Need help reading labs!

Discussion in 'Feline Health - (The Main Forum)' started by Kathryn & Nugget, Jul 2, 2018.

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  1. Kathryn & Nugget

    Kathryn & Nugget Member

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    Hi everyone,

    I just attached screenshots of Nugget's labs to her spreadsheet (on the JUNE/JULY LABS tab).

    I need some help reading/understanding.

    Basically my dilemma is that the vet today strongly recommended a blood transfusion to treat anemia brought on by kidney failure.

    He also told me that her diabetes is now second to kidney failure and that I need to address anemia quickly, or we run the disk of further irreversible consequences.

    I am quite frightened (and have been for the last 10 days), and I am feeling lost. I thought I finally had a handle on the diabetes, and now there's this whole kidney world that I am overwhelmed by.

    Just looking for some advice, if anyone has been in the same place, or has experience reading labs, specifically in regards to anemia. I know HCT is hematocrit and Hb is hemoglobin and those are the important ones to look at in dealing with the anemia.

    Thanks in advance.
     
  2. JanetNJ

    JanetNJ Well-Known Member

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    I can't see any info under the june/July tab
     
  3. JanetNJ

    JanetNJ Well-Known Member

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    Under the regular lab tab I see some values. Looks like he's stage 4... Are you doing sub q's at home? I don't see the hct levels listed
     
  4. Kathryn & Nugget

    Kathryn & Nugget Member

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    They are all images of the labs- I don't know how to read them so I didn't want to start typing in numbers unless I was sure. I was just on the June/July tab, maybe that's why you couldn't see them? I closed out my spreadsheet just in case.
     
  5. JanetNJ

    JanetNJ Well-Known Member

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    Still can't see them. Maybe because I'm on a phone not computer. This is what it looks like. FF786E5C-A03F-4D56-B625-36DF28F25AC2.png
     
  6. Kathryn & Nugget

    Kathryn & Nugget Member

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    Odd.. I just tried to fix it and I think I made it worse. Oops.
     
  7. Veronica & Babu-chiri

    Veronica & Babu-chiri Well-Known Member

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    Thing is when you are adding the photo is adding a link not the actual photo and since we do not have access to your computer all we see is a broken link try just adding the photos to your post here in the tread or if you want to insert them in the spreadsheet you will have to use the paste special feature and paste them as an image
     
  8. Kathryn & Nugget

    Kathryn & Nugget Member

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    I used the insert function on Google Sheets to ensure they were in there properly, but for whatever reason it’s not working. I can try to upload them here as images.
     
  9. Kathryn & Nugget

    Kathryn & Nugget Member

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    Here are results from first animal hospital.
     

    Attached Files:

  10. Noah & me (GA)

    Noah & me (GA) Well-Known Member

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    It looks like you have everything on paper to begin with, is that correct?
    Did anyone sit down with you and prioritize the results? There must be some that are inconsequential right at this time.
    Can we upload a single page from Excel here? Not sure how that would appear on the screen.
    When CJ was borderline anemic we got a lot of help from Google, fewer pop-ups and holistic mish-mash.
    For Kathryn and Nugget. I don't want to clog up the thread.
    Find your priorities. If Nugget's diabetes is under control for now focus on the rest and know that more help is coming with subQ's, diet etc. Big hugs :bighug:
    ...it's okay to cry as long as you remember we're all here. Eat right and try and get some solid sleep for yourself and Nugget. :)
     
  11. Veronica & Babu-chiri

    Veronica & Babu-chiri Well-Known Member

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    In this results it does not appear the creatinine, BUN or SMDA how are they determining the kidney failure?

    I'm not an expert but his electrolytes (sodium, calcium, potassium and chloride )do seem a little bit off but not terribly off is he getting IV fluids? If so what kind of fluids getting a lot of fluids can lower this numbers

    I hope someone with a little bit more expertise in blood labs jumps in
     
  12. Kathryn & Nugget

    Kathryn & Nugget Member

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    B8119B0B-57C6-4444-A580-BC9E28EB113F.jpeg 654D1177-3D44-49CB-BC7D-508EF48B6254.jpeg
     

    Attached Files:

  13. Kathryn & Nugget

    Kathryn & Nugget Member

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  14. Kathryn & Nugget

    Kathryn & Nugget Member

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  15. Kathryn & Nugget

    Kathryn & Nugget Member

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    She was on IV fluids 6/23-6/26, and then sub q at home, 100 ml, every day since then
     
  16. Kathryn & Nugget

    Kathryn & Nugget Member

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    Not being he has really sat down with me to explain, save for BUN and creatinine. They tell me she’s anemic, but not how bad it is, but apparently bad enough for a transfusion.

