Rhubarb possible CKD

Discussion in 'Feline Health - (Welcome & Main Forum)' started by majandra, Jan 20, 2021.

  1. majandra

    majandra Well-Known Member

    Joined:
    Oct 11, 2018
    I'm starting a thread for Rhubarb to share and discuss her current issues. I'll preface it by saying that I have an amazing vet, and any issues get discussed thoroughly. With covid protocols, things have been a little more difficult since I'm not in the room for the exam and my memory has been crap with recent stresses, so I may not have provided all relevant info to vet. I have also had phone consults to supplement the office visits. Also, like everyone else, I've had a lot of crap going on, and stresses, changes in work, etc etc. I also apologize for the rambling.

    Some basic history: Rhubarb was dxd diabetic in 2018, only needed insulin for 1 month, OTJ and diet controlled ever since. Sugars only mildly elevated with dental infections(low to mid blue), otherwise perfect. Doesn't even get elevated at vet.

    Some more relevant stuff: Through 2020 fall, started drinking more water than usual, variable appetite, with sugars normal. She normally gets chicken flavoured food, but there was a shortage, so she was getting fish or beef flavour, which she isn't as keen on, which of course complicated things.
    I brought her in Dec 23, 2020 to get checked out and to get vaccinated. I was told bloodwork was good, but she had gingivitis. I agreed to Convenia to tide her over until dental (I do NOT need lecture on this, I had a lot going on and had I been thinking better, I would have remembered that I had already decided prior that she would no longer get Convenia, despite never having had a bad reaction. Again, do NOT lecture). Her weight was down a bit from normal, so we started giving her extra freeze dried turkey, some of the other cat's zero carb pouch food, and a bit of chicken babyfood (no spice or carb). I was able to get a small can of another low carb flavour of her normal food, and she devoured it. Still not overly enthused with the fish flavour food.

    On Dec 27, she didn't want her freeze dried turkey, so I pulled some grouse out of the freezer, which she went crazy for. She hadn't eaten much of her food overnight, but that didn't raise any alarms since she no longer likes that flavour. I was already in the process of getting her switched to another food. She devoured her grouse, but when I went to give her some more later, she sounded enthusiastic, but kinda nosed it a little, and wouldn't eat it until I took it out of dish to put on floor. Not long after she went to the litterbox, and then I heard the dreaded "gush" and raced downstairs just in time to catch the food from hitting the carpet. She had diarrhea, and vomited all food that day. I planned to bring her in to vet first thing in morning.

    Dec 28 I had to work,unable to get replaced, and was unable to bring her in until afternoon as an emergency, so I gave her cerenia before work. No more vomiting. She had lost a tiny bit of weight. physical exam was fine, she got subq fluids. we discussed her previous bloodwork. Given the time delay from the shots, the only conclusion we were able to draw was that there was just a perfect storm of events that ended up with her getting sick- tooth pain, possibly a reaction to getting into dishes, maybe even the grouse, and just everything together with getting shots left her sick when she wouldn't have been normally. Then not having enough calories mixed with nausea (and so I could only give her small bits of syringe food to avoid vomiting) caused her to backtrack a little.

    Enough rambling there. Rhubarb went to the vet more since then, had more labs done, I was syringe feeding and giving subq fluids at home, bupe for dental pain, supplementing with emeraid critical care, and she improved and returned to eating and drinking on her own, and gained weight back to the same as she was on Dec 23. She had her dental this monday, and had 2 extractions, one of which was extremely painful absorption. She had recovered well from the dental. I am slowly weaning her off the a/d food, and returning her to the PC chicken food which my dear husband bought the entire supply when the store finally had it again.

    Now for the possible CKD stuff. I have all but her last urinalysis on my spreadsheet. Basic rundown: Her bloodwork from Dec 23 showed her t4 in the grey area, SDMA top of normal, everything else normal. When I brought her in when she got sick, vet said he would be extremely surprised if she was hyperthyroid because symptoms didn't suggest it. Fill in vet I saw later in week recommended further testing though. Her next blood draw didn't have enough to send for ft4 though. Throughout this last month she has become slightly anemic, her SDMA raised to well above normal (retested before dental on monday). Her urine had protein in the free catch sample, as well as the one they obtained on dental day. I do not have the results from dental day urine- all I know is that there was still protein, and it was shipped for ratios, and still waiting for results.

    I may have jumped the gun in thinking it's CKD, this could all be a reaction from Convenia. It could be from dental infection. Her being sick could have been a food reaction. Given that she is 15, drinks a lot more than she did last year, and has large volume urine, I would not be surprised if there is the beginnings of CKD. After all, her SDMA was the very top of normal *before* she got sick. Her getting sick complicates things. I had to take time off work, and my vet has done his best to keep costs down, but I inevitably have paid a lot for this so far. at least I had bloodwork prior to her being sick to compare things to.

    I started adding a part dose of zobaline to her food yesterday and today, and I'll have her to normal dose tomorrow. I will be discussing further treatments/supplements with my vet once we get the remaining test back, which should be today or tomorrow. I already give low phosphorous food, with water added. I now know how to do subq fluids and have the supplies on hand if that is suggested.

