Followup Vet Appt.-urine results added

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beausgrrl

beausgrrl

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I'm really worried about making Shadow wait to eat until after his vet appt. this Thursday. I usually go to bed about 10pm and have been getting up at 4:30a.m. to feed him an ounce of food. The vet wants to do a followup bg test Thursday and his appt. is not until 10:45a.m. She is super booked all the time so an earlier appt. isn't possible. Won't I be putting him in danger with this fasting since he's not on insulin and his bg has been below 80 during the day but as high as 158 first thing in the a.m.(and when he had his last appt. at the vet at around the same time his bg was 366)? Am I overworrying? I'm nervous about the appt. in general even though our vet is pretty approachable... we are going to tell her about testing him at home, and that we won't be using insulin if he's under 200 (by our reading). Are we way off with this?

Thanks for any feedback.
 
Re: Followup Vet Appt.-Fasting 14 hours b4 it?

someone may correct me but I don't know that fasting tests are considered necessary with pets? Obviously it will allow your vet to see how bgs are without the influence of food but.... you won't be putting him in danger unless he's at risk for ketones (ie insufficient food can be a trigger). WIth those nice numbers he may do just fine. But you have time before then to get input from others here

Jen
 
Re: Followup Vet Appt.-Fasting 14 hours b4 it?

I agree with Jen. Even if he doesn't want a test influenced by eating, withholding the food for 4 hours before the appointment would do that. I would be more concerned that a very hungry, angry cat would be stressed out and stress raises bg levels. Even if he is planning a fructosamine test, food shouldn't impact that.
 
Re: Followup Vet Appt.-Fasting 14 hours b4 it?

The only time I have had to fast my kitties is before a surgery / anesthesia.

My vet prefers to test BG at nadir -- so for example -- when Norton's shot time was 5 a.m. and his nadir was +7, we would schedule our appt at the vet for noon. No withholding food
 
Re: Followup Vet Appt.-Fasting 14 hours b4 it?

Hmmm.. she said no breakfast for him and it's an appt. to followup his diabetes diagnosis last week.... I don't think it would involve GI.... ?
 
Re: Followup Vet Appt.-Fasting 14 hours b4 it?

just sounds like a fasting blood glucose test to me...and if I were you i would call and ask whether it is required and mention your concerns.
 
Re: Followup Vet Appt.-Fasting 14 hours b4 it?

So I called our vet today and spoke with receptionist. She's been with the vet for like 20 years and is pretty good, though I'm not good at advocating for my reasons. I asked what the shortest time of fast was for Shadow before the appt. and she said he shouldn't eat after midnight, so then I said I was concerned for him because I have been monitoring his bg at home and feeding him on a schedule seems to be helping with his bg levels. She responded that he wasn't on insulin and therefore not in any danger. I said ok, thanked her (she's going to make copies of his test results for my records) and ended the call. I'm so bad at communicating and not getting upset with things like this. I think I'm going to feed him at 3am and then it will be 8 hours til his appt. at 11ish. Shadow gets really scared at the vet so I am afraid his bg is going to go way up and lead to ketones, though the last test he had showed no ketones.
 
Re: Followup Vet Appt.-Fasting 14 hours b4 it?

So that would be 11 hours without food? From midnight to 11am? He is going to be crabby.... :mrgreen:

It's up to you. IMHO, unless it is a fructosamine test, it really isn't going to tell you much. If he is hungry and angry and stressed out, any test results will probably be questionable. Could you put it off until she has an early morning appointment? Or can you just call, speak to the vet and tell her you have been hometesting and will be glad to fax her the results. And then you can go in to see her about discussing them.

You are hometesting - you have blood glucose levels. I don't really understand what the test is going to tell them, but I suppose they won't consider insulin unless they get a number. Not that you are sure you are going to need it.

It is a delicate balance. You need a vet you can work with. But having unnecessary tests done is frustrating.
 
Re: Followup Vet Appt.-Fasting 14 hours b4 it?

Well the vet visit went well and I'm relieved we don't have to put Shadow on insulin for now! I ended up feeding him a few ounces at 4am today!

His urine sample results were:
SG 1.010
PH 7
LEU 500 (I read online these are unreliable results as they tend to be false positive?)
NIT neg
PROT 30
Glucose (not surprised)- >250
Ketones _ negative
UBG - normal
BIl neg
BLD 10

He was not happy going back to the vet (and he'll be going in 2 weeks for another bg followup) but his bg reading there was 178, not bad considering how terrified he is there. I am not too keen on taking him back in 2 weeks for another followup but she's happy about me hometesting and she went along with my feeding the wellness rather than the prescription stuff so I guess the 10.00 visit isn't so bad.

