Howdy! Thanks for the CRF site. We've got a cat about 3 months into a CRF diagnosis -- named Toulouse, a Russian Blue. So far, the most life-threatening aspect for him has been severe constipation -- we've had him at the vet twice to clear things out, and have been giving him enemas about 2x/week to keep things moving. You might want to consider adding this to the Management section of the page; our vet says it's a pretty common issue with CRF cats he sees, and it can sneak up on you (it sure did on us!).

Philip

Thank you for your web site. Spot was a brave cat, who endured his debilitating disease with grace and dignity. But getting him to eat was another matter. When all else failed I would feed him broth. I started off with the stuff from the store but he liked fresh broth better. So it became a weekly part of my routine to boil down the bones of chickens (usually) or cows (a treat) and feed him the broth. He was usually excited while the broth was boiling and thankful to slurp it all down. I liked making it fresh because I knew what went into the pot, and I felt that I was helping him to get both fluid and nourishment. Maybe this tip will help other people trying to help their kitty friends.

thank you
kimberly

My cat "Bandit" was diagnosed with CRF in March of 1997, when I had taken him in to the vet due to his refusal to eat. After tests upon tests, the vet gave him the diagnosis of having 25% kidney function followed by a life span of "2 months or 2 years." Well, that was almost 2 years ago and he is a bit thinner, but still doing well. The following suggestions I would like to make in the hopes that they help someone else; however, please take this information as you would anyone's opinion - as general information.

The way I have been able to deal with CRF, the changes that had to be made, and hopefully the extension of Bandit's quality of life is by the following:

I use the "Nature Made" brand of Potassium Gluconate 550mg, found at Target stores, due to the high cost of the vet brand of the same ingredient. Money is an issue with me; however, if getting the vet brand was the only way to save my cat, I would have done it.

I coat any pill form of medication with a touch of petroleum jelly to make it easier to swallow. (Vet suggestion)

When Bandit stops eating or appears to have stomach upset I give him 1/8 to a 1/4 of a 200mg tablet of the ingredient cimetidine, which is found in Tagamet. (The vet first prescribed this for him when he had stopped eating.)

If I do have to leave him to go on a trip and his care is in another's hands I put plain pedialyte in his waterer instead of water, as it has calories and nutritional value.

I normally feed him his choice of food, which has been "Fancy Feast" canned food for the past year. When he is finicky and doesn't eat much, I supplement his diet by adding the "High Calorie Vitamin Supplement" by St. Aubry Veterinary Labs. It is a gel diet supplement that I have researched and found at all Wal-Mart stores. Bandit loves the taste of it, in fact it is the only thing that he rushes to receive.

I have chosen not to frighten him anymore than I have to, in that I do not take him to the vet anymore - as Bandit wouldn't eat following those trips. I have the philosophy that if I were in his "paws," I would not want a bunch of people testing me and then telling me how I had digressed. This way his life is as normal as it can be with CRF.

I have three cats, and Bandit still runs, plays and jumps as they do. The only difference that I can tell is his eating habits and he sleeps a bit more than the others do.

Good luck to all who are dealing with this illness. Try to look at the quality of life rather than the length when you think of your precious one.

L.V.

Thank you all so much for this page (the authors and all my kindred cat families)

My dear friend Stasha (aprox 12 year old rescued 'pound-cat') was diagnosed with CRF early this Jan.'99. She had the usual signs as described in these feedback pages (of which I have poured over with a note-pad).

After several months of over-priced and uninformative care from the "premiere" cat hospital in my area, I decided to get a second opinion. I have to recommend this to all CRF care-takers. Don't think because a vet has the best looking or best advertised facilities that you are getting the best care. You know your pet better than anyone. If your cat is not getting any better (or as in my case, getting worse!) look for another doctor and don't look back! I hunted around and was led to a wonderful (ex-zoo) vet about 30 minutes from my home. He is very down to earth, no nonsense and is very much into minimizing invasive care (no more vaccinations, she is 100% indoor, and no reason to stress her weak system further) and emphasizing home care and patient education.

