SDMA too high, difficulties with cat which hates being handled

gilmargl

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Mogi’s appetite was poor, she was restless, cried in the night and looked in a rather sorry state. First laboratory results (blood and urine) came back looking good. Everything was normal, only the pH-value was high (7) but that could have been from stress.

A few days later I was summoned to the vet and told that her SDMA was too high 1.22 µmol/L (reference value < 0.75).

The vet tried to explain to me the implications, stressing that it could be an indication of the start of chronic kidney failure but it could also be a result of a kidney being damaged from birth, in which case it would not necessarily get any worse. Mogi is 13 years old.

Treatment for the moment is to simply keep her eating and drinking and to give her urinary kibble as treats and, if she will eat it, a paste to improve the pH value of her urine and some carbon powder (?) (Porus One) on her food.

Secondly, to monitor her weight once a week and give her subcutaneous fluids if I think she is dehydrated.

It sounds simple enough – but Mogi is not a cat who allows herself to be handled. If I had to weigh her just once a month, I would put her in her carrier and weigh her on my scales (or use a hanging luggage scale). But, catching her and forcing her into a carrier once a week to be weighed is not a good proposition. I am thinking about buying some scales, with a large, flat platform, on which I can feed her and, once a week weigh her. I use kitchen scales for kittens and have seen that some of you use baby scales for cats. These are cheap enough to buy second-hand, but, for a cat like Mogi, the curved dish would be far too unstable and frightening.

Regarding subqs, we have successfully given fluids to three different cats (twice over many years because of chronic kidney disease and once after a road accident). In all cases the cats were either easy to manage and happy to sit still or were so weak that they accepted their fate. Mogi is still fit and ready for a fight! I am covered in scratches from the last visit to the vet! So, I am determined to get as much water into her as possible without subqs!

I have a water fountain in the kitchen which she ignores (but, at least two of the other cats do drink from it so it will stay there). There is a bowl of water in the hall, next to some kibble and cat grass. But Mogi prefers to follow me into the bathroom and drink from a tap. I have now ordered a second fountain (Swan) where the water flow closely resembles water coming from a tap, in the hope that she will accept it. I’m not sure where I can put it. Ideally it should be in the hall but there is no convenient socket – either it would be in the way and someone would always be kicking it or, worse still, tripping over it, or I would have to fix the cable to go up the wall, across the ceiling and down the other side. (When will someone design a reasonably priced battery-operated fountain?). The bathrooms are out of the question as all sockets are in cupboards. So, the fountain will have to go on carpeted floors in a bedroom or office – I can hardly put it near the litter boxes!

Or can I put it in the living room surrounded by (cat-friendly) plants as a centre of attraction, near the open fireplace? It’s a tiled floor, so perhaps I’ll do just that!

So, I seem to have solved one problem just by writing about it! Just need to sort out the scales and perhaps read more information on SDMA and its consequences.

Has anyone experience giving subqs to very difficult cats? My vet seems to have more faith in my abilities than I have! Thank you for reading.
 

mrsgreenjeens

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I'd go with hiring a Vet Tech to try to give her fluids. Cats normally act much better for other people than for us. We did that with our last kidney cat and it worked great. we just called around to all the Vet Clinics in our area and asked if anyone was interested. Found someone who lived less than a mile away! We worked out a deal that was amicable for all involved.

BTW, just to let you know, one of my boys recently came back with a raised SDMA. We retested 90 days later and it was back within normal ranges. No idea what happened, but sometimes it can just go haywire.

Does Mogi eat wet or dry food? If wet, try adding in a little water into her food, at every meal. I do that now with my non-kidney cats just to try to avoid any future issues. Don't know if it will help prevent anything, but don't think it will hurt.
 

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My eldest female is a scrapper but had to have subq. fluids. At first she dominated the situation. I could not find a tech to help but when it struck me that I HAD to get them in her, she must have sensed my emotions. She still resisted and as soon as it was over, she flew off but turned long enough to give me ,”the look!” I did put on a think coat but she stopped trying to scratch. I think that if it becomes an issue, like the fountain, you will find a way. For now, adding water to her food ,as suggested ,is a good idea. The fountain amongst lush foliage? What kitty could resist that? It will be her own private jungle. Tests results can fluctuate and are sometimes just wrong. We’ll hope for that first.
 
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gilmargl

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Can you place a scale with her food right beside it, inside a threesided box...?

