Renal failure

Discussion in 'Feline Health - (The Main Forum)' started by Zoey & Carol, Dec 29, 2017.

  1. Zoey & Carol

    Zoey & Carol Member

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    Jan 4, 2015
    Zoey is probably in renal failure. We're been out of town and someone has been taking care of her. She quit eating and was very lethargic so my vet came and got her and ran some tests. He just called and said it looks like she's in renal failure. We are stuck in Washington state because of weather and bad roads and I can't get home to her for maybe another day or two. The vet said he could give her fluids and she might bounce back. She doesn't seem to be in pain so I asked him to keep her and do what he can until I get back. Is there any hope that she will get better or am I just keeping her alive until I get home?
     
  2. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    BUMP!

    It might be very helpful if you can upload/ enter her latest Blood Work values in to the SS/ LAB tab - there are some to read it well.

    Vets are often go dramatic - the "failure" verdict might not be very accurate - or at least I hope so! (fingers crossed)

    Sorry, I have no experience but wanted to bump your post up!

    Hang in there!
    :bighug:
     
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  3. Tracey&Jones

    Tracey&Jones Well-Known Member

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    Dec 12, 2016
    I don't see a notation that she was already diagnosed CKD.

    Was this ever mentioned before on bloodwork?

    Fingers crossed that the situation is not as bad as the vet is stating.
     
  4. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    With treatment many cats can live quite a long time with Renal Failure provided there aren't underlying issues such as cancer. Lab reports would help us advise you. She's in good hands for now.
     
  5. Squeaky and KT (GA)

    Squeaky and KT (GA) Well-Known Member

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    Jul 19, 2011
    Dakota has been in 'renal failure' for about 2 1/2 years now...it can be managed for a long time. Labs will help you figure out what stage and what treatment needs to be at that point.

    Tanya's CRF site is a huge lifesaver - link for your convenience:

    http://www.felinecrf.org/

    HUGS!
     
  6. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Hi Carol,

    It is good that Zoey is under the care of your vet right now.

    Did the vet say if Zoey had ketones in her urine and/or blood?

    The following are general things that may or may not be helpful to you:

    * If a cat is badly dehydrated it can negatively impact kidney-related values. We've had reports here of cats whose vets said that they were in renal failure but kidney values improved a lot after the cats received fluid therapy (and possibly other appropriate treatments) at the vets.

    * A cat producing ketones can go on to develop diabetic ketoacidosis and the cat typically becomes inappetent. This is treatable in a hospital setting (fluids and specialist insulin therapy, electrolyte balancing, anti-nausea and appetite stimulant medications possibly with a period of assisted feeding or an e-tube until cat is stable and eating/drinking on its own again). More info on DKA in this forum sticky:

    Are you testing your cat for ketones?

    * If chronic/acute kidney problems are the cause of your cat's symptoms here is some information on 'crashing' from Tanya's Site (the go-to place on the web for cats with kidney disease - the whole site is a goldmine of information on symptoms and treatments that can really help CKD cats).

    http://www.felinecrf.org/symptoms.htm#crashing

    * Another common cause of feline inappetence is pancreatitis. Diagnosis is typically via blood test (SNAP fPL, if your vet offers it, can give an immediate Yes/No indication for pancreatic inflammation; Spec fPL needs to be sent to an external lab but it gives an indication of the severity of the inflammation), ultrasound, and relevant clinical signs. Again, there are treatments available for pancreatitis. Here are links to two resources which I found to be invaluable for nausea/inappetence and pancreatitis information:

    IDEXX Pancreatitis Treatment Guidelines

    Nausea and Inappetence - Symptoms and Treatments (from Tanya's Site)

    Note: I have no idea whether or not any of the above may be helpful to Zoey; just throwing out some things by way of brainstorming.

    Sending prayers and positive vibes that Zoey will respond well and quickly to the vet's treatment.

    :bighug:


    Mogs
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    Last edited: Dec 29, 2017
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  7. Myagi and Heidi

    Myagi and Heidi Member

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    Lots of hugs and prayers. Your baby is in good care for now. So please please breathe and when the roads clear, be very careful and safe. She'll need you, so make sure you breathe and take it easy and get to her ok. :bighug::bighug::bighug:
     
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  8. Zoey & Carol

    Zoey & Carol Member

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    Thank you all for the information and support. I don't have her labs yet because I'm not home. The vet told me several things but I was so flustered I didn't pay a great deal of attention. Creatin? Levels high but liver enzymes ok. I just told the vet to do what's best for her until I get home. I'm hoping she'll bounce back once she gets fluids. I just really wanted to hear that there is hope for her. Thanks for giving me that!
     
  9. Critter Mom

    Critter Mom Well-Known Member

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    (((Carol)))

    :bighug::bighug::bighug:


    Mogs
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  10. donnalea

    donnalea Member

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    Prayers going up for Dakota and Carol.
     
  11. Critter Mom

    Critter Mom Well-Known Member

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    Creatinine. :)

    Here's a link to the Tanya's Site page giving info on creatinine and possible causes of elevated creatinine levels:

    Tanya's Site - Creatinine Info

    Actually that whole page gives a lot of information about blood chemistry test results.

    The page above mentions that sometimes creatinine levels may be elevated in DKA and pancreatitis kitties. Also from the above page:
    [Emphasis mine]

    Whatever's making Zoey feel poorly, fingers and paws are crossed here for a speedy diagnosis and successful treatment thereafter.


    Mogs
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  12. Zoey & Carol

    Zoey & Carol Member

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    Jan 4, 2015
    Just spoke to the vet. Zoey is doing better. Her creatinine was off the scale yesterday and her BUN was 80. Her BG was 637 today but no ketones. He gave her 200 cc of IV fluids yesterday. She is drinking on her own now and eating some of her Pate. I will bring her home tomorrow.

    I will read the information from the CKD website when I get home. Still driving in snow and ice. Is there anything I should ask the vet about specifically when I see him tomorrow?
     
  13. Critter Mom

    Critter Mom Well-Known Member

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    Hi Carol,

    I am very pleased and relieved to read that Zoey is doing better today. IV fluids can make such a difference!

    I'd suggest asking your vet to prescribe some anti-nausea and appy stimulant meds to keep at home for use ad hoc just in case her appetite stalls. Breaking the 'nausea --> poor appetite --> worse nausea --> inappetence' cycle can be tough going on both cat and caregiver plus it increases risk of ketosis, DKA and hepatic lipidosis. I've found that it is far, far easier to keep a somewhat queasy kitty eating with the help of supportive meds (and possibly fluids) than it is to get a badly inappetent cat to start eating properly again.

