? Yum now has heart disease and kidney disease too

Discussion in 'Lantus (Glargine) / Levemir (Detemir)' started by MJW, Aug 17, 2017.

  1. MJW

    MJW Well-Known Member

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    Mar 29, 2017
    So, Yum had her senior wellness exam Monday.

    The doctor heard a heart murmur for the first time and her cardiopet probnp is elevated at 112.
    I guess she will have an echocardiogram and I will obsessively measure her respiratory rate.
    Any words of wisdom on heart issues? Neko had heart problems, right @Wendy&Neko ?

    It also looks like she has the beginning of kidney problems. Her BUN was way up at 55, her SDMA was 22, and her urine was a bit dilute at 1.019. Her creatinine was increased but still normal at 2.3. Her phosphorus was out of range at 7.6. Fancy feast classic pates are so high in phosphorus. I was perusing the food charts for low carb/low phosphorus, but my vet suggested phosphorus binders. That way we wouldn't affect her carb balance with a food change. Do any of you use phosphorus binders?

    All these problems fight each other. Diabetes needs low carb (usually high phosphorus). Kidneys need low phosphorus (usually high carb). Kidneys need lots of fluid. Hearts need not too much fluid.

    I guess heart disease is the most worrisome at this point. Maybe I will read about it after the echocardiogram.

    Her blood glucose has crept up a bit lately too. The vet thinks it might be due to a weight increase. I'm increasing her dose in baby steps.

    Yum is still a very happy active cat. She turned 15 in March.
     
  2. Chubba (GA)

    Chubba (GA) Well-Known Member

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    Apr 30, 2017
    Glad Yum is still happy and active. I would think that is half the battle. :bighug:
     
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  3. Sandi & Chase in AZ

    Sandi & Chase in AZ Well-Known Member

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    I'm so sorry to hear about Yum! :bighug:
     
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  4. Doodles & Karen

    Doodles & Karen Well-Known Member

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    Jun 2, 2015
    @Amy&TrixieCat use P binders with Miss Trix.

    I'm sure Wendy will stop by but yes Neko had heart, kidney and lymphoma:( Getting the echocardiogram is most important to get the proper heart dx. There is HCM, RCM and DCM which are usually treated with an ace inhibitor such as Enalapril. With any luck you caught it early and there is no CHF. Doodles had severe HCM (progressed rapidly) and recurrent CHF. The CHF required a very high dose of Lasix but somehow his kidneys tolerated it...probably because he was only 8.5yrs old. He did well on the meds for a year before it couldn't be managed anymore. Neko had a small dose of Lasix and yes, it's hard on their kidneys so having heart and kidney issues make it a bit more difficult.

    Sending lots of vines and prayers for you both :bighug::bighug::bighug:
     
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  5. Veronica & Babu-chiri

    Veronica & Babu-chiri Well-Known Member

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    Aug 5, 2016
    Sorry to hear about Yum, but I agree that the most important thing is she is feeling well.

    Regarding the murmur the vet heard I would wait until after the ecocardiogram so that you know what's really going on, there are many different things that can cause that murmur, some are treatable or at least controlable and won't cause you mayor problems, Babu has HCM and gets ramipril but it has progressed very slowly so fluids are not yet an issue.

    You should look at https://docs.google.com/spreadsheet...KQ9wlZAe1Xy3LDTDVRofU/edit?pref=2&pli=1#gid=0 this list of low carb low phos foods and try and see if she would accept the food change
     
  6. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Feb 28, 2012
    Sorry about the dual diagnosis.:bighug: Some heart murmurs are benign, some not, so the echo will is a good next tool. Neko's first heart murmur was just due to some age related changes, with a bit from from her acromegaly, so mostly benign. That changed over time. :( But at least we had a baseline to compare against. I recommd going to a cardio vet if you can. It was two years between Neko having a benign tumour and her first CHF which was when I started monitoring respiration rate.

