? 5/17 Zeke AMBG 134; PMBG 72 - OTJ Trial Day 8 (Should we be worried?)

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MrZ

MrZ

Member Since 2013
Good evening L&L Land,

yesterday: http://www.felinediabetes.com/FDMB/threads/5-16-zeke-ambg-77-otj-trial-day-7.137946/#post-1422220

Well another not so great start to the day. Three hours after his AMBG, his BG hadn't dropped but instead tested at 139; however, two hours later he was down to 76. So, should we be concerned that he's hitting these above normal numbers?

Another issue I have a question on is his weight loss. He's lost another ounce. He's now lost 5 ounces in the past 9 days. I figured we're feeding him about a 5.5 ounce can of food a day. Would that be considered too little food or about right? I figured he's getting maybe 210-250 calories a day. Could the lack of insulin be at all the reason behind this weight loss?

Well, would certainly appreciate some insight into what might be going on.

Thanks so much.
 
Let's give him another day. The numbers today don't concern me as much as 5/15 blue numbers. Since he does keep coming down, let's watch him but if he starts showing a trend of going up, we need to rethink the trial.

That also seems like a lot of weight to me. Are you weighing him the same time every day? Are you feeding him the same number of calories you always have? Does he have seasonal trends on his weight? For example, Tobey always loses a bit of weight in the spring/summer as it warms up and gains weight in winter. I think because he is more active and spends more time on the catio in the warmer weather hopping around his condos.

You can always take him in and have some labs done.
 
BC (before cancer), Minka was always heavier when the weather cooled off and lost it in the spring as it warmed up.

I agree with Marje - make sure you're weighing him at the same time every day, especially in relation to when he's eaten. All other things being equal, if he loses any more, I'd take him to the vet for a once over.

Paws crossed that all is just fine and the trial will continue to a successful conclusion.
 
Marje and Gracie said:
Let's give him another day. The numbers today don't concern me as much as 5/15 blue numbers. Since he does keep coming down, let's watch him but if he starts showing a trend of going up, we need to rethink the trial.

That also seems like a lot of weight to me. Are you weighing him the same time every day? Are you feeding him the same number of calories you always have? Does he have seasonal trends on his weight? For example, Tobey always loses a bit of weight in the spring/summer as it warms up and gains weight in winter. I think because he is more active and spends more time on the catio in the warmer weather hopping around his condos.

You can always take him in and have some labs done.
Click to expand...

Thanks Marje.

Well, today he started at 120. At +3 after last feeding he'd only came down a bit (to 96). The diarrhea is still lingering. We keep thinking it's clearing up but he had a very soft BM mid morning, a few hours after a firmer poo BM. He's also lost another ounce since yesterday. I have not been weighing him at the same time. I will start weighing him just before his 8:30 AM test and meal. We're taking him to the vet tomorrow. Unfortunately, that will probably elevate his BG but his health is more important. He just had his 6 month visit in March. I'll try and post his CBC here later.

In response to your feeding related questions. A few weeks ago we started swapping out his 4% wellness with 2% nature's variety lamb. He'd previously been getting some Evo but we'd tappered that off once he cooled to it. We've since added it back into his diet. I would say we are "giving" him the same amount of food - at times, and more so recently, even a little more in fact. The variable however is that a lot more of his meals are being handled by the automatic feeder so we don't know exactly how much food he's acutally eating. Any bit he leaves in the feeder is promptly eaten by Ivan so we've no way of knowing how much he's leaving. As for the tummy issues, it could be that the lamb is too rich. Do you think we should switch back to the wellness ASAP or wait to get the diarrhea cleared up first? Although I'd hate to go to a higher carb food, which may negatively impact his BG, stabilizing his weight and clearling up the diarrhea is our first priority right now. We're just not sure what is the best plan of action to accomplish that goal.

Any thoughts are greatly appreciated.
 
Tricia & Cinco said:
BC (before cancer), Minka was always heavier when the weather cooled off and lost it in the spring as it warmed up.

I agree with Marje - make sure you're weighing him at the same time every day, especially in relation to when he's eaten. All other things being equal, if he loses any more, I'd take him to the vet for a once over.

Paws crossed that all is just fine and the trial will continue to a successful conclusion.
Click to expand...

Thanks Tricia. Zeke, DH and I greatly appreciate the support.
 