    I am crying for sure. I wonder when it will stop. I look at her, I cry. I go to sleep, I cry. I wake up, I cry. I feed her, I cry. It’s tough.

    The diabetes is sort of under control- it’s been hard because if she isn’t eating I am afraid to give her insulin. I don’t give her insulin, and BG shoots up.
     
  17. Kathryn & Nugget

    Kathryn & Nugget Member

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    That should have said No one has really sat down... sorry. I’m on my phone rather than computer, and the one drink I’ve had to try and mellow out (my deceased father’s bday is tomorrow, talk about emotional crap) is going right to my head.
     
  18. Veronica & Babu-chiri

    Veronica & Babu-chiri Well-Known Member

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    You are not alone we are here for you

    Doing transfusions is not something they can do easily were I live so vets down here have to take a maybe not so good approach to this problems down here and since he's at home getting subq we would probably try giving her b complex in the subq and probably some additional b12 methycolbalamine orally plus some other supplements including iron for a few days

    This is just a thought for you to consider and also I would ask them to explain to me in detail what are the numbers they are using to give their assessment before taking any decisión
     
  19. Kathryn & Nugget

    Kathryn & Nugget Member

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    Do you think the vet at the hospital recommended the transfusion because it nets a nice profit for them? Or because he really thinks she needs it?

    I have seen 7 vets since March- everyone tells me something different. I don’t know who to trust anymore... and I know vets are not like human medical doctors. But I should be able to find someone I trust.
     
  20. Harley Baby & Michele

    Harley Baby & Michele Member

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  21. Harley Baby & Michele

    Harley Baby & Michele Member

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  22. Veronica & Babu-chiri

    Veronica & Babu-chiri Well-Known Member

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    As I said I'm far from an expert but
     
  23. Veronica & Babu-chiri

    Veronica & Babu-chiri Well-Known Member

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    Sorry I'm at my phone so I gave send by mistake

    I'm not expert but none of his values seem terribly off and sometimes is not so much for profit but the easiest way so they do not consider other options.

    Ask them if they couldn't do a transfusion (that's what happens here ) what would be the course of action
     
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  24. Noah & me (GA)

    Noah & me (GA) Well-Known Member

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    Kathryn, I thought it would be much easier to find a single sight that would explain blood panels, it's not.
    You might see "CBC" in some searches, it means "complete blood count".
    Wikihow wants me to download something, sounds sketchy, lots of pop-ups etc.
    This is the best of what I looked through;
    All feline hospital...Does not go into numerical values but does explain what each component does.
    http://www.allfelinehospital.com/blood-work-explanation.pml
    PetMD...A super slow sight, lots of ads. If you scroll to the bottom and click Next it goes to a different topic.
    I have found PetMD helpful in really specific areas.
    https://www.petmd.com/blogs/thedail...y-tests-tell-you-about-your-cats-health-30777#
    This is PetMD's home page.
    https://www.petmd.com/
    If you're like me, a real visual learner I have to print things out and sit down with a hi-liter and post-it notes. If I click your profile now I'll lose all the above. Do you live in Ontario?
    Post 13 and 14 showed up very well. That's all I have for now Kathryn. :bighug:
     
  25. Christie & Maverick

    Christie & Maverick Well-Known Member

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    Specifically regarding anemia, there are two types, regenerative and non-regenerative. See link here for more info:

    https://www.felinecrf.org/anaemia.htm

    To me, an HCT value of 23 isn't great, but it's certainly not time for blood transfusion. My recollection is when HCT numbers get under 20, you can try Erythropoiesis Stimulating Agents (ESAs) first. For now I would suggest you try vitamin B supplements. Unfortunately, I can't share much there, my kitty with CRF and anemia dropped very quickly and I needed to go straight to Epogen, one of the types of ESAs.

    There is a lot of other info on kidney disease in cats and you'll find info also on types of vitamin B supplements, at the website I referred you to...www.felinecfr.org.

    I would definitely ask your vet about vitamin B, it can't hurt, some kitties improve with just the supplement.

    BUN and creatinine are quite high in the latest labs. I see you have previous lab results in your SS, but with the new lab values, they will have different ranges than IDEXX, so don't compare the values, you need to refer back to the new lab ranges instead. That said, just a thought, any chance Nugget ate something toxic? That might spike kidney function values, I can't compare March 1st with June 26th, those Nova CXX ranges seem strange to me, not that I'm an expert, just have a bit of experience with my own kitties over the years.
     
