# Early kidney issues - Hills K/D?



## Shybail (Nov 1, 2013)

So my male cat was losing some weight and I was concerned. I am in the midst of trying to change his and my females food but I knew that wasn't the issue. So I took him in for blood work with urinalysis and the vet thought maybe hyperthyroidism because he acts normal other than the weight loss. They called yesterday and his blood work was good. Thyroid fine, no diabetes etc but she mentioned early kidney issues? She suggested putting him on Hills K/D ahead of time to help it from getting worse faster or something. I am kind of confused because he's not in kidney failure and I wonder if he needs that food which I'd rather not give him. I mean it's kinda junk but I will do what's best for him as he needs to live forever 
So is there another grain free food that's better? Maybe close to the low protein and phosphorus but none of the crap fillers? I have the results, just not sure what they all mean. She also mentioned giving him fish oil but I forgot what that helps. I guess I was in shock about the results as I expected to pick up meds and be done. So now his weight loss is either his teeth needing cleaning or this kidney thing even though it's like very early. I was nervous about cost and part listening to what she said. Now we have care credit, dental is scheduled and I am trying to figure the best thing for him with the food thing.
He only eats dry food and won't go near wet. I can try anything that would be the same cost as the prescription food since its either that or something else anyway. Any help and suggestions?


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## laurief (Jun 22, 2008)

I'm sorry for your cat's diagnosis. It would be very helpful if you could provide some more information in order to give us a clearer picture of his condition. First, how old is he? How is his appetite? Any vomiting?

Next, please post ALL of his lab results here for us to see. Include ALL lab values, including those within the lab's reference ranges. It's very important for us to see ALL lab values in order to get a clear picture. When posting lab results, be sure to include the lab's reference ranges like so (this is important because reference ranges will vary from lab to lab):

creatinine 2.7 (0.6-2.0)
BUN 39 (18-36)
phosphorus 4.8 (2.7-7.5)
Total T4 2.1 (1.9-4.8)
etc.

The following link is considered by many chronic kidney disease (CKD) caretakers to be our "bible". It will provide you with an immense amount of information about CKD, including dietary information:

Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Everything You Need to Know to Help Your Cat

Laurie


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## Shybail (Nov 1, 2013)

Ok I will post all results. There are a lot if you want everything she tested. While I am typing all that - he is a male Himalayan, neutered, 13 years old. Never a health issue. About 2 years ago he started throwing up from the nutro max chicken adult cat food they had been eating for like 8 yrs. I tried finding a sensitive food and put him on Purina sensitive systems which stopped his puking that day. Recently started reading about how bad foods are and picking a puppy food. Decided Bailey needed a better food also and same time nutro improved itself and my female stopped eating it too. Been trying new foods, higher quality ones to see what I can get them both on and this happened. He has only thrown up 3 times in the past month we've been trying the new foods. So I do believe he is sensitive to something but not sure what. Right now he has been liking his bg merrick chicken with no issues. He eats normal as far as I can see and drinks fine, nothing abnormal in that or his activities. He was just getting thinner and my female wasn't by about a pound off his normal younger weight. They have never been heavy either so they lose weight and you know it. Always eats dry, no canned, not big on treats. Likes ice cream and baby food meats and that's all. No diarrhea, never goes outside or around strange animals. All I can think of, hope that's all you needed. Now I will get to test results in another post.


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## Shybail (Nov 1, 2013)

Ok here goes:

Hematolology results:
BASO - 0.0% (0-1)
EOS - 7.3% (2-12)
HCT - 38% (29-45)
HGB - 12.0 g/dl (9.5-15)
LYMPHS - 10.0% L (20-55)
MCH - 15.1 pg (1.0-17.5)
MCHC - 31.6 g/dl (29-36)
MCV - 48fL (41-58)
MONOS - 2.6% (1-4)
NEUT SEG - 80.1% H (35-75)
PLATELETS - 235 K/uL (170-600)
RBC - 7.95 M/uL (6.0-10.0)
RETIC CNT - 0.1% (
WBC - 8.2 k/uL (4.2-15.6)
ABS BASO - 0 /uL (0-100)
ABS EOS - 599 /uL (0-1500)
ABS LYMPHS - 820 /uL L (1500-7000)
ABS MONOS - 213 /uL (0-850)
ABS NEUTS - 6568 /uL (2500-12500)
ABS RET - 8 K/uL (3-50)

