? 6/27 Rover AMPS 356; +2 pre-vet 291; +4.5 post-vet 155; labs not good; AminoB-Plex

Yesterday: http://www.felinediabetes.com/FDMB/...-167-9-160-11-189-pmps308-1-310-2-214.160183/

Vet visit this afternoon to find out results of blood work and discuss.

My 25-year-old car has no A/C. Have ice pack for cat cage. Will douse Rover with water before we get in the car. The breeze coming in the windows onto a damp cat should keep him from overheating.

Will watch for stress/dehydration/bounce/drop.

 

prayers.....

great idea with the ice pack....
I always carried those blue ice things to set in the car seat or on my own seat back in the summer time....

 

Sending loads of good vetty vines for the visit today!

Hope it's nothing but good news!!

Funny how I don't think of anywhere in Canada being hot....I think most of us in the states think of Canada and think of snow.....LOL I now have several friends living there and know how crazy the weather can be there....just like it is around here!!

 

Vetty vines from us!

 

Nice. Thank you.

 

Sending good vetty vines.

 

That's almost a 50% a drop between pre- and post-vet.

Basically, kidneys are no more. I've got copies of the blood work report. The difference between May 10th and today is incredible. Only thing we can do is to try and up his hemocrit (almost blood transfusion low). Wants to try Amino B-Plex, even though I pointed out it is high in fructose. (I've used it before with a different cat.) Vet says not enough muscle mass for B12 injections and she'd rather try this first. If his BG #s climb, then maybe the B12. But really, it's only a question of quality and time.

 

I've entered Saturday's blood work. It's attached to his spreadsheet. IDEXX Senior Panel. It's not good. More high and low numbers than normal range numbers.

Hematocrit 19% (29-45%)
As long as Rover wants to eat and good times outnumber bad.
I've started him on the Amino B-Plex, which is all the vet had. Jarrow B-Right should be here Wednesday. I'll look up the dosing. Right now, I just to pour the entire contents down him.

Until the Jarrow gets here, I'm using the Amino B-Plex (1ml 2xdaily) which will make his numbers jump. What are the chances I will have to change his Lantus dosage? I'd like to keep him comfortable - and it's his birthday on Friday.

 

I am so sorry to hear that the results of the b/w were not good. @Marje and Gracie is one of the best around here at interpreting labs, so hopefully she will have time to take a look at them. I know she's busy with her Mom right now, and helping another member, but maybe she'll stop by if she can.

Sending lots of vines and .

 

I'll be happy, too, in just a bit. Got Mom issues handled and helping Silvi with Markies and working on a SS for someone. So if you have just a bit of time, I'll look and get back to you, Red.

 

So sorry to read of the kidney issues with your baby. The BUN and creatinine are pretty high... I had a (non-diabetic) CKD ( chronic kidney disease ) cat that I basically doctored and kept alive for about 3 years after she was first diagnosed. She felt really good right up to the end, and actually did not died of kidney disease, but rather heart failure. She was 18 years old. One of the things that I learned, with her, that I would like to pass along to you is that when the phosphorus value goes high… much above five or six, a phosphorus binder can be extremely helpful to keeping that number low, which contributes to them feeling better! For numbers they're only slightly high (5-7) epakitin is good, but at a really high number like 19.8 aluminum hydroxide powder is a great choice. It is tasteless and can be mixed in with their wet food. It's also inexpensive. It actually doesn't do anything pharmacologically inside the cat.... however, it does bind the phosphorus in the food so that the cat does not absorb the phosphorus… And then the phosphorus levels in the cat's blood goes down and the cat starts feeling better. For dosing on the aluminum binder, and more help with managing kidney disease, try this FB group. https://www.facebook.com/groups/felinecrf/?ref=ts&fref=ts

They are wonderful!

 

Are the reference ranges correct for your vet’s lab? If so, you might want to talk to your vet about a couple days in the clinic on IV fluids if Rover has no heart issues. That will help the creatinine and BUN “usually”. I see you are doing subq fluids at home but I don’t know how much or how often. Usually when numbers get this high, subq fluids won’t do much to bring them down to where they need to be. He should be getting them 1-2 times a day and your vet should let you know how much to give. I say 1-2 times a day because he probably needs more fluids than you could safely give him in one sitting although there is some discussion that anything above 150 ml a day is not that effective. That’s where IV fluids come in.

The other things I would discuss with my vet right away (did he/she mention any of this to you because these are pretty high kidney values and, based on them, he is in IRIS Stage 4 CKD).

• Cara is right that phosphorus level needs to be addressed immediately; P control is integral to longevity and feeling well. If this were my kitty, I would get aluminum hydroxide phosphorus binder and start putting it in his food. For IRIS Stage 4 (which he is at) and the creatinine over 5.0, the target for the P level is 6.0 mg/dL. Here is great information about Phosphorus Binders so you can discuss dosing with your vet since the numbers are so high
• Potassium supplementation: it’s hard to know if his potassium (K) is low due to CKD or due to insulin since insulin will cause the cells to uptake K. However, if I were a gambler, I’d bet it’s the CKD.
• His phosphorus x his calcium is over 70 which means he is also at risk for secondary hyperparathyroidism and tissue calcification
• He is anemic to the point where he needs more than B Vitamins. B Vitamins are fine when the cat is at 29% on the HCT or PCV. But once it falls below 20%, he needs the big guns like Aranasp or other erythropoesis stimulating agents. I like Aranasp because there is less chance of him developing antibodies to it but you still have to keep an eye on it.