  26. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    A HCT of 24 shows your cat is anemic but not at the point that a transfusion is necessary. If it drops much more it would be time for epogen or Aranesp injections which you can do at home. Are you familiar with tanyascrf.org? It explains everything about kidney disease and how to treat conditions caused by it. With the high creatinine and BUN I wouldn’t be surprised if B vitamins and injections are needed. There’s lot you can do.

    Start by reading this:

    http://www.felinecrf.org/anaemia.htm

    I had a cat with levels off the chart and she also had intestinal lymphoma. I used Tanya’s as a guide and she lived nearly a year of quality time before the cancer killed her, not the kidney disease.
     
    Last edited: Jul 3, 2018
  27. JanetNJ

    JanetNJ Well-Known Member

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    BTW, Tanya has a book version of her website that you can get on amazon. I know sometimes it's easier to read a hard copy when there's a lot of information.
     
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  28. Noah & me (GA)

    Noah & me (GA) Well-Known Member

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    Lots of cats with recurring UTI fare much better long term with water fountains / cleaner water. Just a thought so Nugget's situation doesn't get any more complicated.
    This is from a drop down list in Google;
    Is my cat in pain with kidney failure?
    Although kidney failure itself may not be painful some symptoms do cause pain and discomfort. Nausea, gagging at the sight or smell of food, constipation and stomach irritation.
    I have transdermal BUPE for Noah and have given it with a vet's blessing to my other cats with UTI or constipation. It just helps them not be so miserable.
     
  29. Noah & me (GA)

    Noah & me (GA) Well-Known Member

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    @Ana and Frosty
    Can you make sense of reading the blood work results posted above?
    Ana is a brain surgeon everyone, she's just too modest to say so. :rolleyes:
     
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  30. Ana & Frosty (GA)

    Ana & Frosty (GA) Well-Known Member

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    Lmao. I’m not even A surgeon... I’m just the assistant haha

    Let me catch up on all the posts first, as it’s a lot to read. Upon quick skim, it looks like they were doing a blood gas, rather than a normal metabolic panel and complete blood count . In humans, electrolyte values are calculated on a blood gas, rather than reflect an actual number (a close estimation, but not 100% accurate). I don’t know if that’s the same for animals. Perhaps @Janine & Floyd could weigh in? (She’s an actual vet).

    I’ll look at it further and let you know what I think it all means.
     
  31. Noah & me (GA)

    Noah & me (GA) Well-Known Member

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    The doctor will see you now Nugget, tuck your shirt in.
    Thank you Ana.
     
  32. Kathryn & Nugget

    Kathryn & Nugget Member

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    I called the hospital yesterday, but the receptionist said the doctor we are seeing was in the middle of an absolute emergency and that he probably wouldn't be able to get back to me yesterday. Today is a holiday, so hopefully I get an answer tomorrow.
     
  33. Kathryn & Nugget

    Kathryn & Nugget Member

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    Good to know that I shouldn't compare the IDEXX to the Nova.

    The hospital vet said that the ESAs are FAR more expensive than the transfusions, and that they don't always have success, in fact, some ESAs will kill cats. The more I think about this, the more I think maybe he was trying to scare me into a transfusion as the only option.

    You know not one vet has asked if she could have eaten something toxic. The only thing I can thing of is that I caught her drinking out of the bathroom toilet- and I had one of those lysol bulbs on the side of the bowl to help with cleaning. I don't have any toxic plants in the house, she has no access to cleaning chemicals.
     
  34. Kathryn & Nugget

    Kathryn & Nugget Member

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    Thank you for the links... I am going to read them now. I think the hardest part of understanding the labs was knowing what all the "codes" mean. Obviously some I can figure out, but some I just don't know. I have a file folder with all her labs, receipts, etc. so I have been taking notes on everything I am reading. Nope, not Ontario, we are in NYC.
     
  35. Kathryn & Nugget

    Kathryn & Nugget Member

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    I've been reading everything on Tanya's website- she's amassed quite a bit of quality information. Just a lot to read and understand.

    The vet said the injections would be far more expensive and dangerous than the transfusion, and the more I research, the more I see conflicting information that contradicts the vet's information.
     
