Shaikha 6/2 t.i.d. Day 7 + midcycles

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wombat88

wombat88

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Am taking Shaikha to the vet today to ensure she doesn't have a UTI again (pretty sure she does now) and also to get a PCV check as her tongue and gums are paler and her blood seems less "thick" than it had before. No sign of blood in stool, but her stools are darker than they had been so I want to nip a problem in the bud if her PCV is going down again. She was just over 20% before I left for overseas, but it is still too low.

6/1 PMPS = 440, gave 0.8U (yuck!)
+7 = 207
6/2 numbers:
AMPS = 229, gave 0.8U
=2 = 281
+6.5 = 261
MDPS= 387, gave 0.8U (started antibiotics for UTI)
+4 = 162
PMPS = 483, gave 0.8U (ugh, but she just started antibiotics; we'll probably have a few days of high numbers until the UTI clears some)
 
Back from the vet. First, I was right, she definitely has a UTI but thankfully no fever yet. She has a ton of junk in her urine so he put her on an antibiotic. The plan is to keep her on one for a month or more this time to give it ample time to work. He wasn't able to give her the antibiotic he wanted to (what has worked well for her in the past) since he was out of stock, so she's on a less broad spectrum one for the time being. We'll re-evaluate in a week and switch her to a different one if tests show this one isn't adequate to kill the bug, but she needed something today as they tend to get out of control quickly with her white cell counts being so low. She had glucose in her urine (not a surprise), but ketones were negative. The bad thing is that her urine was acidic, much more so than he would expect, so making it more acidic with something like cranberry probably isn't a good plan. It's the sugar likely causing the problem since it is a nice growing medium for bacteria, so if we can get and keep her better controlled I'm hoping that will help.

An additional concern is that her urine was too dilute, which suggests we may be dealing with the start of renal failure. She previously tested high normal for creatinine, and with the steroids that's not helpful if she is indeed developing kidney problems. He needs to do more blood tests next week so we'll do a renal panel then in addition to other tests to ensure her UTI is clearing up. An additional concern is her PCV has dropped slightly to 20%. It had been around 21-22% before I left for overseas. Not a huge change, but we want to see increases, not decreases since she's already anemic. We'll need to monitor that closely as well to ensure she isn't developing a GI bleed. She's had one we suspect in the past (bloody stools), but it seemed to have cleared up. I'll need to bring in a stool sample next time to check for occult blood.

At least blood glucose seems much better controlled today. She's been in the 200s each time I've tested, but hat's better than 300s or 400s. She just snuck some of her brother's dry food again though (got to come up with a better system since she's getting bolder about that) so hopefully that won't make her MDPS too crazy. Got an hour to see how that goes.
 
judy and squamee(GA) said:
So many things to address! What a job you are doing!
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I've unfortunately got a ton of experience dealing with both renal failure and anemia, since my GA Tabriz eventually succumbed to these back in mid-April. He fought hard for years though and beat the odds many times. My guess is we are very early in the process with Shaikha. The good news is I know how to deal with it if she does have CRF, and we can treat her properly before it gets out of hand. What hurt Tabriz was I didn't think it was treatable (my old vet in another state said it wasn't) so he didn't get anything except a renal diet for a year (and not enough testing) and eventually got acute failure on top of the chronic, which started a bad chain of events. I don't know what we'll do on diet, but I don't think renal food will work with her diabetes and pancreatitis since it tends to be higher in carbs or fat to compensate for the lower protein. So, we'll just feed what we can and try to manage phosphorus and other stuff as needed. How to deal with the anemia if it gets worse (hoping it won't!) is a bigger concern. In Tabriz's case, he ended up with serious nonregenerative anemia and eventually developed antibodies to epogen, so he was blood transfusion dependent for years after that (he got 28 transfusions total before anemia took him). Am hoping we can keep her red cell counts up because I'd hate to start on that treadmill with her too. Am hoping that next week's renal panels show not much of a problem yet. Whatever comes, we'll deal with it.
 
judy and squamee(GA) said:
So sorry about Tabriz. Hope this is not as difficult.
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Me too. I just gave away all his renal supplies too. My vet has a lot of clients that can't afford treatment, so they set aside the extra food, IV supplies, etc. I had to dole out for them. If Tabriz's supplies can save other cats that might otherwise be put to sleep, that would honor Tabriz's life greatly. I may need to come calling again on some supplies depending on what we find out next week. Am hoping she won't need much other than monitoring though and maybe some phosphorus binder.
 
I'm so sorry about Tabriz. At least now you know that there are treatments out there and renal failure is a rather slow process.

