5/18 Doodle - 2ps = 75 & CRD :(

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Michelle and Doodle

Michelle and Doodle

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Hello LL peeps. :) It seems that my Doodle is in need of a bit of extra support...I hope you have a room for an oldtimer to post daily.

Many of you don't know Doodle and for that I have some regret. He's the love of my life and truly the most gentle soul I have ever known.
He was diagnosed with diabetes in Sept of 2007 and we used be a regular here in Lantus Land.
I promised him long ago that I wouldn't let him go through this alone... and that I wouldn't let him leave this world without letting as many people as I could, know how wonderful he is.
I don't want to break that promise, so I have decided that I can't stay away from the board any longer.

I don't neccesarily think he is in the last stretch - though I don't think I could bare to admit it even if he was...
However, In the last 10 days Doodle's renal values have deteriorated.
BUN went from 38 to 52, his CREAT went from 2.8 to 3.9 and his PHOS went from 3.0 to 5.0 :( :(
His USG went from 1.030 to 1.023
(all of this in 10 days!)

His Blood Pressure was 220 and his sodium is now higher than ever at 171.
The good news is that his potassium is up from 2.8 to 4.1

He starts amlodipine today and we will take him for a recheck of blood pressure and renal values in a week.
His BG fortunately has been good -- todays preshot was 75 and I will start a new SS this week.

http://picasaweb.google.com/lh/photo/Bq ... directlink
I made this video last year - hopefully I posted the link properly.
 
(((Michelle))) That is a beautiful video, and I think that you and Doodle are both wonderful. I know that you will get a lot of support here with all sorts of strategies for managing his kidney disease. (((Doodle))).
 
awww michelle. i don't think he's on his last legs. meowzi would be highly offended (and very confused as well) to think that you're about to send her off too; her creatinine's been as high as 4.9 (last two checks, beginning and end-march: 4.6 and 4.5, BUN 87 and 71).

you recently changed foods, yes? what are you feeding now? how does that compare in terms of phos content, vs his friskies SD that you fed before? does vettybean think this food change has had an impact on the deterioration?

hugs to you and doodle. i wouldn't even call it bad yet, until you've done the whole kitchen-sink thingy (diet/phos mgmt, squids, suppls/meds etc) and those values don't budge. are these in-house or idexx readings?
 
:) Thank You (((Linda))) - you know we think you're wonderful as well.

Choy-Foong, :) I was just looking at Meowzi's labs last night... Of course I don't think either she or Doodle are on their last leg. :) Tell that sweet beautiful girl I never even suggested as much ;)
I'm mostly concerned that there was such a significant negative change in only 10 days. My Vet seems to think that sometimes rapid changes like that are harder to stabilize. ?? So I'm worried. And of course, you know, I'm a worrier anyway, so...

I did suggest that diet might have something to do with it, and she said that it was possible... and that the IM had reccomended a kidney diet. :-|

I'm putting him back on Friskies SD for now though - I had switched him to FF lo-carb and raw over those 10days.

I'm going to talk to the vet about starting Azodyl - and maybe calcitrol (if recommended) at my next appt.
She said no fluids yet - till we get his BP down and potassium stable. I don't know if that is the right choice or not but I've been reading all night and my brain is not really functioning that well right now so I didn't question it.
 
(((Michelle and Doodle))) there is always room for you :smile:

I know there are some very knowledgeable people about CRD here (and 2 have checked in already ;-)). Love to see both of you again!
 
I am so sorry that Doodle needs the extra support but I am so glad to see another "long timer" to hang out with. There are only a couple of us left and only a few of us here in the early morning. A lot of great newbies to get to know as well as a new Doodle.

I don't know much about kidney issues but I know a lot about support. :YMHUG:
 
HI Michelle and Doodle, hugs to both of you!!!! Sorry we never got to meet but as you know there is always a place for all of us!!!! Sending healing vines to Doodle!!! Take care!
 
