Possible CKD , need expert openion

Discussion in 'Feline Health - (Welcome & Main Forum)' started by rawia, Jul 3, 2020.

  1. rawia

    rawia Member

    Joined:
    Aug 24, 2017
    Hi all,

    today was Meme’s follow up after her teeth extraction which was two weeks ago ( 5 teeth was extracted).

    one teeth was little infected and they gave her another round of long term antibiotics.

    Before her surgery the vet told me that her BUN and creatinine test was little elevated.

    today the vet retest her and her BUN was 40 and creatinine was 2.6 he is thinking that she has CKD and suggested to do B12 injection and to give her medication that control her blood pressure.

    on March I did the IDEXX SDMA test which was in normal range , the result was 11

    And as i read that CKD will appear when 70% of kidney function is damaged.

    i asked him to do other test to be confirm that she had CKD and he said that blood test is enough, I just do not get it, the SDMA test supposed to catch early CKD or I am wrong?!

    can the teeth infection effect her BUN and creatinine?

    some friend told me that they should do ultra sound and X rays for kidney.

    I would be happy if you help me her with any expert opinions.
    @Marje and Gracie

    thank you
     
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  2. Liang & Nathan

    Liang & Nathan Member

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    May 15, 2020
    UTI infection can affect the BUN and CREATININE, but I am not sure teeth infection.

    You may want to recheck in 1 month. If the numbers are still high, then CKD is possible. But again CREATININE 2.6 is not that bad. My cat Kitty is 3.4-3.5. The following link (and the whole website) will provide you an overview of CKD.
    http://felinecrf.org/how_bad_is_it.htm

    Meanwhile you can switch her diet to low phosphorus/moderate protein canned food.
    http://felinecrf.org/catfood_data_how_to_use.htm#choosing_a_food
    http://felinecrf.org/canned_food_usa.htm

    I am also attaching two documents of food list for CKD cats. One is provided by a facebook CKD private group member. The other one is the food I feed my cat. These two documents both use the metabolisable energy (ME): the basis of % caloric distribution for protein, fat and carbohydrate.
     

    Attached Files:

  3. Liang & Nathan

    Liang & Nathan Member

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    May 15, 2020
    I am not sure about the B12 injection since my vet didn't mention it to me. Let's wait for expert's opinion.

    Today I just took Kitty to the vet to check her blood pressure to make sure she doesn't have high blood pressure. So if your vet has the equipment to test, you may ask him to check the blood pressure.
     
  4. rawia

    rawia Member

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    Aug 24, 2017
    Thank you

    food was my first concern because she is also diabetic, I think i will need to order it online.
     
  5. Liang & Nathan

    Liang & Nathan Member

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    May 15, 2020
    I am attaching a food list for CKD cats with diabetes. The WERUVA BFF canned foods are available in Petco. You can buy a couple of cans to see if she likes them.

    Most food in the kitty_food list is also low in carbs.
     

    Attached Files:

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  6. rawia

    rawia Member

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    Aug 24, 2017
    Yes, i think i will order Wellness core tiny , it was also low in carb.
     
  7. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    In addition to a UTI influencing the numbers, so can anesthesia. I think getting the blood work re-run in a few weeks is a good idea.
     
  8. rawia

    rawia Member

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    Aug 24, 2017
    So what i can not understand is why the SDMA came normal and three month later they told me that she has possible CKD, can this happen ? What i understand that SDMA is an early test for CKD
     
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  9. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    I agree. That's why I think several of us are suggesting that you get Meme re-tested in a month or so. The values may have been off due to the UTI (which if it doesn't clear up in a couple of weeks could mean it's a kidney infection), medications, or anesthesia. Any drug that is cleared via the kidneys may cause a change in some of the values.

    FWIW, one of my cats had normal SDMA. He's a big breed cat and his values came back slightly over normal along with a mildly elevated creatinine level. His kidney levels have come back down. I do think he has early stage kidney disease (I changed his diet) but everything is stable. My point being that these values can change.
     
