New vet found undisclosed stage 2 kidney disease, overwhelmed

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stacia

stacia

Member Since 2014
I posted last week that we were going to a new vet and I'm so glad she did.

In short, her approach is much better than the old vet. And while we try to be gentle with the "I'm mad at my vet, therefore vets suck" thing around here, I'm really angry at my previous vet this morning.

Turns out my Tasha has had stage 2 kidney disease since August, when she was diagnosed with diabetes, and the old vet never mentioned it. So in addition to being really unhappy and feeling suspect about how she was handling the diabetes, she failed to mention anything about the kidney issues. I only found out when the new vet mentioned the kidneys felt small and then confirmed numbers in an email last night based on bloodwork. She compared them to numbers the old vet provided from August, which had Tasha in Stage 2 then.

I'm... angry. I'm politely calling for full records on both cats tomorrow morning to transfer vets (the original pretense was for boarding purposes).

But now my focus is what to do for Tasha. I have a full print-out of her test results if there's something there to help guide me. Should I be more specific in food choices? We feed her Friskies pates, which the new vet is happy with. Any other suggestions I should discuss with the doctor? The BUN is 39 (was 37) but the creatine is 2.1 ( was 1.7). Her concentration of her urine is 1.025 so a little dilute.

We also did fructosamine - it was 501. We'll retest that in a few weeks. This vet does NOT like to do in-office curves for all the reasons FDMB doesn't like them, so yay! She was thrilled with my spreadsheet and other than not being thrilled with the sliding scale (and I get why), she was pleased with what we were doing.

I'm glad we made the appointment with the new doctor - we were there for almost two hours on Friday and Tasha, usually a hell-cat at the vet, growled a lot during the exam but was well-behaved. No swatting, hissing, or biting. The non-sugar kitty will have an appointment scheduled as soon as we get his records transferred.
 
Pop over to Tanya's Feline CRF web site, which is back up and running, to get tons of info on managing it. Really good stuff there.
Friskies Special Diet pates are low phosphorus and low carb; you might investigate those foods, to start.
 
BJM said:
Pop over to Tanya's Feline CRF web site, which is back up and running, to get tons of info on managing it. Really good stuff there.
Friskies Special Diet pates are low phosphorus and low carb; you might investigate those foods, to start.
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I'm so sorry to hear about Tasha's kidney disease dx, and the circumstances in which you found out about it...

I second what BJ wrote above. Do have a look at the Tanya website. And I'd really recommend that you join the support forum there too. I joined recently when my latest foster cat was dx with stage 3 CRF/CKD (and can't now be rehomed....) People on the forum have been SO supportive and helpful.

Best wishes and good luck,

Eliz
 
Thank you, both. We're out of food so we'll go for the special diet variety. I'll also check out Tanya's site.

I'm upset to think I could've been doing things differently for 5 months if I had known - and that the original vet had that info the entire time. We were even in for UTIs during that period.
 
We do have some of the other left. She's always been pretty accepting but we'll do that. We're trying to put a little weight back on her as well and I see calories are close to what I was giving her before. This vet calculates calories! The old one told me "feed her what she wants."
 
Stacia, I really empathize with you and I think it's disgraceful that your previous vet got it so badly wrong. I do appreciate that vets have an enormous amount of work to do to acquire the knowledge and skills necessary to provide a service for general practice and I sympathise with that, but there are also vets whose shortcomings are, frankly, completely inexcusable. I lost a cat to HL primarily down to the hubris of the vet I entrusted her to. That's over four years ago. I haven't got over it, I never will, and I continue to worry for other cats that depend on that vet for help. I am beyond thrilled and relieved that you've found a good vet for Tasha. I've got a huge soft spot for your girl because she reminds me so much of my Olwen (now on 'permanent foster' with my dear friend, Peter, who loves her to distraction).

DanandOlwenRelaxingonSofajpeg.jpg


(Ollie's - obviously - on the right of the picture.)

Tanya's site is a goldmine of information for CKD, as well as general health advice. I bought the book: it's excellent, and it guarantees availability of the information all the time - no need to depend on the internet for access. Fingers and paws crossed that Tasha will start doing better very soon. I'm so glad that her new vet is so switched on and caught the condition. Fingers and paws crossed that the appropriate diet and treatment adjuncts can be put into place for Tasha to help her feel better.

