3/8 Ruby TAMU GI results/vet update PMPS 119/+2 104/+4 75

Katherine&Ruby

Katherine&Ruby

Very Active Member
Yesterday on I Dream of Ruby. :cat:

Received a most generous gift of poop this morning, somewhat belatedly to my birthday wishes but it is happily accepted. :rolleyes:

Eating did not go as well as hoped and I’ve ascertained the culprit: Primal frozen raw duck. I eliminated it from her diet for a day, feeding her ground turkey with EZ complete and had no problems. Once I gave her the duck again last night, the vomited recommenced. I am going to hold off on feeding that to her again for a few weeks as perhaps it is too rich to be introducing to her at such an early stage of the raw food transition (we are in our third week). Will make another batch of turkey tonight as well as one of bison to add another protein to the rotation. For sure she has never had bison so it will be entirely novel. Hopefully eliminating the duck will solve our nausea problems as well as stop the vomiting.

Healing thoughts for all the sick kitties and hugs to you beans who love them so. Have a great start to the week, everyone. :bighug::bighug:
 
Butters loooooves bison with FFL in it. I hope Ruby enjoys it, too.
Hopefully the vomiting ceases with the diet change. FFL is probably a better choice anyhow, I think. It uses eggshell for calcium instead of bone, so it is lower overall in phosphorus even after adding the meat. I had a small stockpile of Primal food that I gave away after Butters was diagnosed with CKD, because it has ground bone in it and was too high in phosphorus for her to continue eating.

Have a wonderful day!
 
Butters & Lyla said:
Butters loooooves bison with FFL in it. I hope Ruby enjoys it, too.
Hopefully the vomiting ceases with the diet change. FFL is probably a better choice anyhow, I think. It uses eggshell for calcium instead of bone, so it is lower overall in phosphorus even after adding the meat. I had a small stockpile of Primal food that I gave away after Butters was diagnosed with CKD, because it has ground bone in it and was too high in phosphorus for her to continue eating.

Have a wonderful day!
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I have to admit that I bought the duck excitedly because I myself love eating duck and hoped Ruby would too! This was before I realized it had so much bone in it, so I have been trying to feed it to Ruby in moderation rather than have it be the majority of her raw consumption until I finished the bag as it's rather pricey. So for now it will sit in the freezer for a while. Maybe Olive will like it?
 
I finally received an email response from Ruby's internist after calling her for every day for a week. I found out yesterday that she went on maternity leave and didn't mention it!

I wanted to follow up with you regarding Ruby's appointment with our Internal Medicine service and answer any questions that you may have about her final test results. I see that you had requested the final write up of the abdominal ultrasound from our radiologist, which looks like it was sent to you via email on March 4th. As we discussed at the time of the consult, overall there were no major concerns on the ultrasound related to Ruby's presenting complaint apart from mild small intestinal changes that appear improved from previous evaluations. Ruby's GI panel confirmed that there are no major abnormalities (her B12 level was too high to read - this is good and not pathologic, her folate was at the upper-end of normal - this can be normal or an indicator of small intestinal bacterial overgrowth for which she is already receiving the proper treatment with her probiotics, and her pancreatitis testing returned normal).

Based on her assessment, I think her current problem list includes early (stage II) chronic kidney disease, some sort of underlying intestinal disease (which may require biopsies to definitively diagnose), and chronic hypoglycemia (BG <80) secondary to insulin administration. To address these problems and determine if her appetite improves, I'd recommend transitioning her to a low-protein low-phosphorus diet specifically formulated for cats with chronic kidney disease and potentially considering a combination diet for cats with dietary sensitivities (such as Royal Canin Multifunction Renal Support + Hydrolyzed Protein). If you prefer a more holistic approach, consultation with a boarded veterinary nutritionist could be considered for a home-cooked formulation of a similar diet. I would also recommend discontinuation of her insulin as chronic hypoglycemia may cause her to have a decreased appetite as well. Please let me know if you have any questions regarding the recommendations.

Firstly, she does not address my demand for a more detailed radiology report. Secondly, I have no idea if the GI panel she refers to is the one sent to Texas A&M, and I need those numbers. Thirdly, the "chronic hypoglycemia" really gets my goat. Would love to hear thoughts from all of you as to how I should proceed. Am pulling my hair out.
 
I have nothing to input, I was just curious about your post so read through. I'm sorry you're going through so much! I looked at your spreadsheet and I'm curious how they came to the conclusion of "chronic hypoglycemia." Your numbers look great! I hope things get better.
 