Chemistry results - 
ALB - 3.1 g/dL (2.3-3.9)
ALKP - 17 U/L (0-62)
ALT - 42 U/L (28-100)
AMYL - 2037 U/L (520-2060)
ANION GAP - 16 mEq/L (13-27)
AST - 22 U/L (5-55)
BICARB - 25 mEq/L (13-25)
BUN/UREA - 48 mg/dL H (15-34)
Ca - 10.4 mg/dL (8.2-11.8)
Chloride - 122 mEq/L (111-125)
CHOL - 187 mg/dL (82-218
CREA - 2.2 mg/dL (0.8-2.3)
DBIL - 0.0 mg/dL (0.0-0.2)
GGT - 2 U/L (0-6)
GLU - 93 mg/dL (70-150)
IBIL - 0.1 mg/dL (0-0.3)
LIPA - 72 U/L (10-195)
PHOS - 5.1mg/dL (3.0-7.0)
Potassium - 4.7 mEg/L (3.9-5.3)
TBIL - 0.1 mg/dL (0.0-0.4)
TP - 7.0 g/dL (5.9-8.5)
Sodium - 158 mEg/L H (147-156)
A/G Ratio - 0.8 (0.4-0.8)
B/C Ratio - 21.8 
Na/K Ratio - 34
GLOB - 3.9 g/dL (3.0-5.6)
CK - 286 U/L (64-440)

Endocrinology Results - 
T4 - 1.7 ug/dL (0.8-4.7)

Hematology Results - 
RETIC CNT - 0.1% 
ABS RET - 8 K/uL (3-50)

UA/Microscopy Results - 
Bacteria - None seen HPF
Bilirubin - Negative
Blood - Negative
Casts - See Notes HPF
Clarity - Clear
Color - Straw
Crystals - None Seen HPF
EPI Cell - Rare (0-1) HPF
Glucose - Negative
Ketones - Negative
Mucus - None Seen
PH - 5.5
Protein - Negative
RBC - None Seen HPF (0-5)
SP Gravity - 1.024
UROB - Normal
WBC - None Seen HPF (0-5)
1+ HYALINE (1-2)


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## Shybail (Nov 1, 2013)

Ok those sunglass faces are 8 and then parenthesis but it wouldn't let me edit without going to administrator. Hope it makes sense.


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## Shybail (Nov 1, 2013)

Been reading that site and no foods have as low a phosphorus so maybe I should just get him the k/d. I don't want to make his issue worse or anything. Tried simply nourish treats tonight because my order came in. Neither would touch the grilled chicken or the freeze dried Turkey. Couldn't get them to eat canned once again. I just don't know with these two.

I do see a simply nourish cat food healthy weight is 28% protein and .6 phosphorus. Not grain free. Is it even worth it?


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## Shybail (Nov 1, 2013)

Any vets on here that can give me some insight on these results other than what my vet said? I'd appreciate it. Thanks in advance.


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## emilyatl (Sep 9, 2013)

Well, her Phosphorus and Creatinine are not elevated (Creatinine is on the high side, but not elevated). The only renal value I see that's elevated is BUN, but that can be elevated from dehydration. Her urine gravity is quite low too, which can be an early indicator of renal issues, but it can mean other things too. It can be an indicator of hyperthyroidism, but her T4 is normal, and it can also be an indicator of diabetes. If it's renal disease, it looks like it's in the very early stages (which is a good thing), but I'll let someone else with more experience with renal problems weigh in.

Also, I saw your note indicating you were looking for a low protein food? If your cat is in early stages, I don't think that's necessary (it can cause them to lose more weight), but again, I'll let someone else weigh in on this.


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## emilyatl (Sep 9, 2013)

One other thing I just noticed is the Hyaline in the urinalysis. I've never actually seen this in urine, so I had to look it up. Based on what I've read, they are normally not present in a cat's urine, but are an indicator of kidney issues if they are present. Does anyone else have any info on this?


