Well regulated diabetes, now with elevated BUN and creatinine.. Please advise!

Discussion in 'Feline Health - (The Main Forum)' started by Courtneyk, Sep 23, 2017.

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  1. Courtneyk

    Courtneyk New Member

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    Jan 7, 2017
    Hello,

    I posted here about 9 months ago when my cat was first diagnosed with diabetes, and although I didn't post after my initial introduction, I found great support and guidance through perusing the message board. Anyway, I am back with a new problem and I am looking for advice! Through home testing and insulin dosing, as well as finding a low carb food that my cat loves (she has also had pancreatitis and since then is very picky with her food) , I have gotten my Wiggles' diabetes pretty well regulated. (Her most recent fructosamine level was 360 and when I test her at home, her BG level is generally 100-175. Her insulin dose is usually 1u, 2x daily, although I sometimes give her 0.5 if her BG is on the lower end. She takes Lantus.) However, the blood test now showed elevated creatinine (2.6) and urea nitrogen (50). Her BUN/Creatinine ratio is normal (19) but I don't really know what that means. Just two weeks prior to this test she had an unrelated overnight ER visit, and at that time her creatinine was 2.2 one day and 2.6 the next, and her BUN was 34 one day and 35 the next. I know that there are some people here who are good with interpreting results like this and I'm wondering if I can get some insight?

    Do these numbers indicate that it is time to look for a low phosphorus/low carb food? Wiggles' diabetes regulation improved drastically when I switched her to tiki cat foods, but they are not low in ph. and I am so worried about giving her a food that is higher in carbs. I have done some research and am considering Instinct by Nature's Variety chicken canned food and Weruva paw lickin chicken and Truluxe steak frites.

    Any insight/advice/support will be appreciated!! You guys are great!

    Courtney
     
  2. FurBabiesMama

    FurBabiesMama Well-Known Member

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    Jul 6, 2017
    Hi. Which Tiki Cat food are you using? Some of theirs are low in phosphorous. For example, the Koolina Luau (chicken) has 149 mg of phosphorous. That is lower than the Weruva Paw Lickin' Chicken which has 196
     
  3. Courtneyk

    Courtneyk New Member

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    Jan 7, 2017
    She eats the succulent chicken, wild salmon, and ahi tuna.. unfortunately the one you mentioned makes her throw up (maybe the egg?). I have been using this chart: http://www.felinecrf.org/canned_food_usa.htm and comparing it to Lisa's and I find that they are not always consistent with one another.. If I can keep her on the lower phosphorus tiki cat foods, that would be ideal. The other food chart I'm using makes them all seem to have higher phosporus levels though..
     
  4. Veronica & Babu-chiri

    Veronica & Babu-chiri Well-Known Member

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    Hi I'm not an expert just learning about CKD myself, you don't mention why was she in the ER, sudden high levels of BUN and creatinine can be because of a kidney infection or stones or dehidration.

    If something like that has already been discarded with that value of Creatinine you should start taking care of her kidneys, you do not mention her phosphorus levels, but even if they are normal is advisable to change her to a low carb low phosphorus diet that she accepts.
     
  5. Tasha & Darwin

    Tasha & Darwin Member

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    Jun 22, 2017
    That BUN (urea nitrogen) level is quite high, and with the moderately elevated Creatinine as well - I would definitely think a low phosphorous food is in order. I can't seem to find a link, but there is a nice list of low carb/low phosphorous food on here somewhere! Did your vet recommend a diet change with those renal elevations? Did he check her urine concentration - that would be a good indicator of how well Wiggle's kidneys are functioning as well.

    I'll have a better look and see if I can track down a link to that list of food...
     
  6. Tasha & Darwin

    Tasha & Darwin Member

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    Jun 22, 2017
    Here is a link to a list I found of low carb/low phosphorous food!
     
  7. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    Do you have a copy of the latest labs?

    With a bun that high as well as high creatine your cat will benefit from added water to his food. It was also around that point that I started giving my ckd cat sub q fluids twice a week to make him more comfortable.

    Low carb low phosphorus food is a good idea. What was the phosphorus level at his last checkup? If it's really high then a phosphorous binder (aluminum hydroxide) can be added to his food.

    There's a great group on Facebook called Cats with Chronic Renal Failure.
     