Michelle,

I wish you and Doodle well in controlling his Kidney issues. My Samantha has increased levels of BUN and Creatinine since last year(very mild from what I remember), and in that year of feeding a strictly wet Kidney diet, her values haven't changed. I did try Azodyl, but her eating seemed to diminish on it, and I also used Epakitin, a phosphorus binder. I haven't used either in quite some time. Kidney diets are a tough sell, and she only likes Hi-Tor Neo and occasionally she'll eat the Royal Canin varieties. If you are going to stick with the current diet, you should ask about the Epakitin since it will keep Doodle from absorbing the phosphorus.

You never can tell with Kidneys, but with plenty of water and a proper diet, they have a great shot at a long, great quality of life.

Jason
 
Michelle--You and Doodle are ALWAYS welcome here--Doodle is one of the special ones from LL--
Many members have given you some insights, and you must remain hopeful. Doodle has been through a lot & always seems to bounce back--Yes, he's our Doodlebutt!
So we are sending you Our Very Strongest Healing vines to our dear Doodle, and Big Healing Hugs to you-
We :YMHUG: :YMHUG: :YMHUG: :YMHUG: are here for you!!
 
(( Michelle & Doodle ))

You're in the right place, we love you and Doodle, and we're sending tons of healing thoughts and snowflakes his way.
 
Oh (((Michelle))) and (((Doodles))). Hoping you both pull through this most recent battle. He is certainly a beautiful cat with a lovely personality. His faces is shaped just like Crash's. (((hugs))) to both of you.

Sending snowflakes and snuggles.
 
I love seeing and hearing about Doodle -- maybe not so much because she's needing some additional support, though. And a warm welcome back on days other than Oldtimer's Day.
 
always have to ask whether the labs were done in-house or outside, because my vet's in-house lab gave us some scary renal value for cleo that haven't borne out when tested by the outside labs.
cleo's creatinine's been higher than that. hoping this is just a temporary thing and doodle's values are more normalized when you test him next. (((HUGS)))
 
Jason & Belle said:
Michelle,
If you are going to stick with the current diet, you should ask about the Epakitin since it will keep Doodle from absorbing the phosphorus.
Click to expand...

I don't know what Doodle's calcium level is, or his Calcium X Phosphorus product, and I don't know if you will be using Calcitriol, but I might be hesitant to use a calcium based phosphorus binder like Epakitin. If you are going to use a phosphorus binder, I would suggest aluminum hydroxide, which you can buy from Thriving Pets (if you aren't Canadian :cry: ) Disclaimer: I am a CRD newbie.
 
I guess I should have said to just ask about phosphorus binders, since I don't know any of the benefits/disadvantages of any particular product. My vet gave me the Epakitin, and I didn't look at alternatives.


Linda and Bear Man said:
Jason & Belle said:
Michelle,
If you are going to stick with the current diet, you should ask about the Epakitin since it will keep Doodle from absorbing the phosphorus.
Click to expand...

I don't know what Doodle's calcium level is, or his Calcium X Phosphorus product, and I don't know if you will be using Calcitriol, but I might be hesitant to use a calcium based phosphorus binder like Epakitin. If you are going to use a phosphorus binder, I would suggest aluminum hydroxide, which you can buy from Thriving Pets (if you aren't Canadian :cry: ) Disclaimer: I am a CRD newbie.
Click to expand...
 
You guys are the greatest!
I very much appreciate all your thoughts and ideas.
-- Jason - no problem, in suggesting a particular brand you're familiar with. It's always good to have names of products to start a conversation with... And the resulting comments and additional info that comes along in the brain storms around here is good for everyone -IMO. (Thanks Linda!)

Chris - the labs were done in-house and then sent out to Idexx as well (the in-house was run so I wouldn't have to wait) the results were nearly identical. :(
I'm still hoping for improvement next week.

Miriam - I hope to wake my lazy butt up and see you early in the mornings ;)

I'll visit some condos this evening. thanks again!
 
The video was incredible Michelle.
I sure hope you are here a lot more -- you guys mean so much to us.
We used to have the best time in your condo.

