Hello - hope you all had a beautiful thanksgiving.
Update... have been giving Max sub-q fluids consistently 3x week. Issue is there is a disconnect/inconsistency between his numbers (which would indicate extremely mild kidney disease, along with the extra drinking/urination) and the impact to appetite (which is indicative of a more advanced stage) as well as general lethargy. He does act hungry/eager for his meals but then is reluctant to eat, and rejects things that used to be favorites. We took him off Entyce (which didn't seem to help) and put him on a mild oral steroid, under the hypothesis that there might be some mild inflammation somewhere in his body that is causing the inappetence... but that didn't do anything either so we are weaning him off.
We have tested for other things that could produce these symptoms (like Addisons, thyroid malfunction) and they are negative. I read in depth about other things that can elevate SDMA (besides kidney problems) but none of these apply... all normal.
His most recent blood panel this weekend shows BUN, Creatinine and SDMA back in normal ranges, and urine was good also (concentrated and no protein)... but the appetite and lethargy continue (along with more drinking and peeing - although no accidents - always goes on the pad). Also had full body xray which was unremarkable.
Because the blood and urine look good, and the disconnect about appetite... we are:
- stopping subQ fluids - we will re-test him in a week and see if his levels go back up again without them.
- vet recommended we get a second opinion from a veterinary internist - she said they see all the "odd" cases and may have more of a point of reference for what else might be causing the appetite issues, drink/pee and lethargy. We live in SF bay area and so the area is dense with these types of specialists - our vet referred us to four specifically by name - so that's our next stop.
Otherwise, it's continue to monitor. Our sweet little boy is still super loving, but definitely a little lower energy than usual. |