Update- Back home again- HELP 1/5/21 Moo Moo won't eat, getting a lot worse

Moo Moo isn't doing very well. I had to take her to the emergency vet Sunday, they said she had went into ketoacidosis. They kept her overnight, and now she's back home.

She won't even eat her treats, she's become so lethargic and I am very scared. Just before Christmas and a little after she was eating very well. She was prescribed (by a vet I don't normally see) amoxicillin and potassium clauvanate on the 29th (the vet had said it could be a herpes flare up, an eye infection, or a root tip infection, but didn't specify which one), could that be whats making her not eat? She didn't get it when at the emergency vet for 24 hours, and from how they sounded she was eating and drinking and doing well. Now she's home, and she did really well for the first couple hours Monday, and then got progressively worse again (I had given her the antibiotics when she got home). She hasn't been eating except what I hand feed her a couple times a day (she refuses any more than that), and her blood sugar numbers have been so low that I can't give her her insulin because of it.

In a previous post, I talked about how I was frustrated with the vet that prescribed her the antibiotic, and now I'm scared it's done some real damage. Please help, I haven't given her today's dose of antibiotics because I don't want her to get worse. I'm seeing her regular vet tomorrow for a follow up from going to the emergency vet, will that be too late?

 

Reading and looking at spreadsheet ...


Mogs
.

 

Previous thread here:

https://www.felinediabetes.com/FDMB/threads/frustration-with-vet.240701/#post-2708670

.

 

Isn't that Clavamox? Lola was prescribed a 14-day course of Clavamox, and it was sheer hell. We made it 12 days, and I had to syringe-feed her for several times a day for pretty much the entire time, and that was with the assistance of Ondansetron and Omeprazole.

 

Co-amoxiclav antibiotics can make a cat feel really nauseated. I had similar problems re inappetence with my civvie, Lúnasa, last year. I had to give her ondansetron twice a day while she was on that antibiotic and it helped a lot but she needed a fair amount of encouragement at times to get enough food down her every day (2 x 4-week courses).

With Moo Moo being lethargic, not eating, not getting insulin and having some form of infection/inflammation ongoing that's ticking every single box for DKA risk.

With those clinical signs I strongly recommend getting Moo Moo back to a vet as a matter of urgency. (DKA, while treatable, is a life-threatening complication of diabetes and both moderate/severe ketosis and DKA are medical emergencies.) Would your normal vet be able to see her as an emergency case today? If not, then you'd need to find someone capable of treating ketosis/DKA to see her as soon as possible today.


Mogs
.

 

Correct. It goes by different brand names (e.g. Kesium tablets in the UK). 'Co-amoxyclav' is a catch-all description for this type of antibiotic formulation. And yes, it's an absolute pig of an oral treatment.


Mogs
.

 

@Critter Mom I will call my vet as soon as I compose myself a little, give me a few minutes. I will update when I get off the phone

 

@phakewishard -

When at the vets, I suggest asking then whether they can give an injectable antibiotic. IIRC, there is an injectable co-amoxyclav product available. Each injected dose lasts 3 days. It might mean a few extra trips to the vets for the injections till the course is completed but it would be less likely to cause GI upset. Saoirse did better on the jabs than on the pills.

Also, when Moo Moo's ready to come home again, I'd strongly recommend pushing the vet to prescribe anti-nausea tablets that you can give at home if needed in order to help Moo Moo get enough food and insulin, thus preventing another relapse.


Mogs
.

 

I feel for you. It's a scary situation. Take all the time you need. Breathe...



(((Moo Moo)))


Mogs
.

 

I agree with Mogs, you may need help to get the ketones under control and likely get the electrolytes back into balance, and certainly the fact that Moo Moo isn't eating can add complications to the situation.

I'd also suggest picking up some Ketostix from the pharmacy if you can, especially with history of DKA, you want to be able to monitor for ketones regularly.

 

I have been checking her ketones and everytime it says none, but that's obviously not the case if the emergency vet said she went into ketoacidosis. She's drinking water now, but she still won't eat.

