11/22 Sootie amps 239, +11/197 Pmps 233,+4/184

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HWright

HWright

Member Since 2016
http://www.felinediabetes.com/FDMB/threads/11-21-sootie-amps-190-pmps-156.168481/#post-1826914

Good morning, and hoping all had gentle night

Sootie's amps 239...oops...
If nature...we go with the flow. if a bounce I'm feeling my fault for falling sleep and missing a post shot recheck. Or a mini meal for her in between and earlier than ca. 4am. Wondering too if bc shot earlier on yesterday morning and evening, if that might have come into play. Either way, crossing paws for a smoother day and return to blues.

Azalea ate more ca. 4am, too. And a little just now. 8am her cutoff for fud and water in case today's the go ahead day for eye surgery. Should be hearing from OV between 8-9am about her blood work and what next. Crossing paws too

Love ❤️ hugs Heart ❤️ and thanks ,
Sina
 
I hope Sootie heads back to blue for you today. I'm glad Azalea is eating for you. Sending prayers as you wait to hear from the OV. :bighug::bighug::bighug:
 
Got call from OV about azalea's bloodwork:
Good news bad news on azalea's bloodwork:
Good news: she's no longer anemic and WBC and platelets normal range. Every else except bun and creatinine normal
Bad news: bun elevated about same as 1 1/2 months ago creatinine higher than 1 1/2 months ago. He is seeing this as being in early renal failure that she may already have about 75% loss of kidney function.

OV said he had contacted an anesthesia specialist yesterday for additional protocol advice for renal cats. His concern for Azalea is that if her kidneys compromised, her kidneys might shut down bc of anesthesia. Which becomes the question of proceed with surgery knowing risks that she might come through but in his opinion greater risk now that she'd not come through? Continue with eye drops (and increase fluid therapy etc re renal problems) hoping it will help her to be more comfortable (but likely not work) but know it will come to PTS sooner or later?

I have call in to reg vet to discuss with him. And texted homeopathic vet. I call OV back this morning with decision.
Not seeing the Lab report yet, hard to gauge it in relation to her total history...she always has been slightly high in bun and creatinine.

Factors could be? White coat stress (she did get very stressed out yesterday when they drew blood..they said they had to draw from neck vein)? does glaucoma beta blocker have a renal side effect? . Diet ? She has been rejecting food with her standard process supports and other supplements as well as foods (freeze dried slurry etc) that are more renal-friendly. Hence has been mostly beef bone broth, a/d (grrr), and wellness or weruva.

Azalea ate more ca 4am, not much b'fast and is meatloafing this morning.

To my 'if she were your cat..': it's really your decision.
Rock and hard place again?
 
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I'm so sorry that the decision is so difficult.

What was her phosphorus like? As far as I understand bone broth is high in phosphorus and not recommendable for renal kitties.

It's not surprising that her kidney values are off, given her age, and that she's a cat.
Are you waiting to hear back from the anesthesia specialist?
 
:bighug::bighug::bighug:Ugh...... I am sorry that the BW came back with questions of how to proceed. I don't know the answer if the beta blocker has side renal side effect.

I hope you hear back from the anesthesia vet soon and are giving some hope. There are more than one factor in the equation now to make the decision. If the anesthesia vet thinks that she has a good chance to pull through the surgery, that will help you to weigh it all out. I guess it comes down to a gamble. Supposed she does make it through just fine and is out of pain and has some more quality of life? I don't remember how old Azalea is but that is a consideration also.

I hope you can get some answers soon and know what direction to go so you can have peace about it. Until then, sending lots of vines.
:bighug::bighug::bighug::bighug::bighug::bighug:
 
Gill & George said:
I'm so sorry that the decision is so difficult.

What was her phosphorus like? As far as I understand bone broth is high in phosphorus and not recommendable for renal kitties.

It's not surprising that her kidney values are off, given her age, and that she's a cat.
Are you waiting to hear back from the anesthesia specialist?
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I'll know more about the phosphorus level when talk to reg vet. OV did say that other than the bun and creatinine numbers, her blood work was good and with the WBC, platelets and anemia indicators in normal range now.

