Blood test help pls

Discussion in 'Feline Health - (The Main Forum)' started by Tilou, Jan 20, 2018.

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  1. Tilou

    Tilou Member

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    Hi everyone
    I would be grateful for any help/comments re the attached blood results that diagnosed my cat's diabetes last Monday.
    Bob was an overweight cat at 8.5kg a year ago. In November he was just under 7kg, but had been on a low calorie regime for several months. Then after a loss of bladder control last weekend we took him to the vet (we're in France, btw) to find his weight down to 5.5kg and high blood glucose.
    The vet also said his kidneys were "very bad", but the creatinine result is within normal range, so can't figure out where that shows on the results.
    We've compared Bob's results to another set we have from a cat we had who died from CKD and there are noticeable differences.
    Problem is the vet says we must only feed Bob on Royal Canin dry diabetes biscuits. He won't eat them as he's a wet food cat, so we've bought the RC diabetes sachets, complemented with tins of Almo Nature.
    He's on two units, morning and evening, of Caninsulin, plus 5 units daily of Semintra for his kidneys.
    Any help much appreciated.
    Tilou
     

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  2. JanetNJ

    JanetNJ Well-Known Member

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    I will tag a person good at reading these. From what I can see on the labs, the kidneys are not "very bad"... not at all... although perhaps dehydrated. did the vet give fluids? Not sure what to make of the high blood platelet count. @Marje and Gracie is better at reading these things then me so I'll defer to her experience.
     
  3. Tilou

    Tilou Member

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    Many thanks, Janet, for your replies - much appreciated. The vet didn't give any fluids. I wondered about the platelet count too, not sure what that could refer to. I did find a website that gave a rundown on how to read these reports and the info on platelets had nothing relevant to being linked to kidneys or diabetes. Ironically, my husband is diabetic and due to medication he used to take for arthritis has damaged kidneys with low creatinine clearance, so we are well versed on that issue as he has monthly blood tests to keep check on things. I'm a bit annoyed that our vet (of 12 years) might be taking advantage of supposed clients ignorance and prescribing unnecessary treatments.
     
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  4. Marje and Gracie

    Marje and Gracie Well-Known Member

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    His creatinine is fine and I don’t see why the vet is saying his kidneys are bad. There are a lot of labs missing that would help give a better picture of his kidneys. His urea is a bit high but it can be if kitty is a little dehydrated.

    Usually, there is no significance to high platelets. I would see what his trends have been and just keep a watch on it. Several things can cause high platelets like chronic inflammation from IBD or pancreatitis but I’ve seen a lot of cat labs for cats with IBD and/or pancreatitis and have seen very, very few with high platelets.

    Of more concern, I believe, is his low hematocrit and even odder is that his hemoglobin is on the higher range. Usually, low hematocrit trending towards 30% is an indication of anemia and you would also see the hemoglobin being correspondingly low. I’m not sure what might be going on that they are on opposite ends of the spectrum.

    His liver enzyme (ALAT) is a little over high normal. This is a very, very mild elevation and might or might not be important but bears watching.

    It’s very hard to get or give a clear picture with just the labs provided. A test that includes all the superchem (liver and kidney levels, phosphorus, calcium, potassium, etc), a complete blood count with red blood cells and white blood cells, and a urinalysis would give a much bette picture.
     
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  5. Juliet

    Juliet Guest

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    Well done that your cat prefers wet. Dry food not good for diabetics as it’s high carb. Not good for any cat actually.
     
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  6. Tilou

    Tilou Member

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    Hi and thank you very much for the comprehensive reply - I'm glad that you've confirmed the creatinine results, as we were quite shocked when the vet said Bob's kidney's were "very bad" and am now left wondering if there was a misinterpretation (either of results or language, although the vet speaks good English and our French is on a similar par).
    Unfortunately we are dealing with a stereotypically arrogant Frenchman - as most "specialists", doctors etc, are here - and it is difficult to persuade him from his way of doing things, so I'm not surprised that the labs are not complete. He presumed immediately from the symptoms it was diabetes and that was what he principally tested for. Whether the follow up tests in two weeks will extend beyond this I don't know.
    As Bob's early medical history remains unknown to us - he joined the family as an adult stray - any underlying problems have never been diagnosed. Generally he's always been in good health, eats well (too well, hence the diagnosis!) and has his annual boosters.
    However one thing he does display, normally manifesting itself a couple of times a year, are cold symptoms of runny nose and eyes, lethargy and loss of appetite. The vet has never taken bloods for this, just gives a shot of antibiotics if we take Bob to him (which we do if it doesn't resolve itself in a couple of days).
    Meantime we are continuing to give Bob his two units of insulin per day, and the Simentra (although am now left wondering if he actually needs it) and feeding him on low carb wet food. He is no longer visiting the water bowl every five minutes and is a lot livelier (although he's always been a lazy cat).
    I will post the next lab results when we get them.
    Best wishes, Tilou
     
