My experience with treating Penny is NOT a substitute for veterinary advice or treatment. Please consult with your vet when treating Feline Chronic Kidney Disease (Feline CKD) or any other ailment.
I am part of a Feline Chronic Kidney Disease Support Group on FB and every day I see posts from pet parents of newly diagnosed Stage 4 CKD kitties. Often, their vets give them no hope.
I’ll start with this – We are taught to treat the CAT, not the “numbers” (meaning, their kidney values). Although I don’t think my vets could have never imagined in a million years that Penny would have gone on to live such a quality life for 20 months after she was diagnosed, they never let on to me that her situation was “hopeless”.
All of Penny’s treatments became such a part of the routine. I already forgot some details since she crossed the Rainbow Bridge November, 2017, so I decided to bust out all of my notes and her worksheets (yes, I kept worksheets) to refresh my memory and blog about her treatment so that I could easily share with others.
There were issues that cropped up along the way. Feline CKD is progressive, and as their kidney function diminishes, new secondary illnesses can develop. When she was first diagnosed, she was not anemic. Even at the end she was only slightly anemic but didn’t require medication. Knowledge is POWER when advocating for our pets! I learned how to read her blood work results and sometimes would find things that the vet missed, including a low-normal hematocrit reading just a few months after she was diagnosed with CKD. You will see that I included B-complex in her regimen, with my vet’s blessing, when I saw her borderline anemia start to develop. I believe that was an integral part of preventing anemia that is so common in CKD cats.
She also developed hypertension secondary to the kidney disease progression about six months after she was diagnosed. Her symptoms were similar to a minor stroke in cats. She had a couple of seizure-like episodes followed by an unstable gait (she was actually stumbling around trying to re-orient herself). These episodes would be over as quickly as they started. I took her to the vet the very next morning and had a blood pressure check done. Her symptoms resolved and never returned once she started treatment for hypertension and her blood pressure remained well-controlled.
I will not be including her Feline Diabetes treatment in this post. If you have a diabetic cat and would like to see her insulin dosage and blood glucose readings, click Here. For more on our Feline Diabetes journey, see Feline Diabetes Category-Penny & The Kits.
At the time we began treatment, Penny was 15lbs. As she lost much-needed weight (her “ideal weight” was 12lbs), her fluids and Adequan doses were adjusted with my vet’s supervision.
- Breakfast: 1/8 – 1/4 teaspoon Miralax mixed in her breakfast on an as-needed basis**
- 9am: Amlodipine 1.25mg, 1/6 Sundown Naturals B-Complex. I used a Size 3 Gel Cap and put both medicines inside so I was only pilling her once. Watch Pill Time here!
- 11am: 150ml lactated ringer’s solution subcutaneously. As she lost weight, the dosage was adjusted. Generally, we stuck to the golden rule of 10ml per pound of body weight. Watch Penny getting fluids here!
- Half hour before her dinner: Pepcid 2.5mg. It’s more effective to give Pepcid on an empty stomach, if possible. This was to combat the excess stomach acid that is common with CKD kitties. I also would get up around 3am to feed her a wet meal (she was a social eater so wouldn’t eat all night when I slept) since stomach acid tends to really bother empty stomachs. She very rarely vomited and when she did, it was typically just a hairball (she was a Maine Coon, after all!)
- Bedtime: Renadyl, 1 capsule mixed with food. I used Weruva Cats in the Kitchen gravy pouches that I purchased from Chewy.com because it mixed easily with the gravy. For more information on how Azodyl/Renadyl can help, click here. Scroll down to the “Probiotics and Prebiotics” section. I chose Renadyl because I only had to give it once per day (rather than three times) and it’s less expensive than Azodyl. I firmly believe it did make a difference for Penny!
- I gave Penny a B12 injection (0.25ml) once per week. This was recommended by both Tanya’s Comprehensive Guide to Kidney Disease as well as my vet. My vet recommends B12 injections for any cat with chronic disease. Penny was actually taking B12 before her CKD diagnosis because of her diabetes.