OV said that he contacted anesthesiologist yesterday about specifics in feline renal cases, because of our discussion about azalea's history of always being slightly high in bun and creatinine and the Bloodwork of 1 1/2 months ago. He got info from anesthesiologist yesterday. He's also concerned that she may need additional restraints because of being difficult to handle.

I didn't realize that bone broth is high in phosphorus and not indicated for renal kitties. Good to know. I used to add dehydrated egg whites as a phosphorus binder to her food, but then she rejected it.

Am waiting to hear from reg vet. Did hear back from homeopathic vet who is suggesting doing more with complex carbohydrates for Azalea and step up the supplements.

This is a horrible horrible horrible dance.

Azalea looking really ragged this morning and def dehydrated. I'd do fluids here but she banshees about needles at home. I'm going to call back reg vet, bring her in for fluids and try to catch him then if he doesn't call back by 10. All of which would mean hold off on today's eye surgery.
 
Bobbie And Bubba said:
:bighug::bighug::bighug:Ugh...... I am sorry that the BW came back with questions of how to proceed. I don't know the answer if the beta blocker has side renal side effect.

I hope you hear back from the anesthesia vet soon and are giving some hope. There are more than one factor in the equation now to make the decision. If the anesthesia vet thinks that she has a good chance to pull through the surgery, that will help you to weigh it all out. I guess it comes down to a gamble. Supposed she does make it through just fine and is out of pain and has some more quality of life? I don't remember how old Azalea is but that is a consideration also.

I hope you can get some answers soon and know what direction to go so you can have peace about it. Until then, sending lots of vines.
:bighug::bighug::bighug::bighug::bighug::bighug:
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Thanks Bobbie. This all is a miserable dance to weigh and balance it all, with new vectors in play at any moment.

Azalea's 18. We've been together since she was about 2 years old. Now is the most senior age kitty since Bo passed away (he was near 24).

Oh my.......
 
I'm so sorry you didn't get better news. I don't really have any advice. I know with senior kitties you have to be careful about anesthesia under normal circumstances. Does the vet think her eye has a chance to heal on it's own? Sending prayers. :bighug::bighug::bighug::bighug::bighug::bighug::bighug:
 
Hi Sina......aww nuts, this stinks. Had to get that out first and foremost.
This complicates things most definitely. BUT if she were my cat, as you asked, I would have to weigh QOL..here are the questions I would be putting down on my what do I decide paper
if I don't do surgery is she going to continue to decline overall?
If I don't so surgery can I keep her comfortable for any length of time?
For me those questions would have to be honestly looked at.
The surgery comes with obvious risks, but so does not doing it as she is declining as she continues with this eye condition. You might go to this site and ask some of the kidney folks about their experiences with surgery..
http://www.felinecrf.org/
They are for kidney disease what we are for FD..someone there may have answers that will help..
I am so very very sorry this is happening...:bighug::bighug::bighug: I am sure you just want to crawl into a parallel universe with your Kits in tow and close the door on this one:bighug::bighug::bighug:
 
We are home from reg vetty. His evaluation of yesterday's lab work was that the kidney numbers were consistent with her history but not necessarily an indication that she was at 75% loss of kidney function. Renal...yes...with age a factor and a risk. Took a look see at her eye and gunky-again mouth. Re the former: looks marginally improved; the latter not great but it's been worse.

I feel like a bouncing ball between brick walls. And, as Leslie said, I do feel like crawling into some parallel universe away from this spinning vortex of ever changing factors that weigh heavily on decisions in azalea's QOL. This vortex exhausts...again I crashed once home.

Surprisingly, Azalea's gained 2/10 pound in two weeks...now is a whopping 6.2# (her prime youthful weight was about 6.5-7.5#) His evaluation as of today and with the developments of the past week was to go week by week, hold off on surgery today. OV ok with that.

So, bringing Azalea back to reg vet next Tuesday and to OV next Thursday, in meantime continuing with drops, nutritional supports and TLC. Today she had fluids, B12, penicillin and Onsior injections with fluids. And home with two suringes of subway doses of onsior to tx at home. When talked to OV when done (cell phone reception at reg vetty terrible) he said continue with drops but discontinue Onsior. Bang head.