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## laurief (Jun 22, 2008)

I'm sorry I didn't answer earlier. Sometimes I get lost in the threads here and overlook one. Anyway, just to be clear, I am NOT a vet or a vet tech. I do have a lot of experience taking care of kidney cats, and I have done a lot of reading and researching on kidney disease in cats, but that is the extent of my expertise. Now, having offered that disclaimer ...

First, I will give you links to information that will help you make a little sense of your cat's lab values:

Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Diagnosis
Broadway Veterinary Hospital / Laboratory Assessment Descriptions

And now a link with lots of tips, tricks, and techniques to help transition a kibble addict to canned food:

http://catinfo.org/docs/TipsForTransitioning1-14-11.pdf

Canned food is MUCH preferable to kibble, esp. for kidney cats, so it's well worth the effort to try to get him eating canned. Of course, some cats simply won't convert no matter what you do, and the bottom line for kidney cats is to keep them eating, no matter what you have to feed them. If your boy still has a strong appetite, though, now is your best opportunity to try every trick in the book to switch him to canned. Kidney disease does rob a cat of his appetite as the disease progresses, so take advantage of his appetite now.

CKD cats find it increasingly difficult to maintain proper hydration - so much so that almost all CKD cats reach the point where they require regular subQ fluid administrations to avoid dehydration. This is why switching to canned food is so important, if you can manage it. Kibble is dehydrating, which is the last thing a CKD cat needs. Canned food is hydrating, so it can help keep a CKD cat healthier overall.

As Emily noted, it is not necessarily advisable to reduce dietary protein for early stage kidney cats. That low-protein recommendation has been under scrutiny and highly debated in CKD circles for a number of years now. Some still believe that protein restriction is beneficial for all CKD cats, while others (myself included) believe that protein restriction causes muscle loss and generalized weakening of the cat. Even if my CKD cats would eat a prescription renal diet (which they won't), I wouldn't feed it any earlier than late Stage 3 and Stage 4.

Now to your cat's test results ...

Low lymphocytes may be caused by severe stress related to illness (like distemper or feline leukemia) or inflammatory, infectious, or cancerous conditions.

Slightly elevated neutrophils are most commonly caused by inflammation or bacterial infections.

Slightly elevated BUN may be caused by kidney disease or some other conditions. Coupled with a creatinine near the top of the reference range, it's likely the result of Stage 2 kidney disease.

Your boy's phosphorus is a bit higher than ideal (it's best to aim for keeping phos under 4.0, if possible), so it would be advisable to choose low-phos foods for him ... if he'll eat them.

Slight sodium elevation is most likely indicative of mild dehydration.

It's important to note than creatinine doesn't generally elevate above the lab's reference range until at least 2/3 of kidney function has already been lost, so that's just about where your boy is at this point. That's not intended to scare you. It's just something to keep in perspective. Cats can enjoy a very good quality of life with remarkably little renal function, so you needn't panic. You do need to start monitoring his health more closely, though (including a renal blood panel at least twice yearly) and taking steps (like increasing his hydration, reducing his dietary phosphorus, and starting Calcitriol when appropriate) to slow the progression of his kidney disease as much as possible.

Laurie


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## Shybail (Nov 1, 2013)

Ok so as the vet said it is probably early kidney disease and not something else? He has lost about a pound and eats well I thought but he has bad tartar and the vet said his mouth may hurt so he is not eating normally. He plays drinks and all else normally but he is also a sensitive stomach cat and I've been trying to switch his food to something better as he had been on Purina sensitive systems. I was wondering if the teeth issue or recent food changes caused the blood levels or the fact he lost weight and not kidney disease. Is that even possible? His teeth get done next Friday so I won't see any changes till then.
Now how would I keep him on high protein but low phosphorus? This is where I get confused. Most high protein have high phosphorus. He likes the merrick bg chicken protein 36 but not sure of the phosphorus. He Hasn't liked anything else yet. I will try hard to change to wet but I see him starving himself first to be honest. I have only ever been able to get him to eat baby food. He doesn't even like treats very much. I wish he wasn't so difficult. 
Why the calcitrol and is it like a pill? Vet had said fish oil and he wouldn't eat his food with it in there. Had to dump it and pour a new bowl. He is going to be difficult. Good thing I know how to do sub q fluids for later as I worked with a vet when I was younger but I know nothing about blood values and kidney stuff. I still can't decipher my own with leukemia and its been a year lol. Thanks so much for your responses guys! It really helps.