 

@Critter Mom They have an opening at 11am (2.5 hours from now). Should I give her antibiotic this morning or skip it?

 

Also, while at the emergency vet they gave her Intefferon and hyaluronidase, as well as b12 and a saline solution iv to get her blood pressure up. When she came in, her blood pressure was so low they couldn't get any blood to get a blood sugar reading.

 

From my reading I understand that beta-hydroxybutyrate is the ketone body which has greatest involvement in DKA, but apparently some urine ketone test strips don't detect it. From this article:

Most urine testing kits detect aceto-acetate, not the predominant ketone beta-hydroxybutyrate. It is possible for the test to be negative with high levels of beta-hydroxybutyrate and then, as ketoacidosis improves and ketone levels fall, the urine test becomes positive (to aceto-acetate).​

According to the above, it's possible to have high blood beta ketones but to get a 'false negative' urine ketone test. (Another tick in the 'Pros' column for investing in a blood ketone meter.)


Mogs
.

 

I'm very glad that you've secured an appointment with them. For the sake of the couple of hours before you see them, I'd suggest skipping the antibiotic dose for now and ask them about it. With covid restrictions I'm assuming that you won't be able to go into the vet's office, so I'd suggest writing down brief notes and any questions you have (including a note that you've skipped the antibiotic dose this morning and requesting advice on what to do next). You could then hand the note to the staff member who comes to pick up Moo Moo. Less chance of things being miscommunicated, more chance of answers. (Keep a copy of the notes for yourself too!)


Mogs
.

 

@Critter Mom I'm one step ahead of you, I have a whole binder dedicated to Moo Moo that I'm planning on bringing with all of her info in it. The last time, Dr. B didn't like that I was measuring her blood sugar but my normal vet Dr G gave me pamphlets that talked about home monitoring. I hope I get to see Dr. G, but I don't know if I will have a choice.

 

I'm glad you have an appointment.

Here are some suggestions on how to stimulate kitty's appetite...

https://www.felinediabetes.com/FDMB/threads/suggestions-on-how-to-stimulate-kittys-appetite.130770/

 

@Christie & Maverick Thank you so much!!!

 

To complement Christie's helpful tip list, here's another one from Tanya's Site:

Persuading your cat to eat

With mild nausea, one of the simplest things to try is elevating food and water bowls by a couple of inches. (Stick a couple of paperbacks or similar under them.) With the antibiotics in the mix for Moo Moo, however, I think you're gonna need to break out the 'pharmaceutical big guns' for the time being.

While you're out and about, it might be an idea to pick up some cat-safe baby food (meat and broth; no onions, garlic, chives). There's a list of suggested products in the link above. Many cats will take a little of that even when they won't touch any of their regular foods.


Mogs
.

 

That's the spirit!


Mogs
.

 

PS: Fingers and paws crossed in the Shire that you get to see Dr. G.


Mogs
.

 

Moo Moo's food and water bowls are already elevated because was nauseous before diagnosis, and I thought it would help. It did, but now I can't raise them any more to help again. I wrote down her BG readings for the past week (I don't have a printer to print out the spreadsheet) and put it in her binder. I'm about to make the note about the antibiotic, and then hunt in my kitchen for something that she will eat. I finally got her to eat one of her old treats, even though it's higher in carbs, she then ate some freeze dried chicken to go along with it. I didn't want to give her the high carb treat, but at least she did eat a couple calories worth of food.

 

Parmesan cheese may be working, she ate a tiny bit of her regular food.

 

If ketones are suspected, all calories are good calories. (((Moo Moo))) Feeding little and often can help too.

Be sure to let us know how you get on at the vets.




Mogs
.

 

@Critter Mom @Christie & Maverick
It was Dr. B, but he had a completely different attitude this time. They're keeping her until 5pm, when the office closes. He showed me the blood work and the BUN was so high the machine wouldn't read it. He said that her results show her kidneys are shutting down. He said that she's in critical condition and that it could go either way very fast.
If she makes it through this afternoon, I will take her home tonight and then tomorrow morning bring her back.