Reg vetty did mention a procedure to ask OV about, in use many years ago but not so much now, 0f decreasing/eliminate the fluid in ciliary body by an injection into the eye. It eliminates glaucoma pressure and pain by stopping fluid production in the eye. sounds gruesome but another thing to ask OV about.
 
Gussie's mom said:
Hi Sina......aww nuts, this stinks. Had to get that out first and foremost.
This complicates things most definitely. BUT if she were my cat, as you asked, I would have to weigh QOL..here are the questions I would be putting down on my what do I decide paper
if I don't do surgery is she going to continue to decline overall?
If I don't so surgery can I keep her comfortable for any length of time?
For me those questions would have to be honestly looked at.
The surgery comes with obvious risks, but so does not doing it as she is declining as she continues with this eye condition. You might go to this site and ask some of the kidney folks about their experiences with surgery..
http://www.felinecrf.org/
They are for kidney disease what we are for FD..someone there may have answers that will help..
I am so very very sorry this is happening...:bighug::bighug::bighug: I am sure you just want to crawl into a parallel universe with your Kits in tow and close the door on this one:bighug::bighug::bighug:
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Gussie's mom said:
Here's their link on anaesthesia
http://www.felinecrf.org/anaesthesia.htm
Super hugs Sina
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Thank you, Les. Postponing the surgery helps get handle on things yet again with new vectors...but with another add on to the problem solving hat. Is that why I feel like a lead weight on me?!

Azalea was soooooo happy to be home again....
 
Good to see Sootie playing it safe while mommabean is busy today.:bighug:

I've had to make the decision on surgery/anesthesia with Neko, when she was diagnosed with CKD. A year and a half ago she had a dental (growth removed from her jawbone) that would have been life threatening and a year ago, two days of anesthesia for CT scan and stereostatic radiation therapy for her acromegaly tumor. The latter one was the scary one, not so much because of her kidneys, but because of her heart. She was going to have another dental this year but could not because her heart disease had progressed to the point where it's too dangerous. Back when it was "just" CKD, it helped me and Neko to have a specialist in charge of the anesthesia for the procedure. Some of the board certified anesthiologists will travel to other vet clinics and be there for the surgery. You might want to ask the OV if that is an option.

Good plan on discontinuing the Onsior - even on the manufacturers website is says to be used for short term use only, 3 days max. It has not been tested on older animals for long term use. If she's in pain, you might want to have some buprenorphine around.
 
HWright said:
Thank you, Les. Postponing the surgery helps get handle on things yet again with new vectors...but with another add on to the problem solving hat. Is that why I feel like a lead weight on me?!

Azalea was soooooo happy to be home again....
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I'll bet she was..sending you heeling vines for her:bighug::bighug::bighug:
 
IMG_0976.JPG
Wendy&Neko said:
Good to see Sootie playing it safe while mommabean is busy today.:bighug:

I've had to make the decision on surgery/anesthesia with Neko, when she was diagnosed with CKD. A year and a half ago she had a dental (growth removed from her jawbone) that would have been life threatening and a year ago, two days of anesthesia for CT scan and stereostatic radiation therapy for her acromegaly tumor. The latter one was the scary one, not so much because of her kidneys, but because of her heart. She was going to have another dental this year but could not because her heart disease had progressed to the point where it's too dangerous. Back when it was "just" CKD, it helped me and Neko to have a specialist in charge of the anesthesia for the procedure. Some of the board certified anesthiologists will travel to other vet clinics and be there for the surgery. You might want to ask the OV if that is an option.

Good plan on discontinuing the Onsior - even on the manufacturers website is says to be used for short term use only, 3 days max. It has not been tested on older animals for long term use. If she's in pain, you might want to have some buprenorphine around.
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Thanks Wendy. Wow you are an incredible mom for your amazing Neko.
What journeys you are on together. ❤️

I will ask OV about having board certified anesthesiologist on board for surgery.

