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Blood work report, low phosphorus. Do I need to do something?

Freedom

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I have 5 cats, all teenagers. One has been diagnosed with early stage renal disease, and I have selected commercial foods (dry and soft) based on the databases in Tanya's article. Due to having a multi pet household, I changed the food for all of them.

Link to Tanya's info: Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Everything You Need to Know to Help Your Cat

Crystal is age 14. She has not been diagnosed with renal disease. For several months she was throwing up multiple times daily. I tried changing her foods about every 3 weeks. Nothing was helping. It was horrible for her and also for me as I had cat vomit everywhere. She also had projectile diarrhea which rarely remained in the litter box and over time she was pooping just about everywhere.

Next I started making "Spot's Stew" from The Whole Pet Diet. I had previously home cooked for all my pets for years. I had stopped in 2015 as I moved and then had to have 3 joint replacement surgeries. So I started cooking for all 9 pets about 3 months ago. Almost like a light switch, Crystal was fine, no vomiting no diarrhea. That lasted for about 8 weeks, then she started vomiting again. So I took her in to the vet and had blood work done. Now, I also realized I had adjusted the Spot's Stew recipe once with extra chicken thighs. I made the next batch w/out that and she is fine. So there is no issue with Crystal at this time.

During the exam, the vet noticed that she has licked the fur off all her underside. He commented that this can be a sign of a blockage developing, especially with the vomiting and diarrhea, or it can by psychological. An ultrasound was offered to search for issues, but I have declined that. Then they took blood for the work up. A few days later I received a phone call, all the lab results are fine so since she is OK, no need to do anything. A week or so later I called and had the lab report emailed to me, for Crystal's file. I have attached the lab report. The phosphorus levels are below normal. The markers for renal disease are on the lower ends of normal, if I read this report properly. I am not sure why the vet said not to do anything further for now, when the phosphorus is clearly below normal.

So at this time, the cats all have dry kibble available at all times, Hill's Science Diet adult 11+ indoor, which IS a low phosphorus food on the database. And once daily I set out a large bowl (at least 3 cups) of Spot's Stew, which they all partake and it is gone within an hour. I know that Crystal does eat it, I have no idea how much she eats.

I will be in to the vet on Monday (with 3 of the dogs) so if I have questions I need to clarify with the vet, I have an opportunity to do this coming up. I will ask why he said no need to do anything when the one item is below normal. Thought maybe folks on here can help me understand it better, what to ask, what to follow up on. Thank you.
 

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FeralHearts

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Hi there Freedom Freedom :wave2:

I noticed on the chart notes the Vet has said they mentioned a prescription diet. What diet were they suggesting?
 
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Freedom

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I still have the message on my answering machine, I just listened again. NO Prescription food is mentioned, no special diet or change in diet is mentioned. At the end I am invited to call if I have questions. Message does not say there is more to discuss. I admit, I totally missed that when I read the lab report.

F FeralHearts

So now I am getting angry. Same time as Crystal was in I had one of the dogs in. We did a thyroid test. I have yet to get the results of that, and I have phoned in asking twice now. That was first item on my list when we go in Monday. Thinking I need to get another vet.
 

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Freedom Freedom I miss things on mine too. I now end up reading things a few times because of that lol. I swear I have tunnel vision sometimes.

That is the question I would be asking. What prescription diet and also why. That would be for starters. I'm sure there are more.

She's also dropped a bit of weight over the last 3 years. Steady at about a pound a year, or close to it 0.843 of a pound.

BTW I am very pleased that you got the report and the notes. I highly recommended to everyone they do that for the exact reason we just found. This happens A LOT with vets and people DR's. 👍 They forget to say things and *think* they have.

BTW not a vet here. *disclaimer*
 
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Freedom

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Crystal has been extremely overweight for years. She used to look like she swallowed a basketball.

Crystal was born feral. 2 neighborhood boys took Crystal and her brother from the mother, they wanted to sell the cats and make some money. The kittens weren't even weaned yet! They sold the male but weren't able to sell Crystal. She spent the next 2 months living under the sofa in the living room; the family had a cat who did not want another in the house. They did not take her to a vet, did not have kitten food, nothing.

My next door neighbors back then was a family with 2 sons; the younger knew about the 2 boys above. He also had spent time in my home and saw how my cats are cared for. WITHOUT MY KNOWLEDGE, he went to the boys' mom and said he knew someone who would care for the kitten. He showed up at my door pulling his red wagon, with this tiny calico kitten laying in it looking around. I had her to the vet next day. Based on what we could piece together of her history she was extremely underweight for her age. And having been taken from her mother before she was weaned, various vets over the years advised it was normal for her to over eat and be over weight. In a multi cat multi pet family there was no option of limiting her food intake. At one point I had 11 cats, 5 dogs, had cats staying to recover from surgeries prior to return to their colony in the TNR program, had dogs staying overnight as part of transports, etc. I did have cat rooms with no dogs allowed, but having a place where Crystal could eat and not have access to other food was never an option.