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  7. JanetNJ

    JanetNJ Well-Known Member

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    2 units is actually a high starting dose. The recommended starting dose is 1 unit. Would you be open to learning how to do blood tests at home? I have a video in my signature showing how I test my cat CC at home. It can literally be a life saver.
     
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  8. Larry and Kitties

    Larry and Kitties Well-Known Member

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    The high reticulocyte count means that bone marrow is responding to loss of red blood cell and is producing more red blood cells in order to increase the umber of red blood cells.
    This discusses causes of high eosinophils
    https://pets.thenest.com/elevated-eosinophils-cats-8191.html
    Since they are not that elevated it may not be a concern
     
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  9. Tilou

    Tilou Member

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    Hi Janet
    We have watched your video for home testing - all good stuff. I've actually bookmarked a pet testing kit on Amazon to buy, so now we know how it's done I'll order one. We do, of course, have human testing kits here as hubby has been diabetic for over 30 years, but I saw on another website that there is a difference in readings, hence looking online fir the pet variety.
    Re the two units, twice a day, the vet did say that he'd reduce to one unit twice a day if the next blood test shows the glucose reduction he expects.
    Meantime we are all too aware of the possibility of a hypo - even more so now that his diet is so low carb - and are watching Bob carefully. Fortunately he's a lazy little devil, so doesn't burn up much energy!
    Many thanks again - this is a great forum.
    Best wishes, Tilou
     
  10. Tilou

    Tilou Member

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    Thanks for the link. Having read it I'm beginning to suspect the EOS reading might have something to do with an underlying condition that Bob has periodically suffered from ever since he first arrived with us. He is prone to sneezy, cold-like symptoms with runny eyes, which are possibly re-occuring respiratory tract infections.
     
  11. Tilou

    Tilou Member

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    Update: inspired by Janet's video we have ordered a pet glucose meter. Noticeable today that Bob has been drinking a bit more than the last couple of days - don't know if that's something to worry about. He's still happily eating his Almo Nature canned food, along with a daily Royal Canin diabetes wet sachet per day. We did have an incident of him not leaving the comfort of his pet bed last night and peeing himself!
     
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  12. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Does Bob have any evidence of hind end neuropathy - eg. weakness, difficulty walking, jumping up, etc.? This can be a complication of diabetes and I'm wondering if it can lead to loss of bladder control or contribute to unwillingness to move to the litter box? Diabetic neuropathy can be improved by giving a B12 supplement.
     
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  13. JL and Chip

    JL and Chip Member

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    Has he ever peed in his bed before? If not, I'd wonder whether he went hypoglycemic. You could always use your human meter to check his glucose levels while you wait for the pet meter to arrive. Two units is a bit high for a starting dose and I'd want to get some data asap.
     
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  14. Tilou

    Tilou Member

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    One again, thank you for the informative replies.

    Bob's back legs don't show any signs of problems in walking, he has always walked on his tippy toes, but from he was at his heaviest he has not been able to jump up on things. This has probably masked any weakness attributed to the diabetes. Since his weight loss he has gained more ability to push up onto low level areas, like the sofa and chairs, but doesn't jump.

    It was his involuntary peeing that made us take him to the vet. It first happened once back in November (vet put it down on that occasion to an infection), then twice over the weekend before his diagnosis last week. For those three events he'd left his bed to lie out on the floor (as he does to cool down on the tiles when the log fire is on) He's only peed in his bed on this latest occasion.

    Bob is an outdoor cat (although confined to our garden) and has never used a litter tray, so monitoring his toilet habits involves a lot of stealth - although at the moment due to the weather he has taken to using our wood shed (sawdust makes great kitty litter!).

    If we use hubby's glucose meter, what range should we expect Bob's bloods to fall into?
     
  15. JanetNJ

    JanetNJ Well-Known Member

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    Normal on a human meter is 50-120. Expect a newly diagnosed cat to be much higher than that.... But it's imperative that he not go below 50 at his lowest point.

    Perhaps he has arthritis pain.
     
