8/18 Doodle ~ 1ps = 189

[Michelle and Doodle]

viewtopic.php?f=9&t=22632

thanks for the support and input yesterday everyone! I wanted to respond earlier but for some reason I wasn't able to log back in last night.
Doodle is doing okay. He seems to be struggling with an upset tummy for the last couple of days (vomiting and crouching) and although he hasn't been officially diagnosed, I suspect a pancreatitis flare. Of course it could be from the renal disease I suppose... but I fed him Wellness for 2 days and he almost always does this when I feed him that or Merrick
(you'd think I'd know better) He's getting pepcid, fluids and a tiny bit of bupe.

1ps = 189

[quote="WCF and Meowzi]

You're going to hate me for writing this. This is just my personal opinion, based on what I *may* do for my own kitty.

I would think about putting him on a renal diet if he'll willingly eat it. Or even half-renal diet, i.e. mix half with regular food. Yes, I know it's high in carbs, but FD isn't going to be what kills him. So it raises his BG - you can manage FD - you've done it so well these last few years. My reasoning: of the two cats above on medical treatment sans surgery, *both* the cats succumbed to CRF. This is not a clear-cut progresive CKD issue, IMO, and I don't know if I would want to toy around with lower-phos food, like what we're currently doing with Meowzi, to see if it works. His phos isn't the problem here anyway. Renal diets are more than lower-phos, they're also lower in sodium, and higher in potassium and B vits. With his sodium also elevated, and if hypertension may eventually become harder to control b/c of the aldosterone levels, if I understand you correctly (note that there is as yet no evidence, IIRC, that sodium is a factor in feline hypertension, but no evidence yet doesn't mean there's no link), I'm not sure I would want to gamble. These are very high stakes here, and he's too precious to take chances on. JMHO. I know many would disagree with me here. (On the other hand, if he goes above his renal threshold, i.e. if you can't manage his FD as well, then there may be a risk to his kidneys too. I don't want to come across as advocating a renal diet - I'm on the fence about it - but you and B may want to discuss and evaluate.)

Of course I don't hate you! I want to know your thoughts!! And I have been researching the idea...I actually just recently called Natascha at Feline Future about making a raw kidney diet and she suggested using pumpkin and butter to lower the protein and phos (this would actually address some of the concerns that were mentioned in the thread that Linda linked me to, by using fat rather than simply carbs to alter the values)
I guess this would also be a good time to try to get a consult with Dr. Lisa...
I wish I had a strong opinion on this, but the arguments from both sides seem to have good logic. And of course I can't spend too much time thinking about what to do.

He HAS responded! I swear that stuff has made an amazing difference! His potassium level is now 4.1 and he's only getting 6mEq (down from 15mEq) His sodium is still high (157) but it is not as scary as it was. And you're right they wouldn't do surgery if the lytes are too out of balance.
>>Very relieved to read this! That's one less thing to worry about for now. He's on the dose recommended in the link? 2.5 mg/kg orally once daily? I've seen 1-2 mg/kg as well, not sure what dose you're on. http://wvc.omnibooksonline.com/data/pap ... 7_V120.pdf

Doodle is 9.5 lbs - I think that is 4.3 kg - and he's getting 12.5mg of spironolactone split into 2 doses (every 12 hours) - so that's closer to 3mg/kg

Yes, Surgery is NOT a given until a scan is done.
He'd need the scan to see if this was a tumor or if it is hyperplasia - if they don't see a tumor (or adenoma) then they wouldn't do surgery. I have no idea who I'd get to do the procedure - but it would need to be someone with experience - not just my regular vet!
>>I would have only a board-certified surgeon do it, no other. And preferably one with experience in that area - although that may be difficult. But start talking to vets and specialists, look around for a boarded surgeon. Compile a list of possible surgeons. Doesn't mean you'll eventually do surgery, but it never hurts to be prepared. Finding a surgeon for a complicated procedure like this isn't something you want to rush into if you can help it.

Totally Agree!

Another thought - if you talk to surgeons or even vets, ask if laser surgery instead of traditional surgery could reduce the risk. Meowzi's surgeon used laser surgery, to reduce bleeding - I think the laser seals blood vessels as it cuts - and shorten recovery time.
More info on laser surgery here
Of the five cats that did not survive surgery in that study, three did not make it because of surgical-induced haemorrhage. You can't do much about sepsis, but you may be able to reduce the risk of haemorrhage with laser surgery. I don't know. It would not hurt to ask.

good iea - thank you!

