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

I don’t think we can predict how long we will hold this dose. Right now it’s working. If there’s a drop under 50 a reduction would be earned. With nadirs as low as 50 you would not increase and hang onto this dose. Reductions can also be earned We need to see what his next move is.
 
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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Sorry to just pop in. I have to look at the labs closer and convert them so I’ll be back in a little bit with some thoughts on the labs. I know it’s late there so you might have to read it tomorrow.
 
Fistuk & Shelly said:
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....
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First, I agree doing the USG will give you a lot of info but as Bhooma said, it must be the first sample of the day because that is the one thwt will be the most concentrated. Also note that if he’s gotten fluids within about 24 hours of doing a USG, it’s not going to be a valid test.

When the SDMA test was first developed, it seemed it would be a much earlier prediction of CKD. However, vets are now finding it can be influenced by comorbidities. Certainly, an elevated BUN can be dehydration if he had not had fluids before that test. His creatinine is not that high so I wouldn’t jump to panic. Usually a kidney infection is best diagnosed with an ultrasound as well as a urine test.

His HCT is kind of low but not yet what is considered to be anemic. Still, it should be above 30%. His MCV is normal so that reduces what can possibly be causing his HCT to be lower. That’s something your vet will need to figure out as well as the significance of his different WBCs.

There’s a balancing act between psyllium, S. boulardi, and egg yolk powder which I use for hairball prevention. My little 7.9 lb girl gets 1/16 psyillium twice a day, 2.5b CFU S boulardi a day, and 1/4 tsp egg yolk powder (from food fur life) twice a day and it keeps her poops really perfect. This is definitely an ECID issue.

I hope that helps.
 
Marje and Gracie said:
First, I agree doing the USG will give you a lot of info but as Bhooma said, it must be the first sample of the day because that is the one thwt will be the most concentrated. Also note that if he’s gotten fluids within about 24 hours of doing a USG, it’s not going to be a valid test.

When the SDMA test was first developed, it seemed it would be a much earlier prediction of CKD. However, vets are now finding it can be influenced by comorbidities. Certainly, an elevated BUN can be dehydration if he had not had fluids before that test. His creatinine is not that high so I wouldn’t jump to panic. Usually a kidney infection is best diagnosed with an ultrasound as well as a urine test.

His HCT is kind of low but not yet what is considered to be anemic. Still, it should be above 30%. His MCV is normal so that reduces what can possibly be causing his HCT to be lower. That’s something your vet will need to figure out as well as the significance of his different WBCs.

There’s a balancing act between psyllium, S. boulardi, and egg yolk powder which I use for hairball prevention. My little 7.9 lb girl gets 1/16 psyillium twice a day, 2.5b CFU S boulardi a day, and 1/4 tsp egg yolk powder (from food fur life) twice a day and it keeps her poops really perfect. This is definitely an ECID issue.

I hope that helps.
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Thanks, Majre. I appreciate your support and this and taking the time to figure this out.

Fistuk didn't have his fluids before the this blood test.
I love hearing there's no reason to jump into panic.

The vet asked if I wanted to schedule an ultrasound but when I asked what would be the purpose she said just if I wanted to maybe it's not necessary. Of course I don't want just to do one more test and spend few hundreds if there's no good reason. So annoying. So I get from you that an ultrasound would actually be necessary for diagnosing kidney infection.

Basically the vet (the hospital vet not the local who conducted the blood test) suspects kidney infection but before she prescribes AN she wanted to do those tests

In past years vets always said he's a bit anaemic. When I asked about it at the hospital they said it's no reason for concern. I've given him B12 methyl for about a month now.

It's mind boggling that up until the moment I gave him the homeopathy his poo was a perfection. But the homeopathy just open the flood gates. And maybe it did us a favour and revealed an underlying disease that was just waiting to explode.

I bit myself for giving him constipation. I'll try gradually to find the balance as you suggested between those three
:bighug:
 
Fistuk & Shelly said:
So I get from you that an ultrasound would actually be necessary for diagnosing kidney infection.
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I’ve had a few older cats that had kidney infections and the culture and sensitivity didn’t reveal it. The ultrasound did. You can take a step at a time, which is very reasonable, but just realize that a negative C&S might not rule out kidney infection. I don’t want to suggest you spend more money than you need to. I have seen CGs where the C&S wasn’t really conclusive and they didn’t want to do an u/s due to the cost so they gave their cat the strong a/bs that are required to address a kidney infection. I wouldn’t do that. The hospital seems pretty savvy so talk to her about best options.

Fistuk & Shelly said:
I've given him B12 methyl for about a month now.
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Unfortunately, methylB12 alone won’t address anemia. It has to be give with a multi B like Jarrows BRight. However, that really pertains to CKD cats. We aren’t 100% certain he has CKD but even if he does, anemia comes much later. That makes me wonder if it is an iron deficiency or some other reason. There are some comorbidities that can cause the HCT to drop.

The best way is to see if he is making reticulocytes. If he is, it’s not the anemia associated with CKD. Really, you want his HCT above 30% so I’d press it with the vets.
 
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