Just a quick update about my cat.
He was put on IV fluids for two days. Before the fluids his BUN was 21 (UK) and after 24 hours it had risen to 30. Someone I spoke to previously said that they would probably not go for the fluids as it may dilute something in the blood (not sure of what they meant, but this may have been what happened).
After he came home he was eating solid food. Maybe the steroids he was given helped, I don't know. But he has continued to eat/chew relatively normally for the last 2 weeks - which is the longest I've seen him eat normally.
He's still doing a bit of lip smacking (possibly nausea, but maybe just acid reflux). The stomach acid is something he can have a real problem with. He had no ranitidine (75mg zantac cut into quarter and given twice daily), although I had some. On Sunday he started to struggle and it seemed to be acid reflux. For the next two days he was withdrawn, not eating, not drinking and just looking quite unwell. I didn't know if this was a crash or problems with the reflux. On Monday morning he vomited and it was pinkish in color. I took this to mean his problem was indeed acid and the acid was disturbing the tissue in his stomach or maybe his esophagus. Either way, I gave him his zantac and gave him 24 hours to see how he recovered. Yesterday, he improved quite a lot. Started eating good and was up and about. Still not 100%, but a big improvement.
It all suggests to me, as someone with a CKD cat said to me, that he will need zantac everyday - whether he is showing signs of reflux or not. I can't afford for him to have a bout of bad reflux that has him suffer and go off his food for a couple of days. He is a slim siamese cat, so can't afford to lose too much weight.
He is difficult to pill and so I have ordered a pill shooter/pill gun, which I am sure will help.
Some people have mentioned famotidine but have also said that this drug can be tough for the kidneys to excrete if the kidney levels are high. He hasn't had his creatinine tested for a month, but I think he looks well. All the same, it sounds to me like zantac is the better option unless he starts having bigger problems with the acid reflux.
One thing I would be interested to know is your thoughts on dry food. Pretty much the only solids he eats are dry foods (specialist renal dry food). He has always been a dry food cat and so has always been a cat that drinks plenty. That is still the case but I see lots of people suggesting that dry food is something you need to get the cats off?
I've seen other people mention slippery elm bark as good for the stomach lining and good for reducing nausea.