Re: Cat Sassy - Chronic Kidney Disease? Follow Up Visits

[miguel99nyc]

Hello All,

I write here today to seek some advice, opinions, etc on my cat's health in regards to her kidney disease diagnosed last June of 2017. I'm attaching three images of her blood work and urine done last year, and the latest blood work just done yesterday.

Basically from our visit with our vet yesterday, reason for bring my cat Sassy in was because she suddenly looked lethargic few nights ago and did want to come out to eat like she always does. So she went back to sleep. Next morning she seemed still confused/lethargic..but drank water and eventually went to go eat food, not her usual amount but close enough. Perhaps it was something she ate? But by that same afternoon, she looked nearly as her old self, but I still took her anyway just to get checked and also do blood work see if the kidney disease is progressing.

Doctor looked over the past results (new doctor at office) and was amazed how the results seemed consistent/stabilized in regards to kidney values. Even with my cat only eating friskies and fancy feast as that all she loves the most. The previous doctor in that office wanted her on the K/D diet but she HATES that food. so then I tried a few cans but it all was nothing she accepted. Only fancy feast and friskies and Purina.

Based on this last blood work from yesterday (attached as well), doctor called me today to say that her kidney values went up slightly but still in normal range which was good news despite being on that friskies and fancy feast diet. He still didn't recommend kidney supplement as its still early stages....but just recommended to try make her eat the non cheap foods like Science diet, hills, blue buffalo, etc (I guess petco), but any foods low in phospherous/magnesium.

So my questions are these:
1.) If someone can link that food chart again where I can input brand name and search the values in each canned food? updated 2018 food chart / nutrition value?
2.) Is friskies (prime fillets) and Fancy feast (gravy lovers) that bad for her kdineys? What about this food i onced research last year - Purina Pro Plan urinary tract chicken? I saw it had lower amount of phosphorus which she eats as well. Is that wrong/bad too? What other foods do you all recommend thats non prescription. Again, shes very picky
3.) If any of you can give inputs based on the uploaded blood work, you will see dates on top right corners, interpret and see if she is getting any worse or if shes ok. Shes 16yrs old and means everything to me.

Thank You all so much.

 

[mrsgreenjeens]

Call me crazy, but I don't even see anything out of the norm on this labwork. If you look at the BUN and Creatinine, they are both within the normal range. So is the Bun/Creatinine ratio. So not sure why your Vet is saying kidney disease . Additionally, on the test showing Urine Specific Gravity, IT is also within normal ranges. Did they run an SDMA test at some point? That is the test that can pick up kidney disease at very early stages, but I don't see it on any of these three tests.

I've had three kidney cats (so far), and one of mine just came back with an SDMA of one point over the average range, so he will go in for another test in six months to see what happens. In the meantime we are just keeping an eye on him for anything out of the ordinary. We did the CBC simply because he's a senior and it was his annual exam.

Here is the link to the website you requested: Tanya's Comprehensive Guide to Feline Chronic Kidney Disease- Canned Food Data USA (if you aren't in the USA, let me know and I can send you the link for Europe...I see you have nyc in your user name so I figured maybe you are in the U.S.) It does make a difference WHICH Fancy Feast Gravy Lovers. Some have 1.14 phos, some have 1.15, some have more. The Purina Urinary food has .82, so I think it's great. I tried to keep the phos under 1.0 but wasn't always successful, but our Vet said just keep them eating, period. Friskies Prime Fillets run from 1.2 to 1.4, but that is from another chart from 2012, shown here Cat Food Chart from catinfo.org

 

[miguel99nyc]

Thank you for the feedback!

Well they diagnosed it last year based of the urine test last year saying it was very dilute? Saying thats about 70% kidney function lost...so I don't know. And i know that Kidney food for a fact my cat won't eat. Tried it.

So basically general rule is to keep it under 1.0 phosphate? She loves to eat the chicken gravy fancy feast and beef which is around 1.11 I saw.

 

[mrsgreenjeens]

Some of the foods I fed our last kidney cat were as high as 3.4 on the phosphorus range, but others were under 1.0, so our Vet said not to sweat it. None of ours ever ate the kidney diet either. I just fed whatever food they would eat, and it changed all the time based on how they were feeling, I guess. One day they would love something, the next they would hate it, then a few days later they would love it again . That goal of 1.0 was just MY personal preference. So eventually I just printed up the list of all the foods under 1.0 and bought 1 can of each food to try them out. Most were a bust .

