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🐱 Daily Log

📋 History

Mission Control

Last updated: June 15, 2026 — Tricia & Sean Evans — DOB April 7, 2020 — Neutered Male DSH Gray

Upcoming Appointments

JUNE 19, 2026 — Mountain View Vet, Hayden ID ABDOMINAL ULTRASOUND
Drop off 11:30 AM with Pax radiologist. Kidney architecture assessment plus possible aspirates. Scheduled due to protein-losing nephropathy concern from June 2 labs.
June 2, 2026 visit completed. Full Idexx Comprehensive panel, first-ever urinalysis, first-ever fPL. Kidney concern now the most urgent active issue.

Completed — May Acupuncture & June 2 Vet Visit

May 13 Acupuncture (Springwater)
  • Flare reported, Liver meridian discussion held
June 2 Dr. Rider Visit — Results In
  • Full comprehensive panel, first urinalysis, first Spec fPL run
  • fPL normal — pancreatitis ruled out
  • Urine protein 4+ found — protein-losing nephropathy discussed
  • Abdominal ultrasound scheduled for June 19
  • Still not done: SPEP, allergy/autoimmune panel, ionized calcium, Bartonella, formal UPC, lymph node FNA, dental specialist referral

June 19 — Ultrasound Agenda

Primary Goals
  • Kidney architecture — size, shape, cortex/medulla definition, signs of chronic damage PRIORITY
  • Look for masses or structural abnormality anywhere in abdomen
  • Assess internal lymph nodes given chronic lymphadenopathy history
  • Liver appearance — given Liver meridian focus and elevated liver-adjacent enzymes
  • Aspirates if anything abnormal is found
Questions to Ask
  • Does kidney appearance match the SDMA/protein trajectory, or are kidneys structurally healthier than labs suggest?
  • Ask Dr. Rider to formally request UPC if not already on the order
  • Discuss renal diet transition timing
  • Ask about kidney-supportive medications (e.g. benazepril) if protein-losing nephropathy confirmed
  • Revisit internal medicine referral decision now that ultrasound data will be in hand
  • Ask whether worsening anemia changes any urgency assessment

Last Labs — June 2, 2026

TestResultNormalFlagTrend
T41.20.8-4.7OKwatch (1x dosing)
Calcium10.58.2-11.2OKslight rise
SDMA210-14Hworsening (was 17)
Sodium151147-157OKnormalized
Globulin6.13.0-5.9Himproved (was 7.3)
Albumin2.32.6-3.9Lnew low flag
A/G Ratio0.40.5-1.2Lpersistent
Phosphorus4.42.9-6.3OKimproved
RBC5.396.50-11.53Lworsening anemia
HGB9.110.6-16.7Lworsening
MCV5838-53Hnew — macrocytic
Amylase2809623-2239Hnew high
Lipase140-45OKnormalized
Urine Protein4+NegativeHmajor concern (was 1+ in 2024)
Spec fPL4.10.0-4.4OKnew test — pancreatitis ruled out
Dr. Rider's June 3 call: Mildly anemic, likely anemia of chronic disease. SDMA up 17 to 21. Albumin low, protein in urine. Amylase still elevated. Discussed potential protein-losing nephropathy. Recommended abdominal ultrasound (June 19). Recommended internal medicine referral again — owner wants to start in-clinic first.
What improved: Sodium fully normalized (water switch worked), phosphorus back to normal, lipase normalized, globulin trending down, fPL normal (pancreatitis ruled out).

Weight History (lbs)

2.7
Jun20
9.9
Oct21
9.0
Apr24
7.2
Jul24
7.3
Aug24
9.8
Jun25
9.0
Nov25
9.5
May26
9.0
Jun2-26
Pattern: June 2 official vet weight: 9.0 lbs, down from home-weighed 9.5 lbs three weeks prior. Now matches lowest historical points. Kidney workup is priority; weight may stabilize once addressed.

Active Hypotheses (Updated June 2, 2026)

#1 — Protein-Losing Nephropathy / Progressive CKD (NEW — Most Urgent)
SDMA climbed 17 to 21 (ceiling 14). Urine protein jumped from 1+ (2024) to 4+ (2026) — maximum on dipstick scale. Albumin newly low at 2.3. Non-regenerative anemia worsening with new macrocytic shift (MCV 58, was 51) — consistent with CKD suppressing red cell production. Dr. Rider named protein-losing nephropathy directly. Ultrasound scheduled June 19; UPC should be requested. May explain amylase elevation (reduced renal clearance, not pancreatic — fPL confirmed normal).
#2 — Feline Chronic Gingivostomatitis (FCGS) as Primary Immune Expression
FCGS is a recognized immune-mediated syndrome explaining the entire oral history as one diagnosis. Cycling lymph nodes, mobile teeth, foul breath, poor antibiotic/steroid response all fit. Gold standard: full-mouth extraction by board-certified veterinary dentist. Dental specialist referral never done.
#3 — Post-Infectious Autoimmune Cascade from 2020 Salivary Infection
Original infection triggered immune cascade never fully resolved. Molecular mimicry driving cyclical lymphadenopathy. Globulin trending down (7.3 to 6.1) is a good sign — immune activity may be settling. Doxycycline produced no change, supporting autoimmune not infectious driver. Allergy/autoimmune panel still never run.
#4 — Liver Meridian Dysregulation (Chinese Medicine Framework)
Acupuncturist targets Liver meridian nearly every visit. Lipase fully normalized (62 to 14) — notable improvement since last acupuncture/herb cycle. Globulin also improving. Framework continues to track with Western lab movement.
#5 — Pancreatitis — RULED OUT
Spec fPL run for the first time June 2, 2026: result 4.1 (normal 0.0-4.4). The persistently elevated amylase (now 2809, new high) is not pancreatic — almost certainly explained by reduced renal clearance given kidney findings in #1. Resolved and closed.
#6 — Seasonal Allergic Component
Flares correlate with pollen season and increased patio time. Low flea risk. Co-occurring with #3 rather than independent. Allergy panel still never run.
#7 — Bartonella (Rule-Out Only — Low Probability)
Never tested. Low flea transmission risk. Doxycycline produced no change. Still worth a single PCR + IFA titer — has not been added to any visit yet.
#8 — Mineral Dysregulation from Distilled Water (Resolved — Sodium Normalized)
Sodium was low at 146, now 151 (normal). Water switch to filtered (May 12, 2026) appears to have worked.

