Keep on Keepin' on....

[JanetNJ]

So CC was due for a checkup... and the vet wouldn't approve her insulin until I brought her in... So she went in for a checkup today. They are doing a senior panel and urinalysis. She needs another dental. No surprise there, her teeth are terrible since the diabetes, which is a real shame because for most of her life she had really nice shiny white teeth. It wasn't my regular vet, I haven't seen this one before. She was like "So I see you are giving her 11 units. Are you in contact with Dr. T and she tells you when to raise the dose?"... I'm like, uh, no... been doing this three years. I'm not going to call the vet every 4 or 5 days to find out what does to give her. I just test a lot and raise it if her numbers aren't getting under 200.

She said she and my reg vet were talking about CC the other day (glad she thinks of her) and they were talking about the next step in figuring out why CC's insulin dose was so high. I said well I'd be fine with having her tested for Acro, but honestly I don't see myself doing radiation, and don't think it would really change the way she's being treated other then just KNOWING. So I'll talk to Dr. T in a few days and see what she says about that. I was trying to tell her two years ago I thought that was the problem, and she was like no, that's super rare, blah blah blah… and I'm like I don't think it's as rare as you think. THen a few months ago she said she went to a seminar about FD and they said it's becoming diagnosed much more often now and it's not as uncommon as once thought. well no kidding. lol I have had her tested for IAA and surprisingly she was neg for that.

Anyway, so when I get her lab results in a few days (tues or wed) I'll post them and we'll see how she's doing.

 

[Lisa and little]

Sending positivity your way

 

[Djamila]

Thanks for the update, Janet. I've been wondering how you and CC were doing. Let us know when you hear back from the vet.

 

[JanetNJ]

Thanks for the update, Janet. I've been wondering how you and CC were doing. Let us know when you hear back from the vet.

As far as her numbers she seems to have alternating periods of nicer preshots (250-320) and higher preshots (320-450+). We've been having higher numbers lately but two evenings of better numbers so maybe headed for another period of better range? Guess we'll see.

 

[Kris & Teasel]

I agree with your response to the vet re acro.

 

[JanetNJ]

I agree with your response to the vet re acro.

ty Yeah, she's 15, and a happy girl. Not going to put her through radiation. If she is in more pain I have gabapentin to keep her more comfortable. It is what it is. The teeth we can take care of. Crossing fingers the rest of her labs look ok. As of 8 months ago the kidney's and everything looked good.

 

[Squeaky and KT (GA)]

I like this update Janet!

HUGS!!

 

[JanetNJ]

I like this update Janet!

HUGS!!

Yeah she's doing about the same. The teeth don't look infected just tarter buildup. Better to do it before there's an issue. I'll see if she'll let me wait until the first week of July when we need to board her for a few days or if it's better to do it sooner. If they want new blood work to do it in July we will do it now.

 

[Tina and Gracie (GA)]

I hate seeing a different vet even if its just for a simple appointment. I get so defensive and kick into fight or flight mode, as I know many vets do not approve of changing the insulin without their permission.

Keeping my fingers crossed for CC.

 

[Rachel]

Glad to hear from you! I've been thinking about you and CC lately.

 

[JanetNJ]

Oh and she stuck in a fructosamine test to my bill and I noticed and was like whoa whoa whoa..... Take that off. Lol. I'm not paying $87 for a test to tell me what I already know. They took it off the bill.

 

[MrWorfMen's Mom]

Don't you just love it when the vet decides to do stuff that isn't going to tell you anything you don't already know!

 

[Rachel]

Good for you! Oh those vets...

 

[JanetNJ]

So spoke with the vet. She said she would feel more comfortable with her huge doses if we went ahead with the acro test... I get that. So I'll probably arrange that soon.

THe labs were ok except her kidney values have crept up a bit. Last June her Creatnine was 1.1, bun was 33. This test showed creatnine at 1.7, and bun 40. Not HORRIBLE... but I dread what's to come. I didn't get the email with the labs yet. I'll post them when I do.

