Reptile & Amphibian Forums

How long should a cat go without defecating before you take him to the vet? my cat usually has normal poops everyday, but he went outside (he's an indoor cat but i let him out on the porch with me) and he ended up eating a lot of grass on Sunday. He had diarrhea 3 times on Sunday and then puked up a huge hairball with grass too. He hasn't pooped since Sunday and it's Tuesday night! But i don't want to stress him out by taking him to the vet unneccesarily

Hi There,

I hope by now your cat has defecated. If not, and he is eating well, I would consider talking to a vet about it tomorrow. Either that or you can try adding some canned pumpkin to his food.

Anyway, it would not be unusual for a kitty who has had severe diarrhea to not defecate at all for a few days afterwards. This is because having diarrhea has cleaned him or her out pretty thoroughly. From your post it sounds like that is most likely what happened with your baby.

Take care,

PHKitkat

Now he has diarrhea again! It's been off and on since last week. I'm going to take a fecal sample into the vet to see if maybe he has worms, but he has also had 2 big hairballs during the last week. I've read that sometimes hairballs can become inpacted and his preoccupation with eating grass and having diarrhea could indicate a hairball problem?

Hi There,

If this were my kitty, I would take him in for an exam and possibly an x-ray. Complete hairball obstructions are actually pretty uncommon, but a partial obstruction can be present without a cat being very ill. I would also consider having a blood panel done, which may sound extreme, but you don't know what your kitty may have ingested along with the grass he ate. I would not let him eat grass in the future.

I doubt that worms are his problem, so I personally would have skipped taking a stool sample in. Even if he does have some kind of parasite, it doesn't explain all his symptoms. Besides, cats that have parasites often have no symptoms at all.

Regards,
PHKitkat

thanks for your advice. He's going in next week for a follow up exam on his atrial septal defect they found 6 months ago (after his biological sister died of a heart attack we had him checked)

but he's going to get a complete physical, blood panel, ultrasound, x-ray and echocardiogram of his heart. Maybe they can x-ray his stomach too! He just gets really stressed at the vet, so i didn't want to stress him out too much but taking him in this week and again next week.

I get CBC every 6 months, along with urinalysis and physicals and he's always checked out okay. But maybe I shouldn't wait and should take him in now.

thanks again.

Hi Again,

I can tell that you take exceptional care of your baby. Please do update us when you have some test results.

Some of my cats get very nervous at the vet also so I understand your not wanting to take your kitty in 2 weeks in a row. I always have as much done as possible in one vet visit for this reason. I'm sure an x-ray can be taken next week along with everything else.

Sending Glow for good test and ultrasound results....

PHKitkat

Hi there. Sola had loose stool throughout the weekend and his fecal check turned out to be negative, so I decided to take him in today.

They did an x-ray of his stomach just to be sure he didn't have an impacted hairball or anything and he was fine. A urinalysis and blood panel are being run tomorrow and they will call me back about it. They also gave me metronitazol to give him for 10 days.

He does have a history of IBD and in addition to his loose stools the last 2 weeks, he's also vomited a few times. Hairballs twice and light brown fluid twice. I'm hoping it's just his IBD acting up, but the vet thought that if this continues that maybe we should have a biopsy of his intestines to make sure he doesn't have cancer. He has been fine for the last 11 years (except for his atrial septal defect) and goes through little bouts of vomiting and loose stools, but it's never lasted this long. Have you ever seen cancer in the intestines? And his disposition is totally the same as it was!

Sola's bloodwork came back and everything is normal except for his red blood cell count is low. The vet wants it rechecked next week when he goes in for his echocardiogram and ultrasound of his heart (rechecking his atrial septal defect). Poor baby. He is acting totally normal except for the chronic diarrhea!

Do you recommend a biopsy of the intestine, or do you think this is too rash? they didn't see a growth or anything on the x-ray.

