Yemala out of remission 478 bg at 3 PM

This is the most welcome sad group I have ever had to join. And I'm back. or rather, my little girl is.

Yemala was diagnosed in June of this year with CKD. I will post those readings once I'm no longer at work.

Her BUN and CRE levels were pretty high, but still only early 2nd stage.

Today, I took her in for a followup. Mala threw a 478 - almost never has been that high. I now have a script for Lantus and needles, which I'll get tomorrow.

Dammit.

 

Renee and Davey, I just copied this from Jill & Alex's reply elsewhere and it occurred to me it might be useful for Yemala:

This list Djamila posted in Dr. Lisa's food chart thread might help you out:

Low Carb - Low Phos Wet Food

Low carb is good for diabetes and the low phos is good for CKD I think

 

Labs taken today.

I have a prescription for Lantus, but am working on finding the least expensive option. Advice?

 

@Chris & China can tell you about Marks Marine and choices between a vial and the pens. We also have a Supply Closet where there are sometimes offers for Lantus vials or pens. From what I have read the pens are a better choice because the expiration date can be 2 years out, and the vial insulin effectiveness certainly won't last that long. Also, with the small doses of Lantus that most cats need, the possibility of fully using a vial is very low. Using a pen with syringes allows you to fine dose also.

 

Here's the information on buying Lantus from Marks Marine in Canada

Hundreds of us have bought from them since we found them and they are wonderful!!

 

Her BUN was high, but that can also be caused by dehydration and high protein food. The Creatine was normal as was her phosphorus

Those are good things!!! I think her kidneys are in better shape than you think.

@Marje and Gracie is our pro at reading labs but I think she may be out of town at the moment (but she sometimes still checks in when she can)

 

A little more information:

In June, diagnosed with CKD, Mala went on Science Diet k/d formula. It's the only thing that has changed between June and now, this food.

I have tried to look up the carb stats for that food, but I suspect they are higher than Mala has been getting in the last several years.

I am currently transitioning her from the k/d to a food from Nature's Recipe. It's listed as grain free, and according to the chart Lisa Pierson uploaded, the phosphates are under 200 and carbs under 7. She will eat it, with encouragement.

We will start her on insulin as soon as I can get it. Tomorrow, most likely. The vet wants her to begin at 2 units bid.

I will move this thread over to the lantus forum and continue commenting there.

 

How did they diagnose CKD? Was an SDMA done? Do you have a urine specific gravity?

I agree with Chris....Mala’s BUN could be elevated due to a little dehydration and raw diet. I will say her hematocrit is a bit lower than I would expect.

My very healthy 8 yr old cat has a creatinine of 1.7 so you can’t base it in that alone.

Sorry you have to be back here!

 

I love the community and support, but I hate the reason why.

In June, her urine specific gravity was 1.017 - totally normal. Her CRE was 2.3 when the range is .3 to 2.1. Her BUN was at 43 when range is 10-30. No SDMA has been done to date.

What is the hemotocrit?

still new to all the new terms and abbreviations. Please be patient with me.

 

BTW - the vet I've been using is someone about whom I'm a little ambivalent. He's a dedicated doctor, but he's the one who gave Mala steroids for an ear infection when I told him at the exam that she had been diabetic. I was stupid and didn't check what he gave her, and paid for it with a kitty back on insulin for a month.

He also seemed really amazed to hear that it's possible for people to monitor bg levels and dose kitties appropriately. Had no idea that this board exists, and no notion of how lactated ringers could be acquired inexpensively or how to get insulin on the internet.

But no other vet around me is better or more up to date on care for cats with chronic conditions, either. When our Emmeline had to have 9 teeth pulled in March, no one noticed the cancerous tumor crowding out her teeth and causing them to snap off.

This vet also insisted that Mala go on the Science Diet k/d, and it may be the reason why she's diabetic again. At age 19, there's no guarantee she'll take another trip to the falls.

I'm frustrated with my vets.

 

That is a low USG; it should be above 1.040. However, USG changes throughout the day just as it does in humans. You can’t base CKD on one measurement. The same as with creatinine as other things can affect it other than CKD. I’m not saying she doesn’t have CKD; I’m just saying I don’t think your vet has really established that she does.

One of the best ways to get an accurate reading on USG is to get the very first sample of the day when it is most concentrated and let the vet check the USG. He should have a handheld refractometer in his practice (I would worry about using a vet that doesn’t as I even have one at home). Be sure they calibrate it before he checks her USG. If her USG is above 1.040 with the first sample of the day, then she is able to concentrate her urine and does not have CKD.

The best diagnostic if you can’t do the above is to have him send bloodwork to IDEXX and have the SDMA done.

Hematocrit indicates if they are anemic or not. Hers is on the low side (33%) which is typical of CKD cats but lots of things can cause a lower hematocrit. Again, it’s something that you want to look at the trend unless there has been a reliable diagnosis of CKD.