? 7/7 Bear AMPS 130, +4.5 60, +7.5 67, +10 94, PMPS 139. Diagnosed with kidney failure & pancreatitis

[Meredith Bear’s Mom]

Hi everyone,

Bear had his ultrasound today. They diagnosed him with pancreatitis and also with stage 2/3 of CKD. The vet wants me to drop his insulin to 1 unit as she’s worried he’s getting too low. They also want to switch him to Royal Canin hydrolyzed protein, which is a dry food definitely much higher in carbs. As I’m sure most of you know he needs a low protein low phosphorus diet for his kidneys, and they are prioritizing his kidneys over the diabetes. So they want to do a higher carb food and manage the diabetes with increased insulin. I’m feeling really torn because of everything I’ve learned since being here but also wanting to trust the vet. She said she has never seen a cat with as many issues as Bear in her time as a vet. To recap, he came to us with DKA and a kidney infection, of course the diabetes, later was diagnosed with a heart murmur and asthma, now the kidneys and pancreatitis.

Does anyone else have a cat with issues like this? Does anyone have any food recs? Should I follow their advice in dropping insulin?

TYIA.

 

[Meredith Bear’s Mom]

Previous post: https://www.felinediabetes.com/FDMB...5-46-4-5-67-5-84-7-75-75.279258/#post-3086131

also forgot that @Wendy&Neko already gave me the CKD food list so I should be good there!

 

[Meredith Bear’s Mom]

@tiffmaxee @Bron and Sheba (GA) @Diane Tyler's Mom

 

[Bron and Sheba (GA)]

I would not reduce the dose of insulin unless the BGs tell you to as per the TR protocol.
Can you post the blood results so we can see them please?
He doesn’t need low protein food yet. That’s old thinking. He needs low phosphorus. You can feed him a high protein, low carb, low phosphorus diet that is suitable for the kidney, diabetes and the pancreatitis.
I would not feed the high carb dry food.

What have they done for the pancreatitis? He needs pain medication as it’s painful, antinausea meds if he is nauseated or not eating as he normally does and sub q fluids, but you would need to be guided by the vet with the sub Q fluids if he has a heart issue.

 

[Meredith Bear’s Mom]

I would not reduce the dose of insulin unless the BGs tell you to as per the TR protocol.
Can you post the blood results so we can see them please?
He doesn’t need low protein food yet. That’s old thinking. He needs low phosphorus. You can feed him a high protein, low carb, low phosphorus diet that is suitable for the kidney, diabetes and the pancreatitis.
I would not feed the high carb dry food.

What have they done for the pancreatitis? He needs pain medication as it’s painful, antinausea meds if he is nauseated or not eating as he normally does and sub q fluids, but you would need to be guided by the vet with the sub Q fluids if he has a heart issue.

 

[Meredith Bear’s Mom]

@Bron and Sheba (GA) blood results attached. I don’t understand why vets still think that way if it’s so outdated? Makes no sense to me! Same with all the diabetes stuff. His original bloodwork that was taken last week I don’t have copies of. But I can get it and post it.
They gave him buprenoephine for the pain. Hoping that helps him feel better. He is eating great and doesn’t seem to be showing signs of nausea. Sub q fluids are a maybe because of his heart issue, exactly like you said.

Thank you for the recommendations about food.

 

[Bron and Sheba (GA)]

If you could get the blood results from last week and post that would be good. Hopefully it will include the phosphorus result and other blood results.
I’m glad they gave him some bupe. Do you have any to give at home?
It’s great he is eating well.
Once you post the other results I’ll ask Marje to comment on them

 

[Meredith Bear’s Mom]

If you could get the blood results from last week and post that would be good. Hopefully it will include the phosphorus result and other blood results.
I’m glad they gave him some bupe. Do you have any to give at home?
It’s great he is eating well.
Once you post the other results I’ll ask Marje to comment on them

Let me call the clinic today and ask. I’ll also ask for the urine culture results.
And yes, they sent us home with the bupe to give every 12 hours.
Thank you and Marje in advance!

