? 4/17 George ambg 119 :-(... +3 90 PMBG 96 :-) BW results in

[Gill & George]

Afternoon all,
Still piling on the vines for a speedy and full recovery for Paula.
I am in shock over Cinco, so glad he got an extra day with his beans, but saddened by his loss, my thoughts and prayers are with Tricia and Mark.

Day 5

Well not impressed with his ambg this morning, but happy he came down by +3. Not sure if I am seeing an upward trend in BG???

Also got his BW back on email from vet yesterday, have to translate them and put them on ss. The SDMA test for his kidneys came back and was 10 which is in the normal range, abnormal being above 14, so not sure what that means?? will post up with questions once I have translated and uploaded the results onto his ss some values are out of range.

Looking good, BFG! Marshmallow was regularly in high greens or very low blues when she went OTJ. Some kitties are just a little higher than others.

Hi Shane, did Marshmallow have a strong remission? that's what concerns me.

Surf safely kitties.

 

[Shoeskitty-GA]

I know you want to see the AMBG numbers lower, but try to remember that it is still normal. He looks good!

 

[Judy and Boomer]

Looking good George! A lower +3 means his pancreas is working!

 

[Mandarin'sMom]

I would definitely be encouraged by the fact that his numbers come down after he eats... and 119 is still in the normal range!

 

[Doodles & Karen]

Hey George you're making mama bean nervous so just think green. He headed back to the lagoon so he's doing great!

 

[carfurby (GA)]

Happy Day 5!

Nice to see George can bring his numbers down. Has anything changed with his eating during the night cycle?

 

[Bobbie And Bubba]

So excited for you and BFG and glad that you got confirmation that his numbers are still good. Hoping the BW numbers are good too.

 

[granadilla]

Marshmallow went OTJ by June 8 last year and then crossed the bridge on September 9. I think her remission was pretty strong because even when all her other conditions bothered her (lung disease, CKD, IBD/lymphoma), her BG didn't go above 120. ECID is different of course, and I only have 3 months of OTJ data to look at...

 

[Olive & Paula]

George is looking good.

 

[Chrys & Stomper]

Still looking good BFG! Keep it going!

 

[Gill & George]

Happy Day 5!

Nice to see George can bring his numbers down. Has anything changed with his eating during the night cycle?

I have the autofeeder set to the same time and same food, last night he ate his +9 snack (well it was gone by amps) what I can't be sure is if he ate it at +9 or didn't get up for it and ate it later at +11 say?? the last two previous nights he didn't bother to eat his +9 snack at all, so it's possible he got it late.

Food wise he gets the same am and pm cycle amps +3 +6 +9 pmps +3 +6 +9.

This afternoon I have given a snack at +8.5 instead, I was going to be out so I quickly gave him his snack early, we'll see if it makes a difference.

 

[julie & punkin (ga)]

Congrats on trial day 5!

My fingers, toes and eyes are crossed for George!

 

[carfurby (GA)]

It sounds like George could be eating his +9 snack at different times and it's affecting his numbers. It's probably in the cat manual for how to mess with the bean's mind.

 

[Gill & George]

It sounds like George could be eating his +9 snack at different times

I have been wondering exactly that, the only way to figure that out is to wake up and show him the autofeeder

PMBG 96

I have 'translated' the labs there's a link to the original pdf on the ss and I have put the values in the Lab tab on George's ss. His SDMA was 10, but some values are still out, namely BUN / creatine / Globulin/ total protein / triglyceride are all higher than the ref range. Results area little different in some places to the last, but given the problems we had with the previous BW I won't worry to much about that, and just compare it to the first.
Bilirubin is lower.
The t4 was normal at 2.9, but in the notes on the lab report 2.9 is considered a 'grey zone' (2.3-4.7) in elderly cats with clinical signs compatable with hypert, may have the start of hypert or a none thyroidal concurrent illness.
Gatos mayores, con signos clínicos compatibles de hipertiroidismo y valores de T4 en la zona gris (2.3 - 4.7) pueden padecer un inicio de hipertiroidismo o una enfermedad no tiroidea concurrente

Not sure what clinical signs would be indicative of hypert???

