Can anyone understand Clapton's renal test readings

[Desley (booktigger)]

Rosie didn't think the tuna was much better than the other flavours, but my colleagues cat ate all the flavours she wouldnt!!

[Maddiesmum]

It's in paper form, I can't scan it as it is too big and I can't copy it on my machine as again it is larger than A4 which is the largest mine does. 

[Mark]

Thanks Carol - cancelled my 1/2 typed message to Debsy 

Fingers crossed he likes it - although I still want to give him some quality protein. I'm in the quality protein vs low protein camp.

[CarolM (Wendolene)]

I've put a couple of the tuna flavour in as well as the beef.  Off to PO now

[Debsymiller (Rufus' mum)]

Mark, have you tried him on the RC Renal but the Tuna flavour? It's only been out a couple of months and I know of 3 puds (including my Monty) who wouldn't touch any renal food but now they've tried the tuna flavour, they love it! Monty actually cried for me to feed it to him and won't even try to nick the other cat's food when that's down. It's a new flavour so definately worth a try. I had no luck with the RC chicken or beef flavours but obviously the tuna is tastier!
My friend's cat is on RC renal and was told he would be dead by now(we're 2 1/2 yrs since diagnosis) ... she recently had him tested again and his kidney results have gone back to normal sothe renal diet definately does help if you can get the cat to eat it.

[Mark]

Thanks 

[CarolM (Wendolene)]

Thanks Carol but I don't want to put you out. If it really isn't a problem, otherwise I will go to the vet next week (it's 5 miles away - crazy as there is a vet next door but we aren't best friends  )

No trouble (and Korky wont mind  ). I have to go to th PO this afternoon anyway so if you pm me your address I can post them then.

[Mark]

Mark - do you want me to send you some of the RC pouches to try?

Thanks Carol but I don't want to put you out. If it really isn't a problem, otherwise I will go to the vet next week (it's 5 miles away - crazy as there is a vet next door but we aren't best friends  )

[Mark]

I would be wary of the pork flavour Integra, pork has bigger fat molecules that make it harder to process, which is bad enough in a healthy cat, but could cause issues in CRF - Mark can expand on this, it was his vet that explained it.
Carol, I have some SEB that you can have - my local health food shop sells it quite cheaply, but then I found my existing supply!! PM me if you want me to send some.

He said something along the lines of the molecules being too large to pass through cats' tiny capillaries. There was also something online that I can't find right now.

He probably means the globules of lipids or something  as molecules are obviously tiny. (I will ask my biology lecturer when I see him although nemotodes are his thing  )

[CarolM (Wendolene)]

Thanks Desley.  I'll be out and about this afternoon and will try to get some SEB  but if I fail I'll take you up on your offer.

[Desley (booktigger)]

I would be wary of the pork flavour Integra, pork has bigger fat molecules that make it harder to process, which is bad enough in a healthy cat, but could cause issues in CRF - Mark can expand on this, it was his vet that explained it.
Carol, I have some SEB that you can have - my local health food shop sells it quite cheaply, but then I found my existing supply!! PM me if you want me to send some.

[CarolM (Wendolene)]

Yes its Senior that I've been feeding.  I've a box with lamb, rabbit, tuna and trout and one with beef, chicken, turkey and salmon.  I'm only buying small quantities at the moment until I get a handle on what he will and wont eat.  The beef, rabbit, lamb and tuna have been a success but the others less so - which is in keeping with his preferences in his pre-CRF days.  I got pork flavour Integra (I've never seen a pork flavour before) because the only other flavours they do are turkey and chicken.
What's the best thing to give for nausea?  I used to give Tiny (my Hyper-T) cat Pepcid but the one thats available OTC nowadays has other (undesirable) things added and the original Pepcid is prescription only (and quite a large strength tablet).  I went in H&B yesterday and asked for slippery elm bark powder - I was quite specific that I didn't want any other ingredient in it but stupidly I didn't look at the box till I got it home and she's given me slippery elm food which contains flour and sugar as well so that will have to go back.

