12/13 garfield beggining stage 2 renal failure

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by Cassandra & Garfield, Dec 13, 2019.

  1. Cassandra & Garfield

    Cassandra & Garfield Member

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    @Marje and Gracie hello! I was told to post my cats bloodwork. Just found out he is in beggining of stage 2 renal failure :( and the vet food has a crazy amount of carbs. I got omega 3 to help. Right now he is eating friskies pate and at 1.50 units of lantus. Thank you im so sad already diabetes isnt easy to manage with Garfield and now this. Oh and hopefully your still able to figure out his results because its it french
     

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  2. Sandra And Buddy

    Sandra And Buddy Member

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    Oh no! I am so sorry. :( :bighug::bighug::bighug:
     
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  3. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    Waving to you from Ontario. Go Habs!

    Cassandra – deep breaths. Garfield's numbers are not all that bad. They are pretty good actually, considering. There is an excellent kidney disease site . It is the bible of Chronic Kidney Disease (CKD). Like diabetes, it is a steel learning curve. Take in a bit of information at a time and you will understand the basics in no time.
    CKD and diabetes is manageable. A lot of people here manage both diseases. It can be done.
     
  4. Cassandra & Garfield

    Cassandra & Garfield Member

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    Thank you very much ! Very reassuring ❤️ im looking into low phosphore food or phosphorus binding agent but of course nothing ships to canada
     
  5. Cassandra & Garfield

    Cassandra & Garfield Member

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    Thank you ❤️
     
  6. Sue and Luci

    Sue and Luci Well-Known Member

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    I'm going to tag @Bellasmom - she also feeds her cat low phos food for same issue - not to worry - there is help here for that!

    Try not to become too overwrought - beginning stages of renal failure is frequently associated with those wonky numbers - and although it sounds dire it's very common. I have one kidney and my numbers are chronically off - it's not a death sentence by any means!

    Could you please add Garfield's AMPS to your title today?
     
  7. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    The phosphorus is in range at the moment. You are not in need of a binder yet. The levels can be managed by switching food.
    Here is a list of low phosphorus, low carb food. Go stand in the pet food aisle. I know the BFF, Tiki, and some of the Wellness are available in Canada. You want to stay under 200mg phosphorus if you can.
    For a phosphorus binder, when that time comes, you will need to order aluminum hydroxide powder from thrivingpets.com. The gel that the vets sell contains sugars.
     
  8. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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  9. Cassandra & Garfield

    Cassandra & Garfield Member

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    Thank you so m
    Omg amazing thanks for the info! And sorry where do you see that the phosohorus level is in range in his analysis? Thank you so much!
     
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  10. Cassandra & Garfield

    Cassandra & Garfield Member

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  11. Cassandra & Garfield

    Cassandra & Garfield Member

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    Perfect thank you so much!
     
  12. Cassandra & Garfield

    Cassandra & Garfield Member

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    I tried editing but there isnt an option for editing the title on my phone. It was 288 :)
     
  13. JoyBee&Ravan

    JoyBee&Ravan Well-Known Member

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    My cat Ravan was diagnosed July 2018 with stage 2 Kidney disease. He's 17 yrs 6 months old.He also has diabetes & high blood pressure & began having seizures October 2018.

    He's doing well. I give him something called Calcitriol & low Phosphorus food & his kidney Values have improved. Here's info about Calcitriol http://www.zzcat.com/CRF/calcitriol/calcitriol_docs.htm I order it from a Compounding Pharmacy,you need a Vets prescription.

    It seems not many vets are familiar with using Calcitriol & some think you don't give it until the disease progresses but if you read the information they clearly advise to start as soon as possible . It's a liquid & Ravan gets it 2 times a week.

    Apparently it's helping the Kidney disease so I'll continue to use it . His last labs showed his values are better than from a month ago!

    The Food chart by Dr Pierson tells you the carbs & Phosphorus.I try to keep the Phos. below 200. It's not necessary to feed "special" food for Kidney disease. Vets advise low protein but that's not really good for cats. Ravan eats pretty much what ever he likes. He was raised on a raw meat diet & now occasionally eats premium canned food also. NO fish & no dry food. There's a powder called Aluminum Hydroxide that you can add a pinch to a spoon of water & mix it in the food . It helps to lower the Phos. I also have a few bowls of distilled water that I add a pinch of backing soda to to make it a bit alkaline, it's good for his kidneys.

