<7/8/98 From: Sandy Re: Jane & Rocky>

Jane wrote:
<< 5 months - now for the past  month his liquid stools came back all of a  sudden plus he was vomiting 3 - 4 daily al his food.  Vet gave us a anti  spasmotic pill( vet also practices holistic )  Well vomiting stopped week ago, we also starting giving him plain
yourgert. But liquid stools will not go away. He acts perfectly Rocky like otherwise, eats great, drinks lots of water, uses box, jumps up on  his favorite window sills, enjoys our company etc etc.  Here are his  numbers:
BUN  51.2 mg/dl
CREAT  3.1
GPT (ALT) #77 u/l
BUN/CRET  16.5 >>

Jane, welcome to the list.  I've been following Rocky from the CRF list.  What a trooper he is!  His #s don't look bad at all but isn't it sad how we can't get these CRF guys to gain weight or even keep from losing it?:((  Booey has gone from 10.5 lbs of solid Persian to looking like a Siamese cat, which would be cool if he were a Siamese kitty but he isn't.  He barely weighs 7 lbs now.

<<What do you think about slippery elm for bowel problem..I have read elm  has too much phosperus for CRF kitties.>>

I think Slippery Elm is a good idea.  Course u could try adding some psyllium husk to his wet food, mixed in w/ lots of water to make it soupy; has not failed me yet and no worries about Phos etc.  I asked Boo's previous flakey holistic vet if the Phos in Slippery Elm and Brewer's Yeast is a problem and he said no, there's too lil in there to bother them.  FWIW, Meat has way more Phos.  Really if u start looking at herbs, lots of them have Phos e.g. alfalfa but i don't believe in getting obsessive about it.  Herbs are so healing and I feel balanced in nature that I don't see them harming as much as synthetic allo stuff.  Gee, I'm not too biased, am I? <g>

<< Vet als recommended Hibiscus Tea and Dandalon root power..both for upset stomach.>>

The latter is good for the liver I thought but hey, that's cool if it is also good for the tummy...will check it out.  I add a dash of the root in my herb mix every once in a while. If u really wanna help flush out the toxins, look into Dandelion Leaf. I make a tea w/ it, and squirt in Booey's mouth.

Purrs and headbutts back to Rocky from Booey and his naughty sisters

Sandy

My opinion is to avoid extra phosphorus when possible.  Why tax sick kidneys even more if not 100% neccesary?  Perhaps before resorting to slippery elm try canned pumpkin, that works for Rudy (IBD,CRF) that is until he gets tired of it, and doesn't want to eat it again for a few weeks.  Or what about that stuff Barbara mentioned, Furoxone?  Controlling diarrhea is my new quest (along with finding a good multi-vitamin)

Slippery elm has lots more phos in it than alfalfa. And why do you think Pitcairn has eliminated his healthy powder from his kidney diet?  I think cause of all the extra phos in the bonemeal and lecithin.

<<What do you think about slippery elm for bowel problem..I have read elm has too much phosperus for CRF kitties.>>

<I think Slippery Elm is a good idea.  Course u could try adding some  psyllium husk to his wet food, mixed in w/ lots of water to make it  soupy; has not failed me yet and no worries about Phos etc.  I asked  Boo's previous flakey holistic vet if the Phos in Slippery Elm and  Brewer's Yeast is a problem and he said no, there's too lil in there to bother them.  FWIW, Meat has way more Phos.  Really if u start looking  at herbs, lots of them have Phos e.g. alfalfa but i don't believe in  getting obsessive about it.  Herbs are so healing and I feel balanced in nature that I don't see them harming as much as synthetic allo stuff.>

In Pitcairn's kidney diet, he says to add 1,500mg of  Calcium based on the amount of meat etc.  I assume he  eliminates bonemeal since it contains Phosphorous.  Ok,  here's my problem - I don't think Pit or any of the other  authors really know a whole lot more than we do  collectively, about cat nutrition.

I think it is ok to start w/ saying that since humans w/  kidney failure should or should not do this, so might cats.  But most authors seem to stop there when we know that cats  simply cannot live w/o meat.  The reality is that meat has hi levels of Phosphorous.

