Insulin and kidney disease?

Hello,

I'm dividing up this post because it was rejected the first time.

I haven't posted an introduction or made a signature yet because I'm not sure this is the forum I should be on, but my cat, Trixie, isn't doing so well so I wanted to post a question.

Back in May, she had lost a lot of weight and was constantly hungry. The vet said her glucose was too high (it was around 220) so he put her on insulin and we changed her to a low-carb diet. She started putting on weight and was doing much better. But I had concerns that her glucose wasn't that high, so I started home testing her and found it to be in the 60s on one glucometer and around 100 on another in the morning before the insulin shot and before eating. I stopped giving her insulin because it seemed unsafe with those readings. The vet that I had been taking her to had botched an achilles tendon surgery on her three times, so I no longer trusted him and went to a new vet when Trixie's respiratory rate was too high.

 

Here's the second part:

The new vet agreed that her glucose wasn't high enough to be considered diabetes. She did some blood and urine testing and said she doesn't need the insulin, but her B.U.N level was high so it's kidney disease. She put her on blood pressure medication and daily fish oil, as well as renal support food.

So now Trixie's health seems to be declining again. She's lost a lot of weight again, even though she wants to eat all the time. So my question is should I just put her back on a low dose of insulin even though her numbers aren't that high? When the vet tested her a few days after I had stopped giving her insulin, her glucose level was about 123.

 

She sounds diet controlled.... Was the 123 on a human or pet meter? On a human meter is the high end of normal, on a pet meter it's a normal number.

Can you post the most recent labs? What was the bun and creatnine?

She shouldn't be on Renal food unless she's stage 4 kidney failure. It's high in carb and too low in protien. Long term it will lead to muscle wasting. What you want is a food under 10 percent carb (under 7 is even better) and under 250 phosphorus. Tiki Cat is a good choice. I have a food list in my signature.

 

Thanks for your reply! The 123 was measured by the vet when they did the blood draw, so I'm not sure how she did it. I asked the vet twice if glucose was an issue, and she believes it's not.

Here are the labs. I'm in Mexico so it's in Spanish, but many of them are the same:
ALB 3.2 g/dl
ALP 18 u/l
ALT 50 u/l
AMY 1063 u/l
TBIL 0.3 mg/dl
BUN 38+ mg/dl
CA 11.1 mg/dl
FOS (phosphorus) 5.2 mg/dl
CRE 2.1 mg/dl
GLU 123 mg/dl
NA+ 149 mmol/l
K+ 4.3 mmol/l
TP 7.8 g/dl
GLOB 4.6 g/dl
T4 2.0 ug/dl
COL 99 mg/dl

Urine:
density: 1034
pH: 6
proteins: positive
ketones and everything else: negative

I forgot to mention that she's 12 years old.

I haven't fed her very much renal diet food because it's almost impossible to find here, so maybe that's a good thing. The only brands available here are some Royal Canin, some Hill's, and the usual brands you find in a grocery store.

 

Then the 123 is a pet meter and perfectly normal number.

Looks like stage 2 ckd.... But really not terrible yet. The phosphorus is a little high. High phosphorus can make ckd progress quicker and can make them feel a bit yucky. So check the food list in my signature and find low carb low phosphorus food. Add a little extra water to the food. Skip the renal diet. Not good at this level.

There's a really good group on Facebook for ckd called Cats with Chronic Renal Failure.

 

You said they put her on bp medicine. Did they do a protienuria test? What did they put her on, Benezapril? Did she do a bp test? (The cuff on the leg?) if so what was the blood pressure?

 

Thanks, JanetNJ. I'll check out the CKD Facebook group. Trixie didn't like the few cans of renal diet food I could find anyway, so this is good news.

They didn't do a proteinuria test - I didn't even know what that was so I asked why those lines were blank on her results, and the vet said those tests are done for different reasons. Maybe that's a next step?

They put her on Amlodipine. I don't remember them doing a bp test, but it's possible. I don't have a record of it. I can say her respiratory rate has calmed down since she went on that medicine. The vet wants to do more bloodwork in about a week, so I'll make sure they check her bp.

 

Ask her what the BP number was. That's something you'll want them to recheck when you go back. It would be odd to put her on amlodipine without it. I had a ckd cat on both Benezapril and amlodipine. My cat had VERY high bp... 230. He's lucky he didn't go blind or have a stroke. Retested after starting the amlodipine and it was still high at 180. Doubled the meds and was finally 130.

The protienuria tests looks to see if there's protien on the urine. I see your cat tested positive so I'm surprised she didn't order the test.

 

Okay, I will ask about that. Things are done very differently here in Mexico. Most people can't afford vet care at all, so I think they assume you want the minimal care to get by. The previous vet I worked with never gave me any numbers at all - he just put her on insulin and said come back in a month.

Thanks so much for your advice!