Here's the CBC from Zeke's March 2015 BW. His creatinine was on the high end and his BUN was high at 42. Do you see anything that we should have the vet take a closer look at or recheck?

BTW - This is the visit where he was diagnosed with a UTI and prescribed Zeniquin. The followup visit showed that the UTI was gone.

Thanks!
 

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I can't give advice on the b/w, but am sending lots of vines to Zake and hugs to you!
Good idea to take him to the vet tomorrow.

I think that if they eat something their tummy doesn't agree, their intestines become irritated and could become inflamed.
And I think that if this happens, they cannot absorb the nutrients fully and efficiently, and this could cause weight loss.
It happened to Lucy once. She lost weight slowly over time even though she was eating everything and more.
And they'd have diarrhea too, more frequently over time.
If you see a lot of mucous in his poop, I think it means his intestines aren't happy and probably inflamed, which happened to Cashmere. :rolleyes:
If you suspect lamb, I would take that away for a while and see how he does......
Or it is also entirely possible he's not finishing his food and Ivan is eating the leftover... Is Ivan getting chubby by any chance?
I 100% agree with you that stabilizing his weight and clearing up the diarrhea is more important right now.
:bighug::bighug::bighug:
 
mariko said:
I can't give advice on the b/w, but am sending lots of vines to Zake and hugs to you!
Good idea to take him to the vet tomorrow.

I think that if they eat something their tummy doesn't agree, their intestines become irritated and could become inflamed.
Click to expand...

Thanks Mariko for the vines, hugs and advice.

Yeah, I'm inclined to switch him back to the wellness but we'll wait to see what the vet finds. Ivan had gained a little weight but he's back down some.

Your mentioning that if they eat something that upsets their tummy one could see these types of issues, brings something to mind. I caught Zeke chomping on one of our artificial plants a while back. I promptly moved it out of his reach but it is possible that he ingested some plastic flowers. I'll mention it to the vet tomorrow. Not sure if this is something that kitty would easily pass or not. Guess it will take an US to determine if this may be the cause of his issues.

Hope you, Ginger and Cashmere are doing well.
 
Laura, are you looking at the calories in the foods you are feeding him now, in relation to those you were feeding before? If you're feeding him the same amount, you might still be feeding fewer calories. Just a thought.

Sasha is very sensitive to new foods and will often get an upset tummy or diarrhea when I try something new. If I only feed it once, she recovers quickly, but I recently tried several new foods in a row, and just as Mariko said, her intestines ended up becoming inflamed. Lesson learned, but it took almost a week to get things settled down again. Good thing she likes Forti Flora!

Sending lots of healing, appy, poo and good vetty vines!
 
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Sending good tummy vines for Zeke and fingers crossed for a simple solution for the weight loss...and piling on the green vines! If Zeke's got a little tummy upset that's throwing him off a bit, I'm sure he'll be back at it as soon as the tummy problem is resolved.
 
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Laura

A couple things:

When I switched Gracie off WN, she lost weight, but not muscle mass, and I was getting concerned. Dr. B and I looked at nutritional values and the WN was much higher in fat than what I switched her to. Because her labs were good, clinically she looked great, and she had been a bit "chubby", it was all good but I just have to wonder if that could be "part" of the equation here.

The second thing...and keep in mind I am not a vet and I often look at labs with a chronic kidney disease tainted eye. But consider
  • Weight loss....is he also losing muscle mass?
  • His Urine specific gravity was 1.033; it should be above 1.040. However...keep in mind that it varies during the day and if they have a day that they are thirstier, it might be lower. The best way to determine if he is concentrating his urine is to catch the very first sample of the day. It can be free catch....doesn't matter. You just want the first pee of the day to take to your vet and have them check the USG. Be sure they have a refractometer in their clinic and it's been calibrated...ask.
  • If his USG from the first sample is less than 1.040, then he's not concentrating his urine. There can be other reasons they don't concentrate the urine besides CKD but it can also be an early "warning" of CKD. Discuss with your vet.
  • His creatinine and BUN are elevated. If he's a big cat, his creatinine might be on the high end. You'd need to look and see if it's consistent with his other labs throughout his life. If it's not, I'd have another superchem done. If he's a normal sized cat, his creatinine should be below 1.6. BUN can be elevated if he's a bit dehydrated or eats a high protein diet.
  • His phosphorus is a tad high. For his age, it should be below 4.5 but P sometimes goes up and down depending on what they've eaten, to a certain degree.
I'd recommend talking to your vet about the above and possibly doing a fasting blood panel. If you elect to do a full urinalysis instead of just checking the USG, take the first sample of the day from home because you are just looking for the USG and to see if there is any protein in it. Unless you are worried about infection, it doesn't need to be a sterile catch. Usually two blood tests with elevated numbers would be best before jumping to any conclusions; you've already got one whether it was fasted or not.