Hi There,

I was glad to heat that Sola's blood work is normal. It's possible that his anemia is related to his intestinal issues.

It is a fairly straightforward procedure to do intestinal biopsies on cats. Even though no masses have been detected cancer can still be present, as well as enlarged lymph nodes. One of the types of cancer most often found on biopsies is known as small cell lymphoma, which is very treatable. Cats can often live comfortably for years with steroids and a drug known as Leukeran is sometimes used as well.

Not to scare you, but it is fairly common for cats with IBD to develop lymphoma and for this reason I would have the surgery done. Sola has normal labwork so the surgery should go very well. You would be surprised how quickly cats recover from this type of surgery. They are often eating as early as the next day!

Sometimes during surgery a mass is found that has not been detected by other means, which is another reason to have the surgery done. Plus it's a good thing to know whether you are dealing with just IBD or possibly cancer. The vet would be able to treat your baby according to the surgical findings.

My cat Timothy is strongly suspected of having intestinal lymphoma, but he is older and in poor health so surgery isn't an option for him. In his case, treatment consists of a monthly injection of depo-medrol, which is a long acting steroid. This controls the severe inflammation in his intestines and helps tremendously with his diarrhea. He is still happy, active, and eating well and I am very grateful for that.

Please let us know what you decide and how your baby does. If you have any other questions, please don't hesitate to ask. I understand how scary this all is and want to help as much as I can.

Regards,
PHKitkat

Hi there. Thanks for your response.

I just took my cat Sola in to see a specialist this morning and he had an ultrasound of his intestines. The vet saw a significant thickening of the intestines as well as several lymph nodes and so she just called me to okay an endoscope biopsy. Apparently it's less invasive as the full-thickness biopsy and since he went under a mild anesthetic for the ultrasound she said she can do it right now, so I said go ahead.

The vet mentioned leukeran and prednisone as a possible treatment if it is lymphoma. Yu said your cat Timothy does well on monthly injections of depo-medrol? Does he also take leukeran or prednisone?

Hi Again,

You definitely did the right thing by allowing the vet to biopsy Sola's intestines. Obtaining biopsies by endoscope is the second best way to diagnose intestinal lymphoma, and as you know, the procedure is easier on the cat than an open exploratory.

My Timothy is a semi-feral kitty and is almost impossible to medicate. This eliminates the possibility of Leukeran or oral steroids as his treatment. That is why he gets depo-medrol. It's an injection that doesn't sting so I am able to give it to him easily. The injection also stops his diarrhea until it is almost time for the next shot. Even though Timothy is now going downhill gradually he is still a happy boy and his appetite is good. I'm very grateful for that.

Leukeran is an excellent drug that I would not hesitate to give if it is recommended for one of my cats that can be medicated. Some cats experience poor appetite and digestive upset while on the drug, but it is not given every day so the cat gets a break.

Please let us know when you get the biopsy results and remember that if Sola does have lymphoma it is very treatable. If you have any other questions don't hesitate to ask

Regards,
PHKitkat

Hi again.

The vet just called me last night and diagnosed Sola with moderate lymphoplasmacytic inflammatory Bowel Disease. She said that although the endoscopic biopsy isn't as accurate as the full-thickness biopsy of the small and large intestine, she is pretty confident that it's not cancer.

She wants us to do another ultrasound of his intestines in a month to make sure the intestinal wall hasn't continued to thicken and she wants to put him on panacur and a steroid (not prednisone, but something else) and also switch him over to IVD in a few weeks. So we'll see what happens, but overall it was good news!

But it's just a matter of supressing the lymphoma, right? Because ultimately IBD leads to lymphoma correct?

He's been on pepcid once a day, metronidazole twice a day and sucralfate and metociopramide three times a day for the last week and thankfully he hasn't vomited or had diarrhea! He only has a few more days left on all this and then he's starting the panacure and steroid.

thanks for all your advice, and please let me know if there's anything else you recommend.