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## Shybail (Nov 1, 2013)

Found a way that helps him drink more. He always wants to drink out of people's glasses of water but I never leave mine around cuz my 1 yr old would dump it. So he lays on my fish tank light cuz its warm and he's shaved right now. I out a glass of water on the tank filter so he can just drink right there and not go down the hall. So far I have seen him use it a few times so it's working!


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## laurief (Jun 22, 2008)

Shybail said:


> Ok so as the vet said it is probably early kidney disease and not something else?


Elevated BUN can be caused by several things, but creatinine is kidney-specific. Given your cat's age and his creatinine level, I would have to assume he has kidney disease.



> I was wondering if the teeth issue or recent food changes caused the blood levels or the fact he lost weight and not kidney disease.


Bacteria from the teeth can enter the bloodstream and damage the kidneys, so there is a connection between bad teeth and kidney disease.



> Now how would I keep him on high protein but low phosphorus?


You don't need high protein, you need high QUALITY protein in normal amounts. You can find listings of cat foods by phosphorus content at the following links:

Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - How to Use the Food Data Tables
Binky's Page: Resources for Feline Diabetes



> He likes the merrick bg chicken protein 36 but not sure of the phosphorus.


Merrick BG Chicken is fairly high phosphorus (check the first food table link I provided above), so it's not an ideal choice. Use those tables to try foods lower in phos, and don't fret so much about protein. 



> I will try hard to change to wet but I see him starving himself first to be honest.


Don't let that happen. Cats should NEVER be starved into submission, esp. not kidney cats. Just try all of the tips and tricks in the food transition link I provided you earlier. If you can get him transitioned to canned food, great. If not, just keep him eating whatever he wants to eat. The bottom line is that he MUST eat, regardless of whether or not he eats "ideal" foods.



> Why the calcitrol and is it like a pill?


Here is a link that will teach you everything you need to know about Calcitriol. Your cat's bloodwork doesn't justify starting Calcitriol yet, but it's definitely something to keep in mind as his CKD progresses.

Calcitriol Reference Page



> Vet had said fish oil and he wouldn't eat his food with it in there.


You might try a no-odor fish oil. Sometimes that'll work for cats who refuse to eat smelly fish oil products.



> Good thing I know how to do sub q fluids for later as I worked with a vet when I was younger


That's the single most important skill to have when caring for a kidney cat, so you're already ahead of the game.



> but I know nothing about blood values and kidney stuff.


Just keep reading Tanya's site. Little by little, the information will start sinking in and sticking with you. I've been caring for kidney cats for well over a decade, and I still find myself referring back to Tanya's site frequently. It's an ongoing learning process.



> I still can't decipher my own with leukemia and its been a year lol.


I'm sorry to hear about your leukemia, and I hope you are being successfully treated.

Laurie


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## Shybail (Nov 1, 2013)

Thanks for all your info, I'll look at that list again but most of the low phosphorus foods were hills. How high can I go up to? Can't wait till his teeth are done so I can see if it helps him eating any. I also bought suzies tartar liquid online today to hopefully help but who knows if it really works. I'll try anything to keep them healthy lol.
Ok will not worry about calcitrol yet then. I read that site but then it seems like it says this or that type stuff and then I get confused.
My leukemia is fine for now, it's a long term one and they just keep watch on me. Thanks!


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## laurief (Jun 22, 2008)

Shybail said:


> Thanks for all your info, I'll look at that list again but most of the low phosphorus foods were hills. How high can I go up to?


The canned food tables at both of the sites I linked earlier have lots of brands with lower phos, including Hills. If your boy will eat canned Hill's, go ahead and feed it to him. The fact is that "perfect" foods for CKD cats don't exist. They're all going to have something about them that you'd just as soon avoid. So do the best you can with whatever you can convince him to eat. Ideally, you want to choose foods that are as low in phos as possible, preferably under 1.00 on Tanya's list or under 250 on Binky's list (again, the lower the phos, the better).



> Can't wait till his teeth are done so I can see if it helps him eating any.


