Hi Phil -

There's nothing like being greeted by 5 cats! ...
And I'll bet they were glad to see *you* too!


You should try the CRF support list - You'll get a lot of good information.
I'm sure someone can get you the URL.
....
"Most veterinary nephrologists recommend that dietary protein reduction be
initiated when the animal's blood urea nitrogen concentration is between 60
and 80 mg/dI. Examples of commercially available diets that contain
reduced-quantity, high-quality-protein include Hill's Prescription Diet k/d..

Current BUN is only 32 after a 34 reading in February. Creatinine is
only 1.6 after a 2.4 in Feb. Lab upper normal limits were 34 and 2.3

I've posted a couple questions on the CRF board and done quite a bit of
reading. The problem is that Muffin's kidney values right now don't
qualify him for the CRF category. I've gleaned alot of pertinent info
though, which is what has led me to placing the most credence in
following a low phos diet, but one with lower carbs and higher protein
than k/d in order to treat the diabetes better. The felinediabetes.com
message board has been extremely helpful also.


Was your cat's hydration status determined?
Hydration was OK. I don't have the number for specific gravity - the vet
merely said that kitty was concentrating his urine pretty well.

Was you cat's diabetes confirmed with either fructosamine
Yes - 722
or glycosylatated
hemoglobin tests?
No

These test distinguish true diabetes from
physiologic (stress) hyperglycemia ("white coat effect").

No doubt about it, my kitty is stressed at the vet! Another factor is
that he's been on prednisone for about a year, which can either raise BG
and/or precipitate diabetes. I've been doing home BG testing before and
since changing kitty's diet to higher protein, lower carb and low phos.
The "second opinion" vet hinted that given kitty's current BG curves,
and all the other factors (pred & borderline kidney values) he *might*
be a cat who can be regulated through diet alone. His recommendation
(for now) was to
1. continue insulin - 1u PZI Vet BID
2. wean off the pred (for arthritis) and see if the cosequin (he's been
getting for a couple months now) is working well enough - if not, he'll
look into something besides pred for pain control.
3. feed a moderate protein, low carb, low phos diet
4. home test BG to keep a close watch on BG
5. re-check bloodwork frequently (in a month) to closely monitor kidney
values
6. re-evaluate diet if kidney values start to rise

"second opinion" vet now has a new client :-)

The higher fat
supplies non-protein calories to meet the cat's energy needs while producing
less waste products from protein catabolism

That's pretty much what the vet said - not to worry about fat content
since it doesn't cause the same problems in cats that it does in humans

Obesity can cause a reversible insulin resistance in cats which often
resolves after the cat's ideal weight is reached.

He was up to 15lbs at one point, but is now down to 12.5

Before you set off on any therapeutic plan, I'd have the diabetes confirmed
with fructosamine or glycosylatated hemoglobin tests.

It's definitely been confirmed and I have already seen very positive
results from the insulin. He's *much* perkier/more active, coat is much
better and not peeing so much. From what the new vet has said, I'm just
keeping my fingers crossed that losing the pred and changing diet might
just do the trick without insulin and without sabotaging kidneys. Time
will tell!

Thanks for all your thoughts!
Jean