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Old November 28th, 2009, 08:44 PM
MnM MnM is offline
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Kidney Disease in cat or something else?

I'm hoping for some help here! I'm currently living in Bangkok with my two 12.5 year old cats. The vets here are ok...hard to understand and I'm just wanting to be sure that I'm not missing something. Recently my boy, Mikey, had a urinary tract obstruction and then infection. The doc used the catheter to push back the plug, took blood, gave sub-Q fluids, and meds. This was Monday night. The blood tests came back with BUN at 26 and Creatinine at 2.14-doc said renal failure. Continued sub-Q fluids, pill for bladder lining, pill for anti-inflammatory and an antibiotic. Since then started him on phosphorus meds and had to get an injection for stomach acid reduction. Doc had him eating Hill's C/D then switched Saturday morning to K/D (though that was when he was vomiting and we brought him in for the stomach acid, so didn't really get much of it in). Took blood again and BUN is up to 31 and Creatinine up to 2.41. Back in June of 2008 his BUN was at 26 and his Creatinine was at 1.0.
Does Mikey have renal failure and kidney disease? Is there any chance, any at all, that he could come back from this and live to the ripe old age of 20something? Is there something more I can do? I feel like my heart is breaking...any ideas or info would be appreciated.
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Old November 28th, 2009, 09:26 PM
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Do you have a value for his Urine Specific Gravity?

Another member here, growler, has lots of experience and excellent advice regarding CRF in cats. I'm sure she'll chime in shortly, but in the meantime, here is her thread that is worth reading: http://www.pets.ca/forum/showthread....kidney+disease
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Old November 29th, 2009, 12:04 AM
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Do you have the reference ranges for the lab that was used for the bloodwork? The creatinine @ over 2 is definately high, though most but not all labs put the BUN as normal when under 35.

Was there anything else out of normal on the blood test? I see Mikey's on phos meds - what is the phos level?

Do you have the names of the meds Mikey's on?

Did they do a urine test? Do you have a value for the urine specific gravity (USG), and what was the amount of crystals?

Urinary crystals & stones can also raise the BUN & creatinine values.

Renal failure and kidney disease are two terms for the same condition. Many cats do really well for years with renal failure, my own grrl, who's 18yrs, has been dealing well with renal failure for 2 years now.

This is a wonderful, informative site by a woman in the UK who has had a couple of cats with renal failure - http://www.felinecrf.org/index.htm - it is not meant to replace veterinary advice but written from an owners perspective.
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Old November 29th, 2009, 12:22 AM
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Welcome to pets/ca MnM but sorry to hear about Mikey.

I don't have any advice but just wanted to say that growler and sugarcatmom are the two best members on the forum to give you information about feline kidney disease.
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Old November 29th, 2009, 02:42 AM
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Thanks so much for writing back...I'm feeling helpless being in Thailand. I read through Duffy's entire story-Mikey's sis (McKinley) is a tortie and her face looks so much like Duffy's! We love the 'tortitude', that is SO McKinley.

The 'normal' range for the lab here is BUN (7-26 mg/dl) and Creatinine (0.4-1.8 mg/dl). Mikey's Monday/Saturday were 26/31 BUN and 2.14/2.41 Creatinine. I don't have a copy of the urine tests, but will get those at our appt tomorrow-they're going to do it again tomorrow too. I'm worried about him having had blood drawn so close together (Monday and Saturday). If they want to do it again tomorrow that will be three times in a week. How long should I wait to test his blood again?

His glucose was high, which is high every time I've had his blood tested-in the past we fast him then retest it comes back normal (glucose 267 [normal 79-126]). His protein was at 8.0 (normal 5.8-7.9). The phosphorus was not high, but because of hind end weakness and wobbly balance on Thursday night, that vet trip resulted in Alumilk 1.5ml 3x/day.

There is another thing called "ALK.P" and it was VERY high at 147 (3-60 U/L is normal range), but we don't know what this is and couldn't understand the vet-I'll ask again tomorrow.

He is also on:Cystaid, Mabocyl, and Tofidine and between 250-300ml of subQ fluid a day.

On Saturday morning we rushed him because of vomiting (saliva and then the k/d food) and straining in the litter box with multiple trips and even though he pooed, still coming back and straining-then vomiting. He was given an injection for stomach acid reduction and an anti-nausea injection.

