help renal disease & diabetes??

[dd & savannah]

Hi

I am reposting part of an old post with some updated information. If anyone can please help, I'd appreciate it. Thanks.

Hope everyone is doing well. Savannah is still OTJ, almost two years later!!! I am writing to ask for any advice because it seems as though we may have another health crisis for my little girl. Savannah seems to have lost weight over the course of the past two years. She's currently about 9lbs, probably normal in most cases, but two years ago she was 12lbs. I thought maybe it was due to the fact that her diabetes was under control and she appeared at a healthy weight. Over the past few months she's had some soft stool here and there and diarrhea. It took me a while to bring her to the doctor only b/c I kept thinking it was a change in her diet, she keeps eating anything my baby throws on the floor and/or finds it in strange places. I was being meticulous about cleaning and it was still happening once in a while so we brought her to the vet. She's also started drinking water over the course of the months something she NEVER used to do b/c we only feed her wet food.After her first visit she was given flomax?? an antibiotic to help with the diarrhea, she seemed to want to eat HER food more than my baby's and ended up gaining 10oz in over a week and a half!

Anyways, here is some info that I have...
Based on a couple of tests, it looks like she may have CRF.
Her Creatinine was 2.0(a little high) on 8/14 and then 2.5 on 8/22.
Her BUN was 38 (nomal) on 8/14 and then 53(high!!) on 8/22.
Also,the test we took on 8/14 registered her Eosinophil at 580/ul and then on 8/22 read at 2760/ul. Not sure what this is yet but there's big difference here too.

Her urine also appreared diluted but her doctor still is not convinced it's CRF because of the weight loss and wants to do an ultrasound. Part of me feels like this is about the money. She did also mention that this could be an infection and we could try antibiotics (her last round was only for 5 days) in addition to sub-q fluids and a slightly different diet, which many of you have already suggested too and we are in the process of slowly intergrating some new food. I think I am leaning toward the antibiotics only b/c she seemed to do so well on them the last time and then wait on the ultrasound.

Any questions I should ask the vet, or advice is much appreciated!
Thanks all!
dd

 

[Lisa and Merlyn (GA)]

Well, the numbers really dont indicate CKD at this point. If the urine is dilute she may be heading there, depending on the Urine Specific Gravity. Did they do a Urinalysis and culture and sensitivity?

BUN will be elevated due to a high protein diet, and/or dehydration, so if shes drinking a lot that could fit.

did they do a thyroid test? Cuz losing weight, and drinking a lot can also be hyper T.

In my limited knowledge, eosinphils can be from an allergic response to something.. that might track with the diarrhea, a food allergy? IBD? Diarrhea can also increase drinking. My cat Conor was very good about drinking more when he was having an IBD/pancreatitus flare. IBD can cause a cat to lose weight because their intestines can be inflamed and not absorbing nutrients like normal.

Sending cyber hugs.

 

[dd & savannah]

Thanks for responding. No hyper t. She eats Wellness which is pretty high in protein. We are trying to add some new food to her diet that is better for her kidneys, but I am adding it slowly b/c she's always had sensitive stomach.

I donlt know what they did in terms of a urine test, all she said is that it was dilute. She's not drinking a ton, just drinking water, which is something she never used to do.

I thought it may be IBD too.

She was able to gain back 10 oz, I'm trying to figure out how that was possible too...

Thanks. I feel like she just can't catch a break.

dd

 

[Julia & Bandit (GA)]

While very early stage CKD might be present (it is in many senior cats), I really don't think that's your main problem and beyond feeding a kidney friendly diet (the one suggested in your other thread, NOT a prescription diet) there isn't anything more you'd want to do for that anyway right now. What is the new food you're adding? Wellness Canned Turkey and Chicken flavors are good foods for CKD.

It really appears that something else is going on, like an infection or some other condition like Hyper-T, as Lisa suggested.

How long have the runny poo issues been going on? Are they still happening/frequent? I would also have a stool sample tested to rule out parasites, which can also cause an elevated white blood cell count.

 

[Jen & Gump]

Hi, I'm going to disagree with your vet. I think a creatinine of 2.5 and losing weight does indicate early CKD. http://www.felinecrf.org/how_bad_is_it.htm . And also the dilute urine. You could do another blood test in a few weeks to a month to see what the numbers look like, but even a 2.0 creatinine is indicating early stage CKD. I don't think you have to do an ultrasound to be sure it's CKD, but if you can do that, it would be helpful all around to see how things look. It's not that bad, but now is the time you'll want to learn about this disease and consider feeding some lower phosphorus foods and what other treatments may be needed in the future. You don't have to feed low protein, but lower phosphorus canned food would be beneficial.
www.petmd.com/blogs/thedailyvet/ktudor/ ... %20Protein

(edit: Trying to get the above link to work but it's not. But there is a very good article about the importance of protein for older pets on the petmd.com site)

Most likely this is CKD (early stage) and you'll just have to keep watching numbers (at least every six months) and consider treatments as it's usually a progressive disease (ECID). But being proactive and before it may become more severe would be beneficial. How old is she?