Since allo vets consider Phos the big bugaboo, Pit and gang  eliminated yeast, bonemeal etc. (notice, no explanation
given for this in his book or Frazier's)..the other authors then have that pack mentality and don't wanna say feed the  same level of protein when Pit and Frazier have said to lower it..I can't wait for someone to acutally research  this stuff and be able to back up any claims they are making.

The current info on kidney failure is a total cop-out as far as I am concerned. I have a Scottish relative (distant) who has a barn and has about 40 cats at any given time.   They basically hunt for mice and he gives them some milk, eggs, and raw meat on ocassion.  Boy, sounds like a real hi protein diet, no?  No grains and the only veggies they get are what is in the mouse's tummy.

My mom told me to call him and ask since I was so interested in what outside cats eat. He told me that his cats live to be at least 18-20 yrs old, maybe older.  These are moggies and they live in a clean environment unlike our poor L.A. kitties who must be affected by the smog and crud in the air.  When I called him, he thought I was nuts to run up my phone bill <chuckle>  Anyway, he says he has never ever had a cat w/ CRF.  He does know the cats, btw so he could recognize and tell if a certain kitty was looking lethargic, droopy, drinking more water, etc.  He doesn't know how many mice they eat per day so can't tell if the
older ones eat way less mice or what but I was very happy to hear that in his experience, CRF is virtually unknown in rural (at least his neck of the woods) British cats..cool, eh?

I talked to him about 10 days ago and have been mulling over what he said, and now am more convinced that God/Higher Power did not make an obligate carnivore only to say (a la the Soup Nazi on "Seinfeld" <g>) at age 8 or so "Too bad kid, no more meat for you.  You gotta eat grain now"..it just doesn't compute!  Humans don't need anywhere near as much meat and/or protein to survive so feeding human kidney patients barley and less meat makes sense.  Heck, even in humans, so many people eat lots of meat and never develop kidney failure so Peggy's and my original hunch still makes sense to me - it's the balance (Na-K, Cal-Phos etc.), not the amount, per se.  SOmething happens w/ kidney failure that causes the balance to get out of
whack, and that's the problem, not the meat.

JMNSHO. YMMV

Sandy, just wishing Booey would eat, period.

Just checked Adelle Davis' book "Let's Get Well" and on pages 50 and 51, she makes a great case for adding Lecithin to the diet of a cat w/ heart disease.  She says all atherosclerosis is characterized by an increase in blood cholesterol and a decrease in lecithin"

She says a lack of lecithin is damaging to heart patients as lecithin helps emulsify fats so they can easily pass thru the arterial walls.

And on page 193, "As with artherosclerosis, any deficiency that prevents lecithin production appears to cause kidney disease.  Nephritis has been produced in many species of animals by diets deficient in the B vitamin cholin.  The coils of capillaries are
particularly damaged, severe hemorrhaging occurs, blood lecithin drops far below normal, deposits of cholesterol and fats become so excessive, that urine formation is decreased, circulation inhibited, and so much albumin is released in the urine that dropsy results."

"If the diet is low in both cholin and protein, such acute dropsy develops that digestion, circulation, and other bodily functions are interfered with.  Although cholin deficiency also harms the liver, kidney disease is produced long before liver damage can be detected"

Hmm..so if humans are hurt by this, wouldn't cats be in even worse shape when protein is lowered?  She comes out strongly against lo protein diets for humans.  I like Davis' book cuz it is peppered w/ references to animal studies, mostly rats, who are more like humans than cats but..hey u take what u can get.  She has a really nice (long) chapter on diseases of the kidneys and tons of animal-related stuff..too much to type so I'm just giving the highlights.

She cites studies done on calves and rats, and her recommendation is to give cholin and lecithin (as inositol) together.  She also says Vitamins A, E, and C are good for kidney problems as well as Pantothenic Acid, Calcium, Magnesium and Phosphporous.  I think liver is hi in lecithin so I'm going to add a bit extra when I cook Booey's organic chicken this weekend.  He can use the Vit A in there too.

Sandy

Interesting topic.  Just got out my book 'Vitamins, Minerals & Supplements".

Good sources of lecithin and choline, calves liver, eggs, garbanzo beans, caviar, to name a few.  Under 'Deficiency Symptoms' (Choline) it states "There are no specific deficiency symptoms in man, although some animals can suffer lack of choline.  Lecithin must be present for choline synthesis in the human body."  The deficiency symptoms are the same as for Choline.

