4/22 Max AMPS 314 +5 281 +7 225 +9 205 PMPS 169 +2 116

Max & Lori

Max & Lori

Member Since 2021
Good morning. I have posted Max's lab results on his SS if you have a minute to review and make recommendations. @Wendy&Neko @tiffmaxee @FrostD @Suzanne & Darcy and anyone else who has information on CKD, (and pancreatitis as well).

Max has had pancreatitis twice and recovered. I'm not sure what these new labs mean for him. He will still vomit if he doesn't get Zofran bid. The Budesonide seems to help with his IBD, and he gets Cerenia if he does vomit. He takes Gabapentin once a day, usually at bedtime. He's eating Instinct rabbit or Instinct grain free turkey mostly. He also eats Weruva chicken flavors and turkey flavors, occasionally he wants Weruva tuna. He also eats baked chicken without seasoning. I'm not sure if we need to treat him for pancreatitis with fluids right now because of his heart. His echo is due in a few weeks.

His kidneys have been pretty good until I get this report now. Lab comments say: "Renal Tech Prediction positive in this patient and indicates will develop CKD with the next 24 months with greater than 95% accuracy." He does have 2+ proteinuria, but the other values are pretty good. As I mentioned before his vet is recommending a low protein/renal diet. I'm thinking that is a not good idea though. I haven't given her an answer to her question about starting him on that. Any help/recommendations here are appreciated!

Max is not doing too bad, considering the BCS. I am feeling a little better, but still just concerned over what is going on with me. Trying to take care of myself and Max is a lot. My husband tries to do what he can but he is doesn't want to do any of the medical care required for Max. He's afraid of needles. Anyway, please take a look at the labs when you get a chance. Thanks so very much!
 
My Max had chronic pancreatitis for at least a few years before becoming diabetic. I say at least because that’s when he was diagnosed. I think he likely had it before but wasn’t letting us know. When he was feeling better and acting normal my vet ran the test again and it was still a little high. We never bothered running it again except when the symptoms showed up and he wanted to rule out other issues. If pancreatitis isn’t active the test can show negative. We just treated his symptoms. If your Max has symptoms it’s best to send out fur the SpecfPL test to confirm. It’s more accurate. For my boy treating the symptoms meant ondansetron, occasionally cerenia if he vomited but that was rare, bupe for pain sometimes, and sometimes a day or two of cyproheptadine to get him eating. Often just ondansetron seemed to work. I think he was hospitalized overnight for IV fluids once, maybe twice.

It looks like Max has very early ckd. I would not change to a low protein food. His creatinine and BUN are still in normal range. Was the add on test to address the protein in his urine requested? If not and it’s too late I would recheck that in a month or two. It should still be able to be requested now though.
 
Okay thanks Elise. The labs I posted were the only ones he had right now. He has had the confirmatory pancreatic test (SpecfPL) not long ago. Which add on test were you asking about to address the proteinuria?
 
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tiffmaxee said:
No point in running the pancreatitis test again. BTW, even the phosphorus is good, under 5 is what you want.
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Thanks for looking at the labs for me. Was there an additional test to check the protein in his urine that you mentioned?
 
Max's labs look pretty good. A lot of things can affect USG, which looks borderline at this point - it can vary (as we can see from Max's other tests) so we would be looking for trends over time. And the PSL Lipa test is only really significant if Max has other symptoms of a panc flare -- you did say he will vomit without the Zofran... (also his liver tests are all WNL.) I definitely would not change his food at this point. He needs that protein to help maintain the lean muscle mass. Hopefully, they can do the UPC test for you with remaining blood.

I hope that YOU are feeling better, Lori.
 
I'm curious what number they are using for their predictive factors of him getting CKD. I don't see an SDMA on the list of tests, so I am wondering their renal tech prediction is?
 
Okay... I was so curious that I have answered my own question. I'm attaching the link to the Antech labs Renal Tech Prediction.... I'm very jaded... I hate to see veterinary medicine come down to "increased visits and sales of CKD-related food purchases, etc. Here's a quote from their page about the Renal Tech thing:

"In a one-year retrospective analysis of 730,000 feline patients that visited small animal clinics, RenalTech was a significant driver of increased visits, CKD-related food purchases, and CKD-related medications."

Here's the link:https://www.antechdiagnostics.com/renaltech/
 
Good find@Suzanne & Darcy on the Antech quote!:mad:

Like the others said, I wouldn't change a thing yet. His phosphorus has gone down from a year ago, so definitely not a worry. Maybe the next time you get blood work (no rush) ask to have it sent to Idexx or at least get the SDMA at Idexx. As for answering your vet, just say "not at this time" and you want to wait until there actually are indicators of later stage kidney disease. Kidney diets are too high in carbs for diabetics.