  10. rawia

    rawia Member

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    Aug 24, 2017
    The one thing that make me worry before her surgery and after is that she was drinking more and went to bath room more with little big amount of urine, this situation happened before and her BUN was slight high that is way the vet suggest a SDMA test which it came normal and the vat gave her antibiotics and everything was ok.

    if it is a UTI and it happened again then how can i treat it, and could this lead to kidney failure, plus her gum was very inflamed before surgery and now it is little infected.

    They keep giving her antibiotics every time , is it ok to have antibiotics for long time.

    so i just wait and do nothing if it is UTI? And how i treat this ?
     
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  11. Larry and Kitties

    Larry and Kitties Well-Known Member

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    Dec 28, 2009
    Can you enter the most recent blood work values in the "LABS" section of your spreadsheet?
    What was the measured blood pressure?
     
  12. rawia

    rawia Member

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    Aug 24, 2017
    I do do not think that they even test her blood pressure which i want to be done? I well call and ask for a copy of the result.
     
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  13. Larry and Kitties

    Larry and Kitties Well-Known Member

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    Dec 28, 2009
    Then why in your initial post di you mention blood pressure meds?
     
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  14. rawia

    rawia Member

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    Aug 24, 2017
    Because the vet suggested that but he never mentioned the blood pressure test result ? He only make his diagnosis based on BUN and Creatinine
     
  15. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    Excessive drinking and excessive urination are symptoms of diabetes. (It's referred to as PU/PD -- polyuria and polydipsia). Some diabetic cats are more prone to develop UTIs due to sugar being excreted in the urine and the sugar in the urine is a great medium for bacterial growth.

    I would ask about a blood pressure test. Putting your cat on BP meds if Meme's BP is normal would be unnecessary. Elevated BP can have an effect on the kidneys so it's good to get it looked into.
     
  16. rawia

    rawia Member

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    Aug 24, 2017
    Good day,

    I went today to another near vet to check Meme’s blood pressure and thankful it was normal , near 140, he think that she was little stressed but he said that it is normal, and he agree with you about her test, he said exactly as you said, so I will wait and retest her in a month after her teeth extraction healed , because she still feels some discomfort and her gum little sore.

    thank you all for your help. At least i feel relief that her blood pressure came ok. To be honest her teeth and the surgery was so painful.
     
  17. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    Dec 28, 2009
    Awwwwww keeping Meme in my prayers. ;):bighug:
     
  18. rawia

    rawia Member

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    Aug 24, 2017
    I believe that she still in pain , her gum from one side still sore and irritated , she feels discomfortable when eating on this side , it is two weeks now after surgery i do not know why it is still sore, she had another round of antibiotics.
     
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  19. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    Dec 28, 2009
    Somethings wrong. Have you called the vet and told them this?
     
  20. rawia

    rawia Member

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    Aug 24, 2017
    Yes and he gave her another round of antibiotics, her gum was badly inflamed before the extraction for a while and the vet always thought that it is just infection then he suggested a dental work to have better look which was the problem from her teeth. Plus i did not gave her the Metacam which i think if i did then it will help with the inflammation.
     
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  21. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    Did the Vet get a set of post-procedure x-rays? There's a possibility of a piece of tooth was left behind and that's what's causing the problem. The vet really needs a set of x-rays after extractions to make sure no pieces of a tooth are remaining.
     
  22. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    Dec 28, 2009
    I agree new xrays are needed.
     
  23. rawia

    rawia Member

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    Aug 24, 2017
    There is some infection which doctor think it is the reason but i think that maybe the stitches bothering her, we are now on day 21 and the stitches still there. I used some of the pain killer that he gave me to see if she is on pain or just something bother her, she ate well after with no problem so i think there is something make her feel pain.

    I will make another appointment to see what is happening.

    maybe he tight the stitches too strong
     
  24. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    Dec 28, 2009
    Well if there is some infection that can cause pain too. I would still take her in to be seen . Poor baby sending healing vines to wrap her in comfort.
     
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  25. rawia

    rawia Member

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    Aug 24, 2017
    I just read this again to have more clear idea, so what i understand that if the UTI did not clear in few weeks it can be a kidney infection which can cause CKD? I read somewhere that kidney infection can lead to CKD?

    and if she had kidney infection how can be treated?
     