Would there be a vet tech who might be willing to stop by and help with the fluids?
I am considering the idea of a box or something similar. At the moment, Mogi sleeps in an old battered covered cat bed I previously used for kittens. It lies under the taller cat tree in the living room and is her own favourite hideout. Unfortunately, as soon as I go near it, she comes out, which is exactly what she just did. If I have no food or treats with me she gets nervous and keeps her distance. For Mogi, food is an incentive to come, look and sniff but not necessarily to eat. So placing food in a 3-sided box may work once if I'm quick and the scales work but ......I'll give it a try!

A year ago we considered asking a vet tech who lives nearby and who has her own small mobile business to help when I had to go into hospital and we still had an injured cat needing fluids. The only reason we didn't use her was the fact that the cat concerned was nervous enough anyway and a complete stranger, who is not the quietest person at the best of times, would have made catching the cat, and treatment a nightmare. Both the cat concerned, Katy, and Mogi cannot tolerate closed doors and both sense a stranger coming towards the front door well before the bell rings. They would have both already hidden under a bed or in a cupboard so that a cat and mouse chase would be inevitable. If Mogi were sick we would definitely have a better chance of confining her in one room.
Asking the vet tech to come once I'd caught the cat maybe better than having to drive to the surgery,

Thank you!
 
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gilmargl

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BTW, just to let you know, one of my boys recently came back with a raised SDMA. We retested 90 days later and it was back within normal ranges. No idea what happened, but sometimes it can just go haywire.

Does Mogi eat wet or dry food? If wet, try adding in a little water into her food, at every meal. I do that now with my non-kidney cats just to try to avoid any future issues. Don't know if it will help prevent anything, but don't think it will hurt.
Thank you for answering - yes one value for SDMA is not particularly reliable. Another check in a month may be necessary - though I'm not too happy about Mogi being sedated again for the tests.

Mogi should be eating wet food - I keep to two different brands (paté) and add a third (gravy) to try to find something she just can't resist! For the first meal (nibble) in the morning I put some cat food with gravy on her normal food - to give her someting to lick. At lunchtime I add some warm water (or better still the water from boiling fish or chicken for the cats) - too much water and she won't touch it. I leave dry food out and she crunches a few pieces. Urinary kibble as treats with a couple of Dreamies are usually eaten, but not always.

Thank you for your help!
 
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gilmargl

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My eldest female is a scrapper but had to have subq. fluids. At first she dominated the situation. I could not find a tech to help but when it struck me that I HAD to get them in her, she must have sensed my emotions. She still resisted and as soon as it was over, she flew off but turned long enough to give me ,”the look!” I did put on a think coat but she stopped trying to scratch. I think that if it becomes an issue, like the fountain, you will find a way. For now, adding water to her food ,as suggested ,is a good idea. The fountain amongst lush foliage? What kitty could resist that? It will be her own private jungle. Tests results can fluctuate and are sometimes just wrong. We’ll hope for that first.
Thank you for telling me about your experiences. There is now even more information available on the treatment of cats with kidney problems than there was when two of my cats were diagnosed just eight years ago. SDMA was not mentioned then. According to the literature, I could let the vet take X-rays and sonography is also an option. These could help to show what's going on but they may not show anything untoward. The vet tended towards "Let's wait and see" but then added that another cat who is being given fluids is now doing much better (whatever that means!)

I am not going to try giving Mogi fluids before it becomes necessary. She has never been a good eater. In fact, during routine examinations, vets often commented that her stomach was empty! Her weight has been a constant 8 pounds ever since I can remember, she is now just rather more clingy than normal. She seems to be expecting something from me - but I don't know what.

I wonder if I've still got my ski outfit. Last time I wore it was when I had a huge foster cat to look after. He loved to rub himself against me, purring away happily and giving me a few deep bites causing my hands and feet to swell! The ski suit, gloves and boots were the only solution and I never even tried to pick him up - just taught him to go into the dog carrier by throwing treats into it!
Mogi is a gentle cat. She follows me around always hoping for more interesting food than I'm providing. She just panics when touched or picked up and scoots when visitors appear. I don't intend frightening her with my skiing outfit. With her, I take the scratches as an occupational hazard - it's my fault if I get scratched because I don't manage to hold her properly. Is there such a thing as a robot cat to practice on? 🤖

Thanks again, and I'll post any interesting developments.
 
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gilmargl

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Don’t have time this morning to post a detailed reply but check out The international renal society for info on diagnosing CKD and treatment recommendations. If only, SDMA is abnormal in a senior kitty, I personally wouldn’t be too concerned or stress her too much about giving her fluids.
Thank you and I agree. I don't want to stress her more than necessary. I had already read the IRIS literature I found in German. Her Creatinine was 124.0 µmol/l - so that was no problem. Not sure about SDMA at 1.22 µmol/L - is that equivalent to about 25 (Stage 2 CKD)? Her blood pressure was not taken. I have not had very good experience with vets taking blood pressure - it seems that cats have even more problems with their BP going skyhigh when they are at the surgery than humans do.:)

Thank you for answering - I also have liitle time this weekend as I should be helping with the catering for my grandson's eighteenth birthday.
 