    I read your kitty was shaking? It might be a small seizure. I give Ravan 1 or 2 drops a day of Allevet or Charlottes Web CBD oil. These are the only 2 brands I'll use. Cornell University did a study & they are the Brands they recommend. The CBD Oil does help Ravan . He had a seizure again when I stopped giving him the CBD Oil. CBD is also good for pain & increases his appetite. (I try not to give any pharmaceuticals unless absolutely needed.)

    Here a good web site for Kidney disease info https://www.felinecrf.org/treatments.htm

    The more informed you are the better to help your Kitty. You can check out Ravan's Spread Sheet & his Labs. If you have any questions I'd be happy to try to help.
    Garfield has diabetes for a very long time. You must love him very much & take great care of him! :):cat:

    I don't give dosing advice or interpret Lab results. There are people here that are very good at that that can advise you.


    upload_2019-12-13_12-23-38.jpeg
     
  14. Christie & Maverick

    Christie & Maverick Well-Known Member

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    If I could make a suggestion, could you add the test results and reference ranges in the "labs" worksheet of your spreadsheet? Since you are in Canada, we use the metric system of measurement, so Marje will have to do a quick conversion. Having your numbers in the SS will help her do that.
     
  15. Cassandra & Garfield

    Cassandra & Garfield Member

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    Wow amazing thank you so much!! Garfield seems to have an issue with his ear tilting of
    Thank you so much!!! The vet suggested epilepsie. But he also has an ear tilt often so I feel thats probably related :(
     
  16. Cassandra & Garfield

    Cassandra & Garfield Member

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    I just fill in all the info here? Thanks :)
     
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  17. Christie & Maverick

    Christie & Maverick Well-Known Member

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  18. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    Yes
     
  19. Cassandra & Garfield

    Cassandra & Garfield Member

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    And yes he is like my child. I have had him since I was in the second grade. We grew up together. To me I didnt/don't do enough. If we had more money I would do scans for his head to see what's happening in there why his ears are tilting or if god forbid he had a tumor.
     
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  20. Cassandra & Garfield

    Cassandra & Garfield Member

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    I feel most low carb foods are higher in phosphore so annoying. So far im finding weruva but its quite expensive
     
  21. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    They are. Look for the Wellness ones. They are a bit cheaper, I think. I have not bought cat food, except for my friendly neighbourhood cat visitors for a few years now.

    Some people feed raw but you have to get the raw that does not contain a lot of bone. I'm sure there's a page on the kidney site about it somewhere.
     
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  22. JoyBee&Ravan

    JoyBee&Ravan Well-Known Member

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    What kind of infection did he have that his teeth were pulled?
    I love my animals like children also. Ravan came from a litter of 5 that were born in my garage. The mother cat was feral & got hit by a car when the kittens were only a few days old. I had to feed them every few hours. I got so attached to them I kept all 5!:joyful:

    Even if you had a scan of his head & a tumor was found,would you have surgery on him? I've found that even when you do all the testing sometimes there's really not much you can do to save them.

    Ravan's sister, Peggy Sue, died just 4 weeks ago. (I still can't stop crying,I miss her so much)

    Nearly 8 months ago I thought she had an abscess tooth. Her chin looked a little swollen. Turned out to be Oral cancer. We did chemo & tried many other things, but could not save her.
    She died in my arms ,at home . I'm 73 yrs old & have had many animals die over the years but it does NOT get any easier.

    Best of luck to you & Garfield. :bighug::bighug::bighug:
     
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  23. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    Sometimes people do not get their tags. Putting the tag on a separate line helps. If you do not hear from Marje within a reasonable amount of time, try that.
     
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  24. Cassandra & Garfield

    Cassandra & Garfield Member

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    Thank you ! Omg I cant imagine raising them as babies and having them their whole life ❤️. No idea what type of infection but he smelled as soon as he walked into the room :( they were in a terrible state.
     