  36. Ana & Frosty (GA)

    Ana & Frosty (GA) Well-Known Member

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    Sorry guys, I meant to go to the pool and read all of this, but instead I fell asleep and just woke up.
    I read through this and I understand what's going on. Major disclaimer though - I am not a vet, I take care of human patients, so this is just basically explanation of values. I cannot give you advice on what to do with your cat. I will tell you what I know of a cat who got a blood transfusion though at the end.

    So like I said before, these are blood gasses - not sure if they're arterial or venous, but these are usually taken when a human patient is in the ICU, or sometimes for a faster set of results. That's why they look different than regular labs, and can seem confusing.
    So first, I am going to explain the meaning of each set of labs from 6/24-6/26 and summarize what I think is going on based on these labs. I'll try to explain it the best I can.

    So on 6/24, I see that his Ph is lower than normal. meaning his blood is slightly acidic. I also see that CO2 is low, which is an acid, which means that his body is trying to compensate for a low acidity. Bicarb (HCO3) is at the low end of normal, which is due to kidney failure, probably causing the low pH. (It is low after fluids are given, so it may be falsely elevated here? not sure). I think this is uncompensated metabolic acidosis. His sugar is also 150, so there's probably no ketones present. His oxygen saturation is 94%, which is OK. His Hemoglobin is 9. and hematocrit is 27. That is lower than the reference range, which could also be due to kidney failure - kidneys produce erythropoietin, which makes red blood cells (RBCs), and when they are not functioning well, they produce less of it. His potassium is also low on those labs, but other electrolytes are OK. This may be due to insulin administration, as it tends to drive potassium into the cells. Not too concerned about that, would be more concerned if it was high, as kidneys excrete potassium. BUN and Cr are pretty high, 118/8.4, but bear in mind that the cat's normal range is higher than that of a human, so it might look higher to me than it actually is.

    6/25. His pH on this set of labs is still low, so he is still in metabolic acidosis. CO2 is at the low end of normal, so it is still not compensated. HCO3 is still at the low end of normal, which I think is causing the acidosis. After fluids were given, I see that H/H are even lower. This is probably due to dilution effect by the IV fluids, and 7.7 is pretty low for a human. I don't know what the threshold for a cat is for a transfusion, but for a human it's 7, if they are not actively bleeding.
    Magnesium is high on this set of labs, which may be due to decreased excretion from kidneys. BUN an Cr are lower than the day before, because of the fluids given. Oxygen saturation in blood is 96.9%, which is good.

    6/26 - so here we are still acidic with a lower CO2, and we see that bicarb is low at 14.7, and the body is trying to compensate for the low bicarb. his oxygen saturation on there is 88%, which is low. This is concerning, and could be due to a low H/H, or could just be variation in labs, since the previous 2 days O2 saturation was better. His hemoglobin is lowest here, 7.6/23, again lower because he was given fluids. BUN and Cr are lower too than before, due to fluids, although still higher than normal. So the fluids are working.

    As for question of whether to give a transfusion - again, I do not know the transfusion threshold for cats. Based on his labs, it does look like he has kidney failure that is starting to affect his electrolyte excretion, hemoglobin production, and will eventually cause his blood oxygen saturation to go too low. I realize the cost, but I personally would probably do the transfusion if it were my cat. My friend's "miracle" kitty that I posted about a few posts back (probably in the Cushing's forum), got multiple blood transfusions which saved her life. The way we found out she was anemic was that she started having seizures from the low oxygen in the blood. I think her hemoglobin was 5 something at that time. She had some kind of autoimmune bone marrow issue, and is now in remission on medication (after a $6,000 workup which included a bone marrow biopsy. We are seriously crazy cat ladies over here). Of course we do not want to wait til the hemoglobin is that low to give a transfusion to your kitty, so it would be worthwhile asking your vet, or a vet on here what their transfusion threshold is.

    Also, what was the reason the cat was in the hospital? What were his symptoms? Was he lethargic? Short of breath or tired with minimal activity? Those CAN be symptoms of anemia (but are not specific to it, either).

    I hope this helps a little bit. Let me know what questions you have!
     
    Last edited: Jul 4, 2018
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  37. Kathryn & Nugget

    Kathryn & Nugget Member

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    Thanks Ana, I appreciate it. Nugget did have a CBC drawn on June 23 that was sent out to a lab for processing. All the other labs have been in hospital labs that were literally processed in a half hour. Would a CBC and metabolic panel be worth running?
     
