Pancreatitis and Stage 2 kidney

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Beth AZ

Beth AZ

Member Since 2017
Blue is 16. He was meowing more than usual and very suddenly showed signs of pain. He was diagnosed with Pancreatitis and stage 2 kidney failure. Because of the pancreatitis he was put on Hill's i/d. Is this food also ok for his kidneys? He loves this food and eats every 3 to 4 hours around the clock. No nausea or vomiting. Can anyone explain these results? I was crying too hard at the vet to understand last week. Here are the bad levels next to the normal levels. Any advice would be greatly appreciated.
I am afraid he was exposed to insecticide when he ran outside and romped in the grass that my appartments landscapers sprayed last week. Vet cannot agree, since his liver is normal. He takes Denamarin for his liver, just because he is an old guy.
Was prescribed Valium and Gabapentin for pain and being upset. I only gave it to him for 3 days and he seems fine today. Day 3 on Hill's i/d he showed significant improvement. He was previously on Hill's Urinary and Metabolic because he went from 7lbs to 12 in one year on Primal Freeze Dried Raw.
BUN 66 (14-36)
Sodium 165 (145-158)
Amylase 1611 (100-1200)
Precision PSL 136 (8-26)
Neutrophils 12384 (2500-8500)
Lymphocytes 1152 (1200-8000)
Monocytes 720 (0-600)
 
With pancreatitis, don't stop the pain med to quickly. An episode can be anywhere from days to weeks to subside. Sorry I can't help with the lab results.
 
This was last week. Blue has not had pain medication for a few days and is very comfortable. He is a vocal and sensitive boy and he would let me know if he hurt. Vet said 100mg of gabapentin but 50mg worked great. He is a jumper, loves to jump, gabapentin made him so uncoordinated I was afraid he would get hurt. The Valium was only given 2 days for yowling.
He was drinking with obsession every waking moment last week. His urine output turned his litter box into mud. Then Friday he started drinking normally and urine output is back to normal.
 
I am sorry to hear about Blue's condition. How wonderful that he is still with you after 16 years. I hope he gets better.
 
TempestsMum said:
I don't know much about labs but @Marje and Gracie knows
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Thank you! I hope Marje or Gracie can provide insight on his blood levels. Not understanding them is causing me stress. I want to do everything possible to help him. I have 2 vets. One is my regular vet, the other my friend sent me to. They faxed each other back and forth the records. I want a specialist now. I am not 100% sure everything is being done.
 
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Beth AZ said:
Thank you! I hope Marje or Gracie can provide insight on his blood levels. Not understanding them is causing me stress. I want to do everything possible to help him. I have 2 vets. One is my regular vet, the other my friend sent me to. They faxed each other back and forth the records. I want a specialist now. I am not 100% sure everything is being done.
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Hi Beth

Where are you in AZ? I’m in Tucson. I know several specialists in this area (and some in Phoenix) so might be able to help in that respect.

He doesn’t need i/d for his pancreatitis and the % calories from carbs is 23%.....way too high for a diabetic cat. He is diabetic, yes?

With the labs you listed, there is not anywhere near enough information for a diagnosis of chronic kidney disease much less staging of it. The Precision PSL is also not a diagnostic for pancreatitis and the lab report states that. It might give you a suspicion that pancreatitis might be involved but it’s not the correct diagnostic test. You would need the snapfPL or the specfPL. Also, some vets are still old school and think the amylase is indicative. In dogs, yes. In cats, no.

Bottom line is I can’t really tell you much of anything from the labs you listed. Is this all you have? It would be best to have the entire lab report including urine if there is any. You should ask the vet to provide you with a copy of all labs. You paid for it so you should have it.

You might want to refer to Dr. Lisa’s food charts to find a low carb, low P food. We also have a food chart put together by members here to easily find low carb, low P foods. Generally, you want the P to be below 1% or less than 200 mg P/100 kcal. While there are foods which are lower P, the only really low P foods are the prescription kidney diets but they are also higher in carbs. You typically want a food for a diabetic cat to be less than 10% calories from carbs.

Valium and gabapentin are also not the drugs of choice for pancreatitis. Certainly not valium. Gabapentin is for nerve pain. You might want to read this Primer on Pancreatitis for the most current treatment options for pancreatitis.

Primal raw is an excellent food. If he was gaining weight, he just needed less food. Raw food is much more nutrient dense and so doesn’t require that you feed as much canned food. The recommendation for amount of balanced raw to feed a cat is 2-4% of their weight with most house cats eating more towards the 2-2.5%. For example, my 11 lb 12 oz male (who is indoor but is very active since we have a kitten) was eating 6 oz of canned a day when I converted him to raw. He currently eats 4 oz of balanced raw which is a little over 2% of his weight (11 lbs x 16 oz = 176 oz + 11 oz = 187 oz x 2% = 3.74 oz of food daily).

