Joe is sick

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Susan Pomo

Susan Pomo

Member Since 2021
Joe is holding his own with his BG numbers, but for two days now he has hardly eaten. He hides and is grumpy. The diarrhea is back. I will be making an appt on Monday for blood work. Joe has diabetes and early stage KD.
He had just started to gain weight again and was doing so well.
Are there any other tests I should have the vet do besides a basic blood panel?
thanks
 
I would be testing for ketones at the moment every day while he is not eating well and is unwell. Very important!
Try and get him to eat some food. don’t skip doses of insulin. If you are concerned post and ask for help.
Just be aware that the recipe for DKA is not enough food, not enough insulin and an infection or inflammation.
If he gets worse you may need to go to or ring the ER.
Make sure he is seen by the vet Monday.
 
I'd also be getting him back on a probiotic -- S. boulardii is good for managing diarrhea.

The vet lat at Texas A & M (TAMU) is well know for their GI analyses.Perhaps your vet could look into getting a GI panel run there.
 
H
Sienne and Gabby (GA) said:
I'd also be getting him back on a probiotic -- S. boulardii is good for managing diarrhea.

The vet lat at Texas A & M (TAMU) is well know for their GI analyses.Perhaps your vet could look into getting a GI panel run there.
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Joe is on the S Boulardi Probiotic Fera. I am in Georgia. Sounds like the place you mention is in Texas
 
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Susan Pomo said:
He is on the S Boulardi Probiotic Fera. I am in Georgia. Sounds like the place you mention is in Texas
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Your vet takes a blood sample and sends it to the lab she mentioned, which is in Texas yes. I am in Oklahoma and got this test done for my kitty.
 
Sarah is correct. When Gabby was first diagnosed, they sent her labs to TAMU and I was in Chicago.You may be able to go online and see their prices. My experience with TAMU was many years ago. Your vet should definitely be able to get that information. The vet will also charge you for the blood draw and shipping.

I found this link for their GI lab. They I didn't see a list for pricing.
 
Sienne and Gabby (GA) said:
Sarah is correct. When Gabby was first diagnosed, they sent her labs to TAMU and I was in Chicago.You may be able to go online and see their prices. My experience with TAMU was many years ago. Your vet should definitely be able to get that information. The vet will also charge you for the blood draw and shipping.

I found this link for their GI lab. They I didn't see a list for pricing.
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Pricing is not that important if it might make a difference. What did it tell you about Gabby? More than your vet could tell you?
 
When I talked to my vet on Friday he said "keep in mind with Joe's diagnosis's, he might have bad days or bad periods where he is not feeling well." I accepted this.
It sounds like you are saying more intense scrutiny is needed via blood tests. Can a cat live a good life and feel well with both CKD and diabetes?
 
They were able to diagnose pancreatitis and hepatic lipidosis. At that time, there was not a simple test for pancreatitis. I also don't know if they were looking to rule out other problems. Gabby was pretty sick at the time she was diagnosed. She was in DKA at the time. She was hospitalized at a large specialty based practice that also had critical care. I suspect they sent their labs to specialty clinics. I knew a lot less about FD then so I was a bit clueless.

I'm tagging @Sarah&Soph since she may have more recent information.
 
IMHO, it depends on the cat. The harsh reality is that diabetes is hard on the kidneys. The better you control the FD and keep numbers below renal threshold, the better for your cat. Roughly speaking, you want to keep your cat's numbers below 250 but where this is for your cat can vary. (You can figure out renal threshold by using Ketodiastix which will test for glucose in the urine. If you have numbers that show when there's no glucose in the urine, you're cat's below renal threshold.) Using low phosphorus food or a phosphorus binder, depending on what stage of CKD your cat is at, can also help. Again, depending on the stage, fluids can help.
 