 

[Pat+Raja+Shadow (GA)]

I hope the bupe and fluids help Doodle today...along with the pepcid....feel better Doodle!

 

[Michelle and Doodle]

+6.5 = 75
I guess the bupe helped

 

[WCF and Meowzi]

He seems to be struggling with an upset tummy for the last couple of days (vomiting and crouching) and although he hasn't been officially diagnosed, I suspect a pancreatitis flare. Of course it could be from the renal disease I suppose...

anything's possible, of course, but i don't recall reading much about crouching and renal disease. renal disease doesn't hurt afaik. unless it's making him nauseous? meowzi crouched when she had CP, and UTI - it was the pain - but she doesn't crouch now.

He's getting pepcid, fluids and a tiny bit of bupe.

good if i suspect a CP flare, i usually increase fluids. ask your vet if that's ok, and how much more you can give. not sure you can do it though, esp if doodle keeps playing on the bungee cord razz:

And I have been researching the idea...I actually just recently called Natascha at Feline Future about making a raw kidney diet and she suggested using pumpkin and butter to lower the protein and phos (this would actually address some of the concerns that were mentioned in the thread that Linda linked me to, by using fat rather than simply carbs to alter the values)
I guess this would also be a good time to try to get a consult with Dr. Lisa...
I wish I had a strong opinion on this, but the arguments from both sides seem to have good logic. And of course I can't spend too much time thinking about what to do.

i don't have a strong opinion on it either. you'll find me waffling on any given day :roll: absolutely, get a consult with Dr Lisa - she has a CKD-friendly raw diet recipe. i think heather and boo tried it. i was going to schedule a consult for us too, even had list of questions ready, but then stuff kept happening and i had to keep putting it off. maybe next month we'll have the money to do it; insurance is reimbursing part of cali's root canal claim

i'm not so sure about pumpkin and butter myself - i'd like to hear Dr Lisa's take on that, if you'll ask her. i've actually added cooked egg whites (excellent protein source with low phos) to meowzi's food before, when she was on friskies, to raise protein intake without raising phosphorus.

glad the bupe is helping don't be afraid to use it, if it's CP, it can be very painful.

 

[Michelle and Doodle]

Yes, I was meaning it could be possible that he was crouching due to the nausea (from the renal disease) He's vomited foamy liquid a few times and is licking his lips pretty often.
But the bupe and pepcid (and prolly the fluids too) have helped I think.

I'll ask my vet what's the max amount of fluids I can give - I don't think it really does much to his BG numbers anymore - now that he gets them regularly. You know Doodle - he bungees when he feels the urge. :roll:

If I get a consult, I'll ask Dr. Lisa about the FF recipe.


Hey btw. How and where do you store Bupe?? Mine is at room temp in a dark place. ???

 

[WCF and Meowzi]

Yes, I was meaning it could be possible that he was crouching due to the nausea (from the renal disease) He's vomited foamy liquid a few times and is licking his lips pretty often.
But the bupe and pepcid (and prolly the fluids too) have helped I think.

good. pepcid is SID? we usually do SID because of compromised renal clearance, but i've done BID in special circumstances i.e. CP flare.

I'll ask my vet what's the max amount of fluids I can give - I don't think it really does much to his BG numbers anymore - now that he gets them regularly. You know Doodle - he bungees when he feels the urge. :roll:

75 mls is when i start seeing fluidage. 50 mls does nothing.
yes, i know doodle, and i love him for it :mrgreen: (ot - although my favourite image of him is walking all over the house and furniture with wet-litter paws :razz: )

Hey btw. How and where do you store Bupe?? Mine is at room temp in a dark place. ???

yup, same. in food pantry (in dark) at room temp. at least i hope it's room temp, kitchen can get a little warm if we cook, but not too warm i think. i have both little vials and carpujects, they all stay in their original boxes, so further protection from light.

 

[Michelle and Doodle]

okay good (and thanks) on the Bupe storage.
And yes pepcid is SID - though I have given it BID on occasion.
We're giving 100mls of fluid now (sometimes a little more on accident because we're not quite used to the UTW needles)

And just so you know, I do have to strongly disagree with your favourite image! That is so NOT my favourite!
*Gasp*The horror!! :lol:

 

[Lisa and Do Lou (GA)]

sending feel better vines Doodle's way :YMHUG: :YMHUG: :YMHUG:

 

[heidi and doodles]

Hey Doodle, sorry to hear you aren't feeling good, just wanted to say hi and feel better soon. I could catch you a hummingbird, they taste sweet maybe
that will make your tummy better? Doodles >"<