Diabetes and kidney disease

My vet called with Elvis' bloodwork, and said her kidney values are elevated now, to 3.9. How does that change how I handle her diabetes?

To recap: she's 18, was diagnosed Saturday with a bg of 525 after getting a steroid shot to treat possible IBD/chronic diarrhea/possible lymphoma, and is eating frequently but very tiny amounts as a time. (she's been waking me up every two hours at night for the past few days, wanting to be hand fed. I'm approaching zombie status.)
She eats watered down wet, & dry (I just ordered a bag of Dr Elsey dry low carb food, I hope she will eat it)
I plan to start home testing as soon as I get the strips for the alphatrak I have (that'll be tomorrow.) And I'm going to the vet tomorrow with her to learn how to give her fluids.

 

Hi and Welcome!

Take a big breath you are doing great given the circumstances.

Congratulations on planning to home test!!

2 units is a very high starting dose so is SUPER important that you test before shooting her specially since you are going to change her to a low carb food, and that you try and get some mid cycle ( a cycle is the 12 hour period between the insulin shoots) tests to monitor her.

I don't want to overwhelm you but with a high dose please read and even print if possible this stiky about hypoglicemia ( very low blood sugar levels )http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/ and this with some supplies that you shoud always have in case of a hypo episode http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

Regarding her kidneys problem there are quite a few of us that are dealing with both conditions so hang in there is possible, you did not mention what is the 3.9 value for I'm assuming is creatinine so you will definitely need to give her subcutaneous fluids (subq) I think the best approach is to deal with both conditions simultaneously because you want to get her diabetes under control ( on the long run a non control diabetes could make her kidney condition worse ) while taking care of the kidneys ( I know it sounds complicated but is not that hard after you settle down to a routine )

To do that you first need to look for a wet food that is low carb and also low phosphorus, or even add a phosphorus binder to her food ( you do not mention what her phosphorus level is ), do try and get her off any dry food is the best for both conditions, we use Dr. Lisa's list wich is awsome try to find one that is 10% or less in carbs and under 200 but the lower the better in phosphorus (http://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf)

Also if you can get a time feeder that you can program to open every number of hours during the night so that you can grab some sleep

After you've gone through all of this if your head is not spining already this is the link to the Lantus forum where you will find a lot of infomation about the insulin you will be using and a lot of very experienced people that can help you http://www.felinediabetes.com/FDMB/forums/lantus-glargine-levemir-detemir.9/

One more thing regarding CKD (Cronic kidney disease ) I think this is one of the best information web sites http://www.felinecrf.org/how_bad_is_it.htm

But more importantly keep asking as much as you need we've been where you are and we will try and help you in any way we can

 

If you can get a copy of her labs and post them that would be great. You will want a low carb (under 10 percent)/low phosphorus food (under 250 phosphorus). Glad you are starting sub q's. That will help your cat be much more comfortable.

Depending on the current phosphorus levels you may want to also add a phosphorous binder to the food (Aluminum hydroxide).

 

Thanks... The vet said 3.9 but didn't say what that meant exactly. I'll have to ask about the phosphorus level.
And yes my head is spinning!

Thanks, this is a lot, but it helps to be able to ask questions