BUN & creatine ?

Hi all-

Just wondering about BUN and creatine numbers. Do they generally fluctuate? I read somewhere thatt he more water kitty intakes the lower the creatine number. Does that mean that the numbers could be creatine could be 2.0 one day and 1.5 the next? Is it like glucose where it depends what their "intake" was that day?

BUN can rise according to stress??

 

BUN is affected by diet as well as kidney degradation. A high protein diet tend to elevate BUN. What do you mean by "creatine"?
Creatinine is a blood value that indicate kidney function. It is good and does not really vary with diet.
"Elevated Creatine kinase-activitiy (CK) indicates disturbances of the muscle cell integrity. In addition to primary muscle disease, like trauma, inflammation or dystrophy, diseases of other organs can lead to secondary muscle involvement, which will be indicated by increased serum activities of the CK."
From:
https://www.ncbi.nlm.nih.gov/pubmed/16240913

 

BUN and creatine numbers were high in September, improved greatly in February, now are higher the September. Just wondering how it can improve greatly then worsen "greatly".

 

On human we have to have BUN and creatinine levels to inject catscan patients and yes they do flextuate but not hugely in a given time ...we can use labs within a month.
Both are kidney function.

 

I just don't understand.
-------------------Bun--------------Creatine
9.12.17------------41 -------------------1.7
11.20.17---------------------------------1.9
2.14.18------------31-------------------1.4
4.9.18-------------45-------------------2.2

Why did it drop and then way back up??

 

Boy I really don’t know on a kitty. But on a human these wouldn’t be abnormal curves. I’ll ask my friend from the lab....

 

I was wrong. He said in a human that would be a fairly big variance.

 

And of course the IM vet isn't concerned. Which I guess is good, but not the numbers I want to see. And I don't get the variance. On 2.14 he was as the height of being unregulated diabetic, and now he is in remission, if that was to change numbers...

 

I know Rufus was drinking tons of water around 2.14.18 because of bein unregulated, and now is drinking less. Are numbers higher because he's not drinking as much to filter the kidneys? But then again, more stress was put on them before because of glucose in urine.

 

Sean, what were the normal ranges / values from the lab, and we're all these tests done by the same lab?

 

Dennis (my lab buddy) said they can vary with what’s going on in the rest of the body. He was thrown by the cat numbers, lol. I’ll try to do some research if ER stays ....you know...I can’t say it or it will jinx. If vet wasn’t concerned I wouldn’t worry. I know when I look at a humans labs those are the 2 we look at and they vary. I’m kind of confused now...Dennis kind of did a 180 with that vary question
He did “loan” me some keytone test strips tho

 

Very well could be.

 

Both were IDEXX in-house, same IM vet, different locations. BUN normal range is 16 to 36, and creatine range is 0.8 to 2.4

 

IM vet isn't worried about anything, ever. She didn't even go over the numbers with me. The issue is he is nauseous all the time and I was wondering if its from the kidneys or possible food intolerance/IBD, or both.

 

What is IM vet?
Now that you said the cat values that is more of a jump than I thought. Humans are 7 to 18. But we give contrast up to 24. I’m not sure on human what number is “in the red”
I feel lucky that I have an awesome vet that wants me to test at home etc. so far he’s been great. Old guy in suspenders the small town vet- so cute. Very well liked.
Do you have any other options for vet? It’s so important to like and be comfortable and have them concerned!

 

@Marje and Gracie

might be able to shed some light on this subject

 

IM=Internal Medicine Dr. She's like top of her game type of stuff, by referral only. She's not my normal vet, I was referred to her when we couldn't get Rufus' glucose under control, and have been going to her for bigger things since.

 

I'm not sure if the IM vet told you, but BUN and creatinine tests measure kidney function. Did they also do a urine test? It would be good to know the urine specific gravity (USG). I previously had two kitties with kidney issues, so I know a little...
BUN can be elevated if there is dehydration, or gastro issues;
Cats who are more muscular can naturally have higher creatinine. The BUN:creatinine ratio is 20:1, but that may be because you have a higher protein diet?
My only question is that BUN is higher than normal, and creatinine is getting up there, and it is a bit of a jump from Feb 16th, which is less than 2 months. That may indicate something is going on with the kidneys like a kidney infection. If you have other data like CBC panel, phosphorus, calcium, potassium, sodium that would also help narrow things down. Typically, reading BUN and creatinine alone doesn't really tell you much.

I'm not an expert, but I've tagged @Marje and Gracie ... if you can get as much of your labs into your SS she can help you.

 

Yeah, I do know they are kidney numbers. I asked them to run a CBC. His kidney numbers have been in the back of my mind since August when he first "stopped" eating. Original vet said could be because of "higher" kidney numbers. Then they improved in February, but are "higher" again. He is inappetant and nausoes A LOT, even with pepcid, ondansetron, and occasionally cerenia. I asked her about my concerns with daily pepcid and it's supposed to help cats with kidney issues. She said he didn't have kidney issues, or possible stage 1, but this was before his lab numbers came back. So I am supposed to stop the pepcid but now worry if it is helping or hurting him. Cant figure out why he is nauseated all the time.