This is why each pet has a folder and I get copies of all reports for each file.

Since she is still overweight the vet said not concerned with the weight loss at this time.
 

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Ah good there is hope for my chunky pants then! (I have one of those basketball swallowing ones too. lol)

Crystal was obviously meant to be with you. *hats off at all the work you are doing with the animals) :-)

I love that you keep records too. I have a binder. So I totally get it. Awesome!

I'm not sure of the blood work but can see what you mean in a few areas. I think the good starting point is the what diet and why. I would absolutely be asking about the phosphorus levels and the fact that while the SDMA and CREATININE are within normal, the CREATININE is a bit on the lower range from the little I know.
 
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Freedom

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Good! Thank you.

Well, I did all that volunteer work for about 4 years. All in the past now. I can just about keep up with my 9.
 

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F FeralHearts

So now I am getting angry. Same time as Crystal was in I had one of the dogs in. We did a thyroid test. I have yet to get the results of that, and I have phoned in asking twice now. That was first item on my list when we go in Monday. Thinking I need to get another vet.
Sorry I missed this part above.

Errmmm *hides* it's on the chart too. I believe it's under T4 counts. (If you are referring to Crystals results and not the doggies) 2nd page, almost middle of the page, sort of squished in.

I have to admit. I've never seen reports and results on a chart before. Mine were all separate. The chart was DR notes and over all health and full test results were on a different sheet.

*hugs* I know what you mean. No joke though - a few weeks back I brought on of my girls in to have her paw looked at. It was only by reading the notes I found our she had apnea while knocked out having a biopsy done and I read it a third and forth time and found they failed to mention a fractured Canine too.

Earlier this year - they forgot to tell me my boy had crystals.

It's enough to make you go insane and get super angry. Been there - done that - now I just give up and read the notes 4 times +


Good! Thank you.

Well, I did all that volunteer work for about 4 years. All in the past now. I can just about keep up with my 9.
You're welcome!

Nine is a great number. :-) Good on you!
 
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Freedom

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No, I meant the dog's results. Just a thyroid so it was inhouse test, not sent out to the lab. And of course when I phone in, the reception can't give me the result only the vet can do that. So they leave a note (supposedly). But it has been 10 days. At the time, vet said the result would be another 5 minutes. I'd already been there an hour and half with the dog and cat, and wanted to get moving - the pets did too. Since there was going to be a phone call with lab report results, and he said he could give me the dog's at that time too, that was fine with me. Except there was no follow through.

There are notes within the lab report which are part of the lab report. The stuff under the T4 as an example, that is part of what the lab prints and sends, that is not info added by the vet. The only thing the vet adds is the note at the top, which is to indicate how they communicated that specific report to the owner. With an ill pet, you end up with so many blood workups sometimes, this is how they track that they followed up on that particular report.

I'm sorry you had that problem. The boy with crystals, that seems like a HUGE thing to miss. A fractured canine, well that usually is ignored until it abscesses. Apnea while under for a biopsy, I think most owners don't care. If the dog snores, they know it! And if not, well, it was a medical thing wasn't it? I don't look at it that way and obviously you don't either. But I can see where vets wouldn't report that to the owner. Crystals? Oh come on, that's a bit much.
 

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Freedom Freedom It's certainly a good way to have it like that all in one place.

Even with my two greats Vets - sometimes I have to really do the follow through. More often it seems than I would like.

Thanks, it sucked to find out by way of his regular vet. He's been clear all along but did have blood and infection but 3 tests and no Crystals. The 4th follow up showed crystals and yup - fail to tell me. Told me to give him a special food - my assumption was it had to do with the infection etc. I'm with you - that's a biggie. So is saying you've suggested a diet plan but not telling the caretaker that or why.

The tooth and apnea - still bugged me as, like you, I want to know. I want to be fully aware. The apnea she had was the kind that makes the throat relax and they cease to breath for a bit. If she ever has to have anything again where they need to knock her out, like for the tooth, being away means I can point it out and keep her as safe as possible. The tooth I can now eyeball and try to keep extra clean. For me, all this should be told to the caretaker.

It really does seem to me their is a lot of communication breakdowns in the medical world.

I'm glad you'll be at the vets on Monday so you'll be able to get to the bottom of everything for Crystal and find out the doggys results too. Only a day away. :-)

Please come back and let us know. I hope it's something simply and by way of preventative steps rather than anything bad.
 