Yesterday afternoon was the first I felt hopeful that he may 'recover'. Then the vet called with the new lab results of the elevated BUN and Creatinine. Back into depression I sank.

Last night/wee hours of this morning, Mikey was very much his usual obnoxious self (kneading and drooling in my hair at 3am-though instead of the usual toss off the bed, I let him knead and drool away!). Today he actually PLAYED with a piece of paper and a shoe lace-not for long, but still...I cried (again). He's eating about a can+ of K/D a day-seems to actually like it, though we can't feed his sister something else when he's around or he'll refuse to eat his. He's not drinking ANY water, but the poor guy walks around like a slushy most of the day with that much fluid being poured into him, so I can't blame him.

I can not get ANY of the good canned foods here, I'm lucky to be able to get the prescription ones. I was all of last year (Sept-June) feeding him a homemade cooked diet-duck, sweet potatoes, mung beans with calcium citrate, probiotic, flaxseed oil, taurine added in. He liked it. I also bring back as much as I can carry from the states of canned foods like wellness, weruva, etc, but can't bring enough to last long. Starting this Sept though, I forced him on to a dry diet with a can once or twice a week. He started losing weight (which was what prompted my original move to the homemade/canned food diet, a vet suggested grain allergy after $3K in tests revealed no other cause-ugh; part of this testing did show he had some scarring on the kidneys and two small kidney stones, but everything else checked out). He gained some weight back and had regular bowel movements, he maintained this for a year. Then about three weeks ago I noticed he was dropping weight again and having trouble pooing and was frustrated (as even the dry kibble was grain free). So started throwing whatever canned food he wanted at him-which unfortunately was mostly Thai canned cat foods which I have no idea what was in them, LOTS of fish though.

I noticed him acting 'funny' a week ago Friday. Left for the weekend, came home on Sunday and still had that funny feeling. He didn't cry, or stop eating, or anything that you can describe to a vet-but we knew something wasn't right. Monday night took him in and found the urinary tract obstruction. And then I've told you most of the rest...

He's only 12 1/2...I was banking on another 8 or so years of having to toss the 3am drooler off the bed...with moving around as much as we do, he IS my family, he is home.

Thanks for listening, sharing and giving hope. It's rare to find people that understand that he's not 'just a pet'...thank you.
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Old November 29th, 2009, 03:04 AM
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I'm not the person to give you advice but Growler is logged on and I'm sure she will help you.

I do know that a mainly fish diet is not good for cats ....especially ones with urinary problems so hopefully you can get Mikey to eat some other flavours.
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Old November 29th, 2009, 03:43 AM
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MnM, I left a message for Growler to reply to this thread. It's 1:45am here and I'm off to bed but I'm sure she will respond before she logs off.
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Old November 29th, 2009, 03:49 AM
MnM MnM is offline
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Thanks Rainbow-I appreciate the help.

I'm just looking for some more direction and guidance-my head is spinning from all of the websites I've been reading and the conflicting information. Mostly I'm wavering between confusion and crying! Somehow, too, I don't get the feeling that Thailand is going to have the most current research on how to best help cats in Mikey's situation.

Thanks again...
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Old November 29th, 2009, 04:37 AM
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Quote:
Originally Posted by MnM View Post
The 'normal' range for the lab here is BUN (7-26 mg/dl) and Creatinine (0.4-1.8 mg/dl). Mikey's Monday/Saturday were 26/31 BUN and 2.14/2.41 Creatinine. I don't have a copy of the urine tests, but will get those at our appt tomorrow-they're going to do it again tomorrow too. I'm worried about him having had blood drawn so close together (Monday and Saturday). If they want to do it again tomorrow that will be three times in a week. How long should I wait to test his blood again?
The BUN is not too bad, the creatinine rising but still in low 2's is not alarming (Mikey's BUN & cre are both lower than Duffy's right now but she is good-stable with little to no symptoms right now)

Given the severity of symptoms vs the relatively low numbers I would say there is something else more pressing right now than the kidney numbers, likely either the crystals/stones, a liver issue or a possible diabetes issue

I would say blood drawn no more than 3 times a week once a month in emergency type situations.

Having blood drawn too often on a sick animal can push them into anaemia especially with cats (due to size) & smaller sized dogs.