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  25. Cassandra & Garfield

    Cassandra & Garfield Member

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    Could I just send her a private message if anything? There isnt a rush for now :)
     
  26. Pamela & Amethyst

    Pamela & Amethyst Well-Known Member

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  27. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    You can if she does not respond. Sometimes she's away for a few days travelling.
     
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  28. Cassandra & Garfield

    Cassandra & Garfield Member

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    Im finding that I would be cheaper to add the phosohorus binder. Is it bad if I were to use it now? Also could I affect glucose levels or anything else? Thanks
     
  29. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    FWIW, Gizmo was diagnosed with stage 2 CKD. That was about 2 years ago. The only big change I've made is that he gets 0.5ml of calcitriol. He's eating primarily a raw diet (pork and lamb) and some canned venison. (He also has IBD so he needs novel proteins.) All of his kidney values are back in normal range.
     
  30. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Many of us have managed diabetes and kidney disease at the same time. At this point, it is worth adding some lower phosphorus foods to the diet, so he gets used to them, but not a rush. Be careful of the Wellness, they changed their formula a few years ago and are no longer as low in phosphorus as they once were.

    His phosphorus numbers are well in range, you do not need to add binder yet. The aluminum hydroxide powder does not impact blood sugars when you do get to that point. I managed Neko’s phosphorus for years and only had to add binder for the six months. But she would eat low foods. I made my own with the TCFeleine, then the FoodFurLife premix, turned out to be cheaper than a lot of canned food, for not a lot of work.

    https://felinecrf.org/phosphorus_binders.htm
     
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  31. Cassandra & Garfield

    Cassandra & Garfield Member

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    Besides the vet were would I find calcitriol? My vet says its back order -_-
     
  32. Cassandra & Garfield

    Cassandra & Garfield Member

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    The low phosphore food would be allot more expensive for me then adding the binding agent. Is it bad to start at this point? I won't if I shouldn't. And were in the bloodwork do you see his phosphorus levels? Thanks :)
     
  33. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    I've been getting calcitriol from a compounding pharmacy -- RoadRunner. I get it as a liquid.
     
  34. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    First of your pictures, 6th item down called PHOS. His is 1.45. The page I linked shows you worry if over 1.9. There is a rare side effect of aluminum toxicity. If you don’t need to start binders yet, I wouldn’t. Making your own low phosphorus cat food can be a cheaper solution. You could also start with just some of the low phosphorus foods. And look around, there are cheaper options than Tikicat. Look at the phosphorus level of what you are feeding now, and just feed primarily the lowest phosphorus flavours.
     
  35. Cassandra & Garfield

    Cassandra & Garfield Member

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    Im looking into raw food! Any feedback? Im finding it hard raw food without crushed bone. What is an acceptable phosohorus % ? I found this is this too much?
     

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  36. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    I’m around...just been out today. Let me take a look at his labs and don’t order calcitriol yet. There are some situations where it is not a good idea,

    It will take me a bit as I have to convert the values and I speak French so no worries :)
     
  37. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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  38. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    It’s interesting because his SDMA is normal although it’s high normal. His creatinine is definitely within Stage 2 CKD and his urine specific gravity is lower than it should be. USG (reported as densite urinaire) will vary during the day as the cat drinks more. The question is, can he concentrate his urine and the best way to find out is to take to the vet the first urine of the day. It’s not that I think this is necessary since other numbers point towards early CKD.

    Here are a few things to focus on with CKD as they directly affect longevity, but obviously, there are a lot of “moving parts” and things to keep an eye on:

