CKD numbers

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Mollycat
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Re: CKD numbers

Post by Mollycat »

In Sod's Law style I was on the phone trying to find my parcel that was running 4 hours late when the vet called with results. Molly has remained stable on her Loxicom and vet is unconcerned that creatinine is "very slightly" up from 178 to 196 - it sounds a lot to me but this is the vet I trust 100% with Molly. Phosphorus is "where we would hope it would be at this stage" but she didn't give a number. I don't feel the need to bother her for it, she asked for another recheck in 3 months and we can talk then.

However I now have the weight dilemma. She needs to lose the kilo she has put on since starting renal food a year ago. If I could draw it off and send it to fjm's Tilly I would, but I don't think that's possible. Restricting portions is not an option and I'm not going that route. Options I will consider:

1. Back on the special formula diet food that got her weight down very effectively in 2017 but may or may not have contributed to a crash involving raised liver enzymes, destroyed platelets, yellow stuff out of both ends and alarming weight loss - she was diagnosed hyperthyroid at that time but we have no idea what caused the crash so I am a little wary of this approach, but it would be for no more than 8 weeks, then on normal food again, but unfortunately repeat if necessary which does not sound healthy.

2. Back on the AGAIL that she was on after radioiodine treatment for 2 years until a year ago with no dry food, which maintained her weight just where we want it. Stopping dry is probably the key in this idea and I don't like it as being hand fed the kibble part of her food has played a big part in her relaxation and sociability. When she was on AGAIL this was Dreamies or Crispies and I have just weaned her off those horrors altogether and replaced them with her actual food. AGAIL also has the advantage that she will eat most of it, so she is getting a better level of protein and also more of her medicine dosage.

3. Sit it out with part renal part normal food on the basis that eventually the ckd might cause her to lose weight and that's our safety cushion. Her kidney values are very good and I'm happy to do that, except that the weight is really not helping her joints which are painful enough to make her use the steps I have put everywhere for her. We are starting a joint supplement powder now as well which may or may not help but weight loss definitely will.

Thoughts?
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Re: CKD numbers

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We've ended up with option 3 for Lucy, with the logic that a bit of weight will be a good if she has a crisis. Her joints must be worse in one way, as she has stopped jumping on the worktops (much to my relief, she's such a scavenger), but I was given some Yumove from a colleague who's cat had died, and she seems better on that - typically, I'm nearly out of it, so bought some more and now she's not eating all her food that has it in!
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Re: CKD numbers

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Option 3 is what we've been doing so far but a kilo is quite a lot. Molly was more hesitant to jump but when she stopped going on her favourite sunbathing shelf I knew I had to do something and the steps are a big big help. I accidentally bought some hydrolysed collagen for the dog thinking it was a better version of the Yumove equivalent he was already taking but it's not, it's a powder on its own. Molly can have some of that, today was her first dose so we'll see if that helps at all, but the weight definitely needs to come down a bit - it's the weight preventing her from grooming her back properly!
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Re: CKD numbers

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The problem with renal foods, of course, is that they tend to up the carbs and fat to compensate for the lower protein, and aim to be fairly energy dense as most CKD cats have poor appetites. I would keep the dry just for hand feeding rather than free feeding, and perhaps make some home made treats to hand feed as well - Tilly loves the pancake I make for the dogs. I know Molly gets some real meat as well as the tins and sachets - perhaps choosing slightly lower fat minces would make just enough difference? Not fat free, as that really whacks up the phosphorus per 100kcal values, but chicken thighs with skin or 7% turkey mince are well under 150mg/100kcal (as long as you remove the bones, of course), and much lower in calories than pork mince for example. And then relax, in the knowledge that Option 3 is still a good one if she does not lose weight.

As Tilly's renal values are back in normal range I am juggling my spreadsheets to come up with combinations that come in at around the 125mg/100kcal averaged over the day mark and that she will actually eat! She is ho hum about nearly everything, including Gourmet tins, and today's favourite is tomorrow's yuck. She doesn't like butter, or cream cheese, or any of the other obvious high calorie additions, and even chicken quickly loses its appeal unless it is chunks of breast - the one form which is just a bit too high in Phos for comfort...
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Re: CKD numbers

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Ah I did ask hubby about investing in a mincer - which I thought a great idea - but having been a butcher by trade was against the idea. He may have been thinking of us of course, rather than the animals, but I like the idea of it being ultra fresh and knowing exactly what's gone into it. I recently hit a snag with the lovely little plastic pots I was using to freeze it in portions when I discovered they have a very thin deep ring at the bottom for clipping them in a stack together. Great for dressings, no good when meat has been in it once or twice, so the lot went in the bin. I have thought of a way around it, buying a load more but lining them with cling film before packing them. But I'm buying supermarket minced pork, Madam went off turkey some time ago but I will try again!

