? Update & test results

Urinalysis results
Color- red
Clarity- turbid
Specific gravity-1.024
ph-5.0
Urine protein -4+
Glucose-negative
Ketones-negative
Blood/hemoglobin-3+
Bilirubin-negative
Urobilinogen-4+ (12 mg/dL)
White blood count- none seen
Red blood cells - >100
Bacteria-Rare <9/HPS,RODS and Cocci present
Epithelial cells- none
Mucus- none
Casts-none
Crystals-none

Hematology ( only listed abnormal)
MCH 16.6 ( ref range 12.6-16.5)
Monocytes 856 ( ref range 40-530)
Plates 743 (ref range 155-641
Bun-33 ( range 10-30)
Cre- 2.2 ( range 0.3-2.1)
Glucose-155 ( 70-150 )
T4- 1.5 ( range 1.5-4.8)

His glucose was taken at 10:30 and his dose was due at 12:30.

Today around 2:00 he got a injection of Onsior pain medication, can REALLY tell a difference! But is this “ real” pain Med???? He got it yesterday at 1:30 PM and he acted FINE for 6 hours only ( supposed to last 24 hrs) but 10:30 last night he was back to pacing, squatting to pee and passing small blood clots , blood w urine. Longer it went on, the darker and thicker the blood got w very little to none urine. This is where the subq fluid would have given him more urine to pass, he would not drink at all for me by 12:00 AM or eat . Gave him Fluid about 9:00 AM and he started passing more urine, lighter color blood & no more clots.

Meds antibodies - Veraflox , 2 ml once daily for 7 days
Pain Med- Onsior , 2 tabs daily
Subq Fluid- 100 cc twice daily

What EXACTLY do y’all think about his test results and his treatment plan?

 

Doctor is still saying she doesn’t know if he has a true UTI because of his White blood count results and just see how the meds work. She said he might need more testing , like a ultrasound that she can’t do at her office and wants to refer me out.
I’m sooooo confused

 

I'm glad he's getting antibiotic now. Give it a few days and see if he's improving. If not maybe he has kidney stones and that's why she's recommend the ultrasound. The protien in the urine and if course the blood definitely means SOMETHING is going on. YouR vet did tell you your cat has stage 2 kidney disease, right? so Make sure the food you're feeding is low in phosphorus. What's the current phosphorus level? With that much protien in the urine you may want to ask about having his blood pressure taken as well. My cat had protienuria and the vet put him on Benezapril.

 

How was the urine sample taken? Free catch or did the vet took it at his office with a syringe?

His PH is very low so he is in risk of developing stones, if he doesn't have them already, you should address this with your vet because stones can be very painful for them and could explain some of this results

Considering the creatinine and BUN he does appear to have kidney problem ( stones or CKD) which could explain the blood and protein they found in the urine so the ultrasound to see what could be causing this is I think a good idea

You should also consider changing him to a low phosphorus low carb diet ( you should be careful about kidney diets because those are very high carb)

As Janet said also ask the vet to check his blood pressure blood in the urine can be a sign of high blood pressure

Here's a link to Tanya's page that has a lot of very good information about CKD http://www.felinecrf.org/how_bad_is_it.htm

Also and very important I almost forgot since he's passing some mucus or something like that you have to monitor him because males can get blocked this means they can't pee and that is seriously dangerous in males if it happens you have to take him to the vet inmediatedly

 

What do you mean he has stage 4 kidney disease? Nothing was said about kidney disease at all.
He eats FF pate and Friskies pate

 

Ultrasound was supposed to be if the meds didn’t clear this up meaning that it’s just not a normal UTI. The first night this happened, when he was pushing hard to pee, sometimes clear mucus would come out of his anus. That happened a handful of times and only Sunday night.

I buy cases of Fancy Feast Seafood pack ( cod,sole & shrimp , Salmon and Ocean whitefish & Tuna) and sometimes I get Fancy Feast poultry & beef pack ( beef pate, chicken feast and turkey & giblets)
And
Friskies pate variety pack - Ocean whitefish, mixed grill and Turkey & giblets
Sometimes I also get single cans of Friskies pate chicken, egg w Tuna , chicken w livers or beef w livers

 

Oh, free catch ( I did it) I used to work at a busy animal hospital and I was always the “ catch” person. Unfortunately I know all to well about males & blockages

 

He just used the litter box and NO MORE BLOOD ( at least to the naked eye ) I don’t know why he wasn’t put on antibiotics Monday! Even if his test results came back w no bacteria , then I would’ve stopped it. He has had one dose and his urine LOOKS normal .... at least no red blood or clots coming out. I need to catch it and look better.
Just waited for feed back on my above post, especially about the stage 2 kidney disease.

