12/25 Todd PMPS HIGH, +3 1/2 HIGH, +6 526 (Questions!)

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ToddyTiger

ToddyTiger

Member Since 2010
So I just did Todd's PM BG check and it read simply as "Hi" on the meter, which means it's above 600. I suspect it's high due to the fact that he received his appetite stimulant today and it of course makes him eat more than normal. I had to go to my mothers for the day, so I had him set up in my office with food and water. He eats Hills k/d dry due to his kidney issues.

I'm not sure how much to shoot.. he was getting 1.5u to 1.7u twice a day (depending on his numbers) but this is very high and I'm not sure if I should just shoot the 1.7u or maybe up it to 2u. Any thoughts?? He is due pretty fast here.

He is acting totally fine right now.

Thanks!

*Edit

I did roughly (because it's tough to read on these needles) about 1.90u I hope that was ok. I didn't want to go crazy high or anything. Just a little, to see what it does. I'll recheck his BG in a couple of hours. Like I said, he's acting fine, although I have noticed in the last 2-3 days, he;s been drinking a lot more, even though he is receiving 150ml of Sub-Q daily. Not sure if it;s the diabetes doing this or the kidney issues.

Oh, and one more question.. where do you folks shoot when giving insulin? I was shown how to do it into the scruff of the neck. Is that the best place to do it or should I do it somewhere else? Just curious.

On a high note, I just weighed him and he's up in weight. Not much, but it's still good. He was 9.0lbs on the baby scale at home a few days ago and tonight he was 9.4lbs! I doubt it's water weight, because he got his Sub-Q around 2pm today and I can see it's already all gone. So.. YAY! Weight going up is good. I wonder if it's because we're actively trying to get his diabetes under control, where before, we were not doing testing or adjusting insulin as needed. Oh, I hope I can get him up to 10lbs soon and oh, 11lbs would be so, so wonderful!!

Thanks!
 
Re: 12/25 Todd PMPS HIGH (Help!.. Question)

I took a look at Todd's ss and you gave 1.9u, that's Lantus?
I don't know how you are measuring those doses because I am used to seeing .25/.5/.75 types. Anyways, I don't see any mid-cycle testing so it's tough to know what's happening with Todd's numbers from the doses you are giving. Normally doses are based on the numbers in the middle, so if possible, can you try to get some of the middle numbers?
There would be a big difference if Todd was dropping really LOW in the middle and then bouncing way back up high by his ps test. By increasing his dose, you may be causing the mid cycle BG to go even lower and bounce even higher.
Think of a tennis ball, or a hard rubber ball. Toss it underhand and you may see a gentle bouncing in front of you. Now, take one of those balls and pound it overhand hard into the ground. How much higher does it bounce the 2nd time? Quite a bit higher.

The other possibility is that Todd's numbers are staying fairly high, all across the cycle. That pattern, curve, could be saying alrighty, more insulin please.

Two totally different curves but each could have the ps numbers you have on your ss.
Lantus is based on what's happening in the middle, not what you see at ps times.

How to do a Curve
Example of a typical curve:
+0 - PreShot number.
+1 – Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 – Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (may dip around +10 or +11).
+12 - PreShot number.

Shot locations:
Saddle – locations for Squids/injections
Injection Sites for Cats

I wish I could say more, but maybe others will be along who can offer better suggestions.
 
Re: 12/25 Todd PMPS HIGH (Help!.. Question)

Hey There Gayle,

I have been doing mid-day checks. But I gave his ears a break for the last three days, because they were so bruised up, they wouldn't even bleed. Now that he has had a break, they were much better yesterday (Sat).

I certainly wish I could have done a mid day check yesterday (Saturday) but with it being a holiday, I had to go to my moms home and I had no one to check Todd for me.

Anyway, I just did his +3 1/2 and the meter read 'Hi" again. So it's still above 600 and I will be surprised if it goes down, even with the extra bit of insulin I gave. But we'll see. His BG has kind of been all over the place, but something I have noticed when looking at his SS, is on the days he gets Mirtazapine, his BG is always really high. This is the first day where it's been off the meter high though. I don't know if that means the Mirtazapine is making his BG go up, or if since it is a appetite stimulant, it's just making him eat more and it's showing in the BG numbers.

