Chronic renal failure KITTEN

[ritz]

So i dont scare myself too much, besides this site, could you recommend the best site for a 9 month old kitten who has been preliminary diagnosed with CKD based on blood work ( creatine 2.4) and previous blood urine results. Sudden anorexia only symptom, though still decreased appetite. Also can't find a lot of information about causes of CKD in kittens. Rescused from under a car in July, drank gallons of water. Blood and urine results went back to norma except urine remained diluted. Thanks. (Ps. I feed prey model raw or now anything she will eat)
Vet unable to obtain urine sample (dahalia feisty!), vet recommends ultrasound.
Thank goodness for pet insurance!!
Thanks.

 

[zed xyzed]

It could be antifreeze poisoning since kitty was hanging around cars. How long has she been inside with you?

2.4 is on the high range but I don't think it is a certainty that it is CKD  http://www.felinecrf.com/tests0.htm  

I am hoping @Donutte  can give some advice 

 

[donutte]

Did your vet definitively diagnose CKD? Is your kitty still symptomatic? I'm a bit confused. And what are the lab results now for the blood work (I'm assuming there was more than one set going by what you said)? I know you said "normal" but do you have the values? 

Is she eating normally right now? Did your vet have any recommendations regarding food/treatment? Also, if it is something caused by poisoning, it will be very sudden and profound as far as symptoms as it causes acute renal failure, not CKD. CKD is something that stews over time, only showing symptoms (in many cases) when the creatinine is high enough to upset the appetite. That would be around the 5 level for creatinine.

While CKD can occur in younger cats, it's really more prevalent in older cats. And 9 months old is pretty young. 

And sorry for all the questions, just need all pieces of the puzzle to really help answer your questions. And kidney disease has a LOT of pieces.

 

[handsome kitty]

I would get a second opinion.  It's more likely the kitten ate something that is effecting her kidneys.  So you have any house plants she could have eaten?

 

[ritz]

She has been inside since early July 2015 when she was around five to six months old (adult teeth). She drank gallons of water so got her tested around July 3 in preparation for spaying. Creatine was 5.3, BUN 91; CA 11.8; Phos 10. They said, no spay; go see a full service vet. Vet gave her convenia shot. I believe her T-3 ? T-4 was a little high but additional testing concluded that thyroid was not a problem.

On July 12, 2015, she was retested creatine 2.0; BUN/Creatine ratio 27; Urea nitrogen 53; CPK 589 U/L. platlet count 558; hemo and MCHC low. Blood was 3+, RBC more than 50. I do not have the results of her urine test, but I know her urine has always tested as being "diluted."

Yesterday creatine was 2.4; NA 170, K 6.2m CI 129; BUN 28; RBC 11,27, RDW 23.00 White blood cell count normal. Glucose normal.
Because of her history of urine being diluted and creatine level today, the Vet suspects CKD. She agrees and recommends further testing (urine analysis and ultrasound) before making a definitive diagnosis and treatment.

The vet said antifreeze is almost always fatal unless you catch it right away. I was thinking Dahalia knew what to do--drink a gallon of water--in July.
Yes, there are plants she could have chewed. But other than the above readings, her test results were normal. (I have the complete blood work from July 12 and yesterday if you need further information.

Yesterday the vet gave her 1/4 tablet mirtazipine saying it should last the weekend; it lasted 12 hours. She ate a small amount of Friskies at the vets and unenthusiastically ate food yesterday. She did not eat this morning. Today on advice of cat experts at the cat sanctuary where I volunteer (and who did the initial testing July 3) I gave Dahalia some wet "kitty crack" --Meow Mix tender favorites, seafood flavor, She licked more of the liquid than the solids. They reviewed the test results and agreed that something is not adding up and suspects some type of virus.
Right now she is sleeping in her cat carrier, which I had placed on top of the dryer. She is affectionate, curious, but somewhat tired (not eating will do that to you). Certainly she is still symptomatic.

Thanks for reading and 'listening' and help.

 

[catpack]

This is very odd, indeed. I know you can get elevated Creatine with muscle damage/deteroriation (myopathy.)

Could kidney damage (not CKD) be causing her issues? Or, maybe some sort of genetic issue with the kidneys?

Has she had an ultrasound?

 

[donutte]

You are right about things not adding up quite right. Sounds like she had acute kidney disease for a bit. I don't think drinking a gallon of water would have healed her if she drank antifreeze. The drinking a lot is a symptom, and that kind of poisoning puts cats into renal failure similar to that of Lucky (he was diagnosed at Stage IV, creatinine was 8.3 - it was likely a tumor in his case though). Now that I mention that, you might want to look into getting a scan. Has she had any x-rays at least? Lucky had a HUGE left kidney and a shriveled up right kidney. The left was so big in fact, I barely recognized it as a kidney.

This doesn't sound like normal CKD though. Kidney disease of some sort, sure, but not the chronic aspect of it. That is something that stews over a period of months, even a year or more. She's not even old enough for it to have really been stewing that long. If anything, it sounds way more like she had acute kidney disease at first, and perhaps it left the kidneys damaged. 

I hope you are able to get things figured out. Ultrasound is probably your best bet right now, or if you haven't had one yet at least an x-ray. Has your vet tried giving her Hill's a/d? That is considered "kitty crack" among foods, and is high in calories. Lucky actually loved Temptations, much to my surprise.