In a stable cat the blood values are not going to fluctuate enough for a significant change 1 week to the next. However when formulating a treatment plan for a sick cat (as Mikey would be classed now) one may need more frequent testing.

For chronic conditions such as renal failure once every 3 months is standard, the exception being diabetes however the amount of blood taken for a glucose-only test is far lower than a lab work up.

Quote:
Originally Posted by MnM View Post
His glucose was high, which is high every time I've had his blood tested-in the past we fast him then retest it comes back normal (glucose 267 [normal 79-126]). His protein was at 8.0 (normal 5.8-7.9). The phosphorus was not high, but because of hind end weakness and wobbly balance on Thursday night, that vet trip resulted in Alumilk 1.5ml 3x/day.
Sugarcatmom is better able to guide you regarding the high glucose & possible diabetes. Glucose will rise with stress but shouldn't go 100+pts due to stress more like 20.

The wobbly back legs could be as a result of: low potassium, anaemia, high phos, metabolic acidosis (one symptom being excess stomach acid), diabetic neuropathy, arthritis, hypertension or constipation

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Originally Posted by MnM View Post
There is another thing called "ALK.P" and it was VERY high at 147 (3-60 U/L is normal range), but we don't know what this is and couldn't understand the vet-I'll ask again tomorrow.
Alkaline Phosphatase is an enzyme produced by the biliary tract (liver). High levels indicate bone disease, liver disease or bile flow blockage. Can also be indicated because of vomiting, several days of not eating enough proper balance nutrition.

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He is also on:Cystaid, Mabocyl, and Tofidine and between 250-300ml of subQ fluid a day.
Cystaid is for the bladder lining, Marbocyl treats tissue infections & URI and while I can't find a direct english explaination for Tofidine it appears to be an antibiotic

Are you dividing the amount into 2 subq session a day? Are the fluids fully absorbed by the next day?

Quote:
Originally Posted by MnM View Post
On Saturday morning we rushed him because of vomiting (saliva and then the k/d food) and straining in the litter box with multiple trips and even though he pooed, still coming back and straining-then vomiting. He was given an injection for stomach acid reduction and an anti-nausea injection.
Can you ask the vet about something more frequent acting for controlling stomach acid: http://www.felinecrf.org/treatments....g_stomach_acid Also if you raise the food dishes up about 3-5 inches off the ground it puts their head higher than the stomach when eating so it keeps the acid below & out of the throat. Small frequent meals also helps especially one right before bed.

The straining there was likely him trying to pee & being unable to pass urine due to the stone/crystals. Cats will sometimes vomit after straining w/multiple attempts in the litterbox, this then puts them at further risk if dehydration.

Quote:
Originally Posted by MnM View Post
I can not get ANY of the good canned foods here, I'm lucky to be able to get the prescription ones. I was all of last year (Sept-June) feeding him a homemade cooked diet-duck, sweet potatoes, mung beans with calcium citrate, probiotic, flaxseed oil, taurine added in. He liked it. I also bring back as much as I can carry from the states of canned foods like wellness, weruva, etc, but can't bring enough to last long. Starting this Sept though, I forced him on to a dry diet with a can once or twice a week. He started losing weight (which was what prompted my original move to the homemade/canned food diet, a vet suggested grain allergy after $3K in tests revealed no other cause-ugh; part of this testing did show he had some scarring on the kidneys and two small kidney stones, but everything else checked out). He gained some weight back and had regular bowel movements, he maintained this for a year. Then about three weeks ago I noticed he was dropping weight again and having trouble pooing and was frustrated (as even the dry kibble was grain free). So started throwing whatever canned food he wanted at him-which unfortunately was mostly Thai canned cat foods which I have no idea what was in them, LOTS of fish though.
Why did you take him off the homemade diet and put him on dry? I would suggest to put him back on the homemade diet with canned and most definately get rid of all dry food. It is entirely inappropriate for cats with crystals/stones and compromised kidneys. http://www.catinfo.org/#Common_Felin..._Ties_to_Diet_

You do also want to limit the amount fish in the diet (no more than 1 per week/two weeks) as too much may not only cause an imbalance in vit e but also lead to refusing to eat other varities
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Old November 29th, 2009, 05:30 AM
MnM MnM is offline
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I can't tell you how much I appreciate your thoughts and insight!

Could all of this be linked to diabetes then? I'm so confused and SCARED!

