Muffin, her kidneys, and #SDMA

Well, Muffin's bloodwork came back and we have very disappointing news. She has the start of kidney disease according to her SDMA levels.

The vet started talking about a low protein diet, which shut my brain right off from listening to her because I know full well that low protein is not appropriate for a cat.  She did talk about fish oil, which we had talked about before if she has the beginning stages of arthritis. She talked about other anti-inflammatories as well as weight loss, which we had also talked about with the possible beginning of arthritis.

Muffin is NOT a fan of the weight loss idea

Muffin weighs almost fourteen pounds, which is big for a cat, but she has always been a large cat. When we were giving dry food as treats she weighed even more. Lately, she has been screaming at me for canned food, which I had been giving Fleurp because of her anemia. I would give Fleurp canned food with liqui-tinic (an iron supplement) in my bathroom every few days and Muffin figured out what was going on. She was originally content to lick the empty can and Fleurp's leftovers, but in the last few months to a year, she would come and stand where the food was put down and whine continually.  She would also whine at me in other rooms and when I would go over to see what she was doing, she would lead me into the bathroom and ask for a can of food.  I was so confused. When do you decide that behavior is driven by personality and not physiological need? Did she want the food or did she need the food for some reason?  I tried to tell her no, I tried not to give it to her, but she became more and more insistent.  I would give in and she would be quiet for a while, and then start in again.

To facilitate the change of 'no more bathroom food' for Muffin, I have rearranged the bathroom and where the food went down is now a cat bed.  This seems to have helped a bit but she still whines.

Seriously? How can you resist this face?!?! It helps a little bit that she is getting fish oil so she is getting treats afterwards to ensure she swallows the capsule. a little bit. not much.

Anyway, my main dilemma here is what do I do?  SDMA is so very new there is not a lot of information on what we should be doing at this stage. There isn't a lot of information on how much damage is going on with an 18 vs a 14 which is the upper range. Her last blood test on 11/15 had her SMDA of 13. Is that an excessive jump in six months? I have no idea, and I'm not sure who would. I suppose I could contact Idexx (I emailed them but haven't heard anything), as they have the most experience with this test. Back in November her blood work report said this:

The specific gravity of her urine was 1.019 (and now it is 1.035). Her creatinine level is 2.4 (0.9-2.5) and BUN is 32 (16-37). She has no protein in her urine.

So now I am in full-on research mode. It is not helping that I'm overwhelmed and there is SOOO much information out there.. According to one site I'm doing pretty much everything I should be doing at this point and we'll do a recheck in a few months, but if you want to make any recommendations or suggestions, I'd be happy to hear them..





(found on internet after post was generated)
From Idexx's own PDF:

How much does SDMA vary normally over time or with repeated testing? What constitutes a significant change? SDMA, like creatinine and GFR, has a biologic variability of 15%–20% from measurement to measurement in the same patient over a week or more. Therefore, changes need to be greater than this to indicate a true change. For example, with 20% biologic variability, an initial SDMA result of 14 µg/dL could recheck anywhere from 11–17 µg/dL based on biologic variability alone, just like a creatinine of 1.5 mg/dL could vary from 1.2–1.8 mg/dL.

So there is a chance that her high reading was just a variant. Even if it is, it still means that her levels are high... but it could mean that we are still in the earliest of beginning stages and for a just about 14 yr old cat, I can accept that. I'll have her blood tested again in a few months and we'll go from there.. but I'm still very happy to hear recommendations/suggestions/ideas, etc.