Sub Q

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pricey42
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Sub Q

Post by pricey42 »

Hello, my cat who has kidney failure has become slightly dehydrated again. The vets have said I can administer fluids at home - has anyone any experience with this? Am I just putting off the inevitable (dying from this) or is it worth giving it a go? He's happy enough, being a very fussy eater though - seems starving but won't eat a lot of his food but wants chicken! His blood results showed today that his levels are going the wrong way again. I really don't know what to do for the best.

Thanks in advance x
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Re: Sub Q

Post by Lilith »

Hi there - there will be people much more knowledgeable than me on kidney problems on here, but just off the top of my head I can think of a few ways.

Some people syringe water into their cats' mouths. Others mix a little warm water into their food. You could poach his chicken in a very small amount of water and blend the gravy and meat together into a mush, what I believe the cat food makers call 'pate'. You CAN get 'cat soup'; there are mixed reviews on this but I ended up with some Gourmet samples and they were enjoyed. The other day someone, Lallum I think it was, suggested the water from tuna in spring water.

If he's off his food but begging for chicken, at the risk of spoiling him, perhaps the chicken route might be the easiest to take for the time being.

Poor old chap, many fusses to him and all the best for a speedy recovery x
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Re: Sub Q

Post by Nellyjuke »

I've tried the juice from tuna in spring water & it enticed coco to take his meds & eat. He's not got kidney problems though, recovering from PU surgery. Can your vet suggest something?

I tried syringe with coco & was a nightmare he chucked up!

Hope you can entice him to eat. Sending you purrs.
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Re: Sub Q

Post by Janey »

Hiya, I’ve had cats with kidney problems but no experience of administering Sub Q myself although I think Mark has experience of this, hopefully he will reply shortly, or you could try messaging him. I would think if the vet is suggesting it then it is worth doing. Fusses and get well wishes to your little fella xx
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Re: Sub Q

Post by booktigger »

It's more common in the US, what are his levels?
pricey42
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Re: Sub Q

Post by pricey42 »

Many thanks for your replies :P

I've tried the tuna in spring water and he loved it at first. I offered it again tonight and he drank about half the amount. I must admit i havent offered it for a couple of weeks as i thought he was doing really well :roll: now i feel awful about that. I also have a water fountain for him which he always uses so it's not that he won't drink but maybe not enough. He's just so fussy and won't touch the renal food. I've bought so many different foods I could literally start a pet food shop! One minute he loves one but then won't eat it and vice versa. I think I've spoiled him too much and now he wants the finer things in life!

I didn't want to go down the fluid route but he's so bright and has a good quality of life that I'm thinking it would be good.

I think it is more of a US thing and by the looks of it is extremely common there. I'm getting them to send me his levels so I can see them and look into it but he is staged at IRIS 2.

Xxx
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Re: Sub Q

Post by Didi »

I will confess to knowing nothing about sub q fluid but I do think that our kitties tell us when they have had enough and if he is bright and enjoying life then I would be tempted to try anything.
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Re: Sub Q

Post by booktigger »

Not surd what IRIS 2 is, but if it is similar to stage 2 I wouldn't give up. Have you tried Renal dry, it seems more appealing? There are also binders that can be used on wet food to help levels
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Re: Sub Q

Post by pricey42 »

I might give the dry food a go. Obviously I love my cat and am doing all i can for him but i keep spending so much on foods, my partner is not happy! I'm also picking up the binders today so hopefully that will help. The vet says it will do half the job the renal food does. They have also given me a tablet to help with acid in the gut which I'm hoping will make him feel better if he feels sick or anything.

I would like to know what i can expect from a cat with Kidney failure. Some days he seems fine, others quiet. Last night it was like he wasnt comfortable on my lap, not so relaxed. I'm not sure if going to the vets and having his blood taken unsettled him or if he was feeling ill. Some days there's loads of urine, others not so much. He doesnt seem as keen on going out now which partly I like as I can keep an eye on him. This is so hard :cry:
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Re: Sub Q

Post by Janey »

Feeding little and often should help with the acid too. My cat used to get this, usually if he’d not eaten for a while e.g. on a morning. So making sure there’s always some tasty food so the acid has something to work on should help.
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Re: Sub Q

Post by booktigger »

pricey42 wrote:I might give the dry food a go. Obviously I love my cat and am doing all i can for him but i keep spending so much on foods, my partner is not happy! I'm also picking up the binders today so hopefully that will help. The vet says it will do half the job the renal food does. They have also given me a tablet to help with acid in the gut which I'm hoping will make him feel better if he feels sick or anything.

