10/15 Tess AMPS~212 PMPS~227 +4~420 +8~353 +11~311 labs ???

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Ann & Tess GA

Ann & Tess GA

Member Since 2010
10/14 Condo
10/14 RECAP:
• AMPS~374 fed 1oz. 4% Wellness Turkey, 0.1 (4 drops) Lev , Cosequin , Miralax
  • • +2 fed .5oz. 4% Wellness Turkey
    • +3 fed .5oz. 4% Wellness Turkey
    • +4~379 fed .5oz. 4% Wellness Turkey
    • +8~299
    • +11~222
• PMPS~224 fed 1oz. 4% Wellness Turkey, 0.1 (4 drops) Lev
  • • +2 fed .5oz 4% Wellness Turkey
    • +3~241 fed .5oz 4% Wellness Turkey
    • +4 fed .5oz 4% Wellness Turkey
    • +5~239
    • +11~200
• AMPS~212 fed 1oz. 5% FF Salmon, 0.1 (4 drops) Lev , Cosequin , Miralax

Good Morning LL! Tess is taking her own sweet time coming down at least she isn't pink any more! After her reaction last week I did shoot this morning, even though we will be gone. So nailbite_smile nailbite_smile ll day.

I spent last evening getting Tess's lab results online. There is a tab on the bottom of her SS. Dr. Mimi is concerned that her renal values are creeping up (high end of normal) and her urine specific gravity is on the edge of low. We've known that we needed to keep an eye on this, now the vet is suggesting being proactive and wants us to think about calcitriol.

I'd appreciate it if we could get some eyes on her labs and advice if anyone is using calcitriol or dealing w/ earl stage renal problems. Thanks.

WCR All 5 Ps, Clean Plate Club of course since it was FF Salmon now she is purring up a storm in DH's lap. Got to get ready to leave.
 
Re: 10/15 Tess AMPS~212 labs ???

I'm no help on lab interpretaion, I'm just here to cheer Tess' good numbers. Have a great weekend.
 
Re: 10/15 Tess AMPS~212 labs ???

sorry... no help on the labs or the meds, never used it. It is good though I think that she wants to be proactive. Did she suggest any diet change? Just curious, as that was the recommendation from my vet for my early stage renal kitty (not Mannie), though with FD in the mix, I wonder how others do that.

I don't blame you for shooting, even tough you are out most of the day - after how high she went last week. Hopefully she'll eat the fuds you leave, and not all from the get go. save a little Tess for later, OK?

Have a good day, hope the class goes well.
 
Re: 10/15 Tess AMPS~212 labs ???

Morning you two....I am sorry that I know nothing about the lab results...hope someone will be along with some thoughts.
Good that your vet is on top of things though. I think it's always good to know about these things ahead of time and maybe look for things to do to help prevent it from getting worse.
Hope you guys have a good day...sending hugs to you both! :YMHUG: :YMHUG:
 
Re: 10/15 Tess AMPS~212 labs ???

Interesting bloodwork results. Some things don't really click in my mind. For instance, her BUN/creat are not too bad at all so the USG doesn't make a whole lot of sense to me because she definitely has dilute urine although alot of CRF cats have USG below 1.012. I'm pretty sure you don't give fluids, right?

As an example, Teddi and Gus have very similar blood work. They are both about in the 3.5 range on creat and mid 50s in BUN. Both of them run about 9.8 on Ca and just about 5 on P. Teddi's USG was always about 1.025 even with fluids. Gus's runs just a little less with fluids. Fluids cause the urine to appear to be more dilute so it's good to have a baseline USG before squids are started because once you do start, unless you do not give them the day or so before the urine is taken, your USG will always be more dilute on the tests.

Her P is elevated although it would be interesting to see what her labs over the years show as her norm. Certainly if she has always been around 4, creeping up to 5 is a concern as you want to catch those changes early. Increases in P could possibly indicate hyperparathyroidism but to know for sure, you'd have to have a PTH/ionized Ca test done and I would certainly recommend that before you start calcitriol. I do not think it is wise to start it without making sure that she has an issue there. You might be better off trying to lower her P by feeding lower phosphorus foods; Jill has a list of low phosphorus/low carb foods on Alex's SS. In small doses, calcitriol should not raise the Ca but it is possible and you really don't want her Ca going up any more.

