5/13 - Pookey - New Lab Values

Hi all,

Previous post:
https://felinediabetes.org/fdmb//threads/5-9-pookey-vet-visit-completed.93/

We just got the lab values back and into the spreadsheet.

Kidney values are normal, but on the higher end of normal. She really wants the us to collect a urine sample to look for early signs of kidney disease (not sure what value that is in the urine test).

Albumin and cholesterol are high but she is not too concerned since we didn't fast and he hadn't had any water before the test.

My initial reaction - I'm so relieved that his kidney and phosphorus values are "normal", along with T4. I know how much those conditions complicate things for a diabetic.

Also - 144 glucose? Vet stress??

Curious to see anything else you all spot, I'll be digging into it a bit more tomorrow.

Have a great day! - Tim
 
Hi all,

Previous post:
https://felinediabetes.org/fdmb//threads/5-9-pookey-vet-visit-completed.93/

We just got the lab values back and into the spreadsheet.

Kidney values are normal, but on the higher end of normal. She really wants the us to collect a urine sample to look for early signs of kidney disease (not sure what value that is in the urine test).

Albumin and cholesterol are high but she is not too concerned since we didn't fast and he hadn't had any water before the test.

My initial reaction - I'm so relieved that his kidney and phosphorus values are "normal", along with T4. I know how much those conditions complicate things for a diabetic.

Also - 144 glucose? Vet stress??

Curious to see anything else you all spot, I'll be digging into it a bit more tomorrow.

Have a great day! - Tim
YAY! That's great news! Hope all checks out with the urinalysis as well.

I was thinking of you guys earlier and was going to ask about the glucose reading. I've been thinking a lot about the AT reading higher than the human meter so my assumption would be BG would be higher for the vet blood test as well.
 
YAY! That's great news! Hope all checks out with the urinalysis as well.

I was thinking of you guys earlier and was going to ask about the glucose reading. I've been thinking a lot about the AT reading higher than the human meter so my assumption would be BG would be higher for the vet blood test as well.
Thanks Laurie! Yea that makes sense. He was pretty stressed when they were here too.

The normal range for glucose on the labs sheet they sent shows “72-175”, which is interesting…
 
Looking into it a bit further, the kidney values are trending in the wrong direction from his numbers 6 months ago. It’s only two data points though, so hard to say. I think my plan will be just keep getting water into him and check labs again in a few months.
Hi Tim, glad the labs looked good! 🎉
Do you add any water to his food to get extra water into him?
Does he regularly drink water (I notice Ivy usually only drinking when her numbers are higher).
But, I do add water to her food as part of her daily routine. I add 3 ounces to each feeding, twice a day (meal and snacks, then divided for those feedings) so I know she’s getting 6 ounces a day.
It’s kind of soupy what she eats, but she’s used to it and doesn’t mind. Just a suggestion.

Sending you and Pookey, lots of hugs!! 😻
And good luck getting the urine sample, how’s that going? Any progress?🐈😻
 
Hi Tim, glad the labs looked good! 🎉
Do you add any water to his food to get extra water into him?
Does he regularly drink water (I notice Ivy usually only drinking when her numbers are higher).
But, I do add water to her food as part of her daily routine. I add 3 ounces to each feeding, twice a day (meal and snacks, then divided for those feedings) so I know she’s getting 6 ounces a day.
It’s kind of soupy what she eats, but she’s used to it and doesn’t mind. Just a suggestion.

Sending you and Pookey, lots of hugs!! 😻
And good luck getting the urine sample, how’s that going? Any progress?🐈😻
Thanks Staci!

Right now he gets 3.5 ounces of water total added to his meals and snacks throughout the day. He has a very small amount from the bowl. Thanks for sharing your amounts, maybe I could increase this.

On the urine catch, I made a ladle on a stick and tried it last night. Scared him right out of the box. I think I touched his butt cheeks with it :oops: I’m kind of at a loss though because I really don’t want to put him off of using the box.
 
Thanks Staci!

Right now he gets 3.5 ounces of water total added to his meals and snacks throughout the day. He has a very small amount from the bowl. Thanks for sharing your amounts, maybe I could increase this.

On the urine catch, I made a ladle on a stick and tried it last night. Scared him right out of the box. I think I touched his butt cheeks with it :oops: I’m kind of at a loss though because I really don’t want to put him off of using the box.
Will Pookey pee in a clean box using those non absorbent pellets (no normal litter in the box) then you just dump the collection in the cup?
I think it’s called No Sorb.
Or I was told to use aquarium gravel as “litter” in a box and again just dump the pee in cup and take to the vet.
 
Will Pookey pee in a clean box using those non absorbent pellets (no normal litter in the box) then you just dump the collection in the cup?
I think it’s called No Sorb.
Or I was told to use aquarium gravel as “litter” in a box and again just dump the pee in cup and take to the vet.
We tried PrettyLitter before and he wouldn’t use it. So I’m assuming he won’t, but I haven’t tried aquarium gravel! Thanks for your help Staci 🤗
 
You made me laugh with your laddle touching his butt.
Was the test done in the same lab than last time? With results still in normal range and especially if the labs changed, I would not worry too much about it (I know, easier to say ☺️ ).
Cats cannot stop peeing once they start. With Bella I waited until she started and then put a jar under the stream. I am not sure how it would look with a boy, though!
 
