Seeking second opinion on my cat's CKD, T4, and medication changes.

Question

Hi, I hope to get a 2nd opinion on Beau's lab results. Vet wants to start subq fluid and Azodyl. How severe is his CKD? How is his liver? His T4 is 1.0 and vet wants to lower methimazole from 10mg per day to 7.5 mg per day. Is it better to split 7.5 mg evenly, or can I give 5mg in AM and 2.5mg PM? Also the vet wants to stop predinisolone (for bronchitis) completely. Is that for the sake of CKD and liver and heart murmur? Thank you! Pet's info: Cat | Korat | Male | neutered | 14 years and 10 months old | 9.6 lbs

Linda G, MS, DVM · Accepted Answer

Hello. It is difficult to comment on Beau's kidney function because there is some vital information missing. I would need to see his BUN value, an SDMA analysis, & a urinalysis. SubQ fluids are always a good idea for cats with kidney insufficiency, but without the urinalysis, I cannot say if there is any azotemia ( a term used to describe kidney function abnormalities ). The same goes with the Azodyl, which may help pets with azotemia. With a creatinine of 2.5, & according to the International Renal Interest Society ( IRIS ), Beau's kidney insufficiency is a class 2, or mild, but we really need to see the SDMA to truly classify things. If his T4 is indeed 1.0, I would definitely decrease the methimazole, only you do want to keep the doses the same morning & night. Your vet should recheck the T4 in 2 weeks to see if the Methimazole needs to be decreased further. If the prednisolone is helping the bronchitis, then it is not necessary to stop it. His liver is perfectly fine, & depending on the dose, it too may be titrated down to the very lowest dose to keep him comfortable & control his symptoms. Thanks for using Petco Pet Education Center, formerly Petcoach.

Seeking second opinion on my cat's CKD, T4, and medication changes.

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