Early stage kidney disease

My 12 yr old cat Nosium is 2 yrs into diabetes and now maybe kidney disease. He was having trouble eating so I brought him in to check his teeth. One looks bad so my vet wants to clean his teeth and see if he can save it. He said he has to give him a rabies shot by law. Nosium hasn’t been acting normal for about 6wks maybe. And I’m concerned about the shot. Does anyone here know of a reason I shouldn’t do it? Also, he had his bloodwork done which leads them to believe he has kidney disease. I unfortunately changed his food about 2 months ago and didn’t realize how high the phosphorus was until now. I’ve since switched him to Tiki and Weruva low ph’s. My vet gave me Hills prescription which made his bg’s go through the roof. When I told my vet this he said it’s still better for him and we’ll up his insuline. He’s on Lantus glargine 2 shots of 6 units each. Only 2 months ago he was was on 4 units. Then my vet said he would prefer him on the Hills kibble and that’s when I lost it. I told him I thought kibble wasn’t good for cats. Nosium gained a lot of weight from it and now has diabetes and my other cat kept getting UTI’s. And then he said kibble is better for their teeth and weight. I couldn’t believe he said that. So I’m wondering if a rabies shot on Nosium at this stage would be harmful. I do want his teeth cleaned and tooth fixed. I think he started to go downhill when I changed his food and when his tooth got bad. Any help would be greatly appreciated. I have attached his blood work. Thank you so much

 

Welcome Traceylee and Nosium. You have some very valid questions and issues that FDMB members will have thoughts and comments on.
Let's get the basic housekeeping done so that members can see Nosium's information and BG data before they offer advice.
Please create a signature that will display kitty's pertinent info with each of your posts.
1. Set up your signature (light grey text under a post). Here's how:
click on your name in the upper right corner of this page
click on "signature" in the menu that drops down
type the following in the box that opens: kitty's name/age/date of diabetes diagnosis/insulin you're using /glucose meter you're using/what (s)he eats/any other meds or health issues (s)he has.
2. Another thing that will help us help you now if you've started BG testing at home is to set up a spreadsheet like the one we use here. We can all see it and look at it before offering advice:
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/
This Introduction forum is only the welcome mat and I would like you to post in the Main Health forum so that more members can see and respond to these important issues: HERE
If you like, you can just copy your message here, begin a new thread there and paste.
There are many knowledgeable and experienced members here that will be able to begin addressing these concerns, and an entire community that supports you.
We all want to help you as you negotiate these troubled waters and do what's best for your fur baby.

 

Thank you so much for your help. I am testing at home and will gather my information. I’ll copy and paste to the main health forum. Thank you

 

I created a spreadsheet but can’t manage to copy and paste it☹️

 

You don't have to copy and paste the spreadsheet to the forum, it is linked to your signature, but something is wrong. I'm going to tag a couple of ladies that know about the spreadsheet and see if they can help you out. @Marje and Gracie @Chris & China (GA)

 

Thank you so much. I have another question if you don’t mind. Nosium didn’t feel well enough to have his 8:00 meal which is when I would give him his second insulin shot. He’s high but if he doesn’t eat then I don’t think I can give him insulin. Does that sound right? Or if he’s high I should anyway?

 

You don't have the link imbedded in your signature correctly. Sending a PM

If you know he WILL eat in the next few hours, it's OK to go ahead and shoot. With Lantus, each shot doesn't usually start to "kick in" for 2-3 hours, so while it's not necessary that he eats before the shot, it's important that you're pretty sure he's WILLING to eat over the next few hours (or you can assist feed him if necessary)

 

Okay good to know. Thank you so much. I truly appreciate everyone’s help.

 

I'm afraid that your vet is misinformed in this respect, diabetes takes precedence, diabetes is very hard on the kidneys and high BG (above the renal threshold) are only going to aggravate the ckd, I would not feed the Hills CKD Rx food as it's too high in carbs, look for the lowest P foods you can feed that are also low in carb and if you need to you can add a phosphorus binder. My George has early CKD and this has been my approach, I haven't needed to use phosphorous binders but his kidney values have improved since I made the switch to lower P food.