Thanks Staci!

Right now he gets 3.5 ounces of water total added to his meals and snacks throughout the day. He has a very small amount from the bowl. Thanks for sharing your amounts, maybe I could increase this.

On the urine catch, I made a ladle on a stick and tried it last night. Scared him right out of the box. I think I touched his butt cheeks with it :oops: I’m kind of at a loss though because I really don’t want to put him off of using the box.
Poor Pookey! I can just imagine what's going through his head!

I hope you figure something out. My vet gave me a home collection kit and I said there's just no way! I'll be keeping an eye out for what works for you cause the way they do it at the vet sounds awful!
 
You made me laugh with your laddle touching his butt.
Was the test done in the same lab than last time? With results still in normal range and especially if the labs changed, I would not worry too much about it (I know, easier to say ☺️ ).
Cats cannot stop peeing once they start. With Bella I waited until she started and then put a jar under the stream. I am not sure how it would look with a boy, though!
We were joking after, if he were able to talk to us, he’d probably say “guys you’re not going to believe me when I say this, but I think something touched my butt in there” :LOL:

Maybe a smaller ladle or like a lid to a jar would be easier to sneak under there.
 
Oh, boy, the ladle on a string touching the butt cheeks made me LOL. So you know Jude's had a lot of urinary issues, and we've had to capture specimens frequently. The absolute best is the cystocentesis. I've been with Jude while he's had it, and he doesn't seem too disturbed by it (I was more disturbed than he was!). I've read that it looks worse than it actually is, but no cat has ever weighed in personally to give me a review on the procedure, first hand, so I can't be sure. But for us, it's a clean, untainted specimen, which is what we often need. Previous to our current vet (who does the cystocentesis), we had another vet (who didn't like to do the cysto) who would send us home with the little beads to put in a litter box. This worked fine, too. Since everything was foreign to him, Jude didn't want to go in the box as long as possible, but then he bit the bullet and peed on the beads. The trick was putting a teensy bit of his pee-litter in the corner of the box so that he knew what the box was for and that he was doing the right thing in the right place. Alternatively, I have used flatter food bowls--typically the cats' feeding bowls which are almost flat (to avoid whisker stress). I slid one under Jude while he was peeing in the box. Worked fine. I've done it twice. I've failed at doing it a couple of times too, though, and he would just jump out of the box. But now, thanks to Cecile's excellent advice about cats not stopping the flow once they start, I know why. I think I put the bowl down too early and spooked him. Obviously, the larger the litter box, the better things work with sliding the bowl under him. I also have this stuff that I haven't used yet (because my current vet does the cysto, and we haven't had to use it) called Kit4Cat Cat Urine Sample Collection System which is hydrophobic litter that keeps the cat's urine on top of the litter. You might want to try that as well. Good luck!
 
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Oh, boy, the ladle on a string touching the butt cheeks made me LOL. So you know Jude's had a lot of urinary issues, and we've had to capture specimens frequently. The absolute best is the cystocentesis. I've been with Jude while he's had it, and he doesn't seem too disturbed by it (I was more disturbed than he was!). I've read that it looks worse than it actually is, but no cat has ever weighed in personally to give me a review on the procedure, first hand, so I can't be sure. But for us, it's a clean, untainted specimen, which is what we often need. Previous to our current vet (who does the cystocentesis), we had another vet (who didn't like to do the cysto) who would send us home with the little beads to put in a litter box. This worked fine, too. Since everything was foreign to him, Jude didn't want to go in the box as long as possible, but then he bit the bullet and peed on the beads. The trick was putting a teensy bit of his pee-litter in the corner of the box so that he knew what the box was for and that he was doing the right thing in the right place. Alternatively, I have used flatter food bowls--typically the cats' feeding bowls which are almost flat (to avoid whisker stress). I slid one under Jude while he was peeing in the box. Worked fine. I've done it twice. I've failed at doing it a couple of times too, though, and he would just jump out of the box. But now, thanks to Cecile's excellent advice about cats not stopping the flow once they start, I know why. I think I put the bowl down too early and spooked him. Obviously, the larger the litter box, the better things work with sliding the bowl under him. I also have this stuff that I haven't used yet (because my current vet does the cysto, and we haven't had to use it) called Kit4Cat Cat Urine Sample Collection System which is hydrophobic litter that keeps the cat's urine on top of the litter. You might want to try that as well. Good luck!
Thanks Mary! Really appreciate the response and ideas. I’ve got some stuff to try. They gave me the Kit4Care but it’s like such a small amount of litter…
 
I just found some medical records from November 2023 when I took him in for a potential blockage, and some interesting findings. This was a year before his FD diagnosis.

They gave Buprenorphine, Midazolam, and Dexamethasone. Which doing some quick Googling, it looks like the Dexamethasone is a steroid? I have to wonder if this could have contributed to his FD dx.

