12/21 Asia PMPS 313 Labs in, spoke with vet, disappointing results

[Stacy & Asia]

http://www.felinediabetes.com/FDMB/threads/12-20-asia-pmps-103-1-101-2-68-3-59-5-52.188330/

Asia had a really weird am cycle today. She had a good preshot number and looked like an active cycle was going to happen, but it petered out and she started going up after +2. Didn't give any Karo or HC food today either. I would think it was a failed reduction, but it's been 9 cycles on this shot, so the depot shouldn't be a thing anymore. It also wasn't really a bounce since she came down and then went back up again, right? Maybe she missed me? She was home with one of my daughters for the first bit of the day.

This week is our staycation week so we are doing lots of things and friends and family are coming to visit. Tonight we went to see the Rockettes holiday show, a first for all. It was really fun. Bill and Hillary Clinton were in the audience tonight, people were freaking out trying to get their photos, that type of thing doesn't usually happen in NYC, but I'm sure the Rockettes show was chock full of tourists.

 

[Bronx's dad (GA)]

A night you will never forget!

 

[Christie & Maverick]

http://www.felinediabetes.com/FDMB/threads/12-20-asia-pmps-103-1-101-2-68-3-59-5-52.188330/
Bill and Hillary Clinton were in the audience tonight, people were freaking out trying to get their photos, that type of thing doesn't usually happen in NYC, but I'm sure the Rockettes show was chock full of tourists.

That would be almost as good as a TC sighting , almost, but not quite

 

[Stacy & Asia]

Vet called me tonight, lab results came back and he discussed with me by phone and then emailed the labs to me, I've entered them in to my SS. @Marje and Gracie if you could take a gander when you have the time and give me any feedback, I would love and appreciate that. He said overall, she is doing quite well for her age and her behavior and appetite and those things are quite good. He reminded me she is not her numbers, which I know, but I needed to hear it anyway.

That being said, some of the numbers are beyond shocking. Had a really good cry about it already, probably will have a few more. Lab results support CRF and pancreatitis. Still suggests doing the u/s but the person he uses would not let me be there for it, and he agreed that it probably wouldn't change much treatment wise. BUN went from 37 to 106! All previous labs were antech and this is IDEXX, he said you can't really compare one to the other, but I can't help it, that is a dramatic increase no matter what lab you use. Diabetes did that (says me). Pancreatitis is a new diagnosis, he referred to it as chronic active pancreatitis, whatever that means. I asked if pancreatitis could be what switched on the diabetes and he said yes that is possible, nothing else made sense, that sure would.

Phosphorous is off the charts for the first time, he recommends p binders, says he uses aluminum hydroxide. Is that a good one? Said side effect could be constipation. He recommends I start giving subq fluids 2-3 times a week. I asked how I could tell if the pancreatitis was causing her pain, he said he doesn't see it in cats, with dogs when you palpate their pancreas they wince and he hasn't had the experience of cats doing that (he's an all cat practice). I guess typical GI issues and upset would indicate to me she is having issues there. Touch wood, so far unremarkable in that area. He is going to give her low dose bupe for her arthritis and also to help with oral pain.

I really haven't decided what to do about her teeth. They are bothering her for sure, I don't know how much pain they are causing as she is eating fine. She paws at her mouth sometimes and she rubs her face hard on the corners of books and boxes sometimes, so that's a good indication she is bothered. If I could get them extracted without the hospital and all of that stress and trauma it would be an easy decision. But I don't know what to do about it in light of these other things going on, seems like a ticking time bomb situation with the kidneys. I just don't know. It's a tough decision. I don't want her to be in pain and suffer, I also don't want to intervene all over the place just because I can, some of the treatments can relieve pain and suffering but can also cause new pain and suffering and trauma and stress. I don't know if that's in her best interest or gives her a good quality of life. I'm happy to have her on pain meds and I hope that does something from a palliative standpoint, that I'm 100% on board with. She's pretty nonchalant about all of this, outside of the arthritis stuff and occasional teeth problems, she's happy and talkative and seemingly normal.

Good news from a diabetes standpoint, no glucose in urine, glucose tested in euglycemic range. He thinks it is not in the cards for her to have a remission in light of the kidney/panc stuff. Okay, my hopes weren't high on that anyway, but it doesn't mean I wouldn't try. At least keeping her as regulated as possible will take one complication out of the mix. This poor old lady, we still think she has a good 10 years in her (or that's what we tell ourselves anyway).

 

[Marje and Gracie]

((((Stacy))))). I’m sorry for your upset over these numbers.

I’ve got a lot of info I can give you on CKD. I’ve had four cats with it and all but one stayed stable for a long time and died of something else including my girl that was 21.

