From:
katharine
Date: 2001-06-24 08:04:00 UTC
Subject: Re: Kidneys failing
Bill wrote:
<While I realize there is no cure for kidney
failure is there a good maintenance
plan we can use to help him maintain his current
status. Our vet just
recommended continuing duck soup. Any
thoughts/advice will be appreciated. <
Well, I'm sure everyone is sick to death of
hearing about Champ but maybe I can help. If you
search the archives under "renal failure" or
maybe "kidney failure" there are bunches of posts
(I know...I posted them<g>). This post is
assuming that Moose has chronic (no cure) kidney
failure as opposed to acute (temporary) kidney
failure. This will be totally unscientific since
I'm not a scientist. The vets on this List may
correct what I say, if necessary.
Basically, the two most important things I have
learned is that you need to keep them hydrated and
you need to lower the protein in their diet.
Kidneys that don't function normally don't process
protein very well and they don't retain fluids
very well. Champ was switched to Hill's K/D (low
protein) feline, available from your vet.
Champ will not eat on his own at all. He eats
only soup and only in my lap. His soup consists
of 4-5 1/2 oz. cans of Hill's K/D feline, 16 oz.
of Pedialyte, 2T of canola oil (fish oil or
flaxseed oil has been recommended) and 4 oz. of
Ensure (or equivalent). I usually make two
batches and freeze it all in ice trays. Champ
eats 2 cubes each morning and 2 cubes each
evening. I add a little bit of whipping (not
whipped) cream to each feeding. His weigh has
maintained for several months on this diet. I
always have to get him started on the soup by
letting him lick it off my finger. Eventually, he
will start lapping. I can't just put him down
with a bowl. He will just walk off.
His medications are put in his soup. He gets
Cimetidine (Tagamet) and Tumil-K (to raise
potassium). He gets an Epogen (anemia) injection
every other week. To start out, he only got the
Cimetidine. As kidney disease progresses, other
problems arise, such as potassium levels dropping
(Tumil-K) and anemia (Lixotinic and Epogen). My
understanding is that his phosphorous levels may
get too high (low??) next but he hasn't reach that
point yet. Champ gets frequent bloodwork (every
4-5 weeks) to check all of these levels. His last
bloodwork showed that he is being well managed
(yay for me!) and his BUN and creatinin look
almost normal, though I know the kidneys don't
repair themselves or even improve. I'm just
trying to keep him from getting worse.
That's the diet/medication regimen. The next is
hydration. The body doesn't retain fluids when
the kidneys are failing. Champ started out
getting about 20ml sub-q once a day and now gets
40ml twice a day sub-q of Lactated Ringers. The
last time he was at the vet, his hydration level
looked good (for some reason, I'm terrible about
being able to judge dehydration unless it's
really, really bad). I think this was the first
time that we haven't increased his fluids. Maybe
he's leveling out now. I give him his fluids as
he's eating his soup. He doesn't seem to notice
that he's being poked.
Anyone or anything with kidney failure must be
kept hydrated. That, to me, is the most important
thing. Long-term, excessive dehydration means
certain death, in my opinion. Everything starts
to shut down. I am very surprised your vet didn't
recommend frequent fluids for Moose. When Champ
was first diagnosed, he spent 3 days/2 nights at
the vets office with IV fluids. He was that
dehydrated.
Personality-wise, Champ went from Dennis the
Menace to a pitiful little boy who obviously
didn't feel well. It broke my heart (though I
don't miss the little love nips on the back of my
knee <g>). He has his ups and downs. He sleeps a
lot. He occasionally gets in a playful mood and
it makes my day. His last visit, his potassium
level had dropped again so we doubled the Tumil-K
dosage. I hope that will perk him up a little
bit.
That's about all I can think of. I will be happy
to answer any questions that I can. Good luck
with Moose.
Katharine