6/10/11 Chyna new labs/CKD worse? staying at vet

Hi everyone! Chyna and I wanted to say hello to everyone. I've been creeping the site but not posting much. She's been doing good, her food allergy on just the lamb Ziwipeak seems to be helping the itchies. Her BG has been good when I've taken it weekly (yesterday was 72) and shes maintained her weight/gained a bit. We went to the vet today for her bloodwork since it's been over 3 months since her last one so the BG was 107 from being there. Does anyone elses quiet sweet cat turn into psycho wailing kitty when they hit the vet office? As soon as they took her for bloodwork she made sounds like I've never heard before except last vet visit! :shock:

Anyways, I know this is the diabetic cat website and she is in remission, and I'm still trying to figure out the posting on Tanyas CKD support group site...but I know some of you deal with CKD and was hoping you can look at my labs from today? They are in a spreadsheet with her other labs done here: Chyna SS Labs

The actual copies I scanned in of the labs are on one of the bottom tabs of that spreadsheet too.

The tech that called me said the vet wants me to bring her in for the day tomorrow to put her on IV to flush out the kidneys and mentioned starting a phosphorus binder and some other things and mentioned acute renal failure? Right now we are just doing the B vitamin/methylcobalamin and slippery elm bark for supplements. Is this the time to ask about SubQ fluids and are there any other suggestions of things to ask for/about? Her levels of phos have gone up with the BUN and UREA. But from what I can tell the aenemia is better? I was reading if they are dehydrated that may be false though...ack. Sorry to bother you all, I really appreciate any insight

Re: 6/10 Chyna BG 107 at vet, new labs/CKD worse?

Marge has made a really good video on helping you learn to give Fluids at home.
http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=75933&p=821414&hilit=marge+video+fluids#p821247

I'm not used to the test results being in umol/L as J.D.'s are in mg/dL. My vet often tells me that the elevated BUN is from his high protein diet. You can check out J.D. labs for comparison as they are tabs in my spreadsheet too, but I don't know if they'll compare being in a different type of numbers.

I'm glad Chyna is doing well otherwise, and it's certainly nice to see you. There are lots of people here dealing with multiple issues like kidney disease, so I'm sure if you post enough, you'll get some answers. This will bump you up, and feel free to bump yourself up, if you want more eyes on your condo. You're part of our family and always welcome here :YMHUG:

Re: 6/10 Chyna BG 107 at vet, new labs/CKD worse?

Thanks Dyana, hugs back to you! I've watched the video before but now I'll have to memorize it ;-) Marje said she'd pop by later too. I've turned into a giant watering pot for the day, I guess I was just expecting better results today. I thought the levels would at least have stayed the same since she seems to be feeling so much better but I guess that was too optimistic :cry: Of course, on the lab from the vet today they are comparing it to the numbers from after she'd been on IV overnight but they are still higher than the ones from before IV last time...phosphorus doubled. Hopefully the IV flush and phos binder will help that nailbite_smile

Re: 6/10 Chyna BG 107 at vet, new labs/CKD worse?

(((Rachel))))
I don't have any answers for those issues.... but I hope you get some direction so you can make Chyna feel better.

We ( you, me ) still have diabetic cats.... they are just diet controlled so you still belong here with all of us.... all the same....

Re: 6/10 Chyna BG 107 at vet, new labs/CKD worse?

((((Rachel)))))

Sorry it has taken me all day to respond.

I would agree that Chyna is in CKD. Not sure why the vet would mention "acute" because acute has sudden onset and then is resolved. Chyna has been dealing with elevations in her creatinine since at least last Nov.

I do think that Chyna could benefit greatly from subq fluids. In reality, subqs do not flush the kidneys. They are given to help the kitty with hydration as the compromised kidney results in dehydration. It's best, at first, to try and let the kitty compensate by drinking water but at some point, they can't keep up. I think Chyna is at that point. It would be up to you and your vet how much but she should probably have them daily. Be sure her heart is healthy. I'd ask for Lactated Ringers Solution (LRS) instead of Normosol (saline). LRS has potassium which will help her keep her potassium levels up. iF a cat becomes hyperkalemia (high potassium levels) in Stage 4 or end stage, then it's best to give Normosol. But some cats never become hyperkalemic. I've used LRS for three years. I'd also ask for 21g needles until you can order some.

Chyna appears to be in Stage 3 and it is definitely time for her to be on a low phosphorus diet and phosphate binders. If you aren't using Dr. Lisa's Phosphorus Food Tables, you should. I would speak to the vet about getting aluminum hydroxide powder as a phosphorus binder. To me, this is where you really need to focus your efforts....the high phosphorus can make them feel really horrible and can also contribute them to getting mouth and stomach ulcers.

Des she need to be on Pepcid or is the slippery elm holding the acid tummy at bay?

I'm glad her HCT is staying stable. That's great. Keep up with the B12/multiB.

Some find Azodyl helps with the azotemia and brings the BUN down. I've never had good luck with it but ECID.

I hope you can reverse some of those numbers. Usually with the fluids, a low phosphorus diet, and a binder, you can make alot of progress.

Hugs! Glad her BG is still so great. Lt me know if you have questions.

Re: 6/10 Chyna BG 107 at vet, new labs/CKD worse?

Sorry I didn't get a chance to answer, my internet provider is down and I couldn't get online, still can't. I guess it's down in all of AB...so I had to use my crappy cell which has a different internet provider! Hoping it will be back soon so I can use my computer.

