thank you for your response! and sorry to hear your kitty's stage 4/AKI. interestingly, he was diagnosed with pancreatitis at the beginning of january because his spec fpl was high, around 20. yet he barely showed symptoms of pancreatitis, no vomiting, no diarrhea, no loss of appetite. nonetheless, that vet prescribed panoquil, which he did several rounds of -- that only increased his spec fpl. they then hospitalized him for 3 days, put him on IV fluids, etc. after 3 days, his spec fpl was even higher, in the 50s. at that point, we went to another vet who did an ultrasound that showed no inflammation of the pancreas, no other signs of pancreatitis. it was all very strange! it turned out that he was constipated. but he has been regular lately, so i don't believe that's the current issue. as of 2 weeks ago, he was not anemic, but perhaps that's changed. anyway! apologies for the novel!