10/23 Jack amps 119

[saltycat]

last condo

Life's been busy around here lately and I've been getting more nervous about my little furball. The vet office is really starting to lose my faith. I went to pick up his labwork last week but it still wasn't in almost a week after. I got an itemized copy of the bill and while still there had a few *ahem* questions about the bill...

The new doc seemed nice, but seems to like to pad the bills a bit and do things his way regardless of what the patient requests. Going down again today and if the results aren't in, they will get to see a side of me they probably don't want to see.

Boy good vets are hard to find.

Jack's been doing ok, switched foods to a different protein and he likes it, just can't get him to put on weight. LB habits have gotten a little worse as well, low side box worked for a bit, but now he is 50/50 on box versus living room carpet... It is so dilute it doesn't smell too bad which helps. I'm hoping to get him on some steroids to try to calm down whatever is bothering his gut unless it is EPI or SIBO, both of which need different treatments.

At least his numbers have been good even with a few reduced shots due to not being able to monitor.

Hope all the kitties are doing good and the beans aren't having too many PJ parties.

 

[carfurby (GA)]

I hope the bloodwork results are in and you can get a plan to help Jack. I'm glad his numbers are pretty good. Sending prayers.

 

[Doodles & Karen]

Sorry for the vet frustration but boy I know it well. Went through 4 vets and 2 IM vets with Doodles Thankfully his cardiologist was amazing especially since he's the only one in AZ. Hope the results are in today and there is some sort of clear action plan for Jack.

 

[Carol in Chicago]

Sending best wishes for you and Jack. BW results will help figure out the action plan for him. For your action plan, have you considered pee-pads to avoid mess with the carpet? Very sorry because dilute urine is not really a good thing.

I tried several things with the LB and while it is still used, it is not 100% of the time. I am very fortunate that Rosie will seek out the pee-pads when necessary making for an easier clean up (because they have an absorbent pad with a plastic backing). Find them at Walmart or pet store by dog / puppy items. I can only share that I would be lost without these and also my rug machine (Hoover Spin Scrub).

 

[saltycat]

Hope the results are in today and there is some sort of clear action plan for Jack

My sentiments exactly, we are treading water right now and an action plan is definitely needed.... I spent more on cat food yesterday then I did on human food

ve you considered pee-pads

Yes, been through a few boxes of 100. Unfortunately, he loves hitting the edges which allow it to run under the pad. I need some double sided pads lol. On the carpet, I would have to put them all over, he does have (5-6) usual spots until he picks a random spot . He is well controlled bg wise, but the acro is known to keep causing dilute urine. I've resorted to blocking his "favorite" room for now, hopefully he gets the idea

 

[Bronx's dad (GA)]

Hi Wes. Only 4u! wow Sorry to hear about your vet & LB issues, both must be so frustrating. What do you mean acro causing dilute urine?

 

[Christie & Maverick]

I hope you get the lab work back soon. I'd be worried about Jack's kidney function. I believe Kidney disease might account for the non-urine smell to the pee as well as lack of weight gain or weight loss.

 

[saltycat]

So got the lab work back finally. I think they got so sick of me stopping in they actually put me in a room to discuss with a vet since apparently calling an owner with results is too difficult... If you can tell I'm getting pretty irritated with this clinic.

Vet did not want to put Jack on steroids yet since it "wrecks" the kidneys. ALT/AST are higher then I would like. They are going to call back with a price for the SDMA after I griped up a storm for bill padding from the last visit and we JUST sent blood to IDEXX(a whole other story) I was ready to do a credit card chargeback which I have never done.

For now, Jack is on a different brand and protein for fuds, of course vet recommended Hills ID which looks like it is 24% carbs LOL.

@Marje and Gracie Could you take a look at Jack's labwork? The GI panel is in along with a recent Senior panel.

He still eats like a horse, and is not showing his typical pancreatitis symptoms. He is throwing up a bit more then usual.

At this point, I'm getting a bit discouraged. If the kidneys are failing, I'm not sure how much the fluids would help since he drinks well and his last urinalysis the SG was very low. I hate to see him slowly emaciating, even with all the food. I am starting to question if his QOL is getting to that point. He just can't get any weight on him and I feel so bad watching him slowly starve himself.

What do you mean acro causing dilute urine?

Like uncontrolled diabetes, acro can cause excess thirst and urination as well. Even when Jack has a good string of blues and greens, he still pees more then I do

 

[saltycat]

I'd be worried about Jack's kidney function. I believe Kidney disease might account for the non-urine smell to the pee as well as lack of weight gain or weight loss.

Thanks for the insight, I think you might be on the right track although I sure hope not. His kidney numbers aren't bad, not even stage 1 on the CRF site, but the symptoms kind of make me wonder.

