Worrisome news – and a question about Calcitriol

Chun seems to have the beginnings of kidney disease. His creatinine level is slightly elevated and specific gravity low. I’ll post more details later, though that is about the sum of it. He’s only ever had the best diet, and he is only about six. He has not shown any outward symptoms at all.

They are recommending a medication that may slow disease progression if started at an early stage. It is called Calcitriol. I am doing a lot of research to try to come to a decision about it. Does anyone have experience with it?

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17 Responses to Worrisome news – and a question about Calcitriol

  1. Sending good thoughts to Chun and you! I hope he leads a long, happy life in spite of this diagnosis

  2. I’ve never had to give Calcitriol to a cat, but I have to a human being, my mother. I’m a little puzzled, as Mom’s doctor said the medication was supposed to help prevent calcium deficiency in her after she suffered a severe UTI that put her in the hospital for three days and which came close to shutting down her kidneys. From what I know, Calcitriol is mostly vitamin D. Whether that’s helpful for a cat, I don’t know.

    Paws crossed for Chun! We want to see those beautiful blue eyes for a long, long time. 🙂

    • littlemiao says:

      I guess Calcitriol regulates calcium levels in both humans and cats. I used to understand how it worked, from pathophysiology classes, but my brain just isn’t working this week and no matter how much I read I can’t fit the pieces together.

      I asked the vet to share the most recent citations or research supporting its use for cats in Chun’s condition, because she said there was more recent stuff than what I could find online.

      Chun’s calcium levels are normal, as are all his other mineral levels. But the research apparently suggests that very small dosages of Calcitriol may prevent kidney disease from developing as quickly, if you start it early enough. And since it is relatively new there isn’t enough long-term evidence to satisfy me. If it messes with his calcium levels it might make him sick in ways we can’t even predict. But it’s not like I can wait, because you never know how quickly kidney disease will develop.

      I am getting another specific gravity done on Monday to confirm that the low one wasn’t a fluke, but given the circumstances that seems overly optimistic. 😦

      • Yes, do more reviewing of the literature before giving Calcitriol to Chun. You probably know that excessive calcium in the blood can cause kidney stones; it’s why I stopped taking large doses of calcium supplements and Tums. I should have added that Mom continued to get UTIs after she took Calcitriol. UTIs can become a chronic condition in some older women, especially ones who are overweight and sedentary. That can’t be so for a young cat like Chun! So I think you’re right to be skeptical. I sometimes think these studies are generated primarily to sell more prescription drugs.

        • littlemiao says:

          Thanks for your words of caution. I don’t want to trade one problem for another. I will at least be getting two more lab readings done before deciding, since urine concentration can naturally fluctuate, though the ratio or balance between levels was off and suggests that the previous test was not an artifact of dehydration.

          I’m also suspicious that they started recommending this med when a new and fairly recently graduated vet joined the clinic. I wish I could ask to speak to the senior vet who we have known for ten years now, but I don’t want to be rude and specifically ask “so is Dr. so-and-so also prescribing this drug now?” I came as close to asking that as I could, but I did not ask it in so many words.

  3. Oh sorry to hear this about Chun – and he’s so young too! I’m sure it’s something that can be managed but I know nothing about Calcitriol. I know there are special diet foods for cats with kidney issues and I think if you trust and know your vet he’ll steer you in the right direction. It pays to educate yourself though! I hope someone else has info on this med for cats. Sending Chun POTP and hugs…….

    Love, Sammy and Mom Pam

  4. Oldcat says:

    Have you seen http://www.felinecrf.org? Has some info on the meds. Does Chun drink enough water? A fountain might help.

    • littlemiao says:

      Thank you! That site is very helpful. The vet said there is more recent research and she is supposed to get me the information.

      I am setting up a fountain upstairs in a place where he walks by all the time, so hopefully that will entice him. (and hopefully I won’t trip over it!) I never see him drinking much from the bowls downstairs. All the food he eats is canned, though, so it has a high moisture content.

      • Oldcat says:

        I have heard some even add more water to the food and warm it to make a soup to get more water into them. I have always found cats drink much more from fountains than standing bowls.

        • littlemiao says:

          I’ve tried adding warm water. I should be more consistent about it. Chun is so picky in general, and he alway has been, sometimes he likes it and sometimes he doesn’t, but even when he doesn’t he usually slinks back a few minutes later to eat it.

  5. leendadll says:

    sorry, no experience. is this the 1st or 2nd test for kidney disease? what state is it at? Espressa was diagnosed with “the start of kidney disease” more than 5 years ago and it never progressed in the slightest.. no meds or diet changes at all.
    Sending good juju!

    • littlemiao says:

      They compared the blood work with specific gravity of urine. He had bloodwork that suggested dehydration, so they wanted to do another test and found this. When high creatinine (his is 1.9, but high normal would be 1.6 or 1.7) is combined with low specific gravity, that is enough for them to diagnose kidney disease.

      This website would put him at stage 2 (http://www.felinecrf.org/how_bad_is_it.htm), but the doctor told me it was early or mild.

      Do you mind telling me how old Espressa was when she was diagnosed? Chun is young to be manifesting it so I don’t know if that makes it more serious. Of course the doctor couldn’t tell me if his age meant it would advance faster or more slowly, but I had to ask anyway. I have just been getting my anxiety under control and I honestly don’t think I can deal with Chun getting sick. 😦

  6. *hugs* I hope it was just a fluke (maybe he didn’t drink enough for a couple of days? Hung out moar in the sun than usual?) – but the vets will figure it out, I’m sure.

Miao & Purr!

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