 

My recollection is that with in-house tests they can't measure BUN past 130, so I'd park that concern for the time being. Did they mention what the creatinine value was? It can happen that when both BUN and creatinine are suddenly elevated, that may indicate a kidney infection or some other acute issue. I'd be curious too about the electrolytes, can you see what those values are? If Moo Moo is in ketoacidosis, that can also affect BUN and creatinine levels. I'd ask what those electrolyte levels look like (I.e. Potassium, sodium, chlorides) as well as phosphorus levels. Can you ask for a copy of the blood tests and urinalysis? I wouldn't necessarily say kidneys are shutting down, just based on high BUN alone. Sending lots of positive vines and thoughts.

 

He showed me the blood work, but I didn't really look at the other values in the moment. I believe phosphorus was high and so was creatine. I didn't see sodium chloride, but I assume it was high because she was on a saline IV sunday night into monday morning. I will get a copy of the blood work when I pick her up this afternoon. I think they ran a urinanalysis as well, which I will get a copy of. Sorry for the late reply, I've just been processing all of this information.

 

(((Moo Moo and her human)))

(I'm sorry, I don't know your name. )

Did the vet say anything about Moo Moo's hydration status? Dehydration can impact labs too.

Sending prayers and positive vibes for your little one and some for you.


Mogs
.

 

My name is Sydney, no worries on that. She had been drinking water through the night and this morning, but they're still giving her an IV right now to help. So, I assume she was dehydrated even though she was drinking water.

 

Hi Sydney.

The IV fluids should help with electrolyte balance. What were Moo Moo's ketone levels like?

I really feel for you.


Mogs
.

 

I know you are overwhelmed right now, I remember that feeling all too well, staring blindly at the labs and thinking what in the world am I supposed to tackle first, and it was many years ago when I dealt with kidney issues. Hoping when you get Moo-Moo home, we can help process some of the data and offer suggestions to help.

 

The vet didn't mention it, and I didn't see it when he briefly showed me the papers. There were a lot of red bars, indicating a lot of things were high on the blood test. Her white blood cell counts were all basically normal he said except for one but he said that could jusy be stress. Her sugar was low 200's, she didn't get an insulin shot this morning and only ate a couple treats. So that's also probably from stress.

 

Praying for your baby girl Sydney.I hope she's going to be ok, she's such a cutie pie.
Please keep us updated ♥♥

 

@Diane Tyler's Mom I will, and thank you so much. She's a fighter and stubborn, so I'm trying to keep my spirits up

 

All females are fighters and stubborn !
Sending positive vibes ♥

 

We just got home from the vet and she is eating some, below are her blood tests from this morning. The vet said to not give insulin or amoxicillin tonight, and to bring her back in tomorrow morning. He said that they had given her some shots to get her through the night, but didn't say which ones.

He said her swollen eye is in fact an abscess, and he was able to aspirate it some and draw some puss out of it. She looks so sad with a swollen eye and shaved legs for the IVs.

Her potassium is way lower than it was on 12/16. It was 5.5 12/16, and is 3.4 today.

 

Tagging @Marje and Gracie to look at the labs.

 

Poor girl. (((Moo Moo)))

I'm tagging @Christie & Maverick and @Marje and Gracie to ask them to look at the lab results for you, Sydney.

I don't see a result for ketones.

Maybe pain relief and anti-nausea might have been among them? (Speculating here, nothing more.)


Mogs
.

 

I didn't see a result for ketones either, I don't think he ran a urine analysis on her. Which, in my unqualified opinion, is weird.

 

With a possible kidney issue in the mix I'd be inclined to agree. Hopefully it was done but they just forget to give you a copy of the results. Maybe check with them in the morning?


Mogs
.

 

I will, and if they didn't I'll ask for one to be done. I don't think Dr. B sees as many diabetic cats as Dr. G, and Dr. G will be in tomorrow while she's there.

 

How are you bearing up yourself, Sydney?


Mogs
.