Also, the 1.9u is a rough guess. It wasn't quite at 2u.. I wasn't sure how to write that. Perhaps I did that wrong. But lets just call it, not quite 2u is what he got tonight.

Thank you!
 
Re: 12/25 Todd PMPS HIGH, +3 1/2 HIGH (Help!.. Question)

Hi, i don't have access to your SS from my phone, but I shoot Baby in the side of her chest or tummy. Is there anyway you can transition Todd off dry food? Have you had an opportunity to look at the diet information?
 
Re: 12/25 Todd PMPS HIGH, +3 1/2 HIGH (Help!.. Question)

Sadly, he refuses to eat canned food of any kind, unless it happens to be tuna. Anything else, he won't touch it. Believe me, we have tried. What makes it even harder is not only is he a diabetic, but he has CRF, so he's on a kidney diet right now. He won't touch any of the canned kidney diet foods. We have been trying for months now. I even tried putting tuna water IN some canned food. He knew I was trying to fool him and wouldn't go for it.
 
Re: 12/25 Todd PMPS HIGH, +3 1/2 HIGH (Help!.. Question)

It is hard, I about pulled my hair out trying to get Baby on canned :YMSIGH: but I bet your #s will be a lot better once you can make the switch. Here is a link viewtopic.php?f=14&t=956. Hopefully someone can come by about your dose, hang in there, your doing great.
 
Re: 12/25 Todd PMPS HIGH, +3 1/2 HIGH (Help!.. Question)

I know what it's like to have a cat who is that stubborn with food. Lucky for me, Booboo's a civie. She refused to eat for 2 days when I took up the dry when Shadoe was first dx. Shadoe went OK fine and ate the wet. Booboo went hrumph and refused to eat, drank only water, hid and hissed and growled at me. I gave up for her but she gets her dry ONLY when I am around. Other times, she is welcome to have any of the wet that is out for the others.

So, I wonder if Todd eats tuna, maybe you can feed him tuna on those days when his meds will make him go higher in BG. Is that allowable? What dry food is he eating and do you know the carb % for it? If he will eat tuna wet food, could you give him that wet food on his meds days, or try to alternate some days the wet tuna food and others the dry?

If nothing really works, there is nothing to stop you from just giving more insulin because of the dry food. Sure, it would be great to have him eating all the nice low carb wet food and getting less insulin, but if that can't happen, well just up the insulin.
I know it's said that even stubborn cats can be switched, but I do not believe it. I do believe that there are a few who are just set on what they like and would refuse to eat if pushed.
All we can do is the best that the cat allows, accepts.
 
Re: 12/25 Todd PMPS HIGH, +3 1/2 HIGH (Help!.. Question)

Todd is one of those cats that just doesn't like change, of ANY kind. The vets are on the fence about the tuna. I give him a sliver of tuna (low sodium canned in water) as a treat, but feeding just tuna probably won't work, because of all of the protein. It's not good for the kidneys.


He eats Hills k/d dry and I do have the canned as well. I always offer the canned, but he just looks at me like I am crazy. He won't touch it. I don't know what the carbs are like on the k/d dry, but I imagine they are very high.
 
Re: 12/25 Todd PMPS HIGH, +3 1/2 HIGH (Help!.. Question)

Part of the problem is that K/D dry is 35% carb. That's a huge % of carbs for insulin to try to counter. The K/D canned is 27% carb. What I would suggest is that you post on Health about alternatives for food for a cat with CRD and FD. There are many cats here who have both conditions are are fed a low carb diet. I don't know if anyone provided this link for you. It's to Janet & Binky's food chart. It contains info on carbs, protein, fat, and phosphorus content.

