Cat refusing renal diet

[JohnRoss]

I know some of you may have older cats here in France and some experience of cat's renal diet. Ben, 18 this year, has been on Renal diet for well over two years. He has either Purina NF Renal Function Feline Formula or Royal Canin Chicken or Tuna sachets or Royal Canin dry Renal Diet food at the vets suggestion. He has lost just over half his body weight over the last two years, he was 9.5 Kg, never fat just big, and now weighs in at 4Kg.

 

Of late he has become very fussy about his food and we have tried to stimulate him by giving him a meal of cooked chicken or turkey from time to time. Now some sites suggest that doing that makes the Renal diet a waste of time but is that true? Whilst he has progressive kidney problems and I well understand that high protein does not help it seems strange to say that despite the bulk of his food being Renal diet any normal food completely negates the effect of that, can this be right? He now often refuses to eat unless it is something he likes. He loved the Tuna Renal diet for a time and now won't eat it. He liked the chicken Renal diet but now is not keen. He still likes the dry Royal Canin Renal diet , tends to make him drink more water,  but it give him the trots after a few days. He has a cough from time to time, neck extended close to the floor, which the local vet has treated with antibiotic saying his gums are infected at times and the stuff going down his throat causes the cough. He does not want to sort his teeth/gums out as he says Ben is too old/frail to withstand the anaesthetic. Despite this Ben happily crunches the dry food without any obvious sign of pain.

 

He sleeps a lot but still can play chasing things from time to time. He does not go out and is a house cat not exposed to other animals. He seems not to be in pain or distress most of the time. We could take him back to the vet for blood tests to check on the kidney disease but to what purpose, he finds such visits stressful. We know he has not got long but we want to make whatever time he has left as comfortable as possible. We can get antibiotics from the vet to treat his cough, sometimes clears it up for a few weeks although I understand that a cough may also be a symptom of kidney problems. Do we give him what he likes to eat i.e. normal food or watch him starve refusing the Renal foods. Any suggestions folks?...................JR

[suein56]

[quote user="JohnRoss"]He has a cough from time to time, neck extended close to the floor, which the local vet has treated with antibiotic saying his gums are infected at times and the stuff going down his throat causes the cough. He does not want to sort his teeth/gums out as he says Ben is too old/frail to withstand the anaesthetic. Despite this Ben happily crunches the dry food without any obvious sign of pain.[/quote]

When treating our beloved Badger for renal failure our lovely vet thought that B's lungs were filling with fluid, so he was coughing in an attempt to move the fluid. This came and went.

She put him on microsolone, which did seem to help. She also rehydrated him with a drip under the skin when she felt he needed it.

He also had Ipakitine - which doesn't suit all cats - sprinkled on his food. He took Vasotop to help his heart - or rather the French equivalent Fortekor, after we moved here.

Badger wasn't too keen on the renal diet and did go off certain flavours just like yours so I did give him chicken and fish from time to time to supplement the dried foods and sachets. We tried lots of different ones - it might be worth visiting a different surgery just to see what brands they have - this is what I did.

[quote user="JohnRoss"]

He sleeps a lot but still can play chasing things from time to time. He does not go out and is a house cat not exposed to other animals. He seems not to be in pain or distress most of the time. We could take him back to the vet for blood tests to check on the kidney disease but to what purpose, he finds such visits stressful. We know he has not got long but we want to make whatever time he has left as comfortable as possible. We can get antibiotics from the vet to treat his cough, sometimes clears it up for a few weeks although I understand that a cough may also be a symptom of kidney problems. Do we give him what he likes to eat i.e. normal food or watch him starve refusing the Renal foods. Any suggestions folks?...

[/quote]

Badger had one blood test, which didn't really help in his case. He was unbelievably stressed by it so we left it at that. He liked to go outside - just for a little tour round the garden. He also slept a lot. In the end he became exhausted with it all and we asked the vet to put him to sleep, but choosing the right moment for him was the hardest thing I have done.