 

*finger guns* It is what it is, I'm going to be stressed until she feels better. Right now, I think she's irritated with me and her carrier, since she's had to go in it a bunch and gets poked when she does.
I'm just glad she was able to come home, I probably won't be sleeping much tonight to be honest. I have to leave work tomorrow morning to drop her off at the vet, so hopefully everything with that will work out. I will also probably have to leave work early to pick her up, and hopefully my manager doesn't fuss about it.

 

There are a few things that jump out. That is a sharp drop in potassium.
From my past experience, it would be something that I think needs to be managed via supplements, you want her firmly above 4. http://felinecrf.org/potassium.htm

Her weakness is a classic symptom of low potassium. But, you need to monitor regularly via blood work with vet if you give supplements, since too high is even more problematic, with serious health complications.

The phosphorus value is way too high, you need to get that in check immediately with phosphorus binders in her food, it is likely contributing substantially to her feeling unwell. Please do consult with your vet, but this is a good reference on phosphorus binders, and when they are needed, I know it is a lot of reading, but this website in general holds a lot of important info relating to kidney disease...http://felinecrf.org/phosphorus_binders.htm

I recall something about risk of tissue calcification when calcium x phosphorus is above 70, which she is, likely because the phosphorus is so high. I'm sure Marje will help refine some of my points, and may have other comments.


ETA: poor girl, I quickly scanned the labs before, and just saw your comment about the abscess in her eye . Give her lots of extra love from me, I'm glad she is home with you.

 

So sorry to hear about Moo Moo. Just wanted to ask if you got an invoice for today? I know my vet puts meds on the invoice so maybe you can see there what shots she was given. Hope she feels better

 

@JaxBenji Because she's coming back in tomorrow morning, they're waiting to give me a total invoice

 

Oh gotcha. Just a thought I had incase you had it. Hang in there Sending lots of love and support from afar.

 

Thank you ❤️ And thank you to everyone else as well for helping and looking out for Moo Moo right now, I can't explain how much that means to me

 

I know the sleepless bit very well. I'm glad Moo Moo was able to come home to you.

Hope the manager doesn't give you any grief. Will keep you both in my prayers.

(((Sydney and Moo Moo)))




Mogs
.

 

Great tip, Susanne.


Mogs
.

 

@Christie & Maverick - Thank you!


Mogs
.

 

Sydney, please do keep us posted if you have any issues or concerns tonight. I remembered this liver shake recipe too, but I never had all the ingredients on hand myself, (ie. liver ) you might consider this though for tomorrow. It would be good to have Moo Moo continue to eat a little.

https://www.felinediabetes.com/FDMB/threads/the-liver-shake-for-sick-cats.30432/

 

Christie is spot on about the phosphorus and that is one of the most critical values to keep under control with CKD. Her creatinine is not that bad, her potassium is a little low, her calcium is fine, her hematocrit is ok (should be above 40% but CKD cats are often under 30%)

The phosphorus being that high will make her very nauseous and it can also cause mouth and stomach ulcers. Right now, eating is imperative so it’s really important to get binder and add it to every single portion of food you give her. Aluminum hydroxide is best as it is tasteless. Here is info about binders. That is the fire that needs to be put out right away regarding her kidneys. Once the DKA is better addressed, there are other kidney issues to attend to.

 

@Marje and Gracie What should I say to the vet tomorrow in regards to the binders? I was reading about them earlier, and will continue to do more research tonight.

@Christie & Maverick Will do, she doesn't really want to move around right now, but I think that's because she's favoring the leg they put the IV in. She has been eating when offered and drinking when offered.

 

In the info section on phosphorus binders from Tanya's CRF, there are some suggested sources of aluminum hydroxide binders for people in the USA. You want an odourless, tasteless one. I believe quite a few people here have used the Thriving Pets brand (bought direct from) and have been happy with it.
http://felinecrf.org/phosphorus_binders.htm#usa

Just let the vet know that you are going to be getting phosphorus binders, I'm actually surprised they didn't suggest it after seeing how high Moo Moo's phosphorus is.

 

He might tomorrow, I think he's trying to see how she responds tonight and tomorrow morning before recommending anything. If he doesn't, I will ask about it

 

I understand. My vet many many years ago dispensed Epakatin, which was ok for us at the time, but these aluminum hydroxide ones are much better. Just mentioning it in case that is what they offer you, and you can just let him know that you've done some research on the subject.

