Help With BUN/Creatine Lab Results

[ty3535]

Hi!
At Enzo’s most recent wellness check his labs were:

BUN 30
Creatine 2.4

These are both very slightly elevated from his labs from one year ago (25/1.7 respectivel) I really love my vet, and she knows how invested I am with his health/diet. So I usually trust her, but she told me that everything looked “great” and that if she didn’t know his age (14) she’d guess he was a much younger cat. Which I felt super happy about! But when I googled normal cat lab results it looks like the creatine is at the high end of normal, which, according to the sites I read indicates mild renal failure in older cats. Can anyone offer some help? I find it hard to believe she wouldn’t have mentioned this to me given our history, and the phone call we had was fairly lengthy. But now I’m concerned.

 

[Furballsmom]

Hi! You'll want to call her back and talk with her about this so that she can explain her thinking for you.

 

[ty3535]

Hi! I definitely plan on doing that but unfortunately she’s not in again until Wednesday. So I’m looking for clarification on what the creatine number means from someone who might have a cat with kidney issues.

 

[FeebysOwner]

Hi! I agree about calling the vet back again when she is in the office, and ask her about the elevation, even if it is still in the 'normal' range. I had a similar type thing go on with Feeby (15+ yo) and asked my vet about it. He said he had seen the change, but wasn't worried about it and apologized for at least not mentioning it to me. He just said that he was glad I actually compare test records on Feeby and can ask about changes. Since Feeby gets semi-annual blood tests, he said he wants to wait to see if the elevation continues or not. He said he suspects it will have stabilized. For now, that is good enough for me! We will see!!

Edit: Btw, creatinine can be elevated some by a bit of dehydration, which seems to be fairy common in cats in general. As far as I understand, for example, one day they don't get as much liquid and that can cause an elevation. I hope that is all it is in Enzo's case!!

 

[BlackCatOp]

Both BUN and creatinine measure waste products in the blood from metabolism. These tests are used to evaluate renal function. Unfortunately, these tests are not perfect and creatinine does not show an increase until 75% of kidney function has been lost! Thus, a small increase in creatinine is considered important.

Personally, I agree I would be concerned with Enzo’s numbers. Especially since it is now recommended that 1.6 mg/dl be used as the upper range cut off instead of 2.3 and his current numbers show an increase over last year’s value. My understanding is that any change in results over 0.3mg/dl is significant.

Did Enzo have a urinalysis also performed? If so, what was his urine specific gravity? In reality a USG should be completed at the time of blood work to properly diagnosis ckd. USG indicates how well the cat can concentrate or dilute its urine.

I would pose my concerns about chronic kidney disease to my vet. Unfortunately, there is not anything that can be done to reverse ckd but with earlier diagnosis one can monitor kidney function and electrolyte values more regularly with the goal of slowing disease progression.

Wishing you and Enzo the best!

 

[ty3535]

Hi! I agree about calling the vet back again when she is in the office, and ask her about the elevation, even if it is still in the 'normal' range. I had a similar type thing go on with Feeby (15+ yo) and asked my vet about it. He said he had seen the change, but wasn't worried about it and apologized for at least not mentioning it to me. He just said that he was glad I actually compare test records on Feeby and can ask about changes. Since Feeby gets semi-annual blood tests, he said he wants to wait to see if the elevation continues or not. He said he suspects it will have stabilized. For now, that is good enough for me! We will see!!

Edit: Btw, creatinine can be elevated some by a bit of dehydration, which seems to be fairy common in cats in general. As far as I understand, for example, one day they don't get as much liquid and that can cause an elevation. I hope that is all it is in Enzo's case!!

Thank you so much!! I am trying to lean more towards being positive since I specifically asked her is the changes should be a concern and she said no. I’ll definitely call Wednesday for clarification though. Thank you so much!!

 

[kittyluv387]

If your cat eats a high protein diet and not dry those numbers are perfectly normal. What does your cat usually eat? My 2 cats creatinine levels are a bit higher than normal because they eat raw.