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  38. Ana & Frosty (GA)

    Ana & Frosty (GA) Well-Known Member

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    I wouldn't. I think this is giving us enough information, it's just in a different format. Blood gasses are ran much faster than the CBC and all the others, and can be done in house, which is probably why they did it. Hope my novel helps ;)
     
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  39. Veronica & Babu-chiri

    Veronica & Babu-chiri Well-Known Member

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    I may be out of line here but I think you need a doctor you can trust and that will at least get back to you when you need something

    You could in the mean time start giving her some B12 they did wonders for my cyvie ( non diabetic cat) when she was borderline anemic, this is the one I use https://www.vitacost.com/vitacost-vitamin-b-12-methylcobalamin-500-mcg-300-capsules this alone is going to help her a lot I give 250 mcg every 12 hours but given her numbers you could give her 1000 mcg ( that would be one capsule in the morning and one in the afteroon ) B12 is water soluble so what ever she doesn't use she will just get rid in the urine so is pretty safe to give ( you can just spread it on her food) and if she accepts you could give her some chicken harts pices in her food like in odd days , this will help her iron levels also with practically no risk
     
  40. Ana & Frosty (GA)

    Ana & Frosty (GA) Well-Known Member

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    This won't help. Anemia in kidney failure is caused by decreased erythropoetin production by the kidney, and has nothing to do with B12, folate, or even iron. Those stores are likely normal in the body. I would stay away from giving anything extra because the kidneys will have to excrete it, and the kidneys aren't functioning well. The last thing we want is vitamin toxicity.
     
  41. Kathryn & Nugget

    Kathryn & Nugget Member

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    Mar 4, 2018
    Hi Ana, WOW do you know a lot! Thank you times a million for taking the time to explain all of that to me. I knew that IV fluids could affect things, but I didn't really understand how.

    A quick recap of what landed us in the hospital:
    3/1- diagnosed with diabetes by a regular veterinary practice
    4/4- saw an internal medicine diabetic specialist at the AMC in NYC.
    5/26- went for follow up at AMC, and to do a fructosamine. That night she started acting very odd- super lethargic, not really interested in food, blood sugar spiked (at least it was a spike for her, I've since been told it wasn't really that high). Emailed the IM doctor, she said to keep an eye, there wasn't much to be done unless symptoms persisted. She also told me the fructosamine was low, and it was a sign we might be headed into diabetic remission, to reduce insulin to one unit once a day. Symptoms persisted for 72 hours and I noticed a huge increase in water intake, but chalked this up to higher than normal blood sugar.
    5/30-6/4- saw an improvement, less lethargic, better appetite.
    6/9- appetite starts to decrease again, lethargy increasing, and is disinterested in a lot- won't play, but will still greet us at the door.
    6/10- Something wasn't sitting right, so I made an appointment with a vet who only deals with cats.
    6/15- we visit said vet. He thinks it is a virus, possibly feline herpes, possibly something picked up at the AMC. He prescribes anti-viral and appetite stimulant, gives her cerenia injection and sub q fluids in office- he weighs her and she is down almost a pound in 2.5 weeks. Says keep an eye- doesn't recommend running labs.
    6/17- I call the vet and say I'm still worried, I don't see much improvement, and she's really struggling to eat. He says take her to ER if things get much worse, otherwise come back in.
    6/23- I bring her back to the vet. The look on his face immediately tells me that something is wrong. He says her kidneys are huge, she is dangerously dehydrated, does an x-ray, notes spots on kidneys that he thinks are stones, temperature and blood pressure are normal, says to go to another emergency hospital so they can do an ultrasound.
    6/23, one hour later- I get to the ER, and they take her in for what I thought was going to be in and out. They come back and say I cannot take her home, she must be admitted. Now I'm scared to death, so I let them admit her.
    6/23-6/24- communication is basically IMPOSSIBLE. I'm told no doctor has examined her, but that the ultrasound showed "obliterated kidneys" and a cyst in the liver. I drive into the city during the Pride Parade, have to park 5 avenues and 5 blocks away from the hospital because I can't get any closer due to street closures, I walk in, demand the cat be released, and then proceed to walk back to the car and drive to an animal hospital in Westchester.
    6/24- she is admitted for another 48 hours in the 2nd hosp, I get a lot more information and updates.
    6/26- I bring her home, with daily antibiotics, daily famotodine, daily cerenia and sub q fluids.
    6/27- We are back in the ER at 10PM because she was hypoglycemic. She gets two oral dextrose doses, and one IV dextrose. They want to keep her overnight, I say no (can't afford it).
    6/28- She urinates all over the couch. She stays outside for a little while with my boyfriend, he brings her in, she pees all over the kitchen floor. I relocate to sleeping on the floor in the office/cat room with her. She has a bout of diarrhea that night. I'm convinced I will wake up to a dead cat.
    6/29-7/2- some improvements (no more incontinence). Better appetite
    7/3- incontinent again, on the couch, in the morning while I was asleep on the couch. Clean up couch again. Has another episode of incontinence in the evening.
    7/4- appetite much better today- but still very lethargic. She is seeking my attention, wants to sit on my lap a lot.