I'll try raising up the food bowls-since the injection (which was only supposed to last 8-12 hours) he has seemed to feel better-no more vomiting or funny lip smacking. We are doing lots of small meals this weekend (but we go back to work tomorrow so that will be harder) and he's eating a lot today. He'll finish a can of K/D and likely start another. It's tough to leave food out because of his sister, so we have been keeping them separated (they don't mind being separated but hate being locked out of parts of the house) and because we live in the tropics so get massive ant infestations if food is left out for too long. Right now I'm combating the little buggers with cinnamon which seems to help for a while.

I would say most of the fluid is gone, he pees 10+ times a day though. Prior to the subQs he didn't ever drink or pee much. We do it in one session-I'm hoping to reduce that/wean him off of it this week after the vet visit tomorrow.

I thought the straining was inability to pee too, which is why we rushed back to the vet (we've been there almost every day this week, once twice in a day!). The vet said his bladder was empty-so determined he was trying to figure out a way to alleviate the pain in his tummy from the stomach acid. That hasn't happened again.

He is very weak still, his legs are all a tiny bit wobbly. He can still jump up on our very high bed and run up and down the stairs, but you can see slight little tremors in his legs.

Do you think we should run the tests again tomorrow? We had planned to fast him for 8 hours to get an accurate test, but with the subQ fluids, would it be an accurate read? I'm so worried about the little guy.

I'll go back to his homemade diet (would you vote for that over the K/D stuff? what about a combo?). I took him off of it because I went back to work full time and thought maybe he didn't 'need' it...so I do feel like I've caused this problem and it just makes it all hurt even more.

Thank you thank you thank you for your help. I appreciate it so very much. Our vet appt is tomorrow afternoon but the blood results won't be back until sometime Tuesday our time. I'll let you know.

On a completely different topic-do torties tend to be heavier? Poor McKinley is about 13lbs and she eats way less than Mikey-we defend her to people calling her big boned. No amount of food regulation or 'diet' food makes a significant difference for her. One vet made me cry because of her weight!
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Old November 29th, 2009, 06:12 AM
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One thing that concerns me. You said you fasted Mikey and then took him into the vet? A cat should never go without food. Even 24 hours can be critical in a cat. I know that SCM can explain much better than I why it shouldn't happen. That in itself would probably make a difference in his numbers.
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Old November 29th, 2009, 09:30 AM
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Two different countries- China (the vet was German though) and the US both had me fast Mikey for 8 hours before they did the second blood test because both times the glucose was elevated. Both times it came back fine on the second read...in the US they even did a further fructosamine (or something like that) test to be sure.

This vet here asked me to do the same to get an accurate reading of the levels for tomorrow.

My earlier optimism is now clouded as Mikey is back to acting like he is in pain and refusing to eat or be petted. This morning was SO good and even into this afternoon he was still a pretty happy cat. Not so now. I did finally get him to eat some chicken breast so I could give him the last of his meds. Looks like it's another night on the bathroom floor for me. Hopefully morning will be brighter.
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Old November 29th, 2009, 11:41 AM
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Pre-blood work fasting of about 8 hrs is normal and not usually a problem. And stress OR infection can actually raise blood glucose quite a bit (even more than 100 pts in some cats). The fructosamine test that you mentioned is the best way to rule out diabetes because it takes an average reading of blood glucose levels over the previous weeks. How long ago was that one done?

What is a little "off" here though is that you say Mikey's fasting blood glucose reading is normal. I would think that if "white-coat" stress was the issue, it wouldn't matter if he had been fasting or not, it still would have been higher. It could be that infection (or pain) was causing it to rise rather than stress those other times, and that at the time that the fasting blood work was done, either the infection or pain wasn't a factor. Does that make sense? (I'm still drinking my morning coffee, so it's possible that it doesn't).

