What tests are suggested for the diagnosis of diabetes mellitus?Generally, the following screening tests are recommended when cat diabetes is suspected: a complete blood count (CBC), a serum biochemistry profile, and a urinalysis.
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These stix are available at any brick-and-mortar or Internet pharmacy that sells human diabetic supplies.
If the foil-wrapped Ketostix, rather than the ones in vials are purchased, you may find it less wasteful. Some reasons for preferring testing glucose levels by using blood over urine testing is that the urine used in testing may have been in the bladder for hours. Urine testing [6] also makes it more difficult to determine whether any hyperglycemia noted is the result of a Somogyi rebound pattern or a true need for an increase in insulin dosage.
It's important to time the test accurately and not take into account any color changes on the Ketostix strip which occur after 15 seconds. In a diabetic, any urinary ketones above trace, or any increase in urinary ketone level, or trace urinary ketones plus some of the symptoms above, are cause to call an emergency vet immediately, at any hour of the day.
If you are testing urine for glucose, the time you test likely affects results in this way: mid-day urine glucose tests would reflect the nadir of glucose in the system--this also represents the peak of the insulin. When the bg readings are high enough to produce some ketones, you've taken action to bring them down and they are normal once more, it is possible to still see some positive urine ketone test results.
If your pet is taking any type of vitamin supplements, it should be noted on his or her medical records. Because most urine tests measure acetoacetic acid, and not the most commonly found beta-hydroxybutyrate acid, it is possible to have ketones present and get a negative urine test result. Further, it's also possible to have high levels of beta-hydroxybutyrate acid, get a negative urine ketone test result, but to have the test turn positive as the ketosis improves, due to the tests' measuring acetoacetic acid and not beta-hydroxybutyrate acid.
Positive-Any other color except yellow or clear [73] May be the result of other disease processes. Cornell University-Feline Health Center-Urine Monitoring Flash MovieHow to Read Ketone Test Strips. The original recommendations were to feed the cat Fluorescein (a non-toxic product used to determine the presence of corneal ulcers). Bringing your pet cat home after a diabetes diagnosis can be traumatic but ultimately rewarding - both for you and the cat. Sometimes in a Feline Friendly household, you and Fluffy really want to keep to the same tried and true successful ways. So to achieve this, you can simply keep to your same litter and just cover it with clingwrap. Step 4: Remove the sample with a syringe, then remove the clingwrap CAREFULLY making sure you don't spill any on the soil or on your floor! The Way To A Cat's (Healthy) HeartThere are endless discussions on what's healthy food for a cat, b ut most of the advice comes from cat food manufacturers.
Why Feline Urinalysis Is The Golden Opportunity For Your PatientsFeline urine tests will tell you much more about a cat's health status than a random (i.e. Feline Flea Proofing For An Itch Free Home Herea€™s how to go about feline feline flea proofing your home and making if a less friendly place for cat fleas and a safer place for your pet cat.
You may be very surprised to learn that a homemade urine collection system, with litter made from odd plastic pieces, is safe and very effective.  And probably free! Urinalysis in cats is an important tool in disease detection (such as diabetes, FLUTD and FUUTD), as well as monitoring and screening feline health[1]. Abnormalities can be indicative of diseases of the urinary system as well as other organ systems, including liver function, acid-base status, and carbohydrate metabolism. Urine should be collected in a clean, dry container that is free of any disinfecting or cleaning chemicals.
Catheterization is performed by placing a small hollow tube into the urethra to the level of the bladder.
Cystocentesis samples are collected by inserting a sterile needle through the body wall into the bladder.
In order to obtain accurate results, the urine collection, storage and handling must be sterile and follow standard procedures. Dipsticks commonly include tests for specific gravity, pH, glucose, protein, blood, bilirubin, ketones, urobilinogen, nitrite, and leukocytes[3].
Urine specific gravity is based on the ratio of weight of urine to weight of an equivalent volume of pure water.
