? Newly Diagnosed, Enlarged Kidneys, Needs Dental Work - HELP!

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catbeans23

catbeans23

Member Since 2018
I have been reading several posts on here the last few days, hoping I can get some help here.

I have a male cat, 16, who was diagnosed with diabetes yesterday. I took him in off the streets 5 years ago. He went in because he couldn't walk. On Thursday he fell off of a table (2 feet high). He was moving around with a limp so I thought he was just sore. Thursday he didn't want to eat, I thought it had to do with pain. Friday was the same only he was struggling to walk. By Saturday, he couldn't walk or sit. It was too late to get him into the vet so I had to wait till Monday. When doing the x-rays to check his spine, the vet noticed his kidneys were very enlarged. Tested him and he diagnosed him with diabetes. He thinks he may have had a spinal stroke from the fall on top of this.

Since Thursday, he has eaten next to nothing. He didn't drink much at first but I at least have him drinking. I offer him water every 2 hours in bed. I have him laying out with towels for when he needs to pee. He was letting me know when he had to go up until yesterday evening when he got back from the vets.

After all this, I noticed today he had something hanging in his mouth. I thought it was food or something. I went to get it out and it was his gums. It looks like his canine went into his bottom gums and sliced them. I don't know how the vet missed this. His lower lip is swollen too. The canine on the other side is severely decayed as well. This either happened when he fell or when he has a stroke. I only noticed because I am force feeding him a supplement while he isn't eating. He drinks on his own but he still wont eat and I think it is because his mouth is in pain. He never lets me near his mouth to have noticed the decaying tooth. I read it was linked to kidney problems in older cats and now I feel horrible for not seeing this sooner.

He is going to the vet in the morning for that now and I am scared he will need to be put under to get work done and already being as weak as he is, it feels so risky. I am a mess over here.

Back in September he went in for sudden vision loss, he was completely blind. The vet didn't see anything wrong and his blood work was okay. He tested him for diabetes and said he was normal. His vision came back a few days after and then another 10 or so days went by, and he couldn't see again. The vet couldn't figure out what was wrong and insisted they were working but he didn't know why he couldn't see. Looking back now, I think he has diabetes for a while and something was missed.

He has been eating a diet of Sheba Pate with Fancy Feast dry prior to this. He didn't eat much dry but I kept it out for him after I went to sleep so he had something if he got hungry.

I need help. What food do I buy? It seems he needs high protein, moderate fat, low carb and low phosphorus. Is there anything I should know about dental work in his condition? I really don't know what to do with myself. I have been a mess. I may have only known him a few years but he means so much to me. He needs to start eating to feel better and heal his back, but he needs to get his mouth sorted so he can eat. I know he is hungry because he leans in for the food but then he pushes it away.

The vet gave me a few cans of the k/d science diet stuff and the proplan NF but I want better food. This is too high in carbs for diabetes.

EDIT: He isn't overweight. He has been a healthy weight since I have had him. I know for some cats, they become diabetic from obesity but he is actually in the range he should be. I forgot to mention this.

Also, his readings for GLU and BUN was 220 and 118. His kidneys are not in good shape. I just want to do everything I can to help him.
 
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If you are in North America, this food chart lists a lot of the commercially available canned foods. Some of them are available elsewhere as well. You want a low carb food (under 10% carbs) and low phosphorus (ideally under 200 or as close to that as you can get). The Fancy Feast tends to be high phosphorus, so not a good choice.

His glucose numbers aren't horrible, given that he may have had some stress at the vet, which can raise the numbers. Was their glucose in his urine? My non diabetic cat once registered about 220 at the vet, then 53 at home the next day when I tested him. Pain/infection/inflammation can also raise his blood glucose. What information did the vet use to diagnose diabetes?

I agree that getting his tooth looked at is a priority. Perhaps a new vet?
 
