10/16 Tess AMPS~308 PMPS~65 +2~166 +4~179 +11~65

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Ann & Tess GA

Ann & Tess GA

Member Since 2010
10/15 Condo
10/15 RECAP:
• AMPS~212 fed 1oz. 5% FF Salmon, 0.1 (4 drops) Lev , Cosequin , Miralax
  • • +2 fed .5oz. 5% FF Salmon
    • +3 fed .5oz. 5% FF Salmon
    • +4 fed .5oz. 5% FF Salmon
    • +9~149
    • +11~221
• PMPS~227 fed 1oz. 2% ProPlan Chicken & Liver, 0.1 (4 drops) Lev
  • • +2 fed .5oz 2% ProPlan Chicken & Liver
    • +3 fed .5oz 2% ProPlan Chicken & Liver
    • +4~420 fed .5oz 2% ProPlan Chicken & Liver
    • +8~353
    • +11~311
• AMPS~308 fed 1oz. 4% Wellness Turkey, 0.1 (4 drops) Lev , Cosequin , Miralax

Good Morning LL! Well, yesterday was quite the day! Wore the bean out so DH shot this morning. We shot a normal shot at a 212 and filled the auto feeder with 5% FF salmon. nailbite_smile So Tess hides in her dog kennel condo under the table (which she has ignored for months), as we are packing up for Santa Barbara. Did she want to come along with us? I seriously doubt it :lol: Last seen coming out of the condo as we leave for Ann's bonsai class. Class went well, but DH was tired and didn't seam to be all there. Ate lunch on the fly and got back at 3:00 to a 149 BG and empty food dishes. But she had a bounce last night all the way to red, so maybe she had been lower than 149 :?: Anyway, DH crashed early last night and is paying for it this morning with the shot duties. Tess even went btb with Ann for a while. Ann was up late researching CRF info. Thanks to you all for your comments and visits yesterday.

WCR All 5 Ps, this morning, though a LB deposit was made during Breffis just before Clean Plate Club was established. We have a happy kitty this morning, so high numbers aren't a problem. Maybe some blues and greens later? :mrgreen: ~ ~O) ~O) ~ John
 
Re: 10/16 Tess AMPS~308

Morning!! What is it with our kitties wanting to visit the red floor yesterday? Mannie did too! Well, she is coming down, hopefully she will find the green floor today. Right Tess?

Sounds like an awfully busy day yesterday... but a good one. Tess behaved herself... Mannie made sure.

have a great day today! And Tess: think green!
 
Re: 10/16 Tess AMPS~308

Hi Ann, Tess, John,
Sorry to miss your condo yesterday, but I could not have commented on the test results in any event. I'm glad you all survived your hectic day yesterday. Stu was diagnosed with CRF, but his values were much worse than anything in Tess' chart. Tanya's CRF page is an excellent source of info., as I'm sure you have discovered.
Have a more relaxing day today. Maybe both Tess and Rusty will get down to blue (or dare we say, green?) later today.

Ella & Rusty
 
Re: 10/16 Tess AMPS~308

It's sounding like something was going on up on the red floor yesterday. Did the kitties have a secret party with forbidden fruits on the menu? Ease on down Tess.
 
Re: 10/16 Tess AMPS~308

Ann...I just realized I posted over on 10/15 regarding the labs. Sorry about that....here it is again:
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.
Click to expand...
 
Re: 10/16 Tess AMPS~308

I just have to very respectfully disagree with only one of Jessica's points and that's a low protein diet. Current research in felines indicates that you do not want to give a cat that loses protein through it's kidneys less protein. You want the kitty to gave a good quality protein....don't overdo it on the % protein, but don't feed a low protein diet. We continued to feed our renal kitties high quality protein diets with lower phosphorus and they remained (and Gus continues to remain) very stable in their renal values.

Jessica did have a very good recommendation to monitor blood pressure. Typically amlodipine is prescribed for high BP....Gus is on this; Teddi never had high bp even though their renal values were very similar. So ECID.

Insofar as phosphorus levels in cats, you want to be sure that you start binders no later than when the number gets to 6. If the phosphorus level is over 7, calcitriol won't help.....you'd have to get the P level back down and then it still might not help. So you can either try to get the P level down using calcitriol if her PTH/ionized calcium indicates it is warranted, or first using lower phosphorus foods and then binders when necessary.