Edit: I see he is older at 14 so some kidney function decline is normal. Might be good to start feeding him lower phosphorus foods and add some fish oil to his diet.

https://felinecrf.org/canned_food_usa.htm

 

[ty3535]

Both BUN and creatinine measure waste products in the blood from metabolism. These tests are used to evaluate renal function. Unfortunately, these tests are not perfect and creatinine does not show an increase until 75% of kidney function has been lost! Thus, a small increase in creatinine is considered important.

Personally, I agree I would be concerned with Enzo’s numbers. Especially since it is now recommended that 1.6 mg/dl be used as the upper range cut off instead of 2.3 and his current numbers show an increase over last year’s value. My understanding is that any change in results over 0.3mg/dl is significant.

Did Enzo have a urinalysis also performed? If so, what was his urine specific gravity? In reality a USG should be completed at the time of blood work to properly diagnosis ckd. USG indicates how well the cat can concentrate or dilute its urine.

I would pose my concerns about chronic kidney disease to my vet. Unfortunately, there is not anything that can be done to reverse ckd but with earlier diagnosis one can monitor kidney function and electrolyte values more regularly with the goal of slowing disease progression.

Wishing you and Enzo the best!

Thanks for responding! I am definitely worried about the elevated creatine since that definitely seems to be out of range. The BUN increased by 5 but is still middle of the road so I’m less concerned about that. I don’t have his USG but he did have a urinalysis and she said his urine was very concentrated which is pretty normal for him. Is this good or bad?

 

[ty3535]

If your cat eats a high protein diet and not dry those numbers are perfectly normal. What does your cat usually eat? My 2 cats creatinine levels are a bit higher than normal because they eat raw.

Edit: I see he is older at 14 so some kidney function decline is normal. Might be good to start feeding him lower phosphorus foods and add some fish oil to his diet.

https://felinecrf.org/canned_food_usa.htm

This makes me so relieved! He eats fairly high protein (wet food only) I would say. It’s Nutro Perfect Portions Turkey/Turkey Liver pate. I’m wondering if liver contains a higher than normal amount of phosphorus? They also have a version without liver. Do you have any opinions on phosphorus binders? He’s the pickiest eater in the world, plus I’m not thrilled with a lot of the renal diet ingredients in most of the foods. I saw that cats who won’t take to renal diets can have success with phosphorus binders but I don’t know much about their safety. Thank you so much!

 

[kittyluv387]

This makes me so relieved! He eats fairly high protein (wet food only) I would say. It’s Nutro Perfect Portions Turkey/Turkey Liver pate. I’m wondering if liver contains a higher than normal amount of phosphorus? They also have a version without liver. Do you have any opinions on phosphorus binders? He’s the pickiest eater in the world, plus I’m not thrilled with a lot of the renal diet ingredients in most of the foods. I saw that cats who won’t take to renal diets can have success with phosphorus binders but I don’t know much about their safety. Thank you so much!

Meat has phosphorus but bone is particularly heavy in phosphorus. So omitting liver is not something you want to do. For example a lot of foods will be bone heavy but it'll still be under "chicken", "turkey " and etc. For me, if my cats were just a little higher than normal in numbers like your cat I would not jump to phosphorus binders. They are aluminum based which isn't the best. I would honestly look for lower phosphorus foods. Please take a look at the link I posted in my last reply and start your research into foods there. Kidney disease is an inflammatory disease so anti-inflammatories would be helpful for your cat. That's why omega 3 fish oil supplements are recommended.

An interview with Dr. Pierson a cat specialist and she mentions omega 3 among other things for kidney cats.