Mark - do you want me to send you some of the RC pouches to try?

[Desley (booktigger)]

Lip licking is a classic nausea sign. I personally would give him a couple of days on senior food and then alternate between the two, to give him some variety. Did you want me to look for the other flavours of Felix Senior for you? i have hte ones with Beef, Chicken, Turkey and Salmon here, I get a good deal on that box through the cash and carry.

[Mark]

Are you feeding Felix senior - it took a while but mine prefer senior the adult now - as you probably know, it is lower phosphurus than adult. The only difference is it is harder to find on offer - that's why I buy 30 or 40 boxes at a time, either Whiskas or Felix so they have plenty of variation.

[CarolM (Wendolene)]

If he won't eat his 'proper' food, then maybe one normal meal with a phosperhous binder is good to kick-start the appetite again.

I tried Felix (no binder though) a couple of weeks ago and he wolfed it down like it was going out of fashion.  After that I tried mixing some Felix with the RC and that worked for a about a week but then he refused that as well.  I think all the Felix has done is to remind him that there are taster things than renal food   I can't decide whether he is holdoing out for something better or whether it is nausea as suggested.  He's interested enough in eating but goes to the dish and either picks at it or eats some then suddenly stops and walks away licking his lips.  I've never been able to get him to drink as much as he should (tried everything!) so he gets most of his liquid from his food and I'm worried about de-hydration if he doesn't eat enough.  I gave him straight Felix again this morning and he ate a full pouch (apart from a few lumps) and was still hanging around the kitchen looking hopefully at the fridge.

[Mark]

I have got an article on the management of chronic kidney disease in cats which is done by Bristol University.  It is 3 larger than A4 pages long and I will send it to you if you want Mark?  It discusses diet as well and lots of other interesting things.  I think it is sent out to vets

Can I be cheeky and ask for a copy as well?  Or maybe you could post it in the Cat Illness and Health Disorders section on Purrs - CRF is very common and it could be of interest to a lot of people.

If that is possible (or maybe ypou only have a paper copy?) that would be good for me as well as I can just save the document. I already have a collection of things to read, including the Orijen white paper which I am a bit dubious about as they say it is fine for CRF cats at 0.7% phos.

[clarenmax]

Mark - Integra and Kattovit from Zooplus are worth a go,

I've just got some Integra to try on Korky on your recommendation Desley.  The jury's out at the moment - he ate the first tray (almost) but not very enthusiastically so we'll have to see.  He's always been a good eater (too good - the problem has been keeping his intake down) so this food faddiness is all very alien to me but I guess I'm going to have to get used to it.

Max has become very faddy with his food as well, I think its a combination of sometimes nausea as Des suggested, and also that the food is so bland its just really boring.

If he won't eat his 'proper' food, then maybe one normal meal with a phosperhous binder is good to kick-start the appetite again.

It works pretty much every time for Maxy.

[Desley (booktigger)]

I wonder if he is just fed up of his prescription food, or if there is some nausea hindering him Carol?

[CarolM (Wendolene)]

Mark - Integra and Kattovit from Zooplus are worth a go,

I've just got some Integra to try on Korky on your recommendation Desley.  The jury's out at the moment - he ate the first tray (almost) but not very enthusiastically so we'll have to see.  He's always been a good eater (too good - the problem has been keeping his intake down) so this food faddiness is all very alien to me but I guess I'm going to have to get used to it.

[CarolM (Wendolene)]

I have got an article on the management of chronic kidney disease in cats which is done by Bristol University.  It is 3 larger than A4 pages long and I will send it to you if you want Mark?  It discusses diet as well and lots of other interesting things.  I think it is sent out to vets

Can I be cheeky and ask for a copy as well?  Or maybe you could post it in the Cat Illness and Health Disorders section on Purrs - CRF is very common and it could be of interest to a lot of people.