  26. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    Dec 28, 2009
    A vet would prescribe antibiotics. Sending healing vines to wrap MEME in comfort and health.
     
  27. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    Any number of things can cause CKD. However, as you initially noted, the kidney values are inconsistent -- not everything is elevated. Kidney disease, if that's what's going on is staged - it's called IRIS staging. It could be that Meme is at an early stage or it could be that the test is reflective of something temporary. At this point, I'd be alert to any changes and get the tests re-run to determine if the values go back to normal or not.
     
  28. rawia

    rawia Member

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    Aug 24, 2017
    So even with CKD is there any treatment that vet should give, my vet only suggested B12 injection if she had CKD.

    if she is in early stage what kind of treatment should provide or i have only change her diet and see.
     
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  29. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    There's not much you can do. At early stages you want to feed foods lowered in phosphorus. Later you can add sub q fluids. I also give oral b12 methylcobalamin a few times per week to keep her hct levels normal. You'll want to have her blood levels checked every 3-4 months to see how she's doing. Ckd cats are prone to high blood pressure so get that checked every so often too. My diabetic ckd cat eats weuva foods.


    Weruva slide and serve pate foods Family Food (.97 phosphorus and 0 carb). Also Jeopurrdy Chicken (0.97 P 6.1 carb)

    Weruva Steak Frites (0.57 phosphorus 7.5 carb although I take out any big pieces of potatoes to try to limit the carbs just a bit)

    Weruva LA isla Bonita - phosphorus 0.77 carb 4.5
    Glam and punk 1% carb, 0.93 phosphorous.

    Weruva paw lickin chicken 3.3 carb 0.82 p and
    Press your lunch 5.9 carb. 0.82 phosphorous

    Bff play Laugh Out Loud chicken and lamb 7.7 carb, 0.82 phosphorous

    BFF play destiny (chicken and duck) 0.87 phosphorus 7.7 carb

    Bff play chicken cherish 0.71 phosphorus 7.6 carb

    Bff play best buds chicken and beef 7.9 carb 0.9 phosphorus

    Bff play chicken Checkmate. 7.7 carb 0.7 phos
     
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  30. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
  31. rawia

    rawia Member

    Joined:
    Aug 24, 2017
    Hi all

    I have a little update on Meme’s situation , I will retest her blood Nd SDMA in about a few weeks , but when i took her to check her blood pressure in other clinic , the vet suggested to do a quick urine test to give me some relief and he said the she had a UTI because her LEU is little high. I posted a picture of the test result.

    so if she had only UTI , could this be a reason why he creatinine and BUN is little high??

    and even with antibiotics i still see her urinating little more than usual and drinking little more water?

    how can I treat UTI ? He said the antibiotics will treat it but i just see little improvement.

    @Sienne and Gabby (GA)
     

    Attached Files:

  32. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    I suggest asking your vet about using a d-mannose supplement as an adjunct to the antibiotic treatment (it can be mixed into wet food). It might help with the urinary tract issue (it aids flushing out of certain bacteria from the urinary tract and shouldn't impact blood glucose regulation).

    If your vet hasn't done so already, it would be an idea to ask about doing a cystocentisis with culture and sensitivity to determine the specific cause of the UTI and therefore the best medicine to treat it.

    Meme's a great name. Beautiful girl, too!


    Mogs
    .
     
    Last edited: Jul 31, 2020
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  33. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    Knowing that there are white blood cells (leukocytes) in Meme's urine really isn't sufficient. To figure out what antibiotic may be needed you have to get a sterile urine sample. The vet needs to do this by using a needle into the bladder (it's called a cystocentesis) and then a culture and sensitivity (C & S) test is done. The latter takes several days as they are growing the bacteria in a culture plate. This allows the vet to identify what the bacteria is and then prescribe an antibiotic that is specifically geared to treat the bacterial infection. Without the C & S, you're vet is just picking an antibiotic out of the air and it may or may not be effective.
     
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  34. rawia

    rawia Member

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    Aug 24, 2017
    Thank you all

    I will mention this to her vet in the next appointment, I didu the urine test in dufferent clinic , so at her next appointment i will discuss this with our vet and will update you, I well also do the SDMA again if needed.
     

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