Not that we wouldn't do anything for our baby, but my husband is the sole bread winner right now as I'm just starting a nonprofit to help shelters market their adoptable animals. Anyway, we've spent $3,000 in the last week on tests, biopsies, etc. and with more ultrasounds to come, it looks like we'll be spending more! Is there a pet insurance that would cover any of this that you know of?

Hi,

Yes, this is definitely good news about Sola! Nice to hear that he hasn't been vomiting or has had diarrhea either. His meds are working well.

IBD does often lead to lymphoma, but not always, and there is a medication that works well in cats with this type of lymphoma, called Leukeran. So even if the worse does happen, there is an option that can keep a cat comfortable for a long time.

Sola's medical problem would be considered a pre-existing condition, so it would be difficult to find insurance to cover him. However, if you like, I'll be happy to do some research for you. Even if insurance wouldn't kick in right away it may be helpful in the future.

I wish you the best of luck in your new nonprofit venture!

Take care, and Regards,
PHKitkat

Hi there. I've emailed you in the past regarding my cat Sola.

Just to re-brief you, he is an indoor, male neutered 11 year old cat and has been totally healthy except he has had a history of IBD (never had a biopsy until now) but his problems seemed to be very sporatic. Diarrhea maybe once a month and periods of vomiting for every day or every other day for a few weeks every few months.

Last month he had a period where he had diarrhea almost every day for 3 weeks. We took him to the vet after this was going on for two weeks and he received a complete blood panel and urinalysis (as I usually do for him every 6 months) and everything seemed normal. We also did an x-ray, but nothing showed up.

We finally took him to a specialist who did an ultrasound of his intestines and found some lymphnodes and thickening of his intestinal lining. The vet did an endocscopic biopsy, which apparently is the most non-invasive method to obtain a biopsy and found that he had moderate lymphocytic inflammatory bowel disease.

He was put on pepcid once a day, flagyl twice a day, sucralfrate three times a day, and metoclopramide three times a day. He did well for a week - no diarrhea, no vomiting, then as soon as he finished his flagyl he had liquid diarrhea and vomited 8 times (more gagging then vomiting really), but we took him to the ER on Saturday and they put him back on flagyl and now he seems to be doing better, no diarrhea since Saturday.

He just finished all his medications (they were only for 10 days) except for the flagyl that got re-prescribed. And he just got a steroid - budesonide - and has been taking then once a day along with the flagyl twice a day. We've also switched him to IVD, which he was on years ago but I stopped because I wanted a more holistic diet and switched him to California Natural and he was fine for several years on this, until last month.

So, finally to my questions:

1. Why would his IBD flare up all of the sudden to the point where he needs all of this?

2. Is it possible that he has intestinal lymphoma, but we don't know because he only got the endoscopic biopsy and not the full thickness biopsy? I just wanted to avoid the risks of anesthesia and he was put on a mild sedative for the ultrasound and stayed on that for the endoscopic biopsy rather then general anesthesia that was required for the other procedure. My other cat Luna was put totally under to remove a cyst that they thought was vaccine-induced sarcoma, it turned out to be negative, but she died several months later of a heart attack and I am still not convinced that it wasn't the surgery (and teeth cleaning) that put a strain on her heart.

3. Should we do a radiograph? I read several websites that recommended a radiograph to diagnose IBD, but I'm not really sure how a radiograph is different from an x-ray and an ultrasound, which he has already had.

4. I know there are side effects to prednisone and I've read that the steroid inhibits the ability to test for lymphoma for some reason. Instead of prednisone, Sola is budesonide. Does budesonide have any side effects? I couldn't find any when I looked on the internet. The vet says that all his blood work and urinalysis came back clean. I personally like to see the results to see if he is even on the high or low side of the normal range, I don't like to just hear that he's "fine". But they don't like sending me the results because they say people freak out! But I'm still a little neurotic ever since I lost Sola's sister several months ago to a heart condition that we had no idea she had.