I agree that the Phosphorus is the immediate concern and I would start aluminum hydroxide right away and get her on as low P foods as possible. I don’t know the P levels of the Radcat. A fairly good starting dose is 27 mg per pound of cat. I always got mine at ThrivingPets.com and their loose binder has 600 mg/ 1/2 tsp. It’s really important to get that down as quickly as possible as her calcium x P is almost 70. Over 70 puts her at risk for tissue calcification.

Since it is late ther and here and I’m sure you are tired and would better absorb info with fresh eyes, why don’t I break it down for you in the morning and give you some links? Is that ok?

 

[Stacy & Asia]

((((Stacy))))). I’m sorry for your upset over these numbers.

I’ve got a lot of info I can give you on CKD. I’ve had four cats with it and all but one stayed stable for a long time and died of something else including my girl that was 21.

I agree that the Phosphorus is the immediate concern and I would start aluminum hydroxide right away and get her on as low P foods as possible. I don’t know the P levels of the Radcat. A fairly good starting dose is 27 mg per pound of cat. I always got mine at ThrivingPets.com and their loose binder has 600 mg/ 1/2 tsp. It’s really important to get that down as quickly as possible as her calcium x P is almost 70. Over 70 puts her at risk for tissue calcification.

Since it is late ther and here and I’m sure you are tired and would better absorb info with fresh eyes, why don’t I break it down for you in the morning and give you some links? Is that ok?

Thanks, Marje! That would be great. I'm sure I'll get over myself by the morning and have a brain to sort some of this out.

 

[Susan&Felix(GA)]

I don't want her to be in pain and suffer, I also don't want to intervene all over the place just because I can, some of the treatments can relieve pain and suffering but can also cause new pain and suffering and trauma and stress.

Ain't that the truth?!

I don't recall right now if you've been through kidney disease before (although I guess most cat lovers have). It can get very bad and then turn around and you get several wonderful happy months or even years until it rears its ugly head in earnest again. This is my clumsy way of agreeing that, yeah, she's not her numbers--and it sure sounds like she's doing really well at the day-by-day level.

Enjoy her! I think she's really enjoying being with you.

 

[Stacy & Asia]

Ain't that the truth?!

I don't recall right now if you've been through kidney disease before (although I guess most cat lovers have). It can get very bad and then turn around and you get several wonderful happy months or even years until it rears its ugly head in earnest again. This is my clumsy way of agreeing that, yeah, she's not her numbers--and it sure sounds like she's doing really well at the day-by-day level.

Enjoy her! I think she's really enjoying being with you.

Thanks, Susan. I have to have a little pity party with the rawness of this info, it's just how I do. I'm sure I will feel better in a while. I felt just like this with the diabetes diagnosis and I got over that. It just stings, but you're right, she's the same cat I had before these labs, and she's doing okay right now.

She was diagnosed CRF (early stage) by my vet about a couple of years ago. Her numbers (creatinine and BUN) have bounced around from bad (but not nearly this bad) to normal since then, it was unclear if it was a slam dunk diagnosis, but now it is, I guess. Have not had any other cats (that I know of) with this issue. That being said, this new era of labs and echos and sonograms and the like for cats is pretty new to me too. We had the old country type vet that came to your house (since I was a kid and until a couple of years ago) and the most fancy thing they would do is a blood draw. Mine would refer out if something obvious and dire was happening, as she did with Asia's tooth resorption. Asia is my first cat I've had all on my own as an adult...I got her when I was 18, it's crazy to think that!

 

[Susan&Felix(GA)]

I have to have a little pity party with the rawness of this info, it's just how I do.

I do that, too. Even when the cats are doing great, I revisit my pity party from time to time, feeling sorry for my future self when they may not be doing so great....

Asia is my first cat I've had all on my own as an adult...I got her when I was 18, it's crazy to think that!

 

[Alicia & Maggie (GA)]

Stacy Sorry I missed this until now... I know this is scary for you, but Asia is in good hands: yours!

 

[Chris & China (GA)]

I don’t know the P levels of the Radcat.

 

[Squalliesmom]

Stacy, I'm sorry you've had such upsetting news. Those of us with older kitties can really relate! Squallie has FORLS (resorptive lesions), too, and there is nothing I can do about it because he has a heart murmur and, at his age, they didn't want to put any additional stress on his kidneys. I agonized over it for quite a while; finally decided all I could do was take it a day at a time and just enjoy loving him. I know he won't be with me forever, and I'm sure we'll be looking at pain management up the road a ways, but I will do my best by him to see that he has a happy, pain-free life, and will keep my promise to him to let him go with dignity if that day arrives. So my recommendation is to love and enjoy Asia just like you have been doing all along, and take each day as it comes. It becomes so much easier if you can accept this with both your heart and your mind.