    Any chance of entering her lab values into the Labs tab of the SS? We might have some more recommendations if we see the numbers. For one thing, I would first try to find a low carb, low phosphorus food she will eat, before adding binders. If she will eat it of course. Long term use of binders can cause their own problems so going without as long as you can is good. For what it's worth, I never gave Neko high phosphorus low carb food in the five years she was diabetic. Initially I used FF gravy for HC, but I changed that too for lower P choices. There are plenty of options.

    Make sure you are adding lots of water to her food, that is fine for the heart. It is subq fluids that are more the worry. Both of Neko's CHF episodes followed a course of fluids.

    Both kidney disease and heart disease can cause insulin resistance.
     
  7. MJW

    MJW Well-Known Member

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    Mar 29, 2017
    I will have to figure out how to add a Labs tab.

    My vet thought the phosphorus binders would be easier for her diabetes, since I wouldn't be experimenting with food. I do have a LOT of low phosphorus food lying around from when her mother had mild kidney disease. I gave the cats some Wellness Complete Health Turkey (original old formula) this evening in place of a portion of Fancy Feast.
    "There are plenty of options", butI recall being unable to get them to eat much of the low phosphorus food. Of course Yum has a much better appetite these days. I would rather control the phosphorus with food than with binders, but I don't want a food war. I read the binders can cause constipation. Aluminum toxicity seemed more doubtful. I will see if Amy and TrixieCat comment on the cons. Yum's mother's phosphorus level was never high, but she wasn't eating FancyFeast.

    VERY interesting that these diseases could be causing her insulin resistance. Could it work the other way too? The heart murmur is new. And although Yum's kidney numbers were creeping up over the past year, they really shot up since the spring (when she was unregulated).

    Thank you for explaining subQ is bad for the heart but oral fluids are not. I wasn't sure about that.

    There are a couple of cardiology vets in the area. I guess I will do the imaging first, or however they schedule it.

    Kind of overwhelming. I was so obsessed with getting her into remission and now this...
     
  8. Wendy&Neko

    Wendy&Neko Well-Known Member

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    The Labs tab is already a sheet on the spreadsheet. If you go to the bottom of your spreadsheet when you are editing (top when just looking), you will see a second tab called Labs. It has a lot of the values and reference ranges, though you might have to tweak it a bit based on what lab your vet uses. If you get them entered, tag Marje and Gracie - she's a whiz at labs, especially for kidneys.

    I got the echo done by a local cardiologist. There is only one around here, you are lucky to have options.
    Focus on quality of life. Diabetes is fairly easy to manage once you've been at it a while. Fortunately Yum has been in pretty good numbers and likely spending most of her time under renal threshold. You are doing a great job with her. :bighug: Insulin resistance just means she might need a bit more insulin. Not the other way around.

    I did the low phosphorus foods for as long as I could, but did eventually have to go to binders when Neko's phosphorus started going up fast. And when she started getting ultra picky.
     
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  9. MJW

    MJW Well-Known Member

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    Mar 29, 2017
    I didn't realize Doodles had heart disease. He was so young for all that. Lots of new acronyms here.
     
  10. Bronx's dad

    Bronx's dad Well-Known Member

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    :cat:
     
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  11. jayla-n-Drevon

    jayla-n-Drevon Well-Known Member

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  12. MJW

    MJW Well-Known Member

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    Mar 29, 2017
    Thank you for Babu's details.
     
  13. Marvin's Mom - Nat

    Marvin's Mom - Nat Well-Known Member

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    Apr 10, 2017
    Sorry to hear that too, I need to get Marvin's heart checked out too, he has a murmur so want to make sure I do what I can for him. If I can afford it want to do the full blood panel too, to see if there was any improvements since he was Dx as I did a full senior blood panel then.
     
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  14. Barbara & Uncle

    Barbara & Uncle Well-Known Member

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    Oct 13, 2016
    So sorry to hear about Yum. Good that she is still active and happy though, both good signs :cat:
    I just found out last week that Uncle now has heart issues along with kidney, so seems like we're both just starting out our navigation on this journey.
    Wendy, Karen & Marje have been giving me great specific advice and answers to questions as they are coming up. And of course everyone else who has experience dealing with such things as well:bighug::bighug::bighug::bighug:
    I will follow you and watch Yum's thread. I already learned something new regarding fluids by reading Wendy's comments.
    Hugs to you and Yum, from Barbara & Uncle :bighug::bighug:
     
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  15. Amy&TrixieCat

    Amy&TrixieCat Well-Known Member

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    Feb 14, 2011
    I'm so sorry about the diagnosis....hopefully the echo will give you answers.