"What Lecithin Does" "Lecithin is a phospholipid composed of saturated, unsaturated and polyunsaturated fatty acids.  It also contains glycerine, phosphorous and choline.  It is found in chemicals that aid passage of many nutrients form the bloodstream into cells."

Peggy, I'm still trying to figure out this Balance Diet stuff.  Have you tasted it yet?

Ann

<< Since allo vets consider Phos the big bugaboo, Pit and gang  eliminated yeast, bonemeal etc.>>

The truth is, the reason I don't take the "experts" food advice as gospel is because they all quote each other (so misinformation is just perpetuated) and because no one has done any real long-term food studies. The only one doing studies out there are the pet food companies! When I first investigated raw food, I read all the books and did things the Frazier way (which is basically the Pitcairn way). But my "recipe" has evolved extensively in the last 2 years alone. My conception of the raw food issue is that the theories evolve as fast as the computer industry as we are fed <g> more information. The Pitcairns and Fraziers and Yarnalls and even McKays who may not be spending every day on the Internet (the way some of us do) couldn't possibly be more up
to date than we are. Even if they are (which I doubt), they still don't have access to *more* info. than we do, and I don't think they are any more qualified to interpret it than we are.

<<I have a Scottish relative (distant) who has a barn and has about 40 cats at any given time.  They basically hunt for mice and he gives them some milk, eggs, and raw meat on ocassion. He told me that his cats live to be at least 18-20 yrs old, maybe older.>>

Oh, no doubt that the genetics and environment of our cats contributes hugely to their health, but this just shows that in a healthy cat, high protein may not contribute to poor health.

Also, remember that even in people, total omnivores, it's been recently shown that high protein doesn't contribute to kidney disease. It's just that *existing* kidney disease patients should get less phosphorous. Which of course brings us back to the idea that if cats are *meant* to eat meat, perhaps this data needs to be re-interpreted for cats.

Remember Lucky, the cat who has lived 7 years with CRF? He's eating basically nothing but his meds. and deli turkey. I wonder if in spite of it all, all that meat is helping in some way.

I'm still convinced that something in dry food contributes to CRF. I don't know if it's the grains or the dryness or what. Maybe because grains are the wrong *type* of phosphorous that cats can't assimilate it as well as Ph in meat?

Peggy
Hester and Elleander

Hi Sandy & list,

I'm not sure if this will exactly h*lp or is in line with what everyone has found, but I checked in my Merck's Veterinary Manual and while I won't type out the whole treatment since some of it suggests using things like anabolic steroids and other methods, here are some of the things I found.

Merck's suggests that the diet should restrict protein intake since it would relieve some of the signs and help slow the progression of renal failure.  But it is also stated high quality protein such as egg or liver should be given the animal, in the case of cats 3.5 g/kg body wt/day.  If any of you are smarter at metric conversions than I am, feel free to do the math.  This isn't one of my strong points, unfortunately.

It also states the administration of  multiple B-vitamin preparations by mouth to make up for the urinary losses of water.

As I said, I may not be on the same track as you are with this but I thought the info on the amount of protein/body weight might be helpful.

Michelle, Libby, Tana, & Squirt  ===^..^===  (MEOW!!!)

Hi Sandy

Pet's Friend has very good glandular. 1-800-868-1009. This is  Dr. Swift's company, he is a homeopath vet, who does long distant consultation. Pet GO is an everyday use wafer. There is Rena GO, specifically for kindny problem. I have not used any glandular for my pets, but I am thinking about it.

A vet need to evaluate your cat as a whole for any homeopathy remedies. Although, you can find many remedies for kidney problems, what's important is your cat's emotional and mind states. Sometime if you are lucky, you can find the right remedy for your cat from these list. What Dr. Swift explained to me was that all these repertory was from old time. In old time, people did not see doctors until their illness got worse. So, they are finding out that these repertory only describe the worse condition, and not the beginning condition. Nowadays, we tend to take our pets or ourselves to the doctor's office in the beginning stage. It is very hard to come up with the right remedies at first time.

Cats: homeopathic remedies lists six remedies for CRF.