Make sure your vet administers fluids while he is under anesthesia and for a while afterwards to keep his blood pressure up and protect his kidneys. And if your vet feels he needs a pain med (in case he requires any tooth extractions), do NOT allow him to administer Metacam. Request buprenorphine or tramadol, instead.



> I also bought suzies tartar liquid online today to hopefully help but who knows if it really works.


I doubt if it will do anything at all to help with tartar, and you want to be really careful about ANYTHING you put into a kidney cat's system.



> Ok will not worry about calcitrol yet then. I read that site but then it seems like it says this or that type stuff and then I get confused.


Then just bookmark it and go back to it later after your cat's creatinine has gone above the reference range. If you still find it confusing then, we can sort it out for you.

Laurie


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## Shybail (Nov 1, 2013)

Yes I did bookmark it and keep reading parts over and over. I think I am going to try and get him to eat the prescription g/d as it has more protein and still low sodium. I am not sure I will find many grain free good foods for him with his issue so we might as well try the prescription now. Website says try it while they still eat well so they will eat it later on when it's important. Would it make sense to mix in a better food? Probably not, ok I will stop worrying about what I think is better and give him what he needs. I'll just be happy if he likes it and gains weight again.


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## Shybail (Nov 1, 2013)

Update - last night I noticed Bailey was not looking so good and it hasn't seemed like he was eating. I gave him baby food meat which he may have eaten half a jar but more than likely ate a 1/4 and my female finished it off for him. I was panicking, he was laying around, wouldn't come when called. I thought he was in big trouble. This morning gave him baby food again and he ate 1/4 jar then nothing but did lick some nutra cal. Called the vet and was so worried waiting for them to call back. 
They had me bring him in for an antibiotic shot which lasts 2 weeks which they said he probably would have gotten Friday with his dental. They gave him a 1/4 tablet of appetite stimulant also. He still weighed the same as he did a week and a half ago when he had his blood work so that was good. They think it's his teeth even though he has early kidney issues. They said the kidney problems are so early it's not likely that's the reason for any of this. So he's had his dental appt set for this Friday and I was afraid he wouldn't make it. 
Got him home and he practically ran to the food and started scarfing it down like no tomorrow. I was like omg look at that! So he's been back to the bowl 4 times since he got home about 2 hours ago. I am amazed and already he's back to purring and laying on the couch with us etc. I am so glad I brought him in for this stuff. I am no longer worried about his dental getting done. I hope that's his problem and once his teeth feel better he is himself again and eating normally. I also went ahead and got his prescription food to see if he'd eat it. He ate some with his regular food before but with the stimulant I thinks he would have eaten poop had that been in his bowl lol.


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## Shybail (Nov 1, 2013)

Well dropped him off at the vet for his dental a little bit ago. Hope all goes well and can't wait to pick him up already. Poor guy is probably scared to death. Anyone else feel horrible when you have to drop pets off like that and leave them?


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## laurief (Jun 22, 2008)

I expect that just about everyone feels horrible when leaving an animal at a vet clinic. I know I do. You'll feel much better when you get your boy home again ... and so will he.

Laurie


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## katrina89 (Jul 30, 2013)

I cried when I dropped my girl off for her dental surgery... I wsd a wreck and called every hour lol she was great when she came home... she may need to go in again for surgery in a couple weeks

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## Shybail (Nov 1, 2013)

Yeah I just hate it and can't wait to pick him up already. They are keeping him till 4 to give him extra fluids. They had to do 4 extractions poor guy. Sending him home with tramadol. They said he'd feel yucky over the weekend. How long do you think till he will eat on? I am sure he'll have to have the appetite stimulant tomorrow to help.
Once they have tartar but not bad enough to need a dental is there anyway to correct it other than the cleaning? Like they said my female has a little tartar but apparently not bad enough for a cleaning. Can I brush her teeth now to fix it or is it a lost cause and once it's there it just is unless they do a cleaning?


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## laurief (Jun 22, 2008)

He really shouldn't eat much this evening, anyway, since he'll probably feel a bit nauseous from the anesthesia until tomorrow. The vet will probably tell you that you can offer him a little food tonight, but don't be surprised if he doesn't eat it (or eats it and vomits it back up).