The other concern I have is that you're dose hopping. My guess is that you are thinking that increasing the dose, even by a drop, will effect the current cycle. Lantus doesn't work that way. A change in dose doesn't necessarily effect the current cycle. You need to remember that any dose change also effects the shed. You've changed the dose 6 times in 9 cycles. Doses need at least 4 - 6 cycles to settle. Without allowing for that time, and with rapid dose changes, you'll end up seeing wonky numbers. I also suspect you are basing your dose decisions on pre-shot numbers. Doses are based on the nadir. Without mid-cycle checks, it isn't wise to change the dose.
 
Would you suggest I bring his insulin dose back down to 1.5u and see how he does? He's not due for several hours, so I can bring it down tp the 1.5u this morning. Also, I just did a mid-night check, at +6 he is 526. It did come down.

The tough part is I have somewhere I have to be at 1pm today, and I tend to do the mid-day check at 2pm. So I'm not sure how to handle this... ugh, holidays are making this hard to deal with.

Thank you
 
oh, and please forgive me for perhaps sounding lazy or something. I have taken a close look at the food chart/guide, and I get myself rather confused with it and I am not at all sure WHAT I should even try. Especially since he is such a picky cat.
 
Sarah, what time is Todd's shot? What kind of spot checks can you get?I know Todd has been on the juice longer than 3 days, but these spot checks are good to begin with:

WHEN FOLLOWING A TIGHT REGULATION PROTOCOL WITH LANTUS OR LEVEMIR...

Kitty should be monitored closely the first three days when starting Lantus or Levemir.
Blood glucose levels should at least be checked at pre-shot, +3, +6, and +9.
More monitoring may be needed.
Click to expand...

oh, and please forgive me for perhaps sounding lazy or something. I have taken a close look at the food chart/guide, and I get myself rather confused with it and I am not at all sure WHAT I should even try. Especially since he is such a picky cat.
Click to expand...

You don't sound lazy, just dont get the impression that it was easy for us to switch our cats over, it is HARD for many of us. Baby was a dry food addict (like many kitties) & I had the hardest time switching her over, I tried everything suggested & one day something just worked, but it did not happen overnight or even over a weekend. It took time.. but we did it & I even have her on a Raw diet now. I would do what Sienne suggested.. post in Health & get some ideas for CRD & FD Diets.
It is overwhelming, but definitely doable & support is just a post away :-D
 
Hi, I haven't been around for a while but thought i'd throw my pennys worth in.
i aGREE WITH Sienne, you need to stay with your dose.
2u was perfect, you got a 64 so then needed to monitor for the next few cycles to see if you earnt a dose reduction(you may find numbers start to go up again, way lantus and lev work, until you get breakthrough dose).if testing was a prob cos of hols you could of temporarily shaved the dose (to a smidge under 2u)

stick with the 1.9u again.have a look at the stickies at the top, in one jill explains the version of the tilly protocol we use here.i'd do it but can only type with 1 hand at the mo and taking forever.

as for the crf/crd-post in health about it.melissa/popcorn? have a post about it.if you scroll through older pages oif health you'll probaby find it.lots of good info.
also a site by tanya i think it is.british but fab reading,guidance etc about these conditions.not on my computer so can't give link-anyone else?

whenever life gets in the way you just err on the side of caution.always leave plenty of fuds.trying to convert from dry is the biggest thing here.
keep going your doing a grand job :mrgreen:
 
Here's what I would suggest regarding dose.

I'd go back to 1.75u providing you can get mid-cycle tests and monitor how Todd is doing. I can appreciate your concern about Todd's ears. However, take a look at Gabby's SS. I test a lot. (Gabby can nose dive and testing is the only way I know of to make sure her numbers aren't tanking.) Gabby's ears are none the worse for wear. It takes a while for the ears to "learn" to bleed.

If you can't get the tests due to holiday commitments, then I'd go back to 1.5u.

Either way, we can help you when it comes to adjusting the dose based on how Todd's numbers are looking. Just remember that Lantus dosing is based on the lowest point in the cycle. Don't tinker with the dose if you see a high pre-shot number. There have been times when Gabby has earned a dose reduction with numbers in the 40s at mid-cycle and her AM and PMPS were in the 400s. Those pre-shot levels can fool you.

