Kidney results question

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Shiloh & Rhonda (GA), May 9, 2018.

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  1. Shiloh & Rhonda (GA)

    Shiloh & Rhonda (GA) Well-Known Member

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    BUN 38.6
    Creatinine 2.6
    Phosphorus 4.6
    BUN/Creat Ratio 14.6

    My DH had to take her this morning as I couldn't. These are her results. I know it's high, but how high is my question.
     
  2. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    It's actually not all that high.

    The BUN can be higher due to a high protein diet or even being a little dehydrated. The creatinine is a little high, but not terribly high and the other two are within normal limits.

    If you're concerned about kidney disease, you might want to ask for an SDMA test. It's a newer test (only done by IDEXX lab so if your vet uses Antech, you may have to ask it to be sent out special) that's supposed to detect kidney disease earlier than the BUN/creatinine levels.
     
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  3. Shiloh & Rhonda (GA)

    Shiloh & Rhonda (GA) Well-Known Member

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    Thank you so much, Chris. The vet has already said she does have kidney disease, but I just didn't know how bad. My further research said maybe Stage 2? She does also have a kidney infection and we were told that she is dehydrated. Working on that.
     
  4. allison and Bubbles

    allison and Bubbles Member

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    you probably know this but just some words of some reassurance...CKD ...l have had several cats diagnosed with it...one of them almost four yrs ago who is still in only stage 2 at worst and purring really loud curled up beside me....
     
  5. Veronica & Babu-chiri

    Veronica & Babu-chiri Well-Known Member

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    Hi I think as Chris said that her values fortunately are not not that hi, CKD is something you can handle together with the diabetes, vet will probably suggest you make some changes to her diet , just make sure the food is low carb, there are a few options that are low carb and low phosphorus to help her kidneys (that way you can address both issues )

    Here's a link to Tanya's webpage where you can find a lot very good information regarding CKD
    http://www.felinecrf.org/how_bad_is_it.htm
     
  6. JanetNJ

    JanetNJ Well-Known Member

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    Stage 2. I'd switch to a lower phosphorus food (not sure what you're feeding now). You wanna get that phosphorus down under 4 if you can. I fed bff cans when I had a cat with ckd. Look for foods 250 and under in phosphorus. Bff cans are also low carb. Add water to the food as well. In the future you will add sub q's and possibly a phosphorous binder. There's a great group on Facebook called Cats with Chronic Renal Failure you should join.
     
  7. PPCW

    PPCW Member

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    Does the kitty drink a lot of water and pee a lot with ckd?

    Coby started drinking and peeing a lot last week but his sugar level is normal. His appetite is relatively normal or maybe a bit less. I am waiting for the lab results right now and also giving him 100ml of sub-q as he is dehydrated while we wait for the re-check.

    Dr said his abdominal feels hard so he suspects pancreatitis. But Coby is not in pain. Isn’t pancreatitis painful? He doesn’t sit in the meatloaf position, in fact, his positions are very relaxed and still sunbathing everyday. He eats with his plate on the floor so I don’t think he is nauseous.
     
    Last edited: May 11, 2018
  8. allison and Bubbles

    allison and Bubbles Member

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    yes cats pee and drink alot with ckd...also from sub q fluids kitty will pee more...there is a test call spec pfl for pancreatitis (dont rely on the "other" test)...I would get it if you can as pancreatitis is very painful (I have had it)...and cats are masters at hiding pain...pancreatitis and ckd often go together I am told...(NOT by vet...by members of the CKD forum you might want to check out Tanya's ...way more info than you can get anywhere !!)...oh...if vet did not include the spec pfl test in the lab work (hope he did)...I am pretty sure...?you can request they do it with the same blood kitty just gave up to a cppl days later...will save you lots of money...
     
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  9. Veronica & Babu-chiri

    Veronica & Babu-chiri Well-Known Member

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    They do start drinking more water and therefore start peeing more with CKD but not al kitties have nausea , specially if their values are not too bad, the pain part is hard they are very good at hiding it and not all sit in the meatloaf position even with pain so try and see if there isn't any other change in his behavior
     
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  10. PPCW

    PPCW Member

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    Thank you. I have read a lot of threads about pancreatitis here but couldn't remember the name of the test when the vet said pancreatitis because I wasn't expecting it at all. I will go to the vet office tomorrow morning to request the test. I think the vet ordered the "other" test as he said it can't positively ID pancreatitis.

    I have been reading Tanya's site and am processing the information. I am researching CKD food right now. I will check out the BFF cans Janet mentioned above and Cats with Chronic Renal Failure facebook.
     
