12/22 Gizmo PMPS=133, +1=144, +2=112, +3=91, +4=105, +5=114, +6=130 **LAB RESULTS**

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10/18
BUN 52
CREATININE 2.1
BUN/CREATININE RATION 24.8
ANOION GAP 24
SDMA 20

12/20
BUN 56
CREATININE 3.1
BUN/CREATININE RATION 18.1
ANOION GAP 24
SDMA 15
GLUCOSE 88 :D
 
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Tricia Cinco(GA) & Harvey said:
Nice cycle today, although it really looked like Gizmo had trouble deciding just where he wanted to park himself.

@Marje and Gracie is our labs guru. Maybe, if she has time, she can take a peak and give you her imput, but I'm glad that you're pleased with it.
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Thank you and thanks for "tagging" the guru. Would love the input. I know what I am looking at as far as the bun/creat. but not much else - but all other numbers (other than kidneys) are in "normal" range.
 
Yay for an almost green number at +2; he's almost in the lagoon!

Glad the BW looks good and glad Tricia tagged the BW guru.

Don't you just love when they are playful and ripping up stuff? ( other than upholstery) Going to take a piece of tissue paper down to the Bubs and see if he will be interested in it. Maybe if I could find mouse paper???
 
The kidney values are still elevated. The SDMA is, however, coming down. Have you tried reducing the phosphorus in Gizmo's diet? There are low carb/low phos diets or you might consider speaking to your vet about getting a prescription for a phosphorus binder you can add to Gizmo's food.

 
Sienne and Gabby (GA) said:
Have you tried reducing the phosphorus in Gizmo's diet?
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Phosphorus level is in normal range. He is on Weruva Cats in the Kitchen Fowl Ball Chicken & Turkey Au Jus which is on the under 1% phosphorus list. I do add 1-3oz can of FF to the 6 oz FB and I know it is higher in phos. (This mixture is for 24hr period).

I read somewhere that binders shouldn't be used if levels were nornal?
 
LizzieInTexas said:
Phosphorus level is in normal range. He is on Weruva Cats in the Kitchen Fowl Ball Chicken & Turkey Au Jus which is on the under 1% phosphorus list. I do add 1-3oz can of FF to the 6 oz FB and I know it is higher in phos. (This mixture is for 24hr period).

I read somewhere that binders shouldn't be used if levels were nornal?
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His phosphorus is too high but if he were my cat, I'd try to get the numbers down through diet first. Binders are usually started at about a level of 6 for the phosphorus. Because it's possible to keep a kitty stable with CKD for a long time, you don't want to risk aluminum toxicity by giving binders when you could have first tried to control with diet. Once his P gets to 6, that's when you want to talk to the vet about binders. You can also add a cooked egg white to his food to help bring the P level down.

The normal range for P includes kittens who have a high P level as they are developing bone. I have found controlling the P critical to longevity and feeling well when a cat has CKD.

I wish they had done a CBC to see how his hematocrit (HCT) is doing. There are things you can do naturally to help keep the HCT up and prevent anemia. But you don't want to start it too soon.

His jump in creatinine from 2.1 to 3.1 in two months is fairly large. While it can vary, it doesn't usually do so by that much. I think it bears watching.

His potassium is also a tiny bit low but it's hard to know if it is due to CKD or Diabetes. With diabetic cats, the insulin causes the cells to uptake potassium so the serum level is lower. In CKD cats, if the serum level is below 4, it's usually lower in the cells, where the K is actually needed. Do I remember that you already have him on a K supplement? You just need to watch that number carefully as well. A too high K level can be harmful. He's ok now, though.
 
:bighug::bighug:
First, thank you so much. Very, very appreciative.

Marje and Gracie said:
His phosphorus is too high but if he were my cat, I'd try to get the numbers down through diet first.
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Anybody Suggestions? The food issue has been my biggest struggle. ^^ Did you mean it IS or IS NOT too high?

Marje and Gracie said:
You can also add a cooked egg white to his food to help bring the P level down.
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Ok, cool. Thst is easy enough. Can I just buy the egg whites in the cartons in the dairy section? How much per Day?

Marje and Gracie said:
I wish they had done a CBC to see how his hematocrit (HCT) is doing
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Is that something outside nornal bw I should be asking for?

Marje and Gracie said:
His jump in creatinine from 2.1 to 3.1 in two months is fairly large
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My biggest disappointment on the bw. Anything I should be doing differently?

Marje and Gracie said:
Do I remember that you already have him on a K supplement?
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Yes, he was on Renal K gel but strongly suspect it had sugar in it from some bg readings. One morning hubby forgot to put it in his food and Gizmo was significantly lower on the BG readings. I discontinued and asked vet for something different but she didn't think he needed it because he was in range. I have since purchased a k powder but have not given it to him because I am not sure how much and because vet said not to.