I don't have much experience with a diet for a CKD kitty. I'll see if I can get some folks who have cats with both diagnoses to stop by and give you some ideas about food. It may take a while to transition Todd to a lower carb diet. This can be done gradually so he won't reject canned food. (To be honest, I'm surprised he'll eat K/D. Most cats are not fond of Hill's products. They used to be a better quality but not so much anymore.)

This is the link to Tonya's CRF/CKD site that Kate mentioned.

I'm attaching a file that Jill sent. It lists out all of the foods that are lower in phosphorus. Also, hydration is important in cats with kidney issues -- hence the push to give canned food rather than dry.
 

Attachments

Good Morning and Happy Holidays! Sorry to see Todd was HI today. :cry: That is NEVER fun to see.

As a brief intro, my cat Latte whom left us earlier this year, had arf/crf, and pred induced diabetes, amongst many other conditions. She was a kibble eater her entire life. Somehow after her ARF I managed to get her a little interested in wet, but not much. With the diabetes I could get her to eat maybe 1/4-1 small can wellness. Otherwise she was eating kibble. It was always a struggle to get her to eat in general, so any food was good food in our eyes. Better than not eating at all.

Due to eating kibble (EVO) she could have some major swings in BG's. With the food she was eating and the amount of testing I did I could see when she would rise and approximately how long it would last. Feel free to peek at Latte's ss. You may see a pattern.

Fluids will also affect the BG. If you are giving a full 150ml, you will likely see a decent size drop within the next hour. It was always important to make sure I did not give fluids when I knew she might drop from the kibble wearing out or about to hit her nadir. It would be important to do some bg tests before and 30-60min after fluids to see how it may be affecting Todd. Have you considered splitting the fluids and giving them twice daily (ie/75ml/day)? Latte was a little cat and got 150-200 for a loooooong time. That is a LOT of fluids, though. Its not always feasible to split but might be more comfortable for Todd and help even out hydration.

Diet- The kd, as sienne pointed out is SUPER high in carbs. If you are going with dry you might want to consider something like EVO. It is high in protein which some will argue is not good for kidneys. Some will say its the kind of protein that is most important. It is also very high in Phosphorus. You can use a phosphorus binder mixed in to help lower that. It is also very high in calories, so if weight is an issue it will help (one of the reasons I chose it in the first place for latte). I know you said you have tried to switch Todd. I also know that not every cat CAN switch for various reasons. BUt most can. In case you have not looked at Dr. Lisa's suggestions, please do.
http://catinfo.org/

Weight- Its good you have a babyscale to weigh him. I think it was a life saver for us, especially when I had to syringe feed for extended periods of time. I would maybe suggest picking a certain time of day and week to do weigh ins. Then you have the same variables involved, for the most part, each time you weigh him. Glad to see he is putting some weight on. Look for a trend of going up or down.

Labs- Sorry, I have not been around much so you may have already talked about bloodwork in previous posts. Do you have a link to a post where you listed Todds bloodwork? Im curious about creatinine, phos, bun, etc (kidney values).

For further support with the kidney issues you can also post on health AND either of the yahoo groups:
http://www.felinecrf.org/index.htm (this is tanyas website, packed with info)
http://pets.groups.yahoo.com/group/tanyas-crf-support/
http://pets.groups.yahoo.com/group/Feline-CRF-Support/?yguid=6606790

Insulin/BG- More spot checks will be important before adjusting doses. Gayle pointed this out pretty clearly. More spot checks will also help you see how much the kibble is affecting Todd's BG's. Im assuming you work all week? Do you have weekends free? COuld you do a curve next weekend? Also, could you get a check before you go to bed each night? Have you been testing for ketones? With high numbers, its usually a wise thing to do. You can get ketostix from most pharmacies (sorry if Im repeating something you know).

If you have any questions, dont hesitate to ask! You are not alone in this situation. Many folks out there are dealing with similar coinciding conditions in their cats. Its a lot of juggling, but It can be managed!
 