He does have gastro issues. Not sure if it's food intolerance or IBD or SCL.

All the numbers that I got today are in my SS. All of the other numbers look normal, except cholestrol. His BG numbers have increased. Thought it was new meds. Maybe a kidney infection? I don't think he's dehydrated. How would I know?

 

Wow I didn’t realize they had specialty areas in vets as they do drs but makes sense. I can’t stand hearing about a “cold” vet though. The first one I took my horses to when I first moved here 5 years ago was beyond awful in personality. Office staff and all...needless to say I won’t use them again. I almost laugh when I hear their warm and fuzzy ad on the radio.

 

It's very frustrating to go see her. They always run late, the tech comes in 15 minutes late, talks for 15 minutes, then wait for DR for 45 mins. Then she always gets up at some point and just leaves, usually when you think she is going to check on something. The the tech comes back in. Ugh. She is VERY in demand though, so I kind of get it, but jeez Rufus is important as the rest your clients!

 

Wish there was a dislike button here. I don’t know, just me and my feelings but I’d rather deal with just a plain vet that cares.

 

Yeah, my regular vet pawned me off on to her. I was going to go back to my old vet, but they thought it would be wise to continue with IM because of Rufus' many issues, and now this I do truly think she does care, it's just so is soooo busy. When she writes her report on the visit, it's like 2 weeks later she is so busy. Sometimes get them in the middle of the night. She is just overworked, but still that's not mine or Rufus' fault.

 

A quick test for dehydration is to pull the skin at the back of his neck, if it bounces back quickly, he's good, if it's slow to go back, he's dehydrated. I'm sorry, I know you've been juggling with a lot. Glad you got the data in, I see there wasn't a urinalysis, it would have been good to see. The numbers look good to me, perhaps that's why the IM vet wasn't overly concerned? But, with the combination of issues that Rufus has, I'm reluctant to add much more about interpreting the labs, as my experience is really limited.

Glucose can be higher if Rufus was stressed at vet's...and he's been eating the higher carb kibble I believe?

 

I'm going to ask my regular vet tomorrow if they will give him some subq fluids. They have told me flat out no before, but have done it twice. I don't think it could hurt, could it? I'm also going to ask regular vet to intrepret the numbers and get her opinion. I suppose I could ask reg vet to do a urinalsis too? Thanks Christie. 2 steps forward,1 step back But we're getting better slowly.

 

The thing with sub-q fluids, is that he doesn't seem to need them at the moment, I can't see anything in the labs that would call for it... yes, it might hurt him, it can throw off the electrolyte balance and processing the fluids puts extra work on the kidneys, and too much ( overhydration) isn't good, it can lead to other problems. I'd add extra water to food at this point. Maybe others will have a different opinion, but this one seems to me like a "if it ain't broke don't fix it" situation.

 

Ah, OK. I was thinking it might help him eat better. I read that dehydrated would be lethargic and not eating well, 2 things he's got going on. He used to love drinking water, and still does, but not as much as he used to (even before diabtes he was a HUGE water drinker).

 

No harm in checking with the vet, my guys definitely drink less water now that they are exclusively on a canned food diet. How's the litter box? Big pees or normal? I suspect the lethargy and lack of appetite may be due to something other than dehydration.

 

Yeah, I'm sure the lethargy and appetite issues are form the GI issues Pees are normalish. He's always had bigger then Ozzie. We have a water fountain, and he does drink quite a bit. He used to drink from the tub too, not anymore. Even with the Adequan he doesn't want to jump in and out as much.

 

Pretty soon we might need a diabetes/IBD/kidney board

 

Ok, talked a little with vet tech. I'm going to drop off his lab work to regular vet to have her take a look. Anyways, she brought something up that I hadn't though off. All of his meds could be raising the numbers. Adequan, Atopica, Cerenia, Ondansetron, Pepcid. I was told yesterday from IM vet to take him off of those last 3 meds to see what he does, but not because of his numbers. Also, dermatologist said to go to every other day for Atopica. Hopefully this is the reasons for him going up.

 

YOu keep using the word creatine when what I think you mean is creatinine, since creatinine is an indicator of kidney function. Do yo have the complete blood analysis results? If so what was total protein (TP)? since that is an indicator hydration.

 

I'm not an expert just have been trying to learn as much as possible about CKD in the past few months , BUN can change from one result to another within the normal range since can be influenced by the diet, cats with a high protein diet tend to have a little bit higher BUN also BUN can be affected by stress ( not as much like glucose but still) by infections specially kidney infection, ketones ( when this happens you will probably see a big increase not only a little change) . Creatinine can also be influenced by issues like pancreatitis, kidney infection, ketones or if your cat has lost a lot of weight lately.

