8/13 Willie PMPS 157, +3~102, +6.5~53

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Christie & Willie (GA)

Christie & Willie (GA)

Member Since 2010
Yesterday's Condo

So, we just got back from the vet and Willie's bladder was, of course, empty. Thought of Roni & Moonie and just laughed. I had even tried to juice him up with some soupy food before we went, but alas, no luck. I was thankful the vet poked around and could tell it wasn't going to work and didn't needlessly poke him with a big needle. Poor guy just wanted to hide in his carrier. Since his numbers really don't reflect infection, we're going to just do a urinalysis first to look for bacteria and specific gravity. She gave me supplies for getting a clean catch, so we're going to start with that. Given that he likes to pee in the same spot in the box and never covers, I'm hopeful we can catch some by putting a shallow container in that corner. We shall see!

I think we're seeing a mini bounce from last night's 49, with a dose of vet/car stress thrown in for good measure. The tale of woe on the 3 minute drive over was especially dramatic. Otherwise, Willie's had a great morning... slept in with the bean then spent a good amount of time outside under his tree. I think he wanted to nap, but there was too much action! Dragonflies, birds, squirrels... his ears were all sideways the whole time! He's now sacked out on the living room rug, doing that sleeping with his eyes open thing that drives me crazy!

I did get the lab results from the vet. I don't have a scanner at home, so i'll have to wait until Monday to get them uploaded into google docs and linked in my signature. Here are pics:





Comparisons from prior labs:
BUN--
Dec. 31
Feb. 48
Aug. 58

Creatinine--
Dec. 1.8
Feb. 1.8
Aug. 2.3

B/C Ratio--
Dec. 17
Feb. 27
Aug. 24.2

Phosphorus--
Dec. 4.8
Feb. 3.6
Aug. 4.0

Potassium--
Dec. 5.0
Feb. 4.7
Aug. 5.1

His cholesterol has also shot up, 181 in December, 171 in February and 260 now, though we've only been back on raw for a few weeks now, so I don't know whether his cholesterol is more a product of the raw diet or the canned foods I was giving him.

Any thoughts anybody has are most appreciated! Hope everyone's weekends are off to a great start! Special sigh of relief and prayers for continued healing for Garland, who's headed home today and whose bean Violet will hopefully be joining us here in Lantus Land soon!
 
Re: 8/13 Willie AMPS 83, +2~106, +3~110, +4~92, +6~132 no pe

Poor Willie! Of course he is exhausted after that awful experience! :o :roll: :lol: I'm no expert on the levels, but it is great that the phosphorus is actually down!

These furkids just will not pee on demand! :roll: :lol: We have the Tidy Cats Breeze LB. It's great just take the pad out of the tray and you can get the catch!
 
Re: 8/13 Willie AMPS 83, +2~106, +3~110, +4~92, +6~132 no pe

Willie's numbers are looking good today!! Champ used to alway pee in his carrier on the way to the vet so he was always empty when we got there. Luckily, he's stopped doing that. So frustrating!!

I hope you're having a great weekend so far!!
 
Re: 8/13 Willie AMPS 83, +2~106, +3~110, +4~92, +6~132 no pe

Christie: Overall, I think his labs look pretty good but IMHO I do think he's starting down that road of renal insufficiency. Also IMHO, I don't think I would do anything right now other than to be adding extra water to all his food and trying to keep his phosphorus intake in his diet down. For a renal kitty, you want them to be able to get as much hydration as possible through their own drinking or through the water in their food. There are some recent studies indicating that alot of times we start fluids a little early. Here is a quote in the CRF group made by an internal med vet who consults to the group:

From: Jory Olsen <jodvm123@yahoo.com>
Subject: Re: [CRF] New here and need some encouragement..
Date: December 11, 2009 3:01:08 PM AKST
Cc: CRF Family <Feline-CRF-Support@yahoogroups.com>

I don't believe that most kidneys disease cats need SQ fluids on a routine basis. Chronic kidney disease is a disease that causes excessive drinking and urination. Most cats are flushing themselves out regularly. If a well compensated cat gets an upper respiratory infection, diarrhea, a sore leg from jumping off the counter, has a stone shift in the kidney, etc., they fail to drink adequately and get dehydrated and the kidney disease is worse. Kidney disease does not appear to get gradually worse. It seems to decrement periodically when there are insults. The reason that regular SQ fluids are attractive is that it is difficult to be sure that you can identify any period of time that there might be an insult to the kidneys. It is reasonable to give fluids only if there is any indication that drinking is reduced, urination is reduced, appetite is reduced, or the cat is lethargic and not feeling up to normal speed. If the kidney values are stable with no fluids or with intermittent fluids, they may remain on more conservative fluids therapy. If the kidney values increase without regular fluids and the values are improved and stable with fluids, it is reasonable to remain on that level of fluids. It is not clear that regular fluids therapy is what keeps these cats going. It is the fluid and hydration support at a critical moment that the kidneys are challenged that is most likely to allow them to live longer. I would not advocate dropping the subcutaneous fluid therapy for all of your cats but realize that many if not most of these cats are capable of supporting themselves unless something intervenes. The important thing is to monitor and see what kind of support is necessary and what therapy prevents worsening if it is persistent. We know that diet and phosphate control are critical. Fluid therapy is helpful in decreasing phosphorus if circulation is not adequate. If the cat is a well compensated, self diuresing cat, fluid therapy may not help. Fluid therapy protects the kidneys when there is an insult or anything that would cause dehydration and reduced circulation. Pick a plan, monitor, adjust the plan to optimize how the cat feels first and how the numbers look second. It is not clear that forcing the creatinine to be at 4 rather than 5 by regular fluid therapy has any impact on survival or quality of life. The important thing is how they feel and there are no periods of dehydration and compromised kidney blood flow.
> Jory Olsen DVM Dipl ACVIM
Click to expand...