Sienne and Gabby (GA) said:
IMHO, it depends on the cat. The harsh reality is that diabetes is hard on the kidneys. The better you control the FD and keep numbers below renal threshold, the better for your cat. Roughly speaking, you want to keep your cat's numbers below 250 but where this is for your cat can vary. (You can figure out renal threshold by using Ketodiastix which will test for glucose in the urine. If you have numbers that show when there's no glucose in the urine, you're cat's below renal threshold.) Using low phosphorus food or a phosphorus binder, depending on what stage of CKD your cat is at, can also help. Again, depending on the stage, fluids can help.
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Although for the last 24 hours I am getting him to nibble on chicken breast (cooked) this is not the norm for him
Joe is on low phosphorus foods (and low carb foods) and hardly ever likes anything he has to eat. I am beginning to feel I am just prolonging his death (with him not happy) rather than prolonging his life (which is what I set out to do)
 
Susan Pomo said:
can you tell me the aprox cost of getting this done this way?
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This is the one I got done for Sophie in 2019 and it was $125 for the test. I had it done while she was getting a dental so they didn’t charge me extra for the blood draw and they also didn’t charge for shipping (unless that was already included in the price). Here’s what all it tested for at the time. For Sophie it confirmed she has chronic pancreatitis. I’m pretty sure the other 3 tests are for EPI. I just asked for my vet for a GI panel and this is what they tested for. They do offer other tests, so if you wanted a specific test done you could probably just ask for it

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What stage ckd is he? What was his most recent phosphorus level? Can you put his most recent labs in your spreadsheet? I would check those kidney values if your doing labs, just to see if they are holding steady or increasing.
Even with weruva low phosphorus foods, depending on his phosphorus levels in the blood you may need to add phosphorus binders, but that depends on what his phosphorus levels are.
I ask because Starburst is also diabetic/ckd and initially the focus was on diabetes control, but during that time her ckd progressed and now I'm focused purely on that. She has to have subQ fluids to keep her hydrated at this point. Hopefully that isn't the case with Joe.
 
StarburstMom said:
What stage ckd is he? What was his most recent phosphorus level? Can you put his most recent labs in your spreadsheet?
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He is Stage 2. I will try to muddle through this in a bit. Have to finish making dog's food. I think I can do it.
StarburstMom said:
She has to have subQ fluids to keep her hydrated at this point. Hopefully that isn't the case with Joe.
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I am pretty sure if this is the case with Joe, I will be drawing the line. I do not want to keep Joe alive at all costs. No offense to anyone that goes that route. He hides from me and cries when I check his blood glucose the last 2 days. I do not want to poke and prod him anymore than absolutely necessary
 
StarburstMom said:
What stage ckd is he? What was his most recent phosphorus level? Can you put his most recent labs in your spreadsheet? I would check those kidney values if your doing labs, just to see if they are holding steady or increasing.
Even with weruva low phosphorus foods, depending on his phosphorus levels in the blood you may need to add phosphorus binders, but that depends on what his phosphorus levels are.
I ask because Starburst is also diabetic/ckd and initially the focus was on diabetes control, but during that time her ckd progressed and now I'm focused purely on that. She has to have subQ fluids to keep her hydrated at this point. Hopefully that isn't the case with Joe.
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@StarburstMom I added as much bloodwork stuff as I could recognize. Thank you for looking at it
 
Susan Pomo said:
I am pretty sure if this is the case with Joe, I will be drawing the line. I do not want to keep Joe alive at all costs. No offense to anyone that goes that route. He hides from me and cries when I check his blood glucose the last 2 days. I do not want to poke and prod him anymore than absolutely necessary
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I felt that way initially as well but it isn't too bad (we are still learning) and she is doing well and from what others have told me she may be able to happily live several more years, depending on how quickly she progresses.
From what I've picked up on (I'm new to all this), Joe's phosphorus isn't terribly high yet, but from the Tanya's ckd site they do recommend starting phosphorus binders when phosphorus is somewhere between 5-6 (depending on the source).
If you do get bloodwork done, I would recommend rerunning the renal and hematology tests just to see if the ckd is stable since July (Starburst went from 2.0 to 3.3 creatinine in that time, so I'm paranoid) and rule it out as to why Joe isn't feeling great.

Info on phosphorus binders, options, and when to use, in case it turns out it is going up.
http://www.felinecrf.org/phosphorus_binders.htm
 
StarburstMom said:
and she is doing well and from what others have told me she may be able to happily live several more years, depending on how quickly she progresses.
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Interesting. I always thought giving fluids was "end of the life supportive care."
StarburstMom said:
If you do get bloodwork done, I would recommend rerunning the renal and hematology tests just to see if the ckd is stable since July
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Will this be done naturally if I ask for a full panel?
 
Im sorry Joe is not feeling well Susan.
I wanted to raise a hand to let you know that i had administered sub q fluids to one of my cats with kidney disease NOT as end of life care. The vet simplified an explanation to me that the sub q served as a cat dialysis. Sending well wishes to joe
 
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