SENIOR KITTIES ROCK!!!

 

[Marje and Gracie]

View attachment 32913

Thanks, Chris. are those numbers on a dry matter basis?

 

[Girlie's mom]

Oh Stacy!

She's pretty nonchalant about all of this, outside of the arthritis stuff and occasional teeth problems, she's happy and talkative and seemingly normal.

This makes me smile: she's happy in herself, outside of the occasional twinges that seniors get. That's something you can truly celebrate!

Asia has really crept into my life through your posts. How did she get that name? I've always been curious...

I know that Marje will give you good, straight advice and tips in the morning your time. Know that we're all here with you, Stacy!

 

[Stacy & Asia]

Thanks, Chris. are those numbers on a dry matter basis?

Yes, those are dry matter values

 

[Stacy & Asia]

Stacy, I'm sorry you've had such upsetting news. Those of us with older kitties can really relate! Squallie has FORLS (resorptive lesions), too, and there is nothing I can do about it because he has a heart murmur and, at his age, they didn't want to put any additional stress on his kidneys. I agonized over it for quite a while; finally decided all I could do was take it a day at a time and just enjoy loving him. I know he won't be with me forever, and I'm sure we'll be looking at pain management up the road a ways, but I will do my best by him to see that he has a happy, pain-free life, and will keep my promise to him to let him go with dignity if that day arrives. So my recommendation is to love and enjoy Asia just like you have been doing all along, and take each day as it comes. It becomes so much easier if you can accept this with both your heart and your mind.

SENIOR KITTIES ROCK!!!

I didn't know that about Squallie, I'm so sorry, it's frustrating to know something like that and not be able to do much about it. It's also maddening to think they can be done in by their teeth, of all things! Sending magical healing toothy vines to your old gentleman.

Thank you! She's pretty dang old, so it's not like I didn't see any of this coming, but at the same time, with all the back and forth in the kidney values, such a huge difference since September is a shock, guess all those pinks, reds and blacks really did a number on her. My best (and highly scientific ) health meter with Asia is that she purrs all the time, literally all the time, if she is not purring, something is very, very wrong. The only time she stops purring is at the vet (extreme stress) or if she's in massive pain. Her purr is really soft and you can't hear unless you feel it under her chin or listen with your ear on her side. When she was diagnosed with diabetes, she wasn't purring as a rule and it took quite a bit of effort with pets and belly rubs to make her purr and then she would stop pretty much when I stopped petting her. I began seriously questioning quality of life just from that, but since being on insulin after a very short while (and before her numbers showed it), she was feeling better again and she's back to her purr machine ways.

 

[LizzieInTexas]

Asia is my first cat I've had all on my own as an adult...I got her when I was 18, it's crazy to think that!

That was my Missy Cat. I got her about 6 months after I moved to Texas (age 19) so she went through so much of my life with me. I can completely understand what you are going through.

I was able to reverse the P levels in Gizmo with food change but you are using Rad Cat and it is already a low P food. Good luck with the binder and keep us informed. I am holding out as long as I can giving it to Gizmo.

 

[Stacy & Asia]

Oh Stacy!

This makes me smile: she's happy in herself, outside of the occasional twinges that seniors get. That's something you can truly celebrate!

Asia has really crept into my life through your posts. How did she get that name? I've always been curious...

I know that Marje will give you good, straight advice and tips in the morning your time. Know that we're all here with you, Stacy!

Thanks, Darrah! I wish I had a good story for her name, my 18 year old self just knew of a little girl named Asia and thought it was a cute name, and I wasn't going to have kids of my own (ha! ) so why not name my cat that? Toki is equally uncomplicated, she had ears too big for her body as a kitten and she hopped on things to attack them, like a bunny. Toki is the Korean word for bunny.

It's a good thing she can't hear anymore, she would be so confused with her many nicknames, she used to come running to me like a dog if I just called her name. My kids have called her "Poof" pretty much since day one, Meatbeard the pirate, Princess Poof Poof, Burgle Bear, Asia Beighah, Toebeans.

 

[Stacy & Asia]

That was my Missy Cat. I got her about 6 months after I moved to Texas (age 19) so she went through so much of my life with me. I can completely understand what you are going through.

I was able to reverse the P levels in Gizmo with food change but you are using Rad Cat and it is already a low P food. Good luck with the binder and keep us informed. I am holding out as long as I can giving it to Gizmo.

Thanks, Lizzie.