Subqs are a great resource but only when it's really needed either because they are really dehydrated ( cats will dehydrate usually because some infection or illness like diarrhea or a lot of vomit other wise odds are he is not) or their creatinine level is over 3.5 ( to help the kidneys get rid of waste) which is not your case, because over hydrating a cat can also be dangerous and can even cause heart problems

 

Thanks for the tag, Christie

Sean...none of those meds will raise the BG unless they are either compounded and have sugar or other sweetener added to flavor them or unless they are liquid, from the vet, and have sugar. Generally, you would see the latter in an antibiotic but not cerenia, ondansetron, Pepcid, or adequan. Atopica is cyclosporine and does not raise the BG in studies conducted. You do need to keep an eye on liver values when you use cyclosporine.

I don’t know how she runs IDEXX labs in house. I’m not a fan of in-house labs unless it is an emergency. I also don’t understand why she didn’t do a urinalysis to check his urine specific gravity. A normal IDEXX lab panel will also include an SDMA which would give you a better idea whether he has early CKD or not.

It is unusual for the creatinine to vary that much unless, as I think Janet said, he has CKD that has progressed or a kidney infection. The latter can cause the creatinine to really jump. There are other conditions which can affect it as well but I certainly would not rule out that he has early CKD because 2.2 is not a normal number for creatinine unless he’s a large cat and that was always his baseline (larger, more muscular cats will have a higher creatinine). We can see from previous labs that this isn’t the case with him.

One simple thing you can do is catch the first pee of the morning and take it to your regular vet and ask her to check the urine specific gravity. The first pee should be the most concentrated. A free catch is fine for this. Your vet should have a refractometer and be able to do this. If his USG is less than 1.040, then he’s not concentrating his urine as he should be and, combined with a creatinine of 2.2, that would indicate to me he’s likely got early stage CKD. That could be verified next time you have labs done if you ask them to send the blood out to IDEXX so you can get the SDMA. I’d ask for a Superchem, CBC, urinalysis (IDEXX includes an SDMA with the Superchem).

If he potentially has IBD, it could be causing the nausea. I prefer to stay away from Pepcid except for occasional use because it stops all acid production and he needs acid to digest food. You can give slippery elm bark powder syrup to help with acid tummy. It also helps to feed several small meals and be sure he has access to something to eat overnight like freeze dried chicken breast or other single ingredient protein as that will help combat morning nausea.

If he does have CKD, that isn’t what’s causing his nausea at this time.

 

Sorry, for some reason I thought it was creatine and have been using that word since August and no one has corrected me until now. Oops. His total proerin was normal at 7.9. All of his lab work is in my SS now. Thanks

 

Ok, sounds good. The tech didn't think he needed them either according to his numbers from yesterday. Thanks

 

I'm getting different answers about this. 2 vets said it doesn't, but when I called Elanco the manufacturer, the guy told me "we haven't tested this product on diabetic cats, but we have had reports of raised BG numbers, and also reports of cases of cats becoming diabetic". Now, did they become diabetic because of the product, or just happened to become diabetic. I don't know. But he did say some cats do have increased BG.

That is what my normal vet's tech told me today. I was at the ER/IM specialist yesterday. When I inquired at regular vet she said they alsways get the SDMA number. I asked what it was last time, and it came back "unable to determine".??

Yeah, he has GI issues. She thinks its from food intolerance. We haven't done a biopsy. He was on pepcid and Ondansetron, and occasionally cerenia and still would not eat. The IM vet didn't want to introduce SEB yet, because we started on Atopica and she wanted didn't want influenced data. We (I) want to start probiotics too. He is actully free feeding now.

I'm wondering though if these meds are causing the higher creatineine. Obviously the kidneys have to work harder when on meds.

thanks for your input, greatly appreciated

 

I use SEB in one of my cyvies that has some stomach acid sometimes , for what I know it shouldn't interfiere or influence anything if you give it to him 1-2 hours apart from other meds and supplements

 

We just wanted to see if the Atopica alone would calm his tummy,that's why we didn't add the SEB or probiotics yet. Now that we are off pepcid and ondansetron, I'm going to try AVJ and SEB.

 

That isn’t the purpose of giving Atopica. It’s to control itching and rashes from dermatitis and allergies.

SEB should not interfere if given as Veronica indicates. I’ve been using it for 20 years and haven’t had any issues.

 

Rufus does have food allergies. He used to vomit for years, now he just gnaws and licks and bites. The Atopica is a 2 in 1 similar to Pred, in that it was help with both the itching and it will calm the GI "supposedly". I'm still waiting for the 2nd part, but supposedly it takes a few weeks for full effect.

 

Was just googling "meds that raise creatinine" and this was one of the first things that came up...

Cyclosporine
Cyclosporine can also cause elevated creatinine levels. The researchers concluded that even six months' use of cyclosporine at a maximum dosage of 10 mg/kg can lead to an irreversible loss of kidney function.

Well, I think I might have my answer to this then. Uuuughhhhh.