How Love and Science Conquered Chronic Renal Failure
“His restless spirit was only defeated by well-executed massages that would mesmerize him into deep, reluctant sleep.”
Astro was a dominant and pampered Siamese who had started out in life quite differently. His nascent lot was to be the much-bullied runt of a large litter that consequently had to be hand-reared. A fact that might explain both his special affinity with people and his uncatlike eccentricities.
When we met him, Astro was small enough to easily fit into a shirt pocket, yet, was very willful and brave. His restless spirit was only defeated by well-executed massages that would mesmerize him into deep, reluctant sleep.
As he grew, Astro developed a very unique character. He moved like a sleek confident panther, was not much interested in stalking real or imaginary prey, fought with some form of feline martial arts that totally unnerved Quaily, our other cat, spoke more than meowed, and growled like an angry dog at suspicious sounds. He was at his happiest cuddling on our couch with whoever was radiating the most heat.
One early spring when Astro was not quite six years old, I noticed some white spots on the fur on his flanks. Around the same time, he had also begun losing weight and throwing up whiteish foam once or twice a day. He had become lethargic, had lost his appetite and had started acting strangely, plucking chunks of fur from his coat.
I had seen similar symptoms exhibited by my human patients who suffered from systemic toxicity. In humans, systemic toxicity can be caused by a wide range of metabolic and organ pathologies. I had my suspicions as to what might be causing these symptoms in Astro, however, a positive diagnosis would depend on some lab tests.
I brought Astro to the vet for a thorough check-up. He took blood and urine samples and sent them to the lab for analysis. He also took an x-ray and administered fluid therapy.
The x-ray was the first result we got back and as I suspected, it wasn’t good news. One kidney was greatly enlarged and there were significant calcium deposits in both. The blood and urine test results were even more devastating. Simply put Astro’s kidneys were shot. His diagnosis was chronic renal failure.
I knew that in humans there is no cure for kidney disease. It is progressive and ultimately results in the patient’s death unless dialysis is routinely performed or they receive a kidney transplant. The vet explained that the same holds true for cats and dogs, though dialysis and transplants are rarely performed due mainly to the prohibitive costs.
The vet and I discussed Astro’s prognosis and treatment options; it seemed options were limited and his prognosis poor. The vet prescribed some potassium pills and we agreed that I would continue hydrating Astro at home by a process called subcutaneous hydration, also known as sub-Q’s. He was also put on a renal diet designed to limit his intake of protein and phosphorus in the hope of decreasing the waste products his kidneys would have to filter out.
As a result of these steps, Astro condition stabilized. Hydrating him seemed to help but nausea continued to plague him. He gained a little weight, had some good days, some bad days. Overall, however, it was clear that his condition would not improve significantly. And though we tried not to dwell on it, we were acutely aware that it was just a matter of time before this fine balancing act would fail him.
Three months after first being diagnosed with kidney disease, Astro’s condition took a dramatic turn for the worse. Subcutaneous hydration was no longer effective in helping flush the toxins out of his system. His nausea grew worse and he had trouble keeping anything down. His already thin frame began to show signs of emaciation again, and he became so weak that at times it was difficult for him to keep his head up.
As a family, we struggled with the question of how much we were willing to put Astro through to keep him alive. Taking him to the vet and leaving him overnight or longer for treatment stressed him out so much that we decided it would no longer be an option.
When Astro, who detested being alone, found himself a secluded niche fare away from everyone and refused to leave it, we knew he was preparing himself for the end. We very seriously began to consider euthanasia.
Astro soon after being diagnosed with CRF. The depigmentation (inside the red dotted line) is clearly visible on his flank.
“When Astro, who detested being alone, found himself a secluded niche fare away from everyone and refused to leave it, we knew he was preparing himself for the end”.
Astro about three months after starting on the formula. He has gained back a lot of weight and no longer needs to be hydrated. (Note the re-pigmentation on his flank).
“Wondrously, in one of those impossible to forget moments, he snapped out of his trance and focused his pupils on me through crystal blue eyes.”
I watched him sit in his sheltered spot late that night after everyone had gone to sleep. There was little left of him, barely fur and bones. He had stopped eating a couple of days before and had now stopped drinking water as well. His eyes were focused on a spot far away and he looked agitated as if he were earnestly waiting for someone or something. I went over to try and comfort him but he pulled away, his gaze never wavering…he didn’t recognize me.
I had watched many patients near their end, it was never easy abandoning the fight for life, yet, one had to know when it was time to let go. It was time to let Astro go.
I was surprised, however, at how difficult it was for me to fully accept this fact and found myself sitting in front of my computer looking up research papers on kidney pathology and cellular metabolism well past dawn.
