09/26 AMPS 86, +2 72, +3.5 59, +4.5 59, +5.5 52, +6.5 68, +7.5 76, +9 86

Fistuk & Shelly

Fistuk & Shelly

Member Since 2023
https://www.felinediabetes.com/FDMB...04-6-103-10-148-pmps-157.281914/#post-3108214

Good morning :)

Fistuk seems to suffer now from constipation. He had a bowl movement last night at +3 which had one formed piece in a good colour topped up with a blob of lighter colour. This morning he had another stool which was mostly formed pieces.

But he keep on walking around the house and from one little box to another trying to get something out without success.

I'm happy he ate for breakfast with the shot.

I gave him 1tsp of psyllium husk yesterday and same the day before. This morning I didn't.

I'd love to have your help/insight on yesterday's lab results. He WBC is pretty high.
:bighug:
 
Hi Shelley,

I was just looking at the labs.

Yes his WBC count was high, along with the neutrophils and lymphocytes.
I believe that indicates inflammation or infection.

His sdma is high did they tell you anything about that?
Creatinine and BUN as well.
 
Gill & George said:
Hi Shelley,

I was just looking at the labs.

Yes his WBC count was high, along with the neutrophils and lymphocytes.
I believe that indicates inflammation or infection.

His sdma is high did they tell you anything about that?
Creatinine and BUN as well.
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Hi Gill

Do you know what high neutrophils and lymphocytes means? Also Creatinine and BUN. I can see they're out of range but don't know how to interpret ...

The vet said inflammation but couldn't say what's the source. She reckoned the diarrhoea.

The Kidney she said could be related to the diabetes. There's another kidney lab measure she had to send to another lab. I'll have the results in couple of day. Sid't say more than that.
 
The BUN, creatinine and high SDMA point to kidney disease, the SDMA is a specific kidney test, supposedly the gold standard.

However, the SDMA can be affected by dehydration, and with his diarrhea it's possible that might be dehydrated and cause the sdma result not to be reliable.

I don't know what specific infections/inflammation we should be looking at.l, with the high WBC, neutrophil and lymphocytes

Let me tag @Marje and Gracie she's always the person I ask about lab results. She may be able to better advise you.
 
Fistuk & Shelly said:
The vet said inflammation but couldn't say what's the source. She reckoned the diarrhoea.
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Did you take a stool sample?
Wondering if that might help determine the cause of the gastrointestinal problems.

Though seems like he's gone the other way with that now.

When he was hospitalised a couple of weeks ago did they give him any antibiotics? Or steroids then?
 
Gill & George said:
antibiotics? Or steroids then?
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no. not the I'm aware of steroids but I'll reconfirm when hospital vet calls me today. I normally scare the bejesus out of them giving AB or steroids without asking me first...

Gill & George said:
Did you take a stool sample?
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I didn't but I can probably still get some from this morning's bc I packed it separately in a bag. Do you think it'll still be good?
 
I find myself quite alarmed by the idea of kidney disease. I just needed to put it out here because that fear can cause me to wait before I taking an action....
 
Fistuk & Shelly said:
not the I'm aware of steroids but I'll reconfirm when hospital vet calls me today. I normally scare the bejesus out of them giving AB or steroids without asking me first...
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:joyful: I am seeing an image of you scaring the polite Swiss vet:joyful:
I'd do the same
Fistuk & Shelly said:
didn't but I can probably still get some from this morning's bc I packed it separately in a bag. Do you think it'll still be good?
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No idea, ask the vet if it's worth it

Fistuk & Shelly said:
Shall I take a +3 or +4 ?
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What do you think? Given the +2 was lower? ;)


Fistuk & Shelly said:
I find myself quite alarmed by the idea of kidney disease. I just needed to put it out here because that fear can cause me to wait before I taking an action....
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Ok we will remind you. George has had kidney disease since 2017, it limits what foods I can give him, and he gets fluids regularly with his food.

If you need to I can point you on the right direction of foods that are both kidney and FD friendly.
 
Gill & George said:
:joyful: I am seeing an image of you scaring the polite Swiss vet:joyful:
I'd do the same
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:p

Gill & George said:
What do you think? Given the +2 was lower? ;)
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Yes... but at +3 I was on a call so thought it'll be ok to take a +3.5. He is indeed going down... I hope not too much :banghead:

by the rhythm of his numbers I'm thinking of taking +4.5 do you think it's the right call?

Gill & George said:
Ok we will remind you. George has had kidney disease since 2017, it limits what foods I can give him, and he gets fluids regularly with his food.
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A reminder is most welcome. Also foods that are good for both kidney and FD :bighug:
 
He is looking great today :bighug:
Did they do a blood test while he was hospitalized? Maybe if they did you could ask them, it would be easier to interpret his WBC with a more recent one, to see if he is going up or down.
 
I am waiting (so far all day!) for a call from the hospital's vet.

But yet they did and it's a good point. I just checked the lab in the SS. He is going down a bit in compared to the first time he was hospitalised on 08/04. Strangely they didn't on 08/31. a shame. I don't know if it's significant but it's gone down from 37.4 to 34.13.

Also I'm noticing that it went up with ketones. Bc before ketones it was 18.7. Out of range but just a bit. So I'm wondering if the elevated WBC is ketones related ?!

Good point - thank you :bighug:
 
What a gorgeous green cycle! A teaspoon of psyllium husk might be too much fiber. Try 1/4.
With the bg staying good infection seems less likely to me than inflammation. I’d probably recheck in a month rather than waiting 2-3 depending on how’s he’s feeling.
 
Gosh if I'll be able to repeat what the vet said I deserve a prize :woot:

So she suggested to collect urine to test the gravity (can't remember what for). We all have an appointment so she could collect urine directly from the bladder and she wants to check his blood pressure.