 

Sydney, per your vet's comments earlier about the machine not being able to give a result for BUN because the value was so far out of range, I note that on the printout of the labs it has "No result available." I also notice that there are several other tests with a similar comment against them (ALP, AST, GGT and Amylase). Did your vet say anything about those tests also being out of range?


Mogs
.

 

Another question:

I'm assuming that the ER also did blood work on Sunday. Did they give you copies of the results?


Mogs
.

 

He did not but he did say when there are those stars for the BUN that means it was too high for the machine to read. And, they did not give me a copy of those results at the emergency vet, but they said they forwarded her paperwork to my vet's office

 

Might be an idea to get hold of a copy of those results as well to see what changes there were between the two sets of tests.


Mogs
.

 

I’d tell him you’ve been reading and you understand his phosphorus is way too high. It’s almost double the level for kittens. An adult cat’s P level,should be 4-4.5. It’s likely you’ll need a prescription for it. I bought mine from thriving pets. You might be able to get it locally.

I’d also talk to the vet about giving subq fluids at home. Usually we start them when the creatinine is 3.5 or above.

 

Moo Moo won't eat again this morning, and she's stopped purring when being pet. I take her back to the vet in 3.5 hours, I'm just trying to make her comfortable until then. Last night she wasn't able to make it to the bathroom and peed on the floor, and she was hiding under the couch for a long time.

 

I'm so sorry to hear shes won't eat again, please let us know what the vet says today. I hope the vet gives her what she needs to get those ranges into better ranges . ♥

 

Hi Sydney,

Fingers and paws crossed the vet will be able to help. Moo Moo's eye must be sore. Maybe that's why the hiding?

As Diane says above, please let us know how things go at the vets. If the antibiotic treatment needs to be continued then maybe ask about one that can be administered by injection (easier on the digestive system?). Maybe ask about ketones - just to know what's going on there - when you're asking about the urinalysis? (I know you're already on top of all this, but I'm an awful Ma Hen and I can't help myself. )

Keeping you both in my prayers.

(((Sydney and Moo Moo)))




Mogs
.

 

He said yesterday that he will need to drain her eye, I'm just honestly really worried she's done fighting.

 

I wish there was something I could do to help.


Mogs
.

 

The vet called and said her sugar is 167 this morning, his plan is to push fluids and to drain the abscess and see if that helps her eat.

 

Oh, I hope it will, Sydney. (((Moo Moo)))

Did the vets mention any other treatments (IV antibiotics, something for for nausea/appetite/pain relief)? Did they say whether they're going to run any more blood work today?




Mogs
.

 

He did not on the phone, but he had just gotten in and they looked pretty busy when I dropped Moo Moo off. Dr. G will be there today too. He said they will recheck her sugar tonight, but I'm not sure if they're doing a whole bloodwork panel or just a glucose meter.

 

I thought Dr. B was going to be in when I dropped her off, but he wasn't. When I pick her up tonight I will be able to ask a lot more questions. I came into work early so I could leave early to pick her up.

 

I'm glad your regular vet is there today, please keep us posted ♥

 

I will, I'm considering calling after lunch and asking about the binders and the anti-nausea/appetite/pain medicines so it's not sprung on him close to closing.

 

Good idea, especially if you need a prescription for the aluminium hydroxide binder.

(((Moo Moo)))




Mogs
.

 

The link you provided does not list it as requiring a script. I previously purchased some from Thriving Pets w/o a script and. Here is some from Chewy's and not script is required.
https://www.chewy.com/rx-vitamins-p...nKFG2f-06Zuky4tKq9TxFGLJyceL-hb0aAmjiEALw_wcB

 

@Larry and Kitties Thank you!!

 

Oh! @Marje and Gracie He had given her a subq last night before she went home for the night and it seemed to help for a little while. Sorry for not mentioning this sooner, I've been trying to figure out and process all this information today.

 

When you try to check out, it asks for a script. It always required it when I ordered it. Perhaps that is by state requirements.

