SS Review Request

[Bama]

I am having trouble figuring out dosing for Bama and I would appreciate it if someone could review my spreadsheet. I am wondering if there is anything I can do to help bring her numbers down and keep them more consistent. Please let me know if I should post this in the ProZinc forum instead of the Main Health forum.

Bama's numbers seem to be all over the place. She came out of remission late August followed by a bout of pancreatitis early September. Her numbers seemed fairly stable during October and November but went haywire at the end of November/early December. Her most recent blood work on January 4th showed elevated BUN and creatine levels which her vet said indicated a significant loss of kidney function. The vet thought a UTI could be responsible for the increased BUN and creatine levels. Could this be why her numbers went wacky?

I am in the process of scheduling an appointment with an internist at Michigan State University's veterinary clinic to review her case and check for a UTI if they agree with our primary vet. In the mean time I am trying to offer Bama food that is lower in phosphorus than FF classics but she seems to only have a passing interest in the new food.

Thank you!

Liz

 

[Critter Mom]

Hi Liz,

Can't help with the insulin side of things, but regarding the kidney issue if you haven't already heard of it, Tanya's Site is the go-to internet resource for all things feline renal. (Very well researched and respected.) High protein, diabetic friendly diets can elevate BUN levels a little. Creatinine is a definite marker that's affected by CKD, as is urine specific gravity. Tanya's Site has a support group. I'd suggest registering with them and asking them to have a look over Bama's labs - there are a number of people there who are very well-versed in CKD. The site itself is an absolute goldmine for feline health issues and treatments (not just for CKD). For CKD it's invaluable - so many things can be done to help.

Infections commonly affect the BG of diabetics. I also learned from Tanya's support group that because cats with renal insufficiency tend to have quite dilute urine and that may increase vulnerability to UTIs.

With pancreatitis in the mix, diet choices can be so limited. If push comes to shove and you can't get Bama to eat a food low enough in phosphorus, there is always the option to use phosphorus binders (not ideal, but better than having no work-around at all).


Mogs
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[Critter Mom]

An afterthought: dehydration can skew test results and sometimes push values outside reference ranges, but when hydration returns to normal the bloodwork may improve. How was Bama hydration-wise when the blood sample was taken?

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[Bama]

I had not heard of Tanya's site, thank you Mogs!

Bama's hydration seemed fine and everything was normal during her physical exam. I add water to her food but she has been drinking more and peeing more lately; I assumed it was because her bg was so high but it is probably related to her kidneys. In the past when she was dehydrated she had the classic loss of elasticity in her scruff but her elasticity was normal when the blood sample was taken.

The vet did blood work at my request. He wasn't going to do any blood work presumably because she had tests in July and September and he said she seemed perfectly healthy during her exam (except for the diabetes of course). I don't have the blood work from September in my SS because those were done at the animal hospital and they were not the easiest to deal with... Lots of we emailed it to you, we will fax it to your vet, your vet's fax machine must not be working, etc. I had to actually go in and have them print everything out (which they didn't really want to do) so I could hand deliver the hospital records to my own vet. I was so aggravated I completely forgot to make a copy for myself.

 

[Critter Mom]

Aaargh!! Jobsworths!!!! Run away!!!!!!!! People like that wreck my head.

Tanya's Site is an a-ma-zing resource. It takes forever and a half to read through it. I'm so grateful to Helen (the site author). My little one was diagnosed with early stage II insufficiency last year. I've picked up some tips on supplements and, of course, phosphorus binders and (anti-jinx, anti-jinx) thus far her labs are quite stable. It's tricky trying to ascertain how well Saoirse's doing day-to-day by monitoring clinical signs because she has pancreatitis and there is a significant overlap in symptoms. That said, since I've managed to get her back on insulin her pees have got a bit smaller (though that might be diet-related; she doesn't need to eat as much on insulin so she is getting less water from her food, even though I've adjusted how much water I add to her meals to compensate).

On the dehydration thing affecting lab values, I've seen two occasions in the past 12 months where labs were out of whack but there were no obvious clinical signs to match. One case is Saoirse. Our vet ran some pre-op bloods prior to her dental earlier this year and thought she might be jaundiced when he ran the sample in-house. The next set of bloods were find for her liver (just a slight elevation of bile acids). It helped to identify that Saoirse needed a liver scan and there are some non-specific lesions (knock-on problem from the pancreatitis, the vets suspect) but most definitely there was no jaundice (anti-jinx, anti-jinx). Her next labs were better.

The other case was a cat on the board who had become anorectic; things were really touch 'n' go at one stage. She had blood work done and the first vet who treated her diagnosed renal failure from the results. She was really sick, the poor thing, but she hadn't presented with discernable dehydration. Another vet saw her afterwards. More blood work was done and all the kidney markers came back normal. The second vet said that dehydration may have influenced the results in the first set of labs. With the appropriate support, the kitty in question recovered and started eating properly again, and her kidneys were fine (at time the relevant threads were posted).



Mogs
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