:bighug:
 
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Thanks, Áine. Spending some time with Tanya's site tonight and working our way back through the information from the new vet as we compose a response to her. I feel like we have the full picture now at least, and a vet actively working with us. Tasha seemed much more relaxed with her as well.

We didn't find much Special Diet, but we found 10 cans of a flavor she's eating now in the Classic Pate so that should help the transition. I'll look for more later this week. I feel a bit like I did when she was initially diagnosed with diabetes, only more betrayed because the vet didn't give me the info for so long.
 
I can relate to how you're feeling somewhat, Stacia. I felt a bit like that when I learned more about food allergies and about IBD as a possible root cause of pancreatitis and subsequent diabetes. I flagged Saoirse's tendency to worry at the fur on her tummy to our previous vets in summer 2011!!! Even when I brought Saoirse in with the PU/PD symptoms in May and asked the vet about her now half-bald, very distended tummy she put the fur loss down to stress (again) and normal ageing, the distended tummy down to age, and the insane level of drinking/peeing as an age-related issue as well. She tried to deflect my request for her to examine Saoirse's tum, and when I really pushed it she eventually performed a brief, perfunctory examination that felt to me as though she was doing it not so much to help diagnose a problem with my cat as to shut me up. I still feel a great deal of anger towards her because I flagged that Saoirse had a problem years before. If she had listened to me then instead of dismissing me as a helicopter cat parent, Saoirse might never have developed pancreatitis, and that really sticks in my craw because I feel that my little one has had years of unnecessary suffering inflicted upon her.

I'm so glad that you went to the new vet. If you had stayed at the previous practice, goodness only knows when that vet would have informed you, if at all. It's withering to be let down like that: We rely on these professionals and trust them with our precious little ones' very lives. What your old vet did was, in my considered opinion, very much a betrayal of your trust. Sins of omission are still sins.

I note from your posts above that Tasha's more relaxed around the new vet. There's a saying in Ireland:
Children and animals know who like them.
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Smart cookie, your little fluffball ... ;)
 
Seriously? Because our other cat has SUCH a bald belly and the (now) ex-vet has been calling it stress and food allergies for years. To be fair, he IS a stress-kitty and seems to be improving somewhat since being placed on anti-anxiety meds. He'll be seeing the new vet as soon as we have his records transferred so we'll discuss it. Our poor babies. We try so hard for them. If only they'd use their words and tell us what's going on!
 
After 11 years, my vet didn't even know my cat. She actually told me that I should take him off insulin with numbers in the 400's and that I should focus on my healthy younger cat while there's still time. Every time I asked for a test on something she would say, "okay, but he's not going to like it."
 
stacia said:
Seriously? Because our other cat has SUCH a bald belly and the (now) ex-vet has been calling it stress and food allergies for years. To be fair, he IS a stress-kitty and seems to be improving somewhat since being placed on anti-anxiety meds. He'll be seeing the new vet as soon as we have his records transferred so we'll discuss it. Our poor babies. We try so hard for them. If only they'd use their words and tell us what's going on!
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Seriously. I read from another member recently (Christi, IIRC) that you can get allergy tests done from a blood sample. I'm assuming it's Ripley that has the bald tum. Saoirse's fur was rusted badly - another thing the previous vet put down to normal ageing. WRONG! It was down to nutrient malabsorption. Saoirse's coat is now beautifully black (apart from the white areas, of course!). I don't know whether the dark areas in a tabby's coat might exhibit rusting or not; I've only seen mention of it in black cats. If not going for allergy tests, I wonder whether getting Ripley's B12 checked might be a good diagnostic indicator for general malabsorption problems? Perhaps other members might be able to suggest other things to look for.

Is Ripley's coat a bit split-looking or scurfy at all? Saoirse's was before the diet change (excessively so at time of FD Dx), and now her coat is very smooth (and beautifully soft).

For completeness, the prescription foods - all dry - that triggered all of this for Saoirse were: Royal Canin Urinary s/o; Royal Canin Urinary s/o Moderate Calorie; Royal Canin Obesity Management. I don't know whether it would help you to bottom out what may be irritating Ripley since ECID, but maybe you might find ingredients in his food that are common to those in the aforementioned RC foods which give you an idea of possible allergens? I've noticed a number of members here post that they had been feeding their cats RC foods before they became poorly. I'd heartily recommend checking it out, Stacia, to head off any possibility of Ripley ending up in the same boat as my Saoirse. IBD/pancreatitis is a really horrible affliction.
 