Wow!!! As ever the greatest resources step up... :thumbup


Just one observation and/or question. You said Todd got his appetite stimulant. Did you "free feed" him on that day? If so that would explain a lot of the HI numbers. Perhaps providing him schedule feedings of the appropriate amount of food on those days would be better, than letting him ''pig out."
 
A few questions, thoughts, observations after looking at your comments on the ss.

I noticed you gave pred on 10/24 and one or two other days. Is this something you continue to give regularly or sporadically (I dont see notes of it anywhere else)? Steroids *can* affect BG's.

Am I correct to say he was diagnosed with fd before his creatinine started rising?
Did they rule out an infection causing the rise in creatinine? Urinary or kidney? It looks like the last kidney panel was done about 2 weeks ago. With his numbers going higher, it might be worth bringing him in for another panel and check for a UTI. For some reason, these high numbers (BG) are really bugging me and causing a little concern that something else is going on. Though it could be as simple as bouncing, which we do not know without spot checks.

I had another thought or question, but now I cant remember it! :lol:

ETA: Now I remember! ohmygod_smile How is he feeling the last few days?
 
hi guys!
you are getting great advise on the insulin in this forum....but also you are being asked good questions regarding his renal issues....

Rocket was dx with CRF (you call it CKD which is the same) back in May08....he was put on the kd dry food as he totally did not want to eat the wet one...i was trying to help him with his renal issues until end of Sep08 when he was dx with diabetes....and i needed to get him off of the dry kd....so i experimented with 1 can of each flavour out there...i'm not joking with that....prior of his CRF diagnosis he was on wet Iams Oceanfish....so the poor thing was all messed up....

if you look at Rocket's old SS you will see that he too registered at HI on the meter at first....but in order to get to lower numbers i had to get him to eat wet food....no way around it....

here are a few questions for you: though you mention you are giving subq daily....are you giving binder as well in his food? how much binder? what are his PHOS values? do you add the binder to the dry food? Rocket does not eat tuna either...he drinks the juice from it....and though i know it's not good for him with his CRF issues....in order to still leave the smell of tuna for him i dilute it a lil bit and mix it into his wet food....

you need his numbers to come down....both diseases ARE manageable....if you look at my signature...Rocket has more issues as well and we are managing them all....it is duable....you are overwhelmed and i totally understand where you are coming from....

if he likes tuna buy fishy smelly cans of food...different brand names....get the ALuminum hydroxide and add it to the food as well....also note that the binder does create constipation....so adding a lil bit of miralax to it will aide him with that....i add miralax and canned pumpkin (only the canned one no spices in it) as well....it works...and Rocket is on an extremely high binder dose....
 
Re: 12/25 Todd PMPS HIGH, +3 1/2 HIGH (Help!.. Question)

ToddyTiger said:
Sadly, he refuses to eat canned food of any kind, unless it happens to be tuna. Anything else, he won't touch it. Believe me, we have tried. What makes it even harder is not only is he a diabetic, but he has CRF, so he's on a kidney diet right now. He won't touch any of the canned kidney diet foods. We have been trying for months now. I even tried putting tuna water IN some canned food. He knew I was trying to fool him and wouldn't go for it.
Click to expand...
crushing almost powder like the kd dry to add as topping on any wet food does work well...you can not start him on a new food but rather you need to slowly get him out of it....that's how i got Rocket out of that dry kd into wet....also mixing the crushed kibble inside the wet food will entice him to eat....the ratio should be more wet than dry of course....give it a try
 
Re: 12/25 Todd PMPS HIGH, +3 1/2 HIGH (Help!.. Question)

ToddyTiger said:
Todd is one of those cats that just doesn't like change, of ANY kind. The vets are on the fence about the tuna. I give him a sliver of tuna (low sodium canned in water) as a treat, but feeding just tuna probably won't work, because of all of the protein. It's not good for the kidneys.