• Arsen Alb - when the cat shows excessive dehydration with increased thirst and dry staring coat. Itching of various parts is seen and conditions are exacerbated towards midnight.
• Chininum Sulph - The amount of urine passed is excessive, the urine being pale and very watery, accompanied by a sour smell. Skin rash may be prominent and occasionally abdominal bloating may occur.
• Colchicum - There is increased urination of dark brown color accompanying joint stiffness and a disinclination to move. Abdominal flatulence may be pronounced.
• Natrum Mur - Excessive urination and frequency is a keynote of this remedy often worse during the night. Mouth lesions in the form of superficial ulcers and blisters are often present while hawking and scraping of the throat occurs.
• Merc Corr - When the increased urination is accompanied by straining with possibly mucous diarrhea as well. Symptoms are worse in the period from sunset to sunrise.
• Phosphorus - Has a beneficial effect on the kidney tissue. Output of urine is increased. Small hemorrhages may appear in the gums and vomiting of food and water occurs shortly after ingestion.

• Mercurius solubilis - for beginning. urine contains proteins, it stinks, cloudy and dirty, often mixed with blood (you may not see it with naked eyes).
• Arsenicum album - Already begun to lose weight, she tires rapidly, her skin is very dry. She is anxious and restless, changes places often, drink little but often, seeks warmth. Her face is sunken, her nose pointed and appears hollow-eyed. Her vomit smells strongly of dead meat.
• Lespedeza - The Blood test shows blood contains waste products and creatines. Diarrhea, vomiting, apathy, weight loss.

   -- Yumi G
 yumig@

<<I would be interested in hearing from anyone with a crf kitties who has tried homeopathy as part of their cat's treatment.  .  My cat has an appt. with an alternative medicine  vet on Friday.  It's her regular vet's partner.  Is anyone familiar with kidney glandulars for the treatment of crf? >>

Sandy,

I am on digest, so it may take me a little longer to reply, but here's my opinion.  I do have a cat in beginning stages of CRF, he is on a homeopathic remedy, but none of those that Yumi mentioned for CRF.  As she stated, homeopathic remedies have to be prescribed for the whole symptom picture/personality.  If you don't have several years experience using homeopathy with people or pets, it's not always effective prescribing, sometimes it works really well, sometimes not.  My cat is presently under
the care of a holistic/homeopathic vet.

He is also taking a couple products that are very similar to glandulars. He's taking Renafood in the morning and Hepatrophin in the evening. Renafood helps detoxify and support the kidney and Hepatrophin aids in liver degeneration and kidney overload.  The Renafood main ingredients are Kidney Bean Plant Extract, Bovine Kidney Extract and Vacuum Dried Bovine Kidney; it also has 700 IU of Vit. A.  The Hepatrophin main ingredient is Bovine Liver Extract.  In August, I'm considering having another blood
panel done to see if there's some improvement in his Creat, BUN and liver values.

Leah
lknipp@

Hey Sandy,

Good to see you on the list.  Sorry to hear about Puff having kidney failure:(  What are Puff's BUN, Creat, and Phos values?

There is lots of hope for cats in kidney failure so I am really glad to see you consulting w/ a vet who is studying homeopathy.  But beware - homeopathy is a very difficult thing to learn.  It sometimes take many many yrs before you can truly begin to figure it out.  My mother is a homeopath and I have been exposed to it since day 1 literally but I worry about vets who watch a few video tapes, attend a lecture or two and then call themeselves homeopath.  This is not to say that your vet may not have that gift; he sure could but tread carefully is what I (and I think Leah) are saying.

Make sure your vet "takes the case" i.e asks you extensive questions on Puff's mental and physical (not just kdiney symptoms) make-up.  He should prescribe only 1 remedy, low potency (<30C), only 1 or 2 times, then wait and watch to see if there is an improvement before asking u to administer more.  After u go to the vet, u can post to the list and get our input (if u want it, that is:)

Re sub-qs: When my oldest (9 yrs old) cat, Tasha was diagnosed w/ CRF, she had already lost over 95% of her kidney function.  She was in the emergency hospital for 8 days where they flushed her body w/ IV fluids.  Then we brought her home and started her on subqs 200 ml a day.  She was only 6 lbs by then.

At first it was really hard to do it but we got good at it after 2 days or so.  Our vet was very nice and showed us how to do it, like making a tent w/ the skin at the back of the neck and going in straight w/ the needle, warming the fluids, making sure the bag hangs right so the fluid flows thru etc.  Even a major needlephobe like me could do it so there is hope for everyone out there.  If ther is someone who can give Puff some treats (we gave Beechnut strained meat) so it distracts her.