Although dipstick strips do have a method of approximating specific gravity, this measurement is best made with a refractometer. Urine specific gravity measured by the dipstick can be falsely elevated by moderate to high concentrations of protein. Causes of acidic urine include: meat diet, systemic acidosis, hypochloridemia, and administration of acidifying agents such as d,l-methionine or NH4Cl.
Causes of alkaline urine include: vegetable based diet, bacterial infection of urease-producing bacteria, systemic alkalosis, urine exposed to room air for an extended time (loss of CO2), and administration of alkalinizing agents including citrate or NaHCO3.
Urine pH also may provide good predictive assessment of crystal and stone morphology as certain crystals and stones form in either acidic or alkaline environments.
Reagent strips measure glucose levels using the glucose oxidase method.1 This method is a sequential enzymatic reaction.
Glucosuria may be either persistent or transient and multiple tests may be needed for differentiation of these conditions. False positive test results may be caused by contamination of the sample with oxidants such as hydrogen peroxide, bleach (sodium hypochlorite), or occasionally pseudoglucose in obstructed cats. False negative test results may be due to high concentrations of ascorbic acid (Vitamin C) in the urine. Dogs and cats normally have small proteins that pass through the glomerular filter, however a majority of these proteins are resorbed by the renal tubules. The protein portion of the dipstick reagent strip measures the protein based on a pH dye indicator method using bromphenol blue. Positive protein results must be evaluated in relationship to the patient’s history, physical examination, method of urine collection, urine specific gravity, and microscopic sediment examination. False positive protein reactions may occur with alkaline urine or if a disinfectant residue is in the urine, possibly from improper cleaning of the collection container.
If the urine protein dipstick is positive for protein, the sample should be further analyzed with a quantitative method at an outside laboratory.
The occult blood test will react positively in the presence of red blood cells, free haemoglobin or free myoglobin.
This test is based on a pseudoperoxidase reaction, which is more sensitive to haemoglobin and myoglobin than intact red blood cells.
Hematuria can be caused by trauma, infection, inflammation, infarction, calculi, neoplasia or a coagulopathy anywhere along the urinary tract. Hemoglobinuria, on the other hand, will have reddish brown urine that does not become clear after centrifugation.
A false positive test result may occur if the urine is contaminated with bleach, or contains large amounts of iodide or bromide.
Bilirubin is produced from the breakdown of haemoglobin, transported to the liver bound to albumin, and conjugated with carbohydrates by hepatocytes. False positive test results may occur if high doses of chlorpromazine, which lowers urine pH, have been given. False negative test results may occur in urine samples with high ascorbic acid or nitrite concentration.
Ketonuria may be caused by starvation, insulinoma, Diabetic ketoacidosis, persistent hypoglycemia, high fat low carbohydrate diets, and glycogen storage disease. False positive test results may occur if urine is pigmented, or has high concentrations of levodopa metabolites. False negative test results are uncommon in fresh urine, but may occur if urine samples are old. The dipstick method measures urobilinogen by reacting with p-diethylaminobenzaldehyde in an acid environment.
A false positive test result may occur if the temperature of the reagent strip is elevated.
A false negative test result may occur if there is formalin residue in the collection container, or if the sample is old, because urobilinogen is very unstable when exposed to light and air.
