Bangwol's situation

I just posted in the welcome forum, so now I will post more about Bangwol.

At the end of August, Bangwol had a minor leg surgery to remove a pin from his leg. (As a kitten both his legs were broken, and he was rescued by the vet and lived at this vet office for 3 years before I adopted him). The surgery went well, and although he ended up pulling out his stitches a few days later, his leg healed nicely. We were told to come back in two weeks for a check up.

On 9/12 we went back for the check up. After a blood test, we discovered his BUN was 50 and creatinine was 3.7. Based on this, the vet diagnosed him with CKD. The vet advised us to leave him to get his levels down. After a few days of IV, they got BUN down to 19 and creatinine was 2. I remember the vet saying "he is back to normal". He wasn't put on KD food, and no other changes were made besides me switching to grain free food because at the time he needed to lose weight to help his arthritis in his leg.

ON 9/22 he couldn't use the litter box, and didn't have a good appetite. Miralax isn't sold in Korea, and he was crying, so I took him in to the vet near my house (different from first vet). BUN was back up at 42, creatinine was 3.2. WBC was 18.80. By the next day after 24 hours on IV, BUN and creatinine were normal, but WBC rose to 20.50. He stayed there until 9/25 and was released with two days worth of inflammatory meds. He was also put on KD food as I was told protein should be limited. Nothing was done regarding his high WBC.

Fast forward a month, he did well after bringing him home on 9/25. He had some constipation issues, but was relatively in a good mood and played with his sister kitten. He had lost a little bit of weight, but he looked good. Everyone said he looked better than before and it was helping his leg. But on 10/21 he just wouldn't touch his food. I fed him with a syringe before work and came home at lunch to take him back to the vet by my house. He felt warm and didn't have a lot of energy. WBC was now 28.10, creatine was slightly raised from last time, but BUN was normal. He didn't give me anything, and just told me to give 100ml of subqs a day for a few days. However I could tell something was very wrong, so when I went back to work after lunch, I asked my friend (and Bangwol's old foster mom), to please take him back to his original vet (where he had leg surgery) And on 10/23 I went to visit him and saw the results of the newest U/S which were nephritis and pancreatitis, as well as diabetes.

As much as a I feel that this vet is good for Bangwol because he knows his whole history, and has basically seen him grow up...he is incredibly frustrating to talk to (however this is a common trait with Korean vets). I have to be careful not to over step my boundaries or question his authority both as a vet, and as someone older than me. This makes for a hard time when I know he should be giving or trying a different treatment, but my requests aren't listened to. For example, a week after he was admitted to the clinic, his WBC was STILL the same. He was on clavamox and cefotaxime, and didn't have an appetite, so they were force feeding. I asked to change the medicine, as it still hasn't done anything, and the clavamox might have been affecting his appetite. The vet only laughed and said he'd take care of it (meaning: no, I am the vet, I will make the decisions).

A few days later, I found out he did change the antibiotics, but not to the ones I asked. He simply added Metranidazole and Doxycycline, but kept the Cefotaxime and Clavamox! I wasn't happy. It took another few days before we saw some results. The WBC dropped slightly.

I visited the vet 10/30 expecting to bring him home. But was told he should remain until Monday at least. Good news was, his WBC was (slowly) coming down. It came down to 27.4 from 35.4 in 4 days. Its was still high, but it was improving. Glucose was stable and hovering around 118. He is getting two units of Lantus twice daily. I got to give him his evening shot for practice.

Now for the frustrating part. I asked my many questions, and got answers I can't comprehend. For food, he is eating Hills WB dry. He said he is adding water to the dry food but kitty doesn't eat it well so he is back to force feeding. I told him he doesn't like dry mixed with water, and to please give him wet WB. He told me Hills doesn't make wet WB food (of course they do, so why...?). I asked if he will need fluids at home, since he still has CKD on top of everything else going on, plus its could help pancreatitis too. He said no. I noted that giving him dry WB food doesn't give much moisture, and he did well on fluids before, and he still said no its fine, just add water to dry food (but he doesn't like it that way!!!). Also I asked what he thought about the pancreatitis and diabetes. If one caused the other or whatnot. He said he definitely has both, but didn't give a reason why he thought so. I asked about B12 injections, and he said its not necessary. He did say that Bangwol has received 2 shots of Epokine (0.5mL) already for RBC (they rose a tad after the blood test yesterday). I mentioned the 4mg ketone level in his last urinalysis last week, and he said he will do another one before he is discharged.