    Last edited: May 11, 2018
    Reason for edit: Deleted the attached picture
  11. PPCW

    PPCW Member

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    Thank you. The only change is Coby has stopped sleeping on my bed at night when all of this started. Other than this change, he acts pretty normally like his usually self. He is not constipated since I followed him like a creep for 3 days and he pooped right in front of me all three days :D. His appetite is more or less normal. He has not lost any weight.

    Should I also request the SDMA test Chris mentioned above?
     
  12. allison and Bubbles

    allison and Bubbles Member

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    l would request the sdma when you request test for pancreatitis
     
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  13. PPCW

    PPCW Member

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    Thank you. I will request that tomorrow as well.
     
  14. tiffmaxee

    tiffmaxee Well-Known Member

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    Last edited: May 12, 2018
  15. JanetNJ

    JanetNJ Well-Known Member

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    Use this chart to find foods under 10 percent carb and under 250 phosphorus. https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf
     
  16. PPCW

    PPCW Member

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    Thanks Janet! Will start a new thread when I get the SDMA and spec fPL back. Right now his

    BUN is 72
    Creatinine is 2.3
    Ratio 31
    Phosphorus is 5.9
    Urine specific gravity is 1.013 so he wasn't dehydrated when blood was drawn.

    Sorry to hijack your thread Rhonda!
     
  17. tiffmaxee

    tiffmaxee Well-Known Member

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    Your cat is not concentrating his urine. USG should be 1.30 or above.
     
  18. manxcat419

    manxcat419 Well-Known Member

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    I have to ask as I've seen this a few times recently in various groups with no evidence to back it, but none of the official expert advice has changed. Where is this phosphorus target of below 4 coming from? IRIS, Dr. Mark Peterson etc all suggest aiming for 4.5 or below in Stage 2. Below 4 is generally neither desirable nor achievable for a CKD cat.
     
  19. JanetNJ

    JanetNJ Well-Known Member

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    Stage 2 you will want the phosphorus level between 2.7 and 4.59 the lower the level the better they feel which is why I said under 4 if you can.

    http://www.felinecrf.org/phosphorus.htm#ranges

    When my Zimmy was stage 2 his phosphorus was 4.7 . By switching to lower phosphorus food he was down to 3.9 5 weeks later. If you try a new food and it's not enough then phosphorus binders can be added to the food (Aluminum hydroxide).
     
  20. manxcat419

    manxcat419 Well-Known Member

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    What I'm asking is who are "they"? Because they're not any of the known and renowned experts on CKD who all say 4.5 OR below. Not 4.0 or below, and not to necessarily aim lower than 4.5 - a lot of cats can't even achieve 4.5 in Stage 2 even with low phosphorus food and binders (which should really only be used when absolutely necessary, not given in large quantities aiming for an even lower number). Or is this one of those things where someone thinks that if 4.5 is good, 4.0 must be better and 3.5 is even better than that and then they say it often enough that the myth perpetuates and starts to be quoted as fact? Also to point out that there won't be a difference in how a cat feels with a phosphorus of 4.0 as opposed to 4.5 as both are within target range. You can't always improve on ideal by taking a "more is more" stance.
     
  21. JanetNJ

    JanetNJ Well-Known Member

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    My vet said she wanted to see the phosphorus 4 and under when my cat was stage 2 and that they feel better and the ckd progresses slower when it's lower. Tanya's site says 2.7-4.59 so there ya go. Yes 4.5 is at the higher end of the good range. The point is its better to get the phosphorus down now, to whatever degree you are able, while he's feeling relatively well and eating good because 5.9 is high for this stage and unless changes are made it will continue to rise which will have a negative effect.
     
  22. manxcat419

    manxcat419 Well-Known Member

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    Well, any absolute range (especially when that 2.7 is being quoted and is the bottom end of the range at most labs) has to be quoted with caution. Some lab ranges are different and if you aim for the very lowest or highest end of a range, then you could end up out of range depending on the lab. I've also seen "ideal" potassium quoted as 4.4. Yet there is at least one lab out there where the high end of range is 4.0 so aiming for 4.4 on that lab would be actively dangerous. The expert opinion is 4.5 or lower, but no binder unless the phosphorus is above 6.0. That's because binders are something to be avoided unless absolutely necessary. Yes, CKD progresses slower when phosphorus is controlled, but again it isn't a "more is more" situation - 4.5 or below is the target to slow progression per the research. If we applied the same logic to diabetic cats where normal is good, but something beyond that just has to be better, then we'd be saying "50 is great...but let's aim for 40 on the meter. Or maybe 35" - and that would clearly be dangerous advice.
     
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  23. Shiloh & Rhonda (GA)

    Shiloh & Rhonda (GA) Well-Known Member

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    I have read it before. I will go back and read again. Unfortunately, another problem has reared it's head. Shiloh is not eating much. I've tried several different foods, milk replacement, straight tuna, Parmesan cheese, tuna water, etc. The one thing that she will take regularly, and without hesitation is her dried liver treats. I'm about to give her a bowl of them, and see what happens.

