Help please with diabetes & chronic kidney disease

Status
Not open for further replies.
B

Bebe Kaye

Member Since 2013
Hi all,

onset
*hungry, but only eating about half of his food
*very needy
*one PMPS high reading of 20 that went down over the next 4-5 hours (yes I worry too much)


Monday 29th April, 2013; my vet rang me to tell me he had bad news...he told me the blood tests were bad and my beloved kitty's kidneys were failing and it wasn't good. He told me all he could do was give him an injection to help and some powder to add to his food. I have a lot of trust in my vet (I hope not poorly placed) and it never crossed my mind to ask for details...I feel like an idiot! Anyway, I took Miley in for the shot and powder (Ipakitine), the vet was actually surprised to hear that Milo was doing well and back to eating and that his BG levels were looking good too, so he told me to leave it a week and then bring him back to see how his kidneys were functioning.

I left the vet determined to find out more about the diagnoses (I originally thought his sugar was playing up which is how I found these forums). I found http://www.felinecrf.org/index.htm and could breathe again, I thought my beloved kitty would be dead in a week! The more I read, the more questions I had, I started writing them down for the next vet visit which is still 4 days off...but then I started worrying about how this would affect Miley's diabetes.

I would be so very grateful if there is anyone out there who knows anything about treating a sugar kitty with iffy kidneys? And what questions I should be asking when I return to the vet. So far the questions I have written for the vet are:
  • What stage is he (1-4)
    Creatinine levels from the blood test?
    Blood pressure?
    Does he have hypertension/ can you test him for it? (showing symptoms)
    Does he have hyperthyroidism/ can you test him for it? (showing symptoms)
    Is he getting enough fluids and how do I test for dehydration?
    What is his phosphorus levels?
    Does he need binders if it's bad?
    What are his proteinuria levels?
    What is his protein:creatinine ratio?
    Does he have any sign of urinary tract infection?
    Is there anything I can test him at home?
    Would a vitamin B supplement be helpful?

That's it so far, I'm also a little lost of how to feed a sugar kitty with kidney issues, the whole high and low protein food thing is doing my head in. I understand that I need to be looking for foods that are low sodium, low phosphorus...but then I get really lost. I'm only just learning everything I didn't know about the diabetes side, so this on top is really doing my head in! I have been home testing Miley since he was first diagnosed (my idea not vets), I just couldn't afford the weekly vet visits, but I also didn't like the idea of injecting his with insulin without first knowing his BG levels...it made no sense to me. What should I be doing to help my furry baby? I keep a bowl of water at hand and encourage him every 30 minutes or so to have a drink...so far he is eating and drinking fine and original symptoms that I took him to the vet with have disappeared.

Thank you for your time!
 
Tangentially relevant: Cat Info - Feline Urinary Tract Health Discusses various renal/bladder issues, shows signs of problems. Also is a page on hyperthyroidism. Foodwise, you're looking for a quality protein source (ie, not from grains or legumes) with low phosphorus levels. There's a PDF file you can print out and then review the phosphorus levals. (Go for the lower values)

What signs of hyperthyroidism are you seeing? Unless you have a really, jumpy/irritable/hyper cat, weight loss and excessive urination may be the diabetes, plus the renal disease combined. If its an older cat, it is worth testing ... but slowing down the thyroid will put more of a burden on the kidneys.
 
BJM said:
Tangentially relevant: Cat Info - Feline Urinary Tract Health Discusses various renal/bladder issues, shows signs of problems. Also is a page on hyperthyroidism. Foodwise, you're looking for a quality protein source (ie, not from grains or legumes) with low phosphorus levels. There's a PDF file you can print out and then review the phosphorus levals. (Go for the lower values)

What signs of hyperthyroidism are you seeing? Unless you have a really, jumpy/irritable/hyper cat, weight loss and excessive urination may be the diabetes, plus the renal disease combined. If its an older cat, it is worth testing ... but slowing down the thyroid will put more of a burden on the kidneys.
Click to expand...