 

[ritz]

They did do an x-ray to rule out an obstruction. The x-ray did show 2 kidneys but that is all that it showed. I don't know her background so do not know if it is genetic. She is a brown spotted tabby, short hair
Yes ultrasound is on the agenda, hopefully Tuesday.
I am concerned that she won't cooperate; will she have to be sedated and how is that on the kidneys? She did finish the meow mix, still sleeping in her cat carriet.

 

[donutte]

Not sure how much sedation affects the kidneys, but pretty much everything is harder on the kidneys if the have kidney disease (even tap water). I'm sure they will do everything they can to not use sedation. Some folks are pretty amazing with cats and can get them to cooperate very well. From what I'm reading, if they need to do a biopsy (I can't imagine they would with this but you never know) they might need to sedate, but they'd let you know beforehand.

I'm glad she ate! Little victories....

 

[cat nap]

@Ritz   I do hope your Dahalia gets better quick.

Some of the websites that I have used for extra information, in addition to the one that Zed Xyzed had mentioned are:

http://www.2ndchance.info/

http://healthypets.mercola.com/sites/healthypets/archive/2012/08/06/kidney-disease-in-cats.aspx

http://www.peteducation.com/article.cfm?c=2+2114&aid=350
 

I do agree with Donutte about the "glad she ate. Little victories"....Having them eat to gain strength, and finding anything that works is good.

I hope that you will be able to find more info on Tuesday, with the Scan.  Continued appetite and Total health vibes being sent for Dahalia.

 

[ritz]

Thanks everyone.
Quick update: Dahalia is 100% back to normal.
On Friday (15th), she is going to have an ultrasound and another attempt at getting a urine analysis. ALSO: she is going to be re-tested for FIV/FeLK: any idea why? She tested negative in early July 2016 ("SNAP" test).
Thanks.

 

[donutte]

Thanks everyone.
Quick update: Dahalia is 100% back to normal.
On Friday (15th), she is going to have an ultrasound and another attempt at getting a urine analysis. ALSO: she is going to be re-tested for FIV/FeLK: any idea why?
Thanks.

Can't think of a reason why, unless they see renal symptoms in kitties with FIV/feline leukemia. I don't know if they are or not, but if they are, and considering her age, it would make sense to re-test. I don't know much about those two diseases (thankfully).

 

[catpack]

I have experience with FIV causing acute renal failure (it's how our cat back in the 90s was diagnosed with the disease.)

I also find that when vets don't have an easy answer for symptoms, they'll want to retest.

When one of my cats became very sick at 9 mo EVERYONE wanted to retest him. He had already been tested twice, once at 6 wks and then again at 6 mo due to where he came from. Both were negative. We agreed to one more testing and, again, negative.

 

[ritz]

Yeah, my philosophy--and perhaps that of the vets--is test for the obvious, then test for the not-obvious: grasping at straws. I was hoping the reason Dahalia drank gallons of water when I first rescued her was due to dehydration or a 'touch' of anti-freeze poisoning. Those explanations have been discounted.

 

[ritz]

Just thought I would update this thread.

The vet who does the ultrasound sent me this report last week. In pertinent part:

Bladder—Moderately to fully distended with urine. Wall measures 0.07/ cm thick.
R Kidney--3.28 cm length with decreased corticomedullary contrast
Ultrasound DDX--Decreased corticomedullary contrast with symmetrical normal to mildly decreased in size kidneys. r/o toxic exposure, raw diet/high protein/red meat, FIP, congenital abnormality, liver disease, infectious/inflammatory disease, trauma, neoplasia/lymphoma, hypoadrenocorticism
Biopsy likely necessary for diagnosis. Consider commercial diet trial, urine culture, SDMA testing, bile acids testing, FNA/cytology as other diagnostic options.

Urine analysis was normal, although specific gravity indicated her urine was a little diluted (1.033)--better than it was in July.

Layman's translation: the contrast between the kidneys isn't as much as it should be. Best guess is, whatever Dahalia ate/licked/chewed in early July was toxic and damaged her kidneys somewhat. Dahalia's vet said there is no reason Dahalia can't live a full and complete life. She also recommended a special diet (kidney) which I am opposed to. She also recommended (and will fill out the paperwork) for a referral to an animal nutritionist connected with the animal hospital at Virginia Tech (Blackstone, VA). I am waiting to see if pet insurance will cover the initial claim--it may be deemed a preexisting illness. And/or consult with one of the many knowledgeable persons on the Raw forum.

Thanks for all your advice and help.

 

[donutte]

It makes me very happy to hear of a success story with acute renal failure. Cats can indeed recover, but they don't always. Even if her kidneys are damaged somewhat, she sure can live a normal life. How long have you had insurance on her? I know they are really weird about things, even if they weren't known about when you got the insurance. If they had the problem, in the eyes of some insurances, that's pre-existing. I guess in the technical sense it is, but well... another discussion for a different day

Anyway, she may need a lower phosphorus diet sooner than most. I forget how old she is, if she's a kitten that would be a tricky situation (since kittens need higher phosphorus).

 

[ritz]

She first saw the vet for this 'illness' on July 3. Second incident was around January 6. So it's close...
Dahalia is around 10 months old and my vet left me a voice mail message saying, if I really want to feed raw, I should chose the 'light' meats such as turkey and chicken. A quick internet search indicates that beef cuts are lower in phosphorous. In any case, I will be giving her egg shell powder in lieu of bones.
Thanks again.