    Questions: Is the specific fpl different from specific gravity? Shiloh's specific gravity was 1.028.
     
  24. Shiloh & Rhonda (GA)

    Shiloh & Rhonda (GA) Well-Known Member

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    Also just looked at the last page, which I had missed. T4 is .81 - which I have googled to learn is about her thyroid, and ALMOST below normal. Hypothyroidism, maybe?
     
  25. tiffmaxee

    tiffmaxee Well-Known Member

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    Yes. The specific fPL tests for pancreatitis. The usg tests urine concentration. Ideally it should be a tad higher. Was she given fluids? That will cause it to be lower as fluids dilute the urine. Someone said the usg was 1.013. That’s is low.

    Sounds like she’s nauseous. I’d ask for cerenia or ondansetron.
     
  26. tiffmaxee

    tiffmaxee Well-Known Member

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    Not hyper-t. The T4 would be high if she was.
     
    Last edited: May 16, 2018
  27. Shiloh & Rhonda (GA)

    Shiloh & Rhonda (GA) Well-Known Member

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    She wasn't given fluids. The vet said she was a little dehydrated, but not enough for fluids at that time. She doesn't act like she is nauseous. Not lip licking and walking away. She will dip into everything that I put down, almost as soon as I put it down, just not much of it. And no vomiting. Am I missing something, or in denial? @tiffmaxee , I trust you to be honest with me, as you always have.

    I edited after I posted. Should have been hypo, not hyper. But it appears that is rare in cats.

    DH and I are leaving tomorrow for 4 days. I'm thinking maybe we should board her at the vet, rather than just relying on a friend to come by and feed her. Any thoughts on that?
     
  28. tiffmaxee

    tiffmaxee Well-Known Member

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    I know low thyroid can mean there is an illness but not which ones. I also would never rely on one test to diagnose anything. Well, maybe high bg plus sugar in urine for diabetes but only if past tests were normal. Lab errors do happen.

    Max never acted nauseous. I remember when he was acting sick after I lost Tiffany and not eating much it was suggested by friends he could be nauseous. He wasn’t lip licking. He just wasn’t eating much and then stopped eating. He was nauseous. Maybe Simba isn’t but I’m throwing it out as a definite possibility. You don’t want her going too long without eating her normal amount. That can lead to fatty liver.

    They do have the best timing, don’t they? Whether to leave her at the vet or home is a hard one to answer. Will she be stressed at the vet? Will she eat there? I guess you could try nausea medication and see if she eats. If not your friend could take her to the vet. Does she know your friend? Will he/she be staying at your home or just be coming twice a day?
     
  29. Shiloh & Rhonda (GA)

    Shiloh & Rhonda (GA) Well-Known Member

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    She does know my friend. He will just coming in to feed her and the dogs. I think Shiloh will be better at home than the vet. She loves one of my dogs, and I think being away from him would be worse.

    I don't know if she would eat at the vet. Last week, the vet gave an appetite stimulant that apparently didn't work at all. (Entyc). I have seen it's not great, but DH took her and I had no say. She has had it a couple of time, no difference. I will make sure that the vet has my friend's name, in case it is needed.

    Recommendation for nausea medication that he could give easily?
     
  30. tiffmaxee

    tiffmaxee Well-Known Member

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    I’d give cerenia or ondansetron. Cerenia is a veterinary drug. Ondansetron is a human drug. You can try 1/4 Zyrtec regular strength as an appy stim. I also like cyproheptadine which is an RX human drug. Just 1/4 a 4mg pill worked for Max. Tiffany got 1/4 but at that time I didn’t know less is often work. Vets like mirtazapine but I personally would not use it without being able to watch closely. I hear the transdermal works with less side effects but leaving tomorrow I would go with one of the other two. Cerenia is given every 24 hours. Ondansetron can be given twice a day.
     
  31. Shiloh & Rhonda (GA)

    Shiloh & Rhonda (GA) Well-Known Member

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    So, to make it easier for my friend, (who is allergic to cats by the way, but still willing to do this for me.) if I get Zyrtec, and grind it up, to where he could add it to her food, or on top of the food, would that work? And hope she eats it? Or would he actually need to pill her?
     
  32. tiffmaxee

    tiffmaxee Well-Known Member

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    I’d be afraid to put anything in her food. If she tastes it she definitely won’t eat. Unfortunately Zyrtec and cyproheptadine on,y work for a few hour so would need to be given at each meal. You could get some and see if it has a taste. I have a virus or sinus infection so I won’t try and taste it. Will she eat baby food? Lots of cats like it. Sometimes I could get mine to eat it when they were not feeling well and cat food was turned down.
     
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