Possible CKD , need expert openion

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rawia

rawia

Member Since 2017
Hi all,

today was Meme’s follow up after her teeth extraction which was two weeks ago ( 5 teeth was extracted).

one teeth was little infected and they gave her another round of long term antibiotics.

Before her surgery the vet told me that her BUN and creatinine test was little elevated.

today the vet retest her and her BUN was 40 and creatinine was 2.6 he is thinking that she has CKD and suggested to do B12 injection and to give her medication that control her blood pressure.

on March I did the IDEXX SDMA test which was in normal range , the result was 11

And as i read that CKD will appear when 70% of kidney function is damaged.

i asked him to do other test to be confirm that she had CKD and he said that blood test is enough, I just do not get it, the SDMA test supposed to catch early CKD or I am wrong?!

can the teeth infection effect her BUN and creatinine?

some friend told me that they should do ultra sound and X rays for kidney.

I would be happy if you help me her with any expert opinions.
@Marje and Gracie

thank you
 
UTI infection can affect the BUN and CREATININE, but I am not sure teeth infection.

You may want to recheck in 1 month. If the numbers are still high, then CKD is possible. But again CREATININE 2.6 is not that bad. My cat Kitty is 3.4-3.5. The following link (and the whole website) will provide you an overview of CKD.
http://felinecrf.org/how_bad_is_it.htm

Meanwhile you can switch her diet to low phosphorus/moderate protein canned food.
http://felinecrf.org/catfood_data_how_to_use.htm#choosing_a_food
http://felinecrf.org/canned_food_usa.htm

I am also attaching two documents of food list for CKD cats. One is provided by a facebook CKD private group member. The other one is the food I feed my cat. These two documents both use the metabolisable energy (ME): the basis of % caloric distribution for protein, fat and carbohydrate.
 

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I am not sure about the B12 injection since my vet didn't mention it to me. Let's wait for expert's opinion.

Today I just took Kitty to the vet to check her blood pressure to make sure she doesn't have high blood pressure. So if your vet has the equipment to test, you may ask him to check the blood pressure.
 
Thank you

food was my first concern because she is also diabetic, I think i will need to order it online.
 
rawia said:
Thank you

food was my first concern because she is also diabetic, I think i will need to order it online.
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I am attaching a food list for CKD cats with diabetes. The WERUVA BFF canned foods are available in Petco. You can buy a couple of cans to see if she likes them.

Most food in the kitty_food list is also low in carbs.
 

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Sienne and Gabby (GA) said:
In addition to a UTI influencing the numbers, so can anesthesia. I think getting the blood work re-run in a few weeks is a good idea.
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So what i can not understand is why the SDMA came normal and three month later they told me that she has possible CKD, can this happen ? What i understand that SDMA is an early test for CKD
 
I agree. That's why I think several of us are suggesting that you get Meme re-tested in a month or so. The values may have been off due to the UTI (which if it doesn't clear up in a couple of weeks could mean it's a kidney infection), medications, or anesthesia. Any drug that is cleared via the kidneys may cause a change in some of the values.

FWIW, one of my cats had normal SDMA. He's a big breed cat and his values came back slightly over normal along with a mildly elevated creatinine level. His kidney levels have come back down. I do think he has early stage kidney disease (I changed his diet) but everything is stable. My point being that these values can change.
 
Sienne and Gabby (GA) said:
I agree. That's why I think several of us are suggesting that you get Meme re-tested in a month or so. The values may have been off due to the UTI (which if it doesn't clear up in a couple of weeks could mean it's a kidney infection), medications, or anesthesia. Any drug that is cleared via the kidneys may cause a change in some of the values.

FWIW, one of my cats had normal SDMA. He's a big breed cat and his values came back slightly over normal along with a mildly elevated creatinine level. His kidney levels have come back down. I do think he has early stage kidney disease (I changed his diet) but everything is stable. My point being that these values can change.
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The one thing that make me worry before her surgery and after is that she was drinking more and went to bath room more with little big amount of urine, this situation happened before and her BUN was slight high that is way the vet suggest a SDMA test which it came normal and the vat gave her antibiotics and everything was ok.

if it is a UTI and it happened again then how can i treat it, and could this lead to kidney failure, plus her gum was very inflamed before surgery and now it is little infected.