Sorry for all the questions. I'm just a little uneasy right now having just lost another cat to a disease where I knew nothing about and found out only after her death that she had an enlarged heart. I just struggle with the fact that even though I took them in every 6 months for a physical, bloodwork, urinalysis and blood pressure check, that the cardiomyopathy was never caught. Luna had very low blood pressure the month before she died but the vet didn't think that was a concern. I think, in hindesight, that that was a sign. So I'm making sure I do everything I can to help Sola!

Thanks in advance for you advice!

Lisa Acho

Hi Lisa,

I took a few notes while reading your post so hopefully I won't forget anything!

IBD is considered to be a progressive disease, which means that it tends to become more severe over time. This is why it can eventually lead to intestinal lymphoma. What might appear to be a sudden flare-up may actually be the eventual worsening of the IBD. As you know, cats are very good at hiding the way they really feel.

Yes, there is a possibility that Sola actually does have lymphoma, but even with a full-thickness biopsy the results can be questionable. I think I would stick with the current treatment and see how your baby does over time.

A radiograph is just another name for an x-ray, so that is one thing you don't have to consider

The steroid budesonide is 15 times stronger than pred, and seems to be used regularly for IBD, although we don't use it where I work. Vets tend to use the drugs that they are most comfortable with and therefore use most often. I would try to find out if over time the steroid will be given every other day instead of every day. This would be much less likely to cause problems over time.

Cardiomyopathy is a tough one. It can be difficult to diagnose and some cats with it are symptom-free. Often it isn't diagnosed unless a necropsy is performed after the cat passes away. I'm paranoid about heart issues also because I had what appeared to be a very healthy 15 year old cat that suddenly developed a heart murmur. After x-rays and tests it seemed that the murmur was what we consider "benign". A few months afterwards Delilah developed heart failure and I had to let her go.

I know what you mean about being nervous about anesthesia, but if the safest type is used (gas)and the cat is well monitored, most do very well. Even though an injection is fine for induction, once the cat is intubated, he or she should be put on a gas/oxygen mixture. A vet that uses injectable anesthesia exclusively is one to be avoided.

Hope this all makes sense and is helpful to you!

Regards,
PHKitkat

Thanks again for your advice and your quick reponse.

This week he has just been on flagyl and eating IVD and seems to be doing great and I've only given the budesonide once (and stopped after reading that you said it is 15 times stronger than pred!). I also decided to ask my vet for Sola's bloodwork that he just got 2 weeks ago (before he started on any medication). She told me his bloodwork came back as "normal" but I always like to see for myself. Not that I'm a vet of course!

But what she called "normal" results I would not consider normal. Which is why I think I'm going to stop the steroid all together.

There were high:
Creatinine = 2.4
A/G ratio = 1.1
MCH = 17.5

These were low:
RBC = 5.62
HGB = 9.2
HCT = 27.8
Globulin = 3.1
Absolute Neutrophil Seg = 2156

I don't really know what anything means except that the creatinine is a measure of the kidney function. His BUN was 27, which seems normal, right? What do you think of the other levels? Do you think he'll be okay on just flagyl and IVD?

Hello Again!

If Flagyl and IVD work for Sola, then that may be all he needs to treat his IBD. Sometimes it's just a matter of what works for each individual cat. I think, though, that you should be open to using steroids, if necessary to control his disease.

I don't blame you for wanting to keep track of your cat's lab results. You don't have to have a degree to see which values are high or low. It might be a good idea to obtain copies of any other labwork that might have been done on Solo in the past year or so. Maybe even start a folder so you have a record at home.

What concerns me in the labwork that you posted is the slightly elevated creatinine, although the BUN is normal. If a urinalysis has not been done on Solo it would be a good idea to have one done. This is because kidney disease shows up in the urine before the blood and you want to know if early kidney disease is present. If the urine is dilute, then you are dealing with the beginning of kidney problems. Slight anemia is present also, which can be caused by chronic problems, such as IBD, or kidney failure. With a normal BUN Sola would have to be in the early stages.