The leukocyte test detects the presence of white blood cells or partial cells in the urine. Leukocytes are measured by a reaction of the esterases in leukocytes that catalyse reaction of pyrrole amino acid ester to release 3-hydroxy-5-phenol pyrrole. False negative test results may develop if the patient has been treated with high doses of tetracycline or other antibiotics. The dipstick portion of urinalysis is an important diagnostic and monitoring laboratory test system. Bacterial cystitis is a relatively infrequent finding in cats, and the majority are either E. Disclaimer: I am not a veterinarian, nor do I have any formal training in any medical field. What to do when blood work is normal in a sick dog Information on additional diagnostic tests. A study comparing the blood work of raw-fed and kibble-fed dogs found that the raw-fed dogs had higher average BUN and PCV (hematocrit, a measure of red blood cells) values. Fasting (no food, but continue to give water) for at least 12 hours before the blood is drawn should eliminate most effects on blood tests that are caused by diet. A study was also done to test whether dogs fed a high-protein diet would have microalbuminuria (albumin in the urine, which can be an early sign of kidney disease), and the results were negative; a high-protein diet does not appear to cause microalbuminuria. Temporary changes in test results due to high-protein diets are not a concern and do not indicate that the diet is harmful. Note that mistakes in the drawing or handling of blood can cause certain test results to be skewed. You can contact me if you have any comments, but I regret to say that I can no longer respond to questions about individual dogs. These descriptions belong to the dogs in the header and other tooltips, but are displayed here because you have javascript turned off. Pashoshe Fisher, a Chihuahua, was a wonderful, joyful companion to his owner for 19 & a half years. If you have chronic kidney disease (CKD) then your kidneys are not working as well as they once did. We encourage you to read any of these popular articles below or search our extensive pet health library. With over 600 hospitals and 1,800 fully qualified, dedicated and compassionate veterinarians, we strive to give your pet the very best in medical care. These are reagent indicator strips that test urine for only ketone (ketostix) or for both ketones and glucose (ketodiastix). Stix do expire, so check the unopened expiration date when you buy them and record the date you open them.
You may test your pet's urine for glucose because you've been instructed to do so by the vet as a method of gauging regulation or your pet is undiagnosed and you want to determine whether there is hyperglycemia.
Because of this, it may not be a reliable indicator of what systemic glucose levels are at the time of testing.

Ketones evaporate quickly, so there's a chance of getting a false negative test result if you're testing older urine. If you see any color change in the glucose portion of the stix, that means that your pet has exceeded its renal threshold since it last urinated.
An incontinence pad on top of the regular litter can be used as the plastic will keep the urine in the pad. In multi-cat homes, the 'cat of interest' will need to be isolated so ensure the correct sample is taken!4.
Samples may be collected by free catch of voided sample, manual bladder expression, catheterization, or cystocentesis[2]. However, voided samples may have contaminants that include bacteria, epithelial cells, and white blood cells. The dipstick analysis should be performed as soon after collection as possible (ideally within 30 minutes of collection) and the sample should be well mixed prior to testing.
It is important not to touch the reagent areas of the strip as this may alter test results.
For example, animals that primarily eat high protein meat-based diets will have acidic urine. In a healthy animal, glucose passes freely through the glomerular filter and is resorbed by the proximal tubules.
Glucose reacts with glucose oxidase to produce hydrogen peroxide, which oxidizes the indicator chemical to produce a color change. Persistent causes of glucosuria include: diabetes mellitus, administration of glucose containing fluids, chronic disease that is not related to the kidneys such as hyperadrenocorticism, hyperpituitarism, or acromegaly. Moderately high concentrations of ketones also may cause false negative test results if the amount of glucose is only slightly elevated.
Due to the negative charge of albumin, if protein (albumin) is present in urine, the pH increases, and a positive test result occurs. Proteinuria may be due to hemorrhage, infection, intravascular hemolysis, or renal disease.
If the proteinuria is due to renal disease, the occult blood test will be negative and the sediment may or may not contain casts.
Trace proteinuria may represent significant protein loss with low specific gravity, but not with high specific gravity. Samples containing urease-producing bacteria may have an elevated pH resulting in a false positive test result. If a voided sample is collected from a bitch in heat, a false positive test may also occur. This occurs by coupling bilirubin with diazotized dichloroaniline in an acidic environment.6 Bilirubin is very unstable when exposed to room air and light. In dogs, the renal threshold for bilirubin is low and renal tubules are able to break down heme and produce some renal bilirubin, therefore slight bilirubinuria can be a normal finding in dogs with concentrated urine. Urobilinogen is usually excreted in faeces, however a small amount may be reabsorbed and excreted in urine. High concentrations of biliary pigments may occur in haemolytic crisis, or cases of hepatic or intestinal dysfunction. The urinary tract infection may involve organisms that do not convert nitrites, or the urine may not have been held in the bladder greater than 4 hours. There are certain techniques of sample collection, handling and testing that should be followed closely to ensure accurate results. The information presented here is not meant to replace your vet's advice or prescribed medications, but only to suggest additional options to explore, based on your dog's condition.