[CarolM (Wendolene)]

dL is the same as L?

No - dL is decilitres i.e a tenth of a litre, and I was wrong about the US units - they use mg/dL not mcg as I said in my earlier post).  If you're ever reading up on things from US sources and want to convert US units to UK units (also known as SI units) or vice versa, this site will do it for you http://www.vin.com/scripts/labquest/converthtml.pl

Korky seems to have decided he is not going to eat the RC wet pouches any more (having been a good boy and eaten them for over a year) so if you want a couple of pouches of beef and a couple of tuna to try on Clapton Mark  just PM me your address and I'll put them in the post for you.  It has been successful in keeping his phosphate well within normal limits despite his creatinine going up.  I think this is why he hasn't been showing any clinical symptoms (apart from peeing a lot) despite his high creatinine.

Gill - the lab your vet uses advertises itself as one of the biggest in the country.  If ever you need info on their reference ranges you can get it from their website (www.axiomvetlab.com - select labguide then click on reference ranges)

[clarenmax]

Max's worst creatine readings were 300+, but came down to 250 something last time around, and last week tested at 168 

We're still treating with diet alone, no tablets as yet.

I think every vet does things a bit differently from what I've seen?

[Desley (booktigger)]

Mark - Integra and Kattovit from Zooplus are worth a go, I think it was Integra I tried with Rosie, she would eat that whereas she wouldnt eat the 3 RC and 2 Hills foods, and the one I bought came in packs of 6 trays, so not a large amount to waste. I would also give the vet another call back and ask for the ranges, that way you know exactly how much higher they are - I know the high end of normal is similar at my vets to Jane for in house tests, but I think the lab ones are different. If that is the case, the Urea isn't too bad, Rosies was higher than that at diagnosis, hers was 252 and Creatnine was 20.9, on the CRF site, 250 is Stage 3.
As Carol says, it does depend on if he was starved, and also if they were done before the vet gave him a steriod jab, as they can affect the kidney readings.

[Maddiesmum]

I have got an article on the management of chronic kidney disease in cats which is done by Bristol University.  It is 3 larger than A4 pages long and I will send it to you if you want Mark?  It discusses diet as well and lots of other interesting things.  I think it is sent out to vets

[Mark]

I will try a few trays of RC renal anyway. I won't make the same mistake of bulk buying as I did with k/d pouches - only last week, I threw out 2 unopened boxes that expired a year ago - I originally bought 4 boxes but none of it was eaten. At the time, I also bough RC renal - also rejected. The only reason I am trying again is I heard they have changed but I still don't hold out much hope. If I can find a binder that works for them, I will just stick to regular food. There is mounting evidence that the reduced protein in rebal diets is harming cats due to muscle wastage and even damage to vital organs - also the cats get to eat the food they like and we don't have to pay silly money for food.

[Janeyk]

They will be like human hospital test results they too have a range which can vary as far I Know.  At the end of the day I don't think any differ to a huge amount anyway.

[Mark]

Thanks Carol, I don't suppose it matters but it's impossible to visualise things in moles -
so 233mmol/L = 6.022 x 10²³ /1000 x 233 = molecules of phosphorus per litre 

Shows my head is like a sieve as I got A+ in solutions & solubility but can't even think of the conversion right now 

Thanks for the link - I will have a look tomorrow when my brain may possibly be working 

dL is the same as L?

[Gill (sneakiefeline)]

the units used on frantas tests were in mmol/l and umol/l for creainine but ranges do not tie up with carol and janey.....sigh it was axiom vet labs that produced the report.

there was also a microbiology report.