I left a message with reg vet about OV wanting no more Onsior done. I will ask him about getting some buprenorphine to have on hand and how long to wait to tx and how long onsior takes to clear. I've read some mentions of anti nausea meds that help appy but am not sure which might be best for Azalea.

I'm including here a photo of Azalea's lab work. It was fasting blood work and she was so hugely stressed by them drawing blood that OV finally had to draw from neck vein.

No one mentioned her elevated glucose (which may have been bc of fasting and stress) but some of the other stuff...
Appreciate eyes more experienced than mine in taking look see and observations, etc.

just now an email from AC who did a healing intensive this afternoon and reports Azalea feeling she is in dire straits.

This is a nightmare....and poor stalwart Azalea....

Hugs and hearts
Sina

ETA: were it only a nightmare/bad dream instead of real.
 
Cerenia or ondansetron are the best for anti nausea. Cerenia is just once a day (shot which stings but gets in, or tiny pill) but should use caution if there are any liver issues. Cerenia also good for vomiting. Ondansetron doesn't last as long so is given more frequently. In cats, usually one or the other works better, some do well with both on board. The two meds attack different nausea receptors.

I wouldn't worry about Azalea's glucose. My civie was once over 210 at the vet due to stress and 53 the next day at home. You can always test her yourself.:bighug:
 
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(((Sina))), I can't be of help with Azelea's issues, but want to send you vines of encouragement. And many beautiful vines for Azalea to help her feel better.

:bighug::bighug::bighug:

Ella & Rusty
 
Hi Sina

Azalea's labs are interesting, to say the least. For her creatinine to be at 2.9, her BUN is not similarly elevated. Her P is really good right now so she doesn't need a binder but I would definitely not be giving bone broth as Gill suggested.

Her hematocrit is great so when you say she was anemic, was her HCT below 30%? That's very early anemia and vets often don't intervene (transfusion, erythropoietin stimulating agents, etc) unless it falls below 20%. So it's likely the anemia was regenerative and not the non regenerative kind CKD cats can get.

I've also always used a board certified anesthesiologist. There are specific protocols for CKD cats. IMHO, her creatinine is not that high and if there was some other life limiting issue going on, I'd certainly talk to a specialist about whether it's safe to go ahead with the eye surgery in light of the kidney values. I mean, really, she is not even at a stage in CKD she you need to do anything yet except add extra water to her food.

Insofar as Sootie, i know you didn't ask but I really think she needs a dose increase to 0.5u bid.

Sending many hugs and vines.
 
Marje and Gracie said:
Hi Sina

Azalea's labs are interesting, to say the least. For her creatinine to be at 2.9, her BUN is not similarly elevated. Her P is really good right now so she doesn't need a binder but I would definitely not be giving bone broth as Gill suggested.

Her hematocrit is great so when you say she was anemic, was her HCT below 30%? That's very early anemia and vets often don't intervene (transfusion, erythropoietin stimulating agents, etc) unless it falls below 20%. So it's likely the anemia was regenerative and not the non regenerative kind CKD cats can get.

I've also always used a board certified anesthesiologist. There are specific protocols for CKD cats. IMHO, her creatinine is not that high and if there was some other life limiting issue going on, I'd certainly talk to a specialist about whether it's safe to go ahead with the eye surgery in light of the kidney values. I mean, really, she is not even at a stage in CKD she you need to do anything yet except add extra water to her food.

Insofar as Sootie, i know you didn't ask but I really think she needs a dose increase to 0.5u bid.

Sending many hugs and vines.
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Thank you Marje for Sootie and Azalea and this now totally head bonking bean.

Azalea's hct 1 1/2 months ago was about 27-28 if I'm remembering correctly. Was 1st time hct dropped below normal range.

Your view of her labwork i much appreciate. This has been a day starting out with OV saying he thinks Azalea in significant renal failure; reg vet saying a few hours later that it's not necessarily that extreme and his new suggestion is to postpone surgery and see how the next week goes; then a few hours later an email from AC saying Azalea in severe distress needs outside intervention; and now your interpretation that is more thorough than both vets and correlates more with reg vet. I'm doing an oy vey to keep from screaming in frustration and worry.
At this juncture and in taking in all the wisdom, experience and suggestions offered here in most deeply felt generosity of spirit for azalea: already stopped bone broth (thanks to Gill and you); asking reg vet tomorrow about getting bupe and the shorter acting anti-nausea that Wendy suggested; continue study of ckd and anesthesia for ckd cats, thank you Leslie for the links; talk with OV at next week's appointment about other options besides drops or surgery, if surgery a go then have on board a bc anesthesiologist (thank you all for suggesting that importance too). My doubts about recent events and Whether to get a third opinion or not is another dance in this maze.

