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Dr. John
Dr. John, Texas Veterinarian
Category: Cat Veterinary
Satisfied Customers: 8578
Experience:  Over 12 years of clinical veterinary experience
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My 17 year old cat has been diagnosed with a urinary tract

Customer Question

My 17 year old cat has been diagnosed with a urinary tract infection and kidney disease. Our vet said on a level of 1-4 (4 the highest) Lucy is between a 1-2. Dr. Osborn prescribed antibiotic for the UTI and subQ fluid for hydration. Lucy hates for us to give her medicine and is not a cat which likes to be held. She is an indoor kitty and has arthritis in her spine. She moves well and jumps on surfaces, such as the bed but is somewhat cautious. Buprinex was prescribed for the arthritis pain. She has lost 2 lbs since her last vet visit and is narrowed through the hips. We attributed age initially but no doubt this was due to kidney disease.

My husband and I cannot see poking and sticking her for the remainder of her life to provide fluids but neither do we want to deny Lucy a good life. Our feeling is the subQ treatment is just postponing the inevitable. We have changed her diet to Royal Canin renal canned feline food, of course fresh water (she has always received bottled water) and a supplement of organic stewed chicken, rice, broth and canned pumpkin. We are seriously considering not doing the subQ and buprinex. Lucy is not howling and is thoroughly enjoying her chicken every night.
I just lost my precious 9 year old tabby, Phoebe (Dr. Bob helped me) when she died suddenly due to lung issues during dental surgery. Now Lucy is ill. We have been blessed to have these two furry family members for a long time but the thought of losing them both is heart breaking. However trying to keeping Lucy with us longer for the sake of our need seems selfish. We are under the mind set of doing as much possible through diet and behavior without doing extreme measures.
Your thoughts?
Submitted: 1 year ago.
Category: Cat Veterinary
Expert:  Dr. John replied 1 year ago.
Hello. My name isXXXXX will be happy to help you. Chronic kidney failure (CRF) in cats can be very difficult to deal with. It is possible that the kidney problems may be secondary to the infection. Treating the infection may improve kidney function. I would recheck the enzymes after finishing with the antibiotics. If still elevated, the SQ fluids are really a good choice to keep the kidneys flush. It can give some cats a lot more time. I have seen cats last for months to years after diagnosis of CRF when giving regular SQ fluids. I always tell owners that it is worth a shot to see how it helps. There are some cats who get too stressed out for SQ fluids and fight it. At that point, it is probably best to just stop the fluids. You can also talk to your vet about trying a medication called Azodyl. It helps with intestinal dialysis to bring down kidney enzymes. Some cats start to loose too much potassium and have elevations in phosphorus. Medications may be necessary to control those values, which will help to improve health. Eventually, the condition does progress. Diet therapy with low protein and low phosphorus diets do help. Please let me know if you have any other questions or concerns. Hope this helps.









My goal is to make sure that you get all your question answered and all the information you need. If you are satisfied with my answer, please rate it. If you feel like it is not helpful to you, or if there is more information you need, please respond back to me before rating. Realize that our conversation is not intended to diagnose or treat a condition. There has to be a valid veterinary-client-patient relationship established with an exam, according to law. You should always follow up with your vet.
Dr. John, Texas Veterinarian
Category: Cat Veterinary
Satisfied Customers: 8578
Experience: Over 12 years of clinical veterinary experience
Dr. John and 2 other Cat Veterinary Specialists are ready to help you
Customer: replied 1 year ago.
Do you feel the diet I have her on is benefical or a detriment? I am going to have Lucy checked again in one month (she was just diagnosed this week.) And I will mention the medicine. Our initial visit, including x-rays on her spine are in excess of $600 so doing testing on an as needed basis is essential. Thank you so much.
Expert:  Dr. John replied 1 year ago.
You are very welcome. I would try to avoid the chicken because it is higher in protein. Increased levels of protein in can cause worsening of kidney function. If on a prescription kidney failure diet, it works best if that is the only food that they eat. Adding other stuff defeats the purpose of controlling certain ingredients that contribute to kidney problems. Let me know if you have any other concerns. Hope this helps.