I’m sorry for the bad news but these numbers are really something to address now. There is potential you can turn them around but you’ll need to work at it.

 

So sorry to hear today's blood work news. I wish it was better but hope there is something you can address. You've mentioned before that you are already adding aluminum hydroxide to Rover's diet. Can I ask where you get it from? I suspect I'll be following you soon on that path.

Nice blues today for Rover.

 

Sorry! I missed that aluminum hydroxide was already being used. However, with the phosphorus value that high (almost 20) the dose of aluminum hydroxide needs to be higher.

If either of you would like me to send you some, I have a quite a large container that I never even opened that would probably have lasted me another two years… But then my girl headed into heart failure in early May, and had to be put to sleep. She was really doing quite well as far as her kidneys were going. She also had well-controlled hyperthyroidism.

If either of you would like a generous supply of powder, just p.m. me your address and I will send it. I don't have any cats that currently have kidney issues.

I always purchased my powder from thrivingpets

 

I'm sorry the results aren't good but I don't think they are hopeless at all. Can you look again and post the HCT? If Red is anemic due to CKDyou can give epogen or aranesp injections. Epogen works faster. Please post the HCT.

 

Thank you for all your input. I'll try to respond as best I can. Rover always gets stressed and dehydrated on a vet trip day. Been working hard on that and need to get back to it.

I lost a CKD cat almost two years ago. She was 18. Had a large cell inoperable tumour on or near her liver, kidney disease, motility, constipation, heart murmur, thyroid, deaf - I'm forgetting something. It was the tumour that took her. It had grown so big, her stomach and other internal organs were squished. She couldn't eat. There just wasn't room. She was highly opinionated and willful. She also had a bucket list. When I got her at age 14, she was a scaredy cat and lived under my bed for the first year, coming out only in the dark to look out the window and jump up on the bed where she slept on me. She only ventured out of the bedroom on her own once. Then she became sick and was a totally different cat! She wasn't scared of anything anymore. She wasn't going until that bucket list had been achieved.
Rover isn't like that. He's a malleable marshmallow. He's a dog, and a dumb one at that. He has never had a good constitution. When he gets sick, he's really sick. So, I'm working extra hard and long with him.
He is on aluminum hydroxide powder and has been since Late November. He gets just under 1/4 tsp a day mixed in with his food. The issue is constipation. He's maxed out on miralax. In all honesty, it's not quite enough ALOH or miralax. It's been a tough balancing act.
Yes, I belong to forum and read most of the posts. Very informative.
Thank you for the offer of aluminum hydrox. I have lots on hand.

The lab results are confusing. His last lab tests were done in May. May is in mmil/L. The results and references posted are in mmo/dL. I should put that in the chart. dL is something I'm only familiar with when I've drooled over menus in Paris. Why do labs do that? It was the same lab. I can see that there have been huge spikes and drops in the last 5 weeks.

Rover is on 2x75ml subq. The maximum I can go, according to the vet, is 190ml per day. That's on top of what he drinks in a day and he has always drank a lot. Ever since he was a kitten.
No signs of heart disease. I thought it was secondary hyperparathyroidism I was seeing Friday night. That is why I got him in Saturday morning so the bloodwork would be done by today.
I'll talk to the DH tomorrow morning about Aranasp/Epogen. The vet was telling us to start thinking PTS. She did mention transfusions but not the boosters. I was overwhelmed trying to figure out his chart, and there were so many questions and explanations to the DH taking place.

I got mine from thrivingpets.com. I remember reading somewhere that there is a chemical company in Burnaby(?) that sells the powder. The query was about whether or not the aluminum hydroxide was human grade quality or not. I went with thrivingpets because I knew their's was.

The HCT is there, listed as "hematocrit."


I did give 1 ml of the Amino B-Plex to see how high his BG #s would go. He's reading HI. A vet trip leaves him not wanting to eat or drink after. I'm dealing with multiple issues and multiple causes. I just don't know if what I'm seeing is a result of the vet visit or as result of the kidneys. I'm the one who has done all the observing and the work and I'm supporting him the best I can for tonight. I'm just one of four owners. I'll see what the morning and discussion with the 3 other owners (DH and the elderly couple who adopted him as a kitten) have to say. And enjoying my time with him to the max. We spent a long time sitting on the front porch communing with the tuxedo from up the street. We went for a slow walk around the block. I carried him a lot of the way. We'll go out again in a little while. Maybe something will go "bump in the night" and get us all excited!

Your help and concern is much appreciated.

 

Sorry. I saw the blank spot next to HCT and missed that it was there. If it's non-regenerative anemia you should start epogen right away. It is not too low for it to work. Aranesp takes longer to work but you could switch to it later. I've used epogen with Tiffany when her HCT was about the same and it worked. She never developed antibodies to it.

 

Thanks for the info on AH. I wasn't sure if thrivingpets would ship to Canada. Burnaby is 5 minutes away. Hmmm.

May you have more good memories with Rover tonight.

 

Thank you for sharing about Rover. It sounds like you're doing an incredible job with him! He is very lucky to have you, and of course you're lucky to have him. Balancing acts with kitty cats are so tough.... And every single balancing act is different (is what I have noticed).
Hugs to you and Rover!