On to a few hints I have picked up or learned. First, sub-Q's: warming the bag made all the difference in the world for us. I thought I would never be able to do the now 3 X per week injections till I found this hint. Also, my cat seemed to feel the needle a LOT when lying down (she has always been a small girl), so I found another way of finding a better 'tent' in her scruff. It is a 2 person job, but we put her in a box about the size of a shoe box, but with higher sides. With brushing and petting, we get her to sit (rear end down, head up). This seems to bunch the skin up more around her shoulders. After she is in this ideal position, we stuff towels around her to keep her in place. With the bag hung HIGH above (off the top of the door) it takes about 1 minute to get 100 cc's in (also using a large 18 gauge needle).

I also found another brand of low-protein food at my local pet-store (which is a small privately-run business). The brand is Hi-Tor, the line is Neo-Diet. The info on the can says "packed for: Triumph Pet Industries Inc. Hillburn, NY 10931" and "Product of Canada" but I am in Maryland, so it is available through-out the states. It is only .5% more protein than KD (which Stasha hates) and does not require driving to a vet's office to get (it is not "prescription", a misnomer I believe has more to do with $-contracts with Hills than anything else). I occasionally mix in cheap tuna in water, when she is not interested in food (the cheaper 'light' tuna instead of 'white' has more fat and richer taste and smell). My vet said that since protein is the problem, not fat, even frying up the food in some butter can help, if they like it (it didn't entice my cat, but worth passing the suggestion on.)

One other thought. On my vet's suggestion, I put Stasha on 3 cc's of Amphogel 2X per day, for one week. We then switched to the same dosage of a liquid Calcium Carbonate (special order from a good privately owned pharmacy, they seem more helpful with special requests than big chains). This switch was to avoid aluminum toxicity from Amphogel too long. I assume we will switch back and forth, ask your vet. I let her get the antacid into her stomach for about 45 minutes before bringing her right to her fresh food. It's as though she hadn't considered that she felt well enough to eat till then, and to my joy, usually does eat some!

Lastly, we do urinalysis at home every 2 weeks. On "pee-day" we fill the litter box with Styrofoam peanuts so the urine will run right through and do a dip-stick.(Hema-Combistix, tests for PH, blood and protein. I ordered them from my wonderful pharmacist, not cheap, but saves a stressful vet-trip). I can call my vet with the results, and take a urine sample to him if he thinks the values sound bad.

I thank you for allowing me to take up so much room and hope some of these hints will help some of you with your wellness care. Cherish every moment with your loved ones, when they come to see you, stop what you are doing and give them some love, soon enough you'll miss those "interruptions" in your life. Best wishes to all.

Tamra Healy and Stasha, my "Kahn"
Stashakahn@aol.com

We're new to the world of CRF and your website is just a fantastic place to find help, information and ideas. We were in shock at the diagnosis and couldn't even think of questions to ask our Vet. We've now learned to read labels (Sheba foods are low in protein), ask questions and experiment.

I'd like to share a trick which may help others. When first introducing the prescription food by mixing it with regular (low protein only) foods, keep the prescription food refrigerated. Warm the regular food until it's hotter than the kitty would like, make a hole in the middle, fill it with cold prescription food, and fold the hot food over the top. When our Cally dives in, she eats right down to the bottom, old and new food together. When the food is cold, they don't taste it, so it's eaten right along with what they like.

Marty

I thank you for a most informative website. Having lost my 18 year old Ginger* female cat two weeks ago to CRF, I was desperate for some answers & more info about what had happened to her for the last 3 years. Being a Medical Technologist, myself, I went first to the Medical sites which were obviously human-related. Somehow in my search I came across your site. How I wish that I had discovered this while she was still with us. I have, however, found great comfort from its contents.

I am from Cape Town, South Africa, & I was amazed to read about all the medications & treatments available to you all for CRF. During the first 2 years of Ginny's diagnosis she was dripped 3 times, one occasion she was on a drip for 4 days. During this stay in hospital I also took the risk of having her teeth cleaned as the vet said that the condition of her mouth was making the disease progress faster. This decision paid off & over the last year she was dripped only once, only because she had a bout of diarrhea. Mostly she has suffered from constipation but I managed to control this by giving her Animalax every 2nd day. I ensured that she drank lots of water, even when she was dozing I used to present her with a bowl of water.

Her appetite was very good. I did have a her on KD pellets in the mornings but in the last 6 months she had a problem chewing them & as I knew her time was near I allowed her to eat whatever she would eat. At times she did go off her food but then I would give her a few doses of an "ulcer " suspension & she would eat again.

