1/22 Cleo AMPS 368, +2.5~267

[chriscleo]

numbers pretty high today, as were kidney values. she was really high at vet also. hopefully cutting the dry food down to LC only will make a difference by today.
she's been looking/acting ok, tho (that is, until i woke her up by eye-droppering some sucralfate & tuna juice into her mouth). looking pretty pissy after that. lol.

 

[WCF and Meowzi]

just a couple of thoughts on yesterday's post, trying to type quickly before break ends.

back from oncologist. red blood cell count better, no signs of fever/infection, so she got her CCNU. BUT creatinine out of whack at 2.5. she's never been past 1.4 or 1.5. hoping it's just the high protein dry food so we're stopping the max kitten component so she gets just wellness core. may switch to evo dry, coz it has less protein than wellness core but i'm still not sure protein is an issue. onco vet mentioned KD catfood but i put kibosh on idea.
her USG was low, too, so we have to monitor. i suggested 75ml LRs BID instead of 100ml SID, like i did when she had ketones at diabetes diagnosis, but onco doesn't think that's necessary.

i don't think high protein food is a direct factor in elevated creatinine. BUN, yes, but not so much (if any) on creat. what ref range do you have for that creat value?

read http://www.felinecrf.org/diagnosis.htm#creatinine, esp "other reasons for raised creat." just in case. has her bp been checked recently?

i forget, is ccnu or any of her other chemo drugs renotoxic?

if kidney disease is a concern, all the low-carb dry foods are too high in phosphorus.

USG will be distorted if she's on fluids.

sorry to post and run, but break ended like 4 mins ago. bbl.

 

[chriscleo]

PMPS 249

doing better. she thought i was gonna inject ondansetron so she hid. when i injected just lantus & famotadine she purred. she got ondansetron via fluids last night, which went well, so i'm bummed onco vet only wants me giving fluids SID. that means the morning zofran shot has to be done directly into body.

wcf, thanks for the feline crf link. i did read it last night and got more concerned. onco assured me it's only one test so she's getting it checked at the outside lab to make sure, coz some values were quite different from the last outside labs. onco staff are gone friday thru sunday so i may have to wait, but it's a 24-hr facility so i can call back to see if they'll fax me stuff once it gets in.

i asked her about phosphorus and she said we won't worry about that now. maybe recheck in 2 weeks if i'm worried, or wait the month.

even with fluids, cleo's USG has previously been normal so it alarmed me last week but i didn't see actual full urine results from this week. they may not be available for another 24 hrs, coz she's faxing me in-house and outside lab results together. (cleo had a dental checkup last week with a specialist who is also an internal medicine specialist. she did some blood/urine tests but not all the ones we needed so onco vet did more yesterday.) grrr about not seeing actual test results on paper. so i don't even know bun/creatinine ratio or any other details. bun was 39, which is higher than last one at 34 but not so bad.

so, the idea of LC dry having more phosphorus.... hmmmm, that concerns me. when she mentioned starting cleo on KD it got my guard up about their not knowing enuf about nutrition. do you think friskies special diet is worth trying if i can tempt her? she's eating some wet now but not enuf for full diet.

 

[Libby and Lucy]

It has to be hard to try to consider so many factors into diet, including just being sure she DOES eat enough. Hang in there!

 

[Cassandra and Sasha]

Like Choy-Foong said, EVO, Wellness Core, and Nature's Variety Instinct are all very high in phos. If she still wants some dry, what about Wysong Nurture? It is low in phos (181) and moderate in carbs (22). It's supposed to have increased levels of meat and fat: Wysong Nurture

Was Cleo's phos already elevated, or is it just her creatinine and USG that are the concern?

 

[chriscleo]

phosphorus

cassandra, don't know about the phosphorus. as i said, i didn't get to see the printout of the test results. vet just told me that kidneys are now a potential concern but she needs to double check that in-house labs weren't screwy. (they did urine testing AFTER doing RBC and giving CCNU chemo.)

she only mentioned creatinine's being of concern.

i asked about usg, coz i had seen it was 1.024 last week and thought dr lisa said it should be 1.035 or higher.
bun has been as high as 54 but normally in the 30s so that didnt worry me but this is the first time i've heard creatinine was above normal (at 2.5). it's always been flat-out normal even when bun was slightly elevated.

i'm anxiously awaiting fax of all blood/urine.

now i'm wondering whether cerenia or mirtz has become an issue, kidney wise. onco wanted to discontinue cerenia in favor of zofran but i wanted to wait and make sure she isn't vomiting before i take the cerenia away.

 

[Cassandra and Sasha]

Re: phosphorus

now i'm wondering whether cerenia or mirtz have become an issue, kidney wise. onco wanted to discontinue cerenia in favor of zofran but i wanted to wait and make sure she isn't vomiting before i take the cerenia away.

Both Cerenia and Mirtz are metabolised primarily in the liver. A reduced dose is suggested for Mirtz with liver or kidney disease, but not kidney disease with Cerenia from what I've ever found (only liver problems).

Cerenia metabolism info:

http://www.vshsd.com/For_Veterinarians- ... 202-08.pdf
http://www.drugs.com/vet/cerenia-injection-can.html

Mirtz metabolism info:

http://www.wedgewoodpetrx.com/learning- ... y-use.html
http://www.veterinarypartner.com/Content.plx?P=A&A=2552