    I *think* I have an understanding of things now, but I want this post here to help others, and also to update and ask questions as needed. In another thread there were some suggestions for B complex vitamins, but I don't seem to be able to get any of them where I live. Does anyone have Canadian suggestions? I would also appreciate any advice on what I should ask my vet when we talk next.

    If you made it this far reading, thank you so much!!
     
    Ilianna and Socrates likes this.
  2. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Tagging some other Canada-based members for you:

    @Wendy&Neko
    @Red & Rover (GA)
    @Christie & Maverick


    Mogs
    .
     
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  3. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

    Joined:
    May 18, 2016
    Wendy will know about the B vitamins.
     
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  4. Christie & Maverick

    Christie & Maverick Well-Known Member

    Joined:
    Aug 1, 2017
    I don't have direct experience with B vitamins, but in this info section there are some details. http://felinecrf.org/vitamin_b.htm

    I believe I have read some people here with CKD cats have used Jarrow's brand of B vitamin complex, and a quick search of Amazon (Canada) shows it is available for purchase. I believe some folks have also done shots at the vet office. Hope this helps.
     
  5. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Is she anaemic? Not sure why the b vitamins.
     
  6. majandra

    majandra Well-Known Member

    Joined:
    Oct 11, 2018
    yes, slightly, but trending downwards more
     
  7. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Sorry, not a god person to ask about sourcing, been a few years now, and I cross border shopped.
     
  8. majandra

    majandra Well-Known Member

    Joined:
    Oct 11, 2018
    Brought her in this morning for followup from dental- developed infection.
    Her protein creatinine ratio came back as 0.2, high end of normal. Her blood pressure is good. So he suggests for now that this is early insufficiency, and to make sure she has a good quality protein, low phosphorus diet. He didn't push the vet one, just let me know one was available there if I couldn't find a good one from regular stores.
     
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  9. Veronica & Babu-chiri

    Veronica & Babu-chiri Well-Known Member

    Joined:
    Aug 5, 2016
    Kidney values sometimes get a bit elevated when there are some other health issues, and usually lower when things get back to normal

    But yes given her SDMA results and her age focusing on a low carb low phosphorus diet seems like a good approach if you take a look into Dr Lisa's list look for one under 250 in phosphorus, ideally under 200 besides being les than 10% carbs
     
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  10. majandra

    majandra Well-Known Member

    Joined:
    Oct 11, 2018
    The one I've been feeding is 267 phosphorus, so not perfect, but at least good enough till I find better. Her phosphorus values are good so far thankfully!
     
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  11. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

    Joined:
    Sep 21, 2018
    Hi @JanetNJ has a kitty who has diabetes andcCKD and she posted she feeds Weruva


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

    What a Crock 0.71 phosphorus and 8 carb lots of gravy so she loves it.

    Goody stew shoes 0.71 phosphorus, 8.5 carb. This one is a big hit

    Weruva Steak Frites (0.57 phosphorus 5.5 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 (used to like, not a favorite anymore)
    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

    New favorite On the Cat Wok 3.8 carb 0.74 phos

    There are other choices that are good too. Weruva is very transparent with the nutrition information on the weruva website.
     
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  12. majandra

    majandra Well-Known Member

    Joined:
    Oct 11, 2018
    How does the 0.7 etc convert to the 200's?
     
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  13. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

    Joined:
    Sep 21, 2018
    I'm sorry I don't know but I will tag @JanetNJ and hopefully she can answer that for you :cat:
     
  14. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    You are looking for foods UNDER 1% PHOS or UNDER 200 MG/100 kcal I'm not sure how to directly convert one to the other.
     
  15. majandra

    majandra Well-Known Member

    Joined:
    Oct 11, 2018
    that's what I needed! thanks!
     
  16. Veronica & Babu-chiri

    Veronica & Babu-chiri Well-Known Member

    Joined:
    Aug 5, 2016
    Yes their are and are not a cause of concern right now and you certainly do not need phosphorus binders, but giving low phosphorus food helps the kidneys so it also helps so that CKD does not progress
     
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  17. SweetAngel

    SweetAngel Member

    Joined:
    May 30, 2014
    Hope Rhubarb is doing well. Angel's first phosphorus readings were horrendous but I'm feeding him 50% a very low 0.03 phos food (unfortunately highish carbs) and 50% a 0.065 phos food with binders, and within about a week his phosphorus and creatinine levels dropped to normal. He does definitely have ckd but it looks like it is being controlled better. Did you join Tanya's site? They are really helpful xx
     
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  18. majandra

    majandra Well-Known Member

    Joined:
    Oct 11, 2018
    I haven't joined yet. I'll wait until I have a followup that shows any progression. I've got enough right now to stress on without joining another community. I'll jist end up spending way too much time there and stress myself needlessly.
     
    Critter Mom likes this.
  19. Veronica & Babu-chiri

    Veronica & Babu-chiri Well-Known Member

    Joined:
    Aug 5, 2016
    Don't stress yourself fortunately you are catching Rhubarb's kidney problem very early so with a proper diet and monitoring who knows it may not even progress in a long time or progress so slowly that it may never be a problem
     
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