Advice for sam

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chuckstables

chuckstables

Member Since 2022
Hey folks,

When sam had his initial diagnosis, his kidney values were borderline low. He also had high urea, and low calcium. He might develop CKD (or might have CKD, but unlikely according to the vet, and I can't spend another 450 bucks on another blood panel; I'll wait till he's regulated). So; what should I be doing to help him?

Should I be giving vitamins/supplements? Phosphate binders? What should I be doing here? He's 12 at this point (almost 12). Would a blood panel every year or so be acceptable?

Also; I had read somewhere there's a society that can help with the cost of test strips. Can't seem to find their info anywhere; can someone link me to them? I'm going broke pretty quickly because of this D:
 
chuckstables said:
Hey folks,

When sam had his initial diagnosis, his kidney values were borderline low. He also had high urea, and low calcium. He might develop CKD (or might have CKD, but unlikely according to the vet, and I can't spend another 450 bucks on another blood panel; I'll wait till he's regulated). So; what should I be doing to help him?

Should I be giving vitamins/supplements? Phosphate binders? What should I be doing here? He's 12 at this point (almost 12). Would a blood panel every year or so be acceptable?

Also; I had read somewhere there's a society that can help with the cost of test strips. Can't seem to find their info anywhere; can someone link me to them? I'm going broke pretty quickly because of this D:
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If you have his bloodwork you can manually put it in on his spreadsheet in the bloodwork tab or you can put pictures on here of it & one of the members can take a look at @Suzanne & Darcy is very good at reading the results & explaining it.
 
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As far as I can tell; the high cholosterol isn't abnormal in newly diagnosed diabetic cats. The low potassium would likely be from the excessive water consumption and excessive urination, the high Urea would be from acute kidney dysfunction caused by excessive water intake/filtering out the excess glucose from the blood, same with the borderline low MCV, as that indicates kidney function.
 
Potassium deficiency can definitely be due to excessive water consumption and therefore dehydration from loss of electrolytes! Things that you can feed him to try and boost his potassium that are diabetes safe are:
  • Salmon
  • Chicken
  • Lamb
If I am remembering correctly, you feed Sam chicken as a treat right? So it seems you're on the right track there!

Very glad that his creatinine levels are normal, but definitely keep an eye on those values in future tests. Creatinine is a waste product from muscle wear and tear, and is constantly around bc of that, but would get elevated if the muscles are wasting away. It is a potential predictor if he is experiencing something serious and chronic, such as kidney disease. Unfortunately thats about all I know, sorry. I would ask your vet how often to do blood panels, and what kinds of situations you would need to have it checked outside of whatever cycle you decide (such as yearly or twice a year, etc)
 
chuckstables said:
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upload_2022-9-13_18-40-37-png.65373
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I do not see indications of kidney disease in these blood values (that’s a relief!) His phosphorus levels appear to be within normal limits. I also don’t see any indication of significant dehydration such as an increased RBC or PCV (they didn’t include PCV in the panel actually) and the Albumin and Globulins are not elevated.

Oftentimes, low electrolytes (sodium, potassium and chloride) are seen in unrelated diabetic cats due to the large volume of dilute urine that diabetic cats produce (where excessive amounts of these electrolytes may be lost in the urine.) I would expect this to improve with better regulation and BG mostly under approximately 250 where the excess urination is usually not present (ECID.) Sam is getting so much better numbers now (when he’s not bouncing) that I expect these numbers to improve. Without going into any elaborate explanations, liver enzymes can also be elevated in unrelated diabetic cats (also related to decreased blood flow to the liver due to dehydration.) Sam’s ALT was at the high end of the range. I expect that also has improved.

The thing that really caught my attention is his elevated Reticulocyte count, while his Hematocrit is WNL (although on the lower end of normal.). So his bone marrow is responding to an increased need for red blood cells but he was not clinically anemic. I don’t want to go into any alarming potential causes for that as it doesn’t seem too severe and it could just be an isolated result. If Sam were my kitty, I would save up and repeat bloodwork in six months. I bet you will see improvements! One year is a long time for a 12 year old cat. Having said that, the blood panel that I typically request the vet to run is the IDEXX Total Health Plus Basic, which is “only” $98 and includes a T4. I am shocked at a $450 price tag for that bloodwork unless it included exam fees and urinalysis and other stuff I am not seeing. Wow! Just Ouch and Wow! I have quite a few cats and none pf them would be getting much bloodwork done ever with those prices. Maybe if he seems to be doing well you can stretch it a month or two?

