Re: Sassy - Chronic Kidney Disease, Possible Check Up Visit Required?

[miguel99nyc]

Hello,

Could not locate the original thread I made back in August so I'm reposting my cat's Sassy'd bloodwork from August 2018. She had went back then because she wasn't eating as much...which lasted I think for few days and she began eating fine again after. I've brought her to vet office whom wanted to run blood work just incase. She was diagnosed in early stages of kidney disease back in June of 2017. So thankfully so far, she hasn't shown any detoriation or getting worse, yet...despite feeding her favorite food she loves.

This not eating issue...has occurred few times since June 2017, brought her to vet those times...only to find nothing really wrong with her and she just cleared up on her own in matter of days and ate normal after. So now, these past few days shes been acting sort of normal, definitely quieter (was meowing spontaneously in weeks past, usually asking for food or water at the sink) but now shes just been sleeping and just going about her business. But at the same time, same issue as before, just eating slightly less. But at same time, not sure if its my eyes or if it seems she lost some wieght? I dont have scale but she does look a little thinner but I read that's the result of kidney disease progressing? She isnt throwing up or anything else showing up wrong. Just seems quieter and eats slightly less. So now...I don't know if i should take her...back to vet again (as she done this in past but vet found nothing wrong) and have her blood taken again to see if kidney disease progressed? Or just wait it out?

Im attaching again the August 2018 blood work and the initial blood and urine tests from June 2017 (to show progression if any?) and hoping to get feedback I'd greatly appreciate it.

 

[kittyluv387]

I am no doctor so take my words with a biiiig grain of salt. But do you know why your cat was diagnosed with kidney disease? Her creatinine levels look very good. And her BUN is higher but still within normal range. Kinda curious what the reason is. They normally look at creatinine and BUN. Also your cat is pretty old and it's normal for them to lose some muscle mass as they age. And their kidneys naturally lose some function in old age. Which means a high quality canned food that is lower in phosphorus is the best for seniors.

 

[miguel99nyc]

I am no doctor so take my words with a biiiig grain of salt. But do you know why your cat was diagnosed with kidney disease? Her creatinine levels look very good. And her BUN is higher but still within normal range. Kinda curious what the reason is. They normally look at creatinine and BUN. Also your cat is pretty old and it's normal for them to lose some muscle mass as they age. And their kidneys naturally lose some function in old age. Which means a high quality canned food that is lower in phosphorus is the best for seniors.

Hello, Thank you for the reply!

Well according to vet in July 2017, she went actually just for a senior check up I think. So blood work and urine was done. It was through the Urine, the vet called me and said that its cloudy and the specific gravity was on the low end meanign it was dilute? If i remember correctly so he declared it in the early stage of kidney disease.

Since then he recommended for her to be on that NF Purina Kidney canned food but she hates it. So ssince that diagnosis, she would only eat what she loves most, her friskies - Prime Fillets. But Ive seen the charts/nutrition on sites provided on here by others, so I aim to get the lowest phosphorus ones for which thankfully she eats. Just lately this past days-week she seems to be eating slightly less, like maybe...a teaspoon of food she leaves behind as apposed to finishing her plate.

But yes, it was through the urine the vet said last year she was in early stage of kidney disease. But it throws me off to beacuse her blood work BUN and creatine is normal, even the latest being in August 2018.

 

[kittyluv387]

Well her USG was technically still in the normal range. I don't think the 2018 tested USG? What were you feeding her before the check up in 2017? My cat also has low USG but that is because I always feed him moisture rich foods. I would add extra water to his already wet food and such. So if you were feeding your cat a moisture rich diet I especially wouldn't worry about the lower USG. If you were feeding her a bunch of dry food and she still had lower USG I could see cause for some concern.

 

[miguel99nyc]

I don't recally exactly...but it was still at that time her Friskies Wet Food, maybe some dry food mixed in but not alot.

 

[kittyluv387]

Well you know it is possible to measure your cat's USG at home if you're really concerned. I bought one of these:
Clinical Refractometer,Tri-Scale-Serum Protein 2-14g/dl,Urine Specific Gravity 1.000-1.060SG for Veterinary Cat,Dog, Pets w/Extra LED Light and pipettes
I used a measuring spoon to catch my cat's urine as he went in the litterbox. Then I used a needleless syringe to take some urine and put it on the refractometer. You have to follow the precise instructions for calibrating it. The hardest part was getting our apartment to 68 degrees since it was summer.

I like to go overboard with the water so I stopped putting too much extra water in my cat's food and his USG was back up to "normal."

