BUN and creatinine

[wasabipea]

Good morning Dr Kris:

In regards to blood panel kidney numbers, in your opinion - how relevant is BUN in relation to creatinie? My kitty's BUN is all over the place - I suppose depending on her hydration level? But she had a downward spiral after her companion cat of 18 yrs was put to sleep and went up to about 3.9 creatine, wasn't eating, basically a mess, depressed, sje looked horrible. I had 3 appts to put her down, but changed my mind because she seemed to be bouncing back. Anyway at her last blood panel, creatinine was 2.2 - one test said BUN was in the 60's and one said late 30s(?)

So, we ascertained that creatine value was the major "tell" - what would cause the BUN to fluctuate so dramatically - and could that possible point to something else?

(she also has a slight heart murmur and probable stomach/intestinal cancer that has only been diagnosed via blood white count numbers and her non-reaction to antibiotics. I'm sorry but the other diagnostic tests are too invasive for a cat her age, and I can't treat it anyway).

Thank you very much - I'll have a few questions during the week I'm sure. This is a very generous forum to are providing us!

PS: I don't know whether or not you saw my comment, but I have been wanting to get the gumption to administer fluids at home, but was being a big wuss with the sticking of the needle. Between my resolve, my support from other TCS members and your instructional video - I finally did it. I'm a visual thinker and seeing the "tent" and the arrow and thnking "this is where you go in" - I kept on visiaulizing that section when I finally did it. So thank you very much

Good day - Wendy

 

[dr kris]

Hi Wendy!

Thank you for your kind comments. I am completely a visualizer as well. There will be more videos on the way to help people like us who need to visualize things!

Yes - BUN can point to other things in the body. GI disease will cause it to rise, so the BUN may be much less reflective of kidneys (it usually is), and very telling about what they eat and the status of gut health.

At that level of creatinine, I am usually suggesting SQ fluids if the person and kitty want to do it. I xray my patients if possible if they have a heart murmer. I ensure their heart size and lungs are clear, then go for it. My cat has a much higher grade murmur, and he does really well with his.

Which WBC’s were elevated? Neutrophils or eosinophils?

k

 

[wasabipea]

Hi Dr. Kris! Thanks for the reply. I'll have to get back to you on the bloodwork numbers, I'm going to the vet's office tonight for fluids (my first two solo flights went terribly, and she needs some fluids, I think) and I'll get a copy of her bloodwork info (she had three panels run since maybe May or so?)

She has a history of UTI's and bladder stones, so the doc put her on antibiotics - firest metronizaole(?) and that gave her such bad side effects I had made an appt to put her down, it didn't occur to me that the medicine was making her so sick - I thought she was dying for sure. Anyway, since she is getting Baytril resistant (on it ALOT), the vet gave her two Convenia shots, at two week intervals. I'm not a fan of Convenia, have heard potential anemia complications, but she handles it well.

Anyway, after the third blood panel was run and the WC was still elevated, my vet consulted with an internal medicine specialist and they came to the conclusion that she most likely has stomach/intestinal cancer.

Since she is 18, I wouldn't put her through the stress of treating it - if there is a treatment for it - and even the diagnostic measures are too invasive for her right now, and somewhat inconclusive. She has a lot going on. And I don't have a definite diagnosis of the cancer either (even ultrasounds are traumatic for her - when she got her belly shaved years ago for ultrasound of bladder/kidney stones, they nicked off one of her nipples and she's been petrified of that since).

The BUN has been all over the board - I want to say the last blood panel, the numbers were all down. I'll get back to you later with the numbers when I get a copy later tonight.

BTW: the vet never suggested an x-ray for the heart murmur, I think it's a little one (I wish she was more approachable with questions) - is there a potential conflict with fluid administration and a heart murmur? Do they ever just "go away"? My vet says things like "she still has the slight heart mumur" - what would make it go away?

Thanks again for your generous offer of help!