 

So I called the vet, and he said he got more pus out of her eye socket than he thought could fit in there. He gave her a long acting antibiotic shot and a pain shot. He wants to see her back on Friday once her body has had a chance to normalize from the infection, and then if her values aren't any better we're going to probably go to phosphorus binders and other medications.

 

She's tough, but she's not doing great. As the emergency vet said "Her body is like a barrel full of snakes". I'm just trying to take it day by day and enjoy the time I have with her.

 

Poor wee thing! Good that the vet got it out, though. Fingers and paws crossed that it will make Moo Moo feel much more comfortable.

With phosphorus levels still potentially high that might not help on the food front (may cause nausea) and Friday's a fair bit away. I'd suggest asking the vet if he could give you something to use at home to manage any pain and nausea should Moo Moo need support in the interim (e.g. buprenorphine and ondansetron). Did you think to ask about getting copies of Sunday's ER lab results, BTW?

As a safety precaution, I'd also suggest perhaps picking up a blood beta ketone meter so that you'd be able to quickly and reliably monitor for ketones at home (no need to collect pee samples, plus they test for a different type of ketone to the urine test strips, as discussed earlier in the thread).

Did you get any of the cat-safe baby food? It might be something nice and soft for Moo Moo to eat.

(((Moo Moo)))




Mogs
.

 

@Critter Mom The fastest I could order a blood ketone meter and it get here would be Monday. I am going to call a couple local stores to see if it's in stock, but I kind of doubt it.

Dr. G will be the one who I talk to tonight, and I can ask about everything then again. It was apparently Dr. B's off day, but he came in to take care of Moo Moo. The paperwork would've been directly forwarded to Dr. G, so if anyone has it it should be him.

I am planning on making a run tonight for supplies once Moo Moo is home and settled. Are there any treats that are low carb and low phosphorus that you know of, or would it be best for me to just feed cat safe baby food and cook some chicken for her?

 

Good on the doc!

Based on observing my own cats, the freeze-dried low carb protein treats can sometimes be a bit too strong for a dicky tummy. I don't know of any low phosphorus treats to recommend, Sydney. I'm tagging @Marje and Gracie to ask whether she can suggest some specific foods and treats. It's vital to help your girl keep eating something, so you might need to try some of her favourite foods (ideally anything you have that's low in phosphorus). If she's a bit sore and has difficulty chewing you might be able to add some water to the food and blitz it into a soupy consistency that she could lap up. It's tricky because ideally a low carb, low phosphorus food would be best but introducing a new food can trigger tummy upsets and that needs to be very much avoided. Ultimately Moo Moo gets to decide the menu choice. Calories are king right now.

(((Moo Moo)))


Mogs
.

 

@Critter Mom That's kind of what I was thinking, as far as eating whatever she wants. She has been barely eating anything, and she is already under her ideal weight.

 

I'm in between work telecoms so apologies for being super brief. While I wholeheartedly agree to looking into low phosphorus foods, which works just fine with mildly elevated P, with such elevated P that you have going on, your primary focus is getting phosphorus binders ASAP. Please don't wait a couple of days. That really is the only way to get a handle on it. She is going to be feeling very unwell until the P levels gets drastically reduced. It is a vicious cycle, she doesn't want to eat because she is feeling icky, she is weak because of the high phosphorus in her system.

With low phosphorus foods, it can take up to a month to see improvement in P levels. With binders you should see a difference within 7-10 days.

 

Okay, I will place an order tonight. Hopefully it will be here ASAP.

 

@Christie & Maverick -

With you 100% on the need for the phosphorus binder. I was just trying to suggest something for tonight unless the vet can give Sydney some form of binder when she goes in later.

Do you know at all whether vets in the US normally keep Ipakitine or similar in stock? If the vet could give Sydney a binder of some sort tonight it would at least be a stopgap until she can get hold of some aluminium hydroxide.


Mogs
.

 

One more comment , if you can get something from the vet, they should have something available, at this point I don't think I would care what P binder it is, then you can use whatever you order when it arrives.

