12/1 Max AMPS 205 PMPS 267

[Max & Lori]

I sure wish I could get rid of these higher preshot numbers he’s back to lately. It’s interesting that at a higher dose he stays more flat, but he’s having a few nadirs in the 60’s so I don’t know if there’s anything I can do about that??? I’m really trying to keep him below renal threshold. That’s my goal. He does tend to have some faster drops on this dose causing the bounce.

Max has had a pretty good day. I’ve noticed on the days he gets that little bit of subQ fluids, he’s up and more playful. I’m monitoring his resting respirations frequently and he’s stable around 22-24. Sweet boy played with the feathers on a string just a little while ago. It’s good to see that.
https://felinediabetes.com/FDMB/thr...93-4-70-5-67-6-93-10-134.284088/#post-3127896

 

[Tiger(GA) and Ruth]

@Max&Lori I have been out of it for awhile, have been unable to log in or change my password. Finally I think I got it straightened out, Good Grief! You and Max have been through a lot, I read your SS and as many prev. condos. I am sorry his kidney values have been increasing. You won't believe this but my DH also was found to be stage 3 at his last check up, so I get your anxiety and am glad you posted it here, you are not alone. You are juggling a whole bunch of balls with Max and doing a great job! Max is blessed to have you! Great to read Max was playful today! How would you rate his 5 P's otherwise? I hope that you are able to see the specialist earlier than January, but this seems to be the way it is with not only veterinarians but our regular Dr's as well! Is he strictly on the renal foods now? I know you are bugged by the higher preshot but considering the change of diet, his SS looks pretty good. And I do realize I am not Wendy, no dosing advice here but I am here for moral support! Hugs!

 

[Max & Lori]

How would you rate his 5 P's otherwise? I hope that you are able to see the specialist earlier than January, but this seems to be the way it is with not only veterinarians but our regular Dr's as well! Is he strictly on the renal foods now?

Thank you Ruth. I’m sorry about your DH’s kidney disease. It does cause me a lot of worry about Max. He has good days and bad. Some days he’s playing and purring and others he just stays in his bed. All the other 5 P’s are normal. I doubt that I will be able to get to the IM before January (when his appointment is). They talked like they are booked up and then the holidays coming. That worries me also because it seems like a long time from now. I hope he can stay stable. He is eating mostly the renal diet, but he also is getting some Weruva that’s low in phosphorus. Max likes a variety of foods and gets tired of the same thing so I have to keep it interesting so he will keep eating. His appetite is not as big as it has been but he does eat his normal food and snacks. He’s just not sitting by the food bowl as much. Life has thrown us some major punches and I’m just trying to keep up. Max is like a little piece of my heart though. I am just sick that this is happening to him.

 

[Max & Lori]

Also thanks for the moral support and your comments as always. It helps to know someone else cares.

 

[Staci & Ivy]

I sure wish I could get rid of these higher preshot numbers he’s back to lately. It’s interesting that at a higher dose he stays more flat, but he’s having a few nadirs in the 60’s so I don’t know if there’s anything I can do about that??? I’m really trying to keep him below renal threshold. That’s my goal. He does tend to have some faster drops on this dose causing the bounce.

Max has had a pretty good day. I’ve noticed on the days he gets that little bit of subQ fluids, he’s up and more playful. I’m monitoring his resting respirations frequently and he’s stable around 22-24. Sweet boy played with the feathers on a string just a little while ago. It’s good to see that.
https://felinediabetes.com/FDMB/thr...93-4-70-5-67-6-93-10-134.284088/#post-3127896

He must feel better when he gets the fluids, Lori. Since you are seeing a definite increase in his overall happiness.
Glad to hear his overall mood and 5 p’s are good. He’s so sweet.

Is there another specialist office you could try to get an appointment with sooner locally? Or, maybe call each week to ask if they have had a cancellation. Can’t hurt to be a gentle, squeaky wheel.
Hugs to you and Max for a feeling good Caturday

 

[Max & Lori]

I guess no answers mean there’s nothing else to do about keeping him under renal threshold. I posted yesterday with a question mark in his title, but maybe I’m just looking for something that can’t be answered (and a little reassurance if I can get it). I’m used to his bouncing and it hasn’t bothered me much until his kidneys went bad. Someone (not here) told me their cat with stage 3 CKD and heart dz only lasted a month and since then I’ve been so worried and anxious. Then someone here (in a dm) told me their cat’s kidney values crashed suddenly like Max’s and it wasn’t a good outcome. I don’t know what to expect with acromegaly, CKD and heart disease. Those are some big, scary diagnoses and me not being knowledgeable about all of this makes me feel so unsettled. I am exhausted. When my questions don’t get answered it just makes me more nervous because I think people don’t want to upset me further. I can’t hardly wait to see the IM vet. That would help… I hope. I’m fighting hard for Max and I've probably been a squeaky wheel for a while now with his own vets and maybe here too. His higher pre shots are probably just bounces, but I’ve never understood why Max’s duration ends before the next preshot. I’ve taken it as he’s a bouncy cat. I was always told not to feed after nadir, but I just read another condo where someone said that they fed their cat @+9 then a light snack at PMPS. Maybe I will try that and see if it helps the bouncing.
Thank you for commenting @Staci & Ivy but I like NCSU where all of his records are. I will keep trying though. I hope you and Ivy have a great day today and she gives you a good cycle today.