Also he said the ultrasound (wasn't clear if it was a new one or same as the one last week), showed his nephritis is quite bad. I noted that since the kidney is the place where the infection is, that is probably why. He agreed. But the likes of it returning back to as it was before infection is not likely.

It was a frustrating talk for the most part, and I tried to be as diplomatic (and polite) as possible while still getting what I needed...which didn't really happen!

As for my kitty, he was in good spirits! You could definitely tell he was feeling better. He had a nice area for sleeping, and even had a friend! When I went into the back to see him, they were snuggled together. Seeing him have company makes me feel SO relieved, since he is such a social cat and needs that affection. So at least he isn't lonely! He also takes walks to go see the cats that live at the vet...his old buddies! (Bangwol lived here for 3 years until I adopted him). As we were leaving, suddenly we noticed someone was following us! Bangwol had opened the heavy sliding door (glass!) Of his area, and waltzed right past us to see his old friends...and proceeded to sleep in their beds, use their litter box, and scratch on their scratcher! What a cat. It was sad to leave him, but he seemed happy and had friends, so it made be feel happy too.

That was a long, but important post! I am going to the vets tonight to hopefully bring him home, and I will post updated blood work again. I'm quite scared, because I feel like I'm not ready to handle this. I was searching for some home testing monitors, and found OneTouch Ultra mini, and AccuCheck Active. I havent ordered one yet, because I want to make sure I'm getting the right one! Also food...As i mentioned the vet was feeding him Hill's WB dry when he started the insulin. I have absolutely no intention of feeding him this high carb food. But I'm worried because I don't have a monitor yet, and when you switch to low carb food after starting insulin, I know your have to check his BG a lot. If I can get wet WB, should I use that until I slowly get him on low carb food? What if I can't find it? I want to switch him to BFF, and maybe mix it up with Evo chicken and turkey. I also need to get urine testing strips, right? I did all this research last night, but my head is a mess now =( I miss him so much!

Posted labs done up til the 30th, plus U/S results. Urinalysis done around the 25th was in Korean, so I translated it. (Remember this was over a week ago, so things should be different after urinalysis tonight):

Urobilinogen 1.2mg/dl (0.1~2.9 mg/dl)
Glycosuria 161mg/dl (0~49 mg/dl)
Biliruben 0.4mg/dl (0~0.4 mg/dl)
Ketone 4mg/dl (0~4 mg/dl)
Urine specific gravity 1.030
Occult blood 1.7RBC/ul (0~7 RBC/ul)
Urine acidity 7.1
Proteinuria 61mg/dl (0~29 mg/dl)
Nitrituria 0 (0~0.04)
Leukocytes esterase 100WBC/ul (0~17 WBC/ul)
Microalbuminuria 24mg/dl (0~30 mg/dl)
Creatinine UPC 0.37mg (0~0.5 mg/dl)

Thanks for reading!!

 

I'm no good at reading lab values but I know @Marje and Gracie are! Hopefully she'll be online and can give you some good advice!

You're totally correct about the foods.....low carb/low phosphorus is the way to go with a diabetic cat with CKD! The W/D is awful...especially the dry but the wet isn't really much better

I'm glad you came over from Facebook Samantha and hopefully some of the people that are better with labs will be able to offer you some extra help. You sure are in a touchy situation with the vet!

It's Sunday night here in the US, so there aren't a lot of people online...if you don't get some other help later, comment on your post....it'll bring it back to the top of the forum. Doesn't matter what you say, but a new comment will bump it back up

 

Hi Samantha, welcome to you and Bangwol. I can't read labs either, but I'm glad you found this site. I'm sure you'll get the help you need. As for the meters, I'm not familiar with the two you mentioned, but most are fine, so check the price of the test strips and get the one with the best priced strips.