In the yahoo CRF group, there are some people that use calcitriol. You do have to do additional blood monitoring to ensure the levels are balancing out. I did have Teddi's PTH and ionized Ca checked and they were normal even tho her P came up a little. I chose to address her P levels with lower phosphorus foods and a phosphorus binder (aluminum hydroxide powder) rather than worry about calcitriol. I didn't even have Gus's PTH/ionized Ca checked....I just went the same route as with Teddi on lowering the P through food and binders.

Here's the link to Tanya's website that discusses the different tests and also discusses P and Ca.
Test Results

Keep in mind that these are my thoughts for a non-diabetic cat. I'm not sure how FD thrown in there affects all of this but there is discussion of glucose on Tanya's site and I know there are FD CRF cats in the yahoo group.

Let me know if you have any questions or how I can help.
 
Re: 10/15 Tess AMPS~212 PMPS~227 labs ???

Good evening, guys!! I'm not much help on the labs... Willie's BUN and Creatine were high on his last bloodwork, though I've been told that isn't uncommon when feeding a low carb/high protein diet. I've tried to stick to low phosphorus foods for Willie... BG Turkey and Wilderness Duck are two varieties we use. I've added some higher phosphorus foods lately, but I mix them with one of the low phos foods and some raw so that the phos is diluted. Fingers and paws crossed you have a clear path on how to proceed soon!
 
Re: 10/15 Tess AMPS~212 PMPS~227 +4~420 +8~353 +11~311 labs

Good morning Ann,
I only have a minute here this morning and have to run to work, but wanted to throw in my two cents quickly!

(In humans (my go to disclaimer ;-) )Calcitriol is a form of vitamin D that is used to treat and prevent low levels of calcium in the blood of patients whose kidneys or parathyroid glands are not working normally . Level of intact Parathyroid Hormone (iPTH) may rise early in occult renal disease, so it would be worth wild to check because persistent renal secondary hyperparathyroidism furthur damages many tissues, including the kidney. Typically, if this was going on, you'd see lower calcium levels and higher phosphate levels. Think of calcium and phosphorus as a scale, and they're either in balance, or one is high and one's low .....I would get it checked though because you could be finding this so early, that the lab effects aren't being seen.

I think there are enough very small indicators of early renal failure to take some proactive steps. So good for you guys for watching this so closely, because the changes are so slight and the lab values are still very normal....that it could have been easily missed.

Here is what we would do in humans:
Dietary modifications:
This is all based on what the kidney can and cannot do when damaged. It's our filter, so the less waste we can add, the better (and especially early...the less we have to make it work, the better).
It also regulates fluids, so fluid balance becomes an important factor...the body now has a harder time getting rid of fluids so too much can be a big problem, but conversely, the kidney's can't concentrate urine, so dehydration can also be a problem. Daily weights are the best and earliest indicator of fluid balance problems.
A phosphorus restricted diet is recommended (and you have ruled out primary hyperparathyroidism). If diabetes wasn't an issue, low protein would be high on the list.....I don't know if there's some balance here your vet could help you with. Phosphate binders are great when phosphate levels are high (yours really are in a normal range right now and I have a hunch that diet alone could handle at this point).
We would also give ACE inhibitors to lower the vaso-constriction that is generally occurs with renal failure. Blood pressure checks would indicate if this is an issue for Tess....and I just did a quick Google search and it looks like they use ACE's in cats and dogs too. There are definitely some risks like with anything, but sometimes benefits outweigh. Long term hypertension plays havoc with not only the kidney's but every system in the body because every system is fed through blood vessels. If you could use an ACE to reduce the pressure (if she has it), you would be dong so much long term good!

Unfortunately...I have to go right now....but consider the iPTH test (which will tell you whether calcitroil is needed right now), a low phosphate diet, balanced fluids, daily weights, blood pressure monitoring and if high, talk to your vet about the possibility of adding an ACE inhibitor.

Sorry to throw all of this out there and run Ann - I know it's a lot. Tess's blood work really does not look bad right now and if I looked at it from first glance, I probably wouldn't have picked up on the slight changes....so good for you and your vet for being on the ball early, because that is the very best thing you can do to slow the progression.
 
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