Sending kidney healing vibes to Shaikha.
 
Awwww :YMHUG: Hope she is feeling better soon. Glad you caught things early.

Acidic urine is fairly uncommon as far as I know. Do you remember the # (I'm curious!)?
 
Joanna & Bix (GA) said:
Awwww :YMHUG: Hope she is feeling better soon. Glad you caught things early.

Acidic urine is fairly uncommon as far as I know. Do you remember the # (I'm curious!)?
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Five!! My vet was shocked. We plan to retest again next week, but it dropped a lot since the last test a month ago (7 then). Am hoping it is an aberration. He couldn't figure out what would cause it other than food, but she's not eating food that is designed to acidify urine.
 
Oh wow, 5 is low. I think that's where my kitty was, though I don't recall exactly. I'd definitely retest when you can. I remember being really freaked out about the possibility of stones, since the oxalate ones won't dissolve when the pee goes back to normal and can only be surgically removed. He didn't have any though thankfully (I made them Xray even though the vets weren't worried, and that's where they stumbled on the cyst actually, they accidentally caught that on the Xrays). Anyhow, my point :-D is I don't think stones develop super-fast at that level, but still I wouldn't want to let it go for long.

I've never heard of food causing it unless she is on a specifically acidifying food (not sure if some of the over the counter foods that say they promote urinary health may be acidifying?). My guy had hypercalcemia, but I never 100% understood the link between that, the acidic pee, and the cyst. I'm not sure the vets knew really, but it all seemed connected somehow. Here is a link on hypercalcemia http://www.marvistavet.com/html/body_hypercalcemia.html if you are interested. I have NO idea if that is even suspected for her, but you might ask the vet. My guy's was only diagnosed through the specialist, but it's certainly something any vet could check for Ithink it is just a blood check.

Here's a link from the same site on oxalate stones & related stuff - has some interesting things I didn't know! http://www.marvistavet.com/html/body_fe ... tones.html. Some of the numbers they use though for defining acidic urine don't make sense to me, but whatevs, maybe it's a typo? Or maybe they are just differentiating btwn overly alkaline? Anyhoo... I might ask about giving her potassium citrate like it mentions. 5 is scary IMO, but hopefully it was just a fluke reading or something.
 
Joanna & Bix (GA) said:
Oh wow, 5 is low. I think that's where my kitty was, though I don't recall exactly. I'd definitely retest when you can. I remember being really freaked out about the possibility of stones, since the oxalate ones won't dissolve when the pee goes back to normal and can only be surgically removed. He didn't have any though thankfully (I made them Xray even though the vets weren't worried, and that's where they stumbled on the cyst actually, they accidentally caught that on the Xrays). Anyhow, my point :-D is I don't think stones develop super-fast at that level, but still I wouldn't want to let it go for long.

I've never heard of food causing it unless she is on a specifically acidifying food (not sure if some of the over the counter foods that say they promote urinary health may be acidifying?). My guy had hypercalcemia, but I never 100% understood the link between that, the acidic pee, and the cyst. I'm not sure the vets knew really, but it all seemed connected somehow. Here is a link on hypercalcemia http://www.marvistavet.com/html/body_hypercalcemia.html if you are interested. I have NO idea if that is even suspected for her, but you might ask the vet. My guy's was only diagnosed through the specialist, but it's certainly something any vet could check for Ithink it is just a blood check.

Here's a link from the same site on oxalate stones & related stuff - has some interesting things I didn't know! http://www.marvistavet.com/html/body_fe ... tones.html. Some of the numbers they use though for defining acidic urine don't make sense to me, but whatevs, maybe it's a typo? Or maybe they are just differentiating btwn overly alkaline? Anyhoo... I might ask about giving her potassium citrate like it mentions. 5 is scary IMO, but hopefully it was just a fluke reading or something.
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High calcium can happen with cancers, actually. Cats with renal failure also often develop it in later stages. It was a large change in a month so I'm hoping it is a fluke. I'll have to go back and read what I know about potassium citrate. I know they used it for some cats with renal failure, but it wasn't usually recommended for some reason. I thought it was because it was too acidifying, but I may be remembering wrong because giving it for acidic urine wouldn't make sense then. He talked about doing an x-ray but he was also doing some other tests to ensure there was no sand in there. So far no hint of vinegar smell wafting from the litterboxes. My vet asked me again to list everything I was giving, I think just to determine whether any of the supplements could be causing this. I haven't made any changes lately though, only the switch to canned food. The venison food came in today so we'll put her on that tomorrow. Hopefully the slightly lower carb content will help with her BG levels.
 
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