Help Interpreting Blood Test: Normal Bun And Sdma, But High Creatinine

[harrylime]

Hi guys,

Quick backstory... my 5 year old cat has eaten raw food for her entire life. About two weeks ago, she started vomiting at night, out of nowhere, maybe 4 times total. (here's the thread I made about the incident: Cat Suddenly Vomiting After Years On Raw Food? )

Worrying that my frozen raw food (venison + Alnutrin w/egg shell) had gone bad, I switched her to a high quality canned food. Everything seemed OK but then she vomited once or twice after having the canned food too. Then I started thinking it might be related to her treats, Vital Essentials freeze-dried rabbit bites. Normally she loves these treats, but I do have to say that the treats themselves are a slightly different color/consistency/appearance everytime I buy a new bag. One time my cat wouldn't touch them at all, so I e-mailed the company and gave them the batch number and they told me that that particular batch had higher liver content than normal.

Anyway, so I brought her to the vet and everything appeared normal, and the doctor did a blood test. The results came back with normal BUN and SDMA, but high Creatinine (2.8). There is a note at the bottom of the lab test stating that these particular results are uncommon. The vet said it wasn't much to worry about, but we could do a urine test next time I bring my cat in, 6-12 months from now. I mentioned this fact to a vet-tech friend of mine, and she made it seem like a much bigger deal than my vet did, and thinks I should get a second opinion ASAP. Also worth noting that she's very against raw feeding (my actual vet is more tolerant of raw feeding). I'm including some of the lab results here. The only out of the ordinary figure is the Creatinine. Any thoughts or insights? Thank you!

 

[kittyluv387]

You are feeding your cat a raw diet, as do I. It is very nutritious and has way more protein than the cats who were used as basis of normal creatinine levels. The vets are right to not make a big deal of this and you're lucky to have such knowledgeable vets. Mine were telling me my cat has kidney disease and that he should go on prescription. Keep in mind that his urine may be dilute compared to the norm if he is eating a moisture rich diet. Again, the cats used in the basis of determining normal urine ph were likely eating crappy dry food. The best thing to do is to keep an eye on his numbers as time goes by. If he is routinely a little above the norm for creatinine levels then it's nothing to be alarmed about.

 

[FeebysOwner]

That creatinine count is not above normal enough to be of alarm. However, I do think it should be checked again in 6 months. I don't think I would want to wait for a whole year - just in case something is beginning to 'brew'.

Just out of curiosity how long ago was the last test before this one - and, was it high at all?

 

[harrylime]

You are feeding your cat a raw diet, as do I. It is very nutritious and has way more protein than the cats who were used as basis of normal creatinine levels. The vets are right to not make a big deal of this and you're lucky to have such knowledgeable vets. Mine were telling me my cat has kidney disease and that he should go on prescription. Keep in mind that his urine may be dilute compared to the norm if he is eating a moisture rich diet. Again, the cats used in the basis of determining normal urine ph were likely eating crappy dry food. The best thing to do is to keep an eye on his numbers as time goes by. If he is routinely a little above the norm for creatinine levels then it's nothing to be alarmed about.

Wow, thank you, this is obviously great to read.

 

[harrylime]

That creatinine count is not above normal enough to be of alarm. However, I do think it should be checked again in 6 months. I don't think I would want to wait for a whole year - just in case something is beginning to 'brew'.

Just out of curiosity how long ago was the last test before this one - and, was it high at all?

Thank you. Good question, I actually don't remember when her last test was. It could have been way back when she was spayed as a kitten. And obviously the SDMA test wasn't around back then. I'll e-mail my vet and ask.

 

[kittyluv387]

Keep in mind declining kidney function is unfortunately a normal part of aging for cats. Once they get older it is best to feed a lower phosphorus raw diet. Normally, commercial raw diets are too high in phosphorous because they use a lot of bone.

 

[harrylime]

Keep in mind declining kidney function is unfortunately a normal part of aging for cats. Once they get older it is best to feed a lower phosphorus raw diet. Normally, commercial raw diets are too high in phosphorous because they use a lot of bone.

Yes, but age 5 seems to be quite young for this. I'm feeding Alnutrin with egg shell calcium so that should keep the phosphorous quite low.

 

[Noirele]

I agree with all other comments. Diet, idratation and appropriate fasting all have a great impact on creatinine value. Just to be on the safe side, I would re-test in 6-12 months. Just make sure that he fasted at least 8 hours (12 