    Did the vet give you any diagnosis of the underlying cause of the spike in creatinine and BUN? If not, if it were my kitty in this boat and if the vet hadn't already done so, I'd ask him to test for pancreatitis (Spec fPL), if only to rule it out and provide information that could be put toward making a differential diagnosis. A check on B12/folate levels would also be helpful (and it might be worth asking the vet to give Zoey a B12 jab before going home (assuming it's not contraindicated for any reason) - B12 can give a cat a bit of a boost and it can help with appetite).

    Other members may have further suggestions.

    Take care on the roads. Wishing you a safe journey home.

    :bighug:


    Mogs
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    Last edited: Dec 30, 2017
  14. Myagi and Heidi

    Myagi and Heidi Member

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  15. jayla-n-Drevon

    jayla-n-Drevon Well-Known Member

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    Hi, I have managed many cats in renal failure with pretty great success.

    I know there is a debate on when to give fluids in controversial on the forum and even vets have a different views.
    My experience is as follows-

    My vet (whom I have assisted many times) recommends beginning fluids at the very early stage of kidney disease in order to slow the progression but if the cat was already showing significant decline he suggests a more aggressive start and then figuring out how much and how often. I have been told by a few vets that kidney failure doesn't show up on a lab until its function is 75% gone. It is remarkable how they can thrive on a fraction of that.

    Some of my fosters have lived another 5 years by giving SQ fluids. They were not diabetic for reference.

    My Dre who is 18 and diabetic has BW done regularly and when his BUN was elevated a bit I began fluids a few times a week and his creatnine started creeping up so I upped the fluids. I am happy to report that we had BW done just this past Monday and I was pleasantly surprised. His BUN is slightly elevated but creatinine is back in normal range.

    I do want to make clear that if a cat has another condition specifically heart disease it is imperative to use caution and work with your vet/cardiologist.

    My Rico is 19 and he also gets SQ fluids in small amounts due to a heart condition from using a steroid. He was getting fluids daily for 5 years prior to the heart issue, I believe the daily fluids prior helped preserve the integrity of his kidneys. His BUN is slightly elevated and the rest of his labs are pretty awesome:cat:
     
  16. Critter Mom

    Critter Mom Well-Known Member

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    Glad you mentioned this, Jayla. It has put me in mind of something ...

    @Zoey & Carol -

    As Jayla mentions above, traditionally it has been very late in the day function-wise that indicators of chronic kidney disease become identifiable in lab results. However, IDEXX Laboratories recently developed the SDMA test which they claim can potentially detect signs of kidney insufficiency when only 40% of function is lost.

    Here's the relevant page from Tanya's Site:

    CKD - Early Detection

    If possible, it might be really helpful for you to read this page before visiting your vets on the morrow. It might provide a helpful foundation for the discussions with your vets and it may give you an idea of whether any of the diagnostic tests mentioned might be beneficial in helping to determine whether or not kidney insufficiency was the root cause of Zoey's clinical signs (nausea, etc.) and elevated blood markers. (For info, since it became available in the UK our vets routinely include the SDMA test when getting blood work done by IDEXX. I think it's a great idea: forewarned is forearmed. ;) )

    Be sure to post an update tomorrow (not least of all to let us know that you got home safe!).

    :bighug:


    Mogs
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  17. Critter Mom

    Critter Mom Well-Known Member

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    Another one for the vet visit hit-list: ask your vet to check Zoey's blood pressure (if not done already).


    Mogs
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  18. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    I take the other view in early fluids. First, it adds sodium not needed. Second if your cat is eating all wet food is is adequately hydrated you risk fluid overload. Pancreatitis can definitely raise the kidney numbers. Not eating can cause dehydration which can falsely raise the kidney values. So can infection. You need to ask for the Spec fPL test for pancreatitis and not the SNAP which is quick but just gives positive or negative so without a number you won’t know if in the gray area.
     
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  19. Squeaky and KT (GA)

    Squeaky and KT (GA) Well-Known Member

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    I tend to agree with Elise on early fluids. I did fluids daily with Dakota when we first discovered his CRF but after a few days, they seemed to make him feel worse. I learned that fluids can overload the system with unneeded electrolytes so quit the dailies. I just give now when I notice he's not drinking a lot and/or shows signs of starting dehydration. I encourage lots of drinking....and he cooperates well.
     
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  20. Zoey & Carol

    Zoey & Carol Member

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    Jan 4, 2015
    Made it home safely. Zoey is back home but not doing well. The vet gave her another IV infusion. He also gave her convenia .1 ml and cyanocobalamin injections. She drank a slight amount but has no interest in eating. He gave me mirtazapine for her appetite. So far it hasn’t done much. She is resting but I’m not sure she’ll make it through the night.
     
  21. tiffmaxee

    tiffmaxee Well-Known Member

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    I’m so sorry to read this. Has your vet diagnosed anything besides kidney failure? Were IV fluids given or sub-q? If severely dehydrated she might need a drip for a few days but it sounded like this was early kidney disease so I’m confused. Did he test for pancreatitis?
     
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  22. Critter Mom

    Critter Mom Well-Known Member

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    I'm sorry, too, and I'm asking the same questions as Elise.

    Is there an ER vets nearby? Could you get Zoey there - and do all you can to get anti-nausea meds into Zoey - ? (The appetite stimulant alone won't do anything much if she is too nauseated to eat. We often see cats here whose vets don't fully grasp the importance of specific anti-nausea treatment. Many vets claim that mirtazapine is sufficient as an anti-emetic but, based on my own experience and many cases I've seen here, treatment with Cerenia and/or ondansetron alongside the appy stimulant works much better.

    A Cerenia injection might start to work faster than ondansetron (although some members here have, I believe, used both at the same time; can't comment because I've not done so). With Saoirse, I'd start anti-nausea with a Cerenia injection (lasts about 24 hours) because it got into her system faster and then I'd start her on ondansetron tablets the following day. Ondansetron had a stronger anti-nausea effect in Saoirse but given orally it took a few doses to build up its full therapeutic effect. Ondansetron is available as an injectable for humans. I'm not sure if it can be given as an injectable to cats (but the ER vets might know more).

    The ER vets might be able to do a SNAP fPL test for pancreatitis or, if push comes to shove and there's no differential Dx, maybe they might treat for pancreatitis on an 'as if' basis? If pancreatitis is the problem then pain may very much be part of the reason why Zoey is not keen to eat. Administration of buprenorphine for pain relief can help a great deal to get the cat back to eating again.