This is what I have:
https://smile.amazon.com/Vet-Soluti...srs=13561540011&ie=UTF8&qid=1482467068&sr=8-1

Heading to bed shortly. Thank you again, so much, for you input and advise.:bighug:
 
I'll let Marje answer most of your questions but I can answer the one about the CBC. It stands for Complete Blood Count and they test everything. It can also be referred to as a full blood panel. I don't recall Gizmo's age, but if he is in his teens, most vets would want to do a Senior Panel every six months, which covers most of those things. If you ask your vet to do a CBC, she'll know what that is.
 
I would not add phosphorus binders or potassium without consulting the vet. Neko was on potassium gluconate powder and it did not affect her sugars.

Your signature says you are feeding FF, but it is too high in phosphorus for a CKD kitty.

A CBC is part of most blood panels. I usually get what is called a senior or geri-panel every 6 months. That also includes checking the thyroid, but even a regular blood panel includes the CBC.

Not much you can do with the creatinine numbers, except when you get to the point of adding regular fluids, if appropriate.
 
You're very welcome!:)

LizzieInTexas said:
Anybody Suggestions? The food issue has been my biggest struggle. ^^ Did you mean it IS or IS NOT too high?
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Yes, his serum phosphorus is too high especially for where his creatinine is. His P level should be lower than 5 but if you can get it lower, say 4.5, you are in a better place to keep him stable longer.

If you look at Alex's SS, you'll see a tab for low carb/lower P foods. Tanya's also has a food chart of lower P foods and she also lists the carbs. Keep in mind that the only truly low P foods are the prescription diets but a goal could be to feed foods that are less than 1.00% on a dry matter basis or less than 200 mgP/100 kcal on an as-fed basis. The one caveat to Tanya's is I suspect the values are all Dry matter basis (which is fine for P) but the carbs have not been converted to % calories. You could verify this by looking at Alex's SS or Dr. Lisa's carb tables and co paring a few. Let me know if you need info on how to convert DMB to % calories (which is what we look at for our diabetic kitties).

Sorry...the "reply" function is not working for me on my iPad now so I'll just address the questions sequentially.

I suppose you can use the egg whites in a carton. Remember that it does not bind the P in the food you are giving but it adds food with a low P value to food with a higher one to bring the overall level down. It isn't the best solution but if he has a food he can't part with that the P level is a bit higher, it could help some. I would strive to get as low P foods as you can. You'll have to experiment on how much egg white...and it must be cooked...he will tolerate mixed in his food. There are no formulas that tell how much you are lowering the overall P so it's a bit of a guessing game.

As answered by Wendy and Tricia, you should ask for a senior panel every time. They are cheaper and have the CBC; it's very important to keep an eye on his hematocrit (some labs do packed cell volume of PCV but the range you are looking for is the same) CKD cats can become anemic if you don't stay on top of it. Once the HCT or the PCV gets below 20%, you have to start giving erythropoietin stimulating agents which can be a pain. The closer you can keep it to 30%, the better and there are natural ways to do that.

Creatinine can potentially increase in some cats if they are having pancreatitis. Larger males with more muscle might have higher creatinine. Do you have any baseline labs to tell you what his creatinine ran before CKD? Other things can cause creatinine to jump....( e.g. kidney stones, kidney infection, DKA). Or..sometimes it just jumps. I found that with my CKD kitties (ECID), if I stayed on top of the things like P that I could control early on, it seemed to help them not have these huge jumps but that is anecdotal.

As far as the potassium, any supplementation must be done under the supervision of a vet. Gracie did not have CKD and her K levels would vary...sometimes 3.9, sometimes 4.4. So it's something you need to watch to see the trends. If your vet said to not give him potassium now, I'd listen. :)
 
@Marje and Gracie :bighug::bighug:

Again thank you. That doesn't quite seem enough to say but you have helped me so much!

The food issue is a nightmare with trying to find LC AND low phosphorus without the fish/seafood. I am working off all lists I can find that meet those criteria (see today's condo)

The labs I have access to are all on my labs tab on the SS. Gizmo will go back for labs again in a few months so I will make sure they do a senior panel then.

Off to hunt down food.
 
LizzieInTexas said:
@Marje and Gracie :bighug::bighug:

Again thank you. That doesn't quite seem enough to say but you have helped me so much!

The food issue is a nightmare with trying to find LC AND low phosphorus without the fish/seafood. I am working off all lists I can find that meet those criteria (see today's condo)

The labs I have access to are all on my labs tab on the SS. Gizmo will go back for labs again in a few months so I will make sure they do a senior panel then.

Off to hunt down food.
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You are very, very welcome. Always feel free to tag me or send me a PM (which I get faster and then can pop on the condo) if you have questions.

I certainly understand about the food issue. And yes, I think he is early enough in CKD that I wouldn't expect his HCT/PCV to be too much lower than 30%, if at all. anti jinx!!!!!
 
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