This is a good idea for all dogs, as a recent meal can also cause lipemia, making blood test results less reliable (see below). There is speculation that a high-protein diet may also increase urine protein-creatinine (UPC) ratio, though once again, it should remain within the normal range (up to 0.5). They are the natural result of protein waste products, which the body is designed to handle, and they vary only because most dogs are still fed diets that are high in carbohydrates, which distorts the average values seen on test results.
Hemolysis may cause falsely elevated CPK, AST, LDH, Total Protein, Phosphorus, Potassium, BUN, Bilirubin and Bile Acids, and falsely decreased GGT, Glucose and Alkaline Phosphatase. Can't diabetes be diagnosed by an elevated blood sugar value alone?-->-->While confirmation of elevated fasting blood and urine glucose (sugar) values is absolutely essential for the diagnosis of diabetes mellitus, other screening tests may give us additional information regarding the severity of the diabetes, any conditions that may be contributing to the diabetes, and any complications related to the diabetic state. Not good toward boarding, grooming, prescription and non-prescription medication, and retail items.
Seeing negative urine glucose test, especially repeated negative ones, can mean the pet is approaching hypoglycemia. When you're getting normal bg readings, it means that there are no more ketones being produced. Others catch urine in a dedicated spoon, ladle, or other collection device and dip the stix into the urine. This is typically performed by gross visual assessment of the urine, microscopic examination, and chemical evaluation. This technique may lead to bladder trauma resulting in haematuria, and in some instances (such as urethral obstruction) may result in a ruptured bladder.
Catheterized samples have less contamination from the distal urogenital tract; however, contamination from the urethra may still occur. A lateral or ventral approach to the bladder may be made without causing severe trauma to any vital region of the bladder. If for some reason the test cannot be performed immediately, the sample may be covered and refrigerated. Compare the blocks to the corresponding color chart provided by the test strip's manufacturer. If the urine is noticeably discolored, the sample may be centrifuged and the supernatant used for analysis.
The dipstick measures specific gravity by measuring the change in pKa of polyelectrolytes in relation to ionic concentration5. High lipid content in urine may also alter the results by either raising or lowering the specific gravity measurement[4]. On the other hand, animals that eat more vegetable-based diets will have an alkaline urine. On the other hand, struvite, calcium carbonate, calcium phosphate, ammonium biurate, and amorphous phosphate crystals are found in alkaline urine. If glucosuria is present, it is due to either an excess amount of glucose reaching the tubules that cannot be resorbed or, less commonly, decreased tubular resorptive function. Other diseases that may result in transient hyperglycemias leading to glucosuria include: hyperthyroidism, acute pancreatitis, stress (especially in cats), postprandial, and administration of certain drugs. The glucose test also becomes less reactive as urine specific gravity increases or as temperature decreases.
Thus, only a very small amount of protein is normally excreted in the urine, which is not usually clinically detectable. This test is primarily sensitive to albumin is relatively insensitive for the detection of globulins and Bence-Jones proteins. Hemorrhage is confirmed by a positive occult blood reaction on the dipstick and the presence of red blood cells in the sediment. Most commonly, hematuria is the cause of the positive test result while myoglobinuria is rare. With intravascular hemolysis, plasma will have a reddish tint due to hemoglobinemia that is detectable prior to hemoglobinuria. Excess bilirubin may be produced when red blood cells are destroyed, or in liver disease, including bile duct obstruction. If the tubular resorptive capacity is saturated, then the ketones are incompletely resorbed, resulting in ketonuria. False negative test results may be observed with voided urine samples obtained from animals with pyometra or prostatitis.
