2/25 Bear Man - Jojo/WCF questions answered

[Linda and Bear Man]

See 2/25 post at bottom ... mistakenly bumped yesterday's condo

viewtopic.php?f=9&t=7235

Miss Emily's labs: http://docs.google.com/fileview?id=0Bwg ... ZmFj&hl=en

Bear Man's labs: http://docs.google.com/fileview?id=0Bwg ... NmJm&hl=en

Bear Man had a nice amps of 121 this morning, but was up to 230 three hours later (with no dry food). He passed some blood today, and is refusing food tonight. I have noticed that on my days off, when I give his phosphorus binder three times instead of twice daily, he doesn't feel well. The bloodwork results from yesterday are in, with good news for Bear, and bad news for Miss Emily.

Emily's urea has increased. Her creatinine is high, as it was last time, and her phosphorus has worsened. Her USG is still low. With the urea so high, the vet suspects a recurrence of pyelonephritis. She has recently had two bouts of it. The C&S results will be back in a day or two, and we will decide on next steps then with respect to more testing (UPC ratio) and CRF tx.

Bear Man's numbers have improved. As I mentioned yesterday, his blood pressure was very good. His urea and creatinine have improved and are in the normal range. There is a tiny improvement in his phosphorus. His potassium has improved. His T4 has climbed up a bit, however, and he is still anemic at about the same levels. The vet wants me to continue what I have been doing with diet, binders, and Fortekor, and retest in about 4 weeks.

Bear is in bed for the night with Teddy, and I don't think I will be doing any more poking and prodding on him tonight. It will be a busy day at work for me tomorrow with snow coming, so I hope to be in bed soon, too.

 

[Libby and Lucy]

Re: 2/24 Bear Man and Miss Emily updates

sorry to hear about the decline in Miss Emily's bloodwork. When it rains it pours. I think a poke-free night for everyone sounds like a nice plan.

 

[Dyana]

Re: 2/24 Bear Man and Miss Emily updates

I am glad that Bear test results are better,
and I am sad that Emily's are not.
You sure have your hands full, Linda.
I hope you get some nice rest with your kittys tonight.

 

[Sienne and Gabby (GA)]

Re: 2/24 Bear Man and Miss Emily updates

I'm glad Bear's numbers are better. Is there anything that can be done for Miss Emily?

 

[joyce-tuscany(GA)]

Re: 2/24 Bear Man and Miss Emily updates

Oh - you must be canadian - your numbers on lab are different. Anyone remember how to convert the creat/bun to US equivalent??

 

[Helene & Tizon]

Re: 2/24 Bear Man and Miss Emily updates

((((Linda)))))

My heart goes out to you! I don't know how you keep everything straight... You have so much going on.
I'm glad to hear that Bearman numbers are better.
As for Miss Emily.... a hug to her!

 

[Nina and KB]

Re: 2/24 Bear Man and Miss Emily updates

Very happy for the Bear news, but sad for Miss Emily, it's so hard to see this. Sounds like a good night for snuggles instead of spot checks.

 

[WCF and Meowzi]

%

Oh - you must be canadian - your numbers on lab are different. Anyone remember how to convert the creat/bun to US equivalent??

divide by 88 to get estimate of creatinine - i don't remember the decimals, is 88.x for creatinine. for bun and the rest, you can do conversions here

Ca x P:
Bear's is coming down Was 73 before, is now 66. Would like to see it below 60. Some say threshold is 70, I've also seen 60-70 range. I'm troubled though that the binder is making him not feel good?

Emily's Ca x P is worrisome, around 74.

Neither of them are on lactulose, right? Although the issue isn't calcium per se; is the product of the two, but is easier to address through phos control. Emily's the kitty that's easygoing, food-wise?

Don't think their creatinine levels in the 2's look bad at all. But maybe I'm just desensitized. Having been into the 5's, we're now happy to see anything in the 3's or even low 4's - it's all relative, so don't take my word for it.