[Judie]

I'm afraid my advice might go against everyone elses, but at his advanced age, I would feed him whatever he fancies, no stressful trips to the vets and if his life is a little shorter because of this, then he will have had a happy end. The most important thing is pain control.

[suein56]

[quote user="Judie"]I'm afraid my advice might go against everyone elses ...

[/quote]

Not at all, IMHO you are right. Now with the benefit of hindsight I wish I had had your insight. One problem I feel most owners have is that they want to do the very best by their pet and believe that the vets are the experts ... well they might well be, but you are the one who knows your pet the best.

[Judie]

[quote user="suein56"][quote user="Judie"]I'm afraid my advice might go against everyone elses ...

[/quote]

 but you are the one who knows your pet the best.

[/quote]

How I agree.

I have had more than 30 cats over the years and have loved every one completely and unreservedly. Some have lived to a ripe old age, some have had an all too short life, but yes I do know my cats best and if their final days are approaching, then they get just what they fancy, loads of attention if that's what they want, or a quiet corner if they prefer. The only thing I look to the vet for is their pain relief.

[cooperlola]

I concur with Judie.  I've been through the renal diet thing with one of our cats (our latest arrival is something like the 40th cat we've given a home to) and I reckon that by the - let's face it pretty advanced - age of 18, your chap deserves a little of what he fancies.  You may speed up his demise but he's probably not all that far off the end so why not let him enjoy a little quality of life in his last months/years.  The renal diet has proabably helped a long way to get him this far and you've done your best for him.

If it were you faced with this choice (eat what you like and live less long, or be on a diet you hate and live longer) which would you go for?

[Christine Animal]

Sue, you already mentioned Ipakitine on another thread for which I'm very grateful.  I just wondered why you say it doesn't suit all cats.

 

John, you may like to have a look at this thread and especialy the link to the marvellous site on Feline Chronic Renal Failure.

http://www.completefrance.com/cs/forums/1156481/ShowPost.aspx

 

[suein56]

[quote user="Christine Animal"]

Sue, you already mentioned Ipakitine on another thread for which I'm very grateful.  I just wondered why you say it doesn't suit all cats.[/quote]

That is what I was told by one vet, though he did add that it is of such benefit in renal failure that it should be tried in all cases.

[val douest]

If you are looking for a choice of renal diets then www.zooplus.co.uk has a good selection and they ship to France for £3.90 (or free for orders over £39).  Goods usually arrive within three days.  It's very interesting to read the customer reviews on the various diets, especially on Integra Protect Renal, which gets good reports from everyone.  I couldn't get the search facility to work on 'renal diets' but 'speciality diets for cats' brings up a longish list with several renal products featured so is worth ploughing through. 

It would be nice to be able to feed Ben something which protects his kidneys and which he really enjoys, too!  Good luck!

Val

[JohnRoss]

Thanks for the replies folks. Several interesting points and links, thank you. This evening we noticed that his breathing was not too good. Flanks moving in a jerky fashion and breathing with mouth open. We have seen this before but only after he has had a coughing fit.

 

So we took him to our local vet who commented on his loss of weight, heart rate being high and took an x-ray which showed that his lungs were shorter lengthways than they should be. He suspects a tumour and possible build up of fluid applying pressure to the lungs causing his panting type of breathing. He was not absolutely certain but thought that this was the most likely cause of his breathing problems and loss of weight. Blood test showed that his kidneys were functioning ok which is a surprise and unexpected. He said that the renal diet was still good for Ben given his age but that we could give Ben, should he continue to turn his nose up at it, other normal foods. We tried stirring in a very small amount of normal Sheba cat food with his renal diet when we got home and guess what he ate the lot!