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Not sure it helps but I confirmed the units for the SDMA testing used in the IRIS chart are in ug/dL. Don’t know why that info was not labeled in the chart. 🙄

So, a SDMA of 18 ug/dL is approx equal to 0.89 umol/L and I agree that Mogi’s value is equivalent to 25 ug/dL.

Even though Mogi does have an elevated SDMA, I still would be hesitant to diagnosis CKD based on a single elevation in SDMA - especially since her other bloodwork is all normal.

I know it’s hard to not worry about our beloved babies but personally, I would talk to your vet about retesting in 3-6 months and hold off on stressing her with fluids for now.
 
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gilmargl

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Update: without actually doing anything Mogi is, as far as I can tell, back to normal. She has never been a big eater though I do have to limit the treats I can't resist giving her when she begs with those large innocent eyes! I will talk to the vet when the next opportunity comes up (with 4 cats it will probably be sooner rather than later), but if all continues to go well, I will not expect her to have more blood tests for another 9 months or so.


I have solved the weighing problem by buying a rather expensive weighing platform. I activate it by putting my foot on it, put a few treats in the centre and Mogi comes along and puts all 4 paws on the scale and I read off her weight, which is still the same as it was 3 years ago so I can't complain.

I bought the second fountain to encourage her to drink. I haven't seen her actually drink from it yet, but Emily certainly does and Meghan plays with the water. My cat oasis, next to the fireplace, now consists of a cheap plant light and a selection of cat-friendly plants which have been outside for the last 3 weeks, to get rid of excessive fertilizers and insecticides. Some of the leaves dried out because of the extremely hot weather we've been having, but most of them look fairly healthy. Cat grass and the herbs have to be thrown out frequently because of attacks by humans and cats. I put the weighing platform permanently in front of the plants, so the cats don’t freak out when I produce it out of the storage cupboard. I’m not sure that my living room could be featured in a posh homes and gardens magazine, but it's fine for us!


Sorry that I’m no good at taking photos (into the light) but these may give you some impression of what I’m trying to do. Any ideas for improvements are welcome!
Platform.jpg
Platform with Emily.jpg
 
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gilmargl

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Did you change the photos? I really like your setup, nicely done!
No! I haven't changed anything! I thought the "setup" would produce some funny comments from my not-so-cat-crazy friends, but no. So I've got used to having a weight scale and plant light in a rather dark corner of my living room. Quite proud of it really! ;)

By the way, here's a vid on carriers.
Nice video. My cats (all 4 of them) change their favourite rooms, chairs, perches, cupboards, beds ... according to the time of day, whether or not mice or birds are on or near the terrace, and depending on who got there first! 2 of them don't eat any treats at all. They sometimes choose to settle in carriers placed strategically or randomly, but very rarely. They don't appreciate my clothes though one of them is strongly attracted to my partner's pyjamas, but only when he has just thrown them off onto the bed before going under the shower!
At the moment, early afternoon, Emily is sleeping near me on a dining room chair, 2 black cats (Mogi and Katy?) are sharing my lounger, one on the footstool, and another black cat (must be Meghan) is sleeping in an igloo-type cat hideout. I need to search for a video - "How to get the right black cat into the carrier for an appointment at the vet". It is one of my recurring nightmares - delivering the wrong cat to a new owner. It did happen on one occasion with almost identical female tabby kittens. The young daughter had found a marking on one of the kittens she thought her parents were buying and was horrified when she discovered the mistake. It all ended happily - the kitten was exchanged. No harm done. :lol:
 
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gilmargl

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Update!
I've been monitoring Mogi's weight for 8 months. At first I was pushing food into her mouth, then, when she weighed 3,7 kg (a gain of 200 g) I stopped forcing her to eat but allowed her to eat as often as she wanted with me in the tiny bathroom. I always have some food out for my 4, no-longer-young cats, but would offer Mogi something fresh. About 2 months ago, her weight started to drop and the amount of food she was consuming in my presence was approaching 1 or 2 teaspoonsfull a day! She gladly ate the 10 Dreamies (aka Temptations) which I was using to coax her onto the scales - but that certainly didn't reduce my concern.