If you can get the labs, I’ll be more than happy to take a look at them and interpret them and hopefully put your mind at ease. Just tag me when you have them posted. To tag me, just type @Marje and Gracie.
 
Marje and Gracie said:
Hi Beth

Where are you in AZ? I’m in Tucson. I know several specialists in this area (and some in Phoenix) so might be able to help in that respect.

He doesn’t need i/d for his pancreatitis and the % calories from carbs is 23%.....way too high for a diabetic cat. He is diabetic, yes?

With the labs you listed, there is not anywhere near enough information for a diagnosis of chronic kidney disease much less staging of it. The Precision PSL is also not a diagnostic for pancreatitis and the lab report states that. It might give you a suspicion that pancreatitis might be involved but it’s not the correct diagnostic test. You would need the snapfPL or the specfPL. Also, some vets are still old school and think the amylase is indicative. In dogs, yes. In cats, no.

Bottom line is I can’t really tell you much of anything from the labs you listed. Is this all you have? It would be best to have the entire lab report including urine if there is any. You should ask the vet to provide you with a copy of all labs. You paid for it so you should have it.

You might want to refer to Dr. Lisa’s food charts to find a low carb, low P food. We also have a food chart put together by members here to easily find low carb, low P foods. Generally, you want the P to be below 1% or less than 200 mg P/100 kcal. While there are foods which are lower P, the only really low P foods are the prescription kidney diets but they are also higher in carbs. You typically want a food for a diabetic cat to be less than 10% calories from carbs.

Valium and gabapentin are also not the drugs of choice for pancreatitis. Certainly not valium. Gabapentin is for nerve pain. You might want to read this Primer on Pancreatitis for the most current treatment options for pancreatitis.

Primal raw is an excellent food. If he was gaining weight, he just needed less food. Raw food is much more nutrient dense and so doesn’t require that you feed as much canned food. The recommendation for amount of balanced raw to feed a cat is 2-4% of their weight with most house cats eating more towards the 2-2.5%. For example, my 11 lb 12 oz male (who is indoor but is very active since we have a kitten) was eating 6 oz of canned a day when I converted him to raw. He currently eats 4 oz of balanced raw which is a little over 2% of his weight (11 lbs x 16 oz = 176 oz + 11 oz = 187 oz x 2% = 3.74 oz of food daily).

If you can get the labs, I’ll be more than happy to take a look at them and interpret them and hopefully put your mind at ease. Just tag me when you have them posted. To tag me, just type @Marje and Gracie.
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No. Blue is not diabetic. This was the only forum I could find that was even close. I am in Tucson. I do have a copy of his blood results. He is not in pain any more. He was meowing for days straight without sleeping, very suddenly. It was so loud as to disturb my neighbors, so the vet me Valium. He has seen both Dr Boyer at Speedway Animal Hospital, a d Dr Miller of Central Animal Hospital. I do want to take him to a specialist Friday. Can I please have your recommendation? Thank you very much. Posting a copy of his results below. @Marje and Gracie
 
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[QUOTE
Beth AZ said:
No. Blue is not diabetic. This was the only forum I could find that was even close. I am in Tucson. I do have a copy of his blood results. He is not in pain any more. He was meowing for days straight without sleeping, very suddenly. It was so loud as to disturb my neighbors, so the vet me Valium. He has seen both Dr Boyer at Speedway Animal Hospital, a d Dr Miller of Central Animal Hospital. I do want to take him to a specialist Friday. Can I please have your recommendation? Thank you very much. Posting a copy of his results below.
Click to expand...
20170814_002746.jpg

="Marje and Gracie, post: 2020642, member: 2058"]Hi Beth

Where are you in AZ? I’m in Tucson. I know several specialists in this area (and some in Phoenix) so might be able to help in that respect.

He doesn’t need i/d for his pancreatitis and the % calories from carbs is 23%.....way too high for a diabetic cat. He is diabetic, yes?

With the labs you listed, there is not anywhere near enough information for a diagnosis of chronic kidney disease much less staging of it. The Precision PSL is also not a diagnostic for pancreatitis and the lab report states that. It might give you a suspicion that pancreatitis might be involved but it’s not the correct diagnostic test. You would need the snapfPL or the specfPL. Also, some vets are still old school and think the amylase is indicative. In dogs, yes. In cats, no.

Bottom line is I can’t really tell you much of anything from the labs you listed. Is this all you have? It would be best to have the entire lab report including urine if there is any. You should ask the vet to provide you with a copy of all labs. You paid for it so you should have it.

You might want to refer to Dr. Lisa’s food charts to find a low carb, low P food. We also have a food chart put together by members here to easily find low carb, low P foods. Generally, you want the P to be below 1% or less than 200 mg P/100 kcal. While there are foods which are lower P, the only really low P foods are the prescription kidney diets but they are also higher in carbs. You typically want a food for a diabetic cat to be less than 10% calories from carbs.