    So there's that!
     
  42. Ana & Frosty (GA)

    Ana & Frosty (GA) Well-Known Member

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    Jan 19, 2018
    @Kathryn & Nugget , WOW, you guys have been through a lot! I'm really sorry you had to go through that :bighug:
    Where do you live? I lived in White Plains for 3 years. I used to take my (other) cats to the White Plains animal hospital, which I really liked. My family lives in Stamford, CT and they have "Just Cats" there which is also good. I know one NYC hospital, we took my friend's dog there when we were in PA school when he had a seizure. Unfortunately, turned out that his kidneys didn't develop normally (he was only 1 ) and he was in severe kidney failure, and we had to put him down. It was pretty traumatic. (She was here for school for AZ, she was 23 at the time and he was her only "family" here.)

    It's hard to tell what is causing the symptoms exactly because they are not specific to any particular illness. It could be the kidney failure and dehydration. I agree with what someone said before, to find a vet that you feel comfortable with and can communicate easily with, and formulate a plan. The incontinence can be due to kidney issues, but at least she is peeing and pooping, which is a good thing I think. Are you continuing to give her fluids? I can't pretend to know much about kidney issues in cats (I'm a PA in general/colorectal surgery, so not even a kidney expert by any means). So I think the best thing would be to find a more affordable place where you can trust and communicate better with the vets.

    I know transfusions are expensive. Did they give you a quote? Is it totally unaffordable?

    I really hope things get better for you guys. Hugs!
     
  43. Kathryn & Nugget

    Kathryn & Nugget Member

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    Mar 4, 2018
    Without airing dirty laundry, I need help.

    I am scheduled to visit my grandma, out of state, for a week. Date of departure is less than a week away.

    My SO (who won't be my SO should I go on this trip), is emotionally and physically unable to give her the fluids or medications.
    He does not want me to bring Nugget with me.
    He wants me to postpone the trip. He says I am SELFISH for going to see my grandma.

    If I postpone, then when it comes up again, he will still be unable to give fluids, and the vicious circle will continue. He is not understanding the importance of these fluids.

    I do not know what to do. There is so much arguing over this. I know I am not selfish... if I was, I wouldn't have done everything I could for this fur baby- he was in denial even about the diabetes- I took the cat by myself to a vet to see what was going on.

    If he can't see everything that I have sacrificed and continue to sacrifice, I can't continue like this. What should I do? I want to go on my trip. I miss my grandma very, very much, I don't get to see her often, and as we all known, we never get enough time with the ones we love.

    He said if she dies and I am not here it is my fault. My heart is just broken. Damned if I do, damned if I don't.
     
  44. Kathryn & Nugget

    Kathryn & Nugget Member

    Joined:
    Mar 4, 2018
    We live in the Bronx. We've been going to the animal hospital in Yonkers. (Prior to that it was a cat vet in Manhattan, the IM vet at AMC, and then I saw three other vets- one in Eastchester, one in Mamaroneck and one in Tuckahoe). I am continuing to give fluids- its someone else who claims to love this cat who can't do it. The quote for the transfusion was $1100... if I have to, I can swing it, it just won't be easy. I'm already in over $6k since March (plus what he spent, another $2000+).

    I appreciate the hug... I need them pretty often these days.
     
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  45. Ana & Frosty (GA)

    Ana & Frosty (GA) Well-Known Member

    Joined:
    Jan 19, 2018
    I am sorry your SO is not supportive. Sometimes, when animals and/or family members are sick or are in need of our attention, it creates strain on relationships, and people do/say stupid things. Sounds like it might be one of those situations (on his part, not yours).

    I think you need to go see your grandma. Can you get a pet sitter or someone who can administer fluids to the cat? We used "next door neighborhood" website/app to find our pet sitter, and now she introduced us to another one - a backup when she is not available. I am thrilled to have 2 pet sitters so I can go away and live my life.

    Also, where do you live? Seems like it might be close to me.
     