 

All good Mogs, for sure good suggestions for tonight, I only had a chance to quickly scan previous messages. I think you and I are on the same page. At this stage, Sydney will likely need to have a smorgasbord of foods anyway, so good to get some low phosphorus options. I agree that trumps the low carb options at this point.

Has this been shared yet? Low phosphorus foods....

http://felinecrf.org/canned_food_usa.htm

 

@Critter Mom There are no blood ketone meters at any of the stores around me, which is in line with almost all diabetic supplies around here also being sold out. Should I go ahead and place the order online for the one that should arrive by Monday?

 

I think that might be your best option, Sydney. Maybe get some extra strips too (especially if there's a bit of a run on diabetic supplies going on at the moment). The only other thing I could suggest is ringing a local pharmacy to ask whether they might be able to order one in for you (plus strips) which they could get delivered to them faster than Monday and you could pick it up from there. (Brainstorming here.)


Mogs
.

 

Dr. G hadn't gotten a chance to look at her paperwork, he said he was so busy today he didn't get to. I asked again about the phosphorus binders and the medicine to help her appetite, and he and Dr. B both want to wait until Friday to see how she does now that her eye socket was drained. He seemed very suprised when I showed him her bloodwork from yesterday (he said 'and when was this from', and I said yesterday and he went but didn't say anything out loud about it), and said that him and Dr. B will put their heads tomorrow. I could only get there 10 minutes before the office closed, but he said to email them any changes I notice (since I go to work before they open and get off after they close) tomorrow. So, we're in the same spot we were before I talked to Dr. G basically. He was very supportive of home testing though, so I guess that's good?? I don't know, I feel like no one communicates well with each other at that office

 

That must be very frustrating for you!
They certainly need to up their game!

 

I think Dr. G really just didn't have a chance to look at Moo Moo's paperwork, and Dr. B had come in today, on his off day, to care for her. They stay very busy at my vet's office. While it's frustrating, I still think she's at the best place for her right now, and I think now they're both in the loop and will work together on this to provide the best care for Moo Moo. I just wish they would've both been in the loop from the beginning

She is eating and drinking a lot more than she has since Saturday, so they are probably right about her wanting to eat more with the abscess drained. Or, it could be that she got another IV today. Either way it goes, I'm just glad she's eating.

I am overnighting some of the Thriving Pets aluminum hydroxide. It said it would ask for a script at checkout, but then at checkout the prescription part basically said non-applicable. I also ordered the blood ketone meter and some extra test strips. I ordered some low phosphorus low carb food that should arrive next week, in the meantime I am going to try to find some low phosphorus foods, even if they are higher in carbs (since even at the bet her sugar was in the 160's)

 

Oh I'm so glad to hear she is eating and drinking a little better tonight, and great news on the phosphorus binders you ordered. I almost dug out my old Epakitin to send you but I think it is well past expired by now

Keep offering food and water, and give her extra love.

 

I'm glad you were able to order the aluminum hydroxide binder, My civie Perry
Tyler's brother had kidney disease was on it.
Just in case you didn't know your vet will tell you how much to give , at one point
Perry's dose had to be decreased. If I remember correctly the dose goes by how high the phosphate number was. I had to put it in every meal he ate. I would divide the
amount I had to give him and put it in every meal I gave him.
He didn't even know it was in the food , no taste at all.

What food did you order Sydney?

 

It could be that thriving pets didn’t require a script because of your state. It does vary.

Here is a pretty current table on foods and P levels. Keep in mind you don’t want to choose one that has really high Na as CKD cats are prone to high blood pressure. Next time you take her in, they need to check her BP.

 

The store I went to didnt have a huge selection for low phosphorus food to be honest, but I got Purely Fancy Feast natural white meat chicken and tuna in a delicate broth (1.11 for both phosphorus and sodium) and I and Love and You purrky turkey pate (1.53 for phosphorus, .54 for sodium) from that list. I also picked up some cat safe baby food in case her appetite tailspins again

 

She's finally purring again (even though it's very slight and weak) and I'm so happy about that I might just cry, she's still very weak but at least she's not 100% miserable