They keep giving her antibiotics every time , is it ok to have antibiotics for long time.

so i just wait and do nothing if it is UTI? And how i treat this ?
 
Excessive drinking and excessive urination are symptoms of diabetes. (It's referred to as PU/PD -- polyuria and polydipsia). Some diabetic cats are more prone to develop UTIs due to sugar being excreted in the urine and the sugar in the urine is a great medium for bacterial growth.

I would ask about a blood pressure test. Putting your cat on BP meds if Meme's BP is normal would be unnecessary. Elevated BP can have an effect on the kidneys so it's good to get it looked into.
 
Sienne and Gabby (GA) said:
Excessive drinking and excessive urination are symptoms of diabetes. (It's referred to as PU/PD -- polyuria and polydipsia). Some diabetic cats are more prone to develop UTIs due to sugar being excreted in the urine and the sugar in the urine is a great medium for bacterial growth.

I would ask about a blood pressure test. Putting your cat on BP meds if Meme's BP is normal would be unnecessary. Elevated BP can have an effect on the kidneys so it's good to get it looked into.
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Good day,

I went today to another near vet to check Meme’s blood pressure and thankful it was normal , near 140, he think that she was little stressed but he said that it is normal, and he agree with you about her test, he said exactly as you said, so I will wait and retest her in a month after her teeth extraction healed , because she still feels some discomfort and her gum little sore.

thank you all for your help. At least i feel relief that her blood pressure came ok. To be honest her teeth and the surgery was so painful.
 
Sienne and Gabby (GA) said:
Excessive drinking and excessive urination are symptoms of diabetes. (It's referred to as PU/PD -- polyuria and polydipsia). Some diabetic cats are more prone to develop UTIs due to sugar being excreted in the urine and the sugar in the urine is a great medium for bacterial growth.

I would ask about a blood pressure test. Putting your cat on BP meds if Meme's BP is normal would be unnecessary. Elevated BP can have an effect on the kidneys so it's good to get it looked into.
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I believe that she still in pain , her gum from one side still sore and irritated , she feels discomfortable when eating on this side , it is two weeks now after surgery i do not know why it is still sore, she had another round of antibiotics.
 
Yes and he gave her another round of antibiotics, her gum was badly inflamed before the extraction for a while and the vet always thought that it is just infection then he suggested a dental work to have better look which was the problem from her teeth. Plus i did not gave her the Metacam which i think if i did then it will help with the inflammation.
 
There is some infection which doctor think it is the reason but i think that maybe the stitches bothering her, we are now on day 21 and the stitches still there. I used some of the pain killer that he gave me to see if she is on pain or just something bother her, she ate well after with no problem so i think there is something make her feel pain.

I will make another appointment to see what is happening.

maybe he tight the stitches too strong
 
rawia said:
There is some infection which doctor think it is the reason but i think that maybe the stitches bothering her, we are now on day 21 and the stitches still there. I used some of the pain killer that he gave me to see if she is on pain or just something bother her, she ate well after with no problem so i think there is something make her feel pain.

I will make another appointment to see what is happening.

maybe he tight the stitches too strong
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Well if there is some infection that can cause pain too. I would still take her in to be seen . Poor baby sending healing vines to wrap her in comfort.
 
Sienne and Gabby (GA) said:
I agree. That's why I think several of us are suggesting that you get Meme re-tested in a month or so. The values may have been off due to the UTI (which if it doesn't clear up in a couple of weeks could mean it's a kidney infection), medications, or anesthesia. Any drug that is cleared via the kidneys may cause a change in some of the values.

FWIW, one of my cats had normal SDMA. He's a big breed cat and his values came back slightly over normal along with a mildly elevated creatinine level. His kidney levels have come back down. I do think he has early stage kidney disease (I changed his diet) but everything is stable. My point being that these values can change.
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I just read this again to have more clear idea, so what i understand that if the UTI did not clear in few weeks it can be a kidney infection which can cause CKD? I read somewhere that kidney infection can lead to CKD?

and if she had kidney infection how can be treated?
 