    • phosphorus level: his is “ok” but could come down. Ideally, you want it between 4-4.5 by feeding a lower P food. The lowest P foods are the renal diets but, as you know, the carbs are often high, the protein is too low, and the ingredients are bad. It’s too early for P binders which are not started until the P is at 6 or above so focus on a lower P food (one that is less than 1.00%P on a DMB or less than 200 mgP/100 kcal on an as-fed basis. Food Fur Life’s EZ Complete is a balanced supplement that you add to raw food and it is lower P (less than 1.00% of DMB and that includes the meats) and uses egg shell calcium instead of bone. Their website includes excellent info on how to transition.
    • Hematocrit (HCT) or packed cell volume (PCV) which relates to anemia: Your vets didn’t run a CBC so you can’t see how he’s doing but you want to try and keep his HCT/PCV above 30% by supplementing with B vitamins as his HCT approaches 30%. It’s very specific so don’t cut corners; in other words they need methylB12 and multiB complex.
    • Blood pressure: have it checked every single time you take him in and be sure you get him started on the appropriate drugs if it’s high.
    • Proteinuria: don’t cut corners by not having his urine checked. Right now, he has no protein in his urine but if he starts to show it, get a urine protein:creatinine ratio. Read about it on Tanya’s while it’s normal so if it changes, you are prepared.
    • Potassium levels: his is already creeping down. Ideally, it should be 4 or above but what makes it more difficult with FDs is that insulin can cause the uptake of potassium into the cells so the serum levels look lower. It’s hard to distinguish if a CKD/FD has low potassium due to CKD or diabetes. Supplementation should be done under the supervision of your vet as too high is as bad as too low.
    Insofar as the use of calcitriol, yes, it has benefits for some but not all cats. It can raise Ca levels and it’s important to be careful because Ca and P work in concert. When Ca x P exceeds 70, you risk tissue calcification so cats with Ca levels at 10 or above should probably not have calcitriol without checking their ionized calcium value. Garfield’s Ca is normal now. It’s also vitally important that you work with your vet on calcitriol. Labs need to be monitored if you use it.

    There is a lot to treating CKD and starting early is smart. My last CKD cat had been diagnosed four years prior to his passing and he was still stable when he crossed.

    Let me know if you have questions.
     
    Last edited: Dec 14, 2019
  39. Si am cat mom

    Si am cat mom Member

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    '


    good stuff !!! further proof that protein is not the enemy of the kidneys...it's so frustrating to still hear vets telling people low protein is best.
     
  40. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Actually, my vet told me high protein and low phos..
     
  41. Si am cat mom

    Si am cat mom Member

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    awesome - they sound like a keeper !
    My friend is a vet...fairly new grad though and when I told her about my cat and the diet changes one of the first things she cautioned me against was the higher protein and how it would be hard on his kidneys. I'm sure it really just depends on the vet but I hear that more than I hear anyone talking to client's about phos levels in foods.
     
  42. Cassandra & Garfield

    Cassandra & Garfield Member

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    Omg amazing you are just so knowledgeable ❤️. Why didnt didnt he take his blood pressure ? Also he just started what we think is epilepsy and the vet suggested keppra. Do you think this will affect his diabetes? She said one of the most popular epilepsy medications would but that keppra wouldnt. Thank you so so much for your help!
     
  43. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    This is info on one study using Keppra. It's a very small study (only 9 cats) and there are clearly unknowns. How did the vet diagnose Garfield as having epilepsy?
     
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  44. Cassandra & Garfield

    Cassandra & Garfield Member

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    He just guessed with the video I showed him. I cant afford testing or scans unfortunately :( but the vet will send a video to a neurologist to get his/her opinion
     
  45. Cassandra & Garfield

    Cassandra & Garfield Member

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    And thanks for the study. So it could be even more damaging for his kidneys? :(
     
  46. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    I didn't take that as the conclusion. There is a concern if a cat has renal insufficiency so this should be discussed at length with. your vet

    How often have you seen a seizure and are you sure it was unrelated to FD?
     
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  47. Cassandra & Garfield

    Cassandra & Garfield Member

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    Last night was the second time. I tried uploading the video of him its not working. First time he was at 162 and last night at 342. It was exactly at the same time both nights 3-4mins after starting to eat and being injected. He was able to eat while seizing. The vet said it is for sure partial because its mostly just his head that shakes and tilts
     
  48. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    You need to download it to YouTube and then use the filmstrip icon in the toolbar to add it. It’s to the right of the photo icon.
     
  49. Cassandra & Garfield

    Cassandra & Garfield Member

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    hope this works !
     