She suspects inflammation and wants to see the kidney's function (I think that's the urine collection) and if there's any inflammation in the kidney.

She also said that diarrhoea could be because of dehydration even though I give SQ daily.

So more to come on that front....
 
Fistuk & Shelly said:
I started with 1/2 tsp and it didn't seem to do anything so I gave him 1tsp in total throughout the day
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That is way too much! From Tanya's website:
"If you are using loose psyllium, you only need to give a tiny amount. The maximum dose is ⅛th of a teaspoon, but you should start with an even smaller dose.

With fibre-based treatments, it is very important to ensure that the cat drinks plenty of water, otherwise the fibre can bulk up in the body and make the constipation worse. Therefore if you mix it with your cat's food, it is probably wise to add a little water too."
http://felinecrf.org/constipation.htm#psyllium
 
Bandit's Mom said:
"If you are using loose psyllium, you only need to give a tiny amount. The maximum dose is ⅛th of a teaspoon, but you should start with an even smaller dose.
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:(
Bandit's Mom said:
With fibre-based treatments, it is very important to ensure that the cat drinks plenty of water, otherwise the fibre can bulk up in the body and make the constipation worse. Therefore if you mix it with your cat's food, it is probably wise to add a little water too."
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I have. I mixed it with the food and added. lot of water bc I know how psyllium sucks water. I also have him water with syringe. But perhaps it was still not enough :(
 
Fistuk & Shelly said:
So she suggested to collect urine to test the gravity (can't remember what for). We all have an appointment so she could collect urine directly from the bladder and she wants to check his blood pressure.
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Urine Specific Gravity is one of the tests used to see if a cat has CKD. Cats with CKD cannot concentrate their urine. CKD cats are also prone to hypertension. But BP readings at the vet can be artificially elevated (just like BG) due to "white-coat syndrome".

Fistuk & Shelly said:
She also said that diarrhoea could be because of dehydration even though I give SQ daily.
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This is a new one. I know diarrhoea could cause dehydration but this is the first I've heard of dehydration causing diarrhoea! But I'm no expert on feline health!

As for the elevation in his kidney values, you might want to test for an infection (as was suggested by others). That can elevate kidney values.

From Tanya's website:

"Your vet should also rule out pre-renal causes (such as dehydration) and causes of acute kidney injury (AKI) because SDMA may be elevated in cases of AKI or if any other condition is present that reduces blood flow through the kidneys."

"Urine Specific Gravity
Measuring urine specific gravity may indicate loss of concentrating ability before anything shows in bloodwork.

However, a cat may have dilute urine for other reasons, such as diabetes, so this is only a guide, not a definitive method of diagnosis. Also, once a cat is receiving fluid therapy, USG can be rather unreliable."


Creatinine: Sudden Increase

If BUN and creatinine rise suddenly, your cat may have developed acute kidney injury or acute kidney disease on top of CKD (ACKD). There is often a particular cause, such as a kidney infection or hypertension. Kidney stones which cause blockages may also cause a sudden and high rise in both BUN and creatinine.



Other Reasons for Raised Creatinine

Cats with a complication of diabetes called ketoacidosis may have elevated BUN and creatinine levels, particularly if potassium and phosphorus are normal.
 
Bandit's Mom said:
Cats with a complication of diabetes called ketoacidosis may have elevated BUN and creatinine levels, particularly if potassium and phosphorus are normal.
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Thank you, Bhooma. That's all very interesting particularly this one bc I had a feeling that it's related to ketones.

Bandit's Mom said:
kidney infection
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That's what the vet suspects which is why, if I remember correctly, she wants to take urine sample from the bladder

Bandit's Mom said:
BP readings
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Yes that I immediately thought of!
 
Fistuk & Shelly said:
Read on Tanya's website and watched the video. No way to get Fistuk relaxed at the vet :( As soon as we arrive at the building he starts stressing out and relaxes only when we're back in the car.
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I think I would focus on the urinalysis to see if you can identify whether there is an infection. That would explain a lot of the elevated values. No harm in getting his BP checked, though!
 
To check for infection you need the vet to get the sample so it’s sterile. To check USG a free catch is fine. Psyllium bark helps with diarrhea but too much can cause constipation. Once Chai’s stool was normal I stopped giving it. She did get 1/8 t.

I would not bother with bringing in a free catch. When giving fluids the urine will be diluted.
 
tiffmaxee said:
I would not bother with bringing in a free catch. When giving fluids the urine will be diluted.
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I did ask her if there's any point to brining urine if I anyways bring him for checkup. The thing is that she said she might not be able to get a sterile sample from the bladder if it's empty. She could only give me an appointment to Thursday morning which quite guarantees his bladder will be empty. He either pees at 6am or at BF time, 8am. I need to call tomorrow to the other branch of this clinic to see if another vet can give me an appointment for Friday afternoon.

I managed to get some pee from him now but indeed I suspect it's quite diluted.
 
Fistuk & Shelly said:
I did ask her if there's any point to brining urine if I anyways bring him for checkup. The thing is that she said she might not be able to get a sterile sample from the bladder if it's empty. She could only give me an appointment to Thursday morning which quite guarantees his bladder will be empty. He either pees at 6am or at BF time, 8am.
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For testing USG, the first pee of the day is recommended since it is most concentrated. if you can get a sample (mid-stream), might as well take it along, although like Elise said, you need a sterile sample to test for infection.

Fistuk & Shelly said:
+11 108
Quite a jump
It was a beautiful cycle
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Might be bouncing from the 50s he surfed today. Good to see him hold the 2U dose :-)
 
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