    I don't have a whole lot of time today - heading out the door for the weekend in a few - but I wanted to answer about p-binders. My Trix had advanced kidney disease and wouldn't eat anything other than Fancy Feast and Purina One for the longest time, both of which are sky-high in phosphorous. I used the binder for 3 years without any issue, and it did help with keeping her phosphorous down.

    With that said, I would prefer keeping phos down with diet, but if all else fails....kitty's gotta eat, and the binders do work well if needed.

    Vines and prayers from us!
     
  16. Heather&Dagron

    Heather&Dagron Member

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    Jun 4, 2017
    No experience with feline heart disease, but I had a rabbit with cardiomyopathy who lived four extra years after diagnosis with a diuretic compounded to transdermal cream that I would rub on his ears. I had him PTS at the age of 10 because of a retrobulbar abscess, but the heart disease was still well controlled at that time! The diuretic we used was furosemide (generic for Lasix).

    Also, I'm not so sure about kidney disease needing a high-carb diet. I know that vets will generally recommend a low-protein diet for that, but some people have been questioning if it's more so the quality of protein that matters and not the amount of protein.
    http://www.felinecrf.org/nutritional_requirements.htm#protein_goal
    http://healthypets.mercola.com/sites/healthypets/archive/2012/08/06/kidney-disease-in-cats.aspx
     
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  17. MJW

    MJW Well-Known Member

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    Mar 29, 2017
    When the vet heard the new murmur (3 out of 6 loudness), she ordered a blood thyroid check to rule out hyperthyroidism and a blood CardioPet proBNP test, which did indicate heart disease. You might also want to check Marvin's resting respiratory rate.
     
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  18. MJW

    MJW Well-Known Member

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    Mar 29, 2017
    Which p-binder did you use? They ate old formula Wellness turkey last night, but not much this morning. Yum is a FF addict. We've been through this before.
     
  19. MJW

    MJW Well-Known Member

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    Mar 29, 2017
    I thought I was barely dealing with the diabetes and now this. I guess our kitties are both seniors now. I have piles of the foods you show in your signature for Uncle, stacked in my pantry from when Yum's mother had mild kidney disease. None of them would eat it. I finally put her mother on a vet kidney diet, which was good for her but would be bad for Yum's diabetes. Has Uncle ever had elevated phosphorus levels? Yum's was 7.6.
     
  20. Marvin's Mom - Nat

    Marvin's Mom - Nat Well-Known Member

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    Apr 10, 2017
    Thank you, I did check a couple times his respiratory rate and was ok. I will try and get him in to vet to start the process now that fd is regulated
     
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  21. Olive & Paula

    Olive & Paula Well-Known Member

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    Sep 6, 2015
    Smokey had all that except the ckd but had chef and asthma. I had his heart meds compounded and flavored into liquid. So one dose contained 3 meds. Liquids are easier for me to give to all my cats.

    Have to go. Contactor just pulled up will finish later.
     
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  22. jayla-n-Drevon

    jayla-n-Drevon Well-Known Member

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    Oct 11, 2015
    I have 2 cents to add :cat:

    I always asked for the vets to specifically check his heart as I know it is often the "silent killer " for cats-
    He is 19 and they never heard anything.
    About a year ago he had a dental-he was getting fluids and had started pred I will jump ahed--he ended up in the ER with a "gallup" heartbeat....needless to say I was shocked as I have BW often and hearts checked .
    The ER vet suggest to pts:eek::eek::eek:
    I told her keep in oxygen and give lasix I will be back in morning-
    went to see him and he then had a "murmur"
    went right to the cardio vet and she heard a murmur and after a few hours she could not even detect a murmur.
    I write this because I have asked and researched and murmurs can come and go-
    I bought a expensive stethoscope and check him and so far things sound good-
    My vet just came and did a exam last week and not a trace of a murmur.
    We have had a long and enlightening year as he also developed FD from the budesonide and now in remission as he is off the budesonide.
    OK this may. be more than 2 cents!:bighug:
    Don't give up....this was all over a year ago and he is happy and bright:cat:
     