There is only 1 thing I worry about w/ subqs, okay two.  One, too much subqs can dump water in areas where it is dangerous e.g heart and lungs.  Cats can die of congestive heart failure and pulmonary edema:(  So, I wouldn't go over 100 ml a day for a cat about 7-8 lbs.  I am no vet so this is just my gut feeling.

The other thing is I feel the cat (and human) body is not designed for either IV or subq.  I'd rather feed it the way mother nature intended - via the mouth, so the body can process it appropriately.  My cat does not get subqs but then I do give him 8 syringes (1 tsp each) of herbal liquid (not tinctures; I brew the loose herbs) each day plus he drinks water on his own.  I know Lactated Ringers are supposed to have the electrolytes added back but how they do know exactly what is being flushed out along w. the toxins?  Maybe they do know, maybe all cats lose the same good and bad stuff, I dunno.  Just seems odd to me esp when
one uses saline subqs.

Personally, I'm glad that when Boo was diagnosed, I was told subqs were out of the question due to his heart problems.  This gave me time to sort of sit back and think about it whereas if the vet had said go for subqs, I would have automatically given them.  I am pretty sure my opinion is the minority one on subqs; it's just that I don't accept anything w/o questioning or trying it so YMMV.  I would say the vocal people on the CRF list are almost 100% in favor of subqs.  My pop psychology theory is that it gives people something to do and they feel they are being active in the care of their cats.  Don't get me wrong, I really admire
the people who take care of CRF cats but I sure wish they used non-invasive means...that would be utopia, no utopia would be where no cat ever got sick or suffered in any way
<sigh>

Sandy, off to look for a place to live <ugh>

Hi Jane and Susanne, both great moms to CRF kitties.

Rocky has the opposite problem, huh?  Jane, check out Dr. Goodpet's Feline Digestive Enzymes which contains acidophilus and enzymes.  I add it to Boo's syringe food every day, and I feel it helps him absorb the nutrients a lot better.

Klebba wrote:
<< psyllium-thing I did not try after interpreting a message here on the list  that it was not good for crf-cats>>

Oh no, psyllium is excellent for everyone - cats and humans.  And as long as u add lots of water to make Sanjay's food soupy, psyllium will be great for him. it is just fiber so it fills up the tummy.

The other thing u can try is something called Triphala which is a blend of 3 Indian herbs.  It is a "bowel regulator" according to Dr. Andrew Weil; check out his website: http://cgi.pathfinder.com/drweil/

<<The only astethic problem is the oily fur, I think of trying a powder that Persian breeders use to *drywash* their cats during showing time. Or does just pure talcum has the same effect? Does anybody know?>>

I would shy away from talcum cuz who knows what stuff is in there.  But I know many persian breeders use cornstarch (is that bad for kitties?).  Since Booey is a black Persian I never tried any white powders on the little guy; what would his friends have said?:)

BTW, I am very happy to hear the paraffin oil is working for him.  Will keep thinking of what to do about the fur besides wiping w/ a washcloth, and combing.

Sandy

One of my magaazines health columns had the folloiwng info:  Cats may not be suited to ingesting large amts of starch found in diets that are low in protein and fat, said Jacquie S Rand, BVSc, DVSc, of Univ of Queensland, Aust.....when fed high starch low-protein diets cats eventually may exhaust insulin-prodcing cell and lose their ability to efficiently metabolize dietary carbohydrates...however, certain forms of starch such as sorghun and barley, help control dogs' blood sugar levels...managing blood sugars can potentially reduce insulin therapy and minimize diabetic episodes.

A paragraph re canine renal failure may be of interst to feline owners: other research shows that the use of fermentable fiber sources shifts excretion of protein waste products from the urine to the feces.  This allows the use of higher protein diets with beneficial health effects...additionally if has been proved that omega 3 fatty acids found in fish oil and flax decrease blood pressure in dogs' kidneys.  HIgh blood pressure hastens kidney deterioration but decrease can slow progression.   Omega 6 and 3 should be in a ratio of 5 to 1 respectively.

Jacqueline G
Borzoi From Somerset
keepers@

<<This  psyllium-thing I did not try after interpreting a message here on the list that it was not good for crf-cats>>

No, I think it was slippery elm that might not be good for CRF cats. Psyllium is nothing more than fiber so should be safe.