Thank you for the link. The only symptoms of hyperthyroidism he's showing is a slight weight loss and excessive urination...but then he IS drinking a super duper lot, i'm not sure if this is because I have more bowls around and am actually offering it to him every 30 minutes or so. He's also been more lethargic than usual since (and just before) the CKD diagnosis...he's always been a sleepy cat, but it's become a lot worse...or maybe he's depressed because he's not allowed outside at all anymore. I can't let him out at all now because I found out he was helping himself to various neighbours cat and dog foods.

Bebe
 
I copied this list from the Diabetic Cat Care (DCC) forum, college of Knowledge (COK), section on Australia specific information.

FOOD

Making a well balanced raw food diet for your Aussie cat might be a better choice if possible as pet food labeling is poor and it is almost impossible to know exactly what ingredients in canned food are. The manufacturers are not required to list ingredients specifically. For example: the label says "cereal" but you have no idea whether it is corn, rice, wheat, etc. All Fancy Feast Labels list exactly the same ingredients.

Fancy Feast varieties that have been checked and are believed to be below 10% carbs are:

Turkey and Giblets Pate - 6.8% dry carbs (apparently is being discontinued)
Chicken & Giblets Pate - 11% carbs if fat content is 4% (6.8% carbs if fat content is 5%)
Kitten Tender Turkey Feast - -4% to -10.2%
Kitten Tender Ocean Whitefish Feast - -6.2% to -12.3%

Evo 95%:
Evo is only sold at Pet’s Paradise stores which are located throughout Australia. Evo 95% can be purchased by the case from: http://www.naturalpetstore.com.au/p/79/ ... brand/evo/

Evo 95% has a slightly higher fat content (9% to 10%) which should be considered if your cat has pancreatitis or liver issues.
95% Venison: -5% based on dry matter
95% Beef: 7.1%
95% Salmon and Herring: 4.7%
95% Chicken and Turkey: 0.4%
95% Duck: 6.8%

Ziwi Peak:
The removal of chicory syrup now makes Ziwi Peak an acceptable low carb food. It is not sold everywhere in Australia but can be ordered here:
http://www.ziwipeak.com.au/shop/where-to-buy/
Canned Lamb - 9.1%
Canned Venison - 4.5%
Canned Venison and Fish - 4.5%
Click to expand...

I don't know how old this information is and if it is still up to date on the food recommendations for a diabetic kitty. Please be aware that DCC is much more restrictive on what they consider allowable for a diabetic cat can eat, then we are on this forum.

This is a starting point of what foods they say are ok for a diabetic kitty. You would then have to determine what the phosphorus level was by contacting the manufacturer. I don't know how old this information is and if it is still up to date on the food recommendations for a diabetic kitty. Please be aware that DCC is much more restrictive on what they consider allowable for a diabetic cat can eat then we are on this forum.
 
Thank you so very much for that list of foods, it's very helpful! I have a very hungry but at times fussy cat...one day he will eat something and turn his nose up at it the second day. I have definitely noticed how lacking the labeling is in Australia, I'm usually the weirdo staking out the pet food isle reading tins for hours, with a confused look on my face. I would love to feed Miley a raw food diet but that's where I get stuck...I'm never sure what raw foods are good and in what quantities. I'm actually a little worried about my boy, he seems more lethargic than usual tonight, i've been doing some extra BG tests but so far they're looking okay...I think lol.
 
