Kidney problem or diabetes?

Hi Dr Marie,

Hicks is 17 years old now. Still moderately active. 2 years ago, she was diagnosed with marginal kidney problem through a blood test. Unfortunately, she is very fierce and impossible to administer any form of oral medication. As such, Azodyl which was recommended by the Vet cannot be used at all as it has to be fed directly and not mixed with food.

At that point of time, we noticed weight lost in her. In order to reduce stress on her kidney, we switched to K-D diet both dry and wet food. As we did additionally research for cure,we found renal essential from Vetri science which worked well on her. We noticed her weight beginning to gain and back to near normal conditions.

About a year ago, we noticed her making some strange noise occasionally when chewing dried biscuits. Along with the sound, she tends to make exaggerated jaw movement trying to chew the food. We did not take pay any special attention to this matter.

6 months ago, she started to consume more water and tends to drool a lot. Not sure is it due to the excessive water consumption. During the same period of time, she tended to "meow" loudly a lot. For example, when she gets back to her bed, she tended to meow loudly once or twice before leaning back to sleep. At the same time, she became very "sticky", following us throughout the house.

About 2 weeks ago, she seems to be weakening and refused to take dry food. Her weight lost became more apparent. My wife started to make boiled chicken breast for hicks as an alternative and she started to eat again. We have also tried to give him more canned K-D which did help a bit.

We also observed that she is very keen to eat but she prefers to be fed directly instead of eating from her own plate. She does not seem to be losing appetite but just very selective with food. This evening, we tried giving her raw beef and she consumed with great enthusiasm. One more thing, we started to add bi-carbonate to her water and she seems to be a little more active.

Thanks for bearing with my long story. My question is what should we do next?

1. Her kidney conditions might have deteriorated but we are not prepare to introduce extra stress to her such as infusion of Q-solutions unless necessary. What would you recommend?

2. Do you think her eating behaviour is caused by bad teeth? Tried very hard to open her mouth; her front and side teeth looks healthy.

3. Do you think if teeth is the problem, can treatment be done safely on such an old cat?

4. Last questions, about 1 month ago, she jumped down from the table and hurt her legs; was limping for a few days and then back to normal. When I observed more carefully later, I realized one of her front leg seems bent but she can walk normally,

Thanks in advance for your advice.

Regards

Hi Doctor Marie,

We did some blood work for hicks with the following summarized results. BUN = 180, CRE = 9, PHOS = 11.3, K+ = 3.5 and PCV = 28. Obviously very alarming readings but she was still eating prior to the Vet visit but in a super picky manner.

The doctor suggested either IV or subQ at home. We went for the latter due to the grumpy nature of hicks. The treatment was done in conjunction of eprex, renal flush and a phosphorus reducing medication. As expected, it was never easy to do a 200ml subQ and all the oral medication. On day 3, we stopped the oral medications. As soon as the treatment started, hicks stopped eating completely, initially she might lick her favourite food once or twice but not more than that. Now she totally lost interest.

On day 6, we did the routine check and did another blood work. This time, BUN = 111, CRE = 6.1, PHOS = 6.6, K+ = 2.8 but PCV felled to 25. Clearly, the subQ did help to bring the readings down but also K+. As we were very concerned that Hicks totally not eating and force feeding (which will introduce more stress) was not an option. Doctor then prescribed K+ and B complex to be added to the SubQ treatment.

Today is day 10. After the last SubQ yesterday, Hicks is now bloated with fluid. I guess she is having fluid retention now. To complicate the matter she is very weak now due to refusal to eat and B complex did not help to make improve her appetite. To make it worst, she did not urinate like the earlier days of the treatment. As such, we stopped SubQ today.

This is a very critical stage for us. Because without food, she will not have the energy or may even die due to starvation. Without energy I don't think red blood cells can regenerate. If we force feed her, her body may reject and causes more stress. In the last 3 days, she tried to vomit, nothing during the first time but today, there were some yellow discharge when she vomited.

She is sleeping at her favourite bed now. Still very alert when we approaches. Do you think her kidney and digestive system has shutdown? Shall we leave her at this stage and expect the worst? Or shall we attempt to force feed? Or shall we wait for B complex effect to kick in so that she will start eating? The irony is before treatment, she was still eating but because she showed some early of weakness in her leg, we decided to send her to Vet.

Thank you so much for supporting us remotely.

Best,

On behalf of Hicks

Dear Dr Marie,

Thanks for your note. Hicks did not made it. She struggled and left us this morning after depleting all her energy. Like you said, no one could predict the future. If we had admitted her since day one or if the Vet had paid more attention to her not eating conditions during our home treatment; she might have survived.

I am very grateful for to you for taking the time replying my note.

Best Regards