 

[Staci & Ivy]

I guess no answers mean there’s nothing else to do about keeping him under renal threshold. I posted yesterday with a question mark in his title, but maybe I’m just looking for something that can’t be answered (and a little reassurance if I can get it). I’m used to his bouncing and it hasn’t bothered me much until his kidneys went bad. Someone (not here) told me their cat with stage 3 CKD and heart dz only lasted a month and since then I’ve been so worried and anxious. Then someone here (in a dm) told me their cat’s kidney values crashed suddenly like Max’s and it wasn’t a good outcome. I don’t know what to expect with acromegaly, CKD and heart disease. Those are some big, scary diagnoses and me not being knowledgeable about all of this makes me feel so unsettled. I am exhausted. When my questions don’t get answered it just makes me more nervous because I think people don’t want to upset me further. I can’t hardly wait to see the IM vet. That would help… I hope. I’m fighting hard for Max and I've probably been a squeaky wheel for a while now with his own vets and maybe here too. His higher pre shots are probably just bounces, but I’ve never understood why Max’s duration ends before the next preshot. I’ve taken it as he’s a bouncy cat. I was always told not to feed after nadir, but I just read another condo where someone said that they fed their cat @+9 then a light snack at PMPS. Maybe I will try that and see if it helps the bouncing.
Thank you for commenting @Staci & Ivy but I like NCSU where all of his records are. I will keep trying though. I hope you and Ivy have a great day today and she gives you a good cycle today.

Hi Lori, I understand about keeping Max at the practice where you are most comfortable. I was just trying to think of alternative ideas to get Max seen.
Perhaps tagging some more expert advisors can help here
@Wendy&Neko @Sienne and Gabby (GA) @Bron and Sheba (GA)

 

[Max & Lori]

Hi Lori, I understand about keeping Max at the practice where you are most comfortable. I was just trying to think of alternative ideas to get Max seen.
Perhaps tagging some more expert advisors can help here

Thank you for that Staci. I know you’re trying to help with that suggestion. I actually thought about it too. The other specialist center where I live has an even longer wait list for new patients. I’m going to keep doing what I’m doing. Max gives me some good days sometimes and that gives me some reassurance, even for a little while. I’m thankful for that.

 

[Sienne and Gabby (GA)]

Lori -

Have you talked to your vet about using a phosphorus binder? It's a tasteless addition to his food. It will allow you to feed Max anything. You just need to remember to add the prescribed amount to his meals.

 

[Max & Lori]

Lori -

Have you talked to your vet about using a phosphorus binder? It's a tasteless addition to his food. It will allow you to feed Max anything. You just need to remember to add the prescribed amount to his meals.

Thanks Sienne, I haven’t asked about that. His phosphorus was on the high end of normal and his calcium was slightly elevated. I would definitely give it to him. What kind of phosphorus binder should I ask for, any specific thing? I’m going this morning to get something else from the vet. I could ask for that also.

 

[Sienne and Gabby (GA)]

If you've never seen Tanya's site for feline kidney disease, it's wonderful. They also have a support group.

I'd suggest adding something to your subject line such as "CKD info needed". There are a lot of people who have cats with kidney issues. It's common both with aging and with diabetes.

 

[Max & Lori]

If you've never seen Tanya's site for feline kidney disease, it's wonderful. They also have a support group.

I'd suggest adding something to your subject line such as "CKD info needed". There are a lot of people who have cats with kidney issues. It's common both with aging and with diabetes.

I have been on Tanya’s CKD site several times. I’m still learning from there. It’s a lot of good info. I will try and put more in the title from now on. Thanks for your help!

 

[Max & Lori]

Max’s vet gave me some aluminum hydroxide to give 4 cc twice a day for phosphorus binder.

 

[carfurby (GA)]

 

[Wendy&Neko]

Nice cycle today. Max telling you to have patience.

sure wish I could get rid of these higher preshot numbers he’s back to lately. It’s interesting that at a higher dose he stays more flat, but he’s having a few nadirs in the 60’s so I don’t know if there’s anything I can do about that???