    I'm not trying to give you unrealistic expectations here but if you find out pancreatitis is the problem then I'd just like to add that a cat can seem sooo ill but then really turn the corner when the right meds/fluids are finally put in place. I've seen it happen in Saoirse (I really thought I might lose her during her first pancreatitis flare - until I got her nausea under control) and I've seen it in other cats here.

    If a vet trip isn't possible maybe try offering Zoey food from your hand? Perhaps dab a little food on the end of her nose just to let her lick it off and get a taste for it; sometimes that can trigger interest in food and if you can start a kitty eating at all then by giving tiny, frequent amounts of food you can help them build up a bit of momentum until they want to eat again under their own steam. If she does go for her food or water bowls, try raising them up a few inches off the ground (e.g. stick a few paperbacks under them) - helps a lot when a kitty's queasy if they don't have to drop their heads down to eat and drink. Warming the food a little can sometimes encourage a kitty to eat (or the heat from your hand can do similar).

    I really feel for you. Sorry I can't think of anything else to suggest to you. Sending healing vibes to little Zoey.

    (((Carol)))


    Mogs
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    Last edited: Jan 1, 2018
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  23. Tracey&Jones

    Tracey&Jones Well-Known Member

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    Have no advice just sending healing prayers to Zoey and these are for you :bighug::bighug::bighug:.
     
  24. Myagi and Heidi

    Myagi and Heidi Member

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    Sending love and healing hugs
    :bighug::bighug:
     
  25. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    When Max first got pancreatitis I didn’t know what was wrong. He just stopped eating. One vet had me bring him for an uultrasound and even though I fasted him didn’t run the test for pancreatitis because her rotten traveling vet who did the ultrasound found everything BUT pancreatitis wrong with him. He recommended surgical biopsies. I went back to my previous vet and he had his radiologist do another ultrasound and ran the right test. Diagnosis pancreatitis. Max never had a biopsy and lived the next 7 years never having cancer and only thevlast with CKD.

    Mogs is right. You need nausea medication and it can take a few doses for it to start working. You need to assist feed small amounts often until the meds kick in. I also would like to see all the labs. Not eating can cause fatty liver disease in just a few days.
     
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  26. Critter Mom

    Critter Mom Well-Known Member

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    Another couple of thoughts:

    Is there any chance that Zoey might be constipated? If she is then that could be another thing putting her off her food (it can sometimes cause vomiting if a cat tries to eat) and normal anti-nausea/appy stimulant meds are unlikely to help until the constipation is sorted out. You'd need to get a vet to check that there's no obstruction or impacted faeces but a few doses of metoclopramide (Reglan) can speed up gastric emptying and help restore normal gut motility. Thereafter normal anti-nausea and appy stimulant meds should start doing their job properly.

    If the anti-nausea and appy stimulant meds don't kick in and Zoey still needs help with eating, there is always the possibility of putting in a feeding tube; they make assist feeding much more straightforward and reliable (protecting the liver). They can and do save the lives of severely inappetent cats. If Zoey is a candidate for a feeding tube it's better not to wait too long to get it placed. Here's a link to more information about feeding tubes:

    Feeding Tubes For Cats (from Lisa Pierson DVM's site, catinfo.org)

    Sending more healing vibes for Zoey and a :bighug: for you.


    Mogs
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    Last edited: Dec 31, 2017
  27. Zoey & Carol

    Zoey & Carol Member

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    Jan 4, 2015
    She drank a little bit and licked up some sauce from a turkey cat food. She talked to me a little and seems a little brighter. She has been peeing some but no bm’s that I know of. I don’t think she’s eaten much for a few days. Maybe tomorrow will be a better day now that she’s home.

    If not I’ll try the emergency vet. Thanks.
     
  28. Veronica & Babu-chiri

    Veronica & Babu-chiri Well-Known Member

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    I hope being at home and with you helps sending you :bighug::bighug::bighug:
     
  29. Critter Mom

    Critter Mom Well-Known Member

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    Attagirl, Zoey! Any interest in food is very welcome! :)

    Even if you can keep offering her some of the gravy to lick from your fingers it may help her to get a little bit more down than she might without the prompting. Keeping some little bit going into her tum will reduce the chance of stomach acid building up and making nausea worse.

    If Zoey's still only licking the gravy off the food tomorrow then hopefully an ER vet will be able to prescribe an appropriate nausea treatment (and maybe pain meds if they suspect pancreatitis might be the culprit).

    I'm glad to read that Zoey's a little brighter in herself. Fingers and paws crossed here that you'll both have a better day tomorrow.

    :bighug:


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  30. Critter Mom

    Critter Mom Well-Known Member

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    Sending more positive vibes for Zoey and a :bighug: for you, Carol.


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  31. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    For support with the ckd, Facebook has a great group called Cats with Chronic Renal Failure. Join and they can help
     
  32. Lesliejm

    Lesliejm Member

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  33. Zoey & Carol

    Zoey & Carol Member

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    Zoey is not much better but I is drinking water and a little chicken broth. 1/2 cup since last night. That seems pretty good but I’m not sure. She’s very weak and occasionally seems to be in pain especially if I pick her up.

    If she’s not feeling better by tomorrow I’m taking her to another vet clinic- one we use for our dogs. I will request a test for pancreatitis, something for nausea, and something for pain. If I can get her through this I will definitely join the cry group. I haven’t even checked her blood glucose since she got home. Seem like a lower priority right now.

    Thanks for your support. I appreciate your suggestions and taking them all into consideration.
     
  34. Zoey & Carol

    Zoey & Carol Member

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    CRF group. I’ve already joined the “cry” group!
     
  35. Myagi and Heidi

    Myagi and Heidi Member

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    Lots of members there! So at least you're in good company. Praying for improvements. Sending love! :bighug::bighug:
     
  36. Critter Mom

    Critter Mom Well-Known Member

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    :bighug::bighug::bighug::bighug::bighug::bighug:

    Another card-carrying member here.


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  37. Critter Mom

    Critter Mom Well-Known Member

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    I don't know whether this might help but if you poach a chicken breast, chop it up really, really finely and add it to the broth she might manage to lap up a bit of protein when she's drinking. Another idea might be to blitz the chicken breast in a blender and add a lot of broth to make a fairly watery chicken soup for her. If you can manage, try to get her to lick a little of the gravy from the cat food like she did yesterday evening because it will have some calories in it. Every tiny bit can help. (((Zoey)))

    It's good that Zoey's getting some fluids down under her own steam.