I would like to know what i can expect from a cat with Kidney failure. Some days he seems fine, others quiet. Last night it was like he wasnt comfortable on my lap, not so relaxed. I'm not sure if going to the vets and having his blood taken unsettled him or if he was feeling ill. Some days there's loads of urine, others not so much. He doesnt seem as keen on going out now which partly I like as I can keep an eye on him. This is so hard :cry:
sadly the worst part of a cat with kidney disease is that it is an emotional roller coaster, they have good and bad days, the important thing is there are more good than bad.
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Re: Sub Q

Post by pricey42 »

It certainly is that :cry: I feel heartbroken. I'm trying to be glad that I have been his mum and know he's had a lovely life but it's terrible. We have such a bond and so much has happened in the time I've had him.

I'm going to try giving fluids. He does seem happy but not as active but I want to feel I've done all I can for him. I just hope I can manage to insert the needle for the first time!
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Re: Sub Q

Post by Jan »

hello pricey42 ... Stage 2 CKD is the Iris Stage II - our Blackie may be slipping into Stage II ... a urine test in a few weeks will give a clearer idea.

If its any help, I can tell you that our Blackie definitely gets the hump after having his blood taken at the vets - he gets quiet and very 'offish' with me in particular. Its all my fault he's been upset :roll:

18 months ago, our vet advised adding a phosphate binder to his normal food and to steer clear of giving him any dry food- but as he was brought up by my late mother on wet food that wasn't a problem. She also told me to add warmed water to his food - he has an extra 80-100ml per day and the vet doesn't think, as I did, it was too much. She told me getting so much water inside him helps not only his kidneys but also keeps his stress related cystitis at bay (Blackie had 2 bad bouts of it 3 years ago).

The only thing I've noticed recently is that he sleeps a lot more but perhaps at almost 14 that's normal. He certainly doesn't seem to like the cold nights anymore!
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Re: Sub Q

Post by pricey42 »

Hi Jan, sorry that Blackie has this too. He sounds good though, it's such a relief when they eat!

I've been adding warm water which he licks up but has started walking away from the food. Every time after mixing the kidney support med, the phosphorus binder and water into his food he will walk away. I'm not sure if it's the binder maybe. I just went to tesco and bought a can of gourmet pate and he ate half which made me feel better but I wish he'd eat the renal food :?

I've decided that I'm not going to do anymore blood tests as it's not going to get better and it stresses him out. Is this the right thing?

We're going away in a weeks time for 4 days and I'm so worried that he'll go down hill. Nightmare!
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Re: Sub Q

Post by MarkB »

As Jane said, I do have a bit of experience doing SubQs, but not the proper way with a bag of fluid with electrolyte salts. I just used plain water with a syringe and injected 50ml of water under Willow's skin at a time (the vet showed me how to do it). The best way to rehydrate if needed, is at the vets and it should be doneforat least 48 hours I was told.

As for binders, which ones are you using? - Renalzin id more effective, but I have found that some cats won't eat food with it in. Ipakitine binders seem much more palatable.

It is important to TRY not to panic. I have had 4 cats over the years with kidney disease. One of them managed for a good 5 years from diagnosis - ironically, he was the one that refused to eat renal food. He loved his wet food. I gave him, Felix senior pouches (lower in phosphorus than adult food) and he loved Tesco own fish selection in jelly pouches (Sainsbury's, Asda, Co-op own brand are all the same food)

He also loved his chicken, so I used to dust it in Ipakitine powder.

I am on the fence about dry renal food. It seems at odds with trying to get as much fluid as possible into them.

One thing I would never give them is the water from tuna - even the one that says spring water. It is a bit of a con as it may be spring water, but it is still very salty (you only need to compare the salt content with the one in brine) which acts as a diuretic and makes them lose more fluids.

Has your vet suggested Semintra? - my vet swears by it https://www.boehringer-ingelheim.com/pr ... s-semintra
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Re: Sub Q

Post by pricey42 »

Hi Mark, thanks for the informative reply :)

The vets are talking about water injections under the skin so it would be as you've done before. Is it easy to do? Is it a daily thing? The vets were supposed to be calling me back but 4 days and still waiting :roll: I've been checking his hydration by lifting his skin and it hasn't gotten worse.

The binders is the Ipakitine. He wouldn't eat much last night and since adding it really. This morning I totally forgot to add it and he ate 2/3rds of a pouch mixed with warm water. I'm wondering how much longer all these medicines give them. Is it worth me keep trying to add to food or just let him eat what he likes? I will try putting the powder on some chicken though!

Very interesting to hear that your longest surviving ckd cat ate normal food! I suppose it's down to each cat and how they are. I just feel like I want him to be happy and have what he wants, I'd rather he has quality rather than quantity however hard that is for me. That's another reason I'm thinking not to bother with blood tests - is there much point? I know his levels are high and I don't want him hospitalised again so again, is there any need for them?

I'll ask the vet about Semintra. From what I've read it looks great.