Wendy&Neko said:
If you are in North America, this food chart lists a lot of the commercially available canned foods. Some of them are available elsewhere as well. You want a low carb food (under 10% carbs) and low phosphorus (ideally under 200 or as close to that as you can get). The Fancy Feast tends to be high phosphorus, so not a good choice.

His glucose numbers aren't horrible, given that he may have had some stress at the vet, which can raise the numbers. Was their glucose in his urine? My non diabetic cat once registered about 220 at the vet, then 53 at home the next day when I tested him. Pain/infection/inflammation can also raise his blood glucose. What information did the vet use to diagnose diabetes?

I agree that getting his tooth looked at is a priority. Perhaps a new vet?
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He just did a blood reading. He is under stress right now because he fell and can't walk. Being at the vets is not a fun time either. I think he is assuming he is diabetic based on his kidneys but he didn't mention insulin. Maybe he wants to get the kidneys in order and see how things read? I need to get him to eat so he has to have his teeth and mouth fixed. Is there anything I should worry about with this? I am taking him in the morning. I am guessing he will need a few pulled and will need to be treated for the gum tear.

He had to get fluids, was given benazepril but he is unable to eat them (soft chews) so I had to shove the first one down his throat. I tried again today and couldn't do it. I am hoping I can get a liquid version in exchange. I am feeding him Rebound by Virbac with a syringe. I believe he got a shot for inflammation and pain, another for the kidneys, and something else for infections. He is supposed to get another shot for his kidneys but not till Saturday. I have to get him in tomorrow because his mouth is not looking good.

He only likes pate foods. I have been looking at that chart for a while now. I had him on Sheba pate before this with dry Fancy Feast but he only ate that sparingly. I know dry is not good for cats. He won't be getting any more after all this. The Sheba food must be too high in phosphorus. My other boy eats Fancy Feast but he (the 16 year old) was getting bad reactions from that late last year. He would get disoriented and confused. I mentioned this to the vet but he said food wouldn't do that. I had him on Sheba since, it didn't give him the reaction.
 
Did the spinal X-rays reveal any problem with the spine?
Maybe he needs something for nausea (cerenia and/or Zoloft) and something for the pain. Can you ask the vet about that?
 
Bron and Sheba said:
Did the spinal X-rays reveal any problem with the spine?
Maybe he needs something for nausea (cerenia and/or Zoloft) and something for the pain. Can you ask the vet about that?
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He believes he had spinal stenosis and the fall aggravated it. He has two points closing in instead of being open. He doesn't act like he is in pain at all. Not even in his facial expression. This is what threw me off but I was told some cats don't show any signs of pain. I will ask him about something for pain and nausea tomorrow. The benazepril I guess is because enlarged kidneys often means higher blood pressure? This is all new to me. I have only ever had to deal with one other cat with medical issues like this and his was pancreatitis.

I'm just trying to make sense of everything. Is anesthesia safe in his condition? I am guessing he will need it for teeth work.
 
catbeans23 said:
The benazepril I guess is because enlarged kidneys often means higher blood pressure?
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My Neko was on benazapril because she had proteinuria, an early sign of kidney disease. Her blood pressure was normal. Was your cat's blood pressure tested?

Cerenia or ondansetron (Zofran) are good ones for nausea. Cerenia is better if vomiting, but contraindicated if there are liver issues. Buprenorphine is a good one for pain. It would be good to know what medicines he was getting in the shots.
catbeans23 said:
Is anesthesia safe in his condition? I am guessing he will need it for teeth work.
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Yes, dentals will need anesthesia. If you have a dental specialist vet near you, they are more used to dealing with cats with secondary conditions.
 
I'm sure the vet won't put him under anaesthetic if he thinks it is too risky.
Benzapril is used in cats for blood pressure, if cats have protein in the urine and in some cats with heart failure. Sheba had it for protein in the urine. It was a small tablet that I crushed and put in food.