  50. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    Thank you. When was the first time he ever did this....before FD, after? You said he has had ear tilting but did it present as this? I’ve had cats that have had seizures but it didn’t look like that; however, ECID and whatever causes seizures can cause them to present differently. I’m trying to figure out any connections. Neither normal BGs within FD nor insulin should cause this.
     
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  51. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    A similar thing happened to Sheba several years before she passed. She was fully conscious during the episodes and was aware and I can see that Garfield is as well as he is still eating and moving around. This is not possible during a full epileptic fit but may be possible during a simple partial seizure......but I could be wrong.

    I took videos of Sheba and I am trying to find them.... and I'm not sure where they are now. I also wrote notes about it in the book I kept her BG levels so will look at those.
    She developed a violent head twitch shortly after I put flea medication on her.
    It kept reoccurring during the following month or 6 weeks but not violently, and it eventually stopped altogether. I took a video to show the vet who first thought it was from a low BG and had me reduce the dose.....even though I told her I had taken the BG and it was fine (this was pre forum days).
    No definite cause was ever found although I suspect it was connected to either the flea medication from the dog or her dose on the back of the neck.
    We had also dosed the dog with flea medication a few days before and on looking at that medication it said that it was toxic to cats if they brushed up against the dog and then licked themselves so we thought that might possibly be the cause also. (We stopped using that brand for the dog after that).
     
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  52. Cassandra & Garfield

    Cassandra & Garfield Member

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    Im just totally clueless as to what It could be :(
     
  53. Cassandra & Garfield

    Cassandra & Garfield Member

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    Ear tilt started after fd. I think its a tumor. Just cant afford the scans :(
     
  54. Cassandra & Garfield

    Cassandra & Garfield Member

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    Oct 30, 2019
    Sorry what is ECID?
     
  55. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    Sorry...every cat is different.

    Have you seen this on Financial Resources?

    You’re welcome. I’m happy to help. Most cats with early stage 2 CKD don’t have high BP but I have seen some and it’s not worth the risk of letting it go. It can cause some really major side effects like blindness. I’ve seen cats whose renal values weren’t bad at all and they had high BP. My Gussie was just on the higher end of Stage 2 when he was dx with high BP.
     
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  56. Cassandra & Garfield

    Cassandra & Garfield Member

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    Ill have to look into the financial aid. Does it work in Canada?
     
  57. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    I don’t know. You’ll have to go through them. If Diabetic Cats in Need is on there, I believe they do.
     
  58. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Cassandra, I've just been looking back through my 2014 logbook for Sheba.
    The twitching started July 6th 2014.
    I got a bit mixed up with the start of it ......the flea solution was not at the beginning.
    I first noticed twitching of the head and trying to scratch under her neck or her ear area.
    The next day when it happened again I went to the vet and that is when she wanted me to reduce the dose because it had happened at the same time of day...just before PMPS.
    I noted in the book that Sheba seemed to stop the twitching when I offered food.
    Looking for why this was happening, I wondered if she had ear mites so I put Revolution on her 16 July. That was when she had the violent twitching (1/2 hour after application) and it lasted for 1/2 hour then gradually reduced to nil over a period of time for that evening. That waswhen we looked into flea applications and found Jessie's (dog) flea treatment was toxic to cats and wondered if that had caused the original problem as it tied in time wise.
    The next day the vet put Sheba on a course of Zenequin in case she had a middle ear infection.....didn't help
    Also tried ear drops.
    On 28July I noted Sheba was scratching a lot and I rubbed her Right ear vigorously to scratch it and it triggered twitching.
    After that she seemed to be scratching her neck a lot and quivering..
    Still twitching off and on during the days and I noted that she was meowing during the twitches..
    On 5 Aug I noted a rash on her neck. Vet ordered dermaid cream for the rash and another antibiotic for her ears which were still bothering her.
    I later used calamine lotion on the rash as well. She lost the hair from that area and the skin looked irritated.
    Noted isolated head nods on 26 aug and still scratching neck.
    Then it all appeared to settle down and nothing much was mentioned In the book after that.

    I am still looking for the videos I took.
     
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  59. Cassandra & Garfield

    Cassandra & Garfield Member

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    Oct 30, 2019
    Thank you! The vet suspects focal epilepsy still waiting on the neurologists opinion :)
     

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