Yes! She has been through it all with me (poor Asia) and my constant companion. She put up with a lot of moving and long hours at work without me, she knew I was pregnant with my first weeks before I did. She helped us raise our kids, she's like that dog "Nanny" from Peter Pan. All she's ever asked for in return is constant affection and pets, that's been her soul food.

Hoping the p binders help and I'm glad radcat is already a decent food for this since I agonized over switching when they changed the Stella & Chewies ingredients.

 

[Bobbie And Bubba]

 

[carfurby (GA)]

It's great to hear Asia is so purry. Remember she is still her sweet self and doesn't know anything about her health issues.

 

[Squalliesmom]

It's great to hear Asia is so purry. Remember she is still her sweet self and doesn't know anything about her health issues.

SO true, and something we all tend to forget!!!

When she was diagnosed with diabetes, she wasn't purring as a rule

Squallie stopped purring, too, when he developed diabetes; that was one clue, for me, that something was not right with him. He is back to purring most of the time now, but still not as much as before. However, he seems happy and content. At 19, he has good days and - not bad days - but days when he's just not as chipper. I take that as just a function of his ageing. But overall he is enjoying life, and I am enjoying spending every minute I can with him.

 

[Stacy & Asia]

It's great to hear Asia is so purry. Remember she is still her sweet self and doesn't know anything about her health issues.

You are right, and I am very thankful for that! Thanks, Carla!

 

[Stacy & Asia]

SO true, and something we all tend to forget!!!

Squallie stopped purring, too, when he developed diabetes; that was one clue, for me, that something was not right with him. He is back to purring most of the time now, but still not as much as before. However, he seems happy and content. At 19, he has good days and - not bad days - but days when he's just not as chipper. I take that as just a function of his ageing. But overall he is enjoying life, and I am enjoying spending every minute I can with him.

It's good to have the purr meter, if she didn't stop purring, I might not know anything is wrong with her most of the time until it's really bad! That's a good way to look at it, good and not so chipper days! Hugs to you and Squallie.

 

[Tasha & Darwin]

Stacy, I am so sorry for your news! It's never good to hear that things have possibly progressed. I am sending lots of hugs, and comfort to you - know that Asia is very lucky to be so loved and well cared for!

 

[Myagi (GA) and Heidi]

​

 

[Olive & Paula]

Stacy having a senior is certainly tough. Smokey was 16 when I took him in. Already diabetic but I known him for 15 of those years. I never heard him purr or even meow. His previous medical was very basic to say the least. Anyhow, I wanted his teeth cleaned as he has never had it done but vet didn't want to do it at his age and the diabetes out of control. Then the p'titis hit and now he is 17. when the ultrasound was done, it showed enlarged heart. The exam by IM also said FORLS and reabsorption and full mouth extraction was needed. By now the cardiologist has dx heart disease and heart attack. So nobody would touch him for a dental. Smokey just kept on thriving though. Ate well even with p'titis. And for the FIRST time ever he purred and actually sat on me and he played with his baby brother a wee bit everyday not for long but he sure was happy. He never had brothers or sisters. We managed the symptoms the best we could, actually the heart disease improved which surprised the cardiologist. I can still hear him say "OMG look at this" and my heart breaks thinking is bad news. When actually it was good. Sorry I rambled. I don't know how old Asia is, and now you have kidneys to deal with. Anesthesia could be a risk not worth taking. Of course the teeth can affect the bs, but that can be dealt with. IMO for what its worth, keeping Asia comfortable, eating and happy would be the goal.

 

[Pamela & Amethyst]

Asia is blessed with a Mom like you

 

[Ella & Rusty & Stu(GA)]

(((Stacy))), I'm just seeing this and am sorry that Asia has so much going on. I can't give any advice, but you have gotten so much good advice already. Asia is one lucky kitty to have you! I hope you can get it all sorted out and that Asia will continue that wonderful purring.

 

[saltycat]

I didn't see it posted today. Tanya's CRF site has a lot of good info. When we suspected some kidney issues with my boy it helped me understand what is good and bad for the kidneys as well as what kinds of treatment are available. Glad Marje was able to give you some insight into the lab values. I swear she has more input and a better explanation on the labs then my vet does!

Paws crossed with some treatment that the numbers will get closer to the normal range. I'm glad you had the SDMA test done, it is a better test then a general CBC for determining kidney function.

 

[PussCatPrince - GA]

Asia is my first cat I've had all on my own as an adult...I got her when I was 18, it's crazy to think that!

I read this a day ago and just didn't know what to say. Have rather taken your old girl to our hearts, have me and Ty.
Anyway, I hope Mrs Purrr Machine finds some good levels with the rotten CKD .
May each day in your 2018 be a good day together.