# Help! My cat is a bag of bones



## JasonVizor (Jan 12, 2014)

Hi Guys n Gals, Freya my 20yrs Chocolate Burmease has renal failure, I have medicine from the vet and she's on a low Phosphorous diet, dry biscuit from vet and chicken and rice, she has a good appetite, but can only manage small portions, else she gets spewey. Vets checked thyroid and is ok, however she is still losing weight. How can I get some meat back on her bones?


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## Marcia (Dec 26, 2010)

Unfortunately this cat may be near the end. Thank you for posting, but I don't think at 20 years old the long term prognosis is very good. Do your best under your vet's guidance but please be sensitive to her well being. There is nothing worse than forcing a cat to hang on in agony for our own sake.


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## JasonVizor (Jan 12, 2014)

My cat is'nt in agony, she can still jump on to the table, she has appetite, she comes looking for love. Looking for advise on nutrition I am, don't give me no more of that doom and gloom thanks.


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## emilyatl (Sep 9, 2013)

As Heather pointed out, there is a really GREAT website (kind of the kindney/renal issue bible) that has a ton of info on what foods are best for your cat to eat if she has renal disease. Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Which Foods to Feed, and Which to Avoid

So does she always throw up her food? It could be there is something in the food that she's sensitive to or allergic to? Or does she only throw up if she eats too much?


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## JasonVizor (Jan 12, 2014)

She throws up if she eats too much, it is'nt a daily occurence, sometimes a week or more could pass, also she throws up if she drinks a pile of water straight after eating, again not a regular occurance. She throws up the vet biscuits more often than chicken. I'll check those websites for other sources of low phosphorus foods, I'm just worried she's so skinny.


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## Jetlaya67 (Sep 26, 2012)

Maybe break up her meals so she eats the same amount but spaced out through the day. If she eats twice a day, you may want to feed her four times a day. I don't have any experience with renal issues, though. Whatever you feed her try to get the best quality food you can get her, she will get more nutrients in her body. Hang in there, one of my fur babies lived 23 years.


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## NebraskaCat (Jan 15, 2013)

Dave's has low phos foods now.
Restricted Diet Archives « Dave's Pet Food Dave's Pet Food

Not saying that's what your cat needs. Your cat may just need to eat what she likes in her waning years. But I wanted to point out that this is available.


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## laurief (Jun 22, 2008)

Hi, Jason, and welcome to the Cat Forum. A number of us here have dealt with renal failure in our cats. Right now I have at least three cats in varying degrees of CKD (chronic kidney disease - previously known as chronic renal failure). I've also had several kidney cats who have since passed. 

It would be very helpful to see your cat's most recent bloodwork lab report, if you have a copy you could post here. If you don't have a copy, I strongly recommend you get one from your vet. There are so many things that can contribute to weight loss in CKD cats. The lab report may help us identify potential issues and possible management strategies that you could discuss with your vet. Without seeing the labs, though, we're just shooting in the dark.

Because kidney cats typically have significant problems maintaining adequate hydration, it's best to feed an exclusively canned food diet, IF AND ONLY IF your cat will eat canned food in sufficient quantities to maintain weight. Better yet, feed her canned food soup (canned food mixed with plenty of warm water) to increase hydration. There are plenty of canned foods available in the U.S. with lower phos content, but I assume you are not in the U.S. ("biscuits" and "spewey" are not words frequently used by U.S. cat owners). If you're in the U.K., I can direct you to cat food charts that would help you choose appropriate foods for your old girl. I personally do not feed low protein diets to my kidney cats because I believe that protein-deficient diets cause muscle wasting. If the low phos food you are currently feeding is also low protein (which most renal prescription diets are), you may want to consider adding some non-prescription foods with higher protein levels to her diet to see if that will help put some weight back on her. Depending on her serum phosphorus level, however, you may need to add a phosphorus binder to her management regimen if you add non-prescription foods to her diet.

All of that said, the golden rule of CKD feeding is - If she won't eat what you want her to eat, feed her whatever she WILL eat. It's much more important that she eats SOMETHING than that she eats the IDEAL thing.

Now for a few questions that will help me get a clearer picture of what may be going on with her:

What medicine(s) and/or supplement(s) are you giving her, and at what dosage(s)?