Valium and gabapentin are also not the drugs of choice for pancreatitis. Certainly not valium. Gabapentin is for nerve pain. You might want to read this Primer on Pancreatitis for the most current treatment options for pancreatitis.

Primal raw is an excellent food. If he was gaining weight, he just needed less food. Raw food is much more nutrient dense and so doesn’t require that you feed as much canned food. The recommendation for amount of balanced raw to feed a cat is 2-4% of their weight with most house cats eating more towards the 2-2.5%. For example, my 11 lb 12 oz male (who is indoor but is very active since we have a kitten) was eating 6 oz of canned a day when I converted him to raw. He currently eats 4 oz of balanced raw which is a little over 2% of his weight (11 lbs x 16 oz = 176 oz + 11 oz = 187 oz x 2% = 3.74 oz of food daily).

If you can get the labs, I’ll be more than happy to take a look at them and interpret them and hopefully put your mind at ease. Just tag me when you have them posted. To tag me, just type @Marje and Gracie.[/QUOTE]
 
The only symptom Blue had was pain, excessive urination, excessive thirst. Blue has never missed a meal in his life. Blue does not throw up. Ever. He doesn't have symptoms of pancreatitis. Blue was howling and pacing for hours without sleeping for 5 days. At first I thought it was separation anxiety because my roomate moved out. He was never alone before now. Then he was whipping his tail and pacing. Meowing ever 10 seconds around the clock. The vet observed him all day. Dr Boyer has an open room where all animals are at the same time. She did urine test and xray. Those were good. Then I went to Dr Miller who diagnosted the pancreatitis. 3 days on i/d and he really did show huge improvement. He has not meowed once in 3 days now.
 
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Blue does not have either excessive thirst or urination at all today. He seems his normal lazy, hungry self.
 
Please provide me with the name of a good vet for Blue. I want to take him as soon as possible. Is Feline Limited good? I knew there would be disagreements about his diagnosis. @Marje and Gracie
 
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Sorry I missed you last night. I went to bed before you posted the labs and I just got up. I need to take care of my kitties and then will be back...30 mins max.

No...I would absolutely NOT go to Feline Limited. I'll have some suggestions for you.
 
Thank you Marje! I want to be as proactive as I can. Blue was so very sick last week. This week he is a little more sleepy than usualy. He was not cleaning himself. Today he is.I had to bathe him several times last week. He is not urinating his normal anount today and I am so worried.
 
I guess he is urinating normal. But he is not drinking as much as he was last week. He was laying in the bathtub drinking. Now, just normal sips.
 
Beth AZ said:
Thank you Marje! I want to be as proactive as I can. Blue was so very sick last week. This week he is a little more sleepy than usualy. He was not cleaning himself. Today he is.I had to bathe him several times last week. He is not urinating his normal anount today and I am so worried.
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You're welcome.

The labs you have do indicate that he could be in Stage 2 CKD but there are other reasons the creatinine can be elevated. IDEXX labs has an SDMA blood test and if the creatinine is elevated and the SDMA is elevated, it's indicative of CKD. Of course, not all vets use IDEXX...many, like the labs you have...use Antech.

The other thing we look at is the urine specific gravity (USG) to see if he is capable of concentrating his urine. A sample taken at home (first pee of the morning) can usually be checked in the vet's office with a refractometer.

His phosphorus is a little high so I would focus on feeding lower phosphorus foods because keeping the P level around 4-4.5 will go a long way towards longevity and QOL with a CKD kitty.

I'm surprised they did not check his tT4 as a cat howling like that, and his age, could potentially be indicative of hyperthyroidism and most vets will run a senior panel (which includes a tT4 and urinalysis).

If he were mine, I likely would not go to a specialist at this point. I'd just find a better vet. I use Sunrise Pet Clinic and I think Dr. Weintraub and Dr. Rademaker are awesome. My vet there, Dr. Burgess, is also incredible but she only sees patients in her nutrition response testing program. I've used Dr. W and Dr. R before when Dr. B was out and they are both great.

Having said that, many, many vets miss the opportunity to treat CKD proactively early on and I believe it is because the caregiver (kitty's parents) usually won't do what is needed. The gold standard for treatment of CKD is Tanya's Comprehensive Guide to CKD.

Insofar as pancreatitis, they either need to run the snapfPL, the specfPL, or ultrasound. If he's better, I might hold off on it.

I'm going to send you a private message and since you do not have a diabetic cat, perhaps we can talk later today. To see the message, look in the upper right corner and you'll see "inbox". Once I've sent you a message, you will see a number there. Click on inbox and then you'll see the PM.
 
And I must say, I love Dr Boyer at Speedway Animal Hospital. I know there is a big controversy about the Hill's i/d food and Prozyme enzymes he takes. But I have seen Blue come back to life on this food. I decided to trust my vet and so far it was a good decision.
 
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