My goal is to make sure that you get all your question answered and all the information you need. If you are satisfied with my answer, please rate it. If you feel like it is not helpful to you, or if there is more information you need, please respond back to me before rating. Realize that our conversation is not intended to diagnose or treat a condition. There has to be a valid veterinary-client-patient relationship established with an exam, according to law. You should always follow up with your vet.
Customer: replied 1 year ago.
I had given you a rating and hopefully payment was received through Paypal. I will check to make sure. Your answer, while informative, was basic information I had obtained through internet searches. I am still confused about the appropriate diet my cat should be on as there is conflicting information on cats with her numbers. Her RETIC is 52.0 K, BUN - 39 mg/dl andn CREA 2.8 mg/dl. She was diagnosed with a kidney infection and has been on Clavamox drops. From what I have gathered Lucy is right on the edge. If I go high protein it could have an affect on her kidneys. If I go low protein it could result in malnutrition. Royal Canin canned and dry was sent home - just read about poisoning from eating this food. I do not know what to do. Either way I feel as if I am killing my cat. And as I stated I just lost a beloved pet after a routine dental cleaning. With $1200 in vet bills I have a dead cat and a 17 yr. old not knowing how to proceed with any certainty. A consult with another doctor is not possible at the point. I thought Just Answer would give me clarity however I am completely baffled. Currently I am feeding her another brand of canned food, considering buying Blue, a water foutain for freshness and enjoy the time I have left with her. She is eating, drinking, using her box and active for a feline her age.
Expert:  Dr. John replied 1 year ago.
Well, the lower protein kidney diets shouldn't cause malnutrition in cats. There should still be enough protein for proper nutrition. The kidney diets are not just lower protein diets, though. They also have reduced levels of phosphorus and sodium and increased levels of omega fatty acids, vitamin B complex and antioxidants; everything to promote more healthy kidneys. Hill's K/D, Royal Canin Low Protein or Purina NF are the best choices for diets for her. As far as I know, there are no recalls on the Royal Canin LP diet. There may have been a recall a few years back, but that was a large scale recall with many companies due to contaminated ingredients from China. We use the diet a lot with no issues. While the BUN and Creatinine are mildly elevated, they are still elevated. What would be important to know is what the urine specific gravity is. That is biggest factor in determining how the kidneys are functioning. It is difficult to comment on the RETIC count at this point. It is better to deal with it in a percentage because it normally has to be corrected based on the HCT (hematocrit) to get an accurate reading. Plus, with cats, you have to deal with two different types of reticulocytes (punctate and aggregate). The aggregate reticulocytes are the more important ones when dealing with regeneration. The test they ran may not differentiate. With chronic kidney failure, normally they will develop a non-regenerative anemia over time. It won't happen immediately. If there is no anemia, there is a possibility that it may be a kidney infection causing these values to be elevated. Kidney diets, periodic SQ fluid therapy, Azodyl, phosphate binders (if necessary), calcium supplements (if necessary) and potassium supplements (if necessary) are the best ways to deal with chronic kidney failure in cats. If this is infection related, you may still need to use this protocol, but it may be only short term until the antibiotics take care of the infection. It is possible for an infection to cause permanent damage to the kidneys. Once you see evidence of chronic kidney failure in the bloodwork (elevated BUN and creatinine and mid range urine specific gravity), then you can usually expect that they have now lost around 75% of their kidney function. You won't see the changes in bloodwork with this disease until that point. I hope this clears things up for you a little more. If it doesn't, please let me know.










DISCLAIMER: My goal is to make sure that you get all your question answered and all the information you need. If you are satisfied with my answer, please rate it. If you feel like it is not helpful to you, or if there is more information you need, please respond back to me before rating. Realize that our conversation is not intended to diagnose or treat a condition. There has to be a valid veterinary-client-patient relationship established with an exam, according to law. You should always follow up with your vet.

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