 

Thank you @Chris & China and @Sharon14 ! I have more news about Bangwol...he had a hypo episode today. His BG was 65mg/dl this morning (didn't find what the evening result was because the vet hadn't checked when I called). He didn't give him insulin today, and said he would decide about giving tomorrow or not depending on the results tonight. However I'm worried. He was being given 2u of Lantus every 12 hours, which I know is quite high, especially in the beginning. I thought there must be some reason why, so I didn't question it at the time. It's been about a week since he was on it. But I think it was too much for him....hypoglycemia can occur as a result of an insulin overdose right? So it doesn't sound like remission at all to me. I wanted to take this opportunity to start him on a low carb food ( as far as I know he is still on WB dry...), and I mentioned the BFF food to the vet along with my concerns about the high carb WB formula...he agreed with me, but made no indication it would be changed. He was supposed to come home today, but I was told not today again...it's been almost 2 weeks now since I brought him there...I don't know if pulling him and taking him home will hurt or help the situation...

 

I also asked for his insulin dosage to be changed, as I expressed my concerns that it was possibly the reason he was in this state. And he really didn't give me a straight answer...just that "yeah it might be a good idea". This is what I meant by being careful not to 'challenge his authority as a vet'. I can tell he doesn't like that I know this much, and he always seems annoyed when I call and tries to rush to end the conversation (my boyfriend felt this too when he has called on occasion). The reason why I'm having such a hard time deciding whether or not to take Bangwol, is because I don't clearly know the full extent of the situation....because I was never told EVERYTHING. I'm having to piece it together as I go, with the little bit of info I get from him, mixed with info people are telling me on Facebook and here...what do I do!!! =(

 

Since Bangwol had an infection, that can raise the BG. Now his BG may be going down because the infection is cleared. Don't know what to tell you about your vet and if you should bring Bangwol home. It would help if you knew everything. If he were mine, and the infection is cleared, and all he needs is BG monitoring and appropriate food and insulin, I would bring him home. That is just my opinion, you have to do what your gut tells you. Good luck and keep us posted.

 

I agree with @Sharon14. If possible, I'd bring him home. If not today then hopefully tomorrow. And when you get him home, I'd lower the insulin as well. I think 1 unit is the typical starting dose. If you change his food to low carb / low phosphorous wet, then please get a meter as soon as possible so you can know what his numbers are. He may not need insulin once the infection is cleared up and if he has a diet switch. Paws crossed at least.

 

I agree with the others have posted. When I lived in Cambodia, I went to two french vets who had very different ideas about treatment than American vets - like treating a cat with CRF with IV fluids at the office, instead of letting the owner do it at home with SQ fluids.. They were shocked my cat with end stage CRF did so well, so long (and in large part, no thanks to them). Do you know if he is still on all four antibiotics? All for his urinary track infection? I would clarify that with the vet and ask whether they cultured the bacteria that was causing the UTI and what antibiotics would work against it. If you have home testing supplies, and can give your cat pills, if he were mine, I would definitely want to bring him home.

 

Oh Samantha, I am so sorry. As if his medical situation isn't hard enough, what an unfair (? not sure if that is the word I want, but it feels right) challenge on top of that.

Your gut will tell you the right thing, but I too wonder if Bangwol is over the hump and would do better at home with you and his sister. I assume that is them cuddling in your profile pic? CUTE. Some mommy and sister love, and getting back to "normal" might do him well in and of itself, and it really does seem that you could manage his insulin better than the vet. And don't be afraid about getting the "right" meter. While some meters seem to be preferred here more than others, my personal feeling would be that any of them would be better than none at all, and that the most important part is that you pick one for which you can reliably get test strips, and that you can afford. I don't know either of the two you mentioned. I know that I have seen folks that use (and recommend) the AccuCheck Aviva, but I have not heard of the Accucheck Active.

You must miss him a TON! I hope things work out well for you, and soon.

 

Thank you everyone! I'm feeling so anxious...I want to bring him home asap. I would assume he is still on the 4 antibiotics, but nothing was mentioned about that in the conversation. @Carol C He actually has a kidney infection, not UTI The U/S showed nephritis, but thats just inflammation as far as I know...so I'm not sure where this infection came from. I asked about his WBC, and he only said it's "getting better" (too vague to celebrate anything yet). My theory is that the closer back to normal the WBC gets, the lower the BG, and the less he needs the insulin. Plausible theory? I asked if he thought the pancreatitis could have been the cause of the diabetes, and now if that it seems to be under control, the diabetes symptoms might go down too. He agreed. However, I still think the hypoglycemia was caused by an overdose....which makes me mad.

 

When he's at the vet, is someone there to monitor him overnight? If not and he's given too much insulin again, it could be bad. Before I knew my vet as well as I do now I used night monitoring as my reason to bring my cats home.

