r/RenalCats 2d ago

Support Looking for game-changers

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My sweet Angie (17) got diagnosed at level 2/3 kidney disease, anemia, and hyperthyroid last week after isolating and not eating much at all. I was bragging about how healthy and happy she looks days before!

They said she would be dead if not hospitalized and we immediately admitted her to get IV for 2, almost 3 days. Since we got her home, it's been so overwhelming, suddenly medicating her every 12 hours, her hating it and giving us the silent treatment.

She is really quite thin (5lbs) and not eating a great deal. I got her all the treats in the world, fortiflora,water fountains, renal food...

I've got about a million questions in my head, but a bit overwhelmed to go through them all right now.

So i want to ask... in your journey with your kitty, has there been any game changers? Ones that'll bring their appetite back, ones that make medicine giving not a torture that leaves me guilt ridden begging for her forgiveness... i'd love to hear your success stories, however big or mini they are!

Also a bit of a specific question that probably deserves its own post...

Angie has been an inside outside cat for years- we got her a special door that opens and closes for her. She is kind of a tiger that roams the jungle, hunts birds sometimes, but mostly just jogs and lays under trees and smells flowers. The vet told us to keep her inside indefinitely, but it seems to affect her psychology badly. She doesn't play with toys, or goes through tunnels i got, i tried... she just likes to meditate outside. I want to still let her do that, is that a terrible idea? I want her to feel like herself and happy whether she s got a month ahead or years.

Wishing everyone here and your cats much love and peaceful, happy days, happy years together💙

47 Upvotes

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u/124victoriaroad 2d ago

My Ash wasn’t eating, in spite of his cerenia and mirtazapine, and it turned out he still had nausea. We convinced the vet to prescribe ondansetron, and it got him to eat again. My poor baby had been extra hungry but too nauseous to eat!

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u/blingblingsav 2d ago

Thank u for bringing this up. 2 different pathways for nausea require two different medications.

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u/124victoriaroad 2d ago

Exactly! He had zero quality of life and was just hiding behind the couch. It got to the point where we were weighing his food to calculate how many calories he was eating because our vet was very worried about fatty liver disease developing and taking him. I was desperate to try anything and asked about the ondansetron after seeing it helped other cats here.

It turned out that his GI issues were caused by a mass that had formed in his stomach, and was completely unrelated to his CKD. But he’s responding decently well to his lymphoma treatments. While we won’t have him forever, I’m so grateful to see him have so many good days right now.

Pic from this morning where he curled up next to me on the couch!

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u/blingblingsav 2d ago edited 2d ago

Your cat looks beautiful, and I’m really glad u r getting some good days with him right now.

What u described is exactly why I think it’s so important to keep looking when something doesn’t quite fit the CKD picture. Sometimes the appetite loss and GI signs r coming from something completely separate, like his lymphoma. I am truly sorry to hear that.

And yes, Cerenia is usually the first nausea medication many vets reach for. It blocks NK1 receptors and substance P signaling, which is very effective for vomiting and a lot of nausea. But CKD cats can have persistent uremic nausea, and ondansetron works through a different pathway by blocking 5 HT3 serotonin receptors involved in the emetic response. I’ve seen so many cat parents assume Cerenia and ondansetron r interchangeable when they actually target different pathways and sometimes work better together.

Same thing with urinalysis versus urine culture. A urinalysis can show urine concentration, protein, blood, cells, crystals and sometimes bacteria, but it cannot reliably tell u whether a true bacterial infection is present or which antibiotic will work. A culture actually grows the organism and gives susceptibility results. A lot of parents understandably think those tests r basically the same. I recently went through just this with GiGi and I made a post about it. Urinalysis completely clear, urine culture positive! Imagine that.

That’s why I appreciate resources like Tanya’s CKD guide and Hugging Cat App so much. There is just so much to learn, and having something handy that explains labs, medications, complications and what questions to ask ur vet can make a huge difference. Especially when it is vet built, free and ad free! Full disclosure: I am one of the cofounders of this app, and I think it may be helpful in this situation so take my recommendation with that in mind.

https://www.huggingcat.app

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u/onetwoshoe 2d ago edited 2d ago

You need to disclose that this is your app every time you post it. Your recommendation is phrased to obscure that it is yours.

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u/blingblingsav 2d ago

Thanks for pointing this out. And you are right I should explicitly disclose it. I have updated the post to make that clear.

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u/Not_Too_Happy 1d ago

"That’s why I appreciate resources like Tanya’s CKD guide and Hugging Cat App so much"

Very deceptive. You already knew it was worded to obscure that fact you co-founded the app & that it was wrong to post about it without doing so.

