DISORDERS THAT MAY ACCOMPANY CKD
Kidney disease is not a single disease. From it, several other problems may stem. Each problem being addressed as it shows. Some of these problems may be (but not definitely):
~ High blood pressure - (a cat's normal blood pressure is in the 120-130 mmHg range. When diagnosed high, it can be controlled by medications such as Amlodipine, Benazepril (or Enalapril) and CBD Oils are also noted for lowering blood pressure. Should a cat have HBP and it goes undetected, the cat can go blind. So everyone, please have the blood pressure checked at every visit (which should be every 3 months).
~Hyperthyroidism - is caused by an increase in production of thyroid hormones (known as T3 and T4) from an enlarged thyroid gland in a cat's neck. A medication called methimazole will help control it, OR you may opt for the I-131 Radioactive Iodine treatment. Radioactive Iodine (I-131) therapy for feline hyperthyroidism is very effective, has few side effects, is a one-time treatment in over 95% of cats with hyperthyroidism, and does not require administration of pills or anesthesia. One injection under your cat's skin is all that is needed!
~ Anemia - To confirm anemia in a cat with CKD, the veterinarian will run a CBC test to check the Hematocrit OR the PCV (Packed Cell Volume) to see how low it is. While each lab has different normal ranges, the approximate range is 30% - 45%. When a cat's level is below 30%, there is anemia. Once the HCT/PCV drops below 20% an ESA (Erythropoiesis Stimulating Agent) is needed. There are two medications. One is Epogen, the other Darbepoetin. These are synthetic human hormones that stimulate the bone marrow into producing more red blood cells. Darbepoetin is favored over Epogen because it is said there is less chance of developing antibodies while using it.
While Epogen is given 3 times a week with close monitoring of the RBCs, Darbepoetin is given only once a week and also carefully monitored. Once the level has elevated to a normal range, you should skip a dose and begin to search for the proper amount to give that will hold the level within the normal range. The strengths preferred for use in cats are: Epogen 2000 iu/1mL or Darbepoetin would be 25 mcg/1mL. Elevation of the HCT/PCV level should never be more than 3%. If it is, it may cause high blood pressure. Iron injections should be given once a month because the cat's body will try to produce a lot of red blood cells when you start giving an ESA, but it needs sufficient iron in order to complete the process. Dosing is up to the veterinarian.
Phosphorus levels are extremely important to monitor. If this goes too high, it can and will deteriorate the kidneys quicker. A normal phosphorus should be around 4. Once it reaches 6, it is wise to begin a phosphorus binder. Doses vary according to the cat's weight and the current phosphorus level. The favored binder is called Phos-Bind and can be purchased on Amazon or Aluminum Hydroxide purchased at Thriving Pets (thrivingpets.com). You will see a list of all supplies under the tab "Supplies Needed.