 

[Yong & Maury GA]

Good luck Janet, to you and CC!

 

[JanetNJ]

Ok got the labs. @Marje and Gracie see anything I should ask about? Going for the acromegaly test tomorrow

 

[Marje and Gracie]

Ok got the labs. @Marje and Gracie see anything I should ask about? Going for the acromegaly test tomorrow

Can you please enter in the lab tab? I’m out of town and can only view from my iPad or iPhone but when I try to enlarge to read, they blur so much I can’t see the values. So sorry!

 

[JanetNJ]

Can you please enter in the lab tab? I’m out of town and can only view from my iPad or iPhone but when I try to enlarge to read, they blur so much I can’t see the values. So sorry!

OK... added all the info to the lab tab. I don't know why the uploaded image was so blurry.... the screenshot looked clear in my photos, but must upload at a lower res. anyway, the info is in there now.

I was glad to see that despite her high preshots she didn't have any glucose presented in her urine.

 

[Sharon14]

don't see myself doing radiation,

I thought the same with Colin, but finally decided I wanted to know for sure. Not sure if you’ve read about cabergoline. Some have had good luck with it. Wish I had known about it early in Colin’s diagnosis. By the time I had learned of it, he had so many other problems, and no one had really tried it, so I didn’t want him to be a guinea pig. Enough members here have used it now though, so you may want to look into it if the test comes back positive. Fingers crossed it doesn’t though and CC is just a high dose girl!

 

[JanetNJ]

I thought the same with Colin, but finally decided I wanted to know for sure. Not sure if you’ve read about cabergoline. Some have had good luck with it. Wish I had known about it early in Colin’s diagnosis. By the time I had learned of it, he had so many other problems, and no one had really tried it, so I didn’t want him to be a guinea pig. Enough members here have used it now though, so you may want to look into it if the test comes back positive. Fingers crossed it doesn’t though and CC is just a high dose girl!

I'll cross that bridge when I get there. I wonder how stressful it is for them. I haven't read about cabergoline

 

[Marje and Gracie]

Hi Janet

Sorry to just get back to you but we are traveling and we’ve been in little towns with sloooowwwwww WiFi since we left NYC.

I finally got to look at her labs and I’d agree that it potentially looks like very early CKD. Her USG is lower than it should be. USG can become more dilute as the day progresses so the way to find out if she is able to concentrate her urine is to take in the first pee of the morning. If that is above 1.040, then CKD is unlikely.

If she’s not able to concentrate her urine, then it is, as I said, most likely early CKD. As you noted, the focus should be getting her phosphorus level down to about 4-4.5 if possible. Everything else looks good right now.

One other thing I did note is her thyroid level is in the gray zone which means she’s over ten and her thyroid level is over 2.5. If she’s having any symptoms of hyperthyroidism, it’s best to do some additional testing. I use Hemopet; Dr. Dodds is greet and she has a feline thyroid panel that tests the fT4, tT4, fT3, and tT3.

I hope this helps.

 

[JanetNJ]

Hi Janet

Sorry to just get back to you but we are traveling and we’ve been in little towns with sloooowwwwww WiFi since we left NYC.

I finally got to look at her labs and I’d agree that it potentially looks like very early CKD. Her USG is lower than it should be. USG can become more dilute as the day progresses so the way to find out if she is able to concentrate her urine is to take in the first pee of the morning. If that is above 1.040, then CKD is unlikely.

If she’s not able to concentrate her urine, then it is, as I said, most likely early CKD. As you noted, the focus should be getting her phosphorus level down to about 4-4.5 if possible. Everything else looks good right now.

One other thing I did note is her thyroid level is in the gray zone which means she’s over ten and her thyroid level is over 2.5. If she’s having any symptoms of hyperthyroidism, it’s best to do some additional testing. I use Hemopet; Dr. Dodds is greet and she has a feline thyroid panel that tests the fT4, tT4, fT3, and tT3.

