? Just Dx with CKD

Hello, can someone that is familiar with a cat that is both diabetic and CKD please take a look at our lab results and offer any advise on where to go from here?

A little background...Kekoa is 14 1/2-15 years old. His kidney values were all normal on 10/20/17 the day of his surgery to remove a tumor from his bladder. He did not recover well and ended up in ICU just 4 days later being treated for a diabetic crisis. His glucose and kidney values were through the roof. He did not eat after surgery and did not get the insulin he needed. The fluid treatment did help bring his Kidney values down, but still left him in the low-high range. He was retested in November to see how his values were hanging and they were same as when he left the ICU. Two months later now and his BUN went from 29 to 46, creatinine went up from 2.4 to 2.5. I took him to his regular vet last night (another FDMB member recognized that he may need Cerenia for some nausea symptoms that I didn't recognize). He got the injection last night and I since we were there, I asked for them to run a SMDA test. They came back with the results this morning and he's at 20.

My vet wants me to put him on a RC renal diet, but I know that won't be good for his diabetes. Which condition do I treat first?

Any advise is much appreciated. Also, how bad do you think he is? Stage?

https://drive.google.com/file/d/1NIepjV-Nme2EJwAAcYvROQP1PTyHqccY/view?usp=sharing
https://drive.google.com/file/d/1QwohDP7uv4DDm9uBzzMVRbIT4Xj7D6Uq/view?usp=sharing

Thank you!

 

Hi Anela,

Sorry to hear about Kekoa's CKD diagnosis.

I'm tagging April for you (@manxcat419) to ask if she can look at Kekoa's labs for you next time she's online.

Many people with CKD kitties find the following specialist sites really helpful:

Tanya's Site (the go-to site on the internet for information on Feline CKD)

Yahoo Feline CRF Support Group

Experienced members of the Yahoo group should also be able to help you with the labs and diet advice.

Also many members here have dealt with both CRF and feline diabetes so hopefully will be able to help you.


Mogs
.

 

Thank you for responding!

 

Hi sorry to hear about Kekoa's diagnose ( I like his name) I'm not by any means an expert just been where you are a little bit earlier than you, you should definitely take a look at Tanya's web site they've mentioned earlier, it has lots of very good, actually amazing information.

With a creatinine of 2.5 and an SMDA of 20 I think he would be stage 1, bordering on stage 2, but that's not all that matters the good news is for what I can see his kidney numbers are quite ok his phosphorus is at a very decent level at this point so is potassium, not sure about some other stuff in his labs though, hopefully one of the very experienced can take a look at them soon

I would say you will have to treat both conditions at the same time, at least that's what I've been trying to do, renal diets are not really recommended at stages 1 and 2 even without the diabetes, because they have little protein and and that can cause him to loose muscle mass which is not good on top of that they are really high in carbs which will mess with his diabetes and that's not good unregulated diabetes can damage his kidneys more, what is recommended at his stage would be that you give him food that is low carb for his diabetes but that is also low phosphorus to help protect his kidneys , take a look at Dr Lisa's list and find one that suits you and of course that he likes ( you may need to try more than one. Before you find the right one)

 

@Chris & China... I think we talked a little about Kekoa's BUN elevation and (I think) you suggested that I get a SMDA test. I did last night which I took Kekoa in for a Cerenia injection (good catch!) and his SMDA came back as 20. So I'm thinking that it's not just the increase of protein (adding Primal Raw Dehydraded Nuggets to his Fancy Feast).

 

Thank you Veronica. I'm just so hyper sensitive with everything happening to Kekoa as he's had a pretty tough couple of years, yet has remained the super sweet and very compliant with everything that we do to him. First it was the diabetes, then Thyroid, then his heart, and then the ugly C word, cancer! I thought this was going to be his year because they did manage to remove his tumor in his bladder with clear margins (doesn't mean it won't come back though ). But its really a miracle because TCC in the bladder is super rare in cats and has a very low survival rate amongst both cats and dogs. Now the Kidney's... I had a cat pass away a couple years ago from Renal Failure, she passed away so quickly after being diagnosed. I didn't find Tayna's website until recently and there was so much that was never suggested to me to treat her...just fluids and a binder...that was it. I feel terrible now knowing how sick she must have felt with nausea and other systems.

Just hoping to do it right for Kekoa this time. I'm bummed because I just got him going well on Fancy Feast Pate after 10+ years on Prescription C/D. I started adding dehydrated raw to their FF hoping to give them more nutrition and hopefully transition them onto it, but that sounds like I may need to scratch that idea.

Thank you for responding. Sorry to hear that your kiddo also has the kidney issue going on.

 

I hate that you're having to go through it again, but if you can find a food that's lower in phosphorus, that's the best thing you can do for his kidneys.

Have you ever tried him on RadCat? It's a frozen raw food that a lot of cats are willing to eat...it's both low carb and low phosphorus, but it's more expensive to feed too (of course). I get ours at a "specialty" pet food store (it's not available in places like PetSmart or Petco)

IF you can't get him to eat anything other than FF, you could try using a phosphorus binder.

There are lots of other cats here that are both diabetic and CKD so hopefully some of them will be along to give you some other ideas

 

Thank you, I’ve been wanting to try them on Rad Cat. I haven’t been able to get to the store that sells it. I’ve been wodering about the price and how much it will cost to feed two cats. I will have to try this weekend for sure. I tried giving them Organix Organic Chicken (its on the list for low carb and low pros) wet food this past weekend but neither one wanted anything to do with it, even mixed with FF.

 

None of my cats would eat that either.....they tried to bury it!! That's definitely the "mark of death"!

I pay about $15 for a 32oz tub (which is why China's the only one who eats it as her major food....the civvies get Friskies with just a little RadCat "treat")