As far as the urinanalysis goes, I am not sure what to think, we didn't do a complete one, but I should say that I got some litter in the sample and the litter we use is wheat based so it may cause a problem with the protein test.

On the same sample I checked with the dip stick, it was negative for protein (albumen) negative for blood, negative for ketones, negative glucose. SG was done by the vet 1020. I think I will get another sample and get that rechecked.

@Marje and Gracie I would greatly appreciate your views on the BW, I think from what I have read that it is possible that your suspicions are right about early CKD, even thought the SDMA is normal, the creatine and urea being raised places him in stage 2 according to info I have read on the idexx website. I haven't been able to get his BP checked, vet said she is not able to measure it, doesn't have the kit to do it. I will see if I can get it checked somewhere else locally.

 

[Marje and Gracie]

I'll be glad to do it although it will be a little later today if that's alright?

 

[Gill & George]

I'll be glad to do it although it will be a little later today if that's alright?

Absolutely there is no rush, I will speak to my vet regarding the results later on in the week when I take the droolers in for their vaccinations. So no rush, and thanks in advance

 

[Chris & China (GA)]

Congratulations on day 5 George!!! Looks like you're having fun keeping the bean spinning in circles wondering what you're up to (typical cat thing to do....lol)

 

[Wendy&Neko]

Woohoo, happy day 5! Is there any way to change your autofeeder to rotate it again at +10 so he can't eat later?

 

[Gill & George]

Is there any way to change your autofeeder to rotate it again at +10 so he can't eat later?

Yes!!!! and that's why I love this board, I should have thought of that but sometimes you just can't see the wood for the trees.
Thanks Wendy
I was going to set the alarm and get up, but I think I like your idea better

 

[Tara & Ivana (GA)]

Day 5!! Go George, and remember to eat your fuds at the right time buddy

 

[julie & punkin (ga)]

Happy Day 5, George. Keep it up!

 

[Tricia Cinco(GA) & Harvey]

I'll bet once he realizes there's a cut off time after which the food goes away, he'll start eating it!

Go George! Go George! Go George! Go George! Go George!

Thanks for thinking of us. We are still shell shocked.

 

[Marje and Gracie]

DAY FIVE!!!!!

I looked at his labs. Really nice to see his liver values staying down! With his urine specific gravity so low (1.020) and an elevated creatinine and BUN, I still think you are looking at early CKD. I'm just not sure why the SDMA is not picking up on it. You would expect for a larger cat to potentially have a higher creatinine but his was normal and now it's been rising. Things like kidney infections can cause elevated creatinine but the USG shouldnt also be low. At this point, you just need to watch the numbers every three months or so because they can rise quickly. Even though his phosphorus is good, I'd keep him on a low P diet as that will help.

Anything you can think of to discuss?

 

[Gill & George]

DAY FIVE!!!!!
View attachment 19926

I looked at his labs. Really nice to see his liver values staying down! With his urine specific gravity so low (1.020) and an elevated creatinine and BUN, I still think you are looking at early CKD. I'm just not sure why the SDMA is not picking up on it. You would expect for a larger cat to potentially have a higher creatinine but his was normal and now it's been rising. Things like kidney infections can cause elevated creatinine but the USG shouldnt also be low. At this point, you just need to watch the numbers every three months or so because they can rise quickly. Even though his phosphorus is good, I'd keep him on a low P diet as that will help.

Anything you can think of to discuss?

Would his weight loss be causing any of the numbers to be an issue? 250g in 4 weeks. I am restricting his cal intake and he is loosing at a rate that should be safe. He has another 500g to loose to be at his ideal weight. And though he has lost weight since his FD diagnosis his muscle tone has improved.