Either way - he was 21lbs back then, eating dry food and tons of treats. So it's not like he wasn't at greater risk anyways.

This report does say his kidney values were elevated. I wonder if they kept the full bloodwork records. Would love to where all his values were at back then.
 
Interesting. I don't know for sure, but I'm not seeing an antibiotic in that list, which suggests to me that there was no infection, which suggests that his blockage was a symptom of feline interstitial cystitis.
 
Interesting. I don't know for sure, but I'm not seeing an antibiotic in that list, which suggests to me that there was no infection, which suggests that his blockage was a symptom of feline interstitial cystitis.
It says the urinalysis showed mild inflammation and concentrated urine. No bladder stones. And they did get him to urinate for them in the office. So I don't think he was actually blocked from the sounds of it.

Oh - their diagnosis was Feline Urinary Syndrome/Sterile cystitis.
 
It says the urinalysis showed mild inflammation and concentrated urine. No bladder stones. And they did get him to urinate for them in the office. So I don't think he was actually blocked from the sounds of it.

Oh - their diagnosis was Feline Urinary Syndrome/Sterile cystitis.
Since Pookey's had cystitis, it's good that he takes Cosequin, which is also prescribed to heal the bladder's lining. It's what I give Jude for his FIC (along with d-Mannose).

Jude had received three steroid shots within a year of developing FD (he was having hot spots--licking himself raw). The last shot he received was given one day before he fell very ill and was diagnosed with FD. I feel very certain that the steroids contributed to his FD.

Were you ever able to capture the urine sample?
 
Since Pookey's had cystitis, it's good that he takes Cosequin, which is also prescribed to heal the bladder's lining. It's what I give Jude for his FIC (along with d-Mannose).

Jude had received three steroid shots within a year of developing FD (he was having hot spots--licking himself raw). The last shot he received was given one day before he fell very ill and was diagnosed with FD. I feel very certain that the steroids contributed to his FD.

Were you ever able to capture the urine sample?
Oh wow, yea that seems like it could be correlated. Poor Jude, he’s doing so good now though so it’s okay.

Not yet. I think I have my strategy nailed down but it’s been the weekend. I’ve been conditioning him to allow me to stand near his box. So tomorrow I’m hopefully going to sneak a small cup under there.

Do you know what they look for in the urine test that doesn’t show in the blood?
 
Oh wow, yea that seems like it could be correlated. Poor Jude, he’s doing so good now though so it’s okay.

Not yet. I think I have my strategy nailed down but it’s been the weekend. I’ve been conditioning him to allow me to stand near his box. So tomorrow I’m hopefully going to sneak a small cup under there.

Do you know what they look for in the urine test that doesn’t show in the blood?
Good luck, stealth dad💪🏼
 
Do you know what they look for in the urine test that doesn’t show in the blood?
Here is what Dr. Google linked: Chronic Kidney Disease Screening and Confirmation Testing in Cats.

"Urinalysis. The importance of this screening test cannot be overemphasized, given that concentrating ability is often lost before BUN or creatinine increase. The urinalysis (including a microscopic sediment examination) measures urine specific gravity and determines presence or absence of proteinuria, red and white blood cells, bacteria, crystals, and casts. The International Renal Interest Society (IRIS; iris-kidney.com) guidelines on CKD in cats suggest that those with specific gravity <1.030 be further evaluated, but other data suggest that older, apparently healthy cats with specific gravity <1.035 undergo additional diagnostics, including blood pressure and SDMA measurements. Multiple factors can play a role in decreasing a cat’s urine concentrating ability (e.g., age, sex, dietary moisture content, drinking avidity, and fasting status). If proteinuria is detected on a dipstick, or if there is other evidence to support a diagnosis of CKD, the urine protein:creatinine ratio should be determined. If proteinuria is confirmed and the ratio is >0.4, medical and/or dietary intervention is warranted because proteinuria is associated with decreased survival times in cats."
 
Here is what Dr. Google linked: Chronic Kidney Disease Screening and Confirmation Testing in Cats.

"Urinalysis. The importance of this screening test cannot be overemphasized, given that concentrating ability is often lost before BUN or creatinine increase. The urinalysis (including a microscopic sediment examination) measures urine specific gravity and determines presence or absence of proteinuria, red and white blood cells, bacteria, crystals, and casts. The International Renal Interest Society (IRIS; iris-kidney.com) guidelines on CKD in cats suggest that those with specific gravity <1.030 be further evaluated, but other data suggest that older, apparently healthy cats with specific gravity <1.035 undergo additional diagnostics, including blood pressure and SDMA measurements. Multiple factors can play a role in decreasing a cat’s urine concentrating ability (e.g., age, sex, dietary moisture content, drinking avidity, and fasting status). If proteinuria is detected on a dipstick, or if there is other evidence to support a diagnosis of CKD, the urine protein:creatinine ratio should be determined. If proteinuria is confirmed and the ratio is >0.4, medical and/or dietary intervention is warranted because proteinuria is associated with decreased survival times in cats."
Gosh okay that’s important. Previous labs he was right on the edge at 1.037. I have to get that urine asap.
 
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