Cats are notorious for not showing signs of pain. When Sheba was given medication for pain, her BSL dropped significantly and I was unaware she was in pain. That was early on in her FD journey.
I would have a list of questions for the vet and don't be afraid to ask the hard questions. You are your boy's advocate and you are paying the bills.
I would ask about medication for nausea and pain.
Also if he does do the extraction, how is he going to manage the post op care....eg antibiotics, pain relief, suitable food while he recovers.
 
Wendy&Neko said:
My Neko was on benazapril because she had proteinuria, an early sign of kidney disease. Her blood pressure was normal. Was your cat's blood pressure tested?

Cerenia or ondansetron (Zofran) are good ones for nausea. Cerenia is better if vomiting, but contraindicated if there are liver issues. Buprenorphine is a good one for pain. It would be good to know what medicines he was getting in the shots.

Yes, dentals will need anesthesia. If you have a dental specialist vet near you, they are more used to dealing with cats with secondary conditions.
Click to expand...

For some reason, the vet I go to doesn't test for blood pressure in cats. I have called around and the only one does in my area and it would have been far too expensive to take him there. I wanted it to be tested when he lost his eyesight last year.

No specialist around here for dental that I know of, I wouldn't be able to afford one right now anyway. I am able to do payment plans with the vet I go to. He has been in practice for many years so I would imagine he knows what he is doing but I am still a bit scared. I shouldn't read things online I guess. My anxiety shot through the roof.
 
Bron and Sheba said:
I'm sure the vet won't put him under anaesthetic if he thinks it is too risky.
Benzapril is used in cats for blood pressure, if cats have protein in the urine and in some cats with heart failure. Sheba had it for protein in the urine. It was a small tablet that I crushed and put in food.

Cats are notorious for not showing signs of pain. When Sheba was given medication for pain, her BSL dropped significantly and I was unaware she was in pain. That was early on in her FD journey.
I would have a list of questions for the vet and don't be afraid to ask the hard questions. You are your boy's advocate and you are paying the bills.
I would ask about medication for nausea and pain.
Also if he does do the extraction, how is he going to manage the post op care....eg antibiotics, pain relief, suitable food while he recovers.
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He didn't test any urine. I am going to ask him why it was prescribed. He only took it yesterday. He is unable to chew the treat and I can't force it down, it just falls apart. My hand is fall cut up from giving him the one yesterday. Took me nearly 20 minutes.

I will make a list of things to ask. I want to make sure he gets the best care.
 
Can you post a copy of his labs please? How can he diagnose him with diabetes with one test in the low 200's? That's barely advice normal, and to be expected with a cat who is tremendous stress. I don't feel this diagnosis is correct or should at least be confirmed with a fructosamine test.

Enlarged kidneys is more associated with kidney disease.... My cat had been diabetic for two years and her kidneys are fine.

The bun is very high. He must likely needs sub q fluids.
What was the creatnine level?
Hct?
Potassium?
Phosphorus?

You have to find someone to do a blood pressure test. Crazy to me your vet doesn't do it. My vet is expensive and even they only charge $40 for the BP test. Call various places again and ask for the price.
 
Blood pressure is easy to take. Vet should have no problem. Benazepril can be in liquid form from compounding pharmacy but will take time to get. It does sound as if it's high blood pressure and when kitty lost his sight it should have been the first thing checked.

I get the 5mg pill and split it into 4 pieces. They will be super tiny. I give 1.25 mg twice a day. Depending on the size you are giving you could dissolve in tiny amount of water and syringe it in followed with a water chaser.
 
JanetNJ said:
Can you post a copy of his labs please? How can he diagnose him with diabetes with one test in the low 200's? That's barely advice normal, and to be expected with a cat who is tremendous stress. I don't feel this diagnosis is correct or should at least be confirmed with a fructosamine test.

Enlarged kidneys is more associated with kidney disease.... My cat had been diabetic for two years and her kidneys are fine.

The bun is very high. He must likely needs sub q fluids.
What was the creatnine level?
Hct?
Potassium?
Phosphorus?

