Re: 8/12 Lucy AMPS=113;+2=119
Hi Mariko
Nice numbers for Lucy this morning.
I'm sorry it took me a while to get back to you on the labs. We had unexpected company.
LUCY
On her CKD, I think the fluids you are giving her now are fine. Her creatinine indicates she is in IRIS Stage 2 of CKD. Normally, subqs are started at around 300 umol/L or Stage 3. However, with her pancreatitis, the fluids are a good thing and IMHO, I'd continue as your vet has suggested. Her Urea just shows a little bit of dehydration but I wouldn't worry about it; other things can affect Urea and it is not as good a factor at evaluating CKD as the creatinine. Her phosphorus level looks GREAT! For a cat her age, you want to keep it under 1.45 and hers is 1.37 on the last bloodwork. Stellar!
Her potassium also looks really good. Her USG is a little dilute but it depends on whether you gave her fluids the day before or the day of the blood test. If you did, you would expect it to be dilute. Overall, I think her blood work looks pretty good. The one thing that I find curious is her ALT is LOW.
I really don't know why that would be and so I'd rely on my vet but I would ask the question. Her AST is fine as are her other liver values.
On her IBD, I'm just wondering if the vet has ever discussed using budesonide instead of pred? I might have asked you this before and my apologies if I did but I don't recall or, if I did ask, what you said. Budesonide is supposed to be more localized and is also supposed to be more specific for IBD. You might want to look into trying it if you hadn't. I'm assuming the vet will still have to wean her off the pred but I don't know how they wean one/start the other. But you could ask the question.
You also had these additional questions:
Can IBD raise her number?
I don't know the answer as to whether IBD specifically can raise her number but I think pain associated with it definitely could.
* She was on pred for IBD and asthma way before dx'd with diabetes, but what if a kitty is dx'd with diabetes first and then IBD.
Would a vet still prescribe steroids? Or is there any other med that's more suitable for a diabetic kitty.
I have seen vets prescribe steroids for FDs with IBD. I'd still ask about the budesonide. Yes, it is a steroid but it's supposed to not work so systemically as pred. And I imagine it is also ECID.
* If the low protein levels and her diarrhea are really caused by IBD, I want to treat it even with more pred and manage her diabetes around it, but how do I know that's what she has?
Combined with low protein levels, soft poops and higher BG, do you think it's pretty obvious that's what it is?
I've not had a cat with IBD in almost 20 years and so the treatments are much different now. I wonder if there is a good yahoo IBD group? I'm sorry I can't help with this but I am out of my area of knowledge. With her specfPL being what it is, I would almost wonder if her BG is connected more to that and pain from that than anything else. She may just have a mild, chronic case of pancreatitis that just keeps her feeling a little ick now and then and raising her BG.
Insofar as testing her B12 levels and supplementing with B12, I think it's a good idea to test and see where she is. I did recently read an article on
Treating IBD with B12 that I found very informative.
I also notice her wanting to lay on the hardwood floor (to cool her tummy?)....
I don't know but I wouldn't read alot into it. Cats lie in different places for different reasons at different times of the year.
GINGER
I would agree on Ginger that she is in really early CKD but I also would not do anything at this point other than monitor her. While her phosphorus levels look fine now, you can feed the lower phosphorus foods; it won't hurt her and it might keep them lower as her Urea and creat increase.
I hope this helps. Again, my apologies and please let me know if you have questions.