Marje, re Sootie, our beloved most sweet and obliging sweetheart with the patience of Jobe during all this:
Based on CURVE (1st one in slgs) done this weekend, suggestion was to hold at current dose for a week. Are you suggesting double the dose amt to .50 midcycle or wait til end of cycle and after next weekend's curve? Reasons?

Also updated ss and thread title to include night Bgs.

Thank you all from this overtired bean and Sootie and her tribe,
Sina
 
Hi Sina.

Sorry I didn't get the tag sooner. I've been offline all day getting ready for DMIL's arrival tomorrow (still not ready).

HWright said:
Based on CURVE (1st one in slgs) done this weekend, suggestion was to hold at current dose for a week. Are you suggesting double the dose amt to .50 midcycle or wait til end of cycle and after next weekend's curve? Reasons?
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You have been testing enough for TR, so just looking at your spreadsheet would make one assume that is what you are doing. Those of us that have been following you know that your are actually doing SLGS. IF you were doing TR, you would want to follow Marje's advice and increase to .5 tomorrow morning. If you want to adhere strictly to SLGS, you would wait until next weekend (next curve) to increase (assuming the numbers stay about the same). SLGS is supposed to be somewhat customizeable, so I am going to suggest a compromise: why not take the skinny off and go to a full .25 now? Just my thought.

I'm sorry the news about Azalea is so conflicting. Unfortunately, it is not uncommon to get different answers from different vets. I think your current plan is reasonable. I still think removing the eye is the best option, given her discomfort, but you have to be okay with the risk of the surgery, so looking at getting a board-certified anesthetist is a great idea. You know her best, and you are with her day-to-day, so really only you can make the ultimate decision about what is best for her. I feel for you - this isn't an easy position to be in. Whatever path you take, we're here for you. :bighug:
 
Tricia Cinco(GA) & Harvey said:
Hi Sina.

Sorry I didn't get the tag sooner. I've been offline all day getting ready for DMIL's arrival tomorrow (still not ready).

You have been testing enough for TR, so just looking at your spreadsheet would make one assume that is what you are doing. Those of us that have been following you know that your are actually doing SLGS. IF you were doing TR, you would want to follow Marje's advice and increase to .5 tomorrow morning. If you want to adhere strictly to SLGS, you would wait until next weekend (next curve) to increase (assuming the numbers stay about the same). SLGS is supposed to be somewhat customizeable, so I am going to suggest a compromise: why not take the skinny off and go to a full .25 now? Just my thought.

I'm sorry the news about Azalea is so conflicting. Unfortunately, it is not uncommon to get different answers from different vets. I think your current plan is reasonable. I still think removing the eye is the best option, given her discomfort, but you have to be okay with the risk of the surgery, so looking at getting a board-certified anesthetist is a great idea. You know her best, and you are with her day-to-day, so really only you can make the ultimate decision about what is best for her. I feel for you - this isn't an easy position to be in. Whatever path you take, we're here for you. :bighug:
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:bighug::bighug::bighug::bighug::bighug:
Thank you Tricia
Yes compromise dose increase you suggest aok by me! Starting it with this am's dose.
Thank you too for hanging in there with us all including Sootie, Azalea and this bean...especially while you're readying for DMIL holiday visit! Have a wonderful and restful Thanksgiving.
:bighug::bighug:❤️❤️
 
HWright said:
Thank you Marje for Sootie and Azalea and this now totally head bonking bean.

Azalea's hct 1 1/2 months ago was about 27-28 if I'm remembering correctly. Was 1st time hct dropped below normal range.