((((((((((((((((Prince Doodle))))))))))))))))))
princedoodle.jpg
 
Hi Michelle,
I am relatively new to LL, but not to FD. My Blackie who is 17 was diagnosed with CRF more than a year ago. I feed him Wellness Turkey and Chicken and Merrick Cowboy Cookout, both relatively low in phosphorus. He's also gotten Azodyl and Renal Essentials since March of 2009. I added potassium last fall when his values reached the lower range. You can see his blood work in my signature below - its still not too bad. I have recently added Rehmannia 8 to his supplements which is a Chinese herb combo that was recommended by a holistic vet.

I hope to get to know you and Doodle more.
Ele
 
welcome back, michelle... although i wish it were under different circumstances.
i'm just beginning to learn about this stuff, so i don't have much to offer, but i just wanted to stop by to say hi!
 
Hi Michelle & Doodle, I'm a relative newcomer, too, and I don't know much about Doodle's diagnoses, but I just wanted to say that Stu and I are glad that you are back here and we are sending all those healing vines to Doodle.

Ella & Stu
 
Michelle and Doodle said:
Choy-Foong, :) I was just looking at Meowzi's labs last night... Of course I don't think either she or Doodle are on their last leg. :) Tell that sweet beautiful girl I never even suggested as much ;)
Click to expand...
She's very happy to 'hear' that ;-)

I'm mostly concerned that there was such a significant negative change in only 10 days. My Vet seems to think that sometimes rapid changes like that are harder to stabilize. ?? So I'm worried. And of course, you know, I'm a worrier anyway, so...
Click to expand...
You've ruled out the usual suspects? UTI, kidney/bladder stones, kidney infection, pancreatitis ... ? Some of those can cause a rapid non-permanent spike.

I did suggest that diet might have something to do with it, and she said that it was possible... and that the IM had reccomended a kidney diet. :-|
Click to expand...
I'm neutral on that. It's something you'll have to read and come to a decision on by yourself; there are pros and cons to either. We haven't done a kidney diet as her primary source of calories, FWIW, but doesn't mean we won't eventually. We're still undecided on that. The problem with kidney diets is there is only one low-carb option left on the market, and I'm not even sure if it's been reformulated. The second option (same company, RC) was discontinued at the end of last year/early this year.

I'm putting him back on Friskies SD for now though - I had switched him to FF lo-carb and raw over those 10days.
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Aha! Therein may lie the problem. Which FF? There are only 2 FF flavours on Janet and Binky's chart with phos below 200 mg/100 calories (and both are high carb), 7 FF flavours with phos 200-250 mg/100 cal (and 6 are high carb). Which leaves only one FF flavour that's low-carb and lower in phos content, and I'll bet you weren't feeding only that one, if at all, full-time the last ten days. The rest are all above 250 mg/100 cal of phos, and deemed too high for a kitty with CKD.

If the raw is Feline Pride's or a similar recipe, phos content is too high, above 350 mg/100 cal. If you wish to continue feeding raw, you may wish to schedule a consult with Dr Lisa; she has a kidney-friendly raw recipe. In fact, if you can swing it, a consult with her would be an excellent step - she'll cover all the things you need to have a good handle on managing CKD.

Another option if you don't wish to change food is to add a phos binder, of course. A couple of peeps have already suggested it. It's generally not recommended until phos is above 6, but I think Latte's internist actually starts his patients on it a little earlier. Go with an aluminium-based one; they are the most effective and affordable. Epakitin is costly and not as effective, I'm afraid.

One caution on moving back to Friskies, or to a kidney diet. It's not a primary consideration, but I've noticed that Meowzi's fur and tail are back to their lovely, fluffy state again. I can't be sure it's the diet, but I have a feeling it is - she's on Wellness now that she's being syringe-fed. Friskies was keeping her phos and renal values under control, but her fur wasn't in the best condition, and she had a stud tail problem (which has all but gone away when i checked this past weekend). But if it comes down to pretty fur vs manageable CKD, I'd go with manageable CKD. Am kind of dreading our next round of labs to see if her renal values have deteriorated on wellness - we've been adding two phos binders but we're not sure if it's enough. If it's deteriorated, we may have some difficult food decisions to make.