 

[Don & Xena]

Hi everyone,

Bear had his ultrasound today. They diagnosed him with pancreatitis and also with stage 2/3 of CKD. The vet wants me to drop his insulin to 1 unit as she’s worried he’s getting too low. They also want to switch him to Royal Canin hydrolyzed protein, which is a dry food definitely much higher in carbs. As I’m sure most of you know he needs a low protein low phosphorus diet for his kidneys, and they are prioritizing his kidneys over the diabetes. So they want to do a higher carb food and manage the diabetes with increased insulin. I’m feeling really torn because of everything I’ve learned since being here but also wanting to trust the vet. She said she has never seen a cat with as many issues as Bear in her time as a vet. To recap, he came to us with DKA and a kidney infection, of course the diabetes, later was diagnosed with a heart murmur and asthma, now the kidneys and pancreatitis.

Does anyone else have a cat with issues like this? Does anyone have any food recs? Should I follow their advice in dropping insulin?

TYIA.

Bear is such an adorable little fella … I am sorry that he has so many issues going on. I do think though, that he is very blessed to have landed in your home, in your care. I know there is only so much that we as humans can do when it comes to medical issues (for cats AND people for that matter), but for all he has going on you really are doing a great job. You guys are in my thoughts and prayers.
Science and medicine can do quite a bit these days, but there is no substitute for Love.

 

[Wendy&Neko]

I agree with everything @Bron and Sheba (GA) has said.

They diagnosed him with pancreatitis and also with stage 2/3 of CKD. The vet wants me to drop his insulin to 1 unit as she’s worried he’s getting too low.

You test enough to know how low he's getting. The problem with dropping the insulin dose is that he'd then spend more time over renal threshold, making his kidneys work even harder to remove excess sugar from the urine. When Neko got her kidney diagnosis, my goal was to keep her under renal threshold as much as possible.

I don’t understand why vets still think that way if it’s so outdated?

Depends how long ago they got their training, whether they've kept up to date on that particular topic. They have to learn about a lot of conditions and a lot of animals. Sometimes feline specialist vets are more in tune with what a cat needs. Or a consult with an internal medicine vet may help to balance differing needs and meds when a cat becomes more "complicated".

 

[Meredith Bear’s Mom]

Bear is such an adorable little fella … I am sorry that he has so many issues going on. I do think though, that he is very blessed to have landed in your home, in your care. I know there is only so much that we as humans can do when it comes to medical issues (for cats AND people for that matter), but for all he has going on you really are doing a great job. You guys are in my thoughts and prayers.
Science and medicine can do quite a bit these days, but there is no substitute for Love.

This is really sweet. Thank you so much. I needed to hear this

 

[Meredith Bear’s Mom]

I agree with everything @Bron and Sheba (GA) has said.

You test enough to know how low he's getting. The problem with dropping the insulin dose is that he'd then spend more time over renal threshold, making his kidneys work even harder to remove excess sugar from the urine. When Neko got her kidney diagnosis, my goal was to keep her under renal threshold as much as possible.

Depends how long ago they got their training, whether they've kept up to date on that particular topic. They have to learn about a lot of conditions and a lot of animals. Sometimes feline specialist vets are more in tune with what a cat needs. Or a consult with an internal medicine vet may help to balance differing needs and meds when a cat becomes more "complicated".

Exactly what I was thinking too. The ER vet said she’s seen multiple cats come in with insulin overdoses and have to stay multiple days. They even said being in the 60s is too low.

I saw a specialist when Bear was first diagnosed but wondering if it’s time to go back. They had a doctor that I didn’t like very much (she said diet doesn’t matter with diabetic cats and dry food was preferable which shocked me) but I think they have a new doctor on staff.

 

[Wendy&Neko]

The 60's is too low, on pet meters. But you are using a human meter. I think that trips some vets up.

 

[Meredith Bear’s Mom]

The 60's is too low, on pet meters. But you are using a human meter. I think that trips some vets up.

Thats a good point. I did mention that it was a human meter but I don’t know if that registered.

 

[Meredith Bear’s Mom]

@Bron and Sheba (GA) you can let Marge know she can view the results here

Thank you!

 

[Bron and Sheba (GA)]

@Marje and Gracie would you be able to look at Bears lab results please. Some were posted earlier in this thread (post 6) and the rest in the post above this one. Meredith is concerned about the CRD diagnosis and how to manage it as she doesn’t agree with the vets advice. Thanks.