9/23 Nelli PMPS 192 +2 169 +4 146

@tiffmaxee said “Her labs confuse me. If a trace of protein or +1-2, I would just retest in a month. A +4 is significant and her kidney numbers aren’t high which begs the question why. She was also +3 in June. According to Tanya’s site diabetes and heart disease can result in protein in the urine as can infection. If the BP is high I might skip it. If normal, I would want to check again either now or a month from now. It’s up to you. If you trusted your vet I would ask but I’m not so sure you do. :oops::bighug:”

Thanks... I agree completely agree with everything you say... “which begs the question why”
I too have been dwelling on heart disease and infection being a cause. Which has led me to what you are saying have the blood pressure checked if high skip the UPC. Also something of importance to note, which I have been also dwelling on is that she definitely has dental issues. To what extent I am concerned.
Infection, you bet, I believe!?! I was going to put out there/ post if “dental infection could have anything to do with protein in urine?”
What do you think?
You are correct I do not have a vet I can trust other than her cardiologist, Dr. Mulz which I am going to send an email to today regarding this protein in urine and it potentially related to the heart problems.

I cannot resist to share: vet she saw this week (when I brought her in because of the mouth noises and caring on when she would be eating)... I expressed concern about protein in urine and then subsequently spoke with him on the phone Friday night about it again- he told me it could be from her holding her bladder so long!?! Seriously? Nelli has always, always held her bladder it’s just an ECID thing- this could be causing +4 protein in urine?!?
This is indicative of what I deal with when it comes to vets.
 
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She looks flat yellow which can precede a more active cycle. And this is the 5th cycle on the 6 u dose and it can take 4-6 cycles for the depot to completely fill. I think you see some downward action tonight and will be able to know what this dose can do.

How is she doing other than the numbers? It is hard to not regard them as more than their numbers. Is doing all the 5 P's, purring, preening, peeing, pooping and playing? ( I realize she is older so playing could be a stretch)
 
She’s not getting any better. Not worse. Thanks for asking :-).
I am very concerned about her oral hygiene. This could be what is bugging her down also of course this humidity can’t help.
I am hoping I can get her in with the vet tomorrow for a BP check. Regarding her dental, she has an appointment with the veterinarian dentist but not till October 8.
Life is extra tough for each of us today. We need some joy, some good news to get back up.
 
I would still get the UPCR done. Neko had normal blood pressure but high UPCR. For her, it was an early sign of kidney disease, when all the rest of her kidney numbers were fine. Good luck with the vet appointment.
 
I’m glad Wendy answered your question. Even though Nelli’s kidneys appear to be fine right now, if the proteinuria continues, it could become an issue especially at her age.

When Elise said “infection”, I believe she meant urinary tract infection which “can” raise the protein in urine. It normally will not affect the UPC ratio.

What do you want to achieve with Nelli? I understand she’s about 20ish and so your treatment might be more geared to that fact than if she were 10. However, my question is if it improves her QOL and prevents her from developing any further disease, does it hurt to do it? If having the answer can let you implement a treatment that doesn’t stress her in any way and gives her healthy longevity, is there a downside? These are just questions to ask yourself; not questions that you need to answer for us.

As an example, you might want to consider that it’s one thing if it is treatable without causing her undesirable side effects; it’s another thing if you find out that she has really advanced heart disease. Then you can decide if you treat to keep her comfortable or not.

It’s really up to you and none of us can answer this question for you. She’s your cat, you know her. I’m just trying to give you some things to think about without any judgement on what you decide to do for Nelli.
 
Ok Marje.
I do need to be transparent and answer these questions you’ve asked.
Marje and Gracie said:
What do you want to achieve with Nelli?
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I don’t want Nelli to die (feeling) sick. I don’t want Nelli to slip away because she is tired of fighting an illness that she can’t fight. I want Nelli to feel ok. No neuropathy, no discomfort of being in a renal threshold, no dental pain, no pain in her mouth.
 
Marje and Gracie said:
However, my question is if it improves her QOL and prevents her from developing any further disease, does it hurt to do it? If having the answer can let you implement a treatment that doesn’t stress her in any way and gives her healthy longevity, is there a downside? T
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However... of course not Marje. Nellie has a cardiologist which I have sent an email today regarding my concern of the potential connection to QOL +4 urine protein level. I will be sending her Nelli‘s blood pressure report on to her as soon as I get it tomorrow. Nelli‘s cardiologist, is in a group (Blue Pearl)-alerted each time Nelli is seen within the Blue Pearl network. She was aware of her +3 back in June.
 
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Marje and Gracie said:
If having the answer can let you implement a treatment that doesn’t stress her in any way and gives her healthy longevity, is there a downside?
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I will not be implementing a treatment plan for “improves her QOL.”
The one bright medical provider- light we have in our world is Dr. Mulz, Nelli’s cardiologist. Heck, I bet there are peeps on this board who have heard of and or know about Dr. Mul. At minimum, she is very well known throughout Florida and highly regarded as one of the best.
I am going to look to her with confidence for Nelli- in any treatment plan regarding QOL
What I will do and can do is get her blood pressure checked ASAP and get her dental checked ASAP.
 
Marje and Gracie said:
I’m glad Wendy answered your question.
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Wendy did not “answer” any question I had? I looked at Neko’s labs. While I see high UPC, I see Neko also high for a long time in kidney value numbers, same time- bun and in creatinine?
I think those are kidney values? Confused again-
Nelli has not shown high, remotely high in either of theses- kidneys look great?
 
Krystina & Nelli said:
Wendy did not “answer” any question I had? I looked at Neko’s labs. While I see high UPC, I see Neko also high for a long time in kidney value numbers, same time- bun and in creatinine?
I think those are kidney values? Confused again-
Nelli has not shown high, remotely high in either of theses- kidneys look great?
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Yes...she did answer your question:

Krystina & Nelli said:
@Wendy&Neko Wendy, I don’t understand why you say “Proteinuria can speed up kidney disease” Nelli does not have kidney disease, does she?
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She said:
Wendy&Neko said:
I would still get the UPCR done. Neko had normal blood pressure but high UPCR. For her, it was an early sign of kidney disease, when all the rest of her kidney numbers were fine. Good luck with the vet appointment.
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Krystina & Nelli said:
I looked at Neko’s labs. While I see high UPC, I see Neko also high for a long time in kidney value numbers, same time- bun and in creatinine?
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I thought you asked if you should still get the UPCR done. The answer is yes. In December 2014 Neko had a high UPCR but her creatinine and BUN were normal. They started going out of range six months later. Hence the UPCR was an early indicator of pending kidney disease. Which is why we started benazapril. It doesn't mean the same will be true for Nelli, but should be checked.
 
Wendy&Neko said:
I thought you asked if you should still get the UPCR done. The answer is yes. In December 2014 Neko had a high UPCR but her creatinine and BUN were normal. They started going out of range six months later. Hence the UPCR was an early indicator of pending kidney disease. Which is why we started benazapril. It doesn't mean the same will be true for Nelli, but should be checked.
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Ok, thanks.
 
You probably want to changevAMBG and PMBG in your subject line to AMPS and PMPS or it looks like you skipped both shots today:p
 
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