I tend to be very paranoid about kidney problems in senior cats, because I have had several with the disease. Still, most senior kitties will develop some degree of CRF as they age. I have both a 10 year-old and a 17 year-old cat with kidney failure at this time. Both are stable with subcutaneous fluids at home.

Take care, and feel free to keep asking questions

Regards,
PHKitkat

Thanks again for your response!

I did have a urinalysis done (I usually get one every 6 months) and I don't know how to read those, but it said that his specific gravity was 1.036, the color was yellow and the clarity was cloudy. Nothing was flagged as high or low so I'm assuming that was good?

By the way, are their any long term side effects to flagyl?

Thanks again for all your help and for really calming me down through all of this!

Lisa

Hi Lisa,

The urinalysis results are fine. It's a very good idea to have one done on a regular basis in senior kitties. You wouldn't believe how many vets just do bloodwork, which never gives the full picture of kidney function.

Usually Flagyl is given on a short-term basis so that is what I am most familar with. However, I do know that it can cause neuro problems and possibly affect the liver longterm. What I would like to do is look into this further and then re-post. I will do this in the next couple of days.

Hope Sola continues to do well!

Regards,
PHKitkat

Hi Lisa,

I talked to my boss and she feels that it's ok to keep a cat on Flagyl longterm as long as the cat is closely monitored. The main concern is the possibility of neurological problems developing, although the drug can also affect the kidneys and liver.

Since Sola has been doing so well on Flagyl it might be the best drug to treat his IBD. I know you will watch him closely and that you also have labwork done on a regular basis. Perhaps over time, the dose can be lowered, or the medication can even be discontinued. Or possibly changed to something else.

Take Care,
PHKitkat

Hi there. I've emailed in the past regarding my 11 year old cat Sola's IBD problem. Just to refresh your memory, he was diagnosed in July of this year with moderate lymphoplasmacytic IBD after an endoscopic biopsy.

He went from having diarrhea off and on for 3 weeks (which is why we went in for an intestinal ultrasound) and now instead of diarrhea he has very hard and dark stools inconsistently. He had a re-ultrasound of his intestines on Sept 1st and the vet said that the walls of his intestines are still thicker than normal, but they are less thick than they were a month ago. We are going to go in for another ultrasound in 4 weeks. He has been on and off flagyl and now he is on budesonide to help prevent the walls of his intestines from getting thicker.

But the reason I'm writing is because he got bloodwork done again last week and the vet said he's fine, but of course I'm skeptical.

His BUN went from 27 last month to 37 this month. The good news is that his urinalysis was in the normal range and his creatinine went from 2.4 to 1.8 in a month's time as well.

But should I be concerned about his kidneys, and if so is there anything i can do? I tried making homemade food, but he won't eat it no matter what I do. he now eats wet food only, Wellness turkey formula. It is grain free.

And aside from his kidneys, what can I do for constipation? I tried giving him canned pumpkin but he won't eat it. He has a very healthy appetite, weighs 16 pounds, but is a very picky eater!

Any advice would be appreciated!

Thanks so much,

Lisa

But should I be concerned about his kidneys, and if so is there anything i can do? I tried making homemade food....

And aside from his kidneys, what can I do for constipation? ....

====

Hi! I've been off this board for a while and just read up on your string. I recently lost a Senior cat (16 y/o) that had constipation, CRF (Kidney Failure), anemia due to CRF, and also was on steroids long term for brain swelling/tumor... PHKitKat is far more qualified to answer your questions, but I'll give it a stab on some I am familiar with...