Your view of her labwork i much appreciate. This has been a day starting out with OV saying he thinks Azalea in significant renal failure; reg vet saying a few hours later that it's not necessarily that extreme and his new suggestion is to postpone surgery and see how the next week goes; then a few hours later an email from AC saying Azalea in severe distress needs outside intervention; and now your interpretation that is more thorough than both vets and correlates more with reg vet. I'm doing an oy vey to keep from screaming in frustration and worry.
At this juncture and in taking in all the wisdom, experience and suggestions offered here in most deeply felt generosity of spirit for azalea: already stopped bone broth (thanks to Gill and you); asking reg vet tomorrow about getting bupe and the shorter acting anti-nausea that Wendy suggested; continue study of ckd and anesthesia for ckd cats, thank you Leslie for the links; talk with OV at next week's appointment about other options besides drops or surgery, if surgery a go then have on board a bc anesthesiologist (thank you all for suggesting that importance too). My doubts about recent events and Whether to get a third opinion or not is another dance in this maze.

Marje, re Sootie, our beloved most sweet and obliging sweetheart with the patience of Jobe during all this:
Based on CURVE (1st one in slgs) done this weekend, suggestion was to hold at current dose for a week. Are you suggesting double the dose amt to .50 midcycle or wait til end of cycle and after next weekend's curve? Reasons?

Also updated ss and thread title to include night Bgs.

Thank you all from this overtired bean and Sootie and her tribe,
Sina
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Sina

My apologies on the dose recommendation. I should have checked your signature block instead of going on my recollection that you were not doing SLGS. I see now that you have decided to switch to it and, sinc ei hsvent bren on Sootie's condo in a while, I should have double checked.

According to the IRIS staging of CKD, Azalea is at the very, very, very early side of Stage 3 where Stage 2 ends at 2.8 and Stage 3 starts at 2.9. Keep in mind that the elevated creatinine can be caused by other things such as a kidney infection. I've had that happen on one of my CKD cats, because cats with CKD are more likely to get kidney infections, and after treatment with the appropriate antibiotic, the creatinine came down. Not to normal because he had CKD, but it did drop. One of my veterinary sites that I really like also states this (I'm not saying any of these could be a factor; she likely does have CKD but it's also possible the number "might" be a little lower....or not ;))

Depending on how the test is performed, high blood glucose, vitamin C supplements and certain antibiotics (cephalsporins) can falsely raise creatinine readings.
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At any rate, I've had four CKD cats and looked at hundreds of labs and 2.9 doesn't scare me.....it's early and with her other labs looking pretty decent (although usually potassium is more in the 4.5 range but hers is still normal), I'm thinking now is the time to start watching her labs closer, adding water to her food, etc. she certainly does not need regular subq fluids yet. Those are not usually started until the creatininengets 3.5 or some vets even recommend a little higher.

When you say she has a history of slightly elevated creatinine and BUN levels, do you have those labs? Also, was any action taken when her HCT was 27%? Again, a cat whose anemia is caused by CKD cannot regenerate red blood cells so something else was likely causing that anemia.

One thing you might want to do is duplicate the lab tab on Sootie's SS and label it "Azalea's labs" and start tracking her trends. This is very valuable in a CKD cat. If you need help, let me know. I'd go back as far as you can where levels first showed an increase above normal unless she has always been above normal.

If she will let you free catch urine at home, you can run a urine sample in and have them check thenurine specific gravity. The best sample to get is the first one of the morning because it is usually the most concentrated. If it is not concentrated, that can also be an early indicator of CKD.

Last thought is that if your vet also has an account with IDEXX, I'd ask for an SDMA test next time her labs are done as that will definitively let you know on the CKD.
 
Marje and Gracie said:
Sina

My apologies on the dose recommendation. I should have checked your signature block instead of going on my recollection that you were not doing SLGS. I see now that you have decided to switch to it and, sinc ei hsvent bren on Sootie's condo in a while, I should have double checked.

