Our CKD warriors and a sharing on CKD

As I am not a vet, this is not any professional or expert advice on feline chronic kidney disease (CKD).

We have had four CKD warriors now, namely, Vincent, Pole, Bunny and Cleo, who have fought the battle courageously until their natural end. All four had different requirements and needs even though they had the same dreaded condition – CKD, which we know, afflicts cats quite commonly and has no cure. If caught early, perhaps the condition can be managed or even reversed but only for awhile before it creeps back in.

In other words, we can buy some time. But if we choose to do this, let it be quality time.

For Vincent, Pole, Bunny and Cleo, I gave them somewhat different medicines, supplements and care because each cat is different. But one treatment is the same for all of them and that is the subcut fluids.

I learnt the following from our ever dedicated vet yesterday; the information is researched and fair, so I would like to share it with you. Hopefully it helps. I am paraphrasing what I learnt so that any mistakes or errors will be entirely mine.

Is there any specific mortality time-frame for CKD?

Research does not state any specific timeframe for progression of CKD from stage 3 to 4 and there is also no good evidence that gives us the timeframe. It actually depends on when we catch the CKD and how we can manage the symptoms, ie. hypertension, hyperphosphatemia, anemia, proteinuria, dehydration, inappetence, azotemia, etc.

If we find a way to manage it well, we can reverse it but ultimately CKD is a progressive disease, so timely monitoring and routine blood check, BP and urinalysis check should be done.

Once the condition is stabilised, specialists recommended to recheck for stage 2 – every 3 months and stage 3/4 – every 2 months.

What is the link between CKD and heart disease? 

There is a scenario we call cardio-renal syndrome in internal medicine. The kidney and heart can cause failure to one another when one starts to deteriorate. As HCM (hypertrophic cardiomyopathy) progresses, it can reduce the cardiac blood output to the kidneys and slowly, the kidney cells will die off, causing CKD in this case.

About AKI (acute kidney injury) and CKD (chronic kidney disease)

Uncontrolled AKI can develop into CKD once it has caused permanent damage. But if AKI is caught early, it can be treated and possibly reversed. However, oftentimes during the diagnosis, when CREA and UREA levels have been elevated, the damage to the kidneys is already extensive.

And there is no golden rule to really differentiate between AKI and CKD. It depends on factors like the history, clinical findings for infection, toxicity and the response to treatment. Ultrasound can belp to check on the size and shape of the kidneys.

Usually AKI’s are painful and the kidneys are more swollen. In CKD, the kidneys would be small and crinkled.

What is the link between dental hygiene and CKD?

I learnt this during Vincent’s time and it was from a very senior vet. Vincent lived as a street cat until he came to join our (then) patio cats. He had very bad teeth and gum inflammation. So I took him to the vet’s and he had two dental scaling done. But the senior vet had already forewarned me that bad dental hygiene will eventually lead to kidney failure. This is what happens: When there is gum inflammation, the body produces globulins. Globulins destroy the kidney nephrons, making them lose their filtering capacity. This is why dental hygiene is so important.

I give our cats Orozyme to slow down the build-up of plague and tartar, but only if they are willing to take it. Better still, if you can brush your cats’ teeth, that would be more effective. It is usually the plague that leads to tartar, gum inflammation and tooth decay.

After Vincent’s demise, I took every single one of our cats for a check-up and a few of them needed dental scaling, ie. Cow Mau, Bunny, Indy and Ginger. The girls didn’t need any at the time. Cleo needed one later because there was pain in the mouth so severe that it did not permit her to eat. Cow Mau had a second scaling too as the pain in the mouth was bad. Both were done in their geriatric years, so anaesthesia was risky. But it was between not being able to eat at all (hence, starvation) and the risk of anaesthesia. I took that risk. Thankfully, they made it. Cleo, however, had complications from her scaling and recovery was slow. It took about a week, but she did recover and was able to eat again.

I hope the above helps, but I certainly hope you don’t need it for your cats.

Now, for the supplements and supportive care.

Subcut fluids worked for Vincent, Pole, Bunny and Cleo. In fact, for Vincent, he was given up as “just marking time, any time” by his vet. It was when I changed vets that the (new) vet ordered for his subcut fluids to be increased from 180ml (which his old vet said was the maximum) to 250ml. That alone turned Vincent around magically and gave him 4 more months of quality time.

I have spoken with a few vets about CKD too and most of them say what they have found to be efficient are the CKD (lower protein) food and the subcut fluids.

Astro’s Oil’s renal care package helped give Pole 4 months of quality life. But it did not work on Cleo at all. Maybe by the time I started Cleo on it, she was too far gone. Cleo was okay all throughout until her final decline. Maybe at that stage, nothing worked anymore. Not even the IV-drip was able to bring down her off-the-charts creatinine level.

Renal-N, however, sustained Cleo for more than a year and lowered her creatinine level. This powder is also easy to administer and it does not require any refrigeration.

Bunny’s battle was more of the lymphoma than the CKD, actually. His was a gut problem and when the lymphoma spread to the brain, it became a neurological problem. Bunny’s creatinine level was below the danger level too, yet, he had CKD where his kidneys failed. Even for Vincent, his creatinine levels were not dangerously high. So sometimes, a cat has CKD but this is not reflected in the creatinine readings. There are other parameters to watch out for.

Our present CKD warrior is Indy. I am giving him subcut, Renal-N, Astro’s renal care package as well as Kidney Support Gold. I find that the latter has given him a new zest for life. His appetite has improved by leaps and bounds and so has his demeanour. However, Kidney Support Gold did nothing for Cleo.

So, the bottom line is, we have to play it by ear. What works for one may not work for another.

Now, here’s my tribute to our brave CKD warriors:

Our current warrior:

Indy’s eyes are so bright and lively after he started on Kidney Support Gold.

And he has good appetite as well! Before this, he had no appetite and I had to force feed him daily.

My husband, from his kampung background always says that “Being able to eat is prosperity” (translated from Chinese).  I guess coming from an agrarian ancestry, food is foremost in our thoughts and livelihood. True, without food, we cannot survive.

Seeing our cats, I would tweak that adage to “Having an appetite is a wonderful blessing”! I feel so thankful now that I do not need to force feed Indy anymore. He eats all by himself and even asks for food.

To all pet parents, I hope you will never need to use any of the sharing in this post for your pets, but in the event that you do, I hope this sharing helps. But please, please, please, always consult your vet before giving your pets any supplements.

Last but definitely not least, Cow Mau, our oldest cat now, is not a CKD warrior, but he does have hypertrophic cardiomyopathy which could lead to CKD. He is our HEART warrior!

Our vet has given us the green light to start him on Kidney Support Gold as a preventive measure to delay the CKD, this is after she checked all the ingredients to ensure there is no interactions with Cow Mau’s medication. I’m also giving him a probiotic. And of course, he has his blood thinners and high blood medicine, as prescribed by the vet.