The extract below is form https://www.felinecrf.org/diabetes.htm its a great resource for info on all things CKD related.

Diet for Cats with Diabetes and CKD

If you are dealing with both diabetes and CKD, it is more important that the diabetes should be regulated, and in fact once this is achieved, you may find the CKD improves too.



With diabetes, the focus is on carbohydrate control (see above). This is not a problem for CKD cats but people dealing with both diabetes and CKD are sometimes anxious because it appears that the protein requirements of the two conditions are incompatible. In fact reduced protein is not necessarily essential in the treatment of CKD in the early stages, see Nutritional Requirements for more information.



Even if your cat's CKD is more advanced,Keys to management of diabetes in cats(2011) Little S Presentation to the 36th World Small Animal Veterinary Association World Congress states "Current recommendations support the use of a high protein (> 30% DM), low carbohydrate (< 40% DM) diet for management of feline diabetes." A protein level of 28-35% DMA is often recommended for CKD cats so I would aim for a protein level of around 35% DMA for a cat with both conditions if your vet agrees.



The need to moderate phosphorus intake for CKD cats still applies to cats with both CKD and diabetes.Phosphorus levels are usually given in % DMA values for CKD cats (e.g. 0.5% phosphorus on a DMA basis), whereas phosphorus levels are sometimes given in mg per 100 calories for diabetic cats (e.g. 250mg/100 cals). Understandably, many people find it confusing trying to decide if a food is suitable for a cat with both CKD and diabetes. The simplest thing is to aim to feed a food with less than 10% carbs (ME) and as low a protein and phosphorus level as your cat will eat. If necessary, add phosphorus binders.



One of Tanya's CKD Support Group members, April, has kindly created a short list of US cat food with less than 10% carbs (ME) and below 1% phosphorus (DMA). You can find the document here. I have not checked this in any way.

 

Thank you for all this information. I go shopping for cat food every other day depending on what I've learned thanks to people like you and others that have helped me. I'm seeing a different vet tomorrow so hopefully she can be of more assistance. I have a copy of the catinfo composition and the numbers are different in the Soulistic category than the one above (Tanya's support group) So I'm not sure which one is correct. Thank you for all your help

 

I'm sorry I can't help more with the food choices, I'm in europe so we have different foods.
You could ask the question on a new post perhaps, if you make it the thread title you'll be able to get response from folk who are dealing with both, there are many of us trying to manage both conditions. I think some of the foods on Tanyas site are out of date, and are due to be updated.
Have you come across the sortable list you can put in the P content you want and it will come up with list of options. With CKD you want to look at good quality protein in the food.
Here's the link http://catinfo.org/chart/index.php

 

Okay I'll check out the list. Thank you.

 

Nosium has been at the new vets all day. She doesn't think his tooth looks that bad. She wants to hold off on the cleaning until we can get him feeling better. She may want to put him in the hospital for a few days. She is calling a specialist and will get back to me. I like the fact that cleaning his teeth wasn't her top priority. She of course mentioned prescription diets. I've read that people that feed a raw diet see a significant turnaround in their pet. I see on chewy raw-freeze dried. Does anyone know about these foods? Is this what they mean by raw? I know there's directions on how to make and feed raw at home but I don't know if I can do that. Any help would be appreciated. Thank you as always.

 

I've no ecpexperie with the goods you're asking about, why no change the title of the thread, asking for advice on raw diet and chewys freeze dried, use the ? Prefix too.
You can edit the title by selecting thread tools then select edit title.

 

I think it would be a good idea to take the new question about raw diets, and low carb/low phosphorus diets in general, to the Main Forum, get more eyeballs on the subject. There are great alternatives to the prescription diets you get at the vet, better ingredients and much less expensive. Just start a new thread there, as this Introduction forum is mainly just to say Hello getting started.

 

Buddy, my diabetic cat has not had a rabies shot since he became diabetic, on the advice of his vet.