Gumpy is also OTJ (we don't really post here, but we did on the older board) and also has CKD (he's also 18). I feel like I waited too long to really acknowledge he had this disease and I feel like I could have done more for him sooner. His creatinine was on the edge of normal for a while ( 1.9 - 2.3) and I kept thinking it wasn't too bad and that his BUN was elevated due to a higher protein diet. But that thing about the BUN being elevated because of diet only covers the increase so far and it's not always the case. And the kidney numbers (creatinine and BUN) don't even show up as elevated on bloodwork until 60-70 % of the kidney function is gone, so just because creatinine is only 2.0 doesn't mean her kidneys are in great shape, sadly. BUT, this is a manageable condition that can be stabilized with some treatments and many kitties can handle the reduced function, but you have to be aware of what's going on.

Some lower phosphorus foods that are also low carb are a couple of the Merrick varieties: Cowboy Cookout and Thanksgiving Day Dinner are good. Wellness is pretty good too. I also feed some of the Organix varieties which are even lower phosphorus, but I think they are higher carb, but Gumpy has continued to be OTJ even eating these (Thank Catness!). There's a more updated list on felinecrf.org that has the phosphorus content of many canned foods (unfortunately, it doesn't have the carbohydrate info ) http://www.felinecrf.org/canned_food_usa.htm And at some point you might need to use phosphorus binders.

I just wanted to share my experience with you because it's sort of similar. Best wishes to you and beautiful Savannah.

 

[Martica and Fred]

I would NOT give your kitty kidney food. Fred had CRF for 6 years and I refused to give it to him, always gave him the high protein, low carb, no grain canned--like Wellness. He progressed very slowly.

Towards the end I started giving subQ fluids--but be very conservative with the needle size and the dose. Unbeknownst to me, the vet was very aggressive and prescribed 150ml EVERY DAY when he wasn't even that bad, and he was 19 years old. I did it and the first few months he was good, then I started noticing symptoms like rear leg collapsing, etc. the vet did not believe me when I said it was the fluids--it absolutely was. Anyway, long story short, I ended up inducing cardiac heart failure in Fred because he has a very mild underlying heart disease (HCM) and the vet NEVER said--oh you should do an ultrasound on his heart first before we pump him with megadoses of fluids. The lfuids can be very hard on the heart.

The vet SHOULD have started me on something like 30ml 3x a week, enough to help but not to drown his poor little heart. Anyway, I stopped the fluids after that and he still lived another 10 more months and died at 20 and 2m and his kidney values never got worse--and I never gave him that crap kidney food.

Keep him on the high quality high protein food.

What you can do is add phosphorus binder to his food--it's a little powder you mix with water and pour on the food. There are two kinds, forgot the names, but switch between the two, it's safer...Also go on the CRF yahoo groups board and people there can advise you better.

IF you do fluids--DO NOT USE THE 18 gauge needles the vet uses. These are like spears into kitties skin and no need, they are huge. The vets use them because they are fast. It's not much slower to use a smaller nicer-feeling needle. I experimented with all the sizes and ended up using 25 gauge and 26 gauge. 26 gauge is ideal although you have to hold you hand securely there since it's very short needle so it dooesn't slip out. You will have to special order this because usually the online cat needle supply places stop at 23 or 24. Just call them and place the special request. Your kitty will thank you for it. Definitely use a small needle and be very conservative with your fluid doses...but hold off until it's needed.

Also, put little teeny bowls of water everywhere kitty is--not just the kitchen, but by your bed, by the sofa, by your desk, etc. So you make it very easy for him to drink all the time. Maybe get one of those fountains too if it makes him drink more. And give only canned food as it has more moisture, you can add a little more water to the wellness, as much as he'll take...

 

[dd & savannah]

Thanks Martica for the additional info. I'm sorry to hear about Fred. I would like to do an ultrasound, but I'm reaching my limit as to how much I can put on my credit card. I decided to try antibiotics for right now and see how she does and check her values again. Ugh it's so frustrating.

Thanks again,
Dianne