    Have you got any ketone strips at home? If yes, be sure to test Zoey's urine the next time she pees. If you don't, then be sure to get her tested tomorrow at the vets.

    Sending more healing vibes and prayers for you to get a really helpful vet tomorrow.

    :bighug:


    Mogs
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  38. Zoey & Carol

    Zoey & Carol Member

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    I can’t catch her peeing because she’s not using the litter box. She’s just peeing on her towels. She just had a little more broth and water. She’s avoiding even tiny pieces of chicken. I’ll try the blender trick.

    So tomorrow I want the vet to do these things:
    Test for pancreatitis
    Test for ketones
    Cerenia for nausea
    Something for pain
    Check for IV fluids and/or feeding tube

    Anything else I should ask?

    And Happy New Year to you all! Thanks for your support!
     
  39. Critter Mom

    Critter Mom Well-Known Member

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    Also ask for a prescription for ondansetron. (The generic is much cheaper than the branded Zofran version.) It's a human medication so if the vet doesn't stock it you could ask for a written prescription and get it filled at a regular pharmacy. Dosing for a 10lb cat is 1-2mg every 8-12 hours, to a maximum of 4mg per day.

    Thorough physical exam, in particular to assess where Zoey is feeling pain. Also ask vet to check that she's not constipated/obstructed (really important WRT nausea management so that all appropriate treatment(s) can be put in place - may need initial few doses of Reglan followed by ondansetron/Cerenia). Also check whites of eyes and gums to make sure there's no yellowing.

    Ask vet to assess Zoey's hydration levels. Be guided by the vet if he recommends IV fluids (although maybe sub-q fluids might be an alternative, allowing Zoey to come home sooner).

    Get her blood glucose levels checked at the vets, too. And ask about how to manage Zoey's insulin needs while her appetite is poor (some insulin is better than none at all (ketones) so the vet may be able to advise you on a suitable reduced dose).

    I think asking about the feeding tube is a very good idea.

    If you have ketone test strips at home it might be worth trying to rub one on the towels? No idea how reliable the result would be (just chucking out ideas). Try sniffing her breath for fruity/nail polish remover type smells (though not all ketones manifest in the breath). Keeping her drinking (broth if possible) will help keep her system flushed out.

    Sending more healing vibes.

    :bighug:


    Mogs
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  40. Zoey & Carol

    Zoey & Carol Member

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    Just checked her bg and it was 510 so I gave her a reduced dose of 1 unit. Still drinking water. Blended some gravy food with water and she took a few licks. I’ll check her bg again in a couple of hours. Maybe I’ll put some plastic wrap under her to see if I can catch a few drops. Found 3 small hard stools stuck to her bottom.
     
  41. Critter Mom

    Critter Mom Well-Known Member

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    Keeping fingers crossed over here that the insulin dose might perk Zoey's appetite up a little bit when it kicks in.

    With Zoey licking the blended 'gravy food' that's good; she has interest in food. Maybe try some of the gravy on its own as well to see which she might prefer (anything to keep calories going in to tide her over till tomorrow's vet visit). It's also good that she's taking fluids onboard by herself.

    That's a clever idea!

    Poor love! (((Zoey))) Good that Zoey's passing stool. It's tricky trying to gauge what's going on bowel-wise when a kitty's had very little to eat for a few days. Hopefully the vet exam will tell you more.

    Rooting for the two of you.

    :bighug:


    Mogs
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  42. Beth 73

    Beth 73 Well-Known Member

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    Prayers prayers prayers :bighug::bighug::bighug:
     
  43. Critter Mom

    Critter Mom Well-Known Member

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    Fingers and paws crossed for all to go well at the vets today.

    (((Carol and Zoey)))

    :bighug:


    Mogs
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  44. Zoey & Carol

    Zoey & Carol Member

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    Took Zoey to another vet today. He said she is a pretty sick kitty.:( He will keep her for a few days to try to stabilize her and run some tests to see what is going on. Probably kidney failure, but I should know for sure in a day or two.

    She's such a sweetie! I hate to put her through this, but if there is a chance for her to get better, it will be worth it.

    Thanks.
     
  45. Myagi and Heidi

    Myagi and Heidi Member

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    Lots of prayers :bighug::bighug::bighug:
     
  46. PussCatPrince

    PussCatPrince Member

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    You have a hug & I hope Zoey stablises and picks up.
     
  47. Critter Mom

    Critter Mom Well-Known Member

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    (((Carol)))

    Thanks for letting us know how you both got on today. Hopefully the new vets will be very proactive in their efforts to help Zoey get some nourishment into her.

    I really feel for you. It's so hard seeing our little ones being so poorly but where there's life, there's hope. While the vets are looking after Zoey, try as best you can to get some decent sleep yourself. You need to look after you in order to be able to look after your precious girl.

    A thought: when you go in to visit Zoey it's a good idea to bring in a t-shirt or similar with your scent on it so that you can pop it into her kennel to provide a little comfort and reassurance.

    Keeping fingers and paws crossed and sending lots of positive vibes for the new vet to help Zoey feel better asap.

    :bighug:


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    Last edited: Jan 2, 2018
  48. Critter Mom

    Critter Mom Well-Known Member

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    She looks it. :)

    (((Zoey)))


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    Last edited: Jan 2, 2018
  49. Zoey & Carol

    Zoey & Carol Member

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    I left her with a towel that I have been using to cuddle her with. Hopefully that will make her feel better. She walked a little today, meowing for something, and when I picked her up and cuddled her, she quieted down. We have definitely become closer through dealing with her diabetes.

    Thanks so much for all of your hugs and prayers. I will keep you updated.
     
  50. Critter Mom

    Critter Mom Well-Known Member

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    We can feel how much you both love each other. :)

    Keeping you both in my prayers. I know how difficult it is when one is so worried but I hope you manage to get some bit of restorative sleep tonight.

    (((Carol and Zoey)))

    :bighug::bighug::bighug:


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  51. manxcat419

    manxcat419 Well-Known Member

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    @Zoey & Carol :bighug::bighug::bighug: CRF is a tough diagnosis, especially when it's only diagnosed because a cat crashes. But there is much that can be done to keep her feeling good in the longer-term. Were you able to get hold of the lab results at all? As she's weak and not eating, I'm thinking specifically of electrolyte imbalances, or very high phosphorus levels. If potassium levels are off, a cat can appear to be at death's door - we went through 3 potassium crashes with one CKD cat, and 2 episodes of high potassium with another so I've seen it for myself - but once the imbalance is corrected, they bounce right back as though nothing had ever been wrong. Don't give up yet - it's very early days after her diagnosis. Healing vines coming your way from all of us here. And a few more hugs, because you can't have too many of those :bighug::bighug::bighug:
     
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  52. Critter Mom

    Critter Mom Well-Known Member

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    @manxcat419 - Very glad to see you on this thread, April, and with such valuable, pertinent, and timely advice.