Anyway, that is something to keep an eye on. As for food, you might want to go back to making your own, although if you can do raw rather than cooked, that would be best. You also don't need to add sweet potatoes or mung beans, except maybe in very small quantities for additional fibre if Mikey has digestive issues. Not sure if you've seen this site: www.catinfo.org It has excellent info on making your own raw cat food. One caution on the recipe there is that it isn't appropriate for a cat in renal failure because it's quite high in phosphorus. There are modifications that can be made for it to be suitable, or else you could add a phosphorus binder. We can talk about that more later if needed.
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Old November 29th, 2009, 03:08 PM
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Pre-blood work fasting of about 8 hrs is normal and not usually a problem. And stress OR infection can actually raise blood glucose quite a bit (even more than 100 pts in some cats). The fructosamine test that you mentioned is the best way to rule out diabetes because it takes an average reading of blood glucose levels over the previous weeks. How long ago was that one done?
Ooops, sorry. When I see the word fasting I think of 24 hours or more. I don't think 8 hours. I shall back out now........
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Old November 29th, 2009, 04:05 PM
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MnM,I too have no advice to give,other than good luck with the little guy,
I know how heartbreaking and confusing it can be,with a bit of a language-barrier even more so.
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Old November 29th, 2009, 04:12 PM
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I have no advice to give, but am sending you lots of for your kitty.

Here is a for you.

You are in good hands with SCM and Growler
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Old November 29th, 2009, 04:23 PM
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Thanks everyone for your thoughts...

Mikey's last blood tests (before these two this week) were a year and a half ago. Both times the glucose was elevated initially (though not to the point it is now) but with the fasting was normal.

So his elevated glucose from the test Monday could have been from the infection from the urinary blockage? The vet called on Saturday night with the new results and besides the increase in BUN and Creatinine, he didn't say anything else-though it is hard to understand especially over the phone. He did say that all signs of infection had cleared, which he felt was positive. Today at our appointment we'll get a copy of numbers from Saturday's blood test and see what they said. I'm worried as at the initial appt on Monday, the vet did say Mikey was slightly anemic (sp?). I know that drawing more and more blood just increases this risk factor...but not knowing what's going on could be just as risky...I don't know what to do.

Mikey is still really unwell. I spent yet another very sleepless night checking on him. He's weak and wobbly and in pain or uncomfortable. I tried giving him the antacid that the vet prescribed both last night and this morning, but it doesn't seem to be helping. He munched a little bit of chicken breast last night so I could give him his meds and licked at the new can of K/D I opened just now. But it was all half-hearted.

I don't know what else to do! I just wish he could tell me what hurts so I could try and make it better for him. My husband is taking a sick day today because we're scared to leave him.

Thanks for writing-it helps to know someone else understands.
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Old November 29th, 2009, 06:09 PM
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I know that drawing more and more blood just increases this risk factor...but not knowing what's going on could be just as risky...I don't know what to do.
Has a urinalysis been done recently? I would do that before more blood work.
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Old November 29th, 2009, 08:31 PM
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Even though he's been on 300cc's of fluid for the last week? (we did not give it to him today as we're heading to the vet this afternoon and he does it easier at the vet than with us).

Would you recommend waiting a week to do another blood draw-unless symptoms worsen of course. He's just NOT getting all the way better and I don't know what's going on!

My husband just emailed and said he seems marginally better than last night/this morning...
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Old November 29th, 2009, 11:50 PM
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I'll try raising up the food bowls-since the injection (which was only supposed to last 8-12 hours) he has seemed to feel better-no more vomiting or funny lip smacking.
Stack them on something fairly thick & non-slip like a phone book.

Quote:
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We are doing lots of small meals this weekend (but we go back to work tomorrow so that will be harder) and he's eating a lot today. He'll finish a can of K/D and likely start another. It's tough to leave food out because of his sister, so we have been keeping them separated (they don't mind being separated but hate being locked out of parts of the house) and because we live in the tropics so get massive ant infestations if food is left out for too long. Right now I'm combating the little buggers with cinnamon which seems to help for a while.
If you have a tray you can put under the dishes & fill it with water then put in a "mini table" to raise the dishes, the ants can't get to the food through the water. Something similar to this http://www.theantser.com/

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I would say most of the fluid is gone, he pees 10+ times a day though. Prior to the subQs he didn't ever drink or pee much. We do it in one session-I'm hoping to reduce that/wean him off of it this week after the vet visit tomorrow.
If the fluids are not fully absorbed but the next session, you should wait until they are & also slightly reduce the amount you give the next time. One shouldn't give fluids again until the previous amount is absorbed.

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I'll go back to his homemade diet (would you vote for that over the K/D stuff? what about a combo?).
I would remove all the dry stuff, either go back to homemade or do a combo with canned if you/your vet thinks the homemade is not complete enough. I'm not too impressed with the ingredients in the prescription diets but since you can't get the holistic brands, there's little choice. Duffy's raw fed so that of course would always be my first choice.