I knew that Vet no.1 wouldn't help too much - as she assumes Mogi is (or soon will be) needing treatment for CKD. She didn't think it was worth doing a new blood test. Vet no. 2 would immediately want to X-ray her teeth, his standard procedure for any cat. (Make money while you can!)

A couple who adopted one of my foster cats, a few years ago, recommended a cat-only vet. So I made an appointment there. Covid-19 conditions did allow me to go into the surgery and, keeping my distance, watch the proceedings. I was amazed how well Mogi, wrapped loosely in a Felliway impregnated fleece, behaved with the vet - allowing herself to be put on the scales and then examined. Teeth: very good for her age, but very little food in her intestines. The vet took blood with the help of the technician - for the first time ever, without having to sedate boney Mogi.

I was given Mirtazapin to put in her ears to improve her appetite and......... it worked! At least she ate almost 50g Sheba yesterday and a similar amount this morning, plus some tuna fish I put aside for the cats from our lunch.

Today, I received the blood test results - nothing at all to worry about on that score. Everything, even SDMA, within the normal range.
I agreed with the vet to use Mirtapazin for 2 weeks, then see how things develop without medication. I will then make an appointment to have her blood pressure taken and to discuss whatever needs to be discussed.

Do cats suffer from anorexia nervosa? I've had cats who refused to eat while I was away, but they soon changed their minds. Perhaps Mogi hates Meghan (the last foster to join my team, over 3 years ago!). There is certainly no outright fighting going on. :dunno:
 

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So glad her bloodwork came back within normal ranges! That's terrific.

About the anorexia, I have a cat who sounds very similar. He's 12 and needs to be hand fed almost constantly. He only eats well when he's on transdermal Mirataz. We went through the two weeks of giving it to him and he did great, but once we stopped it, he stopped eating :frown: So I talked to the Vet and she said it's ok to give it to him whenever we feel he needs it. That ends up being every other day now. I'm not happy about it, but so be it. I just had him back in because I wanted him to have another thorough checkup thinking this just can't be normal. She checked him every which way, including a full senior blood panel and everything came back perfect. And he seems happy, full of energy, etc, so I guess I should just stop worrying. He just isn't interested in food.
 
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gilmargl

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So glad her bloodwork came back within normal ranges! That's terrific.

About the anorexia, I have a cat who sounds very similar. He's 12 and needs to be hand fed almost constantly. He only eats well when he's on transdermal Mirataz. We went through the two weeks of giving it to him and he did great, but once we stopped it, he stopped eating :frown: So I talked to the Vet and she said it's ok to give it to him whenever we feel he needs it. That ends up being every other day now. I'm not happy about it, but so be it. I just had him back in because I wanted him to have another thorough checkup thinking this just can't be normal. She checked him every which way, including a full senior blood panel and everything came back perfect. And he seems happy, full of energy, etc, so I guess I should just stop worrying. He just isn't interested in food.
Thank you for sharing your experience and I'm glad your cat's blood analysis was fine. My vet also said that, so long as a cat has no other health problems, there is no reason not to continue with the drug. But, I do worry about other side effects. Mogi is not acting "normal" though I can't tell if it's because she feels better or different. The drug is used to treat people with anxiety after a heart attack - the side effect is weight gain. (I remember being given painkillers after an operation and feeling so dreadful that I preferred living with the pain rather than no pain and feeling completely gaga.)

I think that Mogi is perhaps becoming less vocal at night, which must be a good thing. I will continue treating her in the hope that in 2 weeks she will have accumulated some fat to hide her bones and that her fur is in a better condition. After that I'll have to experiment.

I'm not sure that I am clever enough to remember to do things "every other day"- I could try halving the dosage and continuing on a daily basis or perhaps I might be able to manage Mondays, Wednesdays and Fridays.:lol:

Almost 50 years ago, a vet told me that if kittens are taken from their mother too early, their stomachs are not able to develop properly and these cats will have problems digesting food. Mogi was found at 4 weeks old, injured and discarded in a rubbish container. I picked her up from the shelter 2 weeks later - still flea-ridden. I had a lot of problems initially - minced chicken was her staple diat for the first few months to avoid diarrhea. But, although she was never heavier than 3,7 kg she only started looking boney and out-of-condition about 2 years ago. That was after I'd spent quite a lot of time out of the country, when my mother died, and then I was away for 5 weeks, in hospital and convalescence. So, it could be a physical problem (underdeveloped stomach) or a nervous disorder (absence of her main carer). :dunno:

I wish you all the best for your cat and I'm hoping that he and Mogi will remain healthy for as long as possible, with or without an appetite.
 
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