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  46. Ana & Frosty (GA)

    Ana & Frosty (GA) Well-Known Member

    Joined:
    Jan 19, 2018
    I went to Mercy College in the Bronx for PA school! Lots of fond memories. <3
     
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  47. Kathryn & Nugget

    Kathryn & Nugget Member

    Joined:
    Mar 4, 2018
    We are definitely close by- I am about 15 minutes away from Mercy.

    Unfortunately I don't have anyone who can administer the fluids and meds. I just wish he could step up and figure it out... even if he gives 150 ML every other day instead of 100 every day- it would only be Wednesday, Thursday, Friday, Saturday, Sunday, Monday... and if every other day Thursday, Saturday and Monday.

    I told him it was selfish of him to expect me to handle all of this on my own- I can give fluids without his help, and if I had to, I could give meds without his help. I definitely need to see my grandma. And sooner, rather than later, while the cat is as stable as she has been.
     
    Ana & Frosty (GA) likes this.
  48. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Did you start the b12 methylcobalamin yet? You can get them at a pharmacy, grocery store or vitamin shop
     
  49. Kathryn & Nugget

    Kathryn & Nugget Member

    Joined:
    Mar 4, 2018
    Ordered some from Amazon, won't get here until Friday.
     
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  50. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Oh ok... That's not bad
     
  51. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    The injections aren’t dangerous and are less expensive than transfusions from what I’ve seen. Aranesp has a much lower chance of cats building antibodies and if it happens you can transfuse. Walmart Soecialty Pharmacy was the go to place to buy it when my cat was anemic. She was on epogen for 9 months and didn’t build antibodies. I’m not sure why your vet prefers transfusions. You only give a tiny injection. Epogen was three times a week but I think Aranesp is just once. You aren’t at the point of needing to start but could be if the B vitamins don’t help. I’d go see your grandma if I were you. Maybe a tech from the vet will come and give injections while you are gone. I know how hard it can be. My mom was losing her fight with heart disease the whole time Tiffany and Max needed me, in and out of the hospital but lived close by. :bighug:
     
  52. Noah & me (GA)

    Noah & me (GA) Well-Known Member

    Joined:
    Dec 3, 2016
    All hail Ana! ;)
    ana01.JPG She is wise
     
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  53. Noah & me (GA)

    Noah & me (GA) Well-Known Member

    Joined:
    Dec 3, 2016
    Oh Kathryn, sorry I didn't see this. I'm not the councilor here but isn't Nugget part of a package deal? :banghead: Big BIG hugs. :bighug:
     
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  54. Veronica & Babu-chiri

    Veronica & Babu-chiri Well-Known Member

    Joined:
    Aug 5, 2016
    Good hopefully they will help, I started noticing some improvement (better appetite, mobility ) with my cyvie about one week after I started giving it to her it has helped her a lot, she's stage 2-3 of CKD
     
  55. Larry and Kitties

    Larry and Kitties Well-Known Member

    Joined:
    Dec 28, 2009
    What I do not see is a value for phosphorus. Typically CKD cause phosphorous to be high and that results in the cat feeling bad and not eating much. Sometimes a low-phosphorous food is sufficient but sometimes a phosphorous binder like aluminium hydroxide added to the food is required./
     
  56. Kathryn & Nugget

    Kathryn & Nugget Member

    Joined:
    Mar 4, 2018
    She definitely is... and some days I don't know if he keeps me around because he can't take care of the cat, or because he doesn't actually want to get rid of me.

    I suppose no matter what the decision ends up being on his end, she is my Nugget and since I take care of her, I make the decisions.
     
  57. Kathryn & Nugget

    Kathryn & Nugget Member

    Joined:
    Mar 4, 2018
    Hi Larry, the labs that were sent out (I think called CBC) tested phosphorus and it was very high- 20.3
    The vet at the hospital told me not to change her diet because her appetite isn't great and its better for her to eat the diabetic dry food and regular wet food than it is for her to not eat at all.
     
  58. Kathryn & Nugget

    Kathryn & Nugget Member

    Joined:
    Mar 4, 2018
    I can definitely give an injection once a week if that is what will help. I am just concerned now about finding a vet who is knowledgeable and helpful. It is expensive to go to the hospital- and they won't see me regularly, just as a re-check this past week. To find a vet, explain everything that is going on, and ask about B vitamin shots, or giving it at home, plus the Aranesp or Epogen- a new vet is not going to know how much I know no matter how much I explain it.