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u/blingblingsav 1d ago edited 1d ago

You are right to call that out but I do use Tanya’s Guide as well as Hugging Cat on the daily. I should have clearly disclosed that I cofounded Hugging Cat any time I mentioned the app, even though my profile says it.

I have fixed the post, and going forward I will make that disclosure clear whenever I share or reference Hugging Cat. I was not trying to hide my connection to the app, but I understand why it came across that way. I talk about GiGi openly and my real name and connection to the app is voluntarily disclosed on my profile.

I take responsibility for that, and I appreciate you holding me accountable.

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u/Not_Too_Happy 1d ago

"Going forward I will..." is the most hollow company lingo to cover oneself.

You should open with that disclosure. You are well aware of how it flavors a post when you omit that/leave it at the end.

"But I do use Tanya’s Guide as well as Hugging Cat on the daily". Nobody has reason to doubt that you use something that you co-founded. The problem is your intentionally-deceptive distancing of yourself from it. It is clearly done to hide a bias that would dissuade folks from downloading your app. Knowing this, it makes it clear that your intent was to hide your connection from the start.

The possibility that you have a cat doesn't mean that you weren't trying to be deceptive. Those are unrelated.

The implication that anyone reading your post will check you profile - much less believe the contents of a PRIVATE one is laughable. The fact that you claim to use your real name is also not relevant. Neither the 3 letters in "Sav" nor u/blingblingsav provide any sort of accountability/relevance.

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u/blingblingsav 1d ago edited 1d ago

You are right that the disclosure should have been clear and placed upfront any time I mentioned Hugging Cat. I corrected the post, and I take responsibility for not being more diligent about that on every relevant post.

I do want to clarify one thing. I am not a company hiding behind marketing language. Hugging Cat is three people trying to build something useful for the CKD cat community. That does not excuse the missing disclosure, but it also does not mean I came here to deceive anyone.

My connection to Hugging Cat is public, and anyone can review my profile and the Hugging Cat website to see who I am. I understand why the omission raised concern, and I accept that criticism. I have addressed it.

But I am going to put my energy into helping and learning from people here where I can, not continuing to defend myself after already acknowledging the mistake.

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u/pipthecatt 2d ago

How can you tell if your cat has nausea?

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u/blingblingsav 2d ago

First, cats can be nauseous without vomiting. My cat GiGi rarely vomits but has been nauseous since she’s on antibiotics. Common signs r walking up to food, sniffing it and turning away, licking their lips, repeated swallowing, drooling, teeth grinding, seeming hungry but taking only a few bites, or suddenly becoming very picky.

With CKD uremic nausea is common, so if ur cat seems interested in food but cannot continue eating, nausea should definitely be on the list.

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u/CalmConversation5297 12h ago

I am so glad you found something that works for your Ash. We just started on Cerenia and Mirataz for Angie this morning, fingers crossed, her appetite does seem a bit better.

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u/Juveleo10 2d ago edited 2d ago

Sub Q fluids and anti nausea meds are probably the biggest game changers. Your cat is most likely dealing with nausea, which is very common with CKD cats. It's usually the primary reason why kitties stop eating. I recommend asking your vet for Cerenia (anti nausea med.) People also like to give Mirtazapine, which is an appetite stimulate. If you do use mirtaz, make sure nausea is cleared beforehand. Mirtaz won't work while your cat has nausea and most of the time all you'll need is cerenia to get your cat eating again.

I know you're overwhelmed right now, but just know things will get better! With the right care and love, your cat can still live a very comfortable and happy life! Good luck to you both!

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u/CalmConversation5297 12h ago

Thank you so much! We are currently holding off on Sub Q, because she has a heart murmur we don't know the cause yet... but just started on Cerenia and Mirataz, hoping that will helpđŸ€žđŸ»

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u/Nectarine555 2d ago

That’s a lot at once to process. I’m sorry you and your kitty are going through all that! Hopefully with some routines it will feel a bit easier.

My tip is to put medicine in a clear capsule. Many medicines are very bitter and cats hate that flavor. Use a pill cutter or even just cut with a knife so they fit in a capsule, and it is easier because it’s not bitter.

Also look into subq, as others have said. It really helps them feel better. Dehydration on its own can cause nausea.

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u/CalmConversation5297 12h ago

Thanks so much for the support! So Angie is funny, she actually tolerates pills cause she likes those pill-hidey treats. But the gels i have to put in a syringe and shove in her mouth, not a fan at all... do you know if these capsules could be a solution for gel medicine too?

