1/15 Ruby PMPS 120/+2 99/+4 74/+5 78 early CKD advice?

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by PerfumedCatMom, Jan 15, 2021.

  1. PerfumedCatMom

    PerfumedCatMom Well-Known Member

    Joined:
    Oct 8, 2020
    Yesterday was a good day in Rubyland. She's been reminding me that it's test time lately by head butting me and running to the couch where we usually do our thing, assuming the position before I even get the test kit out. Who knew one could train a cat to do anything? :rolleyes::smuggrin:

    Healing thoughts to all of the sick kitties and hugs to you beans who love them so. Can you believe it's Friday already? :bighug::bighug:
     
  2. Tomlin

    Tomlin Well-Known Member

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    May 30, 2019
    Happy Friday and another great day in Rubyland :rolleyes:!

    Love to read that Ruby is leading the charge to get her BG checks :bighug:.
     
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  3. Sue and Luci

    Sue and Luci Well-Known Member

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    Nov 3, 2017
    Isn't that something? I was so impressed when Luci would get up on the testing towel and lay there - waiting for me to get out the tools to do a test! I was so flabbergasted the first time she did that I stopped to take a pic! Who is this cat????

    Have a great day!
     
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  4. JaxBenji

    JaxBenji Well-Known Member

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    Jul 10, 2020
    WTG Ruby :cat: Keep reminding mama who is in charge ;) Hope you all have a wonderful day!
     
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  5. carfurby

    carfurby Well-Known Member

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    Feb 19, 2012
    How cute. Do you give her treats after testing? Furball gets treats if it's not AMPS or PMPS so she looks forward to it. She also gets loving.

    Nice start today. I hope Ruby slides down and surfs safely.
     
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  6. PerfumedCatMom

    PerfumedCatMom Well-Known Member

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    Oct 8, 2020
    Remember how painful that was for us in October? It was :banghead::arghh::blackeye::eek:o_O:nailbiting::confused: for weeks until I got the hang of it.
    I know that cats like routines but wow, I had no idea she would be so compliant!
    No doubt who's in charge around here, and it certainly ain't me. :p
    Ruby isn't very treat oriented, Carla, so that never worked, but I test her before I give her the AM/PM shot and her +2 and +4 meals so that i know what to feed her, so she does associate 6 tests a day with a nice warm meal of watered down pate. Yums!
     
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  7. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    Sep 21, 2018
    Morning Katherine they are so smart aren't they. She's looking so good.
    Have a nice day Katherine :bighug::cat:
     
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  8. JOJI and Kit

    JOJI and Kit Well-Known Member

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    Dec 19, 2019
    surf it safe out there, ruby :cool::D
    next step, flash cards!
     
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  9. PerfumedCatMom

    PerfumedCatMom Well-Known Member

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    Oct 8, 2020
    The world would be a dangerous place if cats gained language acquisition skills.
     
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  10. JOJI and Kit

    JOJI and Kit Well-Known Member

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    Dec 19, 2019
    lol. i was thinking maths. like horses that can tap to count ...
     
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  11. PerfumedCatMom

    PerfumedCatMom Well-Known Member

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    Oct 8, 2020
    +7 = 88. Spoke to Ruby's vet and the news is great/not great. Her fructosamine is 316, so she's on the road to remission but he's leaving that up to me to manage as he said I'm the best diabetic care giver he knows. :) He did say however that her SDMA had dropped back to 11, but her creatinine is 2.4 (IDEXX high ref range is 2.3) which means early stage CKD. He wants me to give her 100 mls of sub q fluids once a week and to recheck her bloodwork in 1-2 months. Will pick up the bag and IV in a few minutes, and will have to watch some Youtube videos on how to administer.

    Of course I'm upset that we have yet another thing to contend with, but I know there's a lot of experience with CKD among you all here so I feel good that I will have support. Is there anything I should be doing with her diet aside from feeding low phosphorus foods, which I am doing already?
     

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    Last edited: Jan 15, 2021
  12. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Have you checked out http://www.felinecrf.org/? It's your new best site. There are also online groups associated with it. This seems a little early for starting fluids. Tanya's site says to start when creatinine is over 3.5. Creatinine can also register a little high if she's dehydrated. Neko went her first couple years of early CKD with just extra water in her food. That and moving to lower phosphorus foods were all I needed to do. Has the vet checked Ruby's heart? That should be checked before fluids started, I know too well how that can go wrong.

    How to Give Subcutaneous Fluids (Video)
     
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  13. PerfumedCatMom

    PerfumedCatMom Well-Known Member

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    Oct 8, 2020
    Thanks, Wendy, I read the same thing on Tanya's site about starting when creatinine is over 3.5 and was just about to ask here on the forum about it. I just spent $60 on a bag and the IV set already. :rolleyes: Her vet has never spoken to me about her heart. Would there be anything in blood tests that would indicate against it or is it a blood pressure issue? The vet wants me to do 100 ml once a week, which doesn't seem like a lot but I also don't want to strain her system or flush out any electrolytes that she might need.