Please check out this cat specialist veterinarian's website on the topic.
Cat Urinary Tract Diseases: Cystitis, Urethral Obstruction, Urinary Tract Infection

 

[miguel99nyc]

Well you know it is possible to measure your cat's USG at home if you're really concerned. I bought one of these:
Clinical Refractometer,Tri-Scale-Serum Protein 2-14g/dl,Urine Specific Gravity 1.000-1.060SG for Veterinary Cat,Dog, Pets w/Extra LED Light and pipettes
I used a measuring spoon to catch my cat's urine as he went in the litterbox. Then I used a needleless syringe to take some urine and put it on the refractometer. You have to follow the precise instructions for calibrating it. The hardest part was getting our apartment to 68 degrees since it was summer.

I like to go overboard with the water so I stopped putting too much extra water in my cat's food and his USG was back down to "normal."

Well I wasn't really concerned about her urine. I mean thats what the vet told me. She does drink more water then she used too many years ago and urinates about 2-3 times a day in litter box, shes been though consistent ever since being diagnosed, never more or less. Others too have questioned as to why Vet thinks she had early kidney disease...but I also thought her drinking more water perhaps was an indication too. But other then that shes fine, other then she just eating ever so slightly less. She wouldn't finish her wet food if I drop in some dry food. Otherwise she'd stop like halfway. So I mix maybe few tablespoons of dry food only to her wet food when she eats morning and nights.

 

[kittyluv387]

Honestly since she's older it's just natural to have a little less kidney function. But it doesn't sound like she's ill. If she were my cat I would just feed her high quality canned with 1.25% dmb phosphorus or less. Have you tried switching up foods (not ckd diet) but other canned brands?

 

[miguel99nyc]

Honestly since she's older it's just natural to have a little less kidney function. But it doesn't sound like she's ill. If she were my cat I would just feed her high quality canned with 1.25% dmb phosphorus or less. Have you tried switching up foods (not ckd diet) but other canned brands?

Yes Forgot to mention, she is currently 16 years, going on for 17 yrs this coming May

 

[miguel99nyc]

1.25%dmb ? What's that or how is that calculated? Im going by the chart on Tanya site and this PDF document

 

[kittyluv387]

Dry matter basis. For example, if a canned food has 78% moisture (as fed, non dry matter basis), you subtract 78 from 100% and get 22 as your dry matter amount. Let's say that the same canned food has .5% phosphorus as fed (with original moisture). To get the dry matter basis of phosphorus you would take the .5 and divide it by the 22 dry matter amount and get 2.3% for phosphorus on a dry matter basis. A lot of times the phosphorus percentage will not be available in either as fed or dry matter basis. In that case you have to do your own research by contacting the company. 300 mg of phosphorus per 100 kcal like in Tanya's Chart equates to 1.6% dry matter basis. Tanya's chart is fantastic but it wont have the newer food brands.

 

[miguel99nyc]

Dry matter basis. For example, if a canned food has 78% moisture (as fed, non dry matter basis), you subtract 78 from 100% and get 22 as your dry matter amount. Let's say that the same canned food has .5% phosphorus as fed (with original moisture). To get the dry matter basis of phosphorus you would take the .5 and divide it by the 22 dry matter amount and get 2.3% for phosphorus on a dry matter basis. A lot of times the phosphorus percentage will not be available in either as fed or dry matter basis. In that case you have to do your own research by contacting the company. 300 mg of phosphorus per 100 kcal like in Tanya's Chart equates to 1.6% dry matter basis. Tanya's chart is fantastic but it wont have the newer food brands.

Ah ok got it.

So should I be then possibly take my cat again to the vet to get her blood work again since last was done in August 2018 or just continue to monitor her?

 

[kittyluv387]

Well that's up to you. Not sure if blood tests will show anything different since you just got one done. But if it doesn't feel right to you and you think she's acting off, you know what's best.

 

[miguel99nyc]

Well that's up to you. Not sure if blood tests will show anything different since you just got one done. But if it doesn't feel right to you and you think she's acting off, you know what's best.

Thank You so much! Def helps!

 

[miguel99nyc]

And if anyone else got input feel free to let me know as well! Thanks.

 

[miguel99nyc]

So somewhat new development, Sassy was drinking water this morning, was acting her normal self upon me waking up. So she went to drink water from her bowl, seemed fine and then maybe shortly right after she was just constantly licking her nose/mouth front end? And I already knew she was going to throw up which she did. She threw up the water she had drank moments before. So first thinking is that she drank too fast or something or acid reflux?

This had happened few times maybe a year ago or so, but I think she managed to hold it in, until she ate breakfast after drinking water and she threw up everything right after. She drank quite bit of water then ate, then threw it all up right after. But the only difference between that situation and todays is that back then she seemed hungry after throwing up as she wanted more food but I was afraid to give her so her stomach can settle? This time like today, she also meowed for food, she ate but very little, maybe half of the amount she would normally eat and then walked away. So I don't know if that has to do with the water she threw up this morning? Or if these are signs of that kidney issue progressing even faster? Bare in mind that she hasn't been eating the same amount for like past week, little less then her normal self. But today this morning, just ate considerably less but maybe i thought its because she threw up that water and left a bad taste in her mouth I guess.

Thoughts?

