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I have posted about my sweet Orange before. He was "diagnosed" back in March of 2023 with possible IBD or possible SCL. The ultrasound doctor (forgive my lack of correct medical terminology) said it was "consistent with IBD" but that we couldn't rule out SCL without a biopsy. We chose not to do the biopsy because he has a heart murmur and did poorly at his last dental cleaning and had difficulty waking up. We initially put him on 5mg daily of prednisolone for about a month and then reduced it to 2.5mg and he did great with the reduction. He also has hyperthyroid (treated with meds) and technically CKD although his numbers have apparently been "stable" for awhile. His "IBD" symptoms were strictly not eating/being EXTREMELY picky with food. He only vomited once and had half a bout of diarrhea once before the ultrasound and never had that again. He has been doing great since he has been on the Pred. He went from slightly less than 9 pounds to now slightly less than 13! Which is the most he's ever weighed since we got him three years ago. He is 15. I've noticed over the past month that he was starting to get pickier with his food (but not as bad as prior to his "diagnoisis").
He was still eating a good amount so I was just monitoring him and watching for any red flags. This last week, his desire to eat has gotten less and less and he has gotten more and more picky. Still no where near what he was prior to "diagnosis". I didn't want to wait until it got beyond our control so I took him to the vet where we had them run a blood panel (see attached). In addition to his picky food behavior/inappitence, he's been sleeping a lot. I sort of chalked that up to "Well, he is 15, almost 16 and has a lot of health problems." His bloodwork came out ok and apparently his kidneys are "stable" according to the Banfield doctor. His potassium came out at 3.3mmol/L and apparently the low range for that is 3.5. They prescribed him a potassium gel, which he hates and is maple flavored. Smells delicious to me, but I'm not a cat. I knew he would have zero interest in the gel and called around to see if I could find the powder version locally to no avail. I ended up ordering it from Chewy andit is apparently out for delivery now I just received it and will try it tonight with his afterpill liquid treat that he usually loves, but has been pickier with the last week. He has a second vet appointment with a vet I trust (not Banfield) on Monday so I can get some guidance on next steps. There is a lot going on here. It could be his IBD is progressing or it is SCL and that is progressing or it could be the low potassium was creating the symptoms or maybe even CKD? Who knows. I am going to ask her how she thinks we should proceed. If that means she thinks we should do another ultrasound and consider a biopsy, I'm leaning towards it. The Banfield vet claimed she did not hear a heart murmur any longer. However, I still worry about anestesia regardless. I'm aware of the Echocardogriam option, so I'm going to ask about that as well -- ie, if it is necessary before considering another ultrasound/biopsy. I do realize they recommend removing the steriod for a few weeks (?) prior to ultrasound, so I'm very hesitant to do that since he has done so well prior to the last week-ish. So, I will ask about thoughts on adding Chemo without an ultrasound, but not sure if that is something people "do".
For now, Banfield (who I went to for the labs on Thursday) said to increase his Pred to 5mg (which I agree with for now in case that might help) and give him the potassium supplement twice a day. In addition, I'm also giving him Cerenia and Mirataz (ear form). Historically, Mirataz/Elura/Miratazpine always backfired with him because, yes it would make him hungry, but he would still not eat anything I put in front of him. It was like creating a starving monster that could only be satisfied eating the souls and emotions of his caretaker. This time, however, he is eating a bit. I'd say maybe a can of something a day (maybe more) and yes, I have tried ALL OF THE TRICKS. Which one he will eat this day is anyone's guess, BUT he is eating at least one of the (5-9 options) I put in front of him, which is a change from prior to his "diagnosis".
Has your cat ever had low potassium? If so, what were their symptoms? The Banfield vet seemed dumbfounded about why his potassium levels would be low when his kidneys are "stable', but upon looking online (which I take with a grain of salt), I see that low potassium can happen with both CKD and Hyperthyroid cats. Could the low potassium attribute for his inappitence as the inernet states as a side effect? Or is it probably IBD/SCL progressing? Any insight on this? Like I said, he has another vet appointment on Monday with a vet I trust. I can go on a rant on Banfield, but I will hold my tongue. We still have a plan with them so I figured I would use them for what I can (ie. lab tests), but I don't trust their opinion on this complicated situation for much else. One of the vets I saw with them "didn't know" if they used Cerenia for cats and only knew that they used it for dogs. I was shocked and disgusted at this comment since I've had multiple cats on Cerenia. That's just the tip of the iceburg.