    :bighug::bighug::bighug:


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  53. manxcat419

    manxcat419 Well-Known Member

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    Thank you Mogs :bighug: Pure chance that I happened to look in and noticed this thread with a 911 tag. I'm glad I can be here. :)
     
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  54. Veronica & Babu-chiri

    Veronica & Babu-chiri Well-Known Member

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    Sending you lots of :bighug::bighug::bighug:, I hope she's feeling better today
     
  55. Zoey & Carol

    Zoey & Carol Member

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    April, thanks for your message. Most of what you said is what is occurring. I didn't get a copy of the labs, but the vet called me last night with detailed information. This is what I know as of last night: Her creatinine is high (I think he said it was over 11?). Her BUN is too high to measure. Her phosphorus and bilirubin are elevated, and her pancreas is inflamed. Her whole system is involved: kidneys, liver, and pancreas. Her BG was over 600, and there were abnormalities in her electrolytes. Also, her body temperature was low. He said her case is extremely complicated.

    She is in "intensive care" right now. He is trying to flush out the toxins from her body (diuresis?). He gave her insulin and an antibiotic injection, and has her on a warming bed. He said that the next 48-72 hours are critical and will tell if she is going to make it or not. Of course, I spent last night crying and trying to get my other cat (Maine Coon Marley) to come in and snuggle with me. He's not sure he wants to take her place!

    I'm going to try to see her today and take with me a towel that I slept with last night! I'll see if I can get a copy of the lab work also.

    Thank you all for your support!
     
  56. Veronica & Babu-chiri

    Veronica & Babu-chiri Well-Known Member

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    Keep us posted on how she's doing we'll be praying for you two
     
  57. Critter Mom

    Critter Mom Well-Known Member

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    That might be due to the pancreatitis.

    My heart goes out to you, Carol. I know what it's like to be sick with worry and unable to stop crying. :bighug::bighug::bighug:

    It sounds like this different vet is really switched on and working hard to help your precious girl. Are they able to give her pain relief for the pancreatic inflammation?

    I hope you'll be able to visit with Zoey today. Prayers for you both continue. Sending more healing vibes across the pond.

    (((Zoey & Carol)))


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  58. Vader723

    Vader723 Member

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  59. Myagi and Heidi

    Myagi and Heidi Member

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    Sending love and prayers :bighug::bighug::bighug:
     
  60. Squeaky and KT (GA)

    Squeaky and KT (GA) Well-Known Member

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    More hugs and thoughts and prayers....

    ....and more and more...
     
  61. Zoey & Carol

    Zoey & Carol Member

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    Off to see Zoey and give her some cuddles (and maybe some food). They are supposed to have new blood test results for me as well. Keeping my fingers and toes crossed!
     
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  62. Critter Mom

    Critter Mom Well-Known Member

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    Fingers and paws crossed over here, too.

    If you can get copies of the labs and post a copy here then April (@manxcat419) might be able to look at them for you.

    (((Carol and Zoey)))

    :bighug::bighug::bighug:


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  63. Zoey & Carol

    Zoey & Carol Member

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    Just got back from visiting Zoey. She is feeling and looking a little better. I was able to get her to eat some "high energy" food. The vet said she had eaten a little of it earlier in the day, so that is some good news. I did get the results of the blood tests from yesterday and today and have posted them with my spreadsheet. I did the best I could with the very limited knowledge I have of these tests! Something that wasn't listed on the template was the fPL test which was "abnormal". The vet said there is some progress with some of the tests, but he is still waiting to see if her kidneys will function. They are giving her constant IV fluids but he said they are probably just running right through her at this point.

    She is in very good hands. The vet said he wasn't sure she would make it through the night last night. (I wasn't either!) But some progress provides a little optimism. (I think I even heard a little purr from her while I was holding her!)

    He said the next 24 hours should tell whether or not her kidneys will start working again.

    Thanks so much for your knowledge, support, hugs, and prayers!
     
  64. PussCatPrince

    PussCatPrince Member

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    Pleased you and she had a little purr together.
    I hope for the best & send you hugs from all across the miles.
     
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  65. Squeaky and KT (GA)

    Squeaky and KT (GA) Well-Known Member

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    That sounds positive Carol....more hugs, thoughts and prayers...

    Those labs are looking better from today. Her potassium is still low enough it's making her feel weak but that will continue to come up with the IV.
     
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  66. Critter Mom

    Critter Mom Well-Known Member

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    So glad you got to visit with Zoey, that she's brighter and eating a little. I know she'll have been very happy to see you - and she gave you a little purr! :)

    I'm tagging April for you to see whether she can give you more information or suggestions (@manxcat419 - April, if you're online could you look at the lab results in Zoey's spreadsheet for Carol, please?).

    Here's a link to the Yahoo support group for CKD kitties. They're quite good at interpreting labs. You should be able to post the link to Zoey's labs for them to check out.

    https://groups.yahoo.com/neo/groups/Feline-CRF-Support/info

    Will post a link or two from Tanya's Site for you tomorrow (have sleep meds on board so I'm about to pass out). The site does stress the importance of giving enough time on IV support to give labs a chance to improve.

    Sending more prayers, healing vibes and :bighug::bighug::bighug:.