You have to find someone to do a blood pressure test. Crazy to me your vet doesn't do it. My vet is expensive and even they only charge $40 for the BP test. Call various places again and ask for the price.
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I thought this was weird too and trust me, I called around. No one tests for it. Only a specialist and that would have been $200 just for a visit not including the test or anything else plus a 45 min drive.

I'm going to have everything mailed to me. He was very busy and fit us in. He is drinking water and I am giving him a supplement. He said the blood pressure medication is to help stabilize the kidneys.
 
Olive & Paula said:
Blood pressure is easy to take. Vet should have no problem. Benazepril can be in liquid form from compounding pharmacy but will take time to get. It does sound as if it's high blood pressure and when kitty lost his sight it should have been the first thing checked.

I get the 5mg pill and split it into 4 pieces. They will be super tiny. I give 1.25 mg twice a day. Depending on the size you are giving you could dissolve in tiny amount of water and syringe it in followed with a water chaser.
Click to expand...

I got it exchanged and got the pills. Someone had returned the liquid kind and said their cat wouldn't take it so to donate to whoever needs it so I got that for free. I will do the liquid first and if he won't take that I have the tiny pills as back up.
 
So a bit of an update. We just got back about 40 minutes ago. He had a sore in his mouth and his teeth were cutting into his gums from an overbite. He numbed the area, cut out the sore and filed the teeth down. He didn't need to go under for that. It took less than 10 minutes. Now I have to see if he will start eating. Once he starts eating, then he will get another shot for his kidneys and we go from there. If it turns out he is not diabetic, I will be somewhat relieved but I am thinking he does have high blood pressure so I have to look into treatment options for that, diet, and everything else there. I need to keep searching for someone who will take it. I don't know why it isn't a common thing around here, it makes no sense.

I am going to get his blood work done again and see what everything reads. I'll be requesting this after he eats and when he goes back in for the second shot. This will be on Saturday. He is drinking water on his own, had a lot when we got back so that is good. I am going to do a bit of pedialyte mixed in the water, just have to get it from the store later. He also gave me CatSure I think it is called. Just to get something in him till he eats. I am hoping he will lick that up on his own but we will see.

No mention of insulin again. I think his main concern right now is his kidneys which makes sense. In the event it is just a kidney issue and not both (diabetic with it) does anyone know what kind of food he should be on for that?
 
catbeans23 said:
So a bit of an update. We just got back about 40 minutes ago. He had a sore in his mouth and his teeth were cutting into his gums from an overbite. He numbed the area, cut out the sore and filed the teeth down. He didn't need to go under for that. It took less than 10 minutes. Now I have to see if he will start eating. Once he starts eating, then he will get another shot for his kidneys and we go from there. If it turns out he is not diabetic, I will be somewhat relieved but I am thinking he does have high blood pressure so I have to look into treatment options for that, diet, and everything else there. I need to keep searching for someone who will take it. I don't know why it isn't a common thing around here, it makes no sense.

I am going to get his blood work done again and see what everything reads. I'll be requesting this after he eats and when he goes back in for the second shot. This will be on Saturday. He is drinking water on his own, had a lot when we got back so that is good. I am going to do a bit of pedialyte mixed in the water, just have to get it from the store later. He also gave me CatSure I think it is called. Just to get something in him till he eats. I am hoping he will lick that up on his own but we will see.

No mention of insulin again. I think his main concern right now is his kidneys which makes sense. In the event it is just a kidney issue and not both (diabetic with it) does anyone know what kind of food he should be on for that?
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Assuming he's not stage 4 kidney failure then you don't need prescription food just something 250 or less in phosphorus. And add extra water to the food.

Let's see the labs... If it's stage 3 you'll want to start sub q's at home.
 
Usually a vet tech can do the blood pressure. That's who did it at the specialty place where Neko had hers done, usually a tech visit is much cheaper than a vet visit.
 
JanetNJ said:
Assuming he's not stage 4 kidney failure then you don't need prescription food just something 250 or less in phosphorus. And add extra water to the food.