 

[miguel99nyc]

This is the other chart I just found, though the phos count is bit different, as its not single digits but in the hundreds? How does that convert to this other food chart on Tanya's page?

 

[mrsgreenjeens]

I don't know. If you look at the one I sent you (NOT Tanya's), it's similar, but has an additional few columns that's shows Dry Matter percentages, and that's where I got the smaller number. YOUR chart is missing that critical info It says how to read it, but it's greek to me.

 

[miguel99nyc]

I don't know. If you look at the one I sent you (NOT Tanya's), it's similar, but has an additional few columns that's shows Dry Matter percentages, and that's where I got the smaller number. YOUR chart is missing that critical info It says how to read it, but it's greek to me.

Ah ok got it.

But just to recap/confirm, in your opinion, based on the sequential blood tests, you don't see her condition worsening or the kidney disease progressing?

 

[miguel99nyc]

Ah ok got it.

But just to recap/confirm, in your opinion, based on the sequential blood tests, you don't see her condition worsening or the kidney disease progressing?

I don't know. If you look at the one I sent you (NOT Tanya's), it's similar, but has an additional few columns that's shows Dry Matter percentages, and that's where I got the smaller number. YOUR chart is missing that critical info It says how to read it, but it's greek to me.

And I guess the other question is, aside from mayb edoing SDMA testing, is there any way to lower that creatine values?

 

[mrsgreenjeens]

Her creatinine did go up in from her original test, but per the lab, is still within normal limits. Things that can cause a rise in creatinine are a recent meal (prior to the blood draw), or dehydration, among other things. If it stays consistently above 1.6, however, that would indicate to me that she does have kidney disease, and it's beyond me why the lab would show this as "normal".

Here is an excerpt straight from Tanya's website:

Cat in IRIS Stage 1, Stage 2 or the Lower End of Stage 3


If your cat seems to fall into IRIS Stage 1, 2 or the lower end of Stage 3, it is early stage and with proper care and a little luck on your side, your cat could live for years.


Most cats in these stages (creatinine below 3.5-4.0 mg/dl US or 300-350 µmol/L international) will not need subcutaneous fluids and can easily be managed with just a few treatments tailored to the individual cat's needs, e.g. treatment for excess stomach acid, constipation remedies and/or control of elevated phosphorus levels.


If your cat has proteinuria or hypertension, these should be properly controlled.


In all cases, it is essential that your cat eats!

Now, here is some lengthy reading, but important, about nutrition for a kidney cat: Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Nutritional Requirements

What I used to do with my last kidney cat was to feed only wet food, and I also added water to each and every meal, which was about 8 or 9 small meals per day. We didn't get her bloodwork drawn all that often because we treated "the cat", rather than "the numbers". So I can't tell you how often her creatinine went up or down, because I simply don't know. If she seemed to feel worse, I would call our Vet and tell her what was happening, and she would make suggestions of what to do (increase her antacids, increase her sub-q fluids once we started on those, etc.) Does your girl have ANY symptoms at all? How old is she? What prompted you to take her in for a bloodtest?

 

[miguel99nyc]

Her creatinine did go up in from her original test, but per the lab, is still within normal limits. Things that can cause a rise in creatinine are a recent meal (prior to the blood draw), or dehydration, among other things. If it stays consistently above 1.6, however, that would indicate to me that she does have kidney disease, and it's beyond me why the lab would show this as "normal".

Here is an excerpt straight from Tanya's website:

Cat in IRIS Stage 1, Stage 2 or the Lower End of Stage 3


If your cat seems to fall into IRIS Stage 1, 2 or the lower end of Stage 3, it is early stage and with proper care and a little luck on your side, your cat could live for years.


Most cats in these stages (creatinine below 3.5-4.0 mg/dl US or 300-350 µmol/L international) will not need subcutaneous fluids and can easily be managed with just a few treatments tailored to the individual cat's needs, e.g. treatment for excess stomach acid, constipation remedies and/or control of elevated phosphorus levels.


If your cat has proteinuria or hypertension, these should be properly controlled.


In all cases, it is essential that your cat eats!