[CarolM (Wendolene)]

Found the link www.nwlabs.co.uk/testinterpindx.html    Just had a wuick look at it (scroll down the list of tests and click the ones you want).  The values they quote are nearer to those that Gill quoted.  Your vet should have given you the normal ranges for his lab when he gave you the results

[CarolM (Wendolene)]

The readings depend on the units used as mentioned but also on the lab doing them.  Different labs have different normal ranges depending on the equipment/methods they use but there is not generally a huge difference between normal ranges for different labs for the same units..  Generally most UK labs measure in mmol/L (US use mcg/dL I think). Clapton's sound like they are in mmol/L.  The reference ranges for urea, creatinine and phosphate from the lab my vet uses are the same as quoted by Janey, i.e. Urea 5.7 to 12.9; Creatinine 71-212; phophate 1.00 to 2.42. 
Was Clapton starved before the blood was taken?  If not, that could go some way to explaining the very high urea reading - or possibly you should have a decimal point in there somewhere?  The creatinine reading is more important than the urea anyway and that puts him in early stage 3 renal failure.
I used to have a fabulous link to lab values and their explanation but it it doesn't work anymore (password protected now so you have to join) but I have another one somewhere (its not as good though) - I'll try to find it for you.

[JackSpratt]

From the limited knowledge I have the readings sound a bit on the high side - didn't your vet explain?

[CC & The Pussycat Guys & Dolls]

Maybe there are set levels for different cats going from weight, age etc? Its the only reason why they would be within different levels 

[Mark]

I wonder how I can compare Clapton's readings with others if they are different measurements? 

We are always being reminded in Chemistry etc the numbers are useless without units. (I was deducted for not stating moles even though my answer was correct  - annoyingly, the question was "how many moles" 

[Gillian Harvey]

  the simpler the better - ie ground shells or something 

Well its worth a try - egshell powder (ESP) is used as phosphate binder in people with renal dysfunction.


To put those readings into context you really need the previous readings and also the reference ranges for the new readings like Janey's posted.

[Janeyk]

It just shows how they differ, I've just found Schui's older results (can't find recent ones) and they say

Urea Normal (5.7 - 12.9) Schui's were 13.1 (high)
Crea     "     (71. - 212.) Schui's were 259. (high)

at that time (2005) the vet never suggested treating him however last test they were higher and vet did suggest treatment but said not to worry if he didn't take meds or renal food as so long as he was eating was main thing (he did have other issues though as you know so it was a quality over quantity)  I haven't usually looked into his results tbh as I tend to leave that to vet.

[Gill (sneakiefeline)]

Hmmmm sounds like my suspicion was right then,,,,,different measurement units are being used.

[clarenmax]

On Max's readings these are different?

Creatinine should be between 72 and 212 and Urea should be between 5.71 and 12.85 

All a bit of a mystery to me to be honest 

[Gill (sneakiefeline)]

I dont know if all test results come up using the measurements in the same units and am no expert.

I have infront of me Frantas readings from end of last year and from them its says:

Urea  should be within range 6 - 10

creatine                             60 - 170

phospate                          1.40 - 2.60

franta was low on phosphate and high on the other two but nothing like clapton and was viewed as pre crf and he has only one working kidney.

franta like clapton will only eat certain things and i think its better to have a happy cat eating rather than one who is very unhsappy and will not eat.

i donr know if that helps

[Mark]

The vet just called and said the only things of any concern are Claptons renal readings (he had full bloods). He said they aren't critical but significant. He thinks I need to push him to eat renal food. I told him I have tried them all but he said I should try RC again. I mentioned that some rubenal (renal support) capsules arrived in the post today but I am concerned that they contain phosphorus. He hasn't heard of them but thought it odd as well. He thinks I should try various binders as well so I am going to try alucaps again as Clapton won't eat food with Renalzin or Ipakitine in. Anyone know of any other binders I can try? - the simpler the better - ie ground shells or something 

Anyway, readings are

Urea 233
Creatine 309
Phosphorus  2.98

He said limiting phosphorus is the most important thing with CRF, followed by Fortekor to help the blood flow to/from the kidneys.