Blood Test Advice

[Desley (booktigger)]

I suppose I should be glad the vet doesn't think it's concerning and they probably are good for a cat 5 years post diagnosis.

She has renal dry food, she's gone off renal wet food, but could only have two pouches a week, as cats with calcium issues shouldn't have any renal food, but the vet felt her kidneys were more important, and anything more than 2 pouches affected her calcium levels, so I went for renal biscuits that have the ingredient she should have for her calcium levels in.

[Frances]

That’s irritating to say the least .  Definitely worth a phone appointment with vet to discuss.

Will Lucy eat renal biscuits?  When Sasa (CKD) and Misa were with me she did eat the wet renal sachets (although he snaffled her leftovers) and they both had renal biscuits – vet said good for her and would do him no harm.

[Desley (booktigger)]

Picked up Lucy's meds and blood results today, not quite as happy as when the message from the vet was nothing concerning! There are two red items on it, her SDMA is the highest it's been, at 18 (top end of scale 14) - it was 16 on diagnosis in 2017 and we did get it down to 9 in 2019, so I think the fact she no longer accepts renal wet food is having an effect, although I have to remind myself that it is 5 years since her initial diagnosis, and her Urea and Creatnine are still within normal limits, so she's not up to 70% loss yet. Her creatnine looks just under half way on the little line - 122, top end of scale is 212, although this is up from 2019, when it was 104 although there is a graph at the top that shows it was a lot higher in 2017. Her urea is near the bottom end of normal, the top end is 12.9, but no comment about the last result. Guessing her BUN:Creatnine ratio (no idea why one is measured as urea and one BUN!) must be normal at 14, as there is no comment against it. The other red item is globulin, but I can see why the vet wasn't concerned, it's 54, and the top end of scale is 51, plus there is no flag against her Albumin:Globulin ratio and a quick google search shows that could just be dehydration - I don't have any water bowls upstairs as when I have, she's refused to drink out of them, she only likes it in the front room, so she had gone without water as I'd kept her in my room all morning.

[Frances]

That's very good news Desley!

What she said

[Lyn (Slugsta)]

That's very good news Desley!

[Desley (booktigger)]

Had a voice mail from the vet, she said there is nothing concerning about any of her blood tests and her calcium is normal, so didn't need to speak to me. I'm picking up a copy of her results next week when I go for her meds. At least it seems the weight loss is the diet and nothing sinist

[Desley (booktigger)]

Rang today, partly to chase the results and partly to order her gabapentin, I'm on the list for a phone call tomorrow, there was a delay with her calcium results. I did get the receptionist to tell me her Urea and Creatnine though, she said Urea is 7.1 and Creatnine 120, and said both said normal at the side, so I'm quite relieved now as I was a bit worried about the 600g weight loss, even though she has been on a diet, and the fact that every time she eats, she goes and has a drink. Surely if her results are normal on a standard pre op type blood test, that means she's still early stage? We normally only get enough blood for an SDMA test, so I'm more used to analysing those!

[Desley (booktigger)]

As long as her bloods don't show anything. The main concern is that we'll have to do that to monitor her calcium levels

[Frances]

not sure I'd do that on a regular basis

I think that now you have managed to get a full blood panel done, with all the extras, you should have all the information you need and will not have to repeat the exercise for a while.  Lucy will be pleased  .

[Desley (booktigger)]

Well, yesterday was the day. She did well being starved, it was girls night out, so I got up, fed them, and me and Lucy chilled in bed watching TV. She has lost weight, now 5.2kg from 5.8kg last year, I'm just hoping it's the diet and nothing more! Apparently she went down really quickly, so they did it all in 20 mins in case she came up as quickly as she went down! We did a full set of bloods, cost a fortune though. I picked her up about an hour later, so she was still wobbly, I was hoping she'd lie on the bed and relax so I could see her while working, but she wouldn't settle till about 3pm (sedation was bout 11am), and she was very quiet and not interested in food, she's only been acting like herself since about 7pm tonight, so not sure I'd do that on a regular basis. Now just waiting for the results, they are going to ring when they are all back and the lab test is about 48 hours, so I might not hear till Mon

[Lyn (Slugsta)]

I agree with Frances; that sounds like a good plan for getting everything done.

[Frances]

That sounds like a good plan Desley particularly if going down the sedation route allows you to catch up on tests Lucy hasn’t had for a while.

[Desley (booktigger)]

No, my vet wouldn't do that, she knows my views on boosters, and we have stopped FeLV now too, especially given that most cats that venture on the street disappear when Lucy growls and hisses at them, there are two new cats on the street behind me, the timid black cat came round the other night to be growled at, not sure it'll come back. I'm going to go for sedation and do everything in one go, she hasn't actually had full bloods since August 17, I realised it was because we don't normally get enough blood for those as well as SDMA and calcium, so she's only had them done since. It would give the vet chance to properly check her mouth, rather than having a go while being hissed at. The machine is to test for her calcium levels, which I want to make sure her hypercalcaemia is being controlled. Just need to check my diary to see when I'll be able to book half a day off, as she'll be there about an hour and half.

[Frances]

I agree with Lyn that a year+ gap between boosters for an adult cat that has had a first course and booster plus periodic boosters would be fine.  Also, never get persuaded that Lucy needs to “start again” at her age.

Given her early CKD status, I think I’d go for the booster plus kidney function tests which presumably will include a general health check.  If anything showed up on the kidney function tests compared to her previous results I’d then consider whether it would be worth waiting for the vet to get their in house equipment fixed/replaced or having her sedated for lab tests.  If her health check shows she needs something like a dental with full GA then of course taking enough bloods for a lab test shouldn’t be a problem.

[Desley (booktigger)]

No, there is no pressure, even if we went over the 8 weeks my vet goes off, she doesn't need them for a cattery or anything. I'm going to ring and book a telephone consult with my vet and discuss it, I like to know exactly what is going on health wise, but hesitant at risking her having a sedation for my peace of mind, not because there is a clinical need for the test.

[Lyn (Slugsta)]

My vet was unable to get vaccs at the end of last year and was prioritising first courses and first booster. They told me that an 18 month gap is OK, so I don't think you need to feel pressurised into making a decision . . .

[Desley (booktigger)]

Need a bit of advice please. Lucy normally has her bloods every March, she's not had any since March 2020, so I wanted both her kidney and calcium levels checked, but the vets EPOCH machine needs a part and it's quite old so they can't get it, so the only thing they can do is the lab test, which requires 1ml of some kind of serum, which takes quite a few ml of blood to get, and the vet doesn't think Lucy will oblige long enough while she is awake, so my options are

1 - Just have her boosters and kidney function test
2 - Sedate her and have boosters, kidney function and calcium levels done in one go
3 - Take her for her boosters and see what the vet thinks, bearing in mind that if we then want to sedate her, it's an extra vet visit

The other downside is that doing the lab test and sedation requires a morning appointment, and Lucy might twig something is going on as she always has evening appointments.

Normally I'd go with sedation and get everything out of the way, but I'm a bit reluctant as she is 14 and has had early stage CKD for 5 years, and obviously sedation is a risk. There is no rush to make a decision, even if I was bothered by her boosters being overdue, the nurse says there is an 8 week grace period so we've got till middle of May.

Thoughts?