  23. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Well-Known Member

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    Dec 28, 2009
    I don't know if your vet gave you the normal values for pro-BNP. Above 100 is considered abnormal. A 112 is barely abnormal. If you're planning on getting an echocardiogram, that will be more definitive. (Just to put this in perspective, I've seen BNP values in humans that are over 1000 and the normal range is below 100. The crazy high values are in people with heart failure in an acute episode.) Did you have blood pressure checked? The kidney values can be out of whack due to blood pressure.

    I did use phos binders. The go to resource for kidney issues is Tanya's website on CRF. There's a ton of information on phos binders.
     
  24. Amy&TrixieCat

    Amy&TrixieCat Well-Known Member

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    I used Thriving Pets (ordered online) "house brand" .
     
  25. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    Jul 18, 2011
    I'm so sorry to read about Yum's new diagnosis. I know it's overwhelming, but as you can see from all the comments, it can all be manageable.

    My civvie Minka didn't have kidney disease, but she did have kidney cancer. She also had a heart murmur. An electrocardiogram was done and found nothing. It came and went during her last couple of years. She was on fluids twice a day her last year and no heart problems developed. ECID, so you just have to take the info you get from the tests and work with it.

    The experience on this Board is phenomenal, for lots of other issues besides FD, and as you are finding, people are happy to share. Take advantage of us.

    Sending lots of good vines to Yum and :bighug:s to you.
     
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  26. MJW

    MJW Well-Known Member

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    Mar 29, 2017
    I have spent the last day totally focused on minimizing phosphorus. Am I supposed to be limiting protein as well, to 35%? I read that in one of the links above. The whole quailty/quantity protein argument for CKD kitties is confusing. I know when I put Yum's mother on a vet diet her CKD reversed a bit and stabilized. However, that was a high carb diet and maybe it pushed Yum towards diabetes. I think I need to get some sleep and read through felinecrf.org again. Today I was trying to get Yum to eat primal freeze dried turkey "instead of" rather than "in addition to" Fancy Feast pate. Very frustrating. Food wars. We started this yesterday. She hasn't had a bowel movement.
    Monday we see the cardiologist.
    Thank you everyone for sharing your experiences. My brain is just spinning.
     
  27. MJW

    MJW Well-Known Member

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    Mar 29, 2017
    Maybe it's a big mistake giving her a high protein raw diet, even if it does have less phosphorus than Fancy Feast.
     
  28. Heather&Dagron

    Heather&Dagron Member

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    Jun 4, 2017
    I can't (and won't) tell you what to do with your cat. If it were one of my boys, I would switch him to an animal-protein, low-carb, low-phos canned food or start making raw again. (I also have a bad habit of not trusting veterinary diets and making my vets absolutely crazy while I try to "fix" my cats through diet that isn't Hill's garbage.)

    I guess what I'm saying is, do your research and don't doubt yourself. It's a lot of blows at once, but you'll pull through.
     
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  29. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Feb 28, 2012
    Depending on stage of kidney disease, you may just want a good quality protein, low phosphorus diet. Looks like Yum is just at stage 2, so that diet should be good enough. Not all raw diets are high protein. Neko did great for two years on low phosphorus raw. There are also low phosphorus good quality canned foods. But most important, a cat has to eat. If she won't eat what is best for her, then you should talk to the vet about binders. Her phosphorus level needs to come down to make her feel better.
     
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  30. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Well-Known Member

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    Dec 28, 2009
    My experience with CKD is limited. You've gotten some great advice already.

    @Marje and Gracie was an enormous help to me when Gabby was diagnosed with kidney disease. The one stand out is exactly what Wendy noted, a good, high quality protein is essential. The notion of a low protein diet is a bit dated. FWIW, Darwin's is a raw food company that has a low phos option. You need a prescription from your vet.
     
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