PS I'm going to post a non-emergency question regarding my failed attempts at solo sub-q for a total newbie. I know there are more pressing questions, so I get that it's a low priority squestion / advice seeking. Thanks so much!

 

[wasabipea]

Well I got the copies and it looks like everything is elevated, I'll try to keep it short:

May 27:
WBC - 19.6 10^3 uL
Neutrophils - 13,720 /uL
Eosinophils - 2,156 :-) uL
BUN-creatinine ratio - 18 ratio ( no BUN seperate number given)
Creatinine: 3.2

Jun 6:
WBC - 30.7 10^3 uL
Neutrophils - 15,657 /uL
Eosinophils - 2,156 /uL
BUN-creatinine ratio - 14 ratio ( no BUN seperate number given)
Creatinine: 2.9

Jun 24:
WBC - 26.2 10^3 uL
Neutrophils - 15,982 /uL
Eosinophils - 4,192 WBC - 19.6 10^3 uL
BUN-creatinine ratio - 27 ratio ( no BUN seperate number given)
Creatinine: 2.2

All of the BUN/creatinine ratios read as normal range on the printouts. Provided she is still with us in a few weeks, I'll get another panel run. I'm a little afraid of getting the results since I'm still hoping there is a chance she doesn't have tummy cancer. FYI, I lost her companion cat of 18 yrs a couple of months ago to cancer, and I'm convinced her health decline is related. She mourned terribly- being with him was all she knew.

In your opinion, could fluid therapy help cancer kitties? How would it improve their quality of life?

This is veering a bit off topic, my apologies. And my thanks once again.

Btw, we got the creatinine from 3.2 to 2.2 with daily fluid therapy for 2-3 weeks.

Cheers and again - really appreciate your time for us.

 

[dr kris]

Well I got the copies and it looks like everything is elevated, I'll try to keep it short:

May 27:
WBC - 19.6 10^3 uL
Neutrophils - 13,720 /uL
Eosinophils - 2,156 :-) uL
BUN-creatinine ratio - 18 ratio ( no BUN seperate number given)
Creatinine: 3.2

Jun 6:
WBC - 30.7 10^3 uL
Neutrophils - 15,657 /uL
Eosinophils - 2,156 /uL
BUN-creatinine ratio - 14 ratio ( no BUN seperate number given)
Creatinine: 2.9

Jun 24:
WBC - 26.2 10^3 uL
Neutrophils - 15,982 /uL
Eosinophils - 4,192 WBC - 19.6 10^3 uL
BUN-creatinine ratio - 27 ratio ( no BUN seperate number given)
Creatinine: 2.2

All of the BUN/creatinine ratios read as normal range on the printouts. Provided she is still with us in a few weeks, I'll get another panel run. I'm a little afraid of getting the results since I'm still hoping there is a chance she doesn't have tummy cancer. FYI, I lost her companion cat of 18 yrs a couple of months ago to cancer, and I'm convinced her health decline is related. She mourned terribly- being with him was all she knew.

In your opinion, could fluid therapy help cancer kitties? How would it improve their quality of life?

This is veering a bit off topic, my apologies. And my thanks once again.

Btw, we got the creatinine from 3.2 to 2.2 with daily fluid therapy for 2-3 weeks.

Cheers and again - really appreciate your time for us.

Hi!

Poor thing - yes those are persistent elevations there.

Not all our cancer kitties need fluids. I'll use them if i can document that they don't want to eat and become chronically dehydrated though. So i do include it for palliative care, along with a few medications.

Best wishes,

Dr. Kris

 

[wasabipea]

So I'm assuming by these numbers that you'd be in agreement that it's likely tummy,intestinal cancer? These numbers, and her behavior, are all I have to go by.

I do get her fluids, now it's 100ccs every three days and B12 shot once a week. Plus Nutrical gel daily to help with vitamins and keeping her weight up. I do the fluids because I think they help her feel better, kidneys look stabilized.

Thank you, again.

And i just realized there were some cut-paste errors, but you got the general idea. Thx.