I don't think Tess is to the point of needing subq fluids.....most vets don't start those until the kitty is between 3-3.5 on creat.....depends on the vet and the kitty. BUT I would definitely start adding extra water to her food. It's best if the kitty can address dehydration by increased intake of water over giving squids but there usually comes a time when squids are needed.
 
Re: 10/16 Tess AMPS~308 +4~121 +6~52 +7~68 +9~51 +10~57

Well, if this is what she did yesterday that red last night is explained. It's almost like she was back on the roller coaster she rode while on Lantus.

Thanks for all the information, sorry I haven't gotten back sooner but I got lost in all the pages of Tanya's site and the Feline CRF site. I'm agreeing w/ the advice given that it may be too early for Calcitriol (at least not until the iPTH test), but lower phos foods are in the near future and maybe phos binders too. We just have to decide which. Marje, I too am hesitant about lowering the protein in her food because that means carbs or fat would have to rise.

Still wading through all the websites and trying to get stuff into printable form. I like to have that so I can make notes and refer back to things easily and not in magenta Comic Sans Serif font. :roll: Now I need to print it all out, but I think I may need a new toner cartridge ofr the laser printer. I have a LOT of pages. :roll:

Sorry to miss condos this weekend, but I've become obsessed again. When I talked to the vet on Friday I thought that I was handling the news well, but as I got more into it things started to get to me. But I keep looking at Tess and she seems so contented sleeping next to me that I know I'm over reacting. :?
 
Re: 10/16 Tess AMPS~308 +4~121 +6~52 +7~68 +9~51 +10~57 +11~

What a turn around! :mrgreen: :mrgreen: :mrgreen:

This is me today
funny-pictures-alice-in-wonderland-overload-happens-to-the-best-of-us.jpg
 
Re: 10/16 Tess AMPS~308 +4~121 +6~52 +7~68 +9~51 +10~57 +11~

Hi again, Ann & Tess,

Do you know Elizabeth M. Hodgkins' book Your Cat (New York, 2007)? When researching CRF because of Stu, I found the chapter on chronic kidney disease to be very informative, especially with regard to food (she decries the so-called kidney diets that deprive cats of the protein they need). One thing she recommends is adding chopped boiled egg white to the cat's wet food:
". . . Egg white is high in top-quality protein but contains no phosphate so it effectively 'dilutes' the phosphorus in the food. This strategy allows the cat to have the protein building blocks of repair and energy production available in abundance, while reducing the intake of a nutrient that may be harmful to the patient. This is truly the best of both worlds."
Click to expand...
(p. 217) Egg white might be a good place to start because it is a food, not a drug, and the possibility of adverse reaction would be minimal.

Tess's numbers sure got better today!!!!! Go Tess! Enjoy the green lagoon and wave to Rusty on your way there!

Ella & Rusty
 
Re: 10/16 Tess AMPS~308 +4~121 +6~52 +7~68 +9~51 +10~57 +11~

I feel lost because I wasn't on the site yesterday and missed Tess' condo with all this info. I'm so sorry with what's going on, but at least you have a lot of people here who can give you advice!! Just one more reason to thank God for FDMB!!! I;m glad to see Tess has had such a beautiful surf today!!!
 
Re: 10/16 Tess AMPS~308 +4~121 +6~52 +7~68 +9~51 +10~57 +11~

(((Ann))) I know any change to the kidney values causes us to be upset because we gotta face it...kidneys are cats' weakest link. BUT remember that any bloodwork is just a snapshot in time. Her creat is basically normal; BUN can be high reflective of a high protein diet....not just dehydration. But have you noticed Tess drinking alot more? It's just that the USG doesn't fit the rest of the picture. She'd be drinking ALOT more to dilute her urine....I just wonder if that test was not a correct reading.

If you want, I can send you an xcel file (let me know) that I use to track Teddi and Gus's bloodwork....primarily anything related to their kidneys. I've seen them go up to 5 on phosphorus and then come back down to 3.9 and then back up again. I think it was reflective of diet because I got them to eat low-P foods and used a little binder; but then Teddi refused to eat those foods and I had to go up a bit in P and their levels came up some. Now I am back to feeding Gus much lower P foods than before so I hope his P will come back down. I think Ella's suggestion of the egg white is awesome!!! And you're right...if you lower protein, something else has to give and in a FD cat, you really don't want it to be either fat or carbs.