Are you giving her any supplemental fluids at home or at the vet clinic? If so, how much and how often?

What does her vomit look like (watery, clear, white, yellow, with or without food), and what time(s) of day does she typically "get spewey"?

What does her stool look like - color, consistency, shape and size?

Laurie


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## JasonVizor (Jan 12, 2014)

The vet has prescribed 2.5mg benazepril hydrochloride 1 daily and 1g ipakitine with food daily, the vet renal bicuit is made by Royal Canin, for liquids, only the water bowl, but she is a good drinker.Her vomit generally looks like soggy vet biscuits, she's not vomiting every day, she sometimes goes maybe 10 days. I think heat is sometimes a trigger she's always looked for the hottest place to settle.



















Both Freya and the turd pictured this evening


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## JasonVizor (Jan 12, 2014)

Sorry about the pictures, I dont know where I went wrong, I hav'nt deleated the images, their hosted on photobucket, I reduced the images to 600 wide, is that still too large?


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## laurief (Jun 22, 2008)

Cats typically aren't "good drinkers" unless they are dehydrated, and dehydration is a very common condition in CKD cats. If you could get a hold of and post her most recent lab results, I could get a much better idea of her condition, including her hydration status.

Assuming that she is dehydrated, which is a good bet given that she is eating an exclusively dry diet with no supplemental fluids, I'm going to make an educated assumption that her intermittent vomiting of undigested food is the result of constipation, which is another and potentially life-threatening common symptom of CKD (and directly related to dehydration).

What was her serum phosphorus on her most recent bloodwork? And total protein, sodium, potassium, creatinine, and BUN? How about her PCV or HCT? 

If her phosphorus is high, Ipakitin is not the most effective choice of phos binder; aluminum hydroxide is.

I strongly recommend you visit the website that Heather recommended: Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Everything You Need to Know to Help Your Cat
This site is frequently referred to as the CKD "bible". It is a comprehensive and indispensible resource of information on CKD and its associated conditions, as well as their treatments and management. There's not much of anything related to CKD that you can't find out on that site. You can and should research everything mentioned in this thread on that site.

Laurie


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## JasonVizor (Jan 12, 2014)

Thanks for the great advise, I forgot to say she also has cooked chicken breast blended with the juice and some rice every other meal, she's fed 6-8 times a day, but only very small portions as the other main trigger for her vomiting seemed to be large portion size. I hav'nt had bloods done in the last year as she was so traumatised after the last blood letting. I'm from Wales in the UK in reply to an earlier question.


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## laurief (Jun 22, 2008)

I'm glad to know that she isn't eating exclusively kibble (though it would be best if she weren't eating kibble at all). If she is constipating (small, hard stools), you may want to eliminate the rice from her chicken meals. Rice can have a constipating effect. Also, mix plenty of warm water into that chicken breast to increase her hydration as much as possible. Also, place more bowls of water around your house, keep the water very fresh, and consider buying a pet water fountain if she enjoys running water.

Small, frequent meals are the best way to feed a CKD cat, because most CKD cats have minimal appetites and are easily put off by large meals. Of course, you've got a different reason for feeding small meals, but it's still a good strategy! 

What time of day does she typically vomit? If she does, or starts, vomiting first thing in the morning, that may be the result of stomach acid building up overnight. If that is the case, an acid blocker like Pepcid AC or Zantac 75 can be very helpful. You can read about them (including dosing guidelines) on Tanya's site.

Speaking of Tanya's site, it is written by a woman in the UK, so much of the information available on the site is specifically applicable to UK sources and supplies. She has included on the site food charts for cat foods available in the UK, along with their comparative nutritional values.

I understand not wanting to traumatize Freya with another vet visit, but it's really VERY important to have bloods run AT LEAST once a year (more often, if symptoms dictate). A CKD cat's blood values can change dramatically and very, VERY quickly, so you must stay on top of them in order to successfully manage her disease and keep her as healthy as possible for as long as possible. 

Not all vets or vet techs are created equal when it comes to drawing blood. My vet's office has several techs who do blood draws, but only one has the technique and presence to keep my cats calm during the procedure. For that reason, I specifically request her any time I go in for blood draws. Don't hesitate to advocate for Freya if there is someone in your vet's office who you prefer to handle her for blood draws.