- Penny was taking Adequan-Canine injections every four weeks for spinal arthritis. It was a Godsend for her. Up until her last day she was still jumping on windowsills to bird watch and had no problem keeping up with The Kits without the assistance of ANY painkillers! If you have a cat with arthritis, PLEASE inquire with your vet about Adequan!
Since Penny was diagnosed at Stage 4 with a very high phosphorus level, I immediately switched her kibble from Young Again Zero (Carb) to Young Again Zero (Carb) Mature Health, which has a phosphorus level of 0.5%. The phosphorus level is the same, if not lower, than the “prescription” diets, yet was still low-carb for her Feline Diabetes. Often, food the vets and experts recommend for CKD kitties isn’t the best for diabetic kitties, especially the “prescription” diets. Most diets formulated for CKD cats are entirely too high-carb for ANY cat, much less a diabetic cat! When feeding a cat with BOTH conditions, it’s important to feed for the diabetes FIRST. If I lost control of her blood glucose levels, glucose would have spilled into her urine, which would only advance the kidney disease that much quicker.
I was able to switch her wet food to the lower phosphorus/lower carb Weruva and Fussie Cat flavors at first. After a while, she started refusing any of the foods that were low-carb and low-phos. I had to switch her back to Fancy Feast Classic pates (her favorite wet food). Fancy Feast is very high in phosphorus, so I added in an aluminum hydroxide (ALOH) binder. I mixed in max dose split between four wet mini meals per day. I purchased the ALOH online from Thriving Pets.
MIRALAX FOR CONSTIPATION AND OTHER DIGESTIVE ISSUES
**Re: Miralax and constipation. Penny had a slight case of IBD. The day I decided to adopt her, she had a very loose bloody stool while I was at the Pet Smart adoption center visiting her. When I took her to her first vet visit, her anal glands impacted and infected. Poop consistency is VERY important for a cat with IBD who has problems with their anal glands. Normally, a cat’s anal glands will extract when they poop, but when the poop is too soft there is enough pressure to properly extract them. If I didn’t see Penny poop for more than 48 hours, I would start Miralax at a more aggressive dose, but I had to be careful not to use too much so her poop wouldn’t get too soft. The dose I listed is a recommended maintenance dose. Ask your vet about using Miralax for your cat.
A note on using slippery elm bark (SEB), which recommended by MANY lay people and “cat experts” on the internet and social media. For a short while, I had decided to try slippery elm bark for Penny in lieu of using Pepcid since I’m a big fan of safe and effective holistic treatments. Slippery elm bark is good for everything from nausea and stomach acid to diarrhea and/or constipation. I know a lot of people who have used it on their cats with great success. However, I’m not one of them. Penny developed the worst case of constipation she ever had while taking SEB – to the point that she stopped eating completely for a day, so we had to discontinue and treat her stomach acid with more traditional drugs.
Quality of Life was Our Goal
As you can see with the videos I included, Penny’s treatments were not stressful for me OR her. She was easy to bribe with raw chicken or Fancy Feast Broths, which made treating her health issues SO much easier for us! The pills, fluids, etc became just a regular part of our day.
Up until Penny, I had never been able to successfully give cats medication on a consistent basis. She was so young when she was diagnosed with Feline Diabetes (5yrs old) and Feline CKD (7yrs old) that I had to figure out what works for US so that I could extend her quality of life for as long as possible.
I had decided in the beginning that I would continue this treatment regimen for as long as it worked to keep her feeling great. If it had worked for ten more years, we would have kept going, but when everything I did no longer worked, it would be “time”.
In hindsight, I’m glad that I made that decision early and stuck by that decision when I was losing Penny and couldn’t think objectively or unselfishly.
Penny was a kitty of grace and dignity. I made SURE she maintained her dignity throughout her entire illness. I’m proud of the fact that we maintained her quality of life for so long. Since cats live in the moment and don’t fear death like we do, it is ALWAYS important to consider that above ALL else when our fur babies get sick. As their trusted parents, caregivers, servants (lol), we OWE them that!
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Any treatments, food and supplements I mention in this post are the result of my own research and experience. Please consult with your vet as necessary.