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  16. Tilou

    Tilou Member

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    Hi Janet
    We will test him on hubby's meter as the pet one we ordered isn't due until Friday and I'm worried about his visits to the water bowl, as they've increased a lout in last 24 hours.
    He does have some arthritis in the back legs - that was also confirmed at the visit we made to the vet last November.
    Will let you know the blood results.
     
  17. JanetNJ

    JanetNJ Well-Known Member

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    I'm not sure what's available by you, but next time you talk to the vet ask about adequan for the arthritis. Works wonders. You may want to give b12 methylcobalamin supplements in case it is the beginning of neuropathy.
     
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  18. Adam Flowers

    Adam Flowers Member

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    This is what I was worried about as well with him peeing himself. But second guessed when it's happened prior to starting insulin as well.

    Please test with your husband's meter until you get one for Bob
     
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  19. Tilou

    Tilou Member

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    Bob has Metacam for when his arthritis is bad. The problem we have in France is access to anything other than through the very expensive veterinary system. All medical services are very well defined, for example even humans cannot buy a simple packet of aspirin in the supermarket (as in the UK) - everything is either purchased through the pharmacy or via doctor's prescription. I can access some things via Amazon UK, but even they are bound by France's rules and will not send many items here. Very frustrating.
    No luck so far with getting a blood test. Despite warming Bob's ears no blood! After three attempts he now has the hump with us!
     
    Last edited: Jan 23, 2018
    Reason for edit: Additional info
  20. Tilou

    Tilou Member

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    B12 supplement for cats - the only product I can buy is Cobalaplex, which is described as:

    Cobalaplex has been formulated to help support normal serum cobalamin (vitamin B12) and folate (vitamin B9) levels in dogs and cats, helping them to enjoy a happy, healthy life. Cobalaplex contains Cobalamin, a water-soluble vitamin that plays an important role in many physiological processes including cellular metabolism, DNA synthesis, amino acid metabolism, fatty acid metabolism and erythrocyte formation. It also contains Folic acid, a synthetic form of folate, another important water-soluble B vitamin that is essential for DNA synthesis and repair thus playing a key role in cell division and growth. Finally Cobalaplex contains Preplex prebiotics to help support a healthy gastrointestinal microbiota.

    Any comments appreciated.

    Edit: Bob has involuntarily peed again tonight - as I gave him his insulin! We shall be popping into the vet to see about B12.
     
    Last edited: Jan 23, 2018
    Reason for edit: Additional info
  21. Tilou

    Tilou Member

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    Further update: spoke to vet, never heard of B12 supplements for this problem. Summarily dismissed. Oh well, that's the price we pay for living in France. Will order the Cobalaplex from the UK (although looks like I'll have to get it sent to mother there and then get her to post it on and hope it doesn't get stopped at French customs) and hope for the best. Meanwhile Bob is spending every waking hour at the water bowl, so that doesn't look good. Blood test booked for next Tuesday.
     
  22. Critter Mom

    Critter Mom Well-Known Member

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  23. Tilou

    Tilou Member

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    Hi - no I haven't, but thank you very much for the information. Have now read your link and will do. Bob is due to go back to the vet on Tuesday for a control blood test (his blood meter is due to arrive today, we have been unable to test using hubby's monitor as can't get enough blood from Bob's ear!).
     
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  24. JanetNJ

    JanetNJ Well-Known Member

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    Don't use your husband's thin lancets. Get some 26 or 28 gauge. The 30+ lancets are too thin.
     
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  25. Tilou

    Tilou Member

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    Ok, will do ;)
     
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  26. Tilou

    Tilou Member

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    Just managed to do Bob's first blood glucose while he was sleeping (got new machine this morning). It's 28.8 - so too high. He had his shot of two units of Caninsulin at 9 this morning (so 7 hours ago). He's eating fine and after a a couple of days of lots of water intake he settled down yesterday on that front but it's obvious his thirst is related to this high number. He's also quite tired. I'm going to test again after he's had his evening shot (or after tomorrow morning's one, depending on how receptive he is).
     
  27. JanetNJ

    JanetNJ Well-Known Member

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    CONGRATES on getting your first reading!! Try to get a preshot test before food and shot so you can see his starting number, and then again around 5 hours after the shot.
     
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  28. Tilou

    Tilou Member

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    Merci! Got a pre shot and food reading this morning of 31.8. Gave Bob his two units of Caninsulin. He's eaten one packet of Integra diabetic wet food. Retested five hours later at 25.2! Got vet tomorrow for his follow-up blood test.
     