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Hello F FeralHearts
Unusual for me, today was a busy day, this is my first time sitting with my laptop!

Went to vet this morning.
1. Asked re Tasha's (dog) thyroid, was told it was normal. I asked for what is the normal range and what was her reading? They printed it out, so I got that info to put in her file.
2. Asked re Crystal which prescription food? Answer: Well there are 4 you could try.
- Hill's Science Diet GI for food sensitivity
- Hill's Science Diet IBD - that food is hydrolyzed.
- Hill's Science Diet GI Biome - this is a new one which is having really good results with cats
- Royal Canin GI Fiber Response - also a new one and cats are responding really well to this.

It was pretty clear neither of the new ones had yet been used with his patients. I said I would think about it.

We moved on to the 3 dogs I had in today, for Lyme testing. Last Spring was horrendous for ticks around here, all 4 dogs AND I had many ticks attach. Since it can take 4 to 6 months for symptoms to show, this was the time to test them. Tasha was in 2 weeks back for Lyme testing, she tested positive for both Lyme and anaplasmosis. This vet prescribed 50 mg doxycycline once a day for 30 days.

Today 3 dogs all tested positive for anaplasmosis, and Riley also tested positive for Lyme. So I got 3 pill bottles of doxy, 50 mg. TWICE A DAY for 28 days. Say what? Oh, I've been talking with other vets, they all seem to prescribe it twice daily so I decided I will do that now as well. Vet gave me a print out of Doxy . . . top line: "This short-acting medication should stop working within 24 hours, although effects can be longer in pets with liver or kidney disease. " Problem is, this is just a sheet of paper with the vet hospital name and info, no source information at all, none whatsoever.

Great. So now what am I supposed to do re Tasha?! Vet: well she is half way through her course of antibiotics, so just keep up with her pills.

I have just checked online, Merck - the manufacturer - recommends prescribing it once daily for Lyme. I haven't found what they suggest for anaplasmosis. So should Tasha have it twice a day? Or should the other 3 have it once a day?

I'm going to go bang my head against the wall, just as soon as I finish my supper. Then I will go post on one of the dog forums I frequent.
 
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Hello F FeralHearts
Unusual for me, today was a busy day, this is my first time sitting with my laptop!

Went to vet this morning.
1. Asked re Tasha's (dog) thyroid, was told it was normal. I asked for what is the normal range and what was her reading? They printed it out, so I got that info to put in her file.
2. Asked re Crystal which prescription food? Answer: Well there are 4 you could try.
- Hill's Science Diet GI for food sensitivity
- Hill's Science Diet IBD - that food is hydrolyzed.
- Hill's Science Diet GI Biome - this is a new one which is having really good results with cats
- Royal Canin GI Fiber Response - also a new one and cats are responding really well to this.

It was pretty clear neither of the new ones had yet been used with his patients. I said I would think about it.

We moved on to the 3 dogs I had in today, for Lyme testing. Last Spring was horrendous for ticks around here, all 4 dogs AND I had many ticks attach. Since it can take 4 to 6 months for symptoms to show, this was the time to test them. Tasha was in 2 weeks back for Lyme testing, she tested positive for both Lyme and anaplasmosis. This vet prescribed 50 mg doxycycline once a day for 30 days.

Today 3 dogs all tested positive for anaplasmosis, and Riley also tested positive for Lyme. So I got 3 pill bottles of doxy, 50 mg. TWICE A DAY for 28 days. Say what? Oh, I've been talking with other vets, they all seem to prescribe it twice daily so I decided I will do that now as well. Vet gave me a print out of Doxy . . . top line: "This short-acting medication should stop working within 24 hours, although effects can be longer in pets with liver or kidney disease. " Problem is, this is just a sheet of paper with the vet hospital name and info, no source information at all, none whatsoever.

Great. So now what am I supposed to do re Tasha?! Vet: well she is half way through her course of antibiotics, so just keep up with her pills.

I have just checked online, Merck - the manufacturer - recommends prescribing it once daily for Lyme. I haven't found what they suggest for anaplasmosis. So should Tasha have it twice a day? Or should the other 3 have it once a day?

I'm going to go bang my head against the wall, just as soon as I finish my supper. Then I will go post on one of the dog forums I frequent.
Freedom Freedom

*banging my head on a wall with you*

Wow ... that Vet confuses me too! All that food suggestion is for GI issues. Is she constipated or something? My Charlie was on Royal Canin GI Fiber Response for 4 years. I had to take him off it due to a suspected Chicken allergy. I can't say it helped all that much with his constipation issues tbh. I noticed you said he said it's new. It might be new to his practice but I assure you that food is not new. Unless being out 5+ years on the market that I know of is considered new?

Did he say why those foods?