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Originally Posted by MnM View Post
On a completely different topic-do torties tend to be heavier? Poor McKinley is about 13lbs and she eats way less than Mikey-we defend her to people calling her big boned. No amount of food regulation or 'diet' food makes a significant difference for her. One vet made me cry because of her weight!
Not sure about that but it is possible, Duffy's adult weight has always been around 12-12.5 lbs, several years ago I also had a calico-Van-point Siamese who was longer, leaner & always around 10 lbs they ate the same food in the same portions. But then my mum has a long haired tortie who is around 8 lbs

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Originally Posted by MnM View Post
Even though he's been on 300cc's of fluid for the last week? (we did not give it to him today as we're heading to the vet this afternoon and he does it easier at the vet than with us).

Would you recommend waiting a week to do another blood draw-unless symptoms worsen of course. He's just NOT getting all the way better and I don't know what's going on!
The subq's will affect the urine specific gravity number, but it will tell if there are still crystals, epithelial cells, or blood in the urine.

Given the anaemia the vet has already stated I would wait a week on bloodwork, unless the vet has a specific value he is looking for that would affect diagnosis/treatment.
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  #21  
Old November 30th, 2009, 12:11 AM
MnM MnM is offline
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Thanks for the advice, Growler, I appreciate it more than I can say.

My husband is giving me hourly updates with an iPhone photo included. Mikey's still showing very little interest in food, but since the vet may decide to draw more blood and originally wanted him fasting anyway, I think we'll wait to pull out all stops to get him eating. Our appt is in three hours...three very long hours. We could go now, but the vet we like the best isn't there until 4pm our time.

On Wednesday when I brought him back in to the vet in a panic because of his blood test results from Monday, they wanted to keep him and put him on an IV. I asked if we could avoid that (he's SUCH a particular cat that I really think if he had to stay it would make it harder for him to get better). That was when they sent us home with the subQs. Now I'm wondering if I made a mistake? Should I have let them keep him, would the IV fluids have been better? He's been absorbing the subQs and peeing a lot. I'm so very conflicted...and obviously being pretty useless at work today!

Could this all be stomach related? If he has ulcers/too much acid could this be a part of the weird blood levels? The antacids I gave him did not make a difference. He's not puking or smacking his lips, but I can hear his stomach making gurgling sounds that is not usual for him.

Does anyone have a crystal ball? Sigh.
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Old November 30th, 2009, 12:56 AM
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You know your cat better than anyone, if you think Mikey would've been worse staying at the vet for treatment then you made the right choice.

The blood values definately drop more significantly & often into normal when on IV because the fluids are flushing the blood directly - right from the veins, where the subq's are flushing more indirectly by way of the filtering through the kidneys. As to whether the IV fluids would've been better, in a true crisis situation yes better, in a chronic situation it's a great temp fix but subq's are still needed afterwards. I guess it would depend on what else if anything is going on & if the infection is truely cleared up.

Forgot to mention the urine testing will also determine if the infection is gone.

Excess stomach acid doesn't necessarily mean he has stomach ulcers. If Mikey is drinking alot of water & vomiting right after I would think it would be more likely. Stomach ulcers would afftect the blood results only if they were bleeding to which you would see the BUN elevated but creatinine normal, curdled blood in the vomit, poops would be black.

for the appt
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  #23  
Old November 30th, 2009, 02:37 AM
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Leaving for appt in 5 min.

Doc said on Saturday night that his blood tests showed the infection was gone. But I'm still wondering if the IV would have been a better way to go.

No vomiting and no drinking water-we've been force feeding some water today as we didn't to the subQs. He has been yawning an awful lot today, which is unusual...is that a sign of something? He right now seems to be asking for some food, but we're holding off until after the appt.

Will write more when I'm back, as long as I'm not crying too hard (Thais don't show sad emotions, so me sobbing in the office is weird to them).
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Old November 30th, 2009, 05:32 AM
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We're back...no good news, but no bad news...sigh.

We couldn't get Mikey's urine sample as he had an empty bladder, of course. But we did do a quick glucose test (just a drop of blood) and it came back fine.