When I have a cat with multiple extractions, I feed warmed canned food soup (canned cat food mixed with warm water to bring it up to the cat's body temp (about 101F). That makes it possible for the cat to eat without chewing and also prevents cold shock on tender gums from cold or room temp food. If the warm water separates from the food and just sits on top of it even after you mix it up, puree the food with a little hot water in a kitchen blender. That will blend it thoroughly enough so that the water doesn't separate.

Laurie


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## Shybail (Nov 1, 2013)

Thanks for the info. Got him home and he seems to be feeling better but they also gave him a bupro shot for pain. She said he probably would not need tramadol tonight but in the morning and he can have it every 6-12 hours. He goes back in 10 days for his recheck. So he was nervous in the car, got him in the house and instantly he was like ahhhhh. I went to the car to get some groceries I got before I picked him up and looked for him. The dopey was at the food bowl eating dry food! I was like oh really? So I guess I don't have to worry about him eating. He's probably a little dopey still and I have him laying on my lap, he's happy, younger stick in out and all lol.
I want to pick them up a toothbrush tomorrow to get into that routine. I also have a liquid for their water and the vet gave me a powder to sprinkle on their food daily that is supposed to help keep their teeth clean. I am just not sure if I can get the tartar that my female already has off or if I just try to keep it from more accumulating. I am going to get him more baby food as well tomorrow. He won't eat wet food but he will eat the baby food for sure and that's soft.


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## laurief (Jun 22, 2008)

I'm glad that he's home and feeling comfortable.

A word of warning about Tramadol. The standard dose that my vet prescribes is too much for the cats I've used it with. It makes them REALLY spacey and anxious. They can't sleep or even settle down. It really disorients them. So, I give my cats only 1/8 Tramadol no more than twice daily. That's enough to manage pain without disorienting them and making them all spooky. 

Laurie


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## zuma (Nov 5, 2009)

So glad he's home and everything went well. 

I work in dentistry, and existing tartar won't come off, you can only prevent more build up. I don't have any experience but I'd be pretty wary of products that go into the food or water. If there was such a thing that worked well in preventing build up, there'd be use for humans too. It might help in conjunction with brushing, but I strongly believe you have to manually brush the teeth to prevent buildup. Some cats (and humans) are more prone to it and they get a lot even with great home care and others never do anything and don't have problems. 


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## Shybail (Nov 1, 2013)

Thanks Laurie, I will do half of her dose than because she said a 1/4 of a pill. So I will just do it morning and night. However please tell me how to do this cuz now I am thinking why in God's name did they give me a pill. I have to squeeze his mouth open to shove a pill down his throat after he had dental, is swollen after 4 teeth removed? He was fighting me and I had to stop. Tried it in some food, he licked till he tasted it and it must taste bad cuz he was drooling and I thought he'd vomit. So now what do I do? Don't want him to be in pain. He can probably go through the night but will need it in the morning. 

Thanks Zuma. I kinda agree there about a liquid and powder doing anything but it's for him after his cleaning. Vet said they give it with every cleaning. You sprinkle it on the food and I guess the extra abrasion when eating helps. Who knows but I will sprinkle it on as long as he still eats. The liquid in the water I just figured I would try. It's suzies tartar liquid, figured it can't hurt and I don't have to buy it again. I'm going to toothbrush them both, just wished I could get rid of any tartar my female had already. If I can prevent more that's ok.


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## laurief (Jun 22, 2008)

It is hard to give oral meds of any kind when the cat has a painful mouth. You just have to do it as quickly as you can and try to avoid the tender gums.

If you don't already have them (and I think every cat caretaker should have them), go to a pet store or vet office in the morning and pick up some Pill Pockets. My cats' favorite flavor is the duck, but they'll usually also eat the chicken and the salmon flavored ones. Cut a Pill Pocket in half, and put the 1/8 Tramadol in one half, pressing the PP around the pill. Do NOT use a whole PP, because it'll be large enough so that your cat will chew it. By using only 1/2 of a PP, it's small enough that he'll likely swallow it whole without any chewing.

Even if he won't eat the PP willingly (which most cats will), he'll be a lot less likely to try to spit the pill out or to salivate excessively if it's tucked away in a PP.