Treatment & Prognosis — Pending June 19 Ultrasound

No prognosis assigned yet. Everything below is contingent on what the ultrasound shows. Two branches depending on kidney structure — fill in actual findings and plan after the appointment.
Branch A — Kidneys Structurally Healthy
  • Likely earlier-stage, more treatable picture
  • Renal support diet — lower phosphorus, controlled protein
  • Possible medication (e.g. benazepril) to reduce protein leak
  • Close monitoring — recheck SDMA, urine protein, albumin in 4-6 weeks
  • Reasonable expectation: years of management possible with this path
Branch B — Kidneys Show Structural Damage
  • More established CKD, likely IRIS Stage 2, possibly approaching Stage 3
  • Same renal diet and medications, framed as slowing progression not reversing
  • Conversation shifts toward long-term management and quality of life planning
  • May need more frequent rechecks (every 4-8 weeks rather than months)
  • Internal medicine referral becomes more strongly warranted
What's Already Reassuring
  • Urine still concentrating well (SG 1.040) — that function intact
  • Creatinine still within normal range
  • Sodium, phosphorus, lipase all improved this visit
  • Cats generally tolerate CKD management better than dogs — multi-year prognoses common with proper care
  • Caught early relative to symptoms — no overt clinical kidney failure signs yet (still eating, drinking, active)
Genuinely Uncertain
  • Whether this is new or slowly building since 2024 — no urine protein checked in that gap
  • Whether kidney issue is primary or downstream of the chronic immune dysregulation that's been the main story this whole case
  • Whether worsening anemia is purely renal or has a separate driver
Fill in after June 19: Ultrasound findings, Dr. Rider's actual staging/diagnosis, agreed treatment plan, recheck schedule, and realistic prognosis timeline.

Current Protocol

  • Thyro-Tabs 0.1mg — half tab twice daily (Fred Meyer Rx, Dr. Rider)
  • Jade Lady (Yu Nu Jian) — capsule with powder, twice daily (Springwater Vet)
  • Acupuncture — currently monthly (Springwater Vet)
  • Diet: Fussy Cat wet food (chicken/gravy) + dry food + treats
  • Water: switched distilled to filtered (May 12, 2026) — sodium now normalized
No flea prevention currently. Discuss with Dr. Rider — Capstar (nitenpyram) as lowest-risk option given sensitivity history.

Open Questions

  • Bartonella ever tested? Still no — re-raise for June 19
  • Allergy/autoimmune panel ever run? Still no — re-raise for June 19
  • What specific Liver meridian points does Springwater use — has protocol shifted? FOLLOW UP
  • Is the Liver imbalance root cause or downstream? FOLLOW UP
  • Which globulin fraction elevated? SPEP still never run. Globulin trending down (7.3 to 6.1) though, less urgent.
  • Pancreatitis question — Spec fPL run June 2: 4.1, normal. Ruled out.
  • SDMA persistently elevated — formal UPC still not run, but urinalysis now shows 4+ protein. Request UPC for June 19.
  • Is FCGS the correct framing for his oral disease? Still unasked.
  • Full-mouth dental radiography under anesthesia? Still no.
  • Current weight — 9.0 lbs official, June 2 2026 (home-weighed 9.5 lbs three weeks earlier)
  • Will Springwater coordinate directly with Dr. Rider? Not yet confirmed.
  • NEW: What does June 19 ultrasound show about kidney structure? KEY QUESTION
  • NEW: Why did urine protein jump from 1+ to 4+ between Apr 2024 and Jun 2026 — any intermediate urinalysis to see when this started?
  • NEW: Is worsening anemia driven by the kidney issue or a separate process?
  • NEW: T4 dropped from 2.3 to 1.2 while dosing reduced to once daily — should it return to twice daily?

📝 Reports

Daily Observations Checklist (Kidney Watch Until June 19)

  • Rock/mineral licking — frequency and material
  • Wet food bowl — finishing or leaving remainder?
  • Post-dinner activity window — present or absent?
  • Palpable lymph nodes — throat and behind knees
  • Breath odor — normal range or worse than baseline?
  • Patio time duration and time of day
  • Water drinking — any increase could reflect kidney concentrating ability changes KIDNEY WATCH
  • Litter box — urinating more or less than usual, any straining KIDNEY WATCH
  • Lethargy or pale gums — watch for signs anemia is worsening KIDNEY WATCH
  • Coat quality — softness or dandruff returning?