On my way to catch a couple of hours sleep, I stopped to look in on Astro. He was awake but transfixed. How long could he endure I wondered? I had resolved that we would not take him to the vet to be euthanized. If there was still some fight left in Astro to re-ignite, I would conjure a weapon that could help us win a few battles.
I had discovered some very promising research on CRF, cellular metabolism and free radical neutralization and coupled with research I had conducted on systemic inflammation, I conceived a possible treatment strategy. The intent was to target the inflammatory mechanisms that propagate kidney disease while at the same time neutralizing free radicals that attack kidney tissue triggering the inflammatory response in the first place. The challenge was to combine the results of this diverse research into a formula designed to arrest, and hopefully reverse the progression of his kidney disease. The formula, once conceived, would be prepared as soon as all the ingredients could be procured, however, we first needed to buy some time. Astro would require an increase in hydration and nutritional intake.
Unfortunately, Astro steadfastly refused to eat his renal diet cat food and forcing him to do so would not be a tolerable solution. Instead, I spent some time offering him a cat treat, gently enticed him to eat. He seemed unwaveringly oblivious to my offering and pleas, it was as though he was fully determined to meet his end.
I made one last attempt speaking more with my heart than head using words more as soothing sounds meant to beckon him back to me. Wondrously, in one of those impossible to forget moments, he snapped out of his trance and focused his pupils on me through crystal blue eyes. Tilting his head slightly, he considered the treat I held before him for what seemed a rather long breath hold…then a surprisingly decisive move, and he gingerly plucked the treat with his teeth and swallowed it down with some effort. He took another and after a few moments again another, always with the same determined birdlike movement of his head. It was his way of telling me he was going to try again. What brought tears to my eyes was his absolute bravery; he had turned his back on what remained a very short path to the end of all suffering.
Morsel by morsel I hand fed him praising him for every courageous bite he accepted. He ate six or seven pieces and a while later, another ten or so. I was never fooled, Astro was coaxed back to life with love not food.
With all the ingredients procured and the proportions calculated, I mixed the formula and administered the first dose with a pipette the day after Astro resumed eating and drinking.
After a month of daily 1.5 ml doses of the formula, Astro’s condition stabilized and he was out of danger. He had regained his appetite and put on some much-needed weight. Based on his blood and urine tests and lack of nausea, six weeks later, I began weaning him off the sub-Qs.
(Subcutaneous hydration is a great way to help a cat or dog that suffers from CRF flush the toxins out of their systems, however, it can be harmful if continued for too long after it is no longer required. It can overburden the remaining undamaged nephrons and actually accelerate the progression of the CRF. There is also a risk of volum overload, and high blood pressure. At the very least, it’s a very good idea to discontinue hydrating every so often to “rest” the already overburdened kidneys.)
I put Astro back on a cat food he liked that had high-quality protein as the first ingredient, low phosphorus, and no grain content; he detested the renal diet stuff. I had come to believe, as a consequence of the research I had done, that limiting the protein in a cat’s diet rather than feeding a diet containing high-quality protein with good bioavailability would cause more harm than good. As for medication, the only thing Astro received was 1.5 ml/day of the formula. I had named it Astro’s Oil in his honor.
His comeback was miraculous, his positive progress continuous from month to month. Astro’s coat which had suffered greatly from his illness having mottled, depigmented and gone bare in places, returned with a vengeance. It was now a shiny, dark chocolate brown frosting various shades of beige undercoat. His ears which had lost most of their fur were now pure damask velvet. He thrived, was happy and enjoyed a great quality of life. Friends who saw Astro at his sickest could not believe that this was the same cat.
When tested, his blood and urine values were high/normal and though his kidneys were damaged we managed to recoup enough kidney function to help him lead a normal, energetic and much-cherished life.
Over 12 years have passed since I first wrote Astro’s Story, and though his journey recently ended on a gray January morning, his story continues to be written daily. There are few countries left in the world that I haven’t shipped Astro’s Oil to. The ones that I did all have their own numerous “Astro’s Story’s” and I have exchanged emails with literally thousands of the “story writers” over those years, some correspondence has endured since the beginning.
Many changes have also taken place within Astro’s Oil as a company. Two new products have been designed and developed to work synergistically with Astro’s Oil and are now available on the new website. A newly developed line designed to help support Congestive Heart Failure pets will launch in the near future and a campaign that hopes to bring Astro’s Products to a vet near you is up and off to an exciting start. What started out a one-man operation has necessarily grown and I now have the support of a great team that I’m very proud of.
I miss my little buddy every day, and yet somehow, he is always an active part of some portion of it.
Edmond Marcovici MD
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Astro 16 months after first starting daily administration of Astro’s Oil.
“Astro’s coat which had suffered greatly from his illness having mottled, depigmented and gone bare in places, returned with a vengeance.”