Kit Cats & CRF

I have two cats that are brothers from the same litter. Velcro who is black and white, and Marmalade who is orange and white. They are both mixed breed but after some research I think they are at least part ragamuffin. Marmalade was sick once as a kitten shortly after I got them and the vet I had at the time just told me that he was dehydrated and gave him subcutaneous fluids and a vitamin shot twice and he was well. For the 8 years I’ve had them there were really no other problems. I also thought they were only 7 years old until I hunted down the old receipt.

Velcro & Marmalade as Kittens

Velcro and Marmalade as kittens

Text in italics below are what I wrote the day it’s listed because I was keeping some people up to date with his progress.

For reference:
BUN (Blood Urea Nitrogen) should be 10-30
Creatinin should be less than 2

This is not to be constituted as medical advice – please talk to your vet if your cat is sick. I wanted to share this for others who are going through similar situations. I extensively researched kidney failure once Marmalade was diagnosed and found a lot of valuable information.

August 25, 2007- Saturday:

BUN 130
Creatinin 11.7

Marmalade started getting sick the Thursday before. I thought it might be just a little bug or something because he just seemed more tired than usual. Friday he was a bit worse so I started watching that he was still eating, drinking and using the litterbox. I remember noticing that his third eyelid wasn’t opening all of the way but didn’t think too much of it since he was sleeping so much and thought it was just because I kept waking him up. Saturday I noticed I hadn’t seen him drink or eat and when I picked him up from his nap and brought him into the living room and put him on the desk standing, he almost fell over. I knew something was wrong.

I called the vet they had been to as kittens and left a voicemail then I drove down there to check their hours since it’s just down the street and went to the pet store and asked there about emergency care. Luckily there’s an emergency pet clinic down the street and that’s where I took him. 4 hours, x-rays, and bloodwork later they told me he had kidney failure. The x-rays showed that his kidney’s were small and abnormally shaped but that he had acute failure because his symptoms were sudden. They asked about antifreeze, rat poison, toxic plants, and pet food recalls – all were ruled out. They asked if I wanted to put him on an IV and have them keep him until Monday – of course that’s what I wanted and that’s what we did.

August 26 – Sunday:
“I’m picking him up from the emergency treatment center tomorrow morning at 7am and taking him to the vet. The good news is that he hasn’t gotten worse and since he’s been on an IV for around 24 hours now he’s less wobbly and dehydrated so although they haven’t done a second round of tests yet which they will do before they release him to me, he’s not getting worse and he’s probably improving a little. Apparently the emergency treatment center will be leaving in the IV and leaving me with the fluids so he doesn’t have to go through getting the IV put back in him at the vet. He hasn’t been eating but she said that it wasn’t abnormal for a cat in his situation and being in a strange environment.I did some research online today and I’m beginning to think it’s a chronic condition that I never noticed before … I just thought for the last 7 years that he was just an unusually thirsty kitty. He was sick once after I got him 7 years ago and they never really told me what the problem was …
since he got better after being given fluids and 1 round of vitamin shots I never bothered to ask. He hasn’t been sick once since then until now. This is my own personal assessment at this point though but I’m afraid that some changes in food after the pet scare might have made him worse since apparently kitties with chronic kidney disease need a lower protein diet (and the food I switched to is probably higher protein)… and some even need special food which is what I will probably be getting if we can get him improved enough to bring home.
It really was all of the sudden that he got sick though … he started to look not so good around Thursday but he was still talkative … just slept more. Friday he slept more but he was still eating and drinking but there was something odd about his eyes …the extra layer they have seemed to not go back all the way. Then Saturday when he almost fell over it was like “he’s definitely sick … we have to take him somewhere now” and he didn’t struggle with me at all … he had no strength like he usually does. I was able to take him to the emergency center with only one howl and one light kick because he’s a kitty that doesn’t like to be picked up at all.The Emergency center said that the kidney failure was probably due to old age but everything I’ve read on that seems that they if it’s not chronic then it usually doesn’t manifest until they are 10 years old or so (unless it’s one of the few breeds with a shorter lifespan of around 9 years.)I am pretty hopeful at this point but I’m not sure I will have the full story until we go to the vet tomorrow.”

August 27 – Monday:

BUN 237
Creatin 12.0

Monday morning we had to transfer Marmalade to the vet. Because I hadn’t heard back from their old vet and because I was pretty sure he would have to spend the night (their old vet did not seem to have anyone there after hours) so I decided to take him to my parents vet in Versailles. I had also called them over the weekend, a vet tech is always there after hours, and they let me know what time they opened and made a note that he might be coming in on Monday.