Urea notwithstanding, I just do not like the reduced protein for older and ckd cats, and yet I can't ignore Misha's healthy happy 8 years on Hills k/d dry plus real meat treats - for her, it really worked.

For Tilly - are the convalescent foods any good? High calorie but I have no idea what else is in them, and they can be diluted with water if necessary. The hospital gave me some for Misha when they sent her home for her final days of palliative care. How about mayonnaise? Molly loves tuna and she loves mayo but put the two together and she is in heaven! Salmon, trout, mackerel? Does Tilly eat beef mince? Molly loves what I give her when we have it but only as an extra, in her bowl it's clearly inedible or possibly even poison.
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Re: CKD numbers

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I thought pork was too fatty for cats to easily digest?
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Re: CKD numbers

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I don't think 100% pork would be a good diet for cats, but the fat level can help balance out lower fat meats. I may try Tilly with tuna mayo - I've avoided it because of the salt levels in the commercial ones, and I rarely make home made these days. She'd probably eat salmon with hollandaise sauce too, but much as I love her that seems a Step Too Far!

I use a lot of the supermarket philly type cheese, and the boxes are very useful for freezing dog and cat food. For smaller quantities I tend to freeze in ice cube trays and decant into a big bag or box once frozen hard - one large cube is just about a cat meal size. Supermarkets used to sell free flow frozen pork and chicken mince which would have been worth trying, but that seems to have got dropped along with many other cheaper lines.
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Re: CKD numbers

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I don't know why I'm restricting my thinking to mince! She is always happy to eat nibble size pieces of raw or cooked chicken and lean pork, duck (as your salmon in Hollandaise, a bit much for a cat!) so I can perfectly well finely chop any muscle meat and add Felini and other powders. I've no idea why I never thought outside the mince.

Tried ice cube trays. Unfortunately they kept getting freezer burn and the cats refused them.

Pork is actually relatively lean, if visible fat is trimmed off. It's not marbled like beef or lamb, so home prep should be fine I would think.
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Re: CKD numbers

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I thought I'd read years ago that it was the fat molecules in pork that made it hard to digest.
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Re: CKD numbers

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Think this warrants some further digging then. I always assumed the reason pork wasn't generally given was something about worms, no idea if either of us has the right information, but in Germany you get pork cat food and so I thought it might have been an English peculiarity. We had pork chops last night as it happens, the main white muscle in the middle is always tough because it's lean while the tail and the part close to the bone is where all the visible fat is and that goes really tender. I've been giving Molly three meals a week of pork mince ever since she went off the turkey.
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Re: CKD numbers

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Sodium and fat https://cooperpetcare.com/can-cats-eat- ... -for-cats/ but is that natural sodium or because some parts are made into bacon and ham? Tenderloin has the same fat content as a skinless chicken breast and I'm struggling to find any other source on sodium.

I've always given the cats pork loin, turkey thigh and chicken thigh, as their own food, but supermarket mince almost certainly won't be the healthiest - maybe a bit better since they put the fat % on the label but it's never stated whether that is % by weight or calories!
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Re: CKD numbers

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I think it is percentage by weight when stated on the main part of the label, and calories when on the traffic light bit. A mouse protein to fat ratio is 7:5, which is a much higher proportion of fat than would be healthy for a human, or even a dog. The US Department of Agriculture food values website https://fdc.nal.usda.gov is the most comprehensive I have found - most useful for basic, raw ingredients as the UK commercial products may not be on there, and even the ones that are may be formulated differently in the States. It is a fascinating rabbit hole for a wet afternoon, even so!
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Re: CKD numbers

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Roll on autumn and windy wet afternoons - oh but wait ...
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Re: CKD numbers

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It might not be a bad thing looking into a mincer, I also remember reading that mince isn't ideal as it can harbour bacteria more than chunks of meat but that may just be raw meat.
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Re: CKD numbers

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Yes that is true, the larger the surface area the more the bacterial load and the higher the histamine, hence the shorter shelf life. For people with histamine intolerance (or more accurately overload) it's important to buy as fresh as possible and as large a piece as possible. Molly tends to have hers raw, or when the two of them used to have a bedtime snack small pieces blanched and rare, but I can't say we've ever had a problem. Pork mince is a recent thing, since Madam refused turkey mince.
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Re: CKD numbers

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UPDATE

3 month recheck yesterday - I confirmed as suspected that the reaction to being picked up is due to discomfort at being picked up badly. Picked her up with one hand holding her chest and the other under her bum and she curled up like a hedgehog and complained much, much less and did not wiggle.