Going through all your feedback pages I did not see any experiences with nasal bleeding. According to the medical sites, platelet dysfunction is a complication of Renal Disease. A month before I had to euthanise Ginny she had her first nasal bleed which occurred after she sneezed due to a cold. A month later she started to bleed slowly through her nose late one afternoon. By 23h00 that night it had not stopped & was causing her distress as it seemed to be running down the back of her throat. We took her to the Emergency Vet who gave her coagulants & dripped her overnight. The next afternoon I fetched her & took her home to spend her last night with us so that we could say good-bye. That night the blood started to clot & the small clots got stuck in her nostrils causing her much distress until I removed them. She did have a fairly comfortable night & the next morning she ate as usual, sat in all her favourite sun spots in the garden & even jumped onto the patio table to get the first rays of the sun. It was like any other day except for the blood slowly dripping from her nose & this made it so much harder to take her for that final ride to the vet!

Many Thanks
Helen
helen@redxch.wcape.gov.za

I am the proud owner of Samantha - "the wonder kitten". She is 19 in August and has had CRF for almost 5 years. Just today I noticed that she was shedding quite a bit so I did a web search to find out if that was one of the symptoms of CRF. Sadly I find that it is.

I would like to share just a few things about my stoic kitten. We call her the wonder kitten because she has gone through those ups and downs you describe so clearly in your wonderful website. She has undergone an international move recently and came through it with flying colours. However, shortly afterwards, began having small bleeds in her beautiful eyes. I took her to the new vet (who had been recommended to me). He was unsure but mentioned it could be high blood pressure - but that there was no blood at the back of the eye - it was visible from the front so he thought it unlikely.

He reco'd to take her home and monitor her. Well, several small bleeds later (she never seemed to be in pain) and quite a few trips to the vet and I was beginning to feel that they did not know what they were doing. Then, she had a HUGE bleed in one of her eyes - so terrible that you could not see any of her eye as it was full of blood. She was in a lot of pain - as was I. I called my old vet - he is wonderful and told me to ask for a referral to a specialist.

I did and am I ever glad. The vet that looked after her is a godsend and in one visit, identified her problem - high blood pressure - in fact it was at 290 - when it should have been 160. The vet said that Sam was lucky not to have suffered a brain aneurysm due to the pressure.

She is on BP meds and is like a new kitty. However, the meds are affecting her kidney function slightly and I know I am on borrowed time but as you say it is the quality of the time spent with her that is important now.

I just wanted to share this with you because you love Avatar and did everything for him that you could. Some people think I am nuts but she is my best friend and a wonderful soul. Even my husband, the cat hater, LOVES her and will be devastated when we lose her. You have to admit - any animal that can change a person like that is pretty special.

Thank you for your website. It is an inspired and wonderful tribute and will help many who feel they are alone with this.

Sincerely,
Judy

Going thru this with Fred, my cat, I've found that mixing AD (anorexic diet cat food from the vet) with an electrolyte solution like Pedialyte or a generic brand instead of water helps supplement his electrolytes. It's available at the grocery store ($5) for kids that have to supplement theirs. Also, mixing Metamucil or a generic brand of fiber laxative (1 teaspoon per meal) helps ENORMOUSLY with fighting Fred's constipation. This has been such a serious issue with my cat. His kidneys pull all the liquid from his GI tract so he winds up seriously constipated and it has nearly killed him. He almost died last month because he was so constipated he wouldn't eat which led to %40 body weight loss to a respiratory infection so he couldn't smell which compacted the eating situation. His BUN level was not high at all but the vets thought it was time to put him down. He was totally lethargic, always trying to eliminate. I decided to fight back and mixed a concoction of food, meds, electrolytes and metamucil with a rigorous enema regime and syringe-fed him 50-60 mL daily in addition to sub Q fluids. Within a week, his constipation was gone and his strength came back. He's gained over 2 lbs and is healthier than before.

Trust your instincts. You know your animal best.

Patty

We originally found your site in May, 1998 when our dear Amelia was diagnosed with CRF. Being very ill, she spent 6 days on IV at the animal hospital and was released to us with instructions on giving Sub Qs daily for a month and then tapering off slowly.

Since we live and travel full-time in our RV, we were told to have her blood levels checked in a month wherever we were. After the 2nd test we showed the doctor the first test results and he commented that we were lucky we had the first vet when she was diagnosed. He said, "This was a classic case of 'Put the cat down." He noted that Amelia's current test results were better than the first. He advised us to complete the Sub Qs and have her tested again in a month or two.