 

[ty3535]

Meat has phosphorus but bone is particularly heavy in phosphorus. So omitting liver is not something you want to do. For example a lot of foods will be bone heavy but it'll still be under "chicken", "turkey " and etc. For me, if my cats were just a little higher than normal in numbers like your cat I would not jump to phosphorus binders. They are aluminum based which isn't the best. I would honestly look for lower phosphorus foods. Please take a look at the link I posted in my last reply and start your research into foods there. Kidney disease is an inflammatory disease so anti-inflammatories would be helpful for your cat. That's why omega 3 fish oil supplements are recommended.

An interview with Dr. Pierson a cat specialist and she mentions omega 3 among other things for kidney cats.

I just ordered a fish supplement, he seems to not mind salmon so I got a 100% salmon oil one. I took a look at the food charts, I saw she has a book that sorts them by brand on amazon so I bought that as well. He has IBD and a lot of food allergies, including chicken and eggs which are pretty much in all the renal diets I’ve looked at. I did read on that same website about the phosphorus binders and the concerns for each kind. I’ll definitely hold off on those until I talk to my vet and find out what his phosphorus level was. It seems like they’re used as a last ditch effort when the cat won’t eat a renal diet. The website is so great, thank you so much!

 

[ty3535]

Hi, I just wanted to update because I spoke to another vet at the practice where Enzo goes and I have excellent news! Apparently when she was giving me his Creatine number, she said that the 2.4 was the high end of normal for the lab they use but his number was 1.7, not 2.4. His urine specific gravity was 1050, and phosphorus was 5. The only thing that makes me slightly worried is that they don’t use SDMA testing, which I read can detect kidney decline earlier than other tests. otherwise, she said the fish oil is a good addition to his diet. Thank you all so much!

 

[FeebysOwner]

Thanks for the update! It all sounds pretty good to me at this point. The urine specific gravity (you meant 1POINT050 - 1.050, yes?) is just a tad high, but that could just mean a tiny bit of dehydration. I am sure they will want to check him again in the near future just to make sure there are no significant changes, but for now it sounds you are on the right track!

 

[ty3535]

Sorry yeah, 1.050. He fasted beforehand so she did say dehydration could’ve played a part, but also that it was better for it to be more concentrated as far as how the kidneys were working than less concentrated. He goes every 6 months, so I’ll definitely keep on top of it. Thank you so so much!!

 

[kittyluv387]

Hi, I just wanted to update because I spoke to another vet at the practice where Enzo goes and I have excellent news! Apparently when she was giving me his Creatine number, she said that the 2.4 was the high end of normal for the lab they use but his number was 1.7, not 2.4. His urine specific gravity was 1050, and phosphorus was 5. The only thing that makes me slightly worried is that they don’t use SDMA testing, which I read can detect kidney decline earlier than other tests. otherwise, she said the fish oil is a good addition to his diet. Thank you all so much!

Fantastic news!!! Thanks for the update. BTW cats who have a water rich diet will have a more dilute USG. Nothing to be alarmed about if you're like me and make their food soupy. SDMA is a good test but since his numbers are actually pretty good you can just get that done at his next check up.

 

[35 year catdad]

My luv bug old honey bun's BUN is 127 so today I went to the very nerdy IDEXX site to understand all our numbers. Great info here and its a bit nerdy but knowledge is power I guess.
Interpreting Your SDMA Results - IDEXX US

 

[35 year catdad]

I read same thing about fish oil so I rubbed a little bit on my kidney patients front paws and 7 days later now she smells like a fish
arrrgh we live we learn
I used human grade molecularly distilled from small fish like herring, and anchovies from non polluted waters etc. Salmon oil may be from farmed fish with loads of terrible toxins in it. Or does the distilling remove more than mercury? hmmmm I test the new bottle gelcaps just one...by biting into one and tasting when I get a new bottle as rancid fish oils are carcinogenic and all our heat waves when things are stored cant help.