Mikey's last urine test on Monday showed his USG at 1.010...no idea what that means.
Other numbers from the test a week ago:
Leuco 3+
Nitrite negative
pH 5
Protein 2+
Glucose 3+
Hemoglobin 4+
All else negative or normal. The doc is most worried about the glucose as he says that is from renal disease since we just got the negative on diabetes. Is that true? Could ALL of this be from his infection and complications from the urinary blockage? I so want to hope that his urine sample comes back with an FLUTD diagnosis and that all of this is from that-which he can recover from. The doc said it is not likely...is he right?

I got a copy of the blood test from Saturday, besides the elevated BUN and Creatinine, these were other numbers:
Sodium 157
Potassium 6.0
Chloride 110
Calcium 11.4
Phosphorus 4.0

We'll do another blood draw next week and retest everything. In the meantime, we are taking more of the cystaid but finished with everything else. Also, fluids only if he starts to become dehydrated.

He said he doesn't think Mikey is in pain (I disagree, there is something making him seriously uncomfortable). He was horrified at my chicken breast feeding and said maybe some fresh water fish if I must do people food. But he really wants me to stick with low-protein (ie K/D). And of course now Mikey is refusing to eat ANY of the K/D. Now what do I do? How long do I wait him out? He had a couple bites of chicken breast at 9:30am and besides a lick of K/D an hour ago, nothing else (at 6:30pm). Help!
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Old November 30th, 2009, 07:29 AM
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Originally Posted by MnM View Post
The doc is most worried about the glucose as he says that is from renal disease since we just got the negative on diabetes.
I thought the positive urine glucose was from last week? And the blood glucose from last night was normal, right? I don't know why the vet would still be concerned about that then. The positive urine glucose could have easily been from infection and is not likely still an issue if the blood glucose is now normal. The glucose has to reach a certain level in the blood (around 200-250) before it "spills over" into the urine.

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He was horrified at my chicken breast feeding and said maybe some fresh water fish if I must do people food. But he really wants me to stick with low-protein (ie K/D). And of course now Mikey is refusing to eat ANY of the K/D. Now what do I do? How long do I wait him out? He had a couple bites of chicken breast at 9:30am and besides a lick of K/D an hour ago, nothing else (at 6:30pm). Help!
Your vet knows nothing about what cats should be eating and I wouldn't listen to a word he says on the issue. Feed Mikey chicken breast if he'll eat it for now (not long-term because it isn't balanced, but he needs to eat now). Do not feed fish!!! And do not feed K/D, especially since Mikey apparently doesn't want it anyway. Can you get Fancy Feast or Friskies there? There are some flavours that are lower is phosphorus than others and they tend to be liked by lots of cats. You can always add a phosphorus binder if necessary. Here are a couple charts showing the nutritional levels of various foods, maybe it will give you some ideas:
http://binkyspage.tripod.com/CanFoodNew.html
http://binkyspage.tripod.com/CanFoodOld.html
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Old November 30th, 2009, 10:40 AM
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Thanks Sugarcatmom-I will look up that info. Canned cat food here (imported) is slim pickings. I'll scour the import stores of Bangkok and see what I can come up with.

So the glucose in the urine could be from infection??? Seriously? This is one of the things the doc is using to bet on kidney failure...yes, the glucose in the urine was from a week ago. Same with the elevated glucose in the blood draw. Tonight the doc took a dab of blood (Mikey fasted today) and put it in the little glucose strip reader. He said anything over 300 was a worry, Mikey's was 130. Next week when we do the blood draw I said to do a full panel of tests-just test for everything. The doc is going to do a fructosamine test then, to be absolutely sure diabetes is not a problem.

Finally we got him to pee (whew, that took a lot of eye droppers of water!). My husband just ran the urine in to the doc and called with the results. I'm taking this as good news: there is still an infection, but it's getting better. We have to send off for the blood cell counts in the urine so wait on that for two days...
The USG was up to 1.030
Leuco 3+
pH 6
Protein 1+
Glucose 1+
All else is negative or normal
Glucose down to 1.5-2

He still won't eat the K/D, so we'll try again in the morning and if not chicken breast it is. I'll try a new recipe with chicken breast, small amt of sweet potatoes and broccoli tomorrow with the added supplements and see if he'll go for that.