The causes of false positive and negative test results also should be considered when evaluating urine dipstick results. Note that all values were still within normal ranges or only very slightly different; values that are well outside the normal range are always meaningful. If this is a concern, feed your dog a lower-protein diet for a day or two before the test. Not fasting a dog for at least 12 hours before a blood test can cause moderately elevated BUN, as well as Lipemia, which can result in inaccurate CBC and Biochemistry analyses. Severity can vary but most cases are: mild or moderate, occur in older people, do not cause symptoms and do not progress to kidney failure.
Knowing that the pet's blood glucose levels are too low means that you can take action with a sugar source or some food to ward off a possible hypo episode. Note that positive urinary glucose results are not indicative of your pet's blood glucose level at the time it urinated. What you are seeing when you test urine for ketones and the blood glucose is in normal ranges are the "leftovers" of the ketones which were produced by the high bg episode. Several chemical parameters can be measured using a commercially available in house dipstick test. Voided samples should be collected midstream to lessen contaminants from the vagina or prepuce. Clipping or surgical preparation of the area along the body wall is not necessary prior to sample collection. The excess urine should be removed to prevent dilution of reagents or mixing of reagents between pads.
Common causes of altered urine color include hemoglobin, myoglobin, bilirubin, and drugs (phosphoenolpyruvate).
The urine sample should be fresh as urine becomes more alkaline on standing due to the conversion of urea to ammonia by bacteria (if present), and loss of CO2. Cold urine (refrigerated specimens) or expired reagent strips may also result in false negative test results.
A urinary infection or cystitis can be confirmed by observing bacteria and white blood cells on sediment examination. Microbial peroxidase that is present in some urinary tract infections, can also lead to false positive test results.
Bilirubinuria may indicate: liver disease, bile duct obstruction, starvation, hemolysis, or pyrexia. In order to achieve an accurate positive test result, the urine must have been retained in the bladder at least 4 hours. Because the dipstick test is easy to perform and economical, all veterinary practices should be able to perform this test in house rather than submitting samples to an outside laboratory. I have additional information on my web site in the sections on kidney disease and liver disease. People with any stage of CKD have an increased risk of developing heart disease or a stroke.
You are then only using what you need when you need it, having the rest still sealed and potent until the indicated expiration date.
They will continue to show up in the urine for a while but their concentration will become less and less until they're gone. Collection of samples from surfaces such as floors, cages, and litter boxes should be avoided, since these will introduce environmental contaminants.

The dipsticks should be stored in the original airtight container to maintain reagent reactivity. This can be achieved by tilting the strip and allowing the urine to run off the edges (Figure 2). Cases of intravascular hemolysis have hemoglobinuria leading to a positive occult blood test. Bilirubinuria in bile duct obstruction is often more severe than that of hepatocellular disease. Ketonuria does not signify renal disease, but rather excessive lipid or defective carbohydrate metabolism. Therefore, it is best to collect a (first) morning sample or ensure the patient has not urinated in at least 4 hours. In house laboratory analysis also provides more accurate results and prevents age-induced artifacts that may lead to false positive and false negative test results. See Eliminating the Confusion in Test Results and Small Mammal Clinical Pathology: The Basics for more information. This is why it is important to detect even mild CKD, as treatment may not only slow down the progression of the disease, but also reduces the risk of developing heart disease or stroke. Typical dipstick strips include the following tests: bilirubin, blood, glucose, ketones, pH, protein specific gravity, and urobilinogen. The bladder is manually immobilized and the needle is inserted through the abdominal wall into the bladder, and the urine is withdrawn. The presence of free red blood cells results in a positive test when blood cells lyse and haemoglobin is released.
It is a good idea to get a copy of all test results and look for comments about hemolysis or lipemia if there are values outside the normal range. This leaflet is for people who have been diagnosed with mild-to-moderate CKD (stage 1, 2 or 3 CKD).
