11/21 Max AMPS 166 PMPS 177

Max & Lori

Max & Lori

Member Since 2021
I took Max back last week for a urine culture to rule out UTI because his BUN, creatinine and SDMA were so bad at his visit on 11/9. The vet told me at that time he was in stage 3 CKD, which progressed very fast since 4 months ago when he was in early CKD. I’m still trying to come to terms with all of it. I also asked for a UPCR last week since they had to get the urine specimen anyway. The urine culture showed no growth, so no UTI. The UPC is 0.3 and its a little higher than last time 0.1 four months ago. I know that’s a good test to determine protein in urine but I’m not sure how it correlates with what stage he is in??? I’ve been studying Tanya’s CKD site. Looks like maybe he has borderline proteinuria based on the UPC? He’s on Enalapril already. I am still waiting for internal medicine to call me with an appointment. I had given his vet info on Cabergoline before, but he has had so much going on I just didn’t think it would be a good idea for him. I’m just managing his insulin and now the CKD, although the heart issues make that difficult as we know. Any thoughts on the UPCR from last week and the BUN, creatinine and SDMA from 11/9 visit? I wonder if dehydration could have affected his labs that much. His USG was normal, but lower. @Wendy&Neko any ideas about the labs? Maybe I’m just hoping it’s not as bad as I think it is.

https://felinediabetes.com/FDMB/threads/11-16-max-amps-169.283659/#post-3123892
 
Well this is disappointing. I guess Max isn’t important enough as other cats to get any feedback here so thanks a lot. I don’t ask for a lot and have managed Max mostly by myself, but I need support too. I am unbelievably worried and upset so I will just leave it right there. I’ve tried, but I’m seriously done here.
 
Hi Lori,
I am so sorry to hear about Max's CKD. And I'm sorry that no one really responded last night.
To be honest, from the thread title, it looks like Max's doing nice and steady, so people may have just assumed all is well.
But I know you are very worried. I'm not familiar with CKD issues - I'll tag some experienced people here to look at his lab
@tiffmaxee
@Bron and Sheba (GA)
@Bandit's Mom

Sending you :bighug::bighug::bighug::bighug::bighug:
 
Mikanmama said:
I'll also tag
@Diane Tyler's Mom
She knows everyone and can see who else may know about CKD
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Thank you Kit, but it’s okay. Because of Max being so complex I think most people don’t feel comfortable posting for him. Maybe that’s it, or maybe I’ve worn out our welcome. I’ve taken in every bit of advice I’ve gotten here and I don’t ask that many questions I don’t think, especially not the same questions over and over. I listen and I read a lot of other condos to take that into consideration and learn as well. I have been discouraged, but tried to remain positive for Max’s sake. God knows I love this cat with all my heart. I just don’t need any more disappointment and I’m not handling stress very well right now. Being here probably isn’t the best thing for me, and I’ve just got to let it go. I keep grasping for something but I think I’ve just got to come to terms with it all myself now. Thank you for always being so thoughtful Kit. I wish all the best for you and Mikan.
 
Hi Lori, I’m so sorry that you didn’t get any responses and are feeling so disheartened. I totally understand what you’re saying.

I know you’ve been here way longer than I have and I certainly don’t know anything.
Do you think maybe putting an ?? And some information in the thread title might help?

I sure hope you get some assistance quickly. I know you’re doing everything you can for Max and I pray you can get some answers and things will improve for him and for you.
Sending you hugs and love and support And thinking of you guys :bighug::bighug::bighug:
 
Max & Lori said:
Thank you Kit, but it’s okay. Because of Max being so complex I think most people don’t feel comfortable posting for him. Maybe that’s it, or maybe I’ve worn out our welcome. I’ve taken in every bit of advice I’ve gotten here and I don’t ask that many questions I don’t think, especially not the same questions over and over. I listen and I read a lot of other condos to take that into consideration and learn as well. I have been discouraged, but tried to remain positive for Max’s sake. God knows I love this cat with all my heart. I just don’t need any more disappointment and I’m not handling stress very well right now. Being here probably isn’t the best thing for me, and I’ve just got to let it go. I keep grasping for something but I think I’ve just got to come to terms with it all myself now. Thank you for always being so thoughtful Kit. I wish all the best for you and Mikan.
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Lori,
You've given me support when I was so stressed out with Mikan's BGs and that meant a lot.
I can tell how much Max means to you - of course this is hard for you. And I know how much you do for him.
Max is a lucky kitty to have you as him momma.
My naive understanding of CKD is that it does progress but you could still give good quality of life - I have no doubt that you will find a way.
There are a lot of support in this place - but it may be short today = People maybe a bit busy this week because of the holiday week.
:bighug::bighug::bighug:
 
@Staci & Ivy and Kit, I probably should have put a question mark in the title, but in past experience most people had still rather not comment on Max because of his complicated history. One or two people usually do though, maybe it is because of the holiday or that I didn’t place a question mark in the title. I thought tagging would be sufficient since that’s where I usually get my information, but really it’s okay. I’m just going to let it go and move on. I don’t like being dramatic, but somehow all of this with Max has made something out of me that I’ve never been….needy. I was grasping for something to give me a little encouragement last night once again, but maybe I went about that all wrong. Other things on my mind as well. It’s okay. I’ve got to get myself together and start preparing Thanksgiving for my family coming tomorrow. I hope everyone else has a nice Thanksgiving too.
 
