Hi Josie
No need to PM...I had some time to get on the board today.
Thanks for setting up her lab SS like that...very easy to read. I'd just suggest you might want to bold the numbers that are out of the reference range. I also keep a SS on Gus because it allows me to follow trends in his kidney values much more easily.
Actually, her numbers don't look that bad. One of the first things to learn with CKD is it's really important to see how Ripley is doing clinically. As with FD, she is not just her numbers. Her phosphorus level is awesome!!! So is her potassium and several of the other numbers we watch for CKD kitties. The numbers that concern me most are her HCT and HGB. For where she is with her CKD, they seem low. I do have a couple suggestions. It's great that you are giving her Methyl B12 but you also need to be giving her a B complex. Most of us in the CRF yahoo group use
Jarrow's B Right. They work together to control the anemia. The usual dose is 1/10 capsule per day for a 10lb cat divided into 2-3 do sings. As an example, Gus has had CKD for over two years now and his HCT is still 28 and his HGB is 9 but he's been religiously getting MethylB12 and Jarrows B Right. Here is some great info about
Vitamin B supplementation. Because the B Right is not that palatable, I buy #3 gel caps (empty) and then I put 1/2 of the methylB12 cap along with the dose needed for the B Right and he takes those in a pill pocket twice a day (bid).
I also wonder if she has any other source of anemia? Do you live in an area with fleas? I think it would be worth a test to see if she has Hemobartonella? I had a friend whose cat had CKD and was severely anemic even though her creat/BUN didn't look bad. She had hemobart. Once they treated that, her HCT and HGB came back up. The thing about treating anemia if it is non-regenerative associated with CKD is you want to try and get those numbers up using the B vitamins if you can because once you start the erhythropoesis stimulating agents like Aranasp...it's a pain. You usually wouldn't start those until kitty is severely anemic (below 20% on HCT) so you have some time to try and get her stable. But I'd definitely look into the Hemobart test just to rule that out.
Other than that, right now, I would just focus on feeding her low phosphorus/low carb foods. She's not really to the point where she needs subq fluids but I would be adding lots of extra water to her canned food every time you feed her. With CKD kitties, the best way for them to get hydration is through their food and water they drink. Giving subq fluids comes later when they are not able to compensate by drinking enough water. Typically, you would not start subq fluids until the creat gets about 3.5 but that's also something to discuss with your vet. If you don't have a kitty fountain, I'd consider buying one because many cats like to drink fresh, running water over water that has just been sitting in a bowl.
I hope this helps...please let me know if I can offer any other thoughts you can discuss with your vet.
