9/27, Susie, 250 AMPS, 179 @+2, 51 @+4

Wendy&Neko said:
Just a FYI on the UPC ratio test. Neko's protein in her urine was high while her kidney values were still within range, so the vet suggested a UPC ratio to see if she had proteinuria. It was the first early sign of her CKD. And yes, that meant 2 UPCR tests a couple weeks apart to make sure it was repeated, then a third one after starting medication, to make the medication was working to keep her numbers in range. It is very important to control proteinuria. Here is the Tanya's website page on proteinuria. Without treating proteinuria, CKD can progress faster. But before treating, you need to know if Susie has proteinuria, which means getting the UPC ratio test done. And that does mean getting it via cysto. Neko once let loose just before the cysto procedure by the vet and they tested that urine anyway. It was way out of whack. Summary, the UPC ratio test was worthwhile for us. It got treatment for proteinuria started earlier, and gave me more time with her.
Click to expand...

What results did you get back after the second urine test? Did you get a conclusive report that Neko was in early kidney disease. I assume you did in order to have been put on medication. What medication did they put Neko on. I am confused because I have read that the results of the UPC are not always conclusive and that other test might be needed i.e. ultrasound of the kidney, biopsy of the kidney, etc I'm just thinking if the UPC is not conclusive, on its own, why don't I just start with an ultrasound of the kidneys? I hope my question is clear?
 
WOW! You had an interesting day yesterday.

Best of luck with whatever you decide to do.

Hope you and Susie are doing well otherwise! Cooling off there I understand :)
 
Marje and Gracie said:
I want to urge you to rethink this. Sometimes there is a small amount of protein in the urine that just is not significant. My kitties often have 1+ protein in their urine but have, on occasion had 2+. If they do have 2+, you can bet I am 100% going to get a UPC done. In each case where they’ve had 2+ protein and I’ve had a UPC done, the UPC was normal meaning they did not have proteinuria. Moral: a slightly elevated amount of protein in the urine does not always equal proteinuria.

But, if the UPC does indicate proteinuria, you absolutely need to address it by doing the three test over two weeks. Proteinuria can be idiopathic meaning it’s not always known why it occurs if there is no indication of CKD. It’s not difficult to treat so why stick your head in the sand because if she is proteinuric, it absolutely needs to be treated.
Click to expand...

Please see my question to Wendy. So, what you are saying is after I do the first two test I will get a result stating "Yes (or no), this cat has Proteinuria" but I will not have a clear answer as to what is causing the Proteinuria and additional test will be required if the cat is positive for Proteinuria?
 
@Wendy & Neko

@Marje and Gracie

So, if after the second urine test, if it is determined that Susie does not have proteinuria then a third urine test will not be required? Right? Isn't the third test only to determine if medication that has been started is working?
 
Summer and Susie said:
@Wendy & Neko

@Marje and Gracie

So, if after the second urine test, if it is determined that Susie does not have proteinuria then a third urine test will not be required? Right? Isn't the third test only to determine if medication that has been started is working?
Click to expand...
Slow down. First, you get one UPC test done. If it is negative for proteinuria, you’re done. Nothing further needed to be done unless her next urine test shows a high numbers, say 3+. This post has a good flow chart (Figure 1) and also some other helpful info about diagnosing causes. Please note that high pH and high USG can affect results (cause false positives of protein amount) and her pH and USG are very high.

Here is information regarding UPC and also a test for microalbuminaria (MA). “Usually” if MA is negative, the USG shows concentrated urine, there are no WBCs or RBCs, then proteinuria is less of a concern. Your vet can guide you on that.

If you get one UPC test done and it indicates she has proteinuria, then you should have two more done within two weeks of the first but check with your vet because approaches change. I have always heard three tests within two weeks for diagnosis as UPC can change throughout the day. However, if after three tests, the UPC remains indicative of proteinuria, the cause would have to be determined through, for example) ultrasound (e.g. does she have a kidney infection). I am not certain of all the diagnostics done to determine the cause of proteinuria when there is no CKD present. If it’s idiopathic and medications are started, then they would test UPC again to be sure the treatment is working.

Have you ever had her blood pressure checked? That would be one cause of proteinuria that is not necessarily CKD related.