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  29. JanetNJ

    JanetNJ Well-Known Member

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    Ok well 25 is better than 28. It's a marathon.
     
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  30. Tilou

    Tilou Member

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    It certainly is :)

    Bob had a glucose blood test at the vet this morning. It came out at 5.27 g/L, so higher than his original reading two weeks ago but by my calculation to mmol it is about 29 and yesterday morning he was 31.

    The vet has decided to up his insulin to three units in the morning, but keep it at two units for the evening.

    However he was pleased that Bob has gained nearly half a kilo in weight and is looking well. He told us to keep monitoring with our blood meter and he'll see us again in a few weeks, or if there is no reduction in his levels.

    I'll keep this thread informed of progress.

    Update: the extra unit of insulin has seen Bob's blood result on our meter come down to 15.3 after five hours.
     
    Last edited: Jan 30, 2018
    Reason for edit: Update
  31. Tilou

    Tilou Member

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    Managed another blood test on Bob today, five hours after giving him his new three units of Caninsulin and reading came out at 16. He's noticeably no longer hugging the water bowl.

    My one problem is getting enough blood from him onto the AlphaTrack strips. Keep getting ERR messages and wasting them - and at a euro a throw they're damn expensive!
     
  32. Nan & Amber

    Nan & Amber Well-Known Member

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    Wow, that's quite a response!

    I'm a little confused about the units you are using, can you clarify? the 5.27 g/L converts to 527 mg/dL (our "usual" US-based units), but is the 16 in g/L (equivalent to 160 mg/dL) or in mmol/L (so equivalent to 288 mg/dL)?

    I ask because 160 mg/dL on an AlphaTrak is pretty much in the normal blood glucose range, and if that's what you're getting on this dose, you actually might want to ease up a little bit while using Caninsulin in order to keep a good safety buffer. It's a great number, but if the Caninsulin is bringing him down that much, you'll have to do a fair bit of testing to make sure you don't overshoot.

    Of course, if that 16 (or the 15.3 yesterday) is in mmol/L, the above does not apply, I just wondered because you mentioned that he's not hugging the water bowl any more, which suggests a pretty big improvement in BG.
     
  33. Tilou

    Tilou Member

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    Hi - no worries, the meters here are all set to mmol/L (even the human ones) ;)

    We've just tested him this evening, as he's been very quiet and not taken any food since around lunchtime and he's zoomed back up to 33!

    He's also been sick (just water because he has been drinking a little in the last hour) but that might be because he was showing signs yesterday of having a fur ball (much eating of grass outside) and Bob has never been good at ejecting them - so am keeping a careful eye on him, as not sure if it's the high blood glucose or the fur ball that's causing him to be so quiet (except for an angry swishing of the tail).
     
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  34. JanetNJ

    JanetNJ Well-Known Member

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    Alphatrak takes a really small drop. Are you sure you are dipping the straw on the side of one of the dots on the edge of the strip in? Not trying to put it on top? Not getting blood on both sides?
     
  35. Tilou

    Tilou Member

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    Hi Janet - many thanks for your reply.
    Yes, I'm using one of the dots on the side and have been successful about half of the time. Those that have worked have done so with a teeny bit of blood. Am beginning to wonder if I've got a bad batch of strips (they are the ones that came as part of the kit) as we've had similar problem before with hubby's strips for his meter.
    I will be buying a new batch, so hopefully won't have this problem.
     
  36. JanetNJ

    JanetNJ Well-Known Member

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    Ok and you are dipping the edge into the blood, not scooping the blood onto the dots, right?
     
  37. Tilou

    Tilou Member

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    I did scoop initially :( but the last couple of times seemed to be due to not enough blood, as it was drying up so quickly. I shall persevere.

    Update: persevered! Had to use his pad as ears just not giving enough blood and he doesn't mind his feet being played with, so less chance of me taking my own blood reading! Came out at 27, so another high afternoon reading (7 hours after 3ui).

    Think I may have found the reason, as seems that Caninsulin does not maintain the 12 hour duration that it does in dogs (see attached chart).

    As Bob starts suffering from incontinence at these high levels, we are going to change his regime and divide what are currently his two injections (of 3ui in morning, 2ui at night) into three injections over the 24 hour period to see if that will help balance things out. Vet says at these current glucose levels very little chance of a hypo and he's happy for us to amend the regime as necessary.
     

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    Last edited: Feb 1, 2018
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