As usual vet complimented her on being such a model patient because she doesn't hiss, growl, scratch or bite, not at the vet's anyway. She was a bit more stressed than usual but that would have been the heat in the car. She gave blood ever so nicely and I'm waiting for her to deliver her urine sample now.

The first great news is that I also managed to comb out the built-up loose hair on her lower back that ends up forming mats and was already causing her discomfort.

The second great news is that she has lost 100g, only 800 minimum still to go, but she has managed to do this without restrictions and while I am trying to find and create a home prepared diet that she is happy with. At the moment raw pork mince is still the only home made food she will eat reliably, so breakfast with Loxicom has to be that or a Felix pouch or a Gourmet Gold tin. Supper I am serving up different things and I'm not worried if she eats very little or even none of it because she has one solid meal daily and free access to renal and digestive care dry.

But the best part is having the best vet for her. The first question was "Is she happy?" and I have never heard this from any vet ever before. Molly's happiness at age 15 with a few really quite minor health concerns is the key to her care, and my answer was yes, absolutely, she is happy. She is relaxed, comfortable, and since stopping the renal food she is playful again. If she feels like playing then her half-dose of Loxicom and all the steps I have put in for her convenience are making her feel happy enough to feel playful again, and that is all that matters.

Fingers crossed her kidney function is not too compromised. And pray for a sample today.
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Re: CKD numbers

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Great news that she's lost weight, fingers crossed for her results. I was surprised when I rang my vets the other week and the receptionist said 'and how's little miss?', it's really nice when they ask about their wellbeing. I'm glad I had her bloods done recently, she's been sleeping so deeply she's worried me a few times, as it's taken so much to get her to wake up! And of course when you do, all you get is glared at.
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Re: CKD numbers

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Yes that is lovely! Molly sometimes doesn't wake up when we come home now. I watch her breathing, less so now that she is more playful, but yes when they start to reach an age when they sleep longer and deeper I suppose it hits a nerve that they are getting old and brings things to our conscious mind that we're happier not thinking of.

In a while I shall have to ring the vets and have them go ahead with just the bloods for now until I can get a sample out of her, because tomorrow I won't have my car to rush it to them quickly. Apparently there is a discount from the lab if both come in together but I don't imagine they can hold the blood too long waiting for the pee.

When I first got Molly we used a cheap litter and she used to perch on the rim of the tray, she no longer does that with the clumping so I guess she hates getting it on her paws, so she will hold on and hold on until she's desperate. As we only get 2 or 3 pee clumps a day, that doesn't help!
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Re: CKD numbers

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She didn't.

She held on for 20 hours until the surgery closed for the night. Knowing if she went the sample would be wasted, I gave her back her trays. Did she go straight in to relieve herself? Not a bit of it. Four hours later she still hasn't been. I had to instruct the vet to send off the bloods and will take the extra cost from Molly's pocket money.

I love her more than anything in this world, but sometimes I could just turn her into a Davy Crockett hat.
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Re: CKD numbers

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We have the blood results already. Urea is up a little at 13.3 but she was a little dehydrated and vet is unconcerned. Creatinine which is the main number we look at is down slightly at 162 - at the same lab. And phosphorus at 1.32. Vet's summary: Stage 2 with good phosphorus control. Happy to keep on Loxicom and keep up the work on weight loss. Recheck in 3 to 6 months hopefully with urine. Despite my worries, it seems the little progress we have made on diet is doing something! Happy Mollymommy.
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Re: CKD numbers

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Glad that her numbers are looking good, and good luck carrying on the weight loss.
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Re: CKD numbers

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It was that time again!

Having figured out that Molly's problem with the carrier may have been pain from the way we used to grab her and chuck her in quick before she could use her mackerel tabbiness to slip out of our hands, I picked her up much more gently and properly. There was a vocal protest but no hissing and no bid for freedom, and calm and dignity reigned. With hydrophobic sand rather than the plastic beads she delivered a urine sample within 12 hours. A much better experience for everyone.

She is a model patient at the vets, she doesn't flinch at the clippers nor the needle in her neck. She seems to understand now that it may be uncomfortable but she is not being rehomed (again).

I don't have numbers but they are very similar to the last check 5 months ago, except that phosphorous is actually down a little! What's more her mobility is noticeably improved - so the daily half dose of metacam is doing its bit and perhaps the joint supplement is helping too. Urine was concentrated so a little more fluids won't hurt, but her current diet and care plan is really working. No protein loss in urine either. Vet is very pleased with her and I could hardly be more proud of her.
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Re: CKD numbers

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It is very reassuring that she is doing well on the metacam - it makes such a difference to daily quality of life. And being able to get her into the carrier and to the vet without trauma makes the prospect of regular checks in the future much less daunting!
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Re: CKD numbers

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That's great news.
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