 

[miguel99nyc]

Hello Everyone, so here's an update on Sassy's situation.

Took her in to Vet Thursday - 1/3. She had an emergency blood work and Xrays done as vet didn't like how she looked. She had lost a pound since AUgust 2018...and was a little dehydrated. We waited for results, and vet was astonished and same time confused because her blood came back completely normal. For her kidney disease, her kidney values if anything lowered slightly her creatine was 2.0 in august down to 1.8 and all other organs and vitals were compeltely normal. Xray revealed nothing as well. So Vet just gave her few injections to start of medications of - Fomatidine, Cerenia, and Mirtazapine to stimulate appetite. She's now due for an ultrasound next week...if she doesn['t come around with eating.

She has been eating little more thanks to Mirtazapine, if anything she kept meowing at me asking for more food last night her first day taking the pill. I didnt want to give her much because Im afraid of her stomach expanding. Vet said that pill supposed to work right away so I was shocked it did. So she wnated food almost every hour until we all went asleep here at home and she did as well. This morning she ate slightly less again but more then the other days. Gave her the other 2 medications but she stopped eating right after Im assuming the taste of medicine go to her. Now Shes resting not asking for food.

So until this Ultrasound, what else coudl it possibly be? I surely thought her kidney disease progressed but it hasn't at all! Also to note, when vet was feeling her organs in check up, she was constantly growling in anger when she never did that before...so as if she's sick inside? Also, my other cat named CHarlie was taken that day too because he too is barely eating as well. Though he isnt throwing up or anything, just not eating. He too got bloodwork but he has pancreatitis which vet believes that may be causing his poor appetite so he is on prednisolone now.

But as for my Sassy, I don't know what else can it be? Vet wrote down for now gastritis...but I just dont know how long it will take her to recover if its even that? Im happy her vitals and blood is completely normal, vet was surprised because he said literally I dont know what could be ailing her and to try the medications he prescribed. If anyone has input on this I would REALLY appreciate it as it hurts me to see now 2 of my cats not eating welll

 

[kittyluv387]

I'm so sorry both your cats are ill. And even worse you don't know the cause for Sassy. I don't have answers for you but I hope they feel better soon and you get the answers you need.

 

[miguel99nyc]

Update: 1/7/19

So it seems like they are responding little better as of today. Sassy in particular had wanted food today about 4 times...and only had given her the Mirtazapine on Friday so far. SHe was due to have it today but didn't want to give it since she still seemed to have her appetite? But at least shes eating bit. Still been giving her Cerenia and Fomatidine every day with her food which thankfully she taking in.

My question is though, is this sign that shes getting better or....its just basically cheating/covering up whats underlying inside (whatever it might be since its still undetermined)? Im just so anxious...and have to wait until Thursday to get the ultrasound since that is when technician is in vet office, if I want to and Vet said if Sassy wasn't responding to medication but to me she seems to be getting slightly better. Now even she jumps to my desk to pet me and meow at me for food too and follow me around. She been drinking plenty water and not throwing up since vet visit. BUt again, I dont know if its just the medication just holding her off ( say once shes off would she get sick again?) or..if she really is improving.

If she's also eating little by little (still not near as much she ate before being sick) should I still be giving her Mirtazapine? If anyone can give me their thoughts would greatly appreciate it.

Thank You Guys

 

[miguel99nyc]

Update: 1-9-2018

Hello everyone!

So an update on my cat Sassy, she is doing thankfully wonderful! Not vomiting and is vear near to already close to eating the amount she used to eat before, thank goodness!!! I called my vet yesterday, informed her about the Mirtazapine and that I only gave it to her once and she began eating right after it. So vet told me if shes eating well to not give it to her, but to finish up her Cerenia and Famotidine which she will finish it by today. Then I had asked him so what he believes he can believe, but now I was kinda getting pissed off because he said basically he doesn't know, there's no diagnosis since blood and Xrays were normal, he wants to do an ultrasound...but depends on how much further I want to investigate. To me sounds like he just wants to make money, but he always had that tone...wanting to do MORE tests if blood or xrays didn't work. He said Sassy could finish meds and see how she reacts after but if she gets sick again after meds are done then ultrasound must be done. So I guess that makes sense?

Now after doing some research, it seems that acid is built up in CKD cats. But, I was wondering if that occurs...regardless what stage they are in? Because again, in Sassy's bloodwork from last week, vet showed me her kidney values and said they were still well within normal range so her kidneys were not an issue. Which made me relieved! So if it wasn't her kidney disease causing the stomach acid (if it was stomach acid) then what could it possibly be? Upset stomach or cancer? She is near to her normal self now after these medications and appetite is back...but I fear now that once she's done with these meds, she could get sick again? In that case she got to be on that Cerenia/Famotidine every day? And is Famotidine safe? I've also read for some cats with CKD it wasn't?

If anyone could let me know, I'd greatly appreciate it. Thank You.