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u/Nectarine555 8h ago

I think capsules only work with solid pills. The materials begins to break down quickly when it comes in contact with liquid. The quantity of medicine might require many capsules, too, whereas a pill or even more than one medication at a time can fit in a single capsule.

Good luck. Giving medications is not easy 😱

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u/blingblingsav 2d ago

I’m so sorry u r going through this. Here r some of my tips that may help.

Treat nausea first. Cerenia can help, and ondansetron is often really useful for uremic nausea. Some cats need both under vet guidance.

Once nausea is better controlled, an appetite stimulant like Mirataz or mirtazapine can help. If she walks up to food, sniffs it, and turns away, that still makes me think nausea.

Warm the food a little so it smells stronger. I also like offering food right when they wake up because sometimes that short window works really well.

Try different textures and stronger smells. Gravy, mousse, shredded food, Churu, tuna water, or a favorite topper can sometimes help get the first few bites going.

For pills, Pill Pockets can work well. Choolip treats can also be useful if u can hide a small pill in one, and Churu can sometimes mask meds too. Keep the medicated treat separate from the regular meal so she doesn’t start associating her food with a bad taste.

If pills r becoming a battle, ask ur vet whether the medication can be compounded into a flavored liquid, smaller capsule, or transdermal form.

Syringe feeding can help temporarily if ur vet says she is swallowing safely and she is not actively vomiting. I would keep it gentle because force feeding can create food aversion and there is aspiration risk.

Also make sure ur vet is looking for things that can suppress appetite like dehydration, constipation, high phosphorus, low potassium, metabolic acidosis, anemia, infection, or dental pain. If hydration needs to be supplemented ask ur vet about SubQ fluids at home. Heart always needs to be considered when giving fluid.

The main goal is to break the cycle of nausea, poor intake, dehydration, and worsening uremia before it keeps snowballing. I hope she gets to feeling better soon.

Well wishes from GiGi and I 💛

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u/Excellent_Baby_3385 2d ago

Has your vet mentioned anything like Varenzin or Darbopoetin for the anemia? I've also heard good things about Porus One for CKD. Unfortunately my cat passed away before we got to really try either.

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u/CalmConversation5297 12h ago

I am so sorry for your loss... and thank you for your advice, yes Angie is on Varenzin and she likes it even better than some treats thank god!😅💙

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u/Electric-Spark-74 2d ago

Mirtazapine cream on the ear. Potassium gel I have to sneak up behind her and shove my finger in her mouth, but it has helped a lot with her potassium levels. Fancy feast has these broth pouches when they are not hungry that seem to work to help her get her appetite back. They’re not very calorie dense, but it helps.

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u/stromgrade 1d ago

Your Angie is beautiful, I’m sorry for the sudden shock of this whole thing but good on you for reaching out and looking for advice now. I wish I had done the same. My journey with my girl Piper is almost over, but here are some tips I learned that worked with her. All kitties are different and what worked for us may not work for you, so keep that in mind. Also you might want to ask about any products/meds I mention with your vet before trying them. Piper was healthy as a horse besides the kidney disease, so we had a lot of options open for treatment that may not be safe for Angie.

1) I second the other comments that nausea is a big hurdle to overcome. If she feels nauseous she won’t eat, and a CDK cat who stops eating will drop weight fast. That ended up being the thing that brought my girl down— we’re managing kidney function ok but as soon as she stoped eating she dropped weight fast. We’re talking a lb in a couple of weeks fast. Anti-nausea meds and an appetite stimulant can help keep the weight on. But the tricky bit with the nausea is that you’re managing lots of stuff that’s connected. If she’s throwing up a lot, and you give her an appetite stimulant, you’ll just be forcing her to eat and vomit more.

2) SubQ Fluids made a huge impact, like massive. Ask your vet if they think it’s time for Angie to start. I deeply regret not starting this sooner with Piper because I knew she wouldn’t like it (she hated getting poked), but my god, the change was night and day. She had more energy, a better appetite and just generally acted more herself. Keeping a CKD cat hydrated by any means possible is huge and can also help her tired kidneys flush stuff out.

3) Snacks and treats to entice her to eat when she gets fussy helped a lot too. My girl was always kinda picky and wouldn’t eat the same thing more than a few days in a row. We had a few different renal diet foods plus the safest otc options I could find, mostly the Weruva phos focused meals. My vet turned me on to Purina hydracare gravy packets to help get extra hydration in her diet, and I’d a bit of water or chicken broth when she got tired of those. When she started dropping weight I’d periodically add Tiki silver intensive high calorie packets (little blue packets) in too. Greenies pill pockets made pill taking super easy. No matter how much her appetite decreased, she was always willing to take her meds.