  8. Courtneyk

    Courtneyk New Member

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    Jan 7, 2017
    Thank you all for your replies. I am attaching her latest labs(the last page includes some of her labs from a few weeks ago, I can include them all if that would be useful).

    I am already adding a good amount of water to her food because she is very constipated. She has always been a constipated cat.. she also takes miralax.
     

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  9. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    This site explains kidney disease really well.

    http://www.felinecrf.org/

    I'm going to look at the labs BRB.

    The USG is low. That along with the high creatinine and BUN show this is likely stage 2 CKD. What did your vet say about the crystals seen in the urine?

    You want to feed foods that are lower phosphorus than the fancy feast pates.

    The calcium is high but I've had that happen and tge be normal on the next blood draw. Just keep an eye on that.
     
    Last edited: Sep 23, 2017
  10. Courtneyk

    Courtneyk New Member

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    Thank you.. I got a message with the results yesterday and was told to call back on Monday to discuss them. I will ask about the crystals in the urine when I talk to him. Do you know why the BUN would jump from 35 to 50 in 2 weeks? That seems like a big jump?
     
  11. Chris & China

    Chris & China Well-Known Member

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    May 10, 2013
    was there any change in diet? A higher protein diet can cause the BUN to go up

    The high BUN usually isn't something to worry about too much....it's more the combination of the BUN, Creatanine and USG

    Look at China's labs on her spreadsheet....Her BUN is right there with Wiggles'...the one USG I have is lower than hers

    You might want to ask your vet to run an SDMA.....the only lab that does it is IDEXX so you may have to have the blood drawn and sent to them specifically

    The SDMA is the newest blood test for kidney failure.....As you can see, even though China's BUN is high and her USG is low, her SDMA is normal.....so her kidneys are doing OK at this point
     
    Last edited: Sep 24, 2017
  12. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    If she ate before the test the BUN can be inflated as well.
     
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  13. Waheeda

    Waheeda Member

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    Hi,
    May I know what is USG?
     
  14. Chris & China

    Chris & China Well-Known Member

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    urine specific gravity....it's a measurement of how concentrated the urine is and is an indication of how well the kidneys are working
     
  15. Waheeda

    Waheeda Member

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    Apr 11, 2017
    I see. Thanks. We couldn't get this last week cos the vet couldn't get any urine from my cat. My cat has cdk and heart failure. On fortekor and his creatinine has dropped from 2.8 to 2.4 in a month. But bun is high cos he's on protein diet. Vet said not to be worried about the high bun. I'm trying to manage his phosphorus with binder but it's still high at 6.2. Asked the vet about calcitriol but she said it's not proven to help with cdk. Anyone gives their cdk cat this?
     
  16. tiffmaxee

    tiffmaxee Well-Known Member

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    I agree with your vet about calcitriol. .
     
  17. Waheeda

    Waheeda Member

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    Apr 11, 2017
    Oh really! Cos on the Fb group for cdk cats one member said it helps her cat. She told me to give it to my cat but since my vet didn't agree and his crea value has dropped, I decided not to push for it.
     
  18. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    Your phosphorus is creeping up there. When I had a ckd cat his phosphorus was 4.7. I started substituting weruva bff food (low carb too!) for some of his meals and in 2 months The phosphorous dropped to 3.9. So a food change can help. Like I said, if it doesn't go down despite the food change, you can always add a binder to the food.

    If he's constipated too add pumkin to some meals. My ckd boy had that problem too.... Went away when we started sub q fluids twice a week.
     
  19. Waheeda

    Waheeda Member

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    Apr 11, 2017
    Janet, is all weruva food low phosphorus or only bff range? Trying to get a friend to bring back from Australia but their bff range is off the shelves cos of some issue. Which other range is good for cdk cats?
     
  20. tiffmaxee

    tiffmaxee Well-Known Member

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  21. JanetNJ

    JanetNJ Well-Known Member

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    Really not sure. I only used the bff pouches and cans with Zimmy.
    Check the catinfo.org chart
     
  22. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    If you go to the Weruva site they list all the phosphorus levels and ingredients for all their foods. I wish all manufacturers were so open.
     
  23. Larry and Kitties

    Larry and Kitties Well-Known Member

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