Buddy's Blood Test Results

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lbeachstace

lbeachstace

Member Since 2022
I've mainly been an observer on this page but today I have a couple of questions about our little guy.
Buddy was first diagnosed in January 2022. He's 12 1/2. He's on Lantus (started on Vetsulin but we switched a few months in), he is now at 6 units twice a day. We feed him 1/2 box of Stella and Chewy Purrfect Pate (Chicken or turkey) and also add a spoonful of Hounds and Gatos Chicken and Liver.

He recently had a blood panel and his BG was 211 on the test. The fructosamine test said 454. The bloodwork was done by Idexx - according to Idexx the fructosamine result is poor. But Merck lists is as 4 points below Good. We are pretty upset about this discrepancy, as we are not sure what to make of the rest of the results then.

His test showed very early stage kidney failure and possible high blood pressure. We have seen more weakness in his legs but overall, he's his sweet loving self and sleeping more than he used to.

(I know we don't test his BG daily and I am not wanting to get into a discussion about that)....I am hoping for help and advice about what we can do to help with beginning stages of kidney disease and overall thoughts on his blood results.

Any help/advice would be appreciated.
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Several of the tests for kidney function are trending upward but are not outside of normal limits. Interestingly, the test that is most predictive of kidney disease is an IDEXX test called SDMA. It's not listed on your spreadsheet. Take a look at the actual lab sheet and see if it's there. The one thing than may help considerably is adding more water to. your cat's food.

IDEXX changed some of the reagents used in assaying fructosamine levels in 2019. It changed the reference ranges. Previously, the normal range was up to 340mmol/L. The range is now 137 - 186mmol/L. IDEXX indicates you subtract 40 from the values produced by the older test. What I don't know if Merck's values are predicated on the same measurement system as IDEXX. Most of these tests are proprietary. You may not be able to compare one company's labs to a different company without seeing reference ranges or knowing more about how they test. Looking at the Merck information, make sure you're not trying to compare normal values to the values for a diabetic cat. They look at normal levels vs levels that indicate good glycemic control. A 454 would put Buddy in a "fair control" range with both IDEXX and Merck -- although it's hard to find the breakdown of the IDEXX ranges on line. (I'm estimating from an old lab printout using the pre-2019 ranges.)

One thought... Once a cat is needing more than 5u of insulin at each shot time, we generally suggest getting the cat tested for acromegaly and insulin auto-antibodies. It's hard to have a feel for Buddy's numbers without more data. Our resident expert on these conditions is @Wendy&Neko. You may want her to weigh in.
 
Sienne and Gabby (GA) said:
Several of the tests for kidney function are trending upward but are not outside of normal limits. Interestingly, the test that is most predictive of kidney disease is an IDEXX test called SDMA. It's not listed on your spreadsheet. Take a look at the actual lab sheet and see if it's there. The one thing than may help considerably is adding more water to. your cat's food.

IDEXX changed some of the reagents used in assaying fructosamine levels in 2019. It changed the reference ranges. Previously, the normal range was up to 340mmol/L. The range is now 137 - 186mmol/L. IDEXX indicates you subtract 40 from the values produced by the older test. What I don't know if Merck's values are predicated on the same measurement system as IDEXX. Most of these tests are proprietary. You may not be able to compare one company's labs to a different company without seeing reference ranges or knowing more about how they test. Looking at the Merck information, make sure you're not trying to compare normal values to the values for a diabetic cat. They look at normal levels vs levels that indicate good glycemic control. A 454 would put Buddy in a "fair control" range with both IDEXX and Merck -- although it's hard to find the breakdown of the IDEXX ranges on line. (I'm estimating from an old lab printout using the pre-2019 ranges.)

One thought... Once a cat is needing more than 5u of insulin at each shot time, we generally suggest getting the cat tested for acromegaly and insulin auto-antibodies. It's hard to have a feel for Buddy's numbers without more data. Our resident expert on these conditions is @Wendy&Neko. You may want her to weigh in.
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Thank you for taking the time to write all of this. It's very helpful. ❤️

His SDMA is 16. i didn't see a field to put that on the chart but i'll manually enter it.

I got the Merck numbers from a FB page I am on. We spoke with a Chewy vet today and she also said you can't compare one company to the other. According to the report, his 454 is in the poor range but we do think there we factors that may have caused this number to skew high - esp since is BG was 211 from blood results. We had one fur shot day and one 1/2 shot day (also due to a fur shot), so his numbers may have spiked a bit because of that.

We tested him today before the chewy call - it was at the 2.5 hour mark and his number was 214. We will do a curve early this week and really see where we are at.

I do add water to his food but i can add a little more - he tends to like to drink it, so i'll put a small amount more in.

I'll reach out to Wendy&Neko and also look for them in the threads to read some posts/responses.
 
Wendy corrected me in another post -- if Buddy reaches 6.0u of insulin, we'd suggest getting him tested.

Hmmm.... even with the old IDEXX levels, Buddy's fructosamine would have to be over 600 to be in the "poor" range. Also, fructosamine wouldn't be hugely effected by the same factors that influence your home testing (or testing at the vet's office) results. It's an average of blood glucose levels over the period of several weeks. If you're familiar with Hemoglobin A1c results for humans, it's very similar. Fructosamine levels are most helpful with making a diagnosis of diabetes. However, beyond the initial test, if you're home testing with regularity, it's not a worthwhile expense. However, you're not testing all that often so there's no way to really assess if your occasional tests are capturing the larger picture or if you're catching outliers.

Buddy's SDMA is slightly outside of the normal range. If he's a big cat, that may skew the results. However, you may want to consider feeding Buddy a lower phosphorus food as a precaution given that his kidney numbers are trending upward.
 
What was his blood pressure when tested? Is is important to treat if high.

I can’t comment much on his blood sugar numbers, as there are too many possible answers based on the data present. Sienne has covered what would be my suggestions for treating early kidney disease. Just one other thing, you may with to look at this website: http://www.felinecrf.org/
 
Wendy&Neko said:
What was his blood pressure when tested? Is is important to treat if high.

I can’t comment much on his blood sugar numbers, as there are too many possible answers based on the data present. Sienne has covered what would be my suggestions for treating early kidney disease. Just one other thing, you may with to look at this website: http://www.felinecrf.org/
Click to expand...

Hey - wanted to follow up since i haven't posted and/or reposted in a bit. buddy's blood pressure was checked and it's good. so now we have to have an echo on his heart :( pretty sad for our little guy, this is a lot for a human - let alone a kitty. <3
 
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