In case this is helpful instead of the attachment, here is a snapshot of his renal numbers over the past year-ish:
April 2021 (this is when we adopted him and he had undiagnosed hyperthryoid for who knows how long. He had been on meds since Jan of 2021. I'm just putting this here for a baseline of what he was at when we technically adopted him).
* BUN/Crea 20.000
* BUN 41.000 mg/DL
* PHOS 6.1000 mg/DL
* CREA 2.100 mg/DL
March 2023
* BUN/Crea none listed
* BUN 33.000 mg/DL
* PHOS 4.7000 mg/DL
* CREA 1.000 mg/DL
August 2023
* BUN/Crea 19.000
* BUN 29.000 mg/DL
* PHOS 4.5000 mg/DL
* CREA 1.500 mg/DL
January 2024
* BUN/Crea 43.000
* BUN 53.000 mg/dL
* PHOS 3.500 mg/dL
* CREA 1.200 mg/dL
Thanks in advance for any of your input!
He was still eating a good amount so I was just monitoring him and watching for any red flags. This last week, his desire to eat has gotten less and less and he has gotten more and more picky. Still no where near what he was prior to "diagnosis". I didn't want to wait until it got beyond our control so I took him to the vet where we had them run a blood panel (see attached). In addition to his picky food behavior/inappitence, he's been sleeping a lot. I sort of chalked that up to "Well, he is 15, almost 16 and has a lot of health problems." His bloodwork came out ok and apparently his kidneys are "stable" according to the Banfield doctor. His potassium came out at 3.3mmol/L and apparently the low range for that is 3.5. They prescribed him a potassium gel, which he hates and is maple flavored. Smells delicious to me, but I'm not a cat. I knew he would have zero interest in the gel and called around to see if I could find the powder version locally to no avail. I ended up ordering it from Chewy and
For now, Banfield (who I went to for the labs on Thursday) said to increase his Pred to 5mg (which I agree with for now in case that might help) and give him the potassium supplement twice a day. In addition, I'm also giving him Cerenia and Mirataz (ear form). Historically, Mirataz/Elura/Miratazpine always backfired with him because, yes it would make him hungry, but he would still not eat anything I put in front of him. It was like creating a starving monster that could only be satisfied eating the souls and emotions of his caretaker. This time, however, he is eating a bit. I'd say maybe a can of something a day (maybe more) and yes, I have tried ALL OF THE TRICKS. Which one he will eat this day is anyone's guess, BUT he is eating at least one of the (5-9 options) I put in front of him, which is a change from prior to his "diagnosis".
Has your cat ever had low potassium? If so, what were their symptoms? The Banfield vet seemed dumbfounded about why his potassium levels would be low when his kidneys are "stable', but upon looking online (which I take with a grain of salt), I see that low potassium can happen with both CKD and Hyperthyroid cats. Could the low potassium attribute for his inappitence as the inernet states as a side effect? Or is it probably IBD/SCL progressing? Any insight on this? Like I said, he has another vet appointment on Monday with a vet I trust. I can go on a rant on Banfield, but I will hold my tongue. We still have a plan with them so I figured I would use them for what I can (ie. lab tests), but I don't trust their opinion on this complicated situation for much else. One of the vets I saw with them "didn't know" if they used Cerenia for cats and only knew that they used it for dogs. I was shocked and disgusted at this comment since I've had multiple cats on Cerenia. That's just the tip of the iceburg.
In case this is helpful instead of the attachment, here is a snapshot of his renal numbers over the past year-ish:
April 2021 (this is when we adopted him and he had undiagnosed hyperthryoid for who knows how long. He had been on meds since Jan of 2021. I'm just putting this here for a baseline of what he was at when we technically adopted him).
* BUN/Crea 20.000
* BUN 41.000 mg/DL
* PHOS 6.1000 mg/DL
* CREA 2.100 mg/DL
March 2023
* BUN/Crea none listed
* BUN 33.000 mg/DL
* PHOS 4.7000 mg/DL
* CREA 1.000 mg/DL
August 2023
* BUN/Crea 19.000
* BUN 29.000 mg/DL
* PHOS 4.5000 mg/DL
* CREA 1.500 mg/DL
January 2024
* BUN/Crea 43.000
* BUN 53.000 mg/dL
* PHOS 3.500 mg/dL
* CREA 1.200 mg/dL
Thanks in advance for any of your input!
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