 

He was not able to say how long Ben has got but he thought it might be a few months though with cats rather than dogs it was more difficult to say. He has given us diuretic, cortisone and antibiotic tablets to see if this combination would help. I think the antibiotic is to offset the secondary effects of the cortisone as I assume on its own there would be increased risk of infection. I don't think he suspects Ben has lung a infection as such. So there we are not a good outlook for the old boy but at least we can make his life a bit more enjoyable with his feeding. The vet did say that he thought that Ben was not in any pain as such but maybe he will feel a bit more comfortable with the treatment, time will tell....................................JR

[suein56]

[quote user="JohnRoss"]

This evening we noticed that his breathing was not too good. Flanks moving in a jerky fashion and breathing with mouth open. We have seen this before but only after he has had a coughing fit.

 

So we took him to our local vet who commented on his loss of weight, heart rate being high and took an x-ray which showed that his lungs were shorter lengthways than they should be. He suspects a tumour and possible build up of fluid applying pressure to the lungs causing his panting type of breathing. He was not absolutely certain but thought that this was the most likely cause of his breathing problems and loss of weight.[/quote]

Please believe me when I say that IMO you do need to change your vet, or follow Judie's advice on page 1. Your cat needs rehydrating, not diuretics.

Do please read all the advice given earlier; it is very sound and based on many posters past experiences.

[JohnRoss]

Hi Sue and thanks for your opinion. I have read the helpful advice but I am not sure why you say he needs rehydrating. The diuretic, if I understood the vet, was given in the hope of reducing the pressure on his lungs which might be caused by the tumour and associated fluid. His pee output is ok just now and in view of the latest kidney function blood test being ok I am not sure what leads one to think he needs more water in his body rather than less but then I am not a vet! Poor old Luke, his buddy, who had really bad kidney function and had to be put down two years ago, peed massive amounts towards the end. I understood that this was a typical symptom of kidney failure which Ben is thought now not to have, well according to today's blood test......................................JR

PS I don't know if Ben could have had kidney problems and has now recovered some function or indeed if this is possible. His blood tests have improved whilst on the Renal diet over the last two years. He has had to be catheterised a couple of times in the past due to blockage and he could not pee, that was a real emergency, and recovered but no problems in that area in the last year or so.

[JohnRoss]

Sue I wonder if you could come back on this soon as the thought that we might be doing the wrong thing in following the vet's advice is causing my wife some stress and in her condition that is not good..........Thanks............JR

PS In other words could you say why you think the diuretic (Furozénol) is a bad thing as whilst I understand that a diuretic may not be good for a cat with kidney problems the blood test allegedly shows his kidneys are functioning ok. We have tried giving him one 10mg diuretic tablet (Furozenol) this evening as soon as we got back but will start the antibioics and cortisone tommorow after speaking to the vet again as the paperwork in the Furozenol box says that it should not be given with antibiotics as this may cause ototoxicité. Mind you he is already stone deaf! We assume that as the vet said his blood test for kidney function was ok he can have a diuretic which if they were dodgy might be a no no. Very confused now.

PPS It also says the effect should be rapid but he had it 4 hours ago and not wanted to pee yet, worrying.

[suein56]

John I have sent you a pm.

[JohnRoss]

Thanks Sue and I understand. Yes well I am somewhat confused in the light of his latest kidney function figures (Urea 0.494 g/L Crea 11.4 mg/L) as they were worse in 2008. I can only assume that the renal diet has caused the figures to improve though I had not thought that possible. We are not going to go mad and change his diet completely and will continue with the renal stuff but maybe spiced up a small amount from time to time with a little normal food mixed in. The heart could be affected indeed also so maybe the pros outweigh the cons for diuretic just now though it is only to be for a few days to see if there is any improvement. We will be monitoring him and reporting any changes/problems to the vet. We don't know how long he has got with us now but just hope to make whatever time he has left as pleasant as possible. Thanks for coming back on this.................JR 

[suein56]

[quote user="JohnRoss"] I am somewhat confused in the light of his latest kidney function figures (Urea 0.494 g/L Crea 11.4 mg/L) as they were worse in 2008. I can only assume that the renal diet has caused the figures to improve though I had not thought that possible. [/quote]

Yes it is possible in that this happened to Badger too.

