Caesar Update 13 Jan

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Edouin

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Hi all,

It's been busy with Caesar. We have his full blood tests and UltraSound done, and we are now waging war with his system with a "most likely" initial onset of CRF - but his Phosphorus numbers are still low enough that we may be able to nip this in the bud, however we are pretty sure that this is what is causing us all this grief!

I am trying to scan the "results" I have on paper using ReadIris Pro 12, then will post as 1 HTML page on my ftsask.ca Domain for all to see (with my copyright on it as I paid for this service, thus I hold copyright!).

Any ways, we are holding Caesar down to 0.5u Lantus BID, even though his numbers are high (in the 20's [4-500's fur you yanks], but we are not using the "R" (Toronto) because even though it has a great 30 minute onset, and drops him a good 10-15 points (2-300), it only has a duration of about 4 hours to nadir, so is already wearing off before the Lantus even kicks in!

So, even if we give him two individual shots (one Lantus, one Toronto "R"), we'd be playing a great Yo-Yo game with his numbers, and I'm not sure that is beneficial to his system.

Also, we are giving him Sub-Q's 100ml (nicely warmed up to body temp to reduce discomfort/shock). The solution also has B12 in it, but it is not the Methyl-B12.

Methyl-B12 - we are putting 3000mcg/Litre in his drinking water, so even if he drinks 100ml of water a day (quite easily), he can get his 250mcg/day recommended dose with no problem. After MUCH research, we find that there is no possibility of over-dosing him with B12 as the system will automatically dispose of any B12 that is not used via his urine with no complications. That is good to know.

His Phosphorus levels are elevated - 3.86 (Norm is 1.07 - 1.98), so we have started him on Epakitin for now and have some Aluminum Hydroxide on order with our pharmacist. This solution may be coming from as far away as Winnipeg (about 2000km), so may take a couple of days to get here, but it is supposed to be much more effective at cleaning the kidneys of the phosphorus than the Epakitin is. I believe the solution we are getting is called Amphojel, a liquid solution that will be much easier to dose Caesar with (an eyedropper) than using powder and hoping that he eats all the food that the powder is mixed in.

We note that a Phosphorus reading of "6" is generally the number that is a baseline for CRF onset, which gives us a lot of hope!

Caesar is not eating a lot - yet - but he occasionally goes on a jag and totally laps up the "gravy" we make of the food - he likes the liquid form better than solid, most likely because of his tooth, the initial problem that we have to eventually sort out (extract!), once we get his "CRF" under control.

I found an excellent website at http://www.felinecrf.org/what_is_crf.htm where she gives tons of info on CRF, but our Vet (and the Ultrasound Vet from Edmonton agreed) that Caesar may only be at the very initial stages "IF AT ALL" of CRF, and the tooth infection may only be exacerbating the effects of this Phosphorus build-up in the kidneys.

Some other numbers that support this theory (remember, this is a theory!) is that his Creatinine is high as well at 979 and his Urea is also high at 87.8. Strangely enough, his BG on this blood test was only 15.9! Wooo!

So, I hope this updates you all on the latest.

Will advise when I have the charts up for all to see.

Here is a snapshot of Caesar receiving 100ml of "good juice" LOL. He is not fussing at all because I warmed up the solution in a bowl of warm water first, so he is not really uncomfortable!

TTFN
Caesar%20Sub-Q-1%20small-1.jpg
 
Hi Ed

What do u mean by R (Toronto) ?lol Are u in Toronto?
Ceasar is a sweet looking kitty! Sending good healthy vibes to Ceasar kitty!

I tried to look at his SS, but it's not "clickable"

Hope u have a good nite :)
 
I intended to just take a quick peek at your thread b/c Jill asked me to, but I'm concerned with what I'm reading.

Phos 3.86 mmol/L (Norm is 1.07 - 1.98) is 11.95 mg/dL in US values. the "6" you refer to is in mg/dl i.e. US values; if I converted this correctly, Caesar's phosphorus is very very high.

Creatinine at 979 mmol is 11.07 mg/dl.

Was the bloodwork run before starting SQ fluids? And the phosphorus binder? How's Caesar acting/feeling?

Would you be able to convert the following into US values using this site? http://www.vin.com/scripts/labquest/converthtml.pl
Do it for BUN, creatinine, phosphorus, calcium, potassium, HCT (not sure if HCT needs to be converted)

It would make it easier for the US folks to review. (I'd convert it for you, but I'm feeling a little stretched right now, running between three different newsgroups and trying to clear out PM's on the old board.)

eta: do you have a USG (urine specific gravity) reading too?
 
I agree with WCF - these are incredibly high numbers. Would be interested in seeing whatever other values you have once converted. You may also want to take a look at the IRIS staging levels for renal disease HERE. A creatinine above 5 mg/dl is considered Stage 4 and severe.

Very happy that you found Tanya's CRF site. It has so much great information.
 
Edouin said:
Hi all,
It's been busy with Caesar. We have his full blood tests and UltraSound done, and we are now waging war with his system with a "most likely" initial onset of CRF - but his Phosphorus numbers are still low enough that we may be able to nip this in the bud, however we are pretty sure that this is what is causing us all this grief!

More thoughts. Have vets ruled out other possible causes of the high renal values - kidney infection, kidney stone, etc? I see he's had u/s - did everything look alright on the u/s? Were x-rays done? If you have CBC numbers, post them too and I'll send Jess a PM to stop by later. Also, urinalysis, C&S if was done. Does he have any other health issues?
 
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