For the first time in a week I'm hopeful that he'll recover and the vet is wrong about the kidney failure. It helps that Mikey just crawled up on me purring too!
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Old November 30th, 2009, 11:05 AM
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That is a MUCH better USG! I would have trouble believing kidney disease is a major concern at this point. Please forget about trying to feed Mikey K/D, it is a nasty food which could actually cause kidney problems instead of "cure" them. I won't go into the details, but basically cats NEED protein. Feeding a diet devoid of quality protein is counter productive to good health.

I think the vet is confused about the glucose issue and how it relates to CRF. Another fructosamine is a good idea, but this would indicate diabetes, not kidney issues.

Let us know what the results are, and good luck with getting more food into Mikey.
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  #28  
Old November 30th, 2009, 04:47 PM
MnM MnM is offline
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Yeah for Mikey's pee!

He's been acting better (we swear it's psychological, a trip to the vet ultimately = feeling better).

This morning already he did a number 1 AND a number 2 AND ate some K/D food. I'm in agreement about what you're saying about his diet. Tonight I'm going to whip up a homecooked recipe with some chicken. Would you recommend just breast meat or a mixture? I'm going to avoid duck for a bit because I want ease him back into the homecooking and he's been having a lot of chicken in his wellness/weruva/etc brands that he was eating off and on (ones I bring back from the US). I'd actually love to do raw, but living in Thailand and the chemicals and hormones they inject into the animals...well, that's too scary for me. I am able to find some chicken pieces that are certified hormone/chemical free, which is what I'm planning to use for the cooked food.

Also, I'm planning a Christmas visit to the States-which again compounds the issues he's having (do I leave him or take him-ugh, usually I leave them with the maid watching them, but I don't trust her to make sure he's fine with what's going on now-and I hate the idea of leaving him at the vet)! But I always make a pet store run and am wondering if there is a mix of supplements for home cooking that I can purchase. Right now I crush the calcium citrate myself, divide a taurine capsule between a couple of containers of food, measure out flaxseed oil and probiotic. If there's something I could order online too (especially if it saves money) I've got time to have it there for me (there is Seattle, WA).

Thanks so very much for the advice and help. Since I started writing to you all, I've been so much better emotionally. Fingers crossed that next week's blood test/urine test is getting us closer to the numbers we want and not closer to confirming the kidney disease.

Right now, Sugarcatmom's having "trouble believing kidney disease is a major concern at this point" officially makes her my most favorite person on the planet right now!
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  #29  
Old November 30th, 2009, 10:45 PM
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Originally Posted by MnM View Post
We have to send off for the blood cell counts in the urine so wait on that for two days...
The USG was up to 1.030
Leuco 3+
pH 6
Protein 1+
Glucose 1+
All else is negative or normal
Glucose down to 1.5-2
Urine testing definately looking better, though infection is still showing.

That's a very good USG

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Originally Posted by MnM View Post
But I always make a pet store run and am wondering if there is a mix of supplements for home cooking that I can purchase. Right now I crush the calcium citrate myself, divide a taurine capsule between a couple of containers of food, measure out flaxseed oil and probiotic. If there's something I could order online too (especially if it saves money) I've got time to have it there for me (there is Seattle, WA).
There's a pre-mix powder from Feline Futures called TC Intincts Plus that you add to raw meat - it has all the necessary supplements including liver, the TC Instincts doesn't have the liver because you add fresh liver yourself. This can be added to cooked chicken as well. http://www.felinefuture.com/
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  #30  
Old December 1st, 2009, 07:26 AM
MnM MnM is offline
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Thanks growler for the advice! Mikey is doing well today, appetite back and almost 'normal' acting. We're keeping a close eye on hydration and still giving him cystoid for the bladder.

I like the website you gave me...I may just give the raw thing a go since I can get higher quality chicken. I'd like to get his sister on to it as well, but she's a die hard kibble eater. Licks the wet stuff a bit, but not really interested. She's not as stubborn as he is, so we might be able to bring her around. I think he may take to raw pretty quickly and easily, but I'm going to hold off on any significant changes until after next week's blood test.Things are good right now, so I'd like to maintain status quo for a bit-for my mental health too!

I will continue to keep you posted-you and sugarcatmom have helped more than I can say. I wish there was some way for me to express my gratitude-no matter what happens, I'm thankful to have people who are willing to listen, offer sound advice, and most of all to care. From the bottom of my heart, thank you.
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