    I already give 1 part water to 2 parts food, and neither Ruby nor my civvie have touched their water bowl in the months since I started adding water to their food, so wouldn't that indicate that she's not dehydrated? She does pee rather copiously (and loudly, like a truck driver!:D) but I chalked that up to all of the water she's getting now versus before.
     
  14. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Ouch! Even my specialist vet never charged that much, I could usually get a bag and IV set for under 30 at my vet. That's without shopping around.
    Getting blood pressure done at some point is a good idea, though likely not urgent. But that's not related to the heart issues. Fluids pushed Neko into heart failure, twice, so I'm hyper sensitive about it. You can get a proBNP test that gives you some information about hearts. As long as the vet took a good listen and didn't hear anything untoward, you are probably OK.

    I did notice Ruby urine specific gravity was lower and that can indicate less ability to concentrate, and thus kidney issues. Getting a urine sample at home, first thing in the day when it's most concentrated, and getting that to the vet for them to retest might help determine whether the USG is really as low as on her labs. Most vets can test in house for the USG.
     
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  15. PerfumedCatMom

    PerfumedCatMom Well-Known Member

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    Oct 8, 2020
    She did get a Cardiopet proBNP test done on December 3, and the result was within the normal range at 28. But I will ask him if he gave her ticker a good listen.

    It's easy for me to get a sample of her pee. It goes into a drawer and I can pour it out as long as the drawer is clean and I can be sure I've seen her and not her sister pee in the box. Did you note the two other recent USG results on the labs? Seems like her USG has been decreasing over time.
     
  16. Butters & Lyla

    Butters & Lyla Well-Known Member

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    May 30, 2020
    Butters was dx'd with stage 2 CKD last month and the vet didn't suggest it was time for fluids yet. I add water to her food at a 1:1 ratio and feed her lower Phosphorus foods and that's all her vet said to do for now. She does pee a lot also. From time to time I check that her gums are moist and her skin as well and she seems to be pretty hydrated.
    Sorry you're dealing with this but it's caught early so at least that's good. :bighug:
     
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  17. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Good news you've had the proBNP test done and it's normal. It wasn't available when Neko first had a murmur detected.

    And yes, I noticed the decreasing USG, but it can vary quite a bit by time of day when when they last consumed liquids. Same thing for humans. So it may or may not be significant. That's why getting a quick test of the first thing of the day pee can be helpful.
     
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  18. PerfumedCatMom

    PerfumedCatMom Well-Known Member

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    Oct 8, 2020
    Thanks, Lyla! Yes, I know Butters was diagnosed last month so was curious as to whether or not she was getting sub-q. The vet only suggested her getting 100 ml once a week, which seems to be much less than I've seen advised on Tanya's site (2-3 times a week at minimum), so if it keeps her comfortable and can't hurt her, I might go ahead with it. Ruby's pretty accustomed to needles by now, sweet girl. I'll call the vet tomorrow about the issues Wendy raised and to ask him for a little more info on his rationale for prescribing the fluids.
     
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  19. thebigfuzz

    thebigfuzz Well-Known Member

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    Mar 9, 2012
    Our guy Marlin (GA) had CKD, and we gave fluids quite regularly. Cosmo has had them too, for his #2 issues. It is pretty easy once you get a good set up and handle on things. We still have a thumb tack above our couch to hang the bag. It was the most comfortable place to give them for us.

    Maybe not the most reliable, but if their pee, doesn’t smell like cat pee, that can be an (at home) indication of their ability to concentrate via the kidneys. I remember our vet letting us know about it and mentioning to be aware of the lack of smell. One more reason to check the litter box :facepalm: Marlin had advanced kidney failure by that point :(

    Lots of experience with CKD and diabetes on the board, so lots of help if you have questions :)
     
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  20. PerfumedCatMom

    PerfumedCatMom Well-Known Member

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    Oct 8, 2020
    Thank you, Tanya. Interesting about the smell, but unfortunately Ruby shares her LB with her civvie sister, who seems to be well at the moment and, happily or unhappily, their pee still smells. :rolleyes: I will pay particular attention when Ruby pees into the clean box to see re: odors.

    Also interesting that Cosmo gets it for his colon issues. I finally feel like Ruby's turned a corner on her constipation with the introduction of powdered egg yolk into her diet, but it would be nice if the extra hydration could tackle two problems at once. :)

    My only concern with administration is that Ruby will want to move, but she's quite a relaxed cat and in the last four months has been poked and prodded by needles quite a bit so perhaps she will know not to move for a few minutes. We shall see. :cat:
     
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  21. thebigfuzz

    thebigfuzz Well-Known Member

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    Mar 9, 2012
    They do tend to want to move away when they get filled up. I would think it’s a bit uncomfortable having this bubble of water sitting on their back/shoulders. The needles are bigger, so they can feel that too as it goes in. DH usually distracts/pets or guides to keep him in place, while I work the line. You can adjust how fast it goes in. I find 100ccs to take 7-10 mins.

    There are some suggestions to give insulin and subq fluids a few hrs apart and in different places from one another. Just like you would rotate your insulin shots.

    Cosmo hasn’t needed subq fluids since July, but had it when he was unable to poop as a way to help soften the stool.
     
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