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    Last edited: Jan 4, 2018
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  67. jayla-n-Drevon

    jayla-n-Drevon Well-Known Member

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    :bighug::bighug::bighug:...sending prayers for Zoey:bighug::bighug::bighug:

    @Critter Mom ... Hi Mogs:).... I am curious about the dosing you referred to with ondansetron.
    I have discussed it with @tiffmaxee a while back about some cats being more resistant and often not given a high enough dose. Rico gets 2-3 mg at least 2x a day and 20 minutes after he goes right to the food:cat:(he is about 13 pounds and 19 yrs). It has been my understanding that ondansetron can last up to 4 hours. He also gets cerenia frequently (3-5x a week) in the same gel cap.. (we are all about preemptive strikes over here at the senior home:rolleyes:)

    Just wondering if it is a each cat is different type of thing? I have read some stuff regarding kidneys but I think that would be a very high dose. @manxcat419 may have some wisdom to share:)
     
  68. jayla-n-Drevon

    jayla-n-Drevon Well-Known Member

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    I am so happy you got to see your baby and that you have comfort that she is in good hands. From your post it sounds like at the very least she is feeling better and with lots of prayer and good vibes coming your way she will get stronger and get the toxins flushed from her system. From my experiences getting those toxins out give her the best chance to bounce back. Sending huge hugs and heartfelt healing for the both of you...:bighug::bighug::bighug:
    ps--The vet should have canned AD and that may be helpful as is is high in moisture and is mostly organ meat and about 10% carb. Many of mine would eat that strangely when they seemed to need it most. It is also easy to syringe.
    :bighug::bighug:
     
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  69. manxcat419

    manxcat419 Well-Known Member

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    Jan 14, 2015
    @Zoey & Carol this is the first chance I've had to look in here today - and for some reason I didn't get email notification of being tagged. Reading the labs now...I'll let you know any thoughts I have on them as soon as I can.
     
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  70. manxcat419

    manxcat419 Well-Known Member

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    OK. So there is some good news there - her numbers are improving. It can take anything up to 5 full days on 24/7 IV fluids to see the full improvement too, so I would definitely get new labs in another day or so to see how things have settled. I'm assuming they're supplementing her IV with potassium as that's increasing even though the other numbers are coming down. A couple of things to watch out for though. Her phosphorus is still high - high enough to be making her nauseous and not wanting to eat. She really needs to be getting a phosphorus binder with every bite of food. Aluminum hydroxide in powder form (not the nasty mint-flavored gel that vets usually stock) is a good way of doing that as it can be mixed direct into her food so that even if she only eats a little at a time, she's getting binder with all her food. Although it looks on paper as though her phosphorus isn't too far above range, the range includes the expected levels for kittens who always have a higher blood phosphorus level. With CKD, the aim is to keep the level ideally around 4.5, but definitely below 6 so she has a little way to go with that one yet.

    Standard ondansetron dosing is 0.5 mg/kg. However, in some cases 1 mg/kg is needed to gain enough effect from the medication. As long as your vet has prescribed the higher dose, it should be fine to give. The higher dose seems more often to be used in cats receiving chemotherapy drugs, but it is a tested dose for cats. So Rico, at around 5 kg, is still not far off the standard dose. For a 10 lb (4.54 kg) cat, 4 mg would indeed be the maximum daily dose, although of course it is always advisable to give the minimum dose that achieves the desired effect.

    One thing I would like you to keep an eye on, in conjunction with the vet, is her hydration level to ensure she doesn't become overhydrated from several days of diuresis (yes, that is the right word). Because her levels are currently Stage 4 and she has high end of normal cholesterol and low albumin, there is a risk of nephrotic syndrome - it's rare, but it can occur. Should she start to develop it, the last thing you want is to add a lot more fluids as the syndrome causes fluid to build in the abdomen.

    And lastly, I want to remind you that often with a later-stage CKD cat, we treat the cat not the numbers. If she can get to the point where she's eating and feeling OK in herself, even though her numbers may still look bad, it's perfectly possible for her to live quite some time with kidney values that look very poor on paper. Some cats just seem to adjust to those higher numbers once they're past the initial crash, so any decisions on treatment etc need to be made on a quality of life basis - don't write off all hope just because her numbers don't come back to where you'd like them to. :bighug::bighug::bighug:
     
  71. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    @jayla-n-Drevon you are right about ondansetron dosing. Max wasn’t getting enough when first diagnosed with pancreatitis. He need 2-3 mg. and he was 14 pounds at the time. Some cats need both cer and ondansetron. They work in different ways.

    When Tiffany crashed she was on IV fluids for neatly a week at the ER. They ran blood tests every day. As long as her numbers were improving they kept her there. While in the ER I met a lady whose cat was given too much and had fluid overload so make sure it’s a slow drip. Her numbers were off the charts at first. They came down a lot but not as much as I had hoped. Still it wasn’t the kidneys but rather lymphoma that caused her passing. As said above treat the cat and not the numbers.
     
    Last edited: Jan 4, 2018
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  72. Zoey & Carol

    Zoey & Carol Member

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    I'm going to try to see Zoey again this afternoon. The vet said they would run another blood test today. I will get the results from those tests and post them after I've seen her. I'll also ask him about the food, phosphorus binder and nausea medication. I'm feeling a little more optimistic after reading your posts. Thanks!
     
  73. Myagi and Heidi

    Myagi and Heidi Member

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  74. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Hi Carol,

    Glad to hear you'll be seeing Zoey this afternoon. As promised, here's the Tanya's Site link:

    http://felinecrf.org/is_there_any_hope.htm

    The key points made include:

    * Assess the labs when the cat has been stabilised.

    * Treat the cat, not the numbers (as wisely counselled by April and Elise above).

    * Make sure that IV treatment during the acute stage is given for a long enough period.

    * Once stabilised, with appropriate treatment lab numbers may continue to show improvement with the right treatments in place following the aggressive therapy to get a CKD kitty through a crisis (may take a few weeks).

    In particular check the section "Cat in Crisis: Very High Numbers and/or Receiving Intravenous Fluids (IV)". In this section it stresses the importance of seeking any possible reason(s) that may have triggered the acute problems (infection - e.g. urinary tract/kidney infection; kidney stones; hypertension; dental problems) to see whether acute kidney injury is a factor.

    I see from your post yesterday that the pancreatitis test was "abnormal". Was this a SNAP fPL test result (sounds like it)? If yes, it would be a good idea for your vet to run a Spec fPL test (if not already in progress - it needs to be sent to an external lab). The Spec fPL result will give a better picture of the degree of inflammation present in the pancreas.

    Keeping up the prayers and sending more positive healing vibes. Please give Zoey a very gentle fuss or two from me.

    :bighug::bighug::bighug::bighug:


    Mogs
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    Last edited: Jan 4, 2018
  75. Critter Mom

    Critter Mom Well-Known Member

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    @manxcat419 - Thank you for answering the tag, April. :bighug:


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  76. PussCatPrince

    PussCatPrince Member

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    More hugs to you and Zoey.
     
  77. Critter Mom

    Critter Mom Well-Known Member

    Joined:
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    Nowt wrong wi' pre-emptive strikes, chuck! I'm all for 'em. :)

    After the above responses, are you OK on the ondansetron dosing front now, Jayla?