Any number of things can cause CKD. However, as you initially noted, the kidney values are inconsistent -- not everything is elevated. Kidney disease, if that's what's going on is staged - it's called IRIS staging. It could be that Meme is at an early stage or it could be that the test is reflective of something temporary. At this point, I'd be alert to any changes and get the tests re-run to determine if the values go back to normal or not.
 
Sienne and Gabby (GA) said:
Any number of things can cause CKD. However, as you initially noted, the kidney values are inconsistent -- not everything is elevated. Kidney disease, if that's what's going on is staged - it's called IRIS staging. It could be that Meme is at an early stage or it could be that the test is reflective of something temporary. At this point, I'd be alert to any changes and get the tests re-run to determine if the values go back to normal or not.
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So even with CKD is there any treatment that vet should give, my vet only suggested B12 injection if she had CKD.

if she is in early stage what kind of treatment should provide or i have only change her diet and see.
 
rawia said:
So even with CKD is there any treatment that vet should give, my vet only suggested B12 injection if she had CKD.

if she is in early stage what kind of treatment should provide or i have only change her diet and see.
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There's not much you can do. At early stages you want to feed foods lowered in phosphorus. Later you can add sub q fluids. I also give oral b12 methylcobalamin a few times per week to keep her hct levels normal. You'll want to have her blood levels checked every 3-4 months to see how she's doing. Ckd cats are prone to high blood pressure so get that checked every so often too. My diabetic ckd cat eats weuva foods.


Weruva slide and serve pate foods Family Food (.97 phosphorus and 0 carb). Also Jeopurrdy Chicken (0.97 P 6.1 carb)

Weruva Steak Frites (0.57 phosphorus 7.5 carb although I take out any big pieces of potatoes to try to limit the carbs just a bit)

Weruva LA isla Bonita - phosphorus 0.77 carb 4.5
Glam and punk 1% carb, 0.93 phosphorous.

Weruva paw lickin chicken 3.3 carb 0.82 p and
Press your lunch 5.9 carb. 0.82 phosphorous

Bff play Laugh Out Loud chicken and lamb 7.7 carb, 0.82 phosphorous

BFF play destiny (chicken and duck) 0.87 phosphorus 7.7 carb

Bff play chicken cherish 0.71 phosphorus 7.6 carb

Bff play best buds chicken and beef 7.9 carb 0.9 phosphorus

Bff play chicken Checkmate. 7.7 carb 0.7 phos
 
Hi all

I have a little update on Meme’s situation , I will retest her blood Nd SDMA in about a few weeks , but when i took her to check her blood pressure in other clinic , the vet suggested to do a quick urine test to give me some relief and he said the she had a UTI because her LEU is little high. I posted a picture of the test result.

so if she had only UTI , could this be a reason why he creatinine and BUN is little high??

and even with antibiotics i still see her urinating little more than usual and drinking little more water?

how can I treat UTI ? He said the antibiotics will treat it but i just see little improvement.

@Sienne and Gabby (GA)
 

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rawia said:
how can I treat UTI ? He said the antibiotics will treat it but i just see little improvement.
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I suggest asking your vet about using a d-mannose supplement as an adjunct to the antibiotic treatment (it can be mixed into wet food). It might help with the urinary tract issue (it aids flushing out of certain bacteria from the urinary tract and shouldn't impact blood glucose regulation).

If your vet hasn't done so already, it would be an idea to ask about doing a cystocentisis with culture and sensitivity to determine the specific cause of the UTI and therefore the best medicine to treat it.

Meme's a great name. Beautiful girl, too!


Mogs
.
 
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Knowing that there are white blood cells (leukocytes) in Meme's urine really isn't sufficient. To figure out what antibiotic may be needed you have to get a sterile urine sample. The vet needs to do this by using a needle into the bladder (it's called a cystocentesis) and then a culture and sensitivity (C & S) test is done. The latter takes several days as they are growing the bacteria in a culture plate. This allows the vet to identify what the bacteria is and then prescribe an antibiotic that is specifically geared to treat the bacterial infection. Without the C & S, you're vet is just picking an antibiotic out of the air and it may or may not be effective.
 
Thank you all

I will mention this to her vet in the next appointment, I didu the urine test in dufferent clinic , so at her next appointment i will discuss this with our vet and will update you, I well also do the SDMA again if needed.
 
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