August 28 – Tuesday:

BUN 207
Creatinine 9.7

“Quick update:

His numbers are lower! He’s doing better! His numbers are still abnormally high so we’re not out of the woods yet but there was talk of me maybe bringing him home tomorrow (after I learn how to give him subcutaneous
I went and visited him today and he did seem much better. He talked to me (he’s always been a very talkative cat), purred when I rubbed on his head and swatted at me when I got too close to the paw that has the IV in it. Anyway – still keep him in your thoughts and prayers if you can. I was so relieved to hear that he was doing better and how much better he was acting when I went to see him today. Thank you everyone for your support thus far!”

August 29- Wednesday:
We brought him home! He walked like a drunk kitty but he was up walking some. Velcro decided he hated his brother and wouldn’t stop hissing at him so Velcro’s food was moved to the hall and there’s a litterbox in the hall as well. We closed Marmalade in the bedroom with food and a litter box.I had also had the foresight to realize Marmalade wasn’t going to be able to jump into bed and had taken the bed off the frame and boxspring so he could get into bed on his own. Tim and I took turns sitting with each cat.Suggested restricted diet: low protient, phosphorus, and sodium. Hill’s Perscriptives k/d diet recommended by the vet.

Subcutaneous fluids : 150cc
(to keep him hydrated and to help flush out toxins)
Pepcid : 1/2 tablet (5mg)
(for upset stomach, something common w/ kidney failure)
Remeron: 1/4 tablet once every third day
(to stimulate appetite)
Aluminum Hydroxide Gel : 1 cc twice daily
(phosphate binder and antacid)
Suggested restricted diet: low protien, phosphorus, and sodium. Hill’s Perscriptives k/d diet recommended by the vet.

August 30 – Thursday:
“Marmalade had his pills this morning (spat them out the first time, we got them down the second time) – pretty much the same story for the liquid medicine. He also got 150 cc of subcutaneous fluids . that took two attempts as well. The first time we tried it like the vet tech said . really fast. which got us halfway through with an angry cat before he turned swiftly and the needle popped out. Second try to get the remaining dose in him we took slow . he was upset by it but he did not fight us like the first attempt (both times, he didn’t seem to notice the needle going in and seemed to get upset as he started to feel the liquid.)He ate more today than he did yesterday and he perked up when we called his brother for soft food and he ate a little then as well. He hasn’t wanted to drink so I’ve been using a syringe to rub his cheek and squirt a little in his mouth from time to time. He also has been using the litterbox. His paw from the IV is swollen but not tender, he is walking around but he is noticeably weak. He lies down every five feet or so to rest. This evening after dinner, he apparently wanted to act like things are normal and he jumped up in a chair and jumped up on the table. this is the most jumping he’s done since he’s been home since I took my bed apart and have the mattress on the floor at the moment. I didn’t want him to try and jump down so I carried him back to the bedroom (he’s a little clumsy with the swollen foot and not enough energy but he’s not swaying with each step like he did yesterday.)For those I haven’t mentioned it to – his brother is another story, he is upset. They are littermates and have always been nice to each other but since we brought Marmalade home, Velcro has been hissing every time he sees him (which would be why I’m closing Marmalade in the bedroom and Tim and I are taking turns sitting with each cat.) Velcro rarely hisses and I’m not sure if it’s how marmalade smells from the vet, the medicine’s smells, or that I have one very self centered cat that liked the 4 nights his brother wasn’t home. Last night the power went out with a storm and Marmalade went looking for Velcro to curl up with . Velcro wouldn’t have anything to do with him and hissed and crouched in the corner of the room. Note: we have made some progress with this since I began typing this up (I got distracted for several hours and this e-mail has been just sitting here waiting to go out.) Velcro came into the bedroom and hissed a little. Came back in a few minutes later and sat at the opposite end of the bed with me making occasional grumbling noises.Velcro does have a vet appointment tomorrow because they kept drilling me about poisons with Marmalade since he got so sick so quickly. I want to get Velcro checked out just to be on the safe side and also check to see if he has the beginnings of kidney disease (I’m wondering if it’s genetic.) They labeled Marmalade as acute/chronic kidney failure. and I thought typically it was one or the other; acute or chronic not both (maybe I’m wrong .)Anyway – I feel like Marmalade needs more fluids and more quality sleep than he’s gotten but he does seem to be improving. If things continue to go well like I hope, we will schedule a check-up appointment for him on Tuesday to see what his numbers are.”