If it is CKD, it's very early...IRIS stage 2. If your vet balks, remind him/her that IRIS stage 2 is creatinine from 1.6-2.8.

And don't panic just because of what I've written. There are other reasons for those numbers to be on the high or low side but it's your vet's job to find out why they might be trending up or down.
 
Thanks Tricia, Jen and Julie for the vines. It's hard to say really how many more or less calories he's getting now due to the reasons explained in my reply to Marje's post. The caloric content of each of the foods seems fairly comparable. The other variable is that I am now preparing most of Zeke's nuggets and meals. DH was feeding a lot more before Otto took over. DH tends to not measure out the food as compulsively as I do so "god only knows" how much more food my DH was giving him. I'm hoping the vet appt will help us identify the issue. Fingers crossed.
 
Marje and Gracie said:
Laura

A couple things:

When I switched Gracie off WN, she lost weight, but not muscle mass, and I was getting concerned. Dr. B and I looked at nutritional values and the WN was much higher in fat than what I switched her to. Because her labs were good, clinically she looked great, and she had been a bit "chubby", it was all good but I just have to wonder if that could be "part" of the equation here.

The second thing...and keep in mind I am not a vet and I often look at labs with a chronic kidney disease tainted eye. But consider
  • Weight loss....is he also losing muscle mass?
  • His Urine specific gravity was 1.033; it should be above 1.040. However...keep in mind that it varies during the day and if they have a day that they are thirstier, it might be lower. The best way to determine if he is concentrating his urine is to catch the very first sample of the day. It can be free catch....doesn't matter. You just want the first pee of the day to take to your vet and have them check the USG. Be sure they have a refractometer in their clinic and it's been calibrated...ask.
  • If his USG from the first sample is less than 1.040, then he's not concentrating his urine. There can be other reasons they don't concentrate the urine besides CKD but it can also be an early "warning" of CKD. Discuss with your vet.
  • His creatinine and BUN are elevated. If he's a big cat, his creatinine might be on the high end. You'd need to look and see if it's consistent with his other labs throughout his life. If it's not, I'd have another superchem done. If he's a normal sized cat, his creatinine should be below 1.6. BUN can be elevated if he's a bit dehydrated or eats a high protein diet.
  • His phosphorus is a tad high. For his age, it should be below 4.5 but P sometimes goes up and down depending on what they've eaten, to a certain degree.
I'd recommend talking to your vet about the above and possibly doing a fasting blood panel. If you elect to do a full urinalysis instead of just checking the USG, take the first sample of the day from home because you are just looking for the USG and to see if there is any protein in it. Unless you are worried about infection, it doesn't need to be a sterile catch. Usually two blood tests with elevated numbers would be best before jumping to any conclusions; you've already got one whether it was fasted or not.

If it is CKD, it's very early...IRIS stage 2. If your vet balks, remind him/her that IRIS stage 2 is creatinine from 1.6-2.8.

And don't panic just because of what I've written. There are other reasons for those numbers to be on the high or low side but it's your vet's job to find out why they might be trending up or down.
Click to expand...


Thank you Marje so much for this information. I will definitely follow up on all the concerns/issues you've raised. I don't think Zeke has loss muscle mass but I'm not sure. DH is taking Zeke to the vet's tomorrow, I'll have him ask her what she thinks. I'll also have him discuss the concern about urine concentration.

I do have a question - when you say the urine catch doesn't need to be sterile, what exactly does that mean?
 
It means as long as you aren't concerned about a UTI, the vet does not need to collect the urine by cystocentesis which is a sterile process. Normally, if you free catch it at home, the chances of contaminating it are pretty high so you don't know if the bacteria is from a UTI or contamination....if you are worried about a UTI. That's why they do cystocentesis if they suspect UTI. The vet sticks a needle into the bladder and the sample is not contaminated.

But just to check the USG, you just need the urine...it doesn't matter whether you contaminate with bacteria or not.
 
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