He eats Hills k/d dry and I do have the canned as well. I always offer the canned, but he just looks at me like I am crazy. He won't touch it. I don't know what the carbs are like on the k/d dry, but I imagine they are very high.
Click to expand...
they do come around.....for years Rocket refused to eat any other flavour aside the Iams Oceanfish....i had to search the city sometimes if the closest petstore didn't have it....and when they changed the recipe it was a nightmare....but it is duable....Rocket has had CRF now 2 1/2 yrs.....and it has not been on the prescribed renal food...that i guarantee you....he is on FF chicken and liver, FF oceanfish, Purina proplan chicken and liver (see how picky he is....same flavour just different brand name).....i add the binder to the food which is way better than giving the renal food....and the FF is high in protein when compared to the renal food....just goes to show you that CRF is manageable when you have all the tools.....we can help you get there ;-)
 
Just a couple of things to add although you have gotten awesome advice:

1. be careful about the tuna in spring water...read the labels; recently the companies made a change and the fine print says "vegetable broth" which has soy...you do not want to give this to your kitty.

2. Beyond Nature organic canned food is low in phosphorus andhas 4% calories from carbs.
 
Blue- YES.. he did free feed yesterday. I think I mentioned that. He was free feeding yesterday while I was out at my mom's. I was gone from about 3pm until 10pm, so I didn't want to leave him hanging. That was why I figured this MUST be from the food. Normally though, he does not free feed. I feed him several small meals throughout the day and maybe once of twice during the night when I wake up for bathroom breaks. hehe

Today is another day where I will be gone for a few hours, but I'm going to try to get back here by his +6 to spot check him.

I'll get back to everyone shortly.. I'm still reading through everyones comments! Thank you!!
 
Carolyn- They have checked him for infections and UTI several times. His white count always seems to be up a bit, but they cannot find the cause. So he's been on several antibiotics in the last few months. He just finished another one, as a matter of fact.


He was on pred for a short time, because our vet thought he may have IBD.. she had him eating Hill's i/d (which he loved, even the canned he seemed to like a bit) and he was doing really well with that. However, not long after that, we noticed his kidney values started going up just a hair, so she had us go see a internal med specialist. He thought Todd might have IBD as well, but felt we should treat the kidneys right away. So he had us stop the Pred (slowly of course) Todd was started on Hill's k/d and was receiving 100ml of Sub-Q every other day. He was fine like that for a while.. Recently, within just the last couple of weeks, is when we noticed his BG going up and up and so were his kidney values. Again, no known cause aside from old age and "this happens to cats with CRD, they get worse". He's had several X-rays and ultrasounds since Aug. We've ruled out tumors and such. And honestly, I think the Internal Med. doctor doesn't know for sure either. I had been wondering for a while about upping his insulin dose, which we finally did a week and a half ago. I have this feeling, if we get his BG under control, he might gain a bit of weight back and feel a lot better, even with the kidney issues. But his numbers are just all over the place. We are due back this week for a recheck of everything. I will of course let everyone know! :)

Yes, he has had diabetes for 3 years now. The kidney issues popped up within the last couple of months.

He's been acting pretty good the last few days, all things considered. He hasn't played in years, so he mostly just sleeps in warm spots, suns himself by the window or follows me around the house. On days where he gets the Mirtazapine, he becomes VERY chatty and happy, and tends to follow me everywhere. Happy side effects. heh One thing to note though, it's been several weeks since he tried to get up onto our bed. It's rather high, even with the pet stairs I added to it. This morning he's gotten up here twice. The first one was to wake me at 9am to tell me he was hungry (by batting at my face and giving a VERY serious meow) and the 2nd was just a few minutes ago, because he wanted to snuggle.
 
Marjorie- I usually do check out all labels, but since it said tuna in water, I didn't think much of it for a couple of weeks. Then one night I actually looked at it and saw the vegi broth, so I was SURE I killed my cat. I found that Bumblebee tuna makes a low sodium tuna packed in water only. So I've been doing that as his little treat. :) It was hard to find tuna that was in water only!

Thank you!


(Still getting through all the comments, folks. heh)
 
wow, there's a lot of good info in this thread. I need to reread it again later to see what I missed the first time around!