<<So I again tried Paraffin oil like I did 2 years before and which some  people on  this list recommended as well.  I again saw no immediate effect on Sanjay,  After 7!!  days the Paraffin now works>>

Are you sure someone on *this* list recommended paraffin? Strange, but if it worked. Honestly, though after 7 days, I wouldn't even be sure if it was actually the parafiin or just the natural processes of his body that worked! Other things in the future that might work are canned pumpkin, butter, or olive oil. Actually, there's a really good constipation recipe in Anitra Frazier's book that I used once with success. Don't know about the vomiting, though. Slippery elm would have been ideal, but we're not sure about the Ph in it. Though, didn't Sandy's vet say that the Ph in slippery elm is actually negliable?

Peggy
Hester and Elleander

<< One of my magaazines health columns had the folloiwng info:  Cats may  not be suited to ingesting large amts of starch found in diets that are  low in protein and fat>>

Pretty much jibes with current thinking. What magazine was this?

<<however, certain forms of starch such as sorghun and barley, help control dogs' blood sugar levels>>

Hm. So I wonder if it's the same with cats. Stay away from gains except for barley if you're diabetic?

<<other research shows that the use of fermentable fiber sources shifts excretion of protein waste products from the urine to the feces.  This allows the use of higher protein diets with beneficial health effects>>

Even more interesting. Are there any other fermentable grains besides barley? What else do people make alcohol out of?

<<additionally if has been proved that omega 3 fatty acids found in fish oil and flax decrease blood pressure in dogs' kidneys. >>

I wonder if it's the same with cats. We know that dogs and humans share certain characteristics that they don't share with those pesky cats.

I actually find this easier to deal with. Dog health seems so complicated to me, with the whole plant assimilation thing. With
obligate carnivores, the general rule of thumb can be, "when in doubt, go for the meat."

Peggy
Hester and Elleander

H there Peggy:  From an issue of "Groom and Board" - but the excerpts printed came from May 1998 Iams Nutrition  Symposium, The Australian vet, also Dr. Greg Sunvold and Dr. Gregory Reinhart were quoted.  Whether or not any of that was appropriate for cats regarding renal problems would be something to ask a feline specialist - but I would think the Omega info would apply to both species.  As it is Iams Co.,  of course they would mention grains in reference to diabetes because we all know their cat foods ain't all meat & veggies.  MIne get about 2 tbls cooked grains to half pound ground meat or mackeral with about 1/4 cup purred veggies...supplements...works for me.

Incidentally, calcium lactate is my choice and its about six bucks at HFS store for 9 oz.  Pitcairn mentions eggshell powder as an alternative (I think second) choice.  The Kritter Kitchen site has a Ca:Phos calculator so one knows exactly how much calcium to add to meat to balance to Ph.

Jacqueline Gregory
Borzoi From Somerset
keepers@

Marty, you and I will just have to agree to disagree on  subqs.  I think it is not w/o risk and will continue to say  so.  When I joined the CRF list more than a yr ago, I can't tell u how many people wrote to me agreeing w/ me about  giving too much subqs.  SO many people said their cats died  from the excess fluids around their hearts.  Even Boo's vet  told me when I took him in for his polyp problem that she  feels emergency vets put kitties in kidney failure in more danger by in some case, literally drowning them in fluids:( Obviously, most of us would be careful about giving too much but I reiterate my concern for the good being flushed out w/ the bad.

I think subqs are invasive b/c I don't fancy being stuck w/ a needle in my back for anywhere from 3-10 mins depending on the size of the needle and amt given, and fluids forced into me a very "natural" approach.  As I said before, YMMV, and yours clearly does.  In the wild, I would expect a cat to seek out herbs and food that will help them but I don't expect them sitting around giving each other subqs anytime soon!

A vet who I am friendly w/ (alas she doesn't live in SoCal) just wrote back to my query on subqs that she (allo, btw) too feels subqs are a "very crude way to deal with CRF" but they don't have any other techniques in their arsenal besides that and lo-protein diets so I'm not sure where that leaves us.

In Boo's case, the specialists and regular allo vets said subqs are too dangerous given his heart problems so my questions to them about subq are purely academic at this point.  Heaven forbid, I ever have to hear the dreaded acronym, CRF, again for any of my 3 precious daughter cats.

Sandy