Laurie


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## JasonVizor (Jan 12, 2014)

Freya loves chicken soup, thanks for that tip, I'll keep you updated as to how we get on.


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## JasonVizor (Jan 12, 2014)

Here's the picture of a typical turd, I appologise in advance to any who may be offended by pictures of poo.


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## laurief (Jun 22, 2008)

Freya is a lovely old gal, but from the clumpy appearance of her coat, she looks like she may be dehydrated to me.

If that stool was recently eliminated and hasn't been sitting in the box drying out for a few days, she's definitely constipated and dehydrated. You need to address both issues ASAP, because constipation is extremely painful and can end up permanently stripping Freya of her appetite. If she becomes severely impacted, it can even be lethal.

It's time to talk to your vet about learning how to administer subQ fluids at home, and you REALLY need to try to get her off of the kibble (if she'll eat canned food).

Laurie


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## JasonVizor (Jan 12, 2014)

I've ordered a supply of low phos wet food, I put the vets kipple in a blender with loads of warm water, it came out like soup, initialy unimpressed, I waved it under Freya's nose and she wolfed it down. I most deffinately go along with the assesment of dehydrated and constipated, she does poo at least once daily but they are small and dry looking and I have witnessed her straining. My mission is to improve her hydration and get some more weight on.


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## laurief (Jun 22, 2008)

Jason, I applaud your efforts on Freya's behalf. Hydration is the single most important element in CKD management. Without proper hydration, CKD cats feel much more sickly than need be. Hydration is key to their overall health, comfort, and kidney support. To that end, I strongly urge you to read through the following links at Tanya's site. In fact, read them several times to help the information sink in. The second link addresses constipation in CKD cats and how to manage and/or avoid the problem. Second only to dehydration, constipation makes CKD cats feel REALLY painful and sick.

After reading through these links, feel free to post any questions you may have about the information.

Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Fluid Therapy
Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Constipation

BTW, it's fine to make that kibble soup for Freya as long as she eats it immediately after you've made it. Do NOT, however, allow it to sit out if she doesn't finish it immediately. Throw out any leftovers. Adding warm water to kibble can promote a lot of bacterial growth very quickly in dry food, and you don't want to expose her to that. Don't store leftovers in the fridge; just throw them out and make a fresh batch of soup at her next feeding.

Laurie


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## JasonVizor (Jan 12, 2014)

Thanks Laurie, you give really good advise and the pointers to Tanya's site is very much appreciated by me and Freya. She's loving her soups, and I'm not leaving anything to fester. I'm going to get me a kitchen scale so I can more properly keep track of her weight. Thank you. Kindest Regards Jason


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## Jetlaya67 (Sep 26, 2012)

He is a beautiful girl. I hope that she puts on some weight soon. You are a good owner.


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## SunnyValentine (Dec 21, 2013)

She's lovely! I can't really see her age! I wish I could age as well as cats. Well my only thought is that when my great grandmother was 90 she was eating pretty well but she was still a bag of bones and it was according to her doctors because of muscle loss and old age. So it's just a thought. She seems to be doing fine otherwise. I wish my Samurai will live as long as yours. He's 14 years old and still living with my mother, he was my teenage years cat.


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## JasonVizor (Jan 12, 2014)

Thanks for all the lovely kind comments, Freya has been on the soup diet for around a week or so now, I hav'nt bothered to put the kibble in the blender since, I just soak the biscuits in hot water from the kettle for about 5 mins, she eats the soggy biscuits first then laps up all the water left behind, I'm also adding water to the wet renal food I got, its again made by Royal Canin same as the kibble and to the chicken breast, I've left out the rice this last week.
I don't know for a fact she's putting on wieght as I havn't got the scales yet, but she feels heavier and her spine doesn't feel so lumpy and her tail feels thicker. Her poo lumps are bigger, she did one about 3" long yesterday, but they do still look dry.

Here's Freya pictured this morning looking just like a kitten.


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## Speechie (Dec 2, 2013)

She is so lovely!!