Be sure to read the colors at those time intervals because the colors will continue to darken and a later reading will be an incorrect result. It is important to stop aspirating prior to withdrawing the needle as this may lead to aspiration of blood cells or epithelium from the bladder wall. In general, whenever you suddenly have changes in blood work, particularly if they are unrelated to current symptoms, it can be a good idea to repeat the test to be sure that the results were accurate before proceeding with further tests or making changes to diet and medications.
A separate leaflet in this series, called Chronic Kidney Disease, is more appropriate if you have more severe CKD (stage 4 or 5 CKD). Rarely, enterocentesis may occur which results in a sample containing bacteria, intestinal villi and other intestinal contents. Although most diabetic animals drink large quantities of water, they still lose a lot of body water because they produce such dilute urine. In the outer part of the kidneys, tiny blood vessels cluster together to form structures called glomeruli. Dehydration can be indicated on the CBC by increases in the packed cell volume (PCV - the proportion of the blood volume that is actually occupied by red blood cells) as well as increases in the total red blood cell count. In some severe diabetic states, lysis (rupture) of red blood cells within the blood stream may occur because of the loss of electrolytes. The structure of the glomerulus allows waste products and some water and salt to pass from the blood into a tiny channel called a tubule. A reduction in the PCV and red blood cell numbers will be seen on the CBC if this is occurring.
The urine then passes down a tube called a ureter which goes from each kidney to the bladder. The presence of an infection may be indicated on the CBC by an increased number of white blood cells. What might a serum biochemistry profile indicate if my cat has diabetes mellitus?The serum biochemistry profile is performed on a separate blood sample from which the serum (the liquid portion of blood) has been separated from the cellular portion.
The main functions of the kidneys are to: Filter out waste products from the bloodstream, to be passed out in the urine. Serum contains many substances including glucose, enzymes, lipids (fats) proteins and metabolic waste products. However, cats present us with a unique challenge because their glucose concentrations can become markedly increased simply due to stress. The stress of a veterinary office visit or the mild restraint associated with obtaining a blood sample may significantly increase your cat's serum glucose value. Therefore, confirmation of diabetes may require more than one blood sample collected over a period of several days. They are involved in many of the body's daily functions, for example nerve conduction and maintenance of proper hydration. Because of the large volume of dilute urine that diabetic cats produce, excessive amounts of electrolytes may be lost in the urine. For example, severe deficits in the electrolyte phosphorus may result in the rupture of red blood cells within the blood stream. The liver related enzymes ALT (alanine aminotransferase) and AST (aspartate transaminase) may be increased mildly in diabetic cats.
These increases may reflect mild liver cell damage that is related to decreased blood flow due to dehydration. However, as many diabetic cats are overweight, greater elevations in liver enzymes may indicate underlying liver disease such as hepatic lipidosis (fatty liver, which results from excess mobilization of body fat).
Because mild changes in liver enzymes can also be noted in older cats with thyroid disease, it may be important to rule out the presence of concurrent hyperthyroidism (a condition whereby the thyroid makes too much thyroid hormone) by measuring serum thyroxine (T4) concentrations.
What might a urinalysis indicate if my cat has diabetes mellitus?-->-->A urinalysis is necessary for the diagnosis of diabetes mellitus. CKD is a better term, as the word failure implies that the kidneys have totally stopped working. Occasionally a small amount of glucose may be found in the urine of a highly stressed cat because its blood glucose values were temporarily increased.
In most people who have CKD there is only a mild or moderate reduction in kidney function, which usually does not cause symptoms, and the kidneys have not failed.
Other important features of the urinalysis that need to be evaluated in diabetic animals include evidence of urinary tract infection.
The presence of glucose in the urine makes conditions ideal for bacterial growth; therefore, urinary tract infections are common. The urine is evaluated for the presence of red blood cells, white blood cells and bacteria. If a bacterial infection is identified or suspected, a culture of the urine may be indicated to identify the types of bacteria and determine the most appropriate antibiotics to treat the infection. The presence or absence of ketones in the urine should always be evaluated in diabetic animals.
