TT was born on Jan. 15, 2016, and turned 8 this year.
She was diagnosed with kidney disease at the very young age of 4.

 

| TT's Crea.

When TT was first diagnosed with kidney disease, her blood tests revealed a creatinine level of 2.5, which put her in stage 2 kidney disease. This would later rise to a maximum of 2.9. However, at present, TT’s creatinine levels are being maintained at a consistent level of around 1.7.

Creatinine levels are valuable indicators for determining how a cat with kidney disease is being treated and cared for. However, as creatinine levels may fluctuate based on various factors, they should not be considered absolute indicators of the kidney’s health.

For instance, if a healthy young cat runs around and tires himself out before taking a blood test, the results will show a high creatinine level.
Other factors that may influence creatinine levels include a cat’s dietary habits.

However, one thing I’ve learned over the past 6 years while taking care of TT and managing her kidney disease is that a creatinine level of 2.5 or over had negative repercussions on her vital signs, regardless of the factors that may have caused the rise in the first place. Even when her creatinine level was under 2.5, her vital signs would get better or worse regardless of her blood test results.

As such, the most important thing when taking care of a cat with kidney disease is to consistently observe their vital signs.

The following indicators can be used to monitor your cat’s vital signs:

Do they have issues running around, eating, or using the litter box?
What is the quality of their coat like? Is it glossy or rough?
Do they act according to their instincts? For example, do they regularly use the scratcher, groom themselves, and show an interest in hunting?

In TT’s case, two symptoms were prominent during her diagnosis.

| Increased Urine Output

One day, as I lay in bed, I happened to hear TT using the litter box and overheard what sounded like a waterfall in my house. Back then, I was simply amazed by how much she’d urinated and complimented her accordingly. As I would later learn, this was an actual symptom of feline kidney disease.

The most prominent symptom of feline kidney disease is an increase in both water intake and urine output. Cats with kidney disease will drink more water than usual, resulting in them urinating more heavily.

| Picky Eating Habits

At some point, TT suddenly refused to eat certain cat foods that she’d previously never had any issues with. At first, I attributed it to her being used to the cat treats I’d been giving her frequently, and bought every type of cat food I could find in the hopes of finding one that would suit her palate. However, no matter how much I cajoled, pleaded, and fretted, TT refused to eat. Her coat became rough, and her weight dropped.

TT would later be diagnosed with acute kidney failure. The very refusal to eat food is a sign that a cat is discomforted in some way.

After TT was diagnosed with kidney disease, she was prescribed Kremezin and Azodyl for her condition. When I first began administering them, I hoped that she would make a speedy recovery. However, her blood test results remained high, and TT was diagnosed with chronic kidney disease.

In most cats, acute kidney failure eventually leads to chronic kidney disease, as kidney cells do not recover once they have been severely damaged. Even so, all is not lost, for kidneys are capable of functioning as long as they retain at least 10% of their cells.

Over the course of multiple years, I gradually changed the way I approached TT’s kidney disease. Since she had already been diagnosed with chronic kidney disease, I decided to focus on gradual adaptation over making large, sweeping changes in her life. In addition, I chose not to put her through subcutaneous fluid therapy sessions.

While SQ fluid administration is considered one of the most effective ways of managing feline kidney disease, two factors influenced my decision.

The first was that TT’s initial diagnosis had placed her in stage 2 kidney disease. The second was that I believed that the stress caused by the SQ fluid administration would outweigh any benefits that could be received from the SQ fluid administration sessions themselves.
That being said, if TT’s test results had placed her in danger of stage 3 kidney disease, I would have chosen to put her through the SQ fluid therapy sessions.

The results of TT’s blood tests and the supplements and medicine administered to her are as follows:

| 2019 ~ 2020

• Supplements: Kremezin, Azodyl, Omega-3, Complivit

• Cat Food: Royal Canin Renal Feline Dry and Hill’s Prescription Diet K/D Cat Food, forcibly fed 3 times a day

• Treats: Small amounts of chicken purée cat treats provided only during hospital visits or for specific purposes, such as to entice TT into taking her medicine

• Cat Litter: Transitioned from tofu-based litter to bentonite-based litter

The greatest hurdle at this specific period of time was TT’s persistent lack of appetite.
Prior to her kidney disease, TT was on a diet of grain-free and high-protein (minimum 40% protein content) cat food. After her diagnosis, she was given prescription cat food that did not taste as good as her original cat food. This, combined with her already diminished appetite from her kidney disease, only served to anger TT.
During this period, TT’s condition deteriorated to the point where she had to be taken to the animal hospital for SQ fluid administration two times. She had to be forcibly fed frequently. Her water intake also plummeted, and I had to make her drink water while I gave her her medicine.
As a result, TT did not experience drastic weight loss. However, she still continued to lose energy, and her coat of fur became rough.