September 1 – Saturday:
“Cat update for Friday and Saturday:
Velcro’s bloodwork came back normal yesterday so he’s fine (I wanted to make sure there wasn’t something environmental or a missed pet food recall that we needed to know about.) No kidney disease for him. He was upset about going to the vets but he got over it pretty quickly when we got home.
I got an extra bag of fluids from the vet just in case Marmalade starts feeling dehydrated (they showed me how to tell if he was not getting enough fluids.) And they said they were giving him over 300 ccs of fluid while there so a little more than the 150 they said to do would be fine. I also got extra needles since Marmalade won’t sit through more than 100 cc’s in one sitting (I think it makes him cold . we warmed the sub-q fluid in a water bath some this morning but he still wiggled right away and the needle popped out before we really got anything in him so I tried putting a heating pad next to him and we got 100 ccs in him with no wiggling so I think that helped a lot.)Today, we’ve had a lot more eating, a lot more drinking. not enough yet but a huge improvement. Used the litterbox a lot #1 and a #2 today! Also, after some cautious attempts, Velcro is now asleep in the bed and so is Marmalade . no more hissing for the moment . but they haven’t made full contact yet . they are still 2 feet away from each other and often before they would sleep side by side.I have been giving both cats filtered water. Before they loved to drink from the sink but I won’t be letting that happen anymore. I’m thinking about getting them a pet water fountain for the filtered water since they both prefer running water to even fresh in a bowl. I noticed today that they get their long fur in the bowl almost immediately so I’m wondering if that’s why they don’t like it. Still using a syringe to water Marmalade some but he’s also drinking from the water bowl sometimes too. I’m also giving him a little distilled water because I was reading that due to it’s lack of basically everything that it can help remove toxins from the body if used in the short term (long term use isn’t good because you can strip your body of minerals and nutrients and end up with osteoporosis and worse.) I don’t do this near his medication times because I want those to have a chance to work and I don’t know if there’s any potential for distilled water to strip those out.We have a follow-up appointment for Marmalade on Tuesday to check his numbers but I’m feeling more optimistic. We still have a ways to go though.”

September 4 – Tuesday:

BUN 107
Creatinin 5.9

“So we are making some good progress. 🙂

Other things we are looking at are potassium, we need to keep that where it is right now or get it up a tiny bit. Sodium, we are lower today and that needs to remain where it’s at. Phosphates, we’re the same as we were when we left the vet and we need to come down on that some. We will be continuing with aluminum hydroxide gel 2 times a day, pepcid once a day, remeron once every third day, and subcutaneous fluids with potassium now added 150 cc per day (1-2 times a day based on how well the cat cooperates and how hydrated he is or isn’t.) So things are looking pretty good so far. He’s also looking better, acting better, wandering around more and eating more. Can’t get him to eat the special kidney diet so I think we’re going to start seeing what we can adjust about his diet some to decrease the phosphate levels if we can. Maybe add some organic chicken and rice to the regular canned soft food (it will bring the phosphorus levels down if we do this and can get them to eat it still.) This was not the vets suggestion. Also going to see if the company that makes the food they like have a flavor that’s lower phosphate with the same low sodium. I went to buy a pet water fountain yesterday and the two stores that carried them were out. One is supposed to get more in tomorrow and the other is supposed to get more in Thursday. I’d order online but that would take longer and I don’t want to pay for overnight. If I don’t have one by Thursday I will be buying a Drinkwell cat fountain online. I’m happy… we still have to get things lower to be normal and not require all of these pills and fluids but there’s been improvement.”

Friday Sept 21

BUN 55
Creatinin 5.1
Phosphates 7.7
Potassium 4.1

November 5, 2007

BUN 90
Creatinin 5.5
Phosphorus 9.3
Potassium 3.8 – they will add more potassium to the next bag

And I won’t be missing any more days of the sub-q fluids. Between Sept 21st and Nov 5th I missed 1-2 days of sub-q per week and it shows in his numbers here.

Velcro & Marmalade February 2008

Velcro and Marmalade as feb 2008

Marmalade now liks to sit on my lap – something he never ever used to do. He still hates to be picked up but he loves to be held now and on the day of this picture I somehow managed to scoot the laptop down just enough so he could basically sit on all of us (Velcro, myself and the laptop.) I used photobooth to take a quick picture here with my laptop’s camera.

October 20, 2008

BUN 123
Creatinin 8.0
Phosphorus 7.3
Potassium 4.8

Update Dec 1 2008: with winter here Marmalade has become a bit dehydrated. Since it was this time last year that he was extremely sick we were giving him 300cc of fluids then and we have had to go back to doing that now. I think we need additional humidifiers because my hands are drying out and starting to become itchy like they’ll crack soon which can’t be a good thing for the cats. He’s still not terribly bad off … he’s sleeping a bit more, sitting on my lap more which he also did last winter. His chest and stomach fur is a bit spikey but that’s how it was last year too. He’s not having any problems going up stairs or jumping or anything. Next year I’ll crank up the humidifiers earlier because it’s hard to get my house and him re-hydrated. Guess we’ll just have to pay more attention in the fall and winter just like I have to pay more attention to my health during those times as well.

We are at 15 months since his acute kidney failure last year.

Marmalade passed away on January 27th 2009. I will write more about this at a later date.