Increased utilization of fat occurs in diabetic animals because their insulin deficiency results in poor utilization of carbohydrates as an energy source.
Depending upon your cat's clinical signs, the presence of ketones in the urine may indicate a more severe or long-standing case of diabetes.
Once my cat has been started on insulin therapy, what monitoring tests will be necessary?-->-->When insulin therapy is first started, we will need to monitor your cat's response to therapy by periodic blood glucose determinations. Ideally, this involves serial blood or serum glucose determinations in the form of a glucose curve. However, because of the nature of most cats, the mere acts of hospitalization and serial blood sampling, no matter how gentle, will result in stress-related increases in blood glucose that will confound the results of a glucose curve.
At home, one of the most simple and important things you can do for your cat is to monitor his appetite, water consumption, energy level, and urine output.
It is very important that you do not make adjustments in dosage without first consulting your veterinarian! Additional home monitoring can involve the evaluation of urine for the presence of glucose. This may involve a bit of ingenuity in obtaining a urine sample; the use of non-absorbing plastic pellets or clean aquarium gravel in the litter box for a short time period may help.
If you are found to have CKD then the eGFR test is usually done at regular intervals to monitor your kidney function. A urine test strip that contains an indicator pad for glucose is then simply dipped into the urine sample and a reading is taken after a specified time interval. These products are essentially strips of material impregnated with glucose detection pads that are added directly into the litter box. At the beginning of insulin therapy, more frequent (daily) monitoring of urine glucose is indicated. The presence of large amounts of glucose for two or three days in a row, or the complete absence of glucose, may indicate the need for adjustments in insulin dosage. Although about half of people aged 75 or more have some degree of CKD, most of these people do not actually have diseases of their kidneys; they have normal ageing of their kidneys.
Once your cat's optimal insulin dosage has been determined and his diabetes is well regulated, monitoring may involve weekly 'spot checks' of urine for the presence of glucose. Serum fructosamine provides us with a retrospective view of the average blood glucose concentration that your cat has achieved over the past 2 to 3 weeks.
However, recent changes in blood glucose concentrations will not be detected with the serum fructosamine test.
However, CKD can also cause high blood pressure, as the kidney has a role in blood pressure regulation.
Therefore, if your cat is showing any behavioral changes that might signal changes in his immediate insulin requirements, then a direct blood glucose test will be more appropriate.
Also, blood tests may be done from time to time to check on your blood level of chemicals such as sodium, potassium, calcium and phosphate. The need for other tests then depends on various factors and your doctor will advise - for example: An ultrasound scan of the kidneys or a kidney biopsy may be advised if certain kidney conditions are suspected - for example, if you have a lot of protein or blood in your urine, if you have pain that seems to be coming from a kidney, etc. In many people, treatment at early stages of CKD can prevent or slow down progression through to eventual kidney failure. For example, good glucose control for people with diabetes, blood pressure control for people with high blood pressure, etc.
You should have checks every now and then by your GP or practice nurse to monitor your kidney function (eGFR). They will also give you treatment and advice on how to prevent or slow down the progression of CKD. The most important treatment to prevent or delay the progression of CKD, whatever the underlying cause, is to keep your blood pressure well controlled.
People with CKD are actually twenty times more likely to die from cardiovascular-related problems than from kidney failure. Briefly, this typically includes: Good control of blood pressure (and blood glucose level if you have diabetes).
A type of medication called an angiotensin-converting enzyme (ACE) inhibitor (for example, captopril, enalapril, ramipril, lisinopril) has been shown to be beneficial for some people with CKD, as it reduces the risk of cardiovascular disease and can prevent further worsening of the function of your kidneys. Note: people with stage 3 CKD or worse should also be immunised against influenza each year, and have a one-off immunisation against pneumococcus.

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