When she was first sick, we did some things that others MAY want to consider. We firmly believe these things have helped Amelia regain her health and build her immune system and other organs.

Once a day we fix a mixture of about 8-10 drops of Essiac Tea (get it a health food store--take no substitutes) and about 2-3 spoons of water. We add 2 drops of Gingko Biloba extract (also found at health food stores). We purchased a large, plastic baby dropper at the drug store. She gets 2-3 droppers of this mixture each morning. At midday and in the evening, she gets 2-3 droppers of plain water. We just turn her onto her back in our arms and slowly feed it to her, giving her time to swallow.

As a treat for being so good, we give her one "Hugs and Kisses" vitamin (purchase at large pet stores) which she loves better than any treat she ever got earlier in her life. Since taking these, her coat has improved and she also sheds less, plus she gets the value of the vitamins. When we get distracted and forget to give her the treat, she just sits on the floor and gives us "the look" until we deliver the goods!

The first vet sold us some special K-D Diet cat food, but we discovered early on that it contains preservatives. Through our research we learned that these synthetic preservatives contribute to kidney problems, so we found cat food that has no preservatives. This is what she eats exclusively AND she loves it. There are a few varieties found in large pet stores now.

Amelia celebrated her 13th birthday in Sept. She seems more spry and healthier than before she got sick. We really appreciated your site and the help we got in coping with her illness, so we thought you might like to share this info with other visitors.

Carol and Tina

I happened upon your site rather by accident (was looking for a people-doctor web site). My own cat, Vash, was diagnosed with CRF in 1995 when she was 5 years old. She spent a week at the vets' with an IV. Her BUN and creatinine were off the scale even after that week in the hospital. I was given a choice of putting her to sleep or taking her home and giving her Sub-Qs. I opted for the Sub-Qs. When I brought her back to the vets' on Monday, they were finally able to get a reading on the BUN and creatinine. She remained on the Sub-Q for several months but finally got to a point where she didn't need them. She's now on a diet of Hill's Feline k/d mixed with a little bit of Sheba (to make it palatable enough to eat) and 1/2 a dose of Winstrol twice a week. She's playful, frisky and otherwise seems perfectly healthy (though she's a bit thin and underweight). My vets are calling her the miracle kitty.

I am lucky in several ways. First, though she's on the Winstrol tablets, she actually *likes* them and all I have to do is put them on the floor and she'll gobble them up. Also, based on my vets' reaction when she first got sick, her level of health seems much higher than they had expected. With the exception of the special food and the pills, one would hardly know she was sick. Prognosis during the first few days looked bleak. They spoke of possibly having to give her regular dialysis if she didn't improve enough on her own. The best they had hoped for was that she would recover sufficiently that she would only require an altered diet for the rest of her life. However, my impression from, not only what they said, but how they said it, was that they didn't expect she would survive. Her BUN and creatinine still register in the high range, but have stabilized at the low end of that range.

The change in Hill's Feline k/d last year was a definite improvement and I was able to increase the amount of food I give her. I've tried weaning her off the Sheba, but every attempt to decrease it even a little has resulted in her refusal to eat the food. I chose Sheba because of the brands of cat food that I found, it came the closest in protein levels to the Hill's k/d. She gets 3/8ths of a 5 oz can of Hill's to 3/16ths of a 3.5 oz can of Sheba twice a day. I realize that seems like an odd amount but it's based on how much I can give her before she ends up leaving the rest. If I start seeing her clean her bowl, I'll increase the amount I give her. If she starts leaving large amounts repeatedly, then I'll cut back for a while. I was giving her 1/4 Hill's to 1/8 Sheba last year, but she showed a definite preference for the new formulation of Hill's so I was able to increase it a bit last summer. Thank goodness that worked. Once the Sub-Qs kicked in and she started to improve her kidney function, she nearly stopped eating all together. Every suggestion by my vets and by Hill's proved ineffective. It was only the addition of the Sheba that got her eating again and stopped her weight loss (she was down to about 4 lbs at her lowest). She's maintained a weight of 5 1/2 to 6 lbs for several years, fluctuating slightly up or down (though I think it went up a little with the change in Hill's formula).

JRP