 

Just some more kitty love to lighten things up! These two were meant for each other, and Honey is going nuts without him =(

 

@Sharon14 its 24 hours, and although the vet leaves at 8pm, there are vet techs there watching the animals at night. They follow his orders exactly, so if he told them as he told me, that Bangwol isn't getting insulin tonight, then the vet techs wouldn't do it

 

Those are too sweet!!!

 

I want to kiss those fluffy bellies!

 

They are just too adorable. I wish my cats would snuggle with each other. I would also ask for all of Bangwol medical records too. That way, if you find another vet, you will have them with you. What is Bangwol's sister name? What does Bangwol name mean?

 

@Merlin Yes I have everything except whatever was done today.

Her name is Honey, and was a rescued in June from a life on the streets. She was about 6 months old then. Bangwol (pronounced more like "Bung ool" not "Bang wall" like my mom thinks!) means 'little bell', and refers to the shape of his eyes! They are very round, just like little bells

 

Samantha, monitoring his BG is especially important, since he's already had one hypo incident. Sometimes this seems to make them more sensitive to insulin.

 

Both Bangwol and Honey are adorable!

I can only imagine your frustration with trying to converse with Bangwol's vet, that would drive me mad! I agree with what the other members have said, if he was mine I would try to bring him home, if at all possible to do without risk to his health. Two weeks is a long time, you must miss him terribly. As long as you can administer his meds at home and monitor his BG, I don't know why his vet wouldn't release him. Is it possible for you to take him back in for any follow up tests the vet may want to make? That would seem to me to cover all bases!

Good luck, I hope you get him back home soon! I'm sending you hugs, I think you could probably use some!

 

Bangwol and Honey are so cute! I love how he snuggles with her. She must miss him so much! My kitties never snuggled like that together. And I love the pic of them both lying on their backs.

Let us know when you have more news from the vet. Hopefully you can bring him home soon!

 

So sorry for all your frustration. I agree there is no reason you can't give the medicines at home. Do you think the vet will give you copies of all the records when you pick him up? It would benefit you to know exactly what's been done if you ever change vets.

 

Hi Samantha. It's April from the CKD Facebook page! I'm really glad to see you signed up here - this is definitely the place to get all the help you need with handling Bangwol's diabetes. It looks as though you're getting some great information and support already. I don't often have a lot of time to be active on here at the moment with Rosa's CKD diagnosis and her numbers still being brought under control gradually as I'm having to focus a little more on that at the moment while I learn how to deal with her new needs, but I just wanted to say Hello and tell you how happy I am that you've joined the board.

 

Good news everyone! I called the vet tonight after work, and he said Bangwol can come home tomorrow! Its been two weeks now...I'm scared to see the vet bill, but so excited to have him back! His glucose is hovering at 110mg/dl, and the vet said he "probably won't need insulin anymore". I don't know how much I believe this, so I will be checking BG at home regardless of his opinion. His WBC is still above what it should be though (didn't get an exact number). So I asked for antibiotics to be given at home and he said sure. It concerns me that this still hasn't been fully taken care of...two weeks on various antibiotics, and still not much of a difference was made. I really don't want to ask for any more tests that might keep him there longer...but if I WERE to ask, what should I say? Also I have a bit of a problem...I have no food for him! I ordered EVO chicken and turkey, but it will take a day or two to arrive....I went to every place in my neighbourhood that sells cat food, and none had anything low carb/low phos. What do I do!! The vet where he is at has a pet store attached to it, so I will check there as my last hope tomorrow...

 

So happy for you guys.

 

Glad he's coming home. Keep us posted.

 

Hopefully it won't be long before you get your EVO. If it isn't going to be too long, maybe you can make his food. I don't have any experience in it and I don't know if it is a solution but I would probably look into that if I was in that situation. I would not buy anything other than low carb food just in case he is in remission.

 

So happy to hear Bangwol is coming home! Such wonderful news!

If the pet store attached to the vet's doesn't have any low carb food and you want to try making your own, go to catinfo.com; Dr. Lisa has a recipe for homemade raw food, if you can get all the ingredients.

So excited for you, Bangwol, and Honey! Please keep us posted on Bangwol's progress!