Good luck with the new/consistent dose. I hope you'll start seeing better numbers once you are giving the same dose all the time for a little while.
 
Thank you for taking time to answer some of the questions asked of you. What is your name btw?
I went back and read your introductory post in LL. It was pretty thurough and I can tell you are a very dedicated bean and really want to make sure you are doing the right things for Todd. I also understand your fear and frustration over not understanding what is going on. Their little bodies can be so complex!

One thing that can cause a rise in bun/creatinine is a kidney infection. Of course any infection in the body can also increase BG's. You have noted in some of your posts about back leg weakness Todd has. Certainly there could be many reasons for this (potassium levels, neuropathy, etc). These infections can cause back pain. I wont go into Latte's situation too much, but after learning (too late) about a kidney stone, her battling multiple infections @ one time, and serious issues with walking/mobility near the end, I do think a bad infection can cause enough pain to limit their mobility. Kidney infections are very difficult to 'diagnose'. Often times, when suspected a course of antibiotics are given for 6-8 weeks. Fluids and diet change are also a part of treatment. Im wondering how much this possibility has been explored?

Here is some information on kidney infections:
http://www.petplace.com/cats/pyelonephritis-in-cats/page1.aspx
http://www.felinecrf.org/causes_of_crf.htm#pyelonephritis

If Todd were my cat, here are the things I would want to do in the next week.

1. Talk to the vet about possible kidney (not urinary tract) infection. Is it a possibility? Could many of his symptoms be related? How would the vet come to the conclusion and how would they want to treat it?

2. More BG spot checks. Do a few curves, both am and pm cycles. This would involve testing every 2-4hrs. You could do a.m. one day and p.m. a day or two later, for sleep and sanity purposes. Take some tests before giving fluids and an hour after. Note this on your ss, for future reference. Test when he eats kibble. Test a few hours later. Test a few hours after that. Get an idea of how the current food is affecting his bg's. Dont hesitate to look at Latte's ss. As you scroll down, you will see how I documented all of this stuff so I could see what was going on. You will notice toward the end of her stay here her BG's could drop 200-300pts in an hr or two and then rise back up that much or more in another hour or two. EASILY missed data had I not been testing so much. I would have just thought she was always HI. I know it feels like a lot of poking. There are a lot of good tips people can share to make it easier on you and Todd.

3. Go to the store with a list of wet foods that are low carb/lower phosphorus and buy 1-2 cans of each. IF ibd is suspected, aim for some grain free. Suggestions that many of us use who have cats with renal issues , fd, and ibd are ff (chicken/liver, chicken, turkey), wellness (turkey, chicken, turkey/salmon), evo (duck, turkey). Look up some of the friskies varieties and see which one's are lower phosphorus. They may not be grain free, but it might be worth seeing if he is interested in it. Pick up some babyfood (meat only - beef, chicken, turkey) for emergencies, enticing to eat wet, or treats. Grab some freeze dried treats to be sprinkled on any wet food you offer (or treats in general). Read over Dr. Lisa's website and give a try offering some wet food. With the mirtazipine at work, you *may* find he is more interested in wet food. Even if you can reduce his intake to 50% wet/ 50% dry that will be a HUGE success.

4. Get a copy of the latest labwork from your vet. Not just chicken scribble they tell you over the phone. Ask for a hard copy. Post it here. Many of us are wondering about other blood work values. If phosphorus is high, you may need to consider a binder (which I could send you free) to mix into his food. The binder would also free you up to use whatever foods you want. You wont feel so stuck on the kidney diet. Potassium may need to be supplemented (could be the reason for back leg weakness).

5. Post an introduction to one of the yahoo groups I suggested in one of my earlier posts. Im favored toward tanya's list (aka helen - feline crf info). But either one can help guide you. They will want to see full blood work as well. So be prepared.

6. Get those keto stix and start testing daily for ketones.

7. Ask the vet about splitting fluids during the day, instead of giving all 150ml at the same time.

8. keep a daily condo and keep asking questions.

9. Love on that boy!

10. Do something for yourself. You must be EXHAUSTED!
 
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