? Thyroid and Kidney Question. Need Advice.

[PPCW]

Hi All,

Coby started drinking lots of water and peeing a lot about 2 weeks ago. His BG has been normal and not losing weight. Took him to the vet last week and the items that are not normal are listed below:

BUN: 72 (high)
Creatinine: 2.3 (just below the high end of the range)
BUN/Creatinine ratio: 31
Cholesterol: 271 (high)
T4: 2.9 (low)
USG: 1.013 (low), based on this, vet said Coby wasn't dehydrated at the time of blood draw.

The vet ordered Precision PSL: acute pancreatitis is unlikely but can't tell with chronic pancreatitis. He also said kidney disease can suppress thyroid function, so Coby may be hyperthyroid. I have been giving him Sub-Q (~100ml) and his drinking has decreased. Also, his fur now has lots of little flakes.

So my questions before I take Coby back to the vet tomorrow:

1. Ask for SDMA to have more accurate information about his CKD?
2. Ask for spec fPL to rule out pancreatitis?
3. What test to determine thyroid function?
4. Need to continue Sub-Q?
5. Is low USG common for CKD cats?
6. Should I give him 1/4 of Pepcid every other day?

Is there anything else I should ask the vet to do tomorrow?

I have been reading Tanya's CKD site and researching low phosphorus food with Dr. Lisa's food chart. I am currently using Nutro and asked the company to provide "AS FED" values for their soft loaf cans.

Thanks for your advice,

Patricia & Coby

 

[Sharon14]

I don’t have any input on your questions, just wanted to wish you luck at the vet.
Also, if Nutro sends the as fed values, please share with us.

 

[PPCW]

I don’t have any input on your questions, just wanted to wish you luck at the vet.

Also, if Nutro sends the as fed values, please share with us.

ETA: please DO NOT use these numbers yet, one Nutro representative said the number is g/can; another person just contacted my saying the number is %/can . I am trying to sort this out with them.

Here is the info I got from Nutro, the number is per can (85g): I am trying to figure out how to convert the phosphorus number to mg/100kcal.

NUTRO® Adult Soft Loaf Duck Recipe

• Protein 12.50g
• Fat 8.26g
• Carbohydrates 2.44g
• Phosphorus 0.23g

NUTRO® Adult Soft Loaf Turkey Recipe

• Protein 14.70g
• Fat 7.06g
• Carbohydrates 0.71g
• Phosphorus 0.36g

NUTRO® Senior Soft Loaf Chicken Recipe

• Protein 13.40g
• Fat 7.04g
• Carbohydrates 0.7g
• Phosphorus 0.37g

NUTRO® Kitten Soft Loaf Chicken Recipe

• Protein 13.20g
• Fat 6.76g
• Carbohydrates 0.6g
• Phosphorus 0.37g

 

[Sharon14]

I will try to contact them too. To calculate %calories from carbs I need the moisture, fiber and ash as well as the protein and fat. I’m not sure how to calculate the phos, I usually figure dry matter for that, so I need the moisture content.

 

[Larry and Kitties]

Ask for SDMA to have more accurate information about his CKD?

Only the IDEXX lab uses SDMA and SDMA is included with normal blood panel. Many vets uses other labs like Antech.

2. Ask for spec fPL to rule out pancreatitis?

You can if yo want but I see no reason

3. What test to determine thyroid function?

The T4 and free T4, Based on a T4 of 2.6 and not symptoms of hyperthyroid I would not do free T4

5. Is low USG common for CKD cats?

Yes, a low USG goes hand in hand with kidney deficiency.

4. Need to continue Sub-Q?

I would

6. Should I give him 1/4 of Pepcid every other day?

My BunBun's oncologist says recent studies show that Pepcid (famotidine) really does not work in cats. What is recommended is Omeprazole (one trade name is PRILOSEC) but the generic is a lot less expensive. Dose is 1/4 of 20 mg coated tab twice daily/as needed.

Is there anything else I should ask the vet to do tomorrow?

What was the blood phosphorus level? YOu want to keep it in the lower spec range. I would use a phosphorus binder like aluminium hydroxide if a low-phosphorus dies is not enough.

 

[Veronica & Babu-chiri]

Hi, his numbers does indicate he has CKD, so starting him with a low carb ( do not let diabetes go unregulated ) low phosphorus diet is probably the best you could also ask your vet about giving him Azodil

Ask your vet about the subq but if he's not dehydrated you may be able to consider not giving him subq because his creatinine number doesn't justify needing them but do check with your vet about it

A low T4 value Hypothirodism is very rare in cats it usually points to something else, he may need to check this value , CKD usually causes exactly the oposite high values of T4 so is something else you need to address with him

Pepcid is for stomach acid/nausea is he having that kind of problem? If he is you could try some other options omeprazole (as they mentioned before), SEB or cernia if the problem is more severe

 

[PPCW]

Thanks for your replies!!!

Here is what happened today:

1. Ordered SMDA.
2. No spec fPl. His abdomen feels much better today. May do it in the future if needed.
3. Doing T4.
4. Sub-q 100ml twice a week as he seems hydrated now.
4. He has a lot gurgling sound from the stomach and burping too. So vet decided to give him Pepcid, 1/4 tablet for 5 days. Now I want to give him Omeprazole.

His phosphorus level is 5.8. Ver doesn’t want to go low phosphorus yet but I want to switch him sooner than later.

 

[PPCW]

I will try to contact them too. To calculate %calories from carbs I need the moisture, fiber and ash as well as the protein and fat. I’m not sure how to calculate the phos, I usually figure dry matter for that, so I need the moisture content.

I think I can calculate the phosphorus level just need someone to check the math.

I asked Nutro to send me the numbers for all their grain free can products. Will see if they will do it.

 

[Veronica & Babu-chiri]

His phosphorus level is 5.8. Ver doesn’t want to go low phosphorus yet but I want to switch him sooner than later.

5.8 is a little on the high side, he would certainly benefit from a low phosphorus diet just not low protein he doesn't need a low protein ( that would be most of the prescription kidney diets ) just now, so as long as the diet is low carb and the lowest phosphorus you can give him it won't hurt and it can help him on the long run

 

[PPCW]

5.8 is a little on the high side, he would certainly benefit from a low phosphorus diet just not low protein he doesn't need a low protein ( that would be most of the prescription kidney diets ) just now, so as long as the diet is low carb and the lowest phosphorus you can give him it won't hurt and it can help him on the long run

That's why I am so eager to find out what the phosphorus content from the food I am currently to all my cats. Nutro grain free pate is the only low carb wet food all cats will eat. Now I have to start the process all over again ....

 

[Veronica & Babu-chiri]

I hope they answer you with the information soon