 

Yay!! Honey is coming home!! Don't know where you are in Korea, but are there any ex-pat grocery stores in your city?- most places I've been in Asia have places mainly for ex-pats to shop. They might have fancy feast and Friskies there.

 

Yay! Honey (and you) will be so happy to have him at home. Please let us know how he's doing.

 

Bangwol is home! Honey and I are so happy! He is also OFF the insulin! (Crossing fingers its for good, not just temporary). His EVO food arrived today, and he ate a bit just now (cleaned the bowl!). He is on antibiotics (same 4 as he had at the vet) for a few more days, but WBC is just 0.01 away from normal! I will be getting a home tester and checking his glucose at home too. He will go back in a week for a check up! The bill...almost 1,400$ (thats in Korean won, so in Canadian $, it would be....a lot more). But his health comes first! He is snoring away on his favourite bed...missed him so much!

 

His labs for the entire 2 week vet visit (is it clear enough?)

 

Hooray!!! So glad he's home, and doing so much better! You and he look so happy ! I like the pic of Honey giving him a "kiss", too, lol!

 

So happy for all of you. Hopefully whatever infection he had is what caused BG to go up and maybe wasn't diabetic to begin with. Wouldn't that be nice.

 

The one thing on his labs that really stands out to me that I would be concerned about is that he is anemic. CKD cats often have anemia but for where his bun/creatinine are, his hematocrit should be higher than it is. There are two kinds of anemia...nonregenerative and regenerative. Typically, it is assumed that CKD cats have nonregenerative anemia (the body can’t correct the anemia itself). When a cat is sick with something else (as in the polynephritis), it can be regenerative. I would discuss this with a vet that can help you more with it. For CKD non regenerative anemia, giving methylcobalmin and a multi B supplement really help unless the HCT is below 20% and then they need something more. Here is a full discussion on anemia from Tanya’s CKD website.

I also think they should have been checking his phosphorus and potassium....these are very important markers in CKD. Also, for kidney infection, the gold standard treatment is baytril for 6-8 weeks. I doubt that the antibiotics the vet is giving him are going to address the kidney infection because they are not specific to it and they are not being given for long enough. So I’d discuss this with a vet as well and see what they say.

He also has a lot of blood and protein in his urine if I’m reading their tests right. Protein in the urine may or may not be due to decreased kidney function and the best way to tell is to have a urine protein:creatinine ratio done on the urine. It’s a more specialized test and is expensive in the US. I don’t know about Korea but it will tell you whether he has Proteinuria or not.

Sending many vines for him. I’m glad he’s home.

 

I second Marje and Gracie's anemia concerns. Did the vet say anything about this?
Also, have they run a new albumin?
EDIT: If they haven't run a new albumin since 10/27, I would watch closely to make sure he doesn't look like he's retaining fluids or having belly swelling.

 

That's quite interesting, because the first question I asked the vet was "is he anemic, and should I be giving him iron". And he flat out said "No". I also asked about B12 last week already, and he said "it's not necessary to give". I'm not sure how to go about this delicate situation...if I phone him today and say "well the people on message boards said this", he will see it as I don't believe his authority/competence as the vet. I've already been pushing it lately...I actually don't know what to do now. No, Baytril was not given, just a bunch of other antibiotics. I think he had mentioned some kind of test to do with urine, but said it was expensive and didn't do it. Also another urinalysis wasn't done before being discharged.

 

I wonder if it would be worth doing a phone/email consult with a vet in the US or Canada? You can email the vet your labs and see what they think. (PM me if you want some suggestions.) Alternatively, is there another vet you can see for a second opinion, or at least another albumin test and to discuss the anemia? I don't want to worry you but low albumin can be dangerous.

 

It would be best to try and consult with another vet as Bangwol is definitely anemic. I don't know if giving iron would be the best solution but also don't know if giving oral methylcobalamin and multiB supplements would be adequate. A vet really needs to address this.

 

It was mentioned in the first post that Bangwol was given two shots of Epokine, an erythropoietin product, which would have been intended to treat the anemia. Sometimes iron is given with this medication to support the expected increase in red blood cell production.

There are potential side effects with this drug so it is not used casually. It is worth following up on the anemia issue to see if his body has resumed making red blood cells and his anemia is improving. The Epokine shots will not have a prolonged effect.

You can read more about this on Tanya's website.