    I want to see my grandma, I miss her so much, and she keeps telling my mom how excited she is that I am coming to visit her. I'm also prepared to give up basically all of my social life to be home to take care of her. That means no more visiting late at night with friends, no more happy hour on Fridays during the school year with my girlfriends, no more work parties, no more vacations... I am willing to give all of that up- but I need to have this upcoming week to spend time with my family.

    I am hoping my SO can pull it together to give fluids every other day- better than none, and it would mean he only has to do it 3 times. I
     
  59. Larry and Kitties

    Larry and Kitties Well-Known Member

    Joined:
    Dec 28, 2009
    The problem is that with a high phosphorous the cat wants to little if any. I would try a phosphorous binder. What I have done in the past was to mxi a little food with all the binder and then syringe feed that right after my cat all all they could. Also, be aware the a binder like aluminium hydroxide cause constipation and thus I add generic Mirlax to the syringe fed food.
     
  60. Kathryn & Nugget

    Kathryn & Nugget Member

    Joined:
    Mar 4, 2018
    Yikes constipation... she is already constipated. I am scared to syringe feed. I had to help my mom do that with her cat a few months ago and it was terrible. She fought us at every turn- she likely had kidney issues too.. unfortunately little Grey cat passed away shortly after. So just the sheer memory of it makes me nervous. The vet never mentioned anything about the phosphorus either. Just prescribed cerenia and mirtazapine to help with the appetite. I'm try to avoid giving those to her unless she needs it. Didn't give it last night, hoping to not have to give it tonight either. Right now we are sitting on the porch outside- been here for about 1.5 hours. It is hot, but not nearly as humid as the last few days. She sleeps mostly, but gets up every so often for water and a snack.
     
  61. Kathryn & Nugget

    Kathryn & Nugget Member

    Joined:
    Mar 4, 2018
    I am trying to stay outside with her. I am afraid to let her onto the furniture because she's already been incontinent three times on the couch. I also think its chilly in the house (thank goodness for central air), but I think the anemia is making her feel colder. When we are outside her nose is very pink, when we are inside its white!
     
  62. Noah & me (GA)

    Noah & me (GA) Well-Known Member

    Joined:
    Dec 3, 2016
    Sorry for going out of bounds last night Kathryn. I just take it for granted CJ and I see the world the same way.
    I was told a pink/pinker nose is a sign of increased blood flow. Sometimes that's stress but maybe Nugget perks up outside, just happy to be with you in the sun and grass. :)
     
  63. Kathryn & Nugget

    Kathryn & Nugget Member

    Joined:
    Mar 4, 2018
    You were not out of bounds!!! Believe me... I need all the advice and help I can get lately.

    She never used to want to be outside.. I used to literally drag her out lol. Now she waits by the door like a little duck. She is in her room right now- I can't keep both eyes on her at the moment and I'm afraid she will pee on the couch again (even though it is draped in plastic and two sheets and three towels folded in quarters to make 12 layers). I am a little hungry and need to make a quick snack, so hopefully she eats her snack and takes a nap because I do have to go out and run some errands.
     
  64. Veronica & Babu-chiri

    Veronica & Babu-chiri Well-Known Member

    Joined:
    Aug 5, 2016
    With phosphorus that high he needs a phosphorus binder probably even if you changed his diet ( this is probably one of the main reasons why he won't eat ) which could be a bad idea or not, funny how sometimes they tend to associate the food they were eating with the nausea so when you change it for a new one they get right into it.

    You can try and mix some phosphorus binder with his food, the one a lot of people use is aluminium hydroxide, which is for what I heard the most effective one, I use calcium carbonate but that is because there's no aluminium hydroxide available where I live

    I'm not sure if they have already given you the link to Tanya's web page, but is a great source of information for everything related with kidneys, there you can find some suggestions on how to use phosphorus binders, where to buy it and doses, what can you do to help with constipation (is quite common in CKD cats )and a lot of other things that will probably help you (http://www.felinecrf.org/how_bad_is_it.htm)

    For mild constipation I use Slippery Elm bark (In Tanya's web page you can find information on this one too)

    Still one thing is true she has to eat somehow, because not eating is very dangerous and as bad as it may seem syringe feeding is not that bad past the first couple of times you just have to find the right consistency on the food you are using for it not to be to liquid so that you don't get a big mess or too solid that it won't pass through the syringe and try and give him just a little bit at a time ( about 2-3 ml) also try and syringe some water to her (just not at the same time)
     
    Last edited: Jul 5, 2018
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