I'm fairly new at the kidney issues and I know how it feels, it's a lot to take in! My cat is diabetic (in remission right now) and early CKD. I have a post with some questions I asked that may help you here:

http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=90280

I had a few other posts on here that people gave me advice on that have CKD and diabetic cats and Tanyas site that you already found is great too. For phosphorus I was told to try for foods under 200 mg phos per 100 kcal (some people have said under 250 is ok) and under 1.0 phos dry matter. I give vitamins and mix water in her food too. Every cat is different though, and it could be more things are needed for your kitty. There are some people on here that are really good at helping you understand your lab results once you have them, I'd ask for a copy of them too :-D

I use Dr. Lisas list for finding foods and get low carb, low phosphorus (the site BJM gave you, catinfo.org). Her food list is here: http://catinfo.org/docs/FoodChartPublic9-22-12.pdf

Hope that helps you some:) I'm sorry I don't know much about your other questions or what foods are available to you but hopefully some will be on the list for you :smile:
 
You are welcome on the food list. You'll need to double check on those Fancy Feast flavors and find out the potassium levels on everything on that list but I thought it was least a starting point for you.

We here in the US are very fortunate to have Dr Lisa Pierson who has put together that food chart that works for us. Someone needs to do that for Australia. If you are going to do the research for the phosphorus levels, you could then type the data up into a spreadsheet type format and put it out into a google document to share with other people that might need that information.

You could also register for the Diabetic Cat Care forum and ask if an Australian members have done a list like this already. You need to register first there on DCC before they let you do anything. You can't read anything on the forums or do a search until you have registered.

Yes, on the numbers. You got some low yellow numbers this evening and a couple of nice blues. A sunny day in Australia with a dip into the lagoon would we say.

Don't know what you did on your spreadsheet, but the US version for today 2/5/2013 only, is showing the number converted to US units. all the other dates are still showing the international numbers. Maybe experiment and blank out some of the numbers on the US version?
 
There's a recipe for raw food on Cat Info, too.

Basically, any fairly lean meat will do, so whatever you've got that fits the bill could be used.
 
Thanks everyone for your help, I'm just back from a little holiday (well hospital stay, but they didn't make me do my own dishes so apart from the needles, hard bed and being woken for obs every hour...it wasn't too bad ;-) ).

Well I got at least a little more information about Milo's CKD, the family took him to the vet while I was 'away' and it was silly, I had the best first half of day and terrible second half. What happened is our usual vet was away and when they asked the new guy what Miley's creatinine levels were he told them it was very low and he was a stage 1...I WAS SO HAPPY! Seriously so! Then they got a call back in the afternoon, the sample they had taken in the morning to retest had come back and made him double check the first test and he then realised his mistake, Milo's creatinine level was actually 500, making him stage 4 and I think he said Miley has lost at least 95% of his kidney function. I cried like a baby for hours, to think he was well to find it was as bad as I had first heard was really devastating. I got out of hospital today so was able to ring back the vet and have a chat, he said that he's really quite surprised, Milo looks really fantastic for a cat that far advanced, he's showing only mild symptoms so far...but he's alo too far along to safely be given the ace inhibitors (think I got that right). He rang up the uber expensive cat clinic to get their opinion, and they said to him that they could in no way support giving a cat with stage 4 CKD it because it could be what pushes them over the edge and be severely detrimental to his current health.

So now I am kinda stuck, my vet hasn't any great knowledge of what to do, and I simply can not afford the prices of the cat clinic, so looks like I will be reading a lot and hoping a lot! It makes it very hard when ones financial circumstances come between the love of a pet and the treatment, but then I guess most of us face that every day with a furry babies. I have to get Miley in for a blood pressure test, which my vet doesn't have the equipment for...the price has come back at $120, I'm glad I was already laying down! Seems a little like highway robbery for an easy test...I guess they have a monopoly on it...if i'm well tomorrow, I may try ringing around a few places and see if I can find a cheaper price. I just have a feeling his BP is a little wonky.