You didn't mention (or I overlooked it) whether or not he has kidney failure/CRF... When my Senior cat was diagnosed at age 14 with early CRF, we switched him to Science Diet Prescription Kidney Diet food (Science Diet KD). It really helped stabalize his numbers for a good 2 years without anything else really needing to be done. His brother from the same litter doesn't have Kidney Disease, has good "numbers" and has eaten the food alongside his brother for two years. The vet said it is OK to keep him on the food with his brother now gone, it has probably helped him not get kidney problems. Something to check into if your cat has kidney problem -- change his diet to something easier on his kidneys. Your vet can advise. Protein and Phosphorous are items I know are lower in kidney diet.

Constipation is very common in Senior cats. Mine would only eat dry food, but the vet recommends wet food (for kidney and constipation). Some cats will only eat dry. The above KD mentioned comes in wet and dry and worked very well in dry for my kidney failure cat (and apparently for my non-kidney failure cat). For constipation, there are things you can try with your vet. Mine wouldn't eat the pumpkin, either. They won't touch savory and smelly wet cat food, the sight of pumpkin caused shocked looks on their faces and gasps... I found a combination of LaxAire (tube stuff you can get from the vet) or hairball remedy treats given about three times a week helped for both cats. For the one with the more significant/diagnosed constipation due to a blockage/impaction at age 13, he was prescribed Lactulose, a stool softner, twice a day. Was on it 3 years, his constipation showed up a year before his kidney problems did, but kidney problems also cause constipation and probably kept him irregular. Since his brother's stools also slowed, but did not block him, I have started and kept him on the LaxAire/hairball treats for a couple years now without having to add in the Lactulose (vet OKed his current treats/tube stuff). Kidney problem cat went #2 about every 3-4 days for the past 3 years, normal cat went from daily #2 to every 2 days as he aged. Tube stuff and treats help him.

I take my senior cats in twice a year for blood and once a year for urine if there aren't problems. If there are problems, they go in as often as needed, usually 3-4 month intervals for my Senior that recently passed away with kidney problems and brain swelling (on steroids for that). His anemia was out of control -- we tried meds and it wouldn't help -- and a side effect is loss of appetite. Anemia is also a side effects of kidney problems. He lost 3 pounds in 3 months and took a sharp decline at the end.

I also wanted to mention steroids. Mine was on Prednisolone (kissing cousin to Prednisone). You have to closely monitor liver and sugar levels. He had dizziness due to a brain tumor that was very well controlled for a year and a half by the pred, but we had to closely monitor blood work as his liver and sugar levels would skyrocket and we'd have to lower the Pred. It was a dance to control the swelling and not affect the liver and sugar (causing diabetes).

One thing you didn't mention to put in your hip pocket is when a cat loses appetite, your vet will sometimes prescribe Cyproheptadine. It is an appetite stimulant that seems to work on some cats more than others. It really works on my surviving cat, not as much on his brother. It can help them to eat when side effect of other problems take their appetite. It will make them hyper in some cases, but eating is important. It is my #1 factor that all is well with my cat, along with regular pee/poop.

Fortunately, the surviving brother has absolutely no problems at this time. Blood and urine come back clean and very normal. His appeite is good. One cat had several chronic senior problems show up from age 13-16 and I lost him to them, and his brother from the same litter has had none of the "common" problems in 16 years. Sometimes it is hard to figure out. I am just grateful his brother is so healthy at 16.

I am treating him for a Kidney Infection he picked up as he is a three legged cat (lost a leg to rabies shot caused cancer/tumor in his leg at age 12 1/2). He's recovered well and no signs of cancer in the past 3 1/2 years, but he is prone to kidney infections due to the way he sits... Which reminds me, if you are giving any vaccinations, talk to your vet -- they are very hard on the kidneys in senior cats. Most vets stop them when they become seniors, except possibly for Rabies. I have stopped rabies in my cat as he has no other legs to lose (now don't you start worrying about rabies caused cancer, he was a rare case, tho it does happen).