Did they check his thyroid or do a urinalysis? Or this is it? Were there any other notes on the lab results?
 
Suzanne & Darcy said:
I do not see indications of kidney disease in these blood values (that’s a relief!) His phosphorus levels appear to be within normal limits. I also don’t see any indication of significant dehydration such as an increased RBC or PCV (they didn’t include PCV in the panel actually) and the Albumin and Globulins are not elevated.

Oftentimes, low electrolytes (sodium, potassium and chloride) are seen in unrelated diabetic cats due to the large volume of dilute urine that diabetic cats produce (where excessive amounts of these electrolytes may be lost in the urine.) I would expect this to improve with better regulation and BG mostly under approximately 250 where the excess urination is usually not present (ECID.) Sam is getting so much better numbers now (when he’s not bouncing) that I expect these numbers to improve. Without going into any elaborate explanations, liver enzymes can also be elevated in unrelated diabetic cats (also related to decreased blood flow to the liver due to dehydration.) Sam’s ALT was at the high end of the range. I expect that also has improved.

The thing that really caught my attention is his elevated Reticulocyte count, while his Hematocrit is WNL (although on the lower end of normal.). So his bone marrow is responding to an increased need for red blood cells but he was not clinically anemic. I don’t want to go into any alarming potential causes for that as it doesn’t seem too severe and it could just be an isolated result. If Sam were my kitty, I would save up and repeat bloodwork in six months. I bet you will see improvements! One year is a long time for a 12 year old cat. Having said that, the blood panel that I typically request the vet to run is the IDEXX Total Health Plus Basic, which is “only” $98 and includes a T4. I am shocked at a $450 price tag for that bloodwork unless it included exam fees and urinalysis and other stuff I am not seeing. Wow! Just Ouch and Wow! I have quite a few cats and none pf them would be getting much bloodwork done ever with those prices. Maybe if he seems to be doing well you can stretch it a month or two?

Did they check his thyroid or do a urinalysis? Or this is it? Were there any other notes on the lab results?
Click to expand...

I’ll take a look; think this was it. I’m canadian, maybe thats why it costs so much more?
 
I have compared some veterinary costs with a few Canadian friends and their costs were significantly higher than mine - at least for vet visits and lab tests- that much I can recall. But you do have less expensive insulin at least.

How is Sam doing these days. What changes have you noticed in him since you started insulin?
 
Suzanne & Darcy said:
I have compared some veterinary costs with a few Canadian friends and their costs were significantly higher than mine - at least for vet visits and lab tests- that much I can recall. But you do have less expensive insulin at least.

How is Sam doing these days. What changes have you noticed in him since you started insulin?
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He’s doing great. He’s gained weight; 12.5 lbs now from 9.5, he drinks a normal amount of water (usually 50 mls or so, he gets the rest now from his wet food). More energy, can jump up on the couch and bed with no issues. Isn’t constantly begging for food. The drinking and peeing stopped when i switched from caninsulin to lantus, he’s back on 1 unit per day now (he was on 3 just 3 weeks ago, turns out he was being overdosed on it, not underdosed).
 
chuckstables said:
He’s doing great. He’s gained weight; 12.5 lbs now from 9.5, he drinks a normal amount of water (usually 50 mls or so, he gets the rest now from his wet food). More energy, can jump up on the couch and bed with no issues. Isn’t constantly begging for food. The drinking and peeing stopped when i switched from caninsulin to lantus, he’s back on 1 unit per day now (he was on 3 just 3 weeks ago, turns out he was being overdosed on it, not underdosed).
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This is so great to hear! That’s what it’s all about! Thank you for making me smile.
 
chuckstables said:
@Suzanne & Darcy I just posted what I believe is his urine test
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That looks good, at least they tested it as part of your overall charges. I don’t see the ketones on there, but I believe you mentioned that he was positive for some ketones when you first took him in. I am glad that he was diagnosed in time. I think that you must have been watching him closely and got him in for diagnosis in good time.
 
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