Just got back from the vet. He's having her take 1/3 tsp daily of the aluminum hydroxide powder. Anyone have experience if their cats noticed the taste? I can maybe put a tiny amount into each food portion and hopefully she doesn't notice, but they recommended giving it to her when she is really hungry. If I put it in her AMPS or PMPS food and she suspects anything is off, she just won't eat.
They also gave Buperenex extended 0.1 ml twice a day. Does that sound like a therapeutic and non loopy making amount? She's not quite 10 pounds. Does anyone have experience if it makes them more sleepy? I hope not.
Not looking forward to subq fluids, I didn't like doing it last go around. Does the extra fluid mess with diabetes in any way? Numbers up or down? Just want to be on the lookout for that.
My cats never seemed to taste the powder but the 1/3 tsp is daily and the goal is to get a little bit in every helping that you can. It will likely seem to disappear faster than you think. I would try to put it in food, first, that is not associated with her PSs and if she eats it fine, then hopefully she will also eat her PS foods fine.
That is a relatively minor bupe dose. My Gus kitty was on that dose for a very long time (and he was a larger cat to start with) and did well with it as maintenance; it did not make him loopy. He was quite active. It just nipped the pain.
ECID but subqs can sometimes affect the BG. It did not happen in Gracie but I’ve seen it drop the BG in other cats the cycle it was given. You’ll have to experiment with it. If you’ve not ever seen our video on
How To Give Subq Fluids at Home, it might help. We made it for FDMB members but also publicly posted it on YouTube and it’s had thousands of hits and I get so many comments and thanks.
Longevity with CKD is dependent on several things but the most critical (I believe based on my experience with it and research that has been published by vets) is (1) Phosphorus control (2) control of anemia (3) control of any proteinuria. I’m not saying there aren’t other important things to address; there really are but those are a really important starting point. If those aren’t addressed, the rest doesn’t matter.
You’ve already started on the P control. Great job!
On anemia, I don’t see it in your signature so please forgive if you are already doing this, but she would absolutely benefit from getting oral methylB12 and a multi B vitamin. When CKD cats get below 30% on their hematocrit, they are anemic. However, it is not critical, requiring erythropoietin stimulating agents or transfusions, until it gets below 20%. By giving the B vitamins, you can hold them steady. Gus, in four years of CKD where his creat was stable at about 3.5, his HCT never dropped below 28%. That’s your goal.....to hold it at least steady. I’m sure you’ve seen Tanya’s Comprehensive Guide to Feline CKD but it’s a lot to wade through so I’ll give you some links to get you right to the correct spot. First, here’s info on
anemia. And here is the info on
Vitamin B. It’s important to understand that a CKD cat needs a higher level of methylB12
plus a multi B. I always used Jarrows BRight for my multi but now they’ve added P and Asia doesn’t need more P. You can look at the other available multi Bs that Helen references on the site or you can see if you can find the Jarrows formulation before they changed it.
Currently, she has no protein in her urine which is excellent!! I wish they had tested MA (Microalbuminaria) but they didn’t. If we see an elevated MA, it can be a precursor to proteinuria even before we see much protein in the urine.
On the ultrasound, I see no reason to do it for the pancreas at this time if she is asymptomatic. Gracie’s specfPL was always elevated but she never once had pancreatitis or even the symptoms of it. She had several u/s and they were all normal regarding her pancreas. It was the issues with her liver and intestines that caused the elevation of her specfPL. The only advantage I see to doing one now is to potentially look at her kidneys. When I see the creatinine pop up that fast, I wonder if it is just age, other factors, or if it can be
pyelonephritis or kidney infection. My Gus had two kidney infections over the four years. While we think we’d see some symptoms or bacteria in the urine, we did not with him. In fact, it’s not that common to not see bacteria even in a C&S with a kidney infection because it’s much higher up in the kidneys. Gus did have some WBCs in his urine on a routine check which is what led us to do the u/s both times and, both times, he had a kidney infection. Asia’s WBCs aren’t outside the norm so there’s nothing that makes me suspect it in her urine. You might want to talk to your vet about the u/s from that standpoint. Again, I am not indicating that anything points to her having a kidney infection but it “can” be a reason why the creatinine pops up.
I, personally, don’t see such a huge difference in tests between labs so I do believe you can give them some comparison. Her creatinine, if run at IDEXX, last time might have been a bit higher but I definitely think you can see and assume an upward trend here.
There will be more CKD info I can give you as we go but I don’t want overwhelm you. Ask for specific info you’d like to have. I know Tanya’s like the back of my hand and I can probably find stuff for you much faster especially as you have your hands full.
It's very difficult to see our babies health decline and feel like your hands are tied. Hopefully the pain meds, binder, fluids and a lower P food will help. Give Miss Asia lots of extra scritches for me.
Paws crossed this has no taste to her. 
So I should be cautious with increases until I know how she reacts with fluids on board? They said to do this 2-3 times a week, I hope it doesn't mean lower numbers on just those days and higher the rest of the time!
I also just gave her the bupe after her shot and while she was pouty with me about it, it was quick and no spitting and drooling, this time! Another score! 
Thanks for your thoughts, as always, Wendy! 
(as far as I know but your vet will absolutely know)], then the creatinine can, and usually does, come down.