Let's see the labs... If it's stage 3 you'll want to start sub q's at home.
Click to expand...

What about protein? Some say high protein is bad other say that low protein is bad. Then you have carbs, fat, and I am assuming I need something low in sodium.

I'll update everything when I get the tests back.
 
Wendy&Neko said:
Usually a vet tech can do the blood pressure. That's who did it at the specialty place where Neko had hers done, usually a tech visit is much cheaper than a vet visit.
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Yeah, it really makes no sense. I called almost all clinics in my area that were opened at the time. Two of them recommended the same very expensive place. The reasons they gave is that most vets feel it is hard to get a reading and unreliable. It still sounds like BS to me. I do have a human reader, is there any way I can do it myself?
 
Oh, and he mentioned his kidneys are working at about 35%-40% so I am assuming this is the beginning of stage 3 but between 2 and 3. I am almost certain now that he lost his vision because of high blood pressure and if someone would have been able to take it for me last year, this likely would have gotten caught a lot sooner. It really makes me upset.
 
catbeans23 said:
What about protein? Some say high protein is bad other say that low protein is bad. Then you have carbs, fat, and I am assuming I need something low in sodium.

I'll update everything when I get the tests back.
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You don’t want low protein unless he’s stage 4.... that leads to muscle wasting.
 
On Tanya's list that one reads:
Soulistic Harvest Sunrise Chicken & Pumpkin Dinner in Gravy
Phos - 0.59
Prot - 56.47
Sod - 0.16
Fat - 12.30
Carb - 27.81
Cals - 21.33
 
I am just trying to find like 5 or 6 specific canned options for him to try. I don't think he is going to take to this NF or KD stuff. He tasted it today and then turned his head. I think if I found something more stinky, he might try and eat. Can anyone give me a few specific cans I can find at a pet store? I am considering getting Whole Earth Farms Grain Free Receipe in chicken and in duck. I need to get him to eat without adding to the kidney issue. I read that acid is something I need to be careful of too. I am just overwhelmed with everything.
 
If you look on the Weruva website they give all the nutritional information you need to know including phosphorus.
I used to use some of their foods for Sheba.
If you look at the bottom lotof numbers....mineral content per kcal, it will tell you the phosphorus per 100kcal.
Look for ones 200 or less in phosphorus, they are suitable for kidney issues.
Here is the link to the cans
http://weruva.com/catsitk-cans-nutrition.php
 
Bron and Sheba said:
If you look on the Weruva website they give all the nutritional information you need to know including phosphorus.
I used to use some of their foods for Sheba.
If you look at the bottom lotof numbers....mineral content per kcal, it will tell you the phosphorus per 100kcal.
Look for ones 200 or less in phosphorus, they are suitable for kidney issues.
Here is the link to the cans
http://weruva.com/catsitk-cans-nutrition.php
Click to expand...

Thanks, I was looking over this. I don't want to do a heavy fish diet as it is not recommended for healthy cats let alone ones with health issues. Also, he doesn't really care for fish. A lot of what they offer in my price range is tuna, tuna and, etc. so I am going to have to keep looking. I also can't get this in store and I need to get it tomorrow. He isn't eating this prescription stuff. I don't know if I should try to get him to eat some Fancy Feast or Sheba or not. Some people say it is better than not eating at all. I am worried though because his kidneys are enlarged, it may put too much stress on them. He is still peeing and drinking a lot. I'm not sure what to do here. He has hardly eaten anything in a week now.
 
I wouldn't use the fancy feast it is too high in phosphorus for kidney issues.
ETA. I guess any food is better than nothing at this point, so it is worth a try, but I wouldn’t keep giving FF
 
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There's a really good group of people on Facebook called Cats with Chronic Renal Failure who can help you with kidney disease.
 
JanetNJ said:
There's a really good group of people on Facebook called Cats with Chronic Renal Failure who can help you with kidney disease.
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Thanks, I will check into this. Going back to the vets in the morning. He has to get a second kidney shot.
 
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