Cat with CKD

Hello. Please help my cat Merlin. We live in Russia and in our city haven't good doctor who understand in CKD. First diagnosis was made in 2015 (CKD, 2 stage). Six years we normally lived on renal diet (Royal Canin), but in may 2021 Merlin suddenly blind (high blood pressure). Our vet recommended Semintra and untill september Merlin felt good. But after september creatinine started to grow. Blood pressure would be high too. Doctor recommended Amlodipine, but she wrong dosage (3,75 instead of 1/8) and Merlin got sick (stopped eat, creatinine over 800). Ten days he lay on intravenous drips. Now Merlin feel better, eat Farmina renal. Together with Semintra we use Ipakitine, 1/8 Amlodipine, Ketosteril, ferum (hemoglobin was lowered) and prebiotics. And SubQ. Please, tell me: - wrong dosage Amlodipine could cause an acute? How much it damaged the kidneys? - high blood pressure could be cause of grow creatinine? - after visited clinik Merlin afraid leave a room. May it be a stress? And what i can do for him? Thank you so much for answers.

Hello!  - I can hear that you and your cat have been having a very stressful time.  Amlodipine is a drug that reduces blood pressure and of course, if blood pressure is reduced too much then lack of energy, fainting, collapse, heart disease and lack of blood flow to the organs, including the kidneys, are all things that might follow.   An acutely raised creatinine or urea wouldn't surprise me because the blood may not be flowing through the kidneys well enough for these waste products to be removed and processed (creatitine and urea are waste products of metabolism that the kidneys normally filter out of the body).  Furthermore, a lack of blood flow to the kidney cells and a build up of creatinine / urea may additionally damage the kidneys further (long-term), especially if the blood pressure was low for a while.  However, I am unable to comment on what happened to your cat;  I simply do not know enough detail of the specific case and it is inappropriate to comment on other vets' cases without seeing and understanding the full veterinary history.  Doing so would constitute a second opinion and is usually carried out by someone with more knowledge in an area than the original vet.  I hear that you are questioning your vet and agree that it may be interesting or useful for you to get a second opinion run in this case.

Often the way to deal with a amlodipine overdose may include putting the cat on fluids in order to support the kidneys.  I'm afraid that blood tests would be needed in order to ascertain the extent to which the kidneys had deteriorated, in comparison to any deterioration that was expected during that time in the first place.

Thank you! Yes, Merlin was very bad two week ago. Blood test we will take soon, but i hope that creatinine fell cause cat eat and his wool looks better. Please, tell me about Semintra. Our vet insist this drug (because had protoinuria), but i read that Semintra may be dangerous when high creatinine. And may it be that amlodipine change the behavior (depression)? I don't know that to do...  Many years we lived with CKD and now everything is bad. SDMA test that we did before amlodipine showed 3 stage, but creatinine did as stage 4. Why?  Sorry for many questions, but i really afraid.

And after the Amlodipine incident I don't trust my vet... It was gross mistake that led to such consequences

It is difficult when you don't feel that you can trust your vet.  Only you can decide whether you go back to them or see a different vet in the practice (if available) or ask to go elsewhere; however any vet with access to your cats history will have a much better angle on what's happening with a case than one on the Internet who doesn't.  For this reason we would either advise going back to your existing practise and talking it over - or changing vets and asking your current vets to get a history across to the new vets for you (in the UK they are obliged to do so) so that the new vets can treat the case with understanding of what happened. Best of luck