I have a SS for Teddi and Gus and I'm happy to send it to you if you like. Just PM me. I would go back to his labs from last year and enter the info and then keep track of it so you can easily see how things change. The numbers you want to keep a close eye on are: BUN, creat, BUN/creat ratio, Phosphorus, potassium, sodium (kidney cats can have high blood pressure so you want to limit their Na intake), calcium, magnesium, HGB, HCT, RBCs, MCV and I also monitor their liver enzymes, their Na/K ratio and for urine their pH, prot/creat ratio, and their USG. Now is a good time to get an idea of what Willie's USG is doing because you aren't giving him squids. Once you give squids, it will bring that number down unless you intentionally stop fluids for a day before the test. Sometimes if the BUN/creat are going up, you'll see the USG start to decrease. And the more things you already have a baseline for when all numbers were normal, the better. His potassium and phosphorus are relatively stable looking at past numbers.

Although it costs more, when you get urine, you might want to get a baseline on his protein/creatinine ratio because it's likely to be normal now. That is an add on test that costs more and I don't know what IDEXX charges for it. Antech is not cheap and it's not a test that you need to repeat every time. I got a baseline and as long as my kitties are relatively steady and the overall protein in their urine does not increase, we won't do another. You might see protein in the urine but it's not a huge deal unless the prot/creat ratio is abnormal...then it is definitely a concern. Gus always has a trace of protein in his urine but his ratio is very good.

If you are talking to Dr. Lisa, then she can give you some ideas on diet. She is very astute to the thinking that good quality protein is important as is lowering the phosphorus intake. The old school (still seen in the prescription diets) is to reduce the protein but now more vets are realizing it does not make sense to reduce the protein in a cat that might be losing it. It's not the protein that puts stress on the kidneys (well, maybe much later on but by then, there's alot going on). Most of the people in the yahoo CRF group go for better quality diets their cats will eat and add binders when that becomes necessary. You don't want to start a binder too early.

Let me know what questions you have. The CRF website is phenomenal but has to be absorbed in small amounts :-D
 
Re: 8/13 Willie AMPS 83, +2~106, +3~110, +4~92, +6~132 no pe

Christie a clean catch isn't recommended to check for bladder infections - it should be a sterile draw right from the bladder for culture and sensitivity. Maybe others can comment on this.

Loved your update on your date with Mr. DMV :cool:
 
Re: 8/13 Willie AMPS 83, +2~106, +3~110, +4~92, +6~132 no pe

Agree with Karrie....if you are looking to check for bacteria, you should go with a cystocentesis and c&s. However, if you have no reason to believe he might have a UTI and just want to check his urine values (protein, USG), then a catch at home is fine.
 
Re: 8/13 Willie AMPS 83, +2~106, +3~110, +4~92, +6~132 no pe

thanks, everyone! Marjorie, I'd love to see the spreadsheet you use for the kids... I'm sure it will be quite helpful!

Because of my schedule, the vet's schedule, and her fear of not understanding Willie's protocol and not wanting to screw things up for me, we decided to go with a 2 step process... the urinalysis first using a clean catch from home, and then if that comes back with anything at all suspicious, we'll do the cytocentesis and C&S at that point, with Willie spending the day at the vet if needed. I like this approach... Willie has typically had skyrocketing BGs at the first sign of any infection, and his numbers have been great this week. I really don't think infection is the issue.
 
Re: 8/13 Willie PMPS 157 lab results

Hi Christie!

Willie's #'s are looking great. Glad you got his test results back and can pick beans brains :smile: here on what they mean. Your an awesome mom!

Thanks for all your support with my sweet Sara.

Nice to hear that things went well with DMV guy. Good thinking on the excuse in case things weren't going good. :-D
 
Re: 8/13 Willie PMPS 157 lab results

Christie:

I'll pm it to you. If you can't modify it, let me know and I'll send it to your private email.

Renee is on Health and sounds like Yemala might have some possible skin issues going on .....sounds like the same condition Willie and Sara have. I told her to check in with you and Jan.

Have a great night.
 
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