 

Let us know how your kitty is and if you want help getting a US/Canada phone consult. I do think getting a second opinion locally would be good because if you need meds, a US/Canada vet can't do much; so the latter would be more informational.

 

That was my thought too, exactly.

 

Hi Samantha. How is Bangwol doing? I'm sure he is happy to be settling back in at home!

 

Hi Samantha - are there any ex-pat vets where you are? Where do other ex-pats take their animals?

 

Bangwol is doing well and is happy to be home He slept under the blankets with me the first two nights he was home, and now he is back to sleeping in his own bed (although he stills comes to my bed periodically throughout the night. Honey has been jealous since he came home...For two weeks she got the attention, and slept by my side. Now that Bangwol is home, I think she feels left out. When I hold him, she meows until I go over to her. And when he was under my blankets (essentially stealing her spot), she got upset and went under the blankets too, lying on top of him. Is cat jealously a thing? I give her just as much attention and play with her too.

Also about his food...I didn't realize it until I asked my mom today if she can get this food in Canada, but its EVO cat and kitten chicken + turkey, not the 95% chicken and turkey like I thought it was...the site I ordered from only said "chicken and turkey", and it didn't even occur to me to Google the can colour before ordering (plus I assumed a cat and kitten can to be pink). After an intensive search, I've found only cat/kitten and the duck one is sold here. There shouldn't be a problem with feeding him what I'm feeding right? He eats it so well! Also, should we be aiming at one of these 156g cans a day? More? Less?

 

Great pics, love seeing him in his little blue bowtie! I'm sure Honey will get over her jealousy soon, and everything will settle down.

The Evo Cat and Kitten is fine for him, carb-wise (3%); the duck may be a little higher in carbs but is also probably okay (if it's the 95% Duck it has 5% carbs). To determine how much he should eat, take his ideal weight, multiply it by 13.5, and add 70; this is roughly the amount (in ounces) that he should be eating daily. You can adjust up or down to meet his needs.

I'm so glad to hear he is doing well at home!

 

@Squalliesmom this might be a silly question, but how do I determine what his ideal weight would be? It is a number I decide, or is there some master chart of healthy cat weight I'm missing? To try it, I randomly picked 5...But after calculations it only came to 137.5. The EVO cans are larger than this, but he easily eats about a can a day and also steals honey's dry Instinct food when he think I'm not watching. He lost weight since being at the vet so long, so that's why I just let him eat as much as he wanted (and boy does he want to eat now!)

 

Do you know about how much he weighed before he got sick? It's hard for me to tell just by looking at his pictures, but he seems to be an average/large kitty. You can weigh him by holding him and stepping on your bathroom scales, the re-weighing just yourself - the difference is approximately what he currently weighs. He looks from the pics like he should weigh around 10-12 lbs, but as I said, I can't really be sure of that by just seeing his pics. If you can find out what he weighs now we can use that as a starting point and go on from there.

 

Also, right now, because he's been so sick and lost so much weight, I would probably give him closer to two 156g (5.5 oz) cans for now, and adjust if he starts to gain too much weight. And tell him to stay away from Honey's dry food, it's not good for him, lol!

 

I guess I should have asked, is that ideal weight for the calculation in kg or lbs? We use kg over here, so I automatically used that one. He should be about 5.3-5.5kg, or 11-12lbs

 

Hmm, it would be impossible to feed him two of these cans a day during the week, since I work all day, and he doesn't eat a large portion all at once. On the weekend it's easier to get many little meals into him.

 

Sorry, I think in pounds! 11-12 lbs seems like it may be about right for him; that would be about 230 oz of food daily, just a little over that.

ETA: 239 CALORIES a day, not ounces a day!!! Sorry, didn't mean to cause undue confusion!

 

I don't know whether or not this would be a viable option for you, but they make automatic feeders that you can set to open at specific times. I don't know what's available to you in your part of the world but here is an example of some, anyway.

http://www.chewy.com/s?dept=all&query=automatic cat feeder&nav-submit-button=Submit

I know they are available from different sources, Amazon, other pet chains/sites, etc.

