? 11/02 Ducia AMPS 242, +4 218 PLS help w/BW & UA interpretation

[Tanya and Ducia]

Good morning L&L,

hope everyone is doing well.

Ducia seems to stuck in highish numbers for the past 2 or 3 weeks. The dose is adjusted relatively close to TR guidelines but here is my dilemma - 1.5 U seems to send too low and 1.25U is not enough.

I kept her on 1.25 this AM (cycle N.7 no Greens for 8 cycles) just to give one more cycle or maybe another day to clear thru.

Some of the pre-shots on 1.5U and even on SK 1.5U are so low that I did not enter them in the SS. Scary. I then take reduction and nothing happens. Nothing.

There is fresh BW and UA in the LABS. Anything in there explains why her number trend up lately?

Food in AM: AMPS 3 teaspoons 0%, from +1 thru +3 2 teaspoons 0% ea, snack 1 teaspoon 0% at +7, supper 2 teaspoons 0% (unless steering is involved) at +9.

Food in the PM: PMPS 3 teaspoons 0%, at + 1 and +2 2 teaspoons 0% ea, sometimes same snack at +7 (not always) and supper 2 teaspoons of 0% at +9.

She always ate at +9, if not - might vomit whitish foam on an empty stomach close to pre-shot time.

Today is day 4 intro to semi baked raw chicken tight w/EZ complete. Going very slowly. (anti-jinx) no LB issues or adverse reactions so far.

Any thoughts and suggestions are greatly appreciated. Ducia is very unpredictable to me.

Have a wonderful day everybody!

Last post

 

[Alicia & Maggie (GA)]

Hope you get her high number situation figured out. Wish I could give suggestions, but I have no idea!

 

[Bobbie And Bubba]

Hi Tanya. The dance between the 2 doses is a pain in the neck for sure ! I would go in between the 2 doses and see if you can keep her in better numbers longer.

Tag Margie to help decipher the BW as she is our go to person and knows her stuff.

Hope you are well.

 

[LizzieInTexas]

my dilemma - 1.5 U seems to send too low and 1.25U is not enough

Uuhhgg. I know it well. Gizmo fluctuates between 0.75 - 1.25U and it is driving me crazy. It would be one thing if I didn't work and could steer him through the lows and shoot through the bounces but I can't so I am just following his lead.

I will follow along and see what is suggested and how it works out.

 

[Stacy & Asia]

That is frustrating. I don't really have any experience or insight but I did read somewhere on this board (wish I knew where, I would link for you) that some cats do better with some carbs over zero carbs? Maybe you could try a higher low carb food, like a 3% or something and see if that makes any difference? If it's impossible to split the dose between 1.5 and 1.25. Sorry, that seems tricky, I hope someone has some wisdom to share.

 

[Bobbie And Bubba]

That is frustrating. I don't really have any experience or insight but I did read somewhere on this board (wish I knew where, I would link for you) that some cats do better with some carbs over zero carbs? Maybe you could try a higher low carb food, like a 3% or something and see if that makes any difference? If it's impossible to split the dose between 1.5 and 1.25. Sorry, that seems tricky, I hope someone has some wisdom to share.

I like that idea for you to add some carbs if at +2 you see that it's going to be an active cycle.

 

[LizzieInTexas]

(wish I knew where, I would link for you)

Is either of these what you are referring to?

• Using Food to Manipulate the Curve
• Feeding Low Carb vs Lower Carb Foods

 

[Stacy & Asia]

Is either of these what you are referring to?

• Using Food to Manipulate the Curve
• Feeding Low Carb vs Lower Carb Foods

Yes! It was that second one! You are a wizard, Lizzie! Thank you

 

[Tanya and Ducia]

Thank you so much, guys,

I would go in between the 2 doses and see if you can keep her in better numbers longer.

Tag Margie to help decipher the BW as she is our go to person and knows her stuff.

I will have to go between the doses again because I too see no other way to try. I PMed Marje with the link to this post, thank you Bobbie.

It would be one thing if I didn't work and could steer him through the lows and shoot through the bounces but I can't so I am just following his lead

Lizzie, you made me ashamed (in a good way, don't worry!!) I do not work, don't really care about full night sleeps and I had been doing just that - and our numbers were better a bit earlier this year. I guess there is nothing else but to try it again. Lotsa pokes involved..

Maybe you could try a higher low carb food, like a 3% or something and see if that makes any difference?

That's exactly what was recommended to us, and for a while we were doing just that, in the past. Thing is - I hate feeding Friskies or FF (now) high P, high fat, tons of unknown filler, etc, you know how it is, I lost trust in the cat food industry completely. I always stock on those, though, and if the +2 is a drop then I use it - like 4% - 5% carbs early in the cycle. Since Ducia always bounces after lows I return then to feeding 0% and the opened and 3/4 full can of Friskies goes to garbage, wasteful.

like that idea for you to add some carbs if at +2 you see that it's going to be an active cycle.

Will try that again, Bobbie. I was successful employing this technique to avoid early drop and to smooth the bounces in general. However, it seems that Ducia has overlap between +2 and +3.5 and if I stop her going into the Green by feeding 4-5% around +1.5 or +2 I may not see any nadir at all this cycle. Sometime she threw late nadirs - in a form of uncomfortably low pre-shot but I can deal even with that...And I was dealing.. But despite all of the efforts her numbers are not good .