The other think that worries me is his teeth. He hasn't had a clean in 5 years, our vet hasn't wanted to do it because of the risk his age and fluffiness being considerations. He's not on pain with them, gums don't appear inflamed, but he has tartar build up, would a niggling problem there be responsible for numbers?
I will repeat his labs in 3 months at the idexx labs and then St least we will be comparing like for like.

I guess it's possible that the sdma score would have been lower for him 6, months ago and 10 represents an increase?
I'll discuss his levels with the vet and see if she has any thoughts on his elevated creatine and bun.
Thanks for taking a look Marje.

 

[Marje and Gracie]

I don't think any of those things would affect his creatinine and certainly not his USG. A lower USG "can be" an early sign of CKD but not always. I note that sample was a morning sample so it should be more likely to be the most concentrated since you aren't giving fluids.

There are other things that can result in creatinine elevations....like heart disease...but it's probably not what is going on here just because of the USG and also BUN.

You're welcome. I hope he stays nice and stable.

 

[Gill & George]

There are other things that can result in creatinine elevations....like heart disease...but it's probably not what is going on here just because of the USG and also BUN.

He has a very mild heart murmur, aside from the vets at the rescue centre in UK where they did an ultrasound to confirm no other vet has ever heard it.
He does get water added to every meal. I guess I could not add it to his food for one day and get a sample in the morning of the next and get it checked?? Maybe he is just keeping very well hydrated??

I've just been reading on Tanya's site that muscle wastage can result in lower creatine and that large cats have higher creatine than smaller cats (tanyas site), it's possible I suppose that the levels we are seeing now are normal for George, since he is a large muscular cat, and that the levels at diagnosis although in normal range were low for him, at that point he had significant muscle wastage (if only we had a baseline for when he was healthy pre FD), and now that he has improved muscle tone he has returned to normal for him.
The other thing that of course is drastically different now from the first BW is his diet, at diagnosis we had only just changed him from a high carb dry food diet to high protein diet, so higher BUN may be related to that.

It is possible that he may have an issue with hypertension, that might cause the bun and creatine to rise, our vet can't measure it, but I am going to see if she knows of anyone locally that has the equipment to measure it. (not holding much hope of find that, but you never know)

It's good to be able to discuss these issues, before speaking to the vet, even if all I have is more questions.

At least I feel like I can have an informed discussion with her rather than just 'Are BW ok?'

In the meantime I will continue with the precautionary measures, keeping him on a lower P diet and keeping him well hydrated, that can't hurt.


Thanks again

 

[Wendy&Neko]

He does get fluids with every meal.

Adding water to the meal is fine, but I don't think you are giving subq fluids yet?

 

[Gill & George]

Adding water to the meal is fine, but I don't think you are giving subq fluids yet?

No Subq, just water with every meal, about equal amounts of water/food his meals are soupy, but he likes them so I've kept adding it, figured it would help to keep him well hydrated.

I've edited the post above so that it is clear that he is having water added to meals, wouldn't want anyone to get the wrong idea and think I was giving Subq and think it was ok to do the same

 

[Marje and Gracie]

Water with every meal won’t drop the USG. I have always done that with my cats and never seen the USG drop unless they got CKD.

Do you have any baseline labs from before FD and the weight loss? I know that larger cats can have higher creatinine due to muscle so it would be good to compare some baselines for when he was well muscled in the past. I just think it’s a pretty big increase from 1.7 to where he is now. I doubt the teeth issue would do it. I’d think that would impact his BG more than anything although it is always possible inflammation can increase the creatinine. I still think if it was that bad, you’d see the BG go up first.

Unless you are feeding a raw diet, it’s not likely caused by a high protein diet as the majority of commercial canned foods have more fat than protein because it’s cheaper. Even the really expensive canned foods still have a little less protein than fat. Only a raw diet will really pump up the percentage of protein.