I have to check the date on the bag, but I do have a lactated ringer bag and needles if the group thinks a few sessions of subq might help.

 

[Carol in Chicago]

Yes, been through a few boxes of 100. Unfortunately, he loves hitting the edges which allow it to run under the pad. I need some double sided pads lol. On the carpet, I would have to put them all over, he does have (5-6) usual spots until he picks a random spot . He is well controlled bg wise, but the acro is known to keep causing dilute urine. I've resorted to blocking his "favorite" room for now, hopefully he gets the idea

Oh no - so sorry to hear this has been a long term thing. I just recently found a 100 pack at Costco. The things I get excited about these days...

Had I known you were a veteran of this war with a few more stripes than me, I would have suggested advanced weapons. My new favorite things are:
Silicone holder for pee pad - helps with edge spills and bleed thru. These can also anchor the pad in place. My younger cats "play" with the pads.

Kennel cage liner - again good for edge and bleed through.

At this point anything washable helps me. Best of luck in the ongoing battle!

 

[Christie & Maverick]

Thanks for the insight, I think you might be on the right track although I sure hope not. His kidney numbers aren't bad, not even stage 1 on the CRF site, but the symptoms kind of make me wonder.

I peeked at the labs, and didn't see much there myself, ya, the BUN is higher than last time, pushing to the top of normal range, but otherwise, I don't think they're that bad at all. Let's have the pros weigh in though, I wouldn't want to lead to astray, I haven't dealt with CKD in a long while. Stay positive, you are doing a lot for Jack, hope you get some traction on improving some of his issues.

 

[Wendy&Neko]

Glad you finally got the lab results. The GI panel took a while for me to get results too, but I live a lot farther away.

Like uncontrolled diabetes, acro can cause excess thirst and urination as well. Even when Jack has a good string of blues and greens, he still pees more then I do

Hmm, sounds off to me. Until CKD arrived, Neko peed twice or three times a day, unless her numbers were really high. Neko's urine was not dilute, until she got CKD. Acro is hard on kidneys, but Jack's numbers don't look bad that way, except the USG which is practically water. Neko's USG never got anywhere near that low. Was the urine specific gravity tested in house or at the labs? The AM urine is usually more concentrated. Not sure what time of day the test was done, but you should be able to do a free catch first thing in the AM, and take that to the vet to test in house, provided they have a calibrated refractometer. That USG is a big drop from last time and concerning. Did the vet say anything about it? I wonder if it's time to try to engage an IM doctor.

The high folate probably means some SIBO. Neko also had high folate. Is his weight stable now? Again, any next step suggestions by the vet?

You can buy washable/reusable pee pads. The good thing about them is that you can get them in very large sizes.

 

[Christie & Maverick]

one other thing I noticed is the sodium levels were up, and the sodium/potassium ratio is low. Might be worth asking the vet about that? I wonder if the higher sodium affects water intake, and maybe one reason for dilute urine? I remember with my first CKD kitty, getting those electrolytes balanced was a bit of a challenge, and she was the one that had dilute urine, but her other blood levels were off too, and she was late stage failure so....it may be nothing in Jack's case. Just throwing it out there , might be something to ask about?

 

[saltycat]

The low sg caught my eye too. The test was done at 9am, he doesn't really have a first in the morning. He will go every few hours, 3-4 times overnight. I can double check his sg, just so happens we use refractometers for the fish tanks. I'll have to check if it is accurate with urine.

Next step from the vet was getting the sdma test done. She didn't really say too much other then not treating without more testing. Her biggest concern without fully saying so seemed to be crf. She was most concerned about bun and creatine rising She didn't like steroids unless absolutely necessary due to concerns with the kidneys. I didn't get a copy of the urinalysis, that will let me know if the urine sg is consistently low.

I'm confused on the diluted urine, but decent kidney numbers. Logically I'd think if the kidneys weren't filtering some of the blood numbers would be higher.

His specfpl is high too even though he is only showing very minor signs of pancreatitis.

At this point my #1 goal is getting some weight back on him.

Thanks for the input on the na/p Christie. The vet didn't make any mention of it but something to keep an eye on. Could be nothing, could be another piece of this puzzle.

I didn't know about the pee pad holders, that might help a lot on the tile. Thanks for the tip.

 

[Carol in Chicago]

I didn't know about the pee pad holders, that might help a lot on the tile. Thanks for the tip.

I should just post a link, but from my phone I can find it via Google if I search for "wee wee pad silicone". My only other suggestion is to double check the dimesions. There are a couple of different holder sizes / manufacturers. When buying by the 100s it helps to get that right.

My best to you and Jack!!!