We all do get needy, Lori.
I know that my mood swings along with Mikan's BGs - too high, I get depressed. Getting low, I get anxious!
And all these seemingly random ups and downs are making me go absolutely looney!
My poor DH gets the blunt of it. :rolleyes: (wait, isn't what husbands are for?)
Enjoy prepping today and family tomorrow! I gotta get going myself for yams and cranberry sauce!
:bighug:
 
Sorry, I pressed Post Reply last night, but it seems not to have taken. And now I've had to remember what I said. I'm rushing out of the house, will do more later.

I've read that steroids can also raise the UPCR value. When Neko was tested, her lab wanted UPCR to be under 0.4. What is the reference range for the lab that Max's blood went to?

Did you ever talk to the vet about the possibility of a kidney infection?
 
Reference range says that it should be less than 0.5. Urine culture is negative so vet says no urinary infection, no uti or kidney infection. No treatment needed.
 
Max & Lori said:
@Staci & Ivy and Kit, I probably should have put a question mark in the title, but in past experience most people had still rather not comment on Max because of his complicated history. One or two people usually do though, maybe it is because of the holiday or that I didn’t place a question mark in the title. I thought tagging would be sufficient since that’s where I usually get my information, but really it’s okay. I’m just going to let it go and move on. I don’t like being dramatic, but somehow all of this with Max has made something out of me that I’ve never been….needy. I was grasping for something to give me a little encouragement last night once again, but maybe I went about that all wrong. Other things on my mind as well. It’s okay. I’ve got to get myself together and start preparing Thanksgiving for my family coming tomorrow. I hope everyone else has a nice Thanksgiving too.
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I completely agree with Kit, this is a very stressful situation and it seems all of us get needy at one time or another. Sometimes more often than not or than others, and I think that’s normal.
Also, I think this is a safe space to come to ask for help and be able to express what’s going on.
I’m so glad Wendy has been able to respond.
In my opinion, Wendy is incredibly knowledgeable and helpful and I for one certainly appreciate her willingness to help. I think you’re in good hands.

Keep doing what you’re doing because you’re doing a great job with Max.
I wish you a very happy Thanksgiving and much love to sweet Max. :bighug::bighug::bighug:
 
Staci & Ivy said:
I completely agree with Kit, this is a very stressful situation and it seems all of us get needy at one time or another. Sometimes more often than not or than others, and I think that’s normal.
Also, I think this is a safe space to come to ask for help and be able to express what’s going on.
I’m so glad Wendy has been able to respond.
In my opinion, Wendy is incredibly knowledgeable and helpful and I for one certainly appreciate her willingness to help. I think you’re in good hands.

Keep doing what you’re doing because you’re doing a great job with Max.
I wish you a very happy Thanksgiving and much love to sweet Max. :bighug::bighug::bighug:
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Thanks Staci. Happy Thanksgiving to you also! I’m always very thankful when anyone here is willing to help us along with advice, kind words etc.
@Mikanmama thank you Kit, I completely understand. :bighug:
 
Marje and Gracie said:
I had a kitty with CKD who had two kidney infections which did not show up on the lab tests. It took doing an ultrasound both times to detect it.
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That’s interesting. I did not know that. I wonder why my vet never suggested that. I had to ask for the urine culture in the first place. I suppose I should call back Monday and ask for a kidney ultrasound. They are closed the rest of the week. I found it strange that his kidney values got really bad so quickly. Thank you Marje.
 
Max & Lori said:
I found it strange that his kidney values got really bad so quickly.
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On the SCL group I belong to, a surprising number of kitties have their kidney numbers go bad quickly, and it ends up being a kidney infection. Some reading for you: https://felinecrf.org/pyelonephritis_utis.htm They typically require a longer course of antibiotics, and in some cases a different one than might be used to treat a UTI.

Getting Neko's IM vet to check for kidney infection was one thing I regret not doing. Her numbers went bad fairly quickly, but I also could not treat due to her heart condition. I also don't know if it's an acro thing, as acromegaly is also hard on kidneys, at least in the one human study I saw.
 
Max & Lori said:
That’s interesting. I did not know that. I wonder why my vet never suggested that. I had to ask for the urine culture in the first place. I suppose I should call back Monday and ask for a kidney ultrasound. They are closed the rest of the week. I found it strange that his kidney values got really bad so quickly. Thank you Marje.
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You’re welcome. When my kitty was treated with Baytril for six weeks, his creatinine came back down.

I dint want to second guess your vet but mine told me because the infection is much higher up (in the kidneys), the culture won’t always show it.
 
Thanks for pointing me to the reading. I’d read it before but reviewed that again. It makes sense to me that the urine culture may not always grow a bacteria if the colonies of bacteria are low. I’d seen that in people as well. I did not realize that a renal ultrasound could diagnose pyelonephritis. What they said about the renal pelvis being dilated (pyelectasis) is actually something they diagnosed on one of my own kidneys. At the time I was being treated for a recurring UTI and the pyelectasis was incidentally found when looking to make sure I didn’t have a stone. The urologist never explained that pyelectasis could be caused by an infection. I’m supposed to get a CT scan if it’s still present in January. Anyway, I find that interesting. I called NC State IM today and asked about the appointment for Max. They said they have the referral but it has to go through a process with whoever reviews the referrals, so I’m waiting. Unfortunately, I think I will have a hard time trying to convince my own vet that a renal ultrasound can diagnose a kidney infection so I may have to wait until we can get to internal medicine. His vet is convinced that he doesn’t have an infection. Thats the other thing, not only is it walking a tight rope trying to balance all of Max’s diagnoses when one treatment is contraindicated in another, trying to navigate through the process of getting what he needs done is challenging right by itself. All I’m trying to do is help him and it feels like the cards are stacked against me most of the time. It’s incredibly stressful. I’m really not exaggerating either. Thank you both for your input. I do value it and I will see what I can do.
 
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