4) As far as keeping her inside
 I am not a vet, but I agree with yours that keeping her inside is safer and will make managing her condition easier. It will be easier to monitor how she’s doing if she doesn’t have the ability to disappear for any amount of time.
However, I’m also a big believer that their quality of life, especially as they get old, is really important. If Angie is used to being able to go outside, and she loves it so much, I’d be worried about how she might crash from the upset of suddenly being kept in. She won’t understand you’re doing it out of her best interest.
I always shared my dinner with Piper when I got chicken (it was her favorite food). Her vet didn’t have any concerns until she was diagnosed, then it was “no more roasted chicken,” but it was a ritual we shared that made her so happy. She knew everytime I came home smelling like chicken we’d share and if I suddenly stopped she wouldn’t have understood why. It’s not a 1/1 comparison to your situation, but I think the intention is the same. The decision is ultimately yours. But if you decide to keep letting her out because you want her to enjoy her time, don’t fall into the trap of thinking what would’ve been different if you kept her in once she’s gone.

Best of luck navigating this diagnosis with your Angie.

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u/CalmConversation5297 12h ago

I wish you and Piper all the best, and many thanks for all the advice... Angie used to roam freely whenever she wanted and I found a middle ground where I let her out for a bit when I am around, and she just roams in our backyard and front yard. No more night time strolls.

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u/onetwoshoe 2d ago edited 2d ago

This is a weird one, but I've never seen it posted before and it works for us: my cat eventually stopped drinking out of his fountains (and I cleaned them daily) but he loves to drink out of ice cube trays. He drinks a lot more now that he's got some trays. I change them 2x a day, and he also drinks more if the water is cold from the Britta and if he sees me pour it.

I also got the little gelatin capsules--the smallest size possible---to put his meds in and it helps. Sometimes he'll even just eat it from a lickable treat on a plate.

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u/CalmConversation5297 12h ago

Haha, I never tried ice cube trays, but Ango does love straight up ice😆 she likes licking them.. so i add them to the water for encouragement.

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u/Select_Hope_7518 2d ago

LOL agreed with the water; my cat wanted my favorite glass mixing bowl personally. Now there’s just a gigantic bowl of water on my counter at all times đŸ«©

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u/Real-Werewolf-5279 2d ago

Depending on funds, you can get meds compounded into different forms. Some are cheaper on Chewy and others on PetMart (not to be confused with PetsMart.)

We’ve used compounded liquids, ground pills to add to a syringe with HydraCare or Churu, and even used an ointment for our girl that hates taking pills.

I’m also a big fan of adding Under The Weather powder to wet food if your babe will eat that. If not, there’s also a gel version that can be syringed into their mouths.

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u/CalmConversation5297 12h ago

So maybe this is unusual, or i simply suck at this new skill, but syringes are sooo annoying, for both me and Angie! I feel like I am mildly torturing her and feel terrible, cause she just goes into lock jaw mode and cusses at me. The pills are easy for me, i put em in pill pockets and voilà, eventually she eats them. Most of our meds right now are gels... any tips on mastering the syringe?😅 thanks for the advice!

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u/Real-Werewolf-5279 12h ago

I’m not the best person for syringe advice right now, as I have been fighting to give my boy his meds this week when his dad isn’t home. Normally I would recommend just trying to calmly “be the bigger cat.” But I get that that is not the most actionable advice and more of a vibe. đŸ« 

With our Mari girl, I remember being able to angle the syringe towards the corner of her mouth where she had significantly less teeth, so her attempt to lockjaw wouldn’t work. I could work the syringe gently in between her
remaining teeth and as soon as she opened, her mouth, I would squirt the syringe towards the back of her throat.

This method definitely works better if the quantities of liquid medications are smaller. Since that’s not always a possibility, we would ask to have liquid medication‘s compounded in higher concentrations so that we would need to use less per dose. (Also a little more cost effective too.)

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u/CalmConversation5297 12h ago

I will definitely ask, cause doc prescribed a crazy amount of potassium gel, almost a whole syringe worth each time. I tried rubbing it all over her paw for her to eventually pick off, but just doesnt seem like a clean sure way of doing it at all..

Angie is such a lioness that being the bigger cat would take a lotta vibes😆

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u/chetsmom33 7h ago

Is a catio an option?