BUT….considering her high pH and high USG, I’d suggest you talk to the vet about starting with a UPC and see if it’s negative. Don’t put the cart before the horse.
 
Marje and Gracie said:
Slow down. First, you get one UPC test done. If it is negative for proteinuria, you’re done. Nothing further needed to be done unless her next urine test shows a high numbers, say 3+. This post has a good flow chart (Figure 1) and also some other helpful info about diagnosing causes. Please note that high pH and high USG can affect results (cause false positives of protein amount) and her pH and USG are very high.

Here is information regarding UPC and also a test for microalbuminaria (MA). “Usually” if MA is negative, the USG shows concentrated urine, there are no WBCs or RBCs, then proteinuria is less of a concern. Your vet can guide you on that.

If you get one UPC test done and it indicates she has proteinuria, then you should have two more done within two weeks of the first but check with your vet because approaches change. I have always heard three tests within two weeks for diagnosis as UPC can change throughout the day. However, if after three tests, the UPC remains indicative of proteinuria, the cause would have to be determined through, for example) ultrasound (e.g. does she have a kidney infection). I am not certain of all the diagnostics done to determine the cause of proteinuria when there is no CKD present. If it’s idiopathic and medications are started, then they would test UPC again to be sure the treatment is working.

Have you ever had her blood pressure checked? That would be one cause of proteinuria that is not necessarily CKD related.

BUT….considering her high pH and high USG, I’d suggest you talk to the vet about starting with a UPC and see if it’s negative. Don’t put the cart before the horse.
Click to expand...
Thanks, Marje. Susie had her blood pressure checked last Thursday. After three test (which were all similar) her average was 141/106.

I just took my first urine sample to the vet. He was upstairs and couldn't come down but told the receptionist that I was supposed to have taken in three samples. I'm just super confused as I don't know what information to follow. Maybe I should have listened to the other vet. He said all I needed was one sample. He did not mention any other samples needed. I'm not sure if my vets know how to do this test properly.

Right now I am upset because Susie is still not eating normally. She dropped low today and did eat a little m/c but not much. When she dropped again she refused to eat anything at all. I had to put honey in her mouth. I don't think I am going to be able to keep her on the 1.25 units until she starts eating again and, yes, I took her to the vet specifically for this problem and the vet had no idea what was wrong with her appetite. That is why I had all the test run.

Thank you for the information.

Anyway, I think I am going to contact an internal medicine doctor in another city and see how he handles the UPC. This is the least of my worries right now.
 
Diane Tyler's Mom said:
Afternoon Summer, Susie sure is keeping you busy today, I wish she would eat more for you. I hope you can get some answers doing the UPC tests :bighug::bighug::bighug:
Click to expand...
Thanks for always checking on us. Bad day. Susie dropped and I was lucky that she ate any m/c. She took a couple of bites. I tried to give her more and she refused. When she dropped, again, to 59 I tried to entice her to eat with h/c. She would have none of it. This is not my cat!!!!!!!! She never refuses food. Now I am scared that I have increased her dose when I shouldn't have because she won't eat to raise her numbers. I had to stick honey in her mouth earlier. :arghh::arghh::arghh:
 
Summer and Susie said:
I just took my first urine sample to the vet. He was upstairs and couldn't come down but told the receptionist that I was supposed to have taken in three samples. I'm just super confused as I don't know what information to follow. Maybe I should have listened to the other vet. He said all I needed was one sample. He did not mention any other samples needed. I'm not sure if my vets know how to do this test properly.
Click to expand...
It’s my understanding that there is a fairly new approach where they take three separate samples, even from the same day, and mix them. Then they do the UPC. Evidently, this is as accurate as doing three in two weeks but I’ve not read enough about it. I thought they were primarily doing this in dogs but I don’t know. You shouldn’t have to see a specialist for this.
 