I hope this helps.

Thank you for taking the time to look over her labs.
The appointment was 3pm so it certainly wasn't the first pee of the day. Next time I'll try to get an earlier appointment time.
I'm keeping her off the fancy feast as much as I can and sticking with Tiki cat and bff. Hopefully the phosphorus will come down. If not I guess we'll bust out the aluminum hydroxide.

We had her thyroid checked two years ago ft4 test and it came back ok. May see if the vet thinks it needs another recheck. She certainly isn't showing any signs of weight loss.... She's a hefty 17.5 lbs... If anything she needs to lose about 4 lbs.

Ugh I just hate that she's got ckd. It's just a horrible horrible condition. It seriously makes me want to cry that she's going to go through this after losing Zimmy who had it.

 

[Marje and Gracie]

Thank you for taking the time to look over her labs.
The appointment was 3pm so it certainly wasn't the first pee of the day. Next time I'll try to get an earlier appointment time.
I'm keeping her off the fancy feast as much as I can and sticking with Tiki cat and bff. Hopefully the phosphorus will come down. If not I guess we'll busy out the aluminum hydroxide.

We had her thyroid checked two years ago ft4 test and it came back ok. May see if the vet thinks it needs another recheck. She certainly isn't showing any signs of weight loss.... She's a hefty 17.5 lbs... If anything she needs to lose about 4 lbs.

Ugh I just hate that she's got ckd. It's just a horrible horrible condition. It seriously makes me want to cry that she's going to go through this after losing Zimmy who had it.

Don’t start using binder until the P is over 6 or the P x Ca is over 70.

Thyroid levels can change easily in less than two years but I wouldn’t worry about it if she has no hyperT symptoms.

I’m so sorry about Zimmy but catching it early and being proactive regarding the P levels, anemia, watching potassium and calcium, etc, can let her stay stable a very long time with little progression.

 

[JanetNJ]

Don’t start using binder until the P is over 6 or the P x Ca is over 70.

Thyroid levels can change easily in less than two years but I wouldn’t worry about it if she has no hyperT symptoms.

I’m so sorry about Zimmy but catching it early and being proactive regarding the P levels, anemia, watching potassium and calcium, etc, can let her stay stable a very long time with little progression.

She is getting closer to that 6 mark. She was at 5.1 seven months ago and now is at 5.6.


Do you have suggestions on which foods to try?

Id love of Dr Lisa would update the chart with some of the newer foods that came out in the last two years.

 

[Sharon14]

Just cutting out the Fancy Feast May help since it’s so high in phosphorus! It’s so hard to find low carb/low P foods. I tried to keep Colin under 200 P on Dr Lisa’s chart. His favs were Whole Earth Duck and Pro Plan Focus Urinary Tract Health Turkey, and if I was at Petco, I’d pick up some Soulistic (can’t remember what flavors though). Occasionally he’d eat some Organix, but he didn’t really like it too much. For a cheap food you can find anywhere, Sheba isn’t too bad, just a little over 200.

 

[Djamila]

I'll put in a plug for EZComplete from FoodFurLife. Making food at home using their supplement powder is super easy, inexpensive, and both low carb and low P. They'll send you a sample for like a dollar so you can try it and see if CC seems to like the flavor. Transitioning onto raw food can take some time, but it's made a big difference in Sam's general health, and takes less time to make than it takes to drive to the pet store for food and back.

 

[JanetNJ]

Just cutting out the Fancy Feast May help since it’s so high in phosphorus! It’s so hard to find low carb/low P foods. I tried to keep Colin under 200 P on Dr Lisa’s chart. His favs were Whole Earth Duck and Pro Plan Focus Urinary Tract Health Turkey, and if I was at Petco, I’d pick up some Soulistic (can’t remember what flavors though). Occasionally he’d eat some Organix, but he didn’t really like it too much. For a cheap food you can find anywhere, Sheba isn’t too bad, just a little over 200.