But, like you, I am very nervous about the remaining cat and watch him like a hawk. It has been almost three weeks since we lost his brother, and I think the remaining cat (Pookey) would just like to eat, poop, and pee without me watching him during each event and checking him off on a checklist when he accomplishes all. Not quite that bad, but close. I keep watching him like something is about to happen. It is hard to get out of the routine when I had to medicate his brother so often the last couple years and monitor his body functions constantly... I hope I can ease up at some point with Pookey, but it is hard.

It's 6AM. Time to give him his antibiotic and see if he pooped/peed overnight... I heard him eat a bit ago, so all is well today...
-----
Tammy and Pookey
(Stanley 8/91 - 8/07)

Thanks for you reply!

Sola's bowel movements have been fine for the last 10 days since he started a steroid (unfortunately).

He's on Wellness canned chicken and gets budesonide every other day for his IBD issues. He seems to be doing just fine has had normal bowel movements everyday, no vomiting, no diarrhea, no constipation! Which is huge for him! My vet said that busesonide targets mainly the intestines, so there usually isn't long term damage to the liver or kidneys.

His anemia is better as well. On his last blood test his RBC and WBC were within the normal range. His WBC went from 4.4 to 6.6 and his RBC went from 5.62 to 6.37.

My only concern now are his BUN and creatinine levels. My vet says he's fine and a kidney diet would not be good for his IBD. But in one month's time his BUN went from 27 to 37 and his creatinine from 1.8 to 2.3 his urinalysis was normal both times though.

But since his BUN and creatinine levels are outside the normal range, doesn't that mean that only 25% of his kidney function is left?

He's going into the vet in 2 weeks for another ultrasound of his intestines (to see if the thickening has gone down) and we'll also redo his bloodwork. But I just don't want to wait till it's too late to do something about his kidneys. I know you "treat the cat and not the bloodwork" and if you saw him you would see that he is acting totally normal, eats, drinks, plays, etc. Has NO loss of appetite whatsoever (he's a Norweigan forest cat mix that weighs 16 pounds!). but again, I have just heard from people that had pets with early CRF that they wished they would have done something sooner.

thanks again for all your advice!

lisa

When Stanley was first diagnosed with early CRF two years ago, the vet said he was at the high end or just outside the normal range. He'd taken a jump in BUN from his visit six months before. Can't recall his creatinine. From age 10 or 11, she their other geriatric vet really watched "concentration" to see how the kidneys were functioning. On the Science Diet KD, he held his values very well for about two years and creeped up to but never went over upper 30s that I can recall.

When he last went in to monitor the anemia/anemia med progress, his values had jumped, but his biggest problem was anemia. He had also started classic symptoms of later stages of CRF -- started declining fast. She said this is common in the CRF guys to take a quick turn almost overnight. He was badly dehydrated, his fur was very rough and dry (like petting straw), he'd had a 3 pound weight loss in a very short time, not eating well, lethargic, etc... We'd started sub-q fluids, but he just declined too fast and never got his appetite back no matter what we did. I won't go into it too much, but he basically stopped eating and nothing would get him to, I pretty much force fed him and he became lethargic and not interested in normal things; got much weaker. It was a very tough time, and it was only three weeks ago... Still is tough.

I started Pookey on the KD the same time as Stanley and he shows no sign of kidney problems at all (recently turned 16). I attribute part of that to the food and part to genetics (although both were from the same litter). His blood and urine levels are good and she said it is OK to continue to feed him the KD.

But, there is one thing in your post that caught my eye. "My vet says he's fine and a kidney diet would not be good for his IBD." I can't speak to the food affecting IBD, as Stanley's problem was constipation from kidney failure not diarrhea. This is something you have to balance. I know with Stanley, he had multiple problems that we had to juggle to treat "the worst first." I learned to address what is most critical first. They won't be with us forever, but with common sense and working with our vets, we help them lead quality senior years with intervention that makes sense. Sometimes treatement is a double-edged sword that will fix one thing, but affect another (really had to watch his liver closely on the steroids for brain swelling).

