Diabetic nephropathy (possibly!)?

Re: Diabetic nephropathy (possibly!)?

Martin Atkinson — Thu, 09 Oct 2014 13:08:03 GMT

[quote user="Robin Grimmer"]Inactive sediment, -ve culture[/quote]Doh!

Re: Diabetic nephropathy (possibly!)?

Robin Grimmer — Thu, 09 Oct 2014 11:16:16 GMT

[quote user="Martin Atkinson"]

However a UTI seems the most likely issue.

[/quote]

Inactive sediment, -ve culture

Re: Diabetic nephropathy (possibly!)?

Robin Grimmer — Thu, 09 Oct 2014 11:09:27 GMT

[quote user="Martin Atkinson"]

You can get cats with significant renal disease with a normal USG although unless has consistent azotaemia its not likely to have CKD.

[/quote]

I disagree with this point. As I understand it with CKD the lack of concentrating of urine is the first thing to go with normal renal parameters which then progresses to azotaemia as more nephrons are lost.

I would have the cat in for a glucose curve with a new bottle of insulin to rule out problems with the insulin itself or user error (though the latter seems unlikely as owners seem pretty switched on). If above normal, I would do an IGF blood test in case possible acromegaly.

Re: Diabetic nephropathy (possibly!)?

Martin Atkinson — Thu, 09 Oct 2014 10:58:12 GMT

You can get cats with significant renal disease with a normal USG although unless has consistent azotaemia its not likely to have CKD. If it is truly proteineuric and hypertensive then I would put it on benazapril or the new stuff Semintra (sorry short mental block) although the latter has not convincingly been shown to have any advantages over an ACEi plus amlodypine. However a UTI seems the most likely issue.

Regards the DM, have you considered changing to insulin glargine, Lantus, if control is not that good with Caninsulin? Also I'm not a fan of special diabetic diets, my feline DM cases are put on high protein kitten food but this may be an issue if this cat is developing true renal disease so I'd hold fire on that one for now.