Considering the SDMA indicating it’s not CKD, I’d do as you suggest. Keep him hydrated, keep the low P foods going, keep an eye on the labs. I think that is a good, conservative plan.

 

[Marje and Gracie]

I just wanted to clarify on USG for others reading this.

The urine specific gravity can change during the day based on amount of fluid intake. As an example, a healthy human that drinks enough fluid in a day to be hydrated will see their urine get lighter as the day progresses because the urine is less concentrated but when they get up in the morning, the urine will be darker and more concentrated.

If we add a lot of water to our kitty's food, the USG might come down as the day progresses but in the morning when they first get up, the urine should be concentrated if the cat does not have CKD or another condition which causes the USG to be lower. If the CG catches the first urine sample of the day, it will show whether the cst can concentrate his urine. If the USG of the first urine sample of the day is above 1.030, they are concentrating their urine. If it is below, they are not.

 

[Gill & George]

Just answering here to keep all the info together

o you have any baseline labs from before FD and the weight loss?

No Baseline BW, as he has been healthy up till his FD guess none of the vets suggested it. But I can see now that it would have been good to have a BW from when he was young and in his prime. I am going to send an email to the Battersea Dog and Cats Home (the rescue centre) I feel sure they will have done a BW but it was 8 years ago now, so not sure they will have kept records going back that far. But I'll try.

I hear what you are saying about the USG, but if he is getting water with food at pmps +3 +6 and +9 same as in the morning, not mean that his am USG would still be the same??

Unless you are feeding a raw diet, it’s not likely caused by a high protein diet as the majority of commercial canned foods have more fat than protein because it’s cheaper

The food I am feed George is quite low in fat I think(according to the labels they have more protein). Especially the Thrive, but would homemade be typically lower?

Granata pet symp (150g approx spread through am and pm cycle)
Protein:10.3% Fat:5.1% ash:2% fibre:0.3% moisture:82%
Calcium:0.22% Phosphor:0.17% Kcal/kg:674.33 MJ/kg:2.82

Thrive 75g@amps and pmps
Protein 16%, Crude Oils & Fats 2%, Crude Ash 1.5%, Crude Fibres 0.1%, Moisture 80%
Mineral g/100g Dry Matter Calcium 1.03 Phosphorus 0.95 Ca/P ratio1:1 Potassium 0.60 Sodium 0.76

Originally he was just on thrive, but as the carb content was too low and he was diving I introduced granata which had slightly higher carbs to try and control his diving, and that worked so he has stayed on it ever since.

I have been toying with the idea of making some home food for him, though will need to research that, I can't get any organic/hormone free protein here, and the implications of that have worried me so I've been sticking to the commercial for the moment.

 

[Marje and Gracie]

I hear what you are saying about the USG, but if he is getting water with food at pmps +3 +6 and +9 same as in the morning, not mean that his am USG would still be the same??

No. The more you drink, the more dilute the urine becomes. It can be cumulative. Then when you don't drink overnight, the urine concentrates if your kidneys are working properly. Test yourself. Check the color of your urine when you first get up. Drink 64 oz of water over the day spaced out and note the color of your urine by the end of the day. Then check it again in the morning when you get up. Unless you are super dehydrated, it should be much lighter at the end of the day and darker when you get up.

Are those values the as-feds or dry matter basis? If they are the guaranteed analysis, you can't go off that. The guaranteed analysis is just minimums and maximums and not the actual values. If you let me know if those a as-feds or DMB I can plug them in a calculator and tell you what the percent of calories each is.

 

[Lydia--(Rosie & Basil) GA]

George is looking awfully good! Sorry about the kidney-ish numbers. As I have said before, I went through this twice before, not counting Rosie, and learned that the whole thing can present in quite idiosyncratic ways. It's a challenge on its own and doubly so when paired with diabetes. But I know you'll do a great job!