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## laurief (Jun 22, 2008)

Such a pretty girl. I can't see her coat along her back and sides in this pic, but it looks good from the front. Does her coat feel softer and silkier since you started adding water to her meals? As her hydration improves, there should be a very noticeable improvement to the feel and appearance of her coat.

It's very encouraging that she seems to be putting on weight, too.

The dry stool is still concerning. You may consider giving her Lactulose daily to help soften her stool to make it more comfortable and easier for her to pass. I understand that Lactulose is available over the counter in the UK. You can read the constipation link I provided you earlier for more information on Lactulose availability and dosing. Miralax is a similar drug, but I understand that the only way it can be acquired in the UK is from certain sellers on Amazon. I prefer Miralax over Lactulose because it is a tasteless powder that is much easier to mix into food. Lactulose is an extremely sweet and sticky syrup.

Laurie


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## JasonVizor (Jan 12, 2014)

Hi Laurie, Big thanks for your advise and continued interest in Freya, her coat does feel softer and more silky, I agree her bowel movements are still a concern, although she is pooping with less obvious straining, I will investigate those laxatives. I've just taken some photo's from a different angle, sorry for the poor quality. Jason


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## JasonVizor (Jan 12, 2014)

The second photo.


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## emilyatl (Sep 9, 2013)

She's really beautiful! Glad to hear she's doing a bit better. I hope she continues to improve!


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## yogakitty (May 2, 2013)

JasonVizor said:


> Freya loves chicken soup, thanks for that tip, I'll keep you updated as to how we get on.


OMG is that her NOW? At 20? She looks amazing...  good for you for taking such good care of her. Hope she has many more years to come...wonderful!


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## Mandy and Ellie (Oct 22, 2013)

You've already gotten wonderful advice, I just wanted to come and say that Freya is SUCH a gorgeous girl - I would NEVER guess she was anywhere near 20! 10 years old _maybe_!

You're taking such wonderful care of her, I hope she continues to improve! <3


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## Wannabe Catlady (Aug 6, 2012)

Also have to chime in on what a beautiful girl she is!!!!

Sent from Petguide.com Free App


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## JasonVizor (Jan 12, 2014)

I had Freya put to sleep on the 26th April, I've not been able to look here until now, I'm crying my eyes out. My beautiful girl is gone. She became weak and her last days were hard and I wish I'd acted sooner. Thanks for the help, she did pick up for a while Laurie gave good advise, if I'd come here sooner, who knows? I let her down, my wife dissagrees, but I know. I should have manned up.
Good Bye Freya, I'll love you always.


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## 10cats2dogs (Jun 16, 2013)

Jason, I'm so sorry...Freya was a Beautiful Girl, and she lived to an amazing age...
Please don't beat yourself up...
You did your absolute best, but just like with us humans, the body can only last for so long...
The most important thing is, she knew she was loved, and had a forever home with home with you.
When the time came...You did set her Free to Fly to the Bridge. 
HUGS,
Sharon


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## Jenny bf (Jul 13, 2013)

I am so sorry for your loss. But Freya lived a long and happy life in a home where she was dearly loved. She has left you with lots of lovely memories. Try to remember those times than the last few days of her life.


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## Mandy and Ellie (Oct 22, 2013)

Jason, I'm so very sorry for the loss of your beloved Freya. She lived SUCH a long, full and happy life with you. Don't forget that. You did everything you could for her.

Don't beat yourself up. Hindsight is always 20/20 and it is hard to let go. I have regrets from my family cat, Sheba... we waited a few days too long to put her down but it's because it's just so hard to let go and really know when it's "time". You always have hope they'll pull through and it can be hard to let go... but ultimately you helped her cross the bridge and she is no longer in pain. She is looking down on you now remembering what an amazing life you gave her.

You did not let her down in the slightest. You gave her an incredible life and cared for her and got her the proper vet care she needed through her issues. You were the best cat parent you could be to her.


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## NebraskaCat (Jan 15, 2013)

I'm sorry to hear this news. She was a beautiful lady who has known nothing but love for a very long time. She was not let down. RIP Freya.


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## marie5890 (May 18, 2011)

Jason, I am so very sorry for your loss.

Freya is and was a beautiful girl. Eternal petpets and nose kisses to her.
And hugs to you...


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