I am going to refresh my memory on the sticky that Lizzie and Stacy talked about and I will try again what you guys suggested with high-ish carbs early unless @Marje and Gracie can see anything in the LABS that would suggest another strategy.

I hope Marje can figure her out - Ducia is a tough cookie, for me anyway .

Thank you all very much and I hope your FD dealings are easier!

 

[Marje and Gracie]

Hi Tanya

I got your PM and looked at the labs and I’ll study her SS tonight and see if I can come up with some ideas for you. I’ll tell you off the cuff that a lot of times, a 3% food isn’t going to do much and, in some cats, what they need to help their curves are foods closer to the 10% range. But.....I’ll offer more info once I have a chance to look at her SS, what you’ve fed her, how you’ve dosed her, etc. and that takes time. It’s not just “at a glance”.

Her labs look pretty good to me but the fact that her urine specific gravity is so low and her creatinine is 1.8 makes me very interested to see her SDMA. It usually only takes a day to get the SDMA back so I’m not sure what the delay is. There are a couple important things to note:

• USG varies during the day and so if the urine sample was later in the day and she drinks a lot of water or you put a lot of fluid in her food, one would expect it to be more dilute later in the day. The way to know if she is able to concentrate her urine is to take the first pee sample of the day to the vet and ask him to check it on his refractometer (I’m assuming he has one). It’s a simple and fast test. I would ask him to be sure and calibrate it before he checks her urine sample. If it is dilute on the first pee of the day, that causes me more concern that her SDMA might be higher since the “old way” we would predict CKD might be starting was when the kitty was not able to concentrate their urine above 1.040
• Creatinine can go up and down so one test at 1.8 doesn’t overly concern me. We look for rising trends or an SDMA above 14 when we are concerned about CKD.

Her calcium is a bit high but your vet did use a different lab and it is within the normal range for their reference. I’d just keep an eye on it. According to that reference range, her WBCs are normal. Her HCT (what we look at with anemia) is fine and has come up substantially. YAY!! Let’s hope it keeps climbing.

We don’t worry about a high MCH; it’s just telling us a little bit about the hemoglobin which we already know. I’m assuming the high MCV (mean corpuscular value or size of the RBCs) is high because she is recovering from anemia although her MCV has been consistently high. There are several things that can cause this besides recovering from anemia. It could be low B12 if she has any intestinal/absorption issues or it could even be that the sample was not run expeditiously as the MCV will rise the longer the blood is stored. But that means that every time the blood was taken for the tests you have, they were slow getting it analyzed. Or perhaps this is just Ducia but it’s been pretty consistent.

I think at one time, I had editing rights on her SS but it does not appear that I do now. I was going to move the “Template” tab over to the right as the “2017” tab should be the first one that opens when we click on your SS link. You can either click on the “Template” tab and drag it right or grant me editing rights again and I’ll do it for you. It’s a simple fix but it would be nice if her SS open to 2017 when one clicks on the link.

I appreciate your patience in giving me time to study her SS and let you know what I think about dosing. I will get back to you no later than tomorrow night. Thank you!

 

[Tanya and Ducia]

Hi Marje,
thank you so much for this!! I still haven't heard from the vet - obviously he wants to be fired.

I’ll offer more info once I have a chance to look at her SS, what you’ve fed her, how you’ve dosed her, etc. and that takes time. It’s not just “at a glance”.

Please, I am lost.. I usually feed 4 - 5% Friskies or other brands LC 6% when needed. have it in stock@home. Anything below 4% acts just like 0% - no use.

her urine specific gravity is so low and her creatinine is 1.8 makes me very interested to see her SDMA.

The urine sample that the vet draw that day would have been her 3 rd pee of the day; she went to LB 3.5 hours prior to the appointment and had about 65 ml water in addition to the 82% moisture containing wet food before vet's. If I am lucky I can catch her 1st one - usually looks darker, not diluted I use white plastic ladle for her urine testing. I am not always able to catch it (too early, like 4am)- only the subsequent urinations which are diluted. ( I inserted a comment with that info into the USG cell).

MCV has been consistently high.

It could be low B12 if she has any intestinal/absorption issues or it could even be that the sample was not run expeditiously as the MCV will rise the longer the blood is stored.

I cannot put it past my vet to be too slow. He really dislikes me..Haven't got back on the SDMA although I paid the entire bill in full.

I think at one time, I had editing rights on her SS but it does not appear that I do now. I was going to move the “Template” tab over to the right as the “2017” tab should be the first one that opens when we click on your SS link.

I think I fixed but I am more than happy to "grant" you the right to edit. I tried to change the Access - it asked for your name or email and when I entered Marje & Gracie it said it cannot recognize the name... PM me what is to be done or what info do you need from me, please. I am hopeless with electronics but I dragged the Templates to the right of the S and Labs (hopefully it sticks there).

Marje , thank you so much for looking in to it!

I was worried about some of her BW values going up if compared to the last test.

I'll fight to get the SDMA in as soon as possible. I think someone else on LL (saltyjack?!) also had complained about the delay getting it..

DH thought (re: MCV and MCH HI) that B12 or folic acid given at home as a supplement may help..at leat it would for human patients. But we are clueless as to should we? how much? how often?..etc...

Looking forward to you r suggestions. THANK YOU!!!


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