Doxycycline is a very good antibiotic, very good - expensive but good from everything I know. So at least the Vet got that right. :-) One of my kitties is currently on it for plasma cell pododermatitis. Liquid though. Not fun at all.

The little I know about it is if its pills try to get water down them with the pill - as both for dogs and cats it can cause ouchy's in the throat. It does say in the system for 24 hours. However, with dogs apparently it can be two doses per day every 12 hours but it's unique to each dog. So I'd ask he Vet again what's up with that.
 
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Freedom

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F FeralHearts the cat issue: Crystal was throwing up multiple times (3 and 4 times) daily and had diarrhea. This continued when I changed to renal disease foods using Tanya's database, a change I had to make because one of the other cats was diagnosed w/ chronic renal disease. I tried a few different foods, none were agreeing with Crystal. Finally I returned to home cooking for my 9 pets. Once I switched to that Crystal was fine, like a switch. Fine for 6 weeks. Until the one time I added too many chicken thighs. Not realizing THAT was the issue I thought we had reverted and thus I had her in to the vet. While the other 4 cats were fine, apparently that was too rich for her. Next batch I did not do that and she has been fine since. So based on the vomiting and diarrhea, the GI foods were suggested. Not going to do it, Crystal is doing fine as long as I stick to the recipe and don't mess with it.

Note: the one cat diagnosed w/ chronic renal disease is also doing well on home cooking, and has gained back the weight she lost!

Dog issue: Had to call in twice more this morning, finally got the vet to up the dose for Tasha the first dog in, who has been on a lower dose of doxycycline than is recommended. THEN I am told Frankie can continue to attend his Agility classes. Um, no, once diagnosed with anaplasmosis you don't want the dog exerting himself until he has completed the meds course.

Hard to believe it is 2 weeks today that I had Crystal and Tasha in. Two weeks trying to sort out, get info and clarifications, and make adjustments.

Needless to say I am now done with this vet. Well, have to go pick up the extra meds for Tasha, but that's minimal.
 

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Freedom Freedom Ah yes, I totally flaked on that. I think I was so focused on her kidneys that I forgot the entire story! *sigh* Very sorry about that.

LOL @ "not going to do it." I laugh because I've had that reaction myself on some things and I can feel your resolve and can't blame you one little bit. I am a believer that there are times to take your heals and dig them firmly into the ground.

It's sounds to me like there's been some serious miscommunication over there. I wonder what's going on. It doesn't sound like it's a new clinic to you - we're they always this sleepy on things?!

How absolutely frustrating!

*big hugs to you*

XOXOXOXOX
 
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Freedom

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It doesn't sound like it's a new clinic to you - we're they always this sleepy on things?!

\
The vet owner is wonderful! He is always busy, always booked, takes 3 and sometimes 4 weeks to get in to see him. He is a fantastic diagnostician, and he is certified to do TPLO - dog knee surgery, he did my Frankie's left knee, luxating patella. He has 2 other vets working for him and encourages everyone to use them. In the 4.5 years I've lived here those 2 positions change frequently . . . about twice a year. So I tried this new vet . . . just out of vet school May 2018. I have no idea what they are teaching at Cornell University School of Veterinary Medicine, but it leaves a lot for them to learn once in a clinical setting. She couldn't handle an issue that is very common in this area - tick borne disease. Not returning to her.

But I'll stick with the practice, because of the owner.* The other position just now is held by a woman vet with 30 years experience who just sold her practice. Typically these are vets who think they aren't ready to retire, so they take a spot like this. Then rather quickly they cut their hours to part time, and by Summer they realize they want to retire and enjoy life. One of the 2 spots at this practice always seems to have a person like this, and I've seen it many times over the years at other clinics as well.

*And I also have another practice I use, but infrequently. It is actually a specialty practice, focused on surgery. Many area veterinarians who aren't interested in doing surgery refer folks to this place. It is NOT an ER hospital, and it is not a specialist hospital, I mean not the eye specialist, the cancer specialist, and so on. Just a "primary care vet" who focuses on surgeries. He is also well known for knee surgeries for dogs, and people come from out of state, put up at a hotel, while their dog is cared for. (I didn't learn about this place until 2 years after Frankie had his surgery.) The owner of this practice does not take on regular patients, only surgical cases. He also has 2 part time vets who take on regular cases and who rotate around through various clinics in the area. Both the part timers are older, experienced, and will make house calls in special circumstances. I've never needed a house call, but it's nice to know that is available. With 9 pets, I just never know WHAT I am going to need. A few years back I had 3 major surgeries myself (total knee replacements and total hip replacement) and I wasn't driving for weeks at a time after each of those. So I figure it can't hurt to have a relationship with this place, for a number of reasons.
 
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