Laurie


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## Shybail (Nov 1, 2013)

Thanks Laurie, was just reading about those and some other ways in another thread. I am totally going to go buy some tomorrow and see if I can get him to like them. He is so very picky with treats also and lately has no favorites or I would literally drill my own hole in it lol.
Normally I would pull fast but one he has a flat face being a Himalayan and his top two back molars where I have to pry open are two of the ones extracted. I was even thinking 1/8 of a pill is so small could I crush it, put it in chicken broth and try to squirt in the side of his mouth. But back I know him,he'd shake his head and shoot liquid all over lol
Gonna try the pill pockets and praying to God those work but if I scruff him and tilt back will his mouth open automatically? I'd try now but he's sleeping and had a bad enough day, gonna just leave him alone for the night.


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## laurief (Jun 22, 2008)

Shybail said:


> Thanks Laurie, was just reading about those and some other ways in another thread. I am totally going to go buy some tomorrow and see if I can get him to like them.


Buy the "allergy formula" duck flavor Pill Pockets if you can find them. They are the most irresistible in my household. Cut one or two of them in half and give him a couple of halves with no meds in them to get him used to eating them. If he'll eat them unmedicated, then you can offer him one with the Tramadol in it. 

Another trick you can try is to go to a pharmacy and ask the vet for some #4 empty gelcaps (you may need to call around to your area pharmacies to find one that carries #4's, since they're smaller than are typically used for human meds). You can then place the Tramadol inside the gelcap to hide its taste, and wrap the gelcap in a Pill Pocket.



> I was even thinking 1/8 of a pill is so small could I crush it, put it in chicken broth and try to squirt in the side of his mouth.


If I remember correctly, Tramadol is supposed to be pretty bitter, so crushing it and mixing it with food or broth isn't likely to work.



> if I scruff him and tilt back will his mouth open automatically?


Maybe, maybe not. If he won't take the PP willingly and you have to scruff him, lift only his front feet off the ground an inch. Keep his hind feet on the ground. Hopefully he'll open his mouth enough so you can place the PP on the back of his tongue.

Good luck!

Laurie


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## Shybail (Nov 1, 2013)

Well he won't take the pill with anything lol. Last night I just had to try dropping it in the mouth and blowing. We got saliva city but he got the meds lol. Today again, wrapped it in cheese and dropped it in his mouth, blew and he spit it out. Got a taste of the meds again I guess cuz he salivated but not as bad as last night. Had to grab the slimey cheese and wrap more and do it again but finally he swallowed. And darn him having no face to grab! Makes all of this 10 times harder!


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## artiesmom (Jul 4, 2012)

Have you tried a pill pusher? it is like a syringe but long and narrow. the end is closed but with slits in it that open when the handle is pushed down. the idea is to open kitty's mouth, and push it in. always give some water after check it out.


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## Shybail (Nov 1, 2013)

I haven't. I did see them online but with shipping time it would get here after I needed it for him anyways. Do you know where they sell them locally as I have never seen them in stores but have to admit never had to look before. Is it like a petsmart thing?


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## laurief (Jun 22, 2008)

You should be able to find a piller at a pet store or vet clinic ... or, of course, online. You should definitely have a piller or two in your animal medicine chest. They make pilling sooooo much easier. The following link is the piller I prefer. Even though it's larger in diameter than the rubber-tipped variety, it is better at expelling pills and capsules reliably. The rubber-tipped piller has an inconvenient tendency to not expel the pill completely, making it necessary to have to try again and again to get it to let go of the pill. But the Bullseye pillgun linked here typically expels pills and capsules all the way:

Dr. Hanson's Bullseye Pillgun | KV Supply

Pillers are cheap, though, so you could buy one of each type and see which you prefer.

As Artiesmom mentioned, it's important to give a little water immediately before and after pilling. Think of it this way; how easy is it for YOU to swallow a pill dry? Cats can and do get pills stuck in their throats just like we do. You should always give a little water by oral syringe (or food, if the cat will eat) immediately before pilling to wet the throat. Then give a little more water immediately after pilling to force swallowing and help flush the pill down the esophagus. You don't need a lot of water; just a cc or two will do it. And make sure you squeeze the water across the tongue from the side - NEVER toward the back of the throat.

Laurie


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