If you notice a little blood in his urine after fish oil or Vit E next day it can thin the blood? ask your vet of course.It happened here 3 times and every time its been after a tuna or wild salmon meal. I only gave 2 drops of natural E mixed tocopherols. I read a study where Purina researchers fed 3 groups of cats 3 diets and the ones with E (other differences too) lived on average one year longer. We'll take that! Someone here posted a link for me to the study and thanks! E wasnt the only difference in those diets.

Our IDEXX blood work had 47 CATa gories and was $214 in No. California, and our emerg vet here wanted 350-400 oh my thats a lot of cat food.....urine testing was $67. For a view of our blood results see my Tortie is sick post where I posted a pic of it.
Other ideas for my research are expensive krill oil and green lipped mussel extract from NZ where the water is purer than most anywhere on our planet. Go ENZO

 

[ty3535]

This is actually crazy weird timing because yesterday was Enzo’s 6mo checkup so I got his labs back today! His numbers are basically identical which is super relieving. Unfortunately I have discovered that he won’t only not accept fish oils, they actually make him throw up. I’ve tried anchovy oil, salmon oil, krill oil. New Zealand green lipped mussels have always made him throw up which sucks because a lot of high quality food contain them. So I have not been able to figure out how to give him omegas. Thank you so much for the link!!

 

[35 year catdad]

Your welcome!! I wish there were more hrs in the day to research cat health (and ours)
Just by eating oily wild fish you will be getting omegas into Enzo if he will go for it. and what a kewl name BTW
I love Italian race cats!
Someone up above mentioned skewed blood numbers from what I think affected ours a lot for allergies etc

Hibou is getting frail like any 19 yr old does and first time ever a health issue had a little pink urine while in out of cat box dribble dribble so in she went to emerg. In bad judgement looking back 3 days before our blood draw I was giving for the first time and she LOVED it and begged for more more more...
raw NZ ground grass fed angus beef and Alaska sockeye salmon-both human grade. BAD move I think ..
.
I always hear "with any changes to diet add new food in slowly starting with 10%" and build up.
hmmm in the wild one day its a rat, then a bird, then a gopher, and then who knows what?


Normally her diet is turkey/chicken wet 90% and some Wysong Geriatrix dry and just recently their U.T. diet
Weird that first is one 48% protein and the U T dry is 42% So being a responsible cat Dad I called and talked to Vicki there, who said Dr Wysong feels its more the quality of protein VS the %. My vet disagreed and sells persc. diets with all sorts of evils (in my mind)
Wysong who I have no connection to $ wise, has been making pet foods since 1979 with every single ingredient having a function.
I wish I did not have short arms/low pockets or i'd be doing another blood test.

Being out in the car in parking lot at emerg. vet for 4 hours she would not drink and got stressed for many hours.
That skewed us all up further.
We need vet assistants to come on over to our cat pads and draw blood/urine at home!
They "feel" the jugular which amazes me in skinny old cats.

I gathered her urine sterile free catch 4 days later and rushed it in which saved her from stress. She stands to pee and I used a small plastic clear bag for 2cc or more urine and if a vet knows and trusts you and your catch technique may let you do this. They tried to get get some at her visit but it wound up on her towel.
Whenever I feed kibble to my 15 yr old boy and Calico 3 yr old I make a slurry with filtered water and then is it not wet food?

Oddly I tried AminaVast kidney support just as a pro active supplement for my ancient Tortie and then we ran out. Two weeks later she is failing fast. Back on it now. Anecdotal fur sure...Your vet will have access to their supplier who will reveal what the secret patented peptide ingredient really is. They said I can use it with our terrible blood work.


Off topic but my 75 yr old cousin was getting her affairs in order 3 yrs ago (refuses dialysis) with a crazy low 7% kidney function and is now 22% she has amazed her medical team and found a great nephrologist who says "I do this all the time" and I may be a whacko but do believe kidneys can heal. Remember when brains cells once damaged were known not to heal or reroute connections and also livers could not regenerate? And ulcers were not a bug but other causes?
Hi to Enzo! hope to see you asking questions about him at age 21