MarleyMoo said:
I'm curious how they came to the conclusion of "chronic hypoglycemia."
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Me too. I guess the vet considers anything <80 to be hypoglycemic. That seems like a rather random number to me. I explained to the vet when provided with Ruby's SS that her BG numbers are based on a human meter, not pet meter. I'm composing a new email to her now, linking the Roomp Rand protocol, so maybe she will come around. Or not. ¯\_(ツ)_/¯
 
PerfumedCatMom said:
Me too. I guess the vet considers anything <80 to be hypoglycemic. That seems like a rather random number to me. I explained to the vet when provided with Ruby's SS that her BG numbers are based on a human meter, not pet meter. I'm composing a new email to her now, linking the Roomp Rand protocol, so maybe she will come around. Or not. ¯\_(ツ)_/¯
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That might be the case. Since pet meter take-action number is 68, it's plausible they see 50-60 and think "hypoglycemia." Maybe it should be restated that <50 is bad on a human meter, not the 70-80 they're used to? Good idea sending them that link. I hope they at least read it and not brush it off.
 
Hi Katherine, I'm glad you found out about the raw duck not agreeing with Ruby.
Saying she has chronic hypoglycemia would get my goat also.
Yeah for the poop!
I hope she continues to eat good with the turkey and will have no problems with the
bison. Have a good day ♥:bighug::bighug::bighug:
 
Katherine, mostly good news. Hair can fall out from stress; don't do any extra pulling!!

From a vet's point of view, if Ruby is testing under 80 on the AT, they will likely see that as low. An example, Tina tests around 100 on the AT at the vet's, and 50-60 at home on the Freestle Lite. I know we reduce at 68 on the AT meter, however, I found guidelines from Queensland, suggesting 80, that others either ignore or don't agree with. Just trying to figure why you are being told to take Ruby off insulin.

So glad Ruby gifted you, even if a bit late!
 
I completely relate with hair pulling in regards to vets lately!! Arrrgh!!

I hate that they didn’t address your request. You may want to reply and just specifically ask for the ultrasound report from the radiologist and Ruby’s full medical record.

That’s so great for no pancreatitis!

I don’t have anything very concrete or helpful, because I feel like I’m chasing specialists and they each point to the other. I will say I have only found ONE small animal internist that I have liked, and he moved to DE.:banghead: They all seem to be “dog people,” and just tolerate cats. :rolleyes:

Big hugs :bighug::bighug:
 
The reduction at 68 on an AT meter comes from the Roomp & Rand (Rand being the person who developed the TR protocol and was at University of Queensland). I'm not sure where you found 80 as the reduction point.

I would consider eliminating poultry products from your cat's diet if at all possible. Have you tried other novel proteins? Foods like pork, lamb, or venison might be better. The suggested renal diet is very high in carbs. If you need lower phosphorus, ask about a phosphorus binder.
 
Sienne and Gabby (GA) said:
The reduction at 68 on an AT meter comes from the Roomp & Rand (Rand being the person who developed the TR protocol and was at University of Queensland). I'm not sure where you found 80 as the reduction point.

I would consider eliminating poultry products from your cat's diet if at all possible. Have you tried other novel proteins? Foods like pork, lamb, or venison might be better. The suggested renal diet is very high in carbs. If you need lower phosphorus, ask about a phosphorus binder.
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Thank you, Sienne. It was not me who found 80 as the reduction point, it was the vet who suggested Ruby was hypoglycemic because she has been under 80 a lot (even though I did tell her I was using a human meter).

I am definitely not feeding her the Royal Canin she suggests which is 45% carbs. I am experimenting with some raw bison today and I have some freeze-dried venison that I can introduce. So far her phosphorus levels are normal, so no binders are necessary right now.
 
RachelG said:
I completely relate with hair pulling in regards to vets lately!! Arrrgh!!

I hate that they didn’t address your request. You may want to reply and just specifically ask for the ultrasound report from the radiologist and Ruby’s full medical record.

That’s so great for no pancreatitis!

I don’t have anything very concrete or helpful, because I feel like I’m chasing specialists and they each point to the other. I will say I have only found ONE small animal internist that I have liked, and he moved to DE.:banghead: They all seem to be “dog people,” and just tolerate cats. :rolleyes:

Big hugs :bighug::bighug:
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I have the radiologist report. It's very vague and I've demanded more detail. It's in this thread: https://www.felinediabetes.com/FDMB...und-results-pmps-85-2-61.244082/#post-2754355
 
MarleyMoo said:
Looking at the Roomp & Rand PDF linked, I do see <80 listed as reduction. I see it on page 4 and 5.
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Thanks! I have it printed and in a binder. From my experience with Tina going off insulin, it happened quickly after changing to a human meter. She was not going under 68 on the AT, but quickly went under 50 on the Freestyle Lite.
 
PerfumedCatMom said:
I guess the vet considers anything <80 to be hypoglycemic. That seems like a rather random number to me.
Click to expand...
Funny, any time I've tested a non diabetic cat, I've seen from the 40's to the 80's - that last one just when a civvie was on steroids. It came down when I reduced his pred dose. I guess they were hypo'ing all the time. :rolleyes:
 
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