When you are looking for low P foods, on Jill's chart you want to get anything lower than 200 and the lower the better. On Tanya's charts, anything lower than 1.00 but, again, the lower the better. I've got Gus eating many of the foods in the 0.68 range.

Tess is looking awesome today!!!! Nice surf she has going.

Try not to worry. Even if her numbers are reflective of beginning renal insufficiency, with the kind of care you give her and being proactive like you are, there is no reason you can't maintain her for a very long time. Remember for Teddi...her kidney values were pretty stable for over 1-1/2 years and when she crossed, her kidney values were still REALLY good for a renal insufficient kitty.
 
Re: 10/16 Tess AMPS~308 PMPS~65 +2~166

With as low as she went today I had to get a +2, but this is just her normal rise. I won't be surprised at a bounce though.

Ella thanks, Dr. Hodgkin's book is th first thing I checked when we got back form the vet. Egg whites are on the top of the list. :thumbup

Marge, thanks I've set up a SS sheet on Google docs w/ all the tests I have records for. It's on a tab on the bottom of Tess's SS. How does it differ from what you did? There hasn't been much change in the last year and a half, except for Phosphorus and that is still right in the middle of normal. Lately I have been letting her have more FF though so I wonder if that is a factor. And of course I just stocked up. I'll call you to pick your brains on food. Unfortunately she has always snubbed Blue Wilderness and Merrick. I was looking at what I calculated for TCfeline and it seems high in phosphorus. :sad: :sad:

As for water consumption we're starting to measure again, but it has been pretty stable. Although the DR. was concerned about the spec gravity it ha only dropped .003 since her FD dx. To me that didn't seem a lot, although I'm no expert. I also read that is nnot unusual for FD cats to have a low spec gravity, so it isn't as good an indicator for renal problems for them.
 
Re: 10/16 Tess AMPS~308 PMPS~65 +2~166

Good evening, guys! We've been keeping an eye on Willie's numbers too in terms of his kidneys. It can be so overwhelming! I would consider doing a consult with Dr. Lisa, and even getting a custom diet made for Tess. She was so helpful to me in terms of explaining what everything meant in the context of Willie's age, specific health issues, etc. I just learned so much during my conversations with her, and the diet she created has been really good for Willie.

Hopefully she doesn't bounce too badly tonight!

I gotz leaf piles, MIss Tess!! Wanna come jump in em? --Willie
 
Re: 10/16 Tess AMPS~308 PMPS~65 +2~166

Ann: carpus...sorry....I'm just tired (didn't sleep well last night and not because of Gracie) and your SS for her numbers is absolutely great. I just wasn't thinking but after you said that, I remembered I looked at her other numbers. I don't remember if her other USG numbers were on there last night but it's helpful that you provided them today.

Hmmmm on the FD cats have lower USG. I've not read that and Gracie's is usually higher when her numbers are high (1.060). I think Dr. Lisa generally considers anything below 1.040 to be indicative of some renal impairment.

Bummer on the TC feline!!!! It must be in the powder because chicken breast has fairly low P.
 
Re: 10/16 Tess AMPS~308

Marjorie and Gracie said:
I just have to very respectfully disagree with only one of Jessica's points and that's a low protein diet. Current research in felines indicates that you do not want to give a cat that loses protein through it's kidneys less protein. You want the kitty to gave a good quality protein....don't overdo it on the % protein, but don't feed a low protein diet. We continued to feed our renal kitties high quality protein diets with lower phosphorus and they remained (and Gus continues to remain) very stable in their renal values.
Click to expand...

Hi Marje and Tess. I just want to make sure I was clear. We go low protein on humans in renal failure, but as mentioned, didn't know if this was ever a protocol with cats or how that would be done, especially with a diabetic cat. Although humans need protein, we digest and need so many other nutrients and can get our protein sources met from other means than meats. I didn't find anything that suggested low protein would be the protocol for a cat, but thought it would be worth wild to bring up with the vet in case there was anything like that out there. I do appreciate you pointing that out Marje if it wasn't clear!
 
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