It's not uncommon for acros to have proteinuria. You could get the urine protein creatinine ratio test done, or wait until you see positive urine again. My vet never liked doing something based on just one test and wanted a second test to see if it was a one off or a trend. Max's previous two urinalysis were negative for protein.
 
Suzanne & Darcy said:
Okay... I was so curious that I have answered my own question. I'm attaching the link to the Antech labs Renal Tech Prediction.... I'm very jaded... I hate to see veterinary medicine come down to "increased visits and sales of CKD-related food purchases, etc. Here's a quote from their page about the Renal Tech thing:

"In a one-year retrospective analysis of 730,000 feline patients that visited small animal clinics, RenalTech was a significant driver of increased visits, CKD-related food purchases, and CKD-related medications."

Here's the link:https://www.antechdiagnostics.com/renaltech/
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Well that is interesting…
 
Wendy&Neko said:
Good find@Suzanne & Darcy on the Antech quote!:mad:

Like the others said, I wouldn't change a thing yet. His phosphorus has gone down from a year ago, so definitely not a worry. Maybe the next time you get blood work (no rush) ask to have it sent to Idexx or at least get the SDMA at Idexx. As for answering your vet, just say "not at this time" and you want to wait until there actually are indicators of later stage kidney disease. Kidney diets are too high in carbs for diabetics.

It's not uncommon for acros to have proteinuria. You could get the urine protein creatinine ratio test done, or wait until you see positive urine again. My vet never liked doing something based on just one test and wanted a second test to see if it was a one off or a trend. Max's previous two urinalysis were negative for protein.
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Thanks Wendy and Suzanne. That is very helpful information. I had a cat before that had CKD. He was not diabetic. It was a horrible disease watching him go down the way he did. His vet didn’t seem to know that much about CKD either. Same thing now with Max and his conditions. Needless to say I’ve become very skeptical about any information about diabetes or CKD from any vet. Seems like they always want you to buy one of their RX diets. Not gonna happen right now. I will check into the additional tests SDMA and the protein creatinine ratio next time. I think feeding him the EZ complete has helped. He will only eat it with ground turkey though. Sometimes he wants a variety so I add the Instinct rabbit to that. I don’t think the Instinct is low in phosphorus though. I also know Weruva is lower in phosphorus so I give him that sometimes too. Anyway making just those changes from what he was eating before may have helped bring the phosphorus down. I don’t know if there’s anything else I could be doing right now? Thanks again for this information.
 
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@Wendy&Neko Max is at 116 now at PMPS +2! I didn’t want to do another reduced dose but maybe I should have. I’m still trying to recover. I just gave him HC. Why he does this when I’m otherwise occupied or not up to par I don’t know. Any other day when he soaring high I can monitor. If he would only do this during the daytime, it would be easier. So I guess he gets HC all night then until he comes up later? This doesn’t help with his pancreatitis either feeding him all of this food. Maybe I should take him back a little, I don’t know.
 
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I wouldn’t panic so much if he was more consistent in the way he reacts to his dose. The diving sometimes and flat other times. I just don’t know what he will do.
 
((((((@Max & Lori )))))) Oh no, of all the times to start trying to swim with the sharks:confused::confused: If you can't monitor, I would go a BCS dose and medium to high carbs if it was me. You have to think if you can stay up that late and you need to take care of yourself first and foremost! I know how hard it is to be the single caregiver, that was me too. My DH had a stroke just prior to my Tiger's diagnosis, and when he got better, he was also scared of hurting her, so I had to do everything just like you. The other day you said you hated to complain and it should be all about you, but I disagree, it is about you!!! This is what a support forum is for, empathy and compassion! You are very important to Max and you have to take care of yourself! :bighug::bighug::bighug::bighug::bighug::bighug: (stepping off the preaching platform now.....:oops::oops::oops:)
 