    FWIW, if Saoirse needed acute nausea support (ETA: non-constipation-related nausea) I'd start with Cerenia and B12 jabs from the vet (can't get Cerenia tablets for cats in the UK). At about 16 hours after the Cerenia jab I'd start Saoirse (10lb) on 2mg q12 ondansetron and keep her on that dose till she was eating steadily. I'd then try to taper down the dose: 1mg AM/2mg PM then either 1mg q12 or 2mg q24, depending on her clinical signs. Any worsening of symptoms and I'd up the dose to 2mg q12 again. As time progressed I moved her to 1mg q12-24 for maintenance. If I got an iffy batch of food I might increase the maintenance dose to 2mg q12 as a prophylactic measure.


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    Last edited: Jan 4, 2018
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  78. jayla-n-Drevon

    jayla-n-Drevon Well-Known Member

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    Oct 11, 2015
    Hi Mogs:)
    Yes--thank you for checking :cat:

    Sometimes I just can't believe my Rico will be 20 this summer.... I remember everything from the exact day I rescued him:smuggrin:
    I taper down as well unless I see his signs of what is usually nausea or a vomit episode. Since doing the preemptive strikes we are (knock on wood) having very few episodes. Still playing with his dose of budesonide to keep the IBD in control while not rising his bg and give small amounts of fluids.
    I am pretty sure the dog cerenia is the same as the cat-

    I also do the B12 and adequan shots weekly.... I clock in to the senior facility after work :rolleyes:
    :bighug:

    Been thinking of you all day Carol --I hope you have a good visit:bighug:
     
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  79. Critter Mom

    Critter Mom Well-Known Member

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    It is.


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  80. Zoey & Carol

    Zoey & Carol Member

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    Thanks, Mogs. It was a SNAP fPL test. I will add that to the list of questions I have for the vet today. I'm so glad I took her to this clinic. We have a rescue dog who needed two knee surgeries a couple of years ago, and this clinic performed them. He's doing great! The only problem is the clinic is about 20 miles from my house!
     
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  81. Zoey & Carol

    Zoey & Carol Member

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    Visited with Zoey again, and she is eating more and looking better! They had not done the blood test at that time, but I just got a call from the vet. I didn't get the whole blood test, but he gave me the most important information over the phone. I posted it on the spreadsheet. Her creatinine is down to 3.9. Still too high, but a big decrease from over 11. BUN is still high but down to 89. Phosphorus is still a little high@ 9.8 He is going to start her on some aluminum hydroxide. And an added bonus, at +8 her BG is 100! She hasn't been that low for a while. He thinks she may be able to come home tomorrow. I will have to watch her carefully and she may need to come in for diuresis again, but now that I've seen how it works, I'm comfortable with that.

    I'll let you know if she gets to come home! Thanks for all of the kind words and advice. I'm registered with the CRF Group on Yahoo, so I'm sure I'll learn lots more about how to deal with this. Diabetes and kidney disease - whew! I'm learning way more about medicine than I ever wanted to know! I'm a retired English teacher. Math and science were not my forte!
     
  82. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    I'm really glad you took her there too, Carol. :) The team there seem really responsive and keen to do all they can to help their patients. It's actually quite frightening when circumstances lead one to realise just how much variation there can be in treatment approach/veterinary expertise from clinic to clinic (and even from vet to vet within a given practice).

    :bighug:


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    Last edited: Jan 4, 2018
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  83. manxcat419

    manxcat419 Well-Known Member

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    That new set of numbers is looking way better, Carol. :) That sort of drop when the IV fluids really kicked in was exactly what I was hoping to see. I think with her creatinine settling around 3.9, the vet may well want you to give sub-q fluids at home long-term. But if you can give insulin, you can learn to give sub-q. And the aluminum hydroxide should help her to feel better each day as her phosphorus level comes down.
     
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  84. jayla-n-Drevon

    jayla-n-Drevon Well-Known Member

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  85. jayla-n-Drevon

    jayla-n-Drevon Well-Known Member

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    Just for clarification I do not give B12 weekly:cat:
     
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  86. Critter Mom

    Critter Mom Well-Known Member

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    What an encouraging update, Carol. And the best bit?

    Numbers schmumbers. It's all about the cat! :)

    ((((((((Zoey))))))))

    I'm so pleased that Zoey is responding to her treatment. :) Blessings to her veterinary team and, most of all, to her wonderful mama!

    ((((((((Carol))))))))


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  87. Zoey & Carol

    Zoey & Carol Member

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    I am picking up Zoey in about 2 hours. I spoke to the vet early because he will be busy when I pick her up. He is going to run one more round of tests before she leaves, so I will post those numbers when I get them. He said she is eating KD food, both dry and canned. I'm going to buy some canned for her to eat at home. She is getting aluminum hydroxide 3 / day, but it sounds like it is a gel. I won't be able to do the mid-day gel every day, but someone stated there is a powder form? The vet doesn't have that available. Is there somewhere I can buy it?

    He is also giving me an antibiotic to give her. Apparently on top of everything else, she had a bladder infection! He said her BG numbers have been pretty good at 1.5 units of ProZinc, so I'll stay with that and try to check her midday when I can. He wants her back in a week for the whole day to check her numbers and give her fluids if she needs them. At that time I'll ask him about Sub Q if it looks like it might be necessary.

    She was a very sick kitty, so I think this vet is a miracle worker! I'll let you know over the weekend how she's doing. (She was also down to 6 1/2 pounds when I took her in.)

    Thank everyone for their caring and advice. I know this is not a short-term problem and that it adds another layer to her care. But I'm willing to take this on and do the best I can for her for as long as she is with me!
     
  88. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Zoey is blessed to have such a loving and dedicated mama! :)

    I've just posted a thread on Feline Health asking members to make recommendations on where to buy powdered aluminium hydroxide (Al OH). Here's a link to the thread:

    http://www.felinediabetes.com/FDMB/...nium-hydroxide-for-phosphorus-control.189171/

    With the powdered AlOH you should be able to mix it into wet food for Zoey and leave some out for her to eat any time you need to be away from the house.

    Re the bladder infection, that is one of the things mentioned on Tanya's Site that can sometimes be the cause of an acute kidney injury.


    Re the food, I wonder whether it might be an idea to get a small bag of the k/d Dry food as well as the canned version? It might be helpful to ask the vet/vet techs who have been looking after Zoey how much she ate of the wet and the dry as a guide. (I'm suggesting this as a 'belt 'n' braces move so that you've got as many weapons in your home nursing arsenal as possible to help Zoey maintain momentum. If she eats well on the canned that'll be great but the dry would be there for a fallback. If you don't need to open the bag of dry I think I've read here that Hill's offer some sort of refund guarantee for their prescription foods so you may be able to return it.)