And I can't believe vets recommend tuna spring water if it has those effects :shock:

Thanks Mark!
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Re: Sub Q

Post by Jan »

I continually ask our vet if I should get Blackie to eat the renal food but her answer, at least at this stage, is no, not yet - give him what he will be happiest eating. Doubt I could get him to eat it anyway - I've tried ... about 1 pouch a week is all he will tolerate - though he seems to like the juice the food comes with.

The vet also told me to limit the amount of fish pouches he has so he gets 1/week only.

His diet is and always has been - Felix - with a particular taste for AGAIL but since June 2015, it has been mixed with Ipakitine - he seems not to notice as long as its mixed in well with the food and added warmed water.

Blackie gets very stressed having his blood taken too but our vet feels that having a blood test 2 x year and a urine test every 3 months is important and I'm content to go along with that advice.

Mark - Is Renalzin still available?
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Re: Sub Q

Post by pricey42 »

The renal food does not look appetising at all! I think for Murray as he's moving into stage 3 it can give them longer but I'd rather he enjoys what he eats.

I've read something about fish intake somewhere and it's not supposed to be great for them. Luckily Murray prefers the meat ones (at the moment anyway!).

The vet asked me to leave the room when they did his bloods on Monday. Is that normal? Maybe I'm not informed enough but is there much more they can do when the kidneys are failing? Maybe I should get them done :?

X
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Re: Sub Q

Post by Jan »

pricey42 wrote: I've read something about fish intake somewhere and it's not supposed to be great for them. Luckily Murray prefers the meat ones (at the moment anyway!).

The vet asked me to leave the room when they did his bloods on Monday. Is that normal? Maybe I'm not informed enough but is there much more they can do when the kidneys are failing? Maybe I should get them done :?

X
Never been asked to leave the room when our vet has taken blood from Blackie. Could it be that your vet thinks Murray may pick up on your stress levels which add to what is a stressful event for any cat? Not saying I don't feel stressed but as long as the usual vet nurse is there I'm ok. She's so good at handling Blackie - much better than me if I'm honest. If I pick Blackie up all I get is the 'death stare'.

Cats are very good at picking up the stress levels of their owners, whether at the vets or in the home. I think I contributed to Blackie's 2nd bout of cystitis 2 months after the first because I was so stressed after first bout because we almost lost him. This is one of the reasons I don't get up first to feed him in the morning because I know I'll be stressed if I find he hasn't used his litter tray overnight :oops:

As far as blood testing is concerned, our vet has advised 2 yearly tests and I'm fine with that - as long as the right vet nurse is in attendance!
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Re: Sub Q

Post by MarkB »

When I did the sub-q, it was just under the skin in the fatty area. I didn't get to do it many times, as Willow went downhill quite fast. She was a tiny cat and I don't think she had the reserves in her.

My newest vet is a cat specialist. She is a firm believer in feeding sick cats what they like (within reason) -she said that most cats end up dying from starvation rather than the illness, so frorcing a cat with a poor appetite to eat unappealing food isn't a good idea. Another thing is, that for years, experts have been saying that reduced protein diets (as renal diets are) can make cats muscles literally waste away. Apparently the original research was done years ago - ON RATS - but the pet food industry still makes renal food as low protein. I don't claim to have a great understanding of it, but it seems to make sense.

Jan, I'm not sure if Semintra is still available, None of my current lot have kidney issues, so I am a bit out of touch.

One more thing is Tanya's CRD sit used to list the phosphorus content of various foods. Atone tine they used to list Felix products (they don't any more) but the senior versions were always lower in phosphorus, so I would always opt for senior food as an alternative to renal. Most cats are happy to eat it and it is the same price as adult food. I have always taken the attitude that all I can do is try to nudge their diet in the right direction, but with food they are still happy to eat.
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Re: Sub Q

Post by booktigger »

pricey42 wrote:Hi Mark, thanks for the informative reply :)

The vets are talking about water injections under the skin so it would be as you've done before. Is it easy to do? Is it a daily thing? The vets were supposed to be calling me back but 4 days and still waiting :roll: I've been checking his hydration by lifting his skin and it hasn't gotten worse.

The binders is the Ipakitine. He wouldn't eat much last night and since adding it really. This morning I totally forgot to add it and he ate 2/3rds of a pouch mixed with warm water. I'm wondering how much longer all these medicines give them. Is it worth me keep trying to add to food or just let him eat what he likes? I will try putting the powder on some chicken though!

Very interesting to hear that your longest surviving ckd cat ate normal food! I suppose it's down to each cat and how they are. I just feel like I want him to be happy and have what he wants, I'd rather he has quality rather than quantity however hard that is for me. That's another reason I'm thinking not to bother with blood tests - is there much point? I know his levels are high and I don't want him hospitalised again so again, is there any need for them?

I'll ask the vet about Semintra. From what I've read it looks great.