Tiger(GA) and Ruth said:
((((((@Max & Lori )))))) Oh no, of all the times to start trying to swim with the sharks:confused::confused: If you can't monitor, I would go a BCS dose and medium to high carbs if it was me. You have to think if you can stay up that late and you need to take care of yourself first and foremost! I know how hard it is to be the single caregiver, that was me too. My DH had a stroke just prior to my Tiger's diagnosis, and when he got better, he was also scared of hurting her, so I had to do everything just like you. The other day you said you hated to complain and it should be all about you, but I disagree, it is about you!!! This is what a support forum is for, empathy and compassion! You are very important to Max and you have to take care of yourself! :bighug::bighug::bighug::bighug::bighug::bighug: (stepping off the preaching platform now.....:oops::oops::oops:)
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Thanks Ruth. I just now asked my husband if I could show him how to check Max. I’ve asked him before as well. He said he just couldn’t. So I guess I’m going to have to stay up because he’s already had his full dose. This is just taking its toll on me though. I have some health issues that I try not to let hold me back, but I have to get my sleep to keep myself going. Max loves throwing those curve balls at me. His pancreas/IBD can’t handle a lot of food at one time either. Gosh I feel like I’m the only one here who can’t get it right with my cat!
 
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Tiger(GA) and Ruth said:
((((((@Max & Lori )))))) Oh no, of all the times to start trying to swim with the sharks:confused::confused: If you can't monitor, I would go a BCS dose and medium to high carbs if it was me. You have to think if you can stay up that late and you need to take care of yourself first and foremost! I know how hard it is to be the single caregiver, that was me too. My DH had a stroke just prior to my Tiger's diagnosis, and when he got better, he was also scared of hurting her, so I had to do everything just like you. The other day you said you hated to complain and it should be all about you, but I disagree, it is about you!!! This is what a support forum is for, empathy and compassion! You are very important to Max and you have to take care of yourself! :bighug::bighug::bighug::bighug::bighug::bighug: (stepping off the preaching platform now.....:oops::oops::oops:)
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You are right, Ruth!
 
Max & Lori said:
Thanks Ruth. I just now asked my husband if I could show him how to check Max. I’ve asked him before as well. He said he just couldn’t. So I guess I’m going to have to stay up because he’s already had his full dose. This is just taking its toll on me though. I have some health issues that I try not to hold me back, but I have to get my sleep to keep myself going. Max loves throwing those curve balls at me. His pancreas/IBD can’t handle a lot of food at one time either. Gosh I feel like I’m the only one here who can’t get it right with my cat!
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Oh no. You are not at all the only one! So many here have unpredictable cats. Have you ever looked at @Lisa & Oberon ’s spreadsheet! He is a bouncer and a diver. He knows when she’s going to be busy working too and frequently chooses those times for shenanigans!
 
Suzanne & Darcy said:
Oh no. You are not at all the only one! So many here have unpredictable cats. Have you ever looked at @Lisa & Oberon ’s spreadsheet! He is a bouncer and a diver. He knows when she’s going to be busy working too and frequently chooses those times for shenanigans!
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Gosh these cats! It must be a thing for these high dose kitties. I feel like I’m beating myself up all the time because whatever try to predict he will do, Max does the opposite. He’s jumped up to 179 now. I gave him the whole 3 oz can of food hoping that will bring him up and hold him for a while. It may have been too much this time but sometimes it takes that much. If it was during the day, I am sure I would do a better job of getting him to surf in green but noooo! He just won’t do that. I will leave him some LC food in his feeder tonight. In the morning he will probably be in outer space again.:blackeye:
 
Max & Lori said:
Gosh these cats! It must be a thing for these high dose kitties. I feel like I’m beating myself up all the time because whatever try to predict he will do, Max does the opposite. He’s jumped up to 179 now. I gave him the whole 3 oz can of food hoping that will bring him up and hold him for a while. It may have been too much this time but sometimes it takes that much. If it was during the day, I am sure I would do a better job of getting him to surf in green but noooo! He just won’t do that. I will leave him some LC food in his feeder tonight. In the morning he will probably be in outer space again.:blackeye:
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It’s okay. This too shall pass. He will come back down. Leave food out and go to sleep. You have an auto feeder right? Or can just leave food for him.
 
It's perfectly fine to lower the dose a bit until you feel you are better able to monitor. Number 1 rule - take care of yourself so you can take care of your cat. :bighug:

Max & Lori said:
He said he just couldn’t.
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It was a work in progress getting husband to finally test too. I've seen some people even get their grandchildren to test.
 
That is great! Mine are too young (and wild lol) right now (3 years old and under) but two of my 3 year olds just love Max. He's not really been used to the children though. I put him away so he can have his privacy when they are at my house. I don't want them to stress him out, or him to scratch or bite somebody. Caroline and Addie are more gentle though and always ask if they can pet him, so I take them one at the time in the room to pet him. He has started purring for them now so he's getting used to those two girls. So sweet.
 
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