    REALLY IMPORTANT!!!

    In addition to the food and the antibiotic Rx, I can't recommend strongly enough that you make sure the vet gives you a prescription for anti-nausea medication and an appetite stimulant (assuming not contraindicated) to make sure that Zoey continues to be able to eat well when she gets home. She may not need the meds but it is much safer to have them to hand at home so that you can give Zoey a little support straight away should she show any signs of nausea again. (It is far easier - and safer - to keep a nauseated kitty eating with appropriate support than trying to get a completely inappetent cat to start taking food again.)

    Also, did the vet run a Spec fPL test? Has Zoey been receiving any pain meds for the pancreatic/bladder inflammation? If yes to the latter then I suggest asking the vet about what her needs for pain management will be for the next few days and to prescribe as necessary. (I don't know whether with the CRF buprenorphine may be contraindicated. Metacam would definitely be contraindicated because it's bad for the kidneys.)

    When you're getting the lab results make sure that they let you know what Zoey's ketone status is (and getting hold of a supply of ketostix or similar from a regular pharmacy for use at home is very much recommended).

    Keep a close eye on Zoey's BG levels because, as the infection clears, her numbers may show further improvement.

    I'm so grateful you found such good vets, and I'm thankful to them for helping your darling girl.

    Sending scritches for Zoey, :bighug::bighug::bighug: for you, and blessings for you both - plus more prayers for Zoey to continue to make a strong and steady recovery upon her return home. Will look out for updates.


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    Last edited: Jan 5, 2018
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  89. PussCatPrince

    PussCatPrince Member

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    I am very relieved for you both . Your vet sounds amazing.
     
  90. manxcat419

    manxcat419 Well-Known Member

    Joined:
    Jan 14, 2015
    You can buy the aluminum hydroxide powder under the brand name Phos-Bind from either vetrxdirect or Amazon online. Or you can buy it just as aluminum hydroxide powder from Thriving Pets (also online). The dose does vary depending on which you get as they're slightly different strengths, so once you have it in hand, let me know which you have and what dose of the gel you're giving and I'll help you figure out how much powder to use each day.

    I am very, very happy to hear that Zoey is on her way home to you. She, you and the vet have all done a great job in getting her feeling better again. Long may it continue. :bighug::bighug::bighug:
     
  91. jayla-n-Drevon

    jayla-n-Drevon Well-Known Member

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    Happy Dance!!!
    So happy to read this update!:bighug::bighug::bighug:
     
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  92. Jan Radar

    Jan Radar Well-Known Member

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    Jun 27, 2015
    This is such great news to hear. A good vet is worth their weight in gold to the heart of a kitty lover. :joyful::woot:
     
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  93. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    Great news. I boug my aluminum hydroxide powder from thrivingpets.com. Look at gveurs if you buy elsewhere to make sure it’s the same.

    It looks like you will need to give fluids at home. You can buy them by the case with a pet discount card at Walgreens. Get terumo needles 20 gauge. The harpoons the gets hsvd are not what you want.
     
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  94. Critter Mom

    Critter Mom Well-Known Member

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    Hoping that Zoey is settling in well back at home. Please let us know how she's doing when you get a chance, Carol.

    :bighug:


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  95. Zoey & Carol

    Zoey & Carol Member

    Joined:
    Jan 4, 2015
    Zoey is snuggled on my lap right now. She seems to be doing so much better. She’s using the litter box again and talking to me. She’s eating on her own. She seems to prefer the dry KD so that’s what I’ve been giving her. Her BG last night was 296 before her shot. This morning it was 452. I’m going to check it a couple of times today. She’s getting 1.5 units. I’m going to keep it at that until she goes to the vet next Friday.
    I can’t figure out how to get a new spreadsheet for 2018. Can someone help me out?
    Thanks so much for your help. I’ll keep everyone updated but I’m so happy to remove the 911 from my post. By the way...Zoey is now worth about $300 per pound!
     
  96. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Bargain! :cat:

    I just have to do this ---> :D:D:D:D:D:D:D:D:D:D:D:D:D:D:D:D

    Absolutely thrilled for both of you. And well done, that vet! :cat:

    I'm glad you got the dry food as well as the wet.

    Looking forward to seeing the latest lab results when you get a chance to add them to your spreadsheet. Talking of which ...

    @Marje and Gracie - Could you please help Carol with set-up of a 2018 tab on Zoey's spreadsheet when you have a moment?


    Mogs
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  97. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

    Joined:
    May 18, 2016
    Dry k/d is a very high carb food. I believe about 35%. It was kitty crack for Rover. – he wanted to just sit and devour every little bit. The phosphorus binder gel is mainly designed for dogs and contains sweetener. That could be why you are sing the higher number this morning. It's a tough act to juggle kidney disease and diabetes, but it can be done.
     
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  98. Zoey & Carol

    Zoey & Carol Member

    Joined:
    Jan 4, 2015
    She's not too interested in food today. A few bites of the KD dry and a few bites of my other kitty's dry food. A lick or two of wet KD. Anything she'll eat at this point is good! I just checked her BG at +6 and it was 306. I gave her some Mirtazapine so that might make her more interested. She is feeling much better than a week ago!
     
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  99. Zoey & Carol

    Zoey & Carol Member

    Joined:
    Jan 4, 2015
    I just updated Zoey's labs from the last 2 days. The vet said things are moving in the right direction. I'm a little concerned about her BG being so high. He said to keep her at 1.5 until next Friday when he will do a curve in his office.
     
  100. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Hi Carol,

    Just had a gander at the labs. Such an improvement! Good to see that phosphorus level came down a bit, too.

    The k/d food is quite carby so that will be influencing the BG levels. As a precautionary measure be sure to test daily for ketones in the urine. With variable appetite and new food in the mix it makes things a bit tricky. The most important thing is that Zoey eats. If she needs the k/d food then your vet will be able to help you work her insulin dosing around that. The BG data you gather at home over the next few days will help inform dosing decisions. Needless to say, be sure to call the vet for advice if you're concerned about anything and also post here to see if we can help.

    Also, did the vet run a Spec fPL test?

    Sorry to hear Zoey's appetite is a bit sluggish today. Is she showing any signs of nausea (useful link to symptom checker here). I see you gave Zoey her mirtazapine about 90 minutes ago. Has it kicked in yet? Also, did the vet prescribe any anti-nausea medication for use alongside the appetite stimulant?

    :bighug:


    Mogs
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