Miley is only showing very mild symptoms- substantially increased thirst, he seems very needy and wants to be close, and a few other very mild things that are either from this or his diabetes: he's showing a little back leg weakness and is a little shivery at times though this seems to go when he is warm. Maybe the mild shaking is to do with the cooler weather and his rather large balding places. Milo is still losing fur (though his thyroid tests came back fine), so vet and I are a little stumped why his black coat is now a deep rusty orange and he continues to lose fur from his bald belly, inside legs, up his sides and even the bottom side of his tail...my poor baby looks so scruffy! With the thyroid being fine the only thing the vet can suggest is that it's possibly just an age related thing to do with hormones (he was spayed at a little kitty). I'm not too sure yet, but I think he is just starting to have issues with stomach acid, over the past day (witnessed by kids and then myself this afternoon), he is making moist mouth noises (not sure how to describe this). It's new and from what i've read, I just assume it's the start of stomach acid problems. His appetite is still really great...maybe too good, he's always been a great eater but that increased with diabetes and has only mildly reduced over the past few weeks.

Oh and he has a lot of heat from the arthritis in his front shoulders, so his right side especially is very crunchy and seems to be causing him a little grief, though nothing too bad from what we've witnessed. I've had to cut out using his Metacam because of the negative affect it will have on his kidneys, so I will keep that up my sleeve for when he is showing obvious distress. He loves his shoulder massages and I think that with heat packs is helping as is right now.

Hope everyone and their furry babies have been safe and well!

Bebe.
 
Both food allergies and Cushings may cause fur loss, although Cushings usually includes thin skin which tears easily.
 
I did a little read up on Cushings...that's a hard one, a lot of the symptoms are also the ones for diabetes...but then most cat's with Cushing's Syndrome also have diabetes. From what i've read of the very expensive diagnostic methods and treatments, I think I will just have to leave it be. Especially when taking into consideration that very few cats actually survive the treatments and they still don't even know a lot about how to treat felines with it at the moment. Miley has always had a bit of a balding tummy, ever since he was about 7 or 8...during his regular vet visits they always just told me it was from over grooming, but it's gotten so much worse since just after he was diagnosed with diabetes...plus the rusting started after this time also. Also with his current medical conditions and rather poor current life expectancy, I just want him to be happy, safe and comfortable as long as possible...still not sure how I shall let him go. :sad:

Oh and also, about the food allergy; he's never shown and symptoms and he's had a pretty varied diet his whole life, he eats just about anything!
 
My Kiddle was fine - no barfing, no sneezing, no nothing, except she groomed herself raw on her abdomen over the stomach and intestines and inner back legs. They did blood tests and it was food allergies. Wound up putting her on Z/D and trying allergy shots. She lived to 18.
 
I may have to have a word to my vet and see what he can do. It does sound a lot like Milo. I think i'd be stuck when it came to food though, he REALLY hates the prescription vet foods with a passion!
 
To my knowledge no urine test has been done to test the gravity ting...another on my list of 'must get done' along with the BP. SO no higher than 160 BP, i've written that one down. Miley is losing weight even though he is eating quite a bit, his poor tummy is sagging...he's always been a big boy. How do I find out phosphorus levels on the food...I should know this but mind has closed up shop on me. I'm writing everything down from yesterdayish, medications are stuffing around with my memory, I feel like an old lady at 36 lol.

I am hoping the new vet I go to can help me a little more, my normal one seems really stumped by everything and pretty much has a euthanasia before treatment thing, he's just so surprised that i'm willing to actually do things at home...I think this worries him. As to the price of the BP, they want $55 consultation cost...even though I originally just wanted BP done and nothing else (thought if I was paying it, I'd take my questions in lol) and then a further 50 for the actual Blood Pressure testing. It seemed wayyyyy over priced to me too, but then i've found most veterinary costs over here are huge...when Miley first got diagnosed as diabetic it cost me $4500 at an animal hospital. $15 for it over where you are...hmmm...might be cheaper to fly him to another place for vet treatments lol.

Thank you for your help and again so sorry Rachel for hijacking your thread :oops:.

EDIT: his has patchwork gums, mostly black but i can see some pink, hope that's a good sign!
 
Status
Not open for further replies.
Back
Top