I'm going to talk to the vet about starting Azodyl - and maybe calcitrol (if recommended) at my next appt.
Click to expand...
Azodyl - won't hurt to try. It won't keep CKD in check, if I understand it correctly, but it'll help him feel good. Calcitriol is a little more controversial; there are some internists who don't believe it's called for, and that it may lead to other issues.

How much amlodipine is he starting on? Was his BP measured with a Doppler or an oscillometric unit?
 
((Michelle))
Thank you for sharing the video of Doodles. How lucky he is to be loved so dearly by you.
We are not posting daily anymore since being OTJ but I am following all of the kitties here.
You know you will get all the love and support on the board here.
 
Michelle,

That is such a nice video of your boy. The song is perfect. Sending your Doodle many snowflakes and healing vines. I hope he is feeling better soon. Would love to see more of you guys in a daily condo. You know your always welcome.

jan and sara
 
What a sweet pic of Doodle, can just tell he is a kind soul. Nice to meet both of you too & hoping for the best for the CRD management. Lanky has 2 housemates with the same. Tis a bummer. But they can to well and they do do well. So hang in there.

Best wishes,
Susan & Lanky
 
Ooooh, please come back every day! Thanks for sharing the video again. Looking at pictures of Doodle always makes me happy. I love his eyes and his smile. :smile:

Sorry I'm not much help with the CRD but I'm glad to see you here.
 
(((Michelle)))) lots of support and friends here for you and Doodlebutt!
You're both always welcomed here, and I hope for the best for Doodle, he is a lucky kitty to have you! cat_pet_icon
 
What a beautiful video!!! He is so handsome and you can tell how much he is loved by the way your talk about your boy.....what a wonderful kitty he is....and you a such a good Mama Bean to him. I am so glad that you are here....All the healing vines and snowflakes from LL peeps can't be beat, right?
So glad so many people are here with suggestions....it will be okay Michelle. Tell Doodle that we are sending hugs and kisses to him and his Mama. (((((Michelle & Doodle))))) See you tomorrow! :mrgreen:
 
That was a really nice video of your gorgeous Doodle. I hope he feels better and gets better real soon.
Sending healing vines and snowflakes to your sweet boy.
 
3ps = 89 (and some answers)

oh my gosh there's NO way I can respond to everyone! LOL! You guys are so great !
(((D))) - you posted the Prince Doodle picture! You know I love that!!! thank you!


Choy-Foong,
his blood pressure was checked on a doppler.
he is on 0.625 amlodipine - once a day. The vet says we may need to increase from there... but that's where she wants to start.
I have to give him 1/4 of a tab (which didn't go too well on the first attempt) :roll:
And NO :oops: we didn't rule out UTI?kidney infection/or bladder stones - I'm assuming all that can only be done through lab analysis of urine and the only thing that was done with urine was USG.
I didn't know those things could raise renal values - and obviously my vet didn't either. grrr...

So okay - when I go next week for BP recheck and CBC/Chem/Lytes ( to be sent to Idexx) I should also ask for a urinalysis to rule those out. correct?


As for diet - I'm not really against renal diets but I'm not ready to go there right now. I had been feeding Friskies SD because everyone was eating it so well and there was no constipation, no diarrhea, no ignored food. But then Doodle's potassium went low and we suspected it might be diet related... His renal values weren't that bad - his phosphorous was even low (2.6 -3.0 for over a year) and everyone kept saying this didn't look like a renal issue... so I thought I should just switch him back to raw (homemade) and FF and see if helped the potassium issue. I totally knew the phos was high :( I just thought if we weren't dealing with renal problems it would be okay. :(
I'd actually love to just feed them Friskies SD and add potassium as needed - but only if it doesn't cause other problems. And i wish they liked Wellness - Doodle will eat the Turkey occasionally, but it's not a big hit. I may indeed need to look into a Phos Binder.
I ordered some Azodyl tonight -- have you used it?
 
Hi Michelle and Doodle,

Doodles and I are sending huge (((((((((doodle)))))))) from the beach. What an awesome video!! So much love, he's a lucky boy to have a mommie like you!
I'm sorry it's so late, my mom had to work all day! We will check in with you tomorrow. Mom says she doesn't know anything except how to send lots of love....