Me likey Bear's potassium reading

 

[jojo and bunny]

Re: 2/24 Bear Man and Miss Emily updates

gee linda bear's renal values look wonderful! i do echo WCF's question about if the phos binder is seeming to make him not feel good? with numbers that good do you think you can get away with giving less if you concur that there is a link between how he feels and the binders? (personally i would sacrifice perfect renal numbers for QOL stuff always). did they do a USG, i didn't see it. and i am sorry if i missed it, has he had a rect. count done for the anemia?
BG numbers~ see you raised dose. may i suggest to go slow between dose increases? i just have noticed over the years that the longer a cat is diabetic the slower many of them respond to dose changes, hence i like to throw more time on a dose before increasing it (like he was getting green only a couple of weeks ago on a dose less than this current one, so even though he is yellow, i would give this 0.75 units more time to see if it has more action before going up in dose again).

miss emily, does she have any signs of litter box discomfort? like how is her WCR? a bit dehydrated, is vet talking of starting a bit of SQuids with her?

do you make your cats line up for their meds and tx's at your house like i do at mine? well try, can't say they have gotten the assembly line idea down yet, but they are starting to answer to "next!" :lol:

how are you?
doing great job of handling all your full plates, a night off for everyone sounds like a great idea.

 

[Roni and Moonie]

Re: 2/24 Bear Man and Miss Emily updates

You are so fabulous--Kitty Mother of the Year!! Hope Miss Emily feels better soon & so Glad Bear Man is sounding like he's much better-
I'm always watching your condo, as you all are so amazing!! Big Hugs to all of you~!!!! Healing Vines to all!!

 

[Linda and Bear Man]

Sorry!!! Did not mean to bump yesterday's old condo. I was working so hard on formatting quotes that I submitted the wrong post!

viewtopic.php?f=9&t=7343

Today: amps 268, pmps 155, WCR sleepy and comfortable

Neither of them are on lactulose, right? Emily's the kitty that's easygoing, food-wise?

Neither is on lactulose. Emily will eat anything. I do have to watch fat and carbs on her as she has a history of pancreatitis, and pre-diabetes, and takes acarbose. I'm concerned about the carbs in a prescription renal food.

did they do a USG,
has he had a rect. count done for the anemia?
miss emily, does she have any signs of litter box discomfort? like how is her WCR? a bit dehydrated, is vet talking of starting a bit of SQuids with her?

Bear USG is 1.021 (up from 1.020).
His last reticulocyte count was in Oct/09. Reticulocytes were 0.4 (reference 0.4 - 1.4%)
Miss Emily is chronically constipated, but is not having any urinary signs of UTI, as she has had in the past. She seems well except for drinking vast amounts of water. I will ask the vet about squids, but Emily is fractious.

Thanks to WCF and Jojo for the comments and advice and to everyone who responded.

 

[WCF and Meowzi]

Emily will eat anything. I do have to watch fat and carbs on her as she has a history of pancreatitis, and pre-diabetes, and takes acarbose. I'm concerned about the carbs in a prescription renal food.

I don't know anything about acarbose, so keep this in mind when reading my comment.

But why a prescription renal food? It's not a secret that I am one of those in the minority who is not averse to rx renal food. I have seen CKD kitties maintain stable renal values on rx renal food, for whatever reason, be it low-sodium, low-phos or low-protein, or something else in the formulation, on the CRF board. So I do not have a strong bias against rx renal foods, although it would not be my first choice, at the stage we are in. You know that.

With that said - why not try a lower-phos non-rx food first? I'm assuming that she's still on a higher-phos diet? Or did you switch her to a lower-phos diet when you switched Bear's? If Emily's being fed higher-phos FF right now, why not switch her to a lower-phos, non-rx food and see how she does? You may possibly reduce her phos intake by just by switching her to one of the foods on the list I sent you. That, and a phos binder and SQuids may be all it takes.

One more thing - has vettybean talked about putting her on a phos binder? I am more concerned - make that *very* concerned - about her phosphorus level than her creatinine. At her age, a little renal insufficiency is not unusual, but that phos level really concerns me.

Did you end up ordering ALOH3 from Thriving Pets? With two cats on phos binders, the powder form would be more cost effective than the capsules you're using now.

Re: Bear - not sure you know, but we have Meowzi on two phos binders, not one. Fosrenol (lanthanum carbonate) isn't used much in cats, but Meowzi doesn't seem to have a problem with it. (Cassandra's dad is on it too but I think she said he hates it :lol: ) Don't know if that's an option for Bear. eta: * (see below)

BTW phos binders can be constipating - I did mention that before, right? Wondering if that's the source of Bear's discomfort.

Gotta go, break ended 2 mins ago :sad:

eta: *Another binder that I've seen used, but not as much, is sevelamer hydrochloride/Renagel is one brand. And then there's niacinamide, which I know pretty much nothing about.