"But since his BUN and creatinine levels are outside the normal range, doesn't that mean that only 25% of his kidney function is left?" I don't think so, he isn't there until the end stages Stanley showed. They say early CRF cats can go a couple or more years without showing symptoms (that's what my vet told me when they first detected his levels just outside the normal range). Each cat is different, but Stanley went around two years before symptoms really started showing about four months ago with his anemia we couldn't control and last month with the final sudden symptoms I mentioned above. It is my understanding symptoms show themselves when the kidneys are something like 70-75% failed. I've heard when they start needing the sub-q fluids and hit the wall with weight loss, etc., like Stanley did, that is a big sign they are at 75% or worse... But, if we could have controlled his anemia and regained his appetite, he might have had up to another year on the sub-q fluids. Many might have beens, but I say this to you to not worry about anemia overmuch, many cats with CRF don't have anemia as bad as he does and many that get the anemia can be helped with the anemia med (Epogen). Stanley just didn't respond and his anemia became chronic the last four months.
-----
Tammy and Pookey
(Stanley 8/91 - 8/07)

It sounds like your kitties had the symptoms, but not necessarily the high kidney values whereas mine doesn't have the symptoms, but has the high kidney values! Maybe that's why my vet doesn't want to start k/d yet?

I appreciate all your advice. Sola has to go in again to the vet in 3 weeks for another ultrasound of his intestines and we'll do bloodwork again and go from there. I think I'm going to try to get my vet to prescribe k/d just so we don't wait till it's too far gone and as you said, cats may have abnormal functioning of their kidneys before they start to show the signs. My baby's only 11 though!

Thanks again.

Take care,

Lisa

I might not have been clear. Stanley did have the high/outside normal range BUN values starting two years ago, we were just able to control them for a couple years until they spiked even higher the last three months. My vet started KD when he first went out of normal range and was around 36 or 37 on BUN. He maintained between 37 and 40 on KD up until the end and then spiked, but might have done OK longer with sub-q fluids if the kidney disease caused anemia hadn't of been out of control, untreatable. It sounds like your cat is just outside of normal range, which is when we first started watching it for Stanley. That is when my vet called it "early" CRF when he was at 36 or 37 BUN. He did increase in values slowly thru two years (much slower with the help of KD) and then his BUN and anemia both spiked at the end.

I think your vet is hesitant on KD for the reason you may have mentioned earlier -- it will affect his IBD.

If I were you, and this is my thoughts only, not professional and you should always go with what your vet says as they know the cat's complete history, but from what you say, he is at the point where I started Stanley on KD. I would ask if I could mix some in with his food very slowly to see how it affects his IBD. It sounds like if there are problems, you can stop the food and go back to the original regimine. But, only your vet knows the whole history and interactions of KD and IBD. It is certainly worth asking...

Ref the age 11 -- that is about the time many cats start showing early CRF on bloodwork from what I've read. I've heard 11 is the magic age for Senior problems to start showing themselves. Stanley started showing Senior signs and problems at age 12 thru the end at 16. But, many can be treated for a long time. He maintained a great quality of life for 4 years on meds and diet change for different problems. CRF isn't an instant death sentence, which I thought it was when he first was diagnosed with early CRF. When Stanley was diagnosed with the BUN levels you show for your cat, at that time, they said 2-4 years. He might have gone longer than the 2 he did if we could have controlled the anemia. Most cats respond better to the anemia med than he did (not all, but most). He started sub-q, which is the next stage after symptoms really show, and many cats can go another year or so on sub-q if everything else cooperates. It is the ripple effects of the CRF you have to control as well as the failing kidneys.

I wish you well. Work with your vet closely. It sounds like he is entering into early CRF. You are where I was two years ago with Stanley, except he had constipation instead of IBD along side of the early CRF.
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Tammy and Pookey
(Stanley 8/91 - 8/07)

thank you so much. I will ask my vet about mixing some k/d into his food. Good idea!!