 

You can also make cat food-cicles: freeze some wet food and leave it out for him during the day. By the time it thaws, he will hopefully be ready for his next meal.,

 

@Squalliesmom @granadilla the only problem I can see with the cat feeder and freezing the cat food, is that Bangwol is a bit of a Prince when it comes to his food...he only eats it if there is warm water inside, and I have to keep adding more when he gets to the bottom of the bowl so he will finish it all =(

 

Well, at least you know he is well-hydrated, lol! In that case, you may have to try one of the low/no carb dry foods, that you can leave out for him during the day, if he'll eat them. Some people have had good luck with Evo Cat and Kitten Turkey and Chicken, it's about 8% carbs (I did not have good luck w/it, it raised Squallie's BG). There is also Young Again Zero Carb, it's expensive but they eat a lot less of it, so it kind of balances out. I had pretty good luck w/feeding Squallie YAZC. The problem is that I don't know if either of those are available to you in Korea?

 

I used to call my cat Marshmallow a Princess Fussypants because she was a drama queen about food too. You will have to leave a little bit of food out for him then while you're at work, obviously. Hopefully his BG will stay in the normal range without insulin but if you can't get low carb dry food, keep testing his BG twice a day, before he eats (as long as he hasn't had food for two hours before the test since food can influence the numbers). Not ideal if he has to eat higher carbs but he needs to eat.

How much weight has he lost? Or, maybe the question should be, how much weight does he need to gain?

Have you found another vet you can take his labs to? I'm glad to hear he's doing well but there were a few questionable things on his labs, as you know. As @SpecklesandMe mentioned, there have to other vets who would be willing to do a Skype consult. Paws crossed for continued good health!

 

Here's a good Body Condition Score Chart to help with determining if he's at a good weight or not

 

I can order most big name foods online, but I've never seen YAZC before. Where do you find the carb % for dry foods if it's not listed on the particular website? I checked on the Nature's Variety and Orijen sites, but it isn't listed, and most of the food lists showing low carb foods are only for wet food. I'd prefer to stick with Instinct, mainly because it's something I know they will both eat (both of them are so picky...), but I want to know the carb% before ordering another bag. EVO Cat and Kitten Turkey and Chicken would be one to fall back on if it turns out Instinct is too high.

As for the vet, the vet my mom uses in Canada refused to discuss Bangwol's labs without seeing him first. There aren't a lot of decent vets near me, and some don't even treat cats (rather, don't know how to) He is doing okay right now, so I will wait it out and go with him for his check up on Friday night or Saturday morning with the same vet. I will mention everything that has been said thus far in the conversation about his anemia, and hopefully will have my glucose monitor by then to ask about home testing. I will ask for complete blood work to be done, since he didn't check anything regarding kidneys for a while... If I don't get the results or answers I need, I have the business card of vet in that area who treats cats, so I can try there too.

 

You can email the company and ask about the carbs. Here is the info I received on Natures Variety Instinct kibble.

 

That's great. It's probably better to have someone local give a second opinion, if necessary, since they can run more tests, but if you do end up needing a phone consult, please don't be discouraged by your mom's vet. We'll help you find someone good. I know at least 2 in the US who'd be willing to do it.
Also, not to sound like a broken record, but please make sure they run another albumin level. In addition to the anemia, this is extremely important. If it drops more than the 10/27 level, it could become a life threatening situation.
Good luck with everything and let us know how he does. Fingers and paws crossed that he stays well!

 

Would just like to update all of you on Bangwol! He went for his check up on Saturday, and had great results! Both WBC and RBC are back in a normal range, and BUN and creatinine only went up slightly. Glucose is also at a nice 93! The only thing he didn't check (although I did ask for all tests to be done regarding kidneys...) was albumin. However judging by his great results, do you think its still needed? I suppose I could always have it done at another smaller vet in my area if he should need it. He is on Cefotaxime for another two weeks, and I was also given Azodyl. I will finish giving him the probiotics I am currently using, and then try the Azodyl. Has anyone had any results with it? Its not cheap, but if it has a positive effect, I would definitely buy more for him. Here are some cite pictures from yesterday! He is acting like a kitten, chasing Honey around! Makes me so so happy <3

 

If the albumin had dropped lower than the original set of lab results you posted, you might see fluid accumulation in his belly. Keep an eye out, but sounds like he's on the upswing. Thank goodness!

 

So happy to hear he is doing better!!! I love the pics, both he and Honey are beautiful. They seem very happy to be back in each other's company, too!

 

Great news, so glad hes doing better! Love the pics, so cute.

@Squalliesmom Lucy, love the new pic!!!!

 

Thank you!