And I can't believe vets recommend tuna spring water if it has those effects :shock:

Thanks Mark!
My neighbours cat was on Semintra, we only lost her last September. From what I remember, it is only used in certain conditions, as it is actually a blood pressure treatment (which is why my neighbours cat was on it).
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Re: Sub Q

Post by Marla »

We have two 19 year old cats (sisters), both with CKD and hyperthyroidism. For the CKD, they're on Semintra and Alu-Cap.

I heard good things about Semintra from people in this forum and asked our vet for it. They weren't willing to prescribe it at first, because it was fairly new and they didn't have experience with it, so I obtained the following information from the Boeringer Ingleheim Vet Enquiry Line (2015):

Both Fortekor and Semintra are licensed for proteinuria (protein in urine). In addition, both slow down the progression of kidney disease, but are not licensed for that because it's difficult to prove in cats. In 30% of cats in their study, Semintra reduced nausea and improved appetite.

A vet might only prescribe Semintra for what it's licensed for (proteinuria) or he/she might prescribe it off-label for slowing down the progression of kidney disease.

Neither Semintra nor Fortekor is licensed for high blood pressure, but they are similar in that respect. Both will cause a drop in blood pressure.

Advantages of Semintra:
- Targeted and more specific. This is always preferable. It is thought that some cats' systems find a way around Fortekor.
- Tasteless liquid that is readily accepted. Fortekor is a bitter tablet.

Later, when our cats both showed high phosphorus in their blood results, the vet prescribed Alu-Cap, a phosphorus binder. It's a capsule of powder that you divide into 16 tiny doses and give only twice a day. We saw a marked improvement in both of them since starting taking Alu-Cap.

They don't seem to notice either one in their food. If a cat isn't good at finishing their food, you can syringe Semintra directly into its mouth.
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Re: Sub Q

Post by Marla »

I too would avoid dry food.

Here's a good article on why wet food is better:
http://catinfo.org/#Cats_Need_Plenty_of ... Their_Food

We also have a water fountain which both the girls use a lot.
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Re: Sub Q

Post by booktigger »

Marla wrote:I too would avoid dry food.

Here's a good article on why wet food is better:
http://catinfo.org/#Cats_Need_Plenty_of ... Their_Food

We also have a water fountain which both the girls use a lot.
Renal dry is more palatable though, and my last CKD cat only ate dry food when I got her, within 6 months of being on renal dry with less than a pouch of adult food a day, her numbers were back in normal limits and she was still on daily Metacam. It was her arthritis that forced my decision, not her kidneys
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Re: Sub Q

Post by Marla »

We feed a non-renal wet food plus Alu-Cap.
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Re: Sub Q

Post by pricey42 »

I have been thinking about trying the dry renal food but mixing with wet food? I'm putting warm water in his food, he has a water fountain plus I let the tap run and put him next to it and he has a good drink. I'll take a look at the link about wet food though - thank you marla.

I will definitely ask about Semintra when the vet calls tomorrow. I must make a list of everything I need to ask!

Murray has eaten really well today with both the Ipakitine and pronefra in - wahey! He has been having 1 tablet a day (I don't know what it's called and I've got 2 cats on my lap that I don't want to disturb so can't go and look!) Of a acid settler which he's been taking for a week. I'm wondering if this is improving his appetite?

Now is alu cap the same sort of thing as Ipakitine? Ipakitine is a binder.

Thanks so much for all the advice! :D
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Re: Sub Q

Post by Marla »

Sorry, I missed that Murray was on Pronefra. I think Ipakitine, Pronefra and Alu-Cap are all phosphate binders (made with different ingredients). Our cats didn't seem to like the taste of Pronefra - although with CKD it's hard to tell if they don't like the taste of something or have just stopped eating for another reason. So we eventually stopped giving that and then later they were prescribed Alu-Cap.
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Re: Sub Q

Post by MarkB »

I also tried Alu-Cap, although never heard of it being prescribed in the UK. It is licensed for use (in humans) as an antacid, so may help there with some CKD cats. I found out about it on a forum for Americans. I bought mine over the counter in Boots (no prescription). I just asked the pharmacist and she counted them out. I still have them in the cupboard - probably out of date by now.

I know there were some that said it could cause dementia, because it is aluminium based, but some said that shouldn't be an issue for cats as it takes years for any significant amount to build up in the brain.
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Re: Sub Q

Post by Marla »

Thanks Mark, I'll check the price at Boots. It has to be cheaper than what we're paying at the vet.
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Re: Sub Q

Post by MarkB »

I checked mine and they say use by March 2015, so probably not much good by now. Shame as there must be about 100 left - I had totally forgotten about them.

I see a couple online pharmacies sell them for around £19 for 120 - oddly, Lloyds pharmacy say a prescription is required.
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