[quote user="JohnRoss"]

We are not going to go mad and change his diet completely and will continue with the renal stuff but maybe spiced up a small amount from time to time with a little normal food mixed in.  [/quote]

If you read the Tanya site - quoted on page one - IIRC then with one cat she had a shelf given over completely to the 18 different foods just for this cat, who would not eat the same thing twice!

[quote user="JohnRoss"]

The heart could be affected indeed also so maybe the pros outweigh the cons for diuretic just now though it is only to be for a few days to see if there is any improvement. We will be monitoring him and reporting any changes/problems to the vet. We don't know how long he has got with us now but just hope to make whatever time he has left as pleasant as possible. [/quote]

Fortikor is usually the drug of choice as it really does what it says and supports the heart really well.

As far as we can tell Ipakitine helped Badger - it is a powder sprinkled on food twice a day - try asking your vet, some have not heard of it.

If Ben is coughing badly then a mild diuretic might be needed in the longer term - to help the heart cope with the added strain.

Please look after yourselves too; it is extremely difficult I know but try.

[JohnRoss]

Thanks again Sue and it has been a really bad year, 2009, what with the wife's surgery, chemo and radiotherapy. Ben really is a member of our family and being somewhat sensitive to the subject of cancer feelings run a little deep just now!...........JR 

[Chrissie]

We went through the same process a couple of years ago, so I really feel for you. 

Have you tried warming the food up to make it more appetising?

Chrissie (81)

[JohnRoss]

Thanks for the suggestion and yes we have. His food bowl is warmed before we put the food in and the food is stored in sealed sachets at room temperature. Anything kept in the fridge is warmed a little before he gets it. He really looks ill at the moment with bouts of coughing. I don't think he is in pain though, his resps are between 36 and 40 at rest but jerky and I gather they would be higher if in pain.......................JR

[Swissie]

JR- I am so sorry you are going through all this after your wife's serious illness and drastic treatment. I have no expertise in the subject- but just wanted to say 'thinking of you all' - hope things improve for all of you- but that you will be able to say Good bye should Ben ever be in pain. Bonne chance xx Swissie

[JohnRoss]

Merci very much appreciated and indeed we will but, of course we hope he will be with us a bit longer but not at his expense! He has perked up a bit and eaten another sizeable meal just now......JR

[suein56]

[quote user="JohnRoss"]He has perked up a bit and eaten another sizeable meal just now......[/quote]

What excellent news - so good to hear.

[Jo]

Having just lost a cat through kidney failure as a result of poisoning, my thoughts are with you.[:(]

[JohnRoss]

Thanks and sorry for your loss. One of the reasons I won't put poison down for mice and loir. Ben had his last diuretic today and his breathing is still a bit jerky. If fluid builds up over the next few days then it will get worse I guess and there will be another visit to the vet to reassess the situation, maybe more diuretic. The antibiotics and cortisone continue for another 7 days. He is still eating ok and when he is not sleeping, most of the time, he seems ok. One day at a time I guess...............JR

[JohnRoss]

Sad to say we had to take Ben for a final visit to the vet today. He had been a little better when on the diuretics but once those had finished the fluid started to build up and he was having difficulty breathing again. The last couple of days he had gone right off his food but was drinking large amounts of water. His tissues were showing a lack of oxygen and he was tired and inactive as you might expect.

 

We took him to the vet this morning and he confirmed that the time had come to say goodbye. To try to prolong his life for a few more days, even if possible which I doubt, would not have been kind at all. I think he had a good life with us and I guess 17 years and a few months is not too bad for a cat. Those of you who have been kind enough to post replies will know how we feel. He will be sorely missed as are all our other rescued cats over the last 37 years...........................JR