# Cat with kidney disease - which medication is best?



## kremlin (May 9, 2012)

Hi,

My cat is 18 years old and was diagnosed with kidney disease around 2 years ago. She was prescribed a supplement called Renalzin (2 drops per day) and Hills Prescription Diet for kidney disease (k/d). She eats the prescription food very rarely but she consumes the Renalzin in her normal cat food.

I was initially told that she had stage 1-2 kidney disease. However, I took her for a check up recently with a new vet. She had blood and urine tests and found that the disease hadn't progressed. In fact, some of the readings were slightly better than a year earlier. Also, my new vet said she wouldn't even classify my cat as having even stage 1 kidney disease - it's just the beginning stages. In any case, my new vet was still surprised that my cat hadn't been prescribed any ACE inhibitor medication by my former vet and prescribed *Benefortin *(benazepril hydrochloride - one 2.5mg tablet per day).

My cat acted out-of-character after taking the second dose: she was overly 'clingy' and unsettled, and after the second dose she vomited a huge amount which was worrying. My vet told me to stop administering the Benefortin and prescribed another ACE inhibitor with a different ingredient: *Enacard *(enalapril maleate). I looked into this medication and came across this website which says under 'Precautions' that: Although enalapril is used to treat some forms of chronic kidney failure, there are instances in both dogs and cats where enalapril therapy has worsened the underlying kidney problems.
Enalapril Maleate for Dogs and Cats

After reading this I asked my vet if it was worth risking the potential worsening of my cat's condition by giving her this medication. My vet said I could return the medication and she would see my cat in 3 months time.

The fact is, I want my cat to have medication if it will help stop the disease from progressing. I just wanted to ask if there is any other medication that might be safer for my cat, apart from Benefortin and Enacard? Does anyone have a good experience with and/or any information on other medications?

Thanks in advance.


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## chillminx (Nov 22, 2010)

My cat with Chronic Renal Failure (CRF) is on Fortekor (Benazepril) 2.5 mg, prescribed for renal insufficiency, and tolerates it well. I believe this is the same thing as Benefortin?

Enalapril can cause side effects such as vomiting in some cats. If your cat is sensitive to an ACE Inhibitor it would be better for her not to take one. It certainly won't help a cat with CRF to be vomiting, because of the high risk of becoming dehydrated.

There is clinical evidence that ACE Inhibitors do improve the quality of life for cats with CRF. Here is an explanation of how they work:

Cat Health - Kidney Disease - Management - Diet - Novartis Animal Health Inc.

There is a lot of useful and sound information about management of renal disease in cats on Tanya's CRF website, which might be worth you looking at:

Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Symptoms, Diagnosis, Treatments and How to Cope With It


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## Ianthi (Oct 21, 2008)

Frankly, I'm surprised your new vet has prescribed ACE inhibitors given the very ( now in dispute ) early stages of the renal disease in addition to the fact you've managed to slow its progression to a virtual halt in the space of two years! Just out of interest what are the current renal readings? Do bear in mind though that blood test results differ from laboratory to laboratory (it's possible to have two different readings from the _same_ sample at different premises ) and this may account for what appears to be a mild reversal of numbers. But even so.......it still demonstrates to me you're managing the condition (if there is one as such ) very well through diet and binders alone.

For this reason I personally wouldn't change anything! Furthermore the use of ACE inhibitors in CRF is still somewhat in debate with some people arguing the claims for its benefits lie mainly with the manufacturers alone!

Here's the link to Tanya's site regarding their use

Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Miscellaneous Treatments (Including Stem Cell Therapy and Fortekor (benazepril))

It might also be worth joining the group there and asking their opinion!


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## kremlin (May 9, 2012)

Chillminx and Ianthi: thanks for replying. I will have a look at that website. I've come across it in the past but it's very informative and I will look into posting on that site too. Many thanks to both of you 

Just another question: I was told that if my cat doesn't eat the renal food I should feed her the senior range of cat food as it's better than the normal cat one. However, I had a look at the protein levels in Felix Senior and the normal Felix cat food and the protein levels were higher in the senior range. I found this strange as protein should be fed at a minimum. What do you think?


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## Jayne31 (Apr 9, 2011)

My cat, Oscar, was diagnosed with CRF last May, my then Vet prescribed Fortekor and I also used Renalzin. I had to stop the Fortekor only because he was a bugger for taking tablets.


I was unhappy with the vet so went back to my old surgery and had new blood work done. Oscar's levels had dropped to the point of merely being considered "at risk" rather than having CRF. We had to wonder whether there was something else going on with him at the time of the first tests which elevated his results.

Even thought his levels were right down the vet still asked me to continue with the Renalzin. Oscar would only eat Wiskas and that's what he remained on until I sadly had to have him PTS in January (I don't think his decline was kidney related), he was 18.5 - in fact it would have been his birthday tomorrow.

Although there are better foods on the market, I took the view that it was more important that he ate what he enjoyed as long as it was mixed with Renalzin


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## kremlin (May 9, 2012)

Jayne31 said:


> My cat, Oscar, was diagnosed with CRF last May, my then Vet prescribed Fortekor and I also used Renalzin. I had to stop the Fortekor only because he was a bugger for taking tablets.
> 
> I was unhappy with the vet so went back to my old surgery and had new blood work done. Oscar's levels had dropped to the point of merely being considered "at risk" rather than having CRF. We had to wonder whether there was something else going on with him at the time of the first tests which elevated his results.
> 
> ...


Jayne, thanks for the reply. I'm so sorry to hear that you had to have your cat PTS. 
I was told to crush up the pill and put in my cat's food by the veterinary nurse - my cat ate it which was good but it's a shame she has a bad reaction to the medication. I wonder if crushing it up alters the medication in some way. Hopefully the Renalzin will work even if my cat is eating normal cat food.


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## chillminx (Nov 22, 2010)

kremlin said:


> > I was told that if my cat doesn't eat the renal food I should feed her the senior range of cat food as it's better than the normal cat one. However, I had a look at the protein levels in Felix Senior and the normal Felix cat food and the protein levels were higher in the senior range. I found this strange as protein should be fed at a minimum. What do you think?
> 
> 
> My cat with CRF is rarely willing to eat a renal diet, and even then can only eat Royal Canin as all other makes of renal dietary food make him vomit.
> ...


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## charleybear (Sep 12, 2012)

Hi Everyone,
Just in case anyone knows. How much Renalzin would be an average does per day please.
its just that my vet has prescribed Renalzin plas Fortikor, plus Denamarim for my 18 year old cat who had blood results back yesterday showing poor kidnet and lover readings. She is well in herself but losing weight.
To bring the cost down a little my vet does price matching and I have found a site that says 50ml = £7.00 150ml £17.99 etc. so I wondered if anyone can remember roughly how much is usually prescribed for each day as I have to take in my pricings tomorrow. The receptionist said that the prescription was reading one tube (pump) which has just confused me.
Many thanks, Dawn (Mollys mum)


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## OrientalSlave (Jan 26, 2012)

You have replied to something mostly from 2012 which I've not read. I'm very sorry about what happened to your cat, but Benazepril - better known as Fortekor - is a ACE inhibitor which is a very common treatment for kidney disease in cats. ACE inhibitors are using in humans as well for many conditions include heart failure, high blood pressure, and some chronic kidney conditions.

However it has a number of contraindications, and bloods should be taken regularly to monitor it's effect especially when it's a new prescription or the dose has been increased. This is the case with humans as well. I would be happy for a cat of mine to have it, should one be diagnosed with CRF


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