pain and distress which cannot be alleviated in due time with anything in the command of modern medicine or holistic treatments in the opinion of a trusted vet…you don’t need to make an immediate decision. (And you might consider leaning toward the possibility of trying something to alleviate any witnessed distress or pain in any case, based upon the review of a competent vet’s advice , since we never know how any individual will respond to treatment for  feline CRF or any disease. especially once back home.)


    Take your pet home with some medications and protocols that will help with their comfort and treatment for CRF.  You may be very surprised to find Take your cat home - give the CRF treatments time to work. how much better your animal responds when back home again, and given a chance for fluids and meds to ‘work’.  After all, we all have heightened responses when in a doctor’s office.

    Our beloved animals experience perhaps far more stress because things cannot be explained to them with words.  They can only feel the unusual probing and poking  by strangers, the unusual smells, the foreign sounds and perhaps barking and meowing of other animals in the facility… all extremely stressful…. and have reactions that make things look far worse than they are.


    If you have any doubts and feel you are able to properly care for your ailing luvbug, (even perhaps with the help of family or friends if necessary –which people often forget to think about) and/or don’t feel that your vet is knowledgeable enough about Chronic Renal Failure  – or perhaps not supportive-  enough to agree to treating your cat with available protocols for feline kidney disease, then do feel free to seek the opinion of another vet and consider a change of practitioners.


      Give Your Cat Time to Recoup from CRF Set Backs

    It may  take some time for progress to show, especially with a dehydrated animal, which needs time to regain its stability with renewed hydration and supportive treatment for kidney disease.  And if they haven’t been eating much or at all, which is likely, they are weakened, likely anemic,  and it will take some time, starting with smaller daily portions of food than normal and then building up before their beleagured systems can appropriately respond.  So don’t give up if there is no overnight ‘sensation’ of progress!  Think about how you respond and recover when feeling ill.


    Since the kidneys aren’t able to remove the toxins they are meant to eliminate, your cat will drink more and more water to compensate and urinate more in this ersatz cleansing process.  With time, it won’t be able to drink enough and toxin levels will rise with the progresson of CRF.  Again, subcutaneous fluids (injected beneath the skin)  are highly needed.



    Prepare Yourself for Some Pain


    Prepare for the inevitable ..the final good bye to your special cat.There is pain that one must accept from the start —  that after the extra loving efforts and hospice care you give for treatment and comfort for your cat with CRF,  you will need to say good-bye at some point —  and you must weigh how well you can handle that grief.  It is never easy, even when you know the day is coming.  But I will never regret the gift of all those extra days, some many more than others, some only a few weeks.  When you know your special furball family members, you will learn to read their desires as well.  And I know my cats wanted to live on…and they let me know when they wanted to go.  Some waited so that I could be with them, some decided to go during the night or when I stepped outside to handle chores. They never lingered long enough to ‘suffer’ after their bodies and their will were no longer strong enough to go on.


    Had there been any sign of unrelievable distress or pain or undue discomfort that would only linger and not be relieved, then the decision to help them beyond this would be undertaken. And I know they would have let me know through their behavior,  interaction adn personalities that they were ready to move on if unable to do so on their own.


    The Gift of Time – More Special Love During Feline Renal Failure treatment

    If you think about it, even though you know a very sad day is coming, this too can be a blessing, because you can prepare and provide any extra or special attention you may long to give to assure them of your devotion and gratitude for their love before they pass on.  And all of our companion cats and pets will pass on some day, so knowing in advance that your days together are shortened,  there is opportunity  to provide some extra time and spend those days in special loving attention and mutual bonds, which is a great gift.


    If you are committed to the long-term well-being of your sweet cat, there is no more reason to put her/him or any other beloved animal ‘down’ than there is a human patient with the same affliction.  Even though far more subdued, our cats all showed interest in seeing us most every day, appreciated our attention, and after regaining some stability, they even asked for food at times and accepted it without incident the rest.  We were always careful to respect their need for peaceful repose and an out of the way refuge with easy access to anything they needed, where they could feel secure and comfortable and away from the normal din of the every day.


    Be sure to provide all the necessary things such as a comfortable cat bed,  (with low sides for easy accessibility) clean, fresh water at all times and easy to access litter box – or simply a rubber boot tray if necessary, covered with newpapers.  Your cat may be weak and not able to climb over the usual litter box sides.

    Keep them comfortably warm but not hot.  Some like a cool area to lie from time to time as well.  So observe and think ahead about what they need to keep them functioning as normal as possible with their new weaknesses from feline renal disease and things will be fairly routine for you in no time, despite some possible day to day changes in your ill cat.


    Subcutaneous hydration via IV is simple to learn for most and very helpful to a cat with CRF. Learning the helpful technique of subcutaneous hydration, committing to hand feeding when it becomes necessary, being ready and able to adjust to any changing needs from day to day, administering any necessary medications and/or holistic alternatives and providing a quiet, secluded sanctuary where your cat can continue to enjoy your special care and love will go a long way to helping your cat enjoy its waning days with you…and give you both more good days, months or years of love and quality time together before you must say good-bye.




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