It's a tradeoff. You could increase his dose by 0.25 units, but the risk is him going below 50.

Have you tested to see what renal threshold is for Max? Neko's IM vet said just brief foray's above renal threshold weren't an issue, it was staying there that needed to be addressed.

Aluminum hydroxide is what I gave Neko too. I think it's the most common one given.

I've posted to you before about the sudden changes in kidney numbers. I think I said before that the SCL group I belong too (mostly older kitties), kidney infection is most often the cause of sudden worsening of kidney numbers. But acro is also hard on kidneys. I'd rule out kidney infection first.

 

[Tiger(GA) and Ruth]

Hi again Lori, I had forgotten to mention the Tanya's Website yesterday, I am still on their mailing list so I read the forum posts daily even though my current two kitties are not CKD. The info and especially the support group is so good, I am glad Sienne mentioned it as it is worth repeating.

One more thing, I see you got an Rx for the phosphorus binder? I am sure your vet probably warned you, but it can cause constipation, nausea, vomiting, etc. I looked in Max's SS, I could swear Max was taking something like psyillium for constipation? I could not find it documented this time though? Just be aware if he does get constipated or shows other GI symptoms. Also, if he is taking pysillium (I cannot spell this word no matter how hard I try LOL) it can interfere with absorption of certain other medications as well as vitamins/supplements. I found this out at my last Dr. check up

You are doing a great job with Max, he is very blessed to have you as his caregiver! I know it is ridiculous to say this, but try not to freak out with the numbers. Max is much more than his numbers. And please take good care of yourself as well,

 

[Max & Lori]

It's a tradeoff. You could increase his dose by 0.25 units, but the risk is him going below 50.

Have you tested to see what renal threshold is for Max?

I will be patient for now. I’m more anxious about his numbers because of the CKD making it more difficult to think clearly. I want to do what’s best for Max and now I have so much more to learn. Thats what I’m trying to do by reading and asking questions. Eventually maybe I will find my way. I’ve said before that sometimes I just need someone to tell me what to do right now.

I have not checked renal threshold for Max. I was just going by what normal serum glucose range is and trying to keep him there.

You did tell me to check for kidney infection and I took him back to the vet for that. She only did a urine culture which was negative, but Marje told me he needed a kidney ultrasound. I also read that on Tanya’s site. My vet does not do this so the only thing I know to do is ask when I can finally get him to IM. I know that’s not ideal but don’t have any choice.
Thanks.

 

[Wendy&Neko]

The renal threshold on cats is somewhat ECID. I've seen some in low blues, but I know Neko's was at least 240. You can figure it out if you get Ketodiastix and see when his sugar spills into his urine, at what BG. I did the easy way, and tested Neko's BG just before she got a urinalysis done. If Max is good for low yellows, you won't feel quite so stressed when he ventures there.

 

[Max & Lori]

I see you got an Rx for the phosphorus binder? I am sure your vet probably warned you, but it can cause constipation, nausea, vomiting, etc. I looked in Max's SS, I could swear Max was taking something like psyillium for constipation? I could not find it documented this time though? Just be aware if he does get constipated or shows other GI symptoms.

Thank you. She did not warn me of the constipation, but I read about that on Tanya’s site. I guess he will have to take Miralax now as well. Just like everything with Max, one treatment for one thing is not the best for the other problems he has. Trying to balance it again I guess. You are right. He does take psyllium and has constipation issues now since he’s gotten CKD.

 

[Max & Lori]

The renal threshold on cats is somewhat ECID. I've seen some in low blues, but I know Neko's was at least 240. You can figure it out if you get Ketodiastix and see when his sugar spills into his urine, at what BG. I did the easy way, and tested Neko's BG just before she got a urinalysis done. If Max is good for low yellows, you won't feel quite so stressed when he ventures there.

I was trying to figure that out by looking at all of the labs he has had done, but I can get some ketodiastix and check it. You are right, I probably would feel better if I knew. Sorry I’m so stressed out. As you know, it really feels overwhelming trying to tackle all of it.

 

[Wendy&Neko]

The hardest thing for me was accepting that there is only so much I could do to help.

 

[Staci & Ivy]

Thank you. She did not warn me of the constipation, but I read about that on Tanya’s site. I guess he will have to take Miralax now as well. Just like everything with Max, one treatment for one thing is not the best for the other problems he has. Trying to balance it again I guess. You are right. He does take psyllium and has constipation issues now since he’s gotten CKD.

Hi Lori, Ivy also takes a phosphorus binder. 1/4 tsp in am and 1/2 tsp at pm mixed in her meal. To date it hasn’t caused constipation. She also takes psyllium husk in her food. But of course ECID. And you will watch the results.