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Mary & Simba said:
After 11 years, my vet didn't even know my cat. She actually told me that I should take him off insulin with numbers in the 400's and that I should focus on my healthy younger cat while there's still time. Every time I asked for a test on something she would say, "okay, but he's not going to like it."
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I know that all vets, doctors and nurses need to maintain some modicum of professional distance in order to protect their own mental health and continue to do their work successfully, but there are times when I do wonder whether some vets go to a special school where they receive compassion bypasses. Most humans don't like tests, either. Definitely not a valid reason to try to deflect a caregiver's attempts to seek help for a beloved companion and family member.
 
Oh, Mary... Like we would just give up on our babies like that! After Tasha's diagnosis, a family member sent me a link to a local shelter so I could "start looking for a replacement." What?!?! And who cares if kitty doesn't like a test? We make the best of it and love them through it so we can carry on.

Áine - Yes, it's Ripley, my tabby, with the nekkid belly. Do you mind if I DM you, since we're getting off-topic to diabetes? But I would like to discuss further if you're open to it. He'll be seeing the new vet soon now that I have their records.
 
When I researched foods for a relatives elderly cat,age 17, that has diabetes and is in the latter stages of kidney disease, I read all about low phosphorus being important, and read that anything rated under 1.00 phosphorus number-wise is good...they are using Wellness and Evo cans, adding a bit of water, plus they hydrate at home with the water every other day using an IV. The 13oz cans can be found online for about 2.40 a can,which may even be less then Friskies, have low phosphorus, no byproducts and are grain free. No byproducts is a huge safety issue with me...
I buy at chewy.com or Amazon and get free shipping. Very healthy food! Been using both myself for years for my diabetic kitty. Anyway, their kitty is doing very well! Please think about checking out those foods if you decide to change food later. They are the ones I've found that by selling big cans make the food affordable as well as being high quality. That helps so much when you have five pets : )
I also read about using egg whites to bring down phosphorus levels, you would have to read about how to do it (no microwaving) and how much as I don't recall. I understand they are a good binder and to never use anything like Tums. Hope your kitty gets better! Sorry to hear what you've been through-glad you found a new vet!
 
Hi Stacia,

I've just been re-reading this thread and another thing popped into my mind. Saoirse is a very quiet, sensitive girl. She is much more relaxed since her health improved - especially since her diabetes remitted and her digestive discomfort lessened. She's not as tense in herself and her facial expression and posture is so much more open. Maybe getting to the root of Ripley's discomfort might help his anxiety? When one thinks about it, cats tend to feel very vulnerable when they're not feeling well (as do humans), hence their tendency to hide at times. I know from my own health issues that when the pain from my back injury gets worse my body tenses and then my anxiety symptoms get much worse. That sets up a rather nasty negative feedback loop. I wonder whether cats may experience similar?

Stacia said:
And who cares if kitty doesn't like a test? We make the best of it and love them through it so we can carry on.
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Perfectly put. :)
 
Zanne - thanks for the food input. We may eventually look at changing foods, in part because I'm having such a tough time finding the Friskies. I'd really prefer to just order online and have it delivered. But I don't want to change too much at once and our more immediate very near-term goal is to regulate things enough that my husband and I can take a trip and feel safe about leaving her, either with the cat sitter or in the vet's care (they board but she's never been boarded).

Áine - I've wondered the same. If he's not feeling well, is it causing him to act out? Which is why we tried to sort things out with him with the ex-vet. We'll try again with the new vet and maybe have better results.
 
Rudy's just been diagnosed with stage 2 kidney as well. Also losing my mind! Switching to friskies this weekend. Adding omega 3, zobaline and cosequin on top of the insulin. I feel like a crazy person! Hopefully he adjusts to the changes and levels out soon. I hope the same for your little sugar kitty also :-) So glad to hear that you have a vet that seems to have a handle on things now. Makes a huge difference!
 
Sounds like you're doing the right things for Rudy. The most important thing is to know so we can make adjustments for them. That's what makes me so mad - the not knowing for months when I could've been making things easier on her little kidneys. But now that I know, I can make some changes.

Love to all the sugar kitties and beans in this post. I hate that any of us are dealing with this but it's good to feel less alone.
 
Sorry to hear about Rudy's diagnosis, Karen. Fingers and paws crossed that the new supplements and diet will help him feel better soon. If you've not come across it yet, Tanya's Site is a wonderful resource. They also have a support group (link is on the site.)
 
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