Anyways, thanks Rhiannon and Marje Chyna is now at the vet for the day on IV, they said to call if I want to see how she is doing and to come back at the end of the day to get her and discuss subqs and binders etc. I wrote what Marje said down on a post it in my purse I've never actually seen the vet that runs the clinic, every time I've been there I've gotten the locum vet so yesterday is the first time he has seen anything on Chyna (unless he reviews stuff done when he's gone?). He's the reason I wanted to go to this clinic in the first place, he has great reviews from friends so here is hoping. He probably just saw her levels from after the last IV and thought acute? Or the tech did, since I didn't actually talk to him, the tech left a message.

Pepcid, I'm not sure, how can you tell if the slippery elm isn't enough anymore? She's eating all her meals with gusto...CPC ;-) What do they need to do to see if her heart can take subqs?

I am using the lowest phosphorus I can find on Dr Lisas list that I can order/buy in Canada, that had an "unusual" protein for her allergies testing, we're only a month into it. It's under 250 but not under DM 1. Will the binder be enough for that? Pretty sure it's chicken and turkey for sure that she is allergic to, and everything seems to have it as an ingredient that is low enough phosphorus...ugh. I'm not sure what to do with that. Even considering me making raw I'm having ingredient trouble in the small town I live they don't have what I need and places won't ship. I'll keep researching that...hugs to everyone . I'm just trying to get through the day with my baby kitty away :YMSIGH:

Re: 6/10 Chyna BG 107 at vet, new labs/CKD worse?

I hope Chyna will be ok,just watched video very well done, I hope not to have to use on my Lucky or the others but can do if need be,I have done on people but they didn't have 4 legs a could try and run mol. Best of Luck to you
Linda

Re: 6/10 Chyna BG 107 at vet, new labs/CKD worse?

Rachel

The day on IV fluids should help ...I've seen it bring the creatinine and BUN down. It probably won't bring down the phosphorus. I'd really push for the binder or else see if you can put her on a prescription diet for renal issues. Talk with the vet about novel proteins....I think they use pork and I don't know how that will work for her.

I wouldn't start the Pepcid unless you see evidence of acid tummy. The SEB might be working just fine for now. Be sure when you start the binder that you separate them in time by quite a bit. If she has acid tummy, she will vomit clear, foamy liquid, she might hunch over, you might hear gurgling tummy sounds. The other thing that helps with tummy acid is feeding frequent small meals to keep the tummy with food in it.

I'm not a fan of antacids but you will likely get to the point where you will need it. We did. But Chyna may do very well still for some time with the SEB and small meals. Especially be sure you feed her late at night.

Have the vet listen for a heart murmur. Discuss with him whether there is any need for an echocardiogram just to be sure the daily fluids don't overwhelm her heart. Most cats are fine but it's a good question to ask. Also...if you make absolutely sure all fluids are absorbed before you give more, then that decreases chances of it affecting the heart.

Many vets like to do more fluids every other day. He might tell you 150 mls, for example, EOD. It is much better for her to give a smaller amount every day. Our Teddi Bear weighed 6 lbs and I gave her 100 mls every day. Her numbers a Gus,ly came down close to normal and then I cut back to EOD. But Chynas creat is high enough now to warrant every day. See she she is after the IV fluids and decide.

Hugs! Be optimistic. We are starting year 4 now and Gus's numbers are staying stable. We've been able to keep his phosphorus around 5.5 which is good.

Re: Chyna new labs/CKD worse? staying at vet

Thanks again Marje, and thanks for the good wishes Linda Still not sure about food, since the renal diets they stock have chicken in them and they are high in carbs...but he is the one who brought up phosphorus binders so I don't think I'll have to push much for one ;-)

The office called late this afternoon and the vet wants to keep Chyna overnight and all day tomorrow on IV. I brought in some food just now (which she will most likely not eat) and saw her for a few minutes but all she would do is hiss at everyone :YMSIGH: There was a really loud cat in the cage next to her and she HATES other cats...and being away from home, and strange places. I bawled like a baby...such a wussie, lol. I'm going tomorrow at 5pm to get her and discuss with the vet. Now I just have to somehow make it another night and day, my stomach is a little sick :sad:

Re: Chyna new labs/CKD worse? staying at vet

:YMHUG: :YMHUG: :YMHUG: :YMHUG:

I really have seen IV fluids make a big difference in the creat. Our Teddi Bear was around 2.8 on her creat and she had to be hospitalized for lymphoma. They had her on IV fluids. Her creat dropped to 1.4. I will hope the same thing for Chyna.

Re: Chyna new labs/CKD worse? staying at vet

Wow I needed those hugs! I know it's for her own good, to help her, but it breaks my heart to leave her feeling all abandoned. It did really help her levels last time. Guess I'm too much of a softie

Awww...poor Chyna, and poor you. Sending tons and tons and tons of vines your way. You're not too much of a softie...you love your girl. I would be the same way. You've got all of LL behind you, though! Please keep us posted.

Hugs for you...
and hope she feels better tomorrow when you get her back.

Hi, (((Rachel))), I know it's so hard leaving Chyna there overnight. You love your girl and she knows it.

Amy's right: you have tons of support here!

Try to get some rest tonight. :YMHUG:
Sending vines!!

Thanks for the support ladies :YMHUG: :YMHUG: I don't realize how often I go to pet her or check on her till she isn't here! I'd sleep there at the vets if I could ;-) Does that make me weird? :lol:

Nope, not weird at all....at least not to us LL-ers!

Nope. you aren't weird.
I'd be there with a cot myself and my fingers in the cage.... ;-)