Summer and Susie said:
Thanks for always checking on us. Bad day. Susie dropped and I was lucky that she ate any m/c. She took a couple of bites. I tried to give her more and she refused. When she dropped, again, to 59 I tried to entice her to eat with h/c. She would have none of it. This is not my cat!!!!!!!! She never refuses food. Now I am scared that I have increased her dose when I shouldn't have because she won't eat to raise her numbers. I had to stick honey in her mouth earlier. :arghh::arghh::arghh:
Click to expand...
Yes I looked at your SS Summer, it's scary when they won't eat when they drop too low, I'm sorry this is happening to Susie. I pray they can find out why all if a sudden she won't eat . Sendy hugs :bighug::bighug::bighug:
 
Marje and Gracie said:
It’s my understanding that there is a fairly new approach where they take three separate samples, even from the same day, and mix them. Then they do the UPC. Evidently, this is as accurate as doing three in two weeks but I’ve not read enough about it. I thought they were primarily doing this in dogs but I don’t know. You shouldn’t have to see a specialist for this.
Click to expand...
Might be taking Susie to the ER tomorrow morning anyway due to her not eating and acting sickish. If I do I will ask them to run a UPC while she is there. I can't help but wonder if her appetite loss is connected to her urinalysis results. Nothing else makes sense. No new diet food. No new chemicals in the house. She doesn't go outside. Why has she stopped eating and I don't mean a small reduction in her appetite? This has been a huge one. I hope it is not cancer.
 
Summer and Susie said:
Might be taking Susie to the ER tomorrow morning anyway due to her not eating and acting sickish. If I do I will ask them to run a UPC while she is there. I can't help but wonder if her appetite loss is connected to her urinalysis results. Nothing else makes sense. No new diet food. No new chemicals in the house. She doesn't go outside. Why has she stopped eating and I don't mean a small reduction in her appetite? This has been a huge one. I hope it is not cancer.
Click to expand...
I thought you just took urine to the vet today?
 
Marje and Gracie said:
I thought you just took urine to the vet today?
Click to expand...
I did. The vet said I was supposed to take three separate samples - not one. So, I brought it home. They didn't indicate they wanted it. I didn't know what else to do. If I take Susie to the ER tomorrow I will take it with me. I don't know if they can use it but it has been in the refrigerator. Supposedly good for 24 hours and I got it today at 12:30 pm. I'm just lost here, Marje. Between the UPC issues and especially her not eating I am feeling overwhelmed. Need to step away for a little while so I can breathe.
 
I have made a decision. I'm taking Susie back to 1 unit of insulin. I am not going to risk more potential problems with her going low and not eating. I guess that means I am no longer on TR. I guess it means I don't fit SLGS either. I don't care at this point if I am not following protocol. I am trusting my gut. When/if I am ever able to get her appetite straightened out I will pursue an increase and try to get back on track.
 
Bama Kitty Mom said:
This is so frustrating and heartbreaking for you. Remember you are doing your best for her. Prayers for strength and wisdom for you, Summer, and healing for Susie. :bighug::bighug::bighug:
Click to expand...
Thanks, Gina. This is just so bizarre. With very good blood test and her usual bad urinalysis why is she refusing to eat? I am starting to really get worried. Is it cancer?
 
There are many reasons cats go off their food, cancer is just one of them. Pancreatitis, a GI issue, a can of food or batch gone off, bug they ate, constipation, all sorts of reasons. If it's been more than 24 hours, going to the vet is an excellent idea. Keep testing for ketones. Infection/inflammation (if that), plus inappetance, plus too low a dose are not a good combo.
Summer and Susie said:
What results did you get back after the second urine test? Did you get a conclusive report that Neko was in early kidney disease. I assume you did in order to have been put on medication. What medication did they put Neko on. I am confused because I have read that the results of the UPC are not always conclusive and that other test might be needed i.e. ultrasound of the kidney, biopsy of the kidney, etc I'm just thinking if the UPC is not conclusive, on its own, why don't I just start with an ultrasound of the kidneys? I hope my question is clear?
Click to expand...
Marje answered in general. But specifically, Neko's second UPC also showed higher than normal. Later blood work confirmed the early kidney disease, but not the one done at the same time. Her BUN/Creatinine were normal at the time and SDMA was not available then. Later bloodwork showed kidney values starting to go off. She went on medication, not because of the early kidney disease diagnosis, which we didn't have yet, but because the UPC ration confirmed proteinuria. She was put on benazapril. She also had her blood pressure checked as that can help determine what causes the proteinuria. Never did have an ultrasound of the kidneys until a couple years later, for another issue.
 
You must log in or register to reply here.
Back
Top