According to the IRIS staging of CKD, Azalea is at the very, very, very early side of Stage 3 where Stage 2 ends at 2.8 and Stage 3 starts at 2.9. Keep in mind that the elevated creatinine can be caused by other things such as a kidney infection. I've had that happen on one of my CKD cats, because cats with CKD are more likely to get kidney infections, and after treatment with the appropriate antibiotic, the creatinine came down. Not to normal because he had CKD, but it did drop. One of my veterinary sites that I really like also states this (I'm not saying any of these could be a factor; she likely does have CKD but it's also possible the number "might" be a little lower....or not ;))

At any rate, I've had four CKD cats and looked at hundreds of labs and 2.9 doesn't scare me.....it's early and with her other labs looking pretty decent (although usually potassium is more in the 4.5 range but hers is still normal), I'm thinking now is the time to start watching her labs closer, adding water to her food, etc. she certainly does not need regular subq fluids yet. Those are not usually started until the creatininengets 3.5 or some vets even recommend a little higher.

When you say she has a history of slightly elevated creatinine and BUN levels, do you have those labs? Also, was any action taken when her HCT was 27%? Again, a cat whose anemia is caused by CKD cannot regenerate red blood cells so something else was likely causing that anemia.

One thing you might want to do is duplicate the lab tab on Sootie's SS and label it "Azalea's labs" and start tracking her trends. This is very valuable in a CKD cat. If you need help, let me know. I'd go back as far as you can where levels first showed an increase above normal unless she has always been above normal.

If she will let you free catch urine at home, you can run a urine sample in and have them check thenurine specific gravity. The best sample to get is the first one of the morning because it is usually the most concentrated. If it is not concentrated, that can also be an early indicator of CKD.

Last thought is that if your vet also has an account with IDEXX, I'd ask for an SDMA test next time her labs are done as that will definitively let you know on the CKD.
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Marje,
Not to worry about the recent switch from tr (well, as best as I'd been trying to do under the circumstances these past couple of months) to SLGS. I am grateful for all your help and from the get-go of when I first became active with this group in September. Seems like both yesterday and yet so long ago. Time and events in life.....has its way with us all.

Re Sootie: I started 'compromise' dose increase from skinny 0.25 to 0.25 this morning, and she's in the green at +6.5. So, you and Tricia were on to something: mid cycle or not, crossing paws that the teeny oomph was enough to start what I think you both were hoping for with an increase. That's a yay for sure!

Re Azalea and yours above:
Yes, thank you for suggesting and offering to set up a tab for Azalea's labwork in Sootie's SS. That'd be great (and you know me....cyber clutz).

I looked at the IRIS CKD staging chart and it's pretty much Greek to me at this point but your explanation and correlation with Azalea's b/w makes it more understandable.

Of the other factors that might contribute to elevated creatinine in that b/w: UTI should be ruled out (early in her life she had a bout or two of cystitis with her bun/creatinine always being just over the cusp of high normal after that).
She was highly stressed at OV and particularly during the blood draw. She gave the doc and tech quite a challenge, with them finally drawing from neck vein. Also, she'd been fasted since midnight the night before, unhappily endured eye exam with flinching and squirming and hissing and was already p'o.'d when we decided to do b/w.

so....while I'm not ruling out any stage of CKD, I do wonder if another possible explanation for the creatinine # not being consistent with bun#... Is the glucose factor you mentioned. Her glucose was high, and I think fasting and stress induced..would the creatinine increase in response to glucose elevated bc of no food and extreme stress?

On food: I've been adding water to her food for quite some time already, so that's a good thing. Began doing this a couple years ago while nursing her in recovery from sudden bout of 'silent seizures' akin to Tia's but different.

She has been on Subq fluids for about a year, beginning after the seizures bout. She began to dehydrate. At first was every month or so, then every few weeks, then every couple of weeks and now for the past few months once weekly with B12.

Oh yes, you asked if any action was taken when she her HCT was low a month and a half ago. No, reg vet felt it wasn't at the level to treat in the ways you mentioned. However, with homeopathic vet, we did shift her standard process supports.

Hope this helps. And again, words don't express adequately how much I appreciate and thank you all throughout all these journeys and in the midst of holidays and life, moment to moment, being what it brings us each and all.

Look forward to hearing from you and wishing you and yours a joyful Thanksgiving....!!!!
Sina
 
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