| 2021

• Supplements: Kremezin, Azodyl, Omega-3, Complivit

• Cat Food: Royal Canin Renal Select Feline Dry, forcibly fed 3 times a day

• Treats: Small amounts of chicken purée cat treats provided only during hospital visits or for specific purposes, such as to entice TT into taking her medicine

 

After 2 years of forced feeding sessions and experiments with various types of cat food, we were finally able to make some progress to the point where TT was willing to eat food by herself.
As TT was raised in a household with multiple other cats, TT would often desire the cat food provided to other cats. This called for a change in feeding plans, and TT would often have to be given her cat food away from the other cats.

| Early 2022

• Supplements: Kremezin (half the original amount), Azodyl (half the original amount), AminAvast (2 capsules a day), Omega-3, probiotics

• Cat Food: Royal Canin Renal Select, fed 2 times a day and forcibly fed 1 time a day

• Treats: Small amounts of chicken purée cat treats provided only during hospital visits or for specific purposes, such as to entice TT into taking her medicine

 

Slowly but surely, TT’s appetite increased with each passing day.
She increasingly began to eat food of her own volition, reducing the need to forcibly feed her. On some days, she would even beg for more treats.
Though her water intake was still an issue that required direct intervention, there was no denying that much progress had been made, and that her willingness to feed herself was a cause for celebration.

| Late 2022

 

• Supplements: Kremezin (twice a week), Azodyl (thrice a week), AminAvast (1 capsule a day), Dr. Toru Protocol AIM (administered prior to release for research purposes), Omega-3, probiotics

• Cat Food: Royal Canin Renal Select and Royal Canin Indoor Adult Dry Cat Food

• Treats: Small amounts of chicken purée cat treats provided only during hospital visits or for specific purposes, such as to entice TT into taking her medicine

 

I was able to establish contact with Dr. Miyazaki Toru, which allowed me to directly make and administer Dr. Toru Protocol AIM to TT.
Though the commercially launched version of Dr. Toru Protocol uses size 3 capsules, the version administered to TT used size 1 capsules.
During the first 3 months of administration, there were no noticeable changes in TT’s vital signs. I also added Royal Canin Indoor Adult Dry Cat Food to TT’s diet.
After 4 months of administration, I no longer needed to force TT to eat. Though it is hard to pinpoint the exact point in time it started, TT began to eagerly run out when it was time for her breakfast. She also became more willing to assert herself, and became much bolder.

| Early 2023

• Supplements: Dr. Toru Protocol AIM (administered prior to release for research purposes), Dr. Toru Protocol Intensive (administered for research purposes, scheduled for release in late 2024), Omega-3, probiotics, AminAvast (1 capsule a day)

• Cat Food: Royal Canin Renal Select and Royal Canin Indoor Adult Dry Cat Food, provided 3 times a day

• Treats: Small amounts of chicken purée cat treats provided only during hospital visits or for specific purposes, such as to entice TT into taking her medicine

 

TT’s appetite and energy began to improve greatly from this point forward. Though her blood test results remained fairly unchanged, her vital signs were noticeably improved, and her coat regained some of its former luster.
Furthermore, as TT was now willing to feed herself, less energy and time was needed to look after her. TT herself also became much happier in her daily life as she no longer had to be forcibly fed.

* Dr. Miyazaki Toru

| Late 2023

• Supplements: Dr. Toru Protocol AIM (administered prior to release for research purposes), Dr. Toru Protocol Intensive (administered for research purposes, scheduled for release in late 2024), Omega-3, probiotics

• Cat Food: Royal Canin Renal Feline Dry

• Treats: Small amounts of chicken purée cat treats provided only during hospital visits or for specific purposes, such as to entice TT into taking her medicine

 

The most notable change in this period was TT’s willingness to use the exercise wheel once more. She would run like the wind twice a day, and get excited when I offered her a treat for doing such a good job of running.

| Jan. 2024 ~ Present

• Supplements: Dr. Toru Protocol, Dr. Toru Protocol Intensive (administered for research purposes, scheduled for release in late 2024), Omega-3, probiotics

• Cat Food: Royal Canin Renal Feline Dry, provided 2 times a day

• Treats: Yum Yum Boss, provided 2 times a day (2 pieces per feeding)

• Dr. Toru Protocol Treats (scheduled for release in May 2024), provided 1 time a day (5 pieces per feeding)

 

Now, TT begs for food every morning, and refuses to leave the kitchen, which has become a problem in its own right. She’s as stubborn as ever, only in the other direction now.
She’s also become a lot more talkative and constantly begs for treats.
We’ve also managed to cut down the number of supplements that TT needs to take every day, which is a relief for the both of us. TT also gets to enjoy periodic snacks, which has certainly improved her daily enjoyment of life.

Managing feline kidney disease is no easy task. However, cats can live without an issue with even just 10% of their kidney’s functions. As such, we should never give up on having hope. Just because your cat doesn’t retain all their kidney functions doesn’t mean they can’t lead happy and healthy lives.

GreyCoat Research is devoted to ensuring healthier and happier lives for cats with chronic kidney disease.