WHY DO THEY MAKE IT SO DANG HIGH IN PHOSPHORUS

 

[Sharon14]

WHY DO THEY MAKE IT SO DANG HIGH IN PHOSPHORUS

Or so high in carbs. Another thing I did for Colin was change my high carb hypo food to Science Diet. Almost all their foods are high carb, low phosphorus

 

[Marje and Gracie]

She is getting closer to that 6 mark. She was at 5.1 seven months ago and now is at 5.6.


Do you have suggestions on which foods to try?

Id love of Dr Lisa would update the chart with some of the newer foods that came out in the last two years.

I also feed EZC from Food Fur Life with raw so I don’t know what canned foods are best now. The EZC with the raw meat is lower P (less than 1.00% on a DMB). I agree with @Djamila ...it takes less time to make than driving to different places to get canned food like I was before I started raw.

Cats also eat less raw because it’s so nutrient dense.

I don’t know if you’ve seen the Food Data Tables from Tanya’s but they might help.

 

[Rachel]

My cats have definitely been way less hungry since starting raw. And I have the peace of mind of knowing that they are eating something that I was able to control so I know the food is healthy and safe.

 

[JanetNJ]

I also feed EZC from Food Fur Life with raw so I don’t know what canned foods are best now. The EZC with the raw meat is lower P (less than 1.00% on a DMB). I agree with @Djamila ...it takes less time to make than driving to different places to get canned food like I was before I started raw.

Cats also eat less raw because it’s so nutrient dense.

I don’t know if you’ve seen the Food Data Tables from Tanya’s but they might help.

So I'm looking at the phosphorous levels of Tanya's chart vs. Dr. Lisa. I know we always tell people to find foods under 200 phospherous... so I fed CC Tiki Cat Puka Puka Luau this morning, which on Dr. Lisa's chart is a good 154 phosperous. Well below the 200 mark. Looking at Tanya's site she recommends keeping the phosperous under 1.0, with that same food being listed as being 1.03 which is slightly higher, or at least on the top end of what she would recommend. So can someone explain how the different measurements translate to each other? Like does 150=1.0

then Dr. L has Tikicat Koolina Luau as 149 Phosperous (less then the other flavor) but Tanya has it listed as 1.06 which is slightly higher.

 

[Marje and Gracie]

So I'm looking at the phosphorous levels of Tanya's chart vs. Dr. Lisa. I know we always tell people to find foods under 200 phospherous... so I fed CC Tiki Cat Puka Puka Luau this morning, which on Dr. Lisa's chart is a good 154 phosperous. Well below the 200 mark. Looking at Tanya's site she recommends keeping the phosperous under 1.0, with that same food being listed as being 1.03 which is slightly higher, or at least on the top end of what she would recommend. So can someone explain how the different measurements translate to each other? Like does 150=1.0

then Dr. L has Tikicat Koolina Luau as 149 Phosperous (less then the other flavor) but Tanya has it listed as 1.06 which is slightly higher.

Unfortunately, you can’t compare the as-fed way of calculating P that Dr. Lisa does with the dry matter basis way that Tanya’s does. In other words, there isn’t a direct correlation between mgP/100 kcal and percent P. Since I’m not at home, I can’t access my calculators for P which is the easiest way to figure them.

The other factor that might be involved is the time at which the data was gathered. Food companies constantly have to check their foods because every batch won’t be identical so it’s possible that, at the time Dr. Lisa got the nutrient analysis, there was a bit of a difference from when Helen’s crew got theirs. However, IMHO, that’s a good selection for carbs and P and if that’s what she will eat and you want to feed her, I’d go with it.

Keep in mind that the only foods that are “low” P are the renal diets but they are also poor quality ingredients and low protein so the goal is to find a food that is LC and lower P that CC will eat. The last part is the most important.

It’s also important to note that if you are going to do any diet changes, do them now while she’s eating well. Switching up diets in CKD cats as the disease progresses is usually a recipe for disaster.