I have been searching for an hour everywhere to see how high a protein level in his urine test results is really bad. I found out that it can be indicative of CRF, hypertension or diabetes. His result was protein 30. I didn't discuss this with her as I didn't get a chance to look at the results until now. We just went over how important it is not to cut back on his food for his weight loss too much. She actually upped his amount daily and since he gained a little weight since his last visit two weeks ago I'm wondering if that amount will be too much now. He was getting 7-8ounces a day the past 2 weeks but she calculated out to stay between 9.2 -10 ounces a day (he's 14.1 lbs)

So, any feedback regarding protein in his urine would be super. Interestingly his blood test showed low potassium (3.7) and sodium (143)
 
Re: Followup Vet Appt.-Fasting 14 hours b4 it?

I am surprised that you are not starting insulin since there is glucose in the urine. The USG of 1.010 and protein is highly suggestive of kidney insufficiency. The blood is the urine is not really good. Was the urine sample spun and the sediment examine under a microscope? This will tell you about leukocytes and the red blood cells.
 
Re: Followup Vet Appt.-Fasting 14 hours b4 it?

Hmmm... We aren't starting insulin as his blood glucose testing at home has been below 150 everytime except once. When he was on dry food 2 weeks ago and in crisis with the crying and drinking water constantly he was tested at the vet with a bg of 366. The vet said that sugar in the urine would be expected with that reading and his excessive drinking and urinating. Would you shoot insulin into a kitty with below 150 readings? I thought from what I've read if the bg readings are below 150 it was safe not to use insulin? (we did diet change).

Yeah, the SG and protein results from his urine test worry me but she didn't bring them up specifically, that makes me think it could all be diabetes related and will regulate as he is regulated by his diet change and small frequent feedings I've been doing...?

I don't know how the tests were conducted, just asked for and received a copy of the results... this is all new to me so super ignorant/newb here sorry. :-0

So, if he is having kidney issues, I'm probably endangering him further with the high protein food and fat he's now on. ugh. I'll call the vet tomorrow and see if I can go over the results for better understanding.

Thanks for your help Larry...
 
Re: Followup Vet Appt.-Fasting 14 hours b4 it?

you need the reference values so you can see what is high and low...but your vet should tell you that as well
 
Re: Followup Vet Appt.-Fasting 14 hours b4 it?

Jen do you mean the reference values for SG and protein in the urine or bg?
 
Hmmm... please bare with me and my lack of grasp on these terms, results, issues.... But, I would really think our vet would have brought this to our attention if she thought it was something other than a diabetic symptom/issue as she is really good with our animals. But I am always looking for input from those with experience ......so the SG of 1.010 can't just be a result of him drinking water excessively and frequently urinating when he was still on dry two weeks ago when we had his blood and urine tested? He was really drinking a ton and filling up the cat box. From my looking online at other sites I'm confused as to whether Shadow continuing to pee alot is good or bad?
 
One thing you might consider... Dr. Lisa (http://www.catinfo.org), who posts from time to time on here, is a veterinarian who will do consultations. They aren't the cheapest, but for me, they have been worth their weight in gold. I recently had her create a diet for Willie and she went over his lab works with me then, and then when we had follow-up bloodwork done a couple weeks ago, I did another consultation, and she went over the changes with me. She told me what each number meant in general, what it meant for Willie, what changes to look for, at what point I should be concerned, etc. I found it to be money well spent, as I can now converse with the vet much more intelligbly and be a better advocate for Willie's care.

I think the 1.010 SG might be of some concern, but I"m not totally sure. Willie is at 1.025, which is considered to be pretty middle of the road... not the best, but not at all surprising for a cat pushing 15 years of age.

Just wanted to throw that option out there! Good luck!
 
the ability to concentrate urine doesn't have much to do with hydration levels but I'm definitely not an expert. you really need to ask your vet for more input

Jen
 
well here's another ignorant question... upon reading about urine samples... I may have compromised the sample since we didn't get any from the box for the vet until after hours, refrigerated it and brought it into them first thing the next a.m.?
 
USG is little affected by storage time. If there was evaporation the USG would go up. How was the sample obtained and collected? Could it have been diluted?
 
I think I did ok by the way I gathered the urine... I "cleaned" out the cat box via scalding hot water several times and dried it... then we used that "fake kitty litter" (didn't realize I could use fish gravel) purchased from the vet and when Shadow peed I poured it off into a sterile cup from the vet and screwed on the top, stuck it in the fridge and then next morning drove it right over (10 mins away) to the vet...
 
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