 

Creatinine between I.6 and 2.8 is considered stage 2 for kidney disease. 2.2 is still relatively low though. Just something to be aware of. It may be a bit elevated from the infection, but I would have it checked in 4-6 months to see what it is.
Phosphorus can make kidney trouble progress faster which is why I asked what the phosphorus level was in the lab report. If the phosphorus is creeping up you may look into a low carb /low phosphorus food like weruva bff or tikicat after dark.

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

So glad to hear there's no more blood! That's great! Antibiotics usually start working pretty fast for uti.

 

stage 2... Not 4, don't panic! Big difference!

 

I'm glad there's no more blood that is a very good sign

Fancy Feast and Freskies are very good options but they do tend to be a little bit high in phosphorus, which is not going to help his kidneys so maybe you will need to start considering changing to one with less phosphorus, in Dr. Lisa's list try to find one under 250 or if you can under 200 that would be even better

 

Here are more test results , i will put his number 1st & will put the normal range beside each one.
ALB- 3.6 ( 2.2-4.4)
ALP - 18 ( 10-90 )
ALT- 51 ( 20-100)
AMY- 712 ( 300-1100)
TBIL- 0.3 ( 0.1-0.6)
BUN-33 ( 10-30)
CA- 11.1 (8.0-11.8)
PHOS -5.4 ( 3.4-8.5)
CRA- 2.2 ( 0.3-2.1)
GLU -155 ( 70-150)
NA+ 143 (142-164)
K+- 4.3 (3.7-5.8)
TP 7.9 (5.4-8.2)
GLOB 4.3 ( 1.5-5.7)
QC - OK
HEM- 0
LIP - 2+
ICT -0

What I’m shocked about is that NOTHING was said at all about Kidney disease. They know he is diabetic that kidneys have to be carefully monitored .If he is in stage 2, I should have been told.

 

His BUN and Creatinine levels may be a little bit influenced by the UTI, and the fact that he may have been a bit dehydrated so maybe your vet is waiting for a follow up when he's better before giving any diagnose, but as you mentioned he's diabetic so you need to monitor his kidneys very carefully and those numbers are not quite ok, his phosphorus level even though is within normal range is a bit high too so considering the low phosphorus food will probably be good for him

 

Thank you. I will start switching his food. His Non-diabetic Brother will also be eating it too. Only place I have around me is Petsense. His brother doesn’t like Salmon or chicken ( will eat if very hungry) I don’t want to order online until I find some they both like.
What’s the best brands? I have no idea how I’m going to afford this....
I’m also going to check Dr Lisa’s food list. Since I only feed FF & Friskies , I’ve only look at the carbs for those 2 brands

 

5.4 isn't terrible but lower is better. I'd switch to a lower phosphorus food and see if you can try to keep it under 5. You want foods under 250 phosphorus. Fancy feast tends to be pretty high in phosphorus. My Zimmy had 4.9 phosphorus and I was able to get it down to 3.9 in just two months with just a simple food switch. He ate bff and some fancy feast because he'd clean the other cats bowls. Lol

 

Look into bff cans or tikicat. I fed my Zimmy bff and it helped with the phosphorus level.

 

Try ordering from chewy.com. Good prices and fast delivery. Plus best customer service.

 

Do y’all recommend I start new food ASAP or get him threw this , retest , see what his cre,bun,phos ,protein are after his better?
He is getting loose stools from the antibiotics now.

It’s mind blowing the difference in prices from one vet practice to another, my “ back up” vet charges over $400 more then my other vet I had to remove skittles bad tooth! BTW... that issue was put on hold by his new vet because she is doing pulse therapy ( small practice without state of the art equipment.... hence why she can’t do ultrasounds,laser surgery, etc )

 

Had his peeing gone back to normal?

 

Yes, it went to normal within hours after getting his 1st dose of antibiotics

 

Great. Sounds like an infection then.

 

I’m over the moon happy about this BUT now I’m very concerned about his kidneys and just how to help stop or slow down anything that’s happening.
My vet has not said anything at all to me about kidney disease ( it was brought up after posting his test results )
I’m going to get new blood & urinalysis after his treatment is done

 

Good plan. In the meantime it can’t hurt to switch to a lower phosphorus food. And add lots of extra water.

 

How many pho do I need to stay under, can’t find the post that had that in it.

 

Under 250 (under 200 is better) or under 1% (under 0.5% is better)

 

Here's info about the phosphorous.

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

 

If you would like other folks familiar with ckd to weigh in, there's a great ckd group on Facebook called Cats with Chronic Renal Failure. You should join.

 

Thank you! I will check that out