You're doing great!!!!
heidi and doodle >"<
 
Re: 3ps = 89 (and some answers)

sleep-typing here, so bear with me :)

Michelle and Doodle said:
(((D))) - you posted the Prince Doodle picture! You know I love that!!! thank you!
Click to expand...
i was just thinking of the prince doodle pic this afternoon! thank you from me too, D! :)

Choy-Foong,
his blood pressure was checked on a doppler.
he is on 0.625 amlodipine - once a day. The vet says we may need to increase from there... but that's where she wants to start.
I have to give him 1/4 of a tab (which didn't go too well on the first attempt) :roll:
Click to expand...
guess what. i tried to call wedgewood compounding pharmacy today b/c they compound amlodipine into chewable treats and oral paste and some other stuff
but they put me on hold for 15 mins and i had to hang up :roll:
let me know if you're interested in details once i get them
our dose is 0.625 mg too - our vet says most cats do well on that dose, rarely have to raise
it works fast, you should be able to see by next week if it's enough


And NO :oops: we didn't rule out UTI?kidney infection/or bladder stones - I'm assuming all that can only be done through lab analysis of urine and the only thing that was done with urine was USG.
I didn't know those things could raise renal values - and obviously my vet didn't either. grrr...

So okay - when I go next week for BP recheck and CBC/Chem/Lytes ( to be sent to Idexx) I should also ask for a urinalysis to rule those out. correct?
Click to expand...
i didn't either, till dr lisa, jojo, jess and cheryl (winnie) pointed them out. not commonly discussed, i think. in fact i didn't even know about the pancreatitis link till meowzi's flare and i was freaking out, and cheryl told me that winnie's renal values rise when she has a cp flare.

UTI - culture (& sensitivity if positive) via cysto
kidney infection - sometimes through bloodwork (wbc), but not always. dont know how else to dx it. maybe u/s? but i doubt he has one - he'd be acting really, really ill.
kidney stone - x-rays. i think i was told u/s may not catch it, but i'm not sure if i remember that correctly. plus x-rays are cheaper ;-)
bladder stone - i don't know. cheryl may know, i think.
hope jess or someone corrects if i'm wrong.

I totally knew the phos was high :( I just thought if we weren't dealing with renal problems it would be okay. :(
Click to expand...
current thinking is that it's fine in healthy kitties. but we don't really know. i would feed raw too, if we're not dealing with ckd. it was on dx that i stopped meowzi's raw diet.

I may indeed need to look into a Phos Binder.
Click to expand...
change to lower phos non-rx diet may be enough.

I ordered some Azodyl tonight -- have you used it?
Click to expand...
yes. make sure it's chilled during shipping. i've seen some ppl complain that theirs arrived at room temp from certain vendors. you want it to arrive cold.

the capsule is too large to pill. nobody in the right mind would try to pill a cat with that size capsule. we open it and mix in a smidgen of her favourite food (1/8 oz fancy feast). actually, in the evenings, we also crush the amlodipine into the same smidgen of food with the azodyl. so far we haven't had a problem getting her to eat it, except during that cp-uti nightmare last year. most ppl on the crf group recommend giving it in higher-fat food like baby food, but i forget why. meowzi doesn't consistently eat baby food, so we didn't try that.

eta: ps - you have a thread going on in health too, i see jess also asked if there's anything else going on. mention the chronic hypokalemia to her, and how long it's been going on and how much you've struggled to bring it up - maybe something will ring a bell.
 
Good morning, Michelle and Doodle. I didn't visit LL last night, Michelle so I just saw your post this morning. I have absolutely no experience or know how or anything to say as far as suggestions or advise on the CRD, but I can offer you some support and send some vines to our little Doodlebug.

Glad you decided to stop on into LL for help and support for you and Doodle. The power of the board is awesome, positive, and so powerful that it can only do good things. (((Michelle and Doodle))).

(I couldn't view the video here at work so I may have to wait until I get home tonight)
 
((((Michelle)))) That video was beautiful. It made me cry--of course I am an emotional person anyway. I am sorry that you are hear under these circumstances but there is always room for you and Doodle. Hugs and scritches :YMHUG: cat_pet_icon
 
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