Now, here is some lengthy reading, but important, about nutrition for a kidney cat: Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Nutritional Requirements

What I used to do with my last kidney cat was to feed only wet food, and I also added water to each and every meal, which was about 8 or 9 small meals per day. We didn't get her bloodwork drawn all that often because we treated "the cat", rather than "the numbers". So I can't tell you how often her creatinine went up or down, because I simply don't know. If she seemed to feel worse, I would call our Vet and tell her what was happening, and she would make suggestions of what to do (increase her antacids, increase her sub-q fluids once we started on those, etc.) Does your girl have ANY symptoms at all? How old is she? What prompted you to take her in for a bloodtest?

I had brought her in the other day because she suddenly stopped eating. It was Wednesday night she didn't want to come to eat dinner. She came out near kitchen but then did a U-turn. I tried bring her the food to her but she just sniffed and went to sleep. APparently she has a tendency to do this once in a while. She also appeared lethargic, just no energy. So i got worried. Next morning she had a little more energy, drank water but at first didn't want to eat but then maybe 20 min after decided to eat. So then i was like - oh maybe was just one night thing. So I still took her that evening after work as she seemed herself again but just to double check. Besides, vet instructed to have her checked every 6 months or so to see how the disease was progressing and overall health. So since last visit was in Novemebr 2017, i figured its been 8-9 months nearly since so I wanted to take her anyway. Vet said upon checkup she has a cavity in her tooth maybe thats why she wasn't eating? but otherwise the vet said her blood is completely normal still just Creatine went up slightly. They want to remove that tooth because he showed me the cavity in her back tooth...but Im not sure if I want to as he explained the anastegia they put can do little harm to the liver or kidneys? Which is also why they did the blood test but he deemed it safe as shes still healthy? So I don't know about that.

But no, she doesn't have any symptoms. Obviously only thing since last year she loves to drink water probably more so then years past, but otherwise thats it. No other symptoms at all which is why i questioned the test results last year in June 2017 when vet called it very early stage of kidney disease.

Yeah her creatine as you see since last June has remained above 1.6...so I guess she does have it as it slightly increase since last June. That was my concern now that it slightly went up.

But as of now, she's eating back to same way herself prior to the other day, she seems fine, grooming herself and all and acting kindly. She's 16 years old, just turned 16 few months ago.

I'd appreciate your replies and continue looking forward to feedback. It really helps!

 

[mrsgreenjeens]

Wow! 16 years old and still going strong. Kudos to you. All three of my kidney cats were diagnosed at 13 years of age and then lived another three years after diagnosis, so you'r way ahead of me.

As to that bad tooth, if it's causing any issues, I would probably think about having the dental work done sooner than later, because the older she gets, the harder it will be on her, plus the older she gets, the more health issues she can get, making it even more difficult to go under anesthesia. I know I cringe at the thought of even my younger cats getting dentals, just because I'm a worrywart, but keeping their mouths in good order is very important too. So it's a Catch 22. I just make sure they get the care during their dentals, meaning they are attached to an IV the entire time in case anything goes wrong they can instantly get certain meds into them, etc. One of my boys has had to undergo anesthesia twice so far and been just fine. And one of my kidney cats had terrible teeth and had to have them cleaned at least once after diagnosis. He was fine afterwards, and wasn't diagnosed until his was further advanced than your girl.

Keep that website I referenced handy, as you will find all kinds of helpful info within it. It was my "go to" for pretty much everything. I would check it before making calls to our Vet just so I would be up on things and could question her about this or that. For instance, our last kidney cat was impossible to pill, but I already knew from reading that website that we could get some of the antacids in shot form, so when she started needing them, we asked the Vet about that. Most Vets would simply say to give Pepcid A/C, but if you know ahead of time that you can give it in shot form, so much the better. Same with some appetite enhancers...we used a transdermal get versus pills. Plus there are all kinds of tricks on how to get them to eat on "off" days, etc.

And we're here too.

 

[silkenpaw]

Honestly, I don’t see any evidence of kidney failure in n the labs I can see (the ones from a November 2017). The BUN and Cr are perfectly normal and so is her hemoglobin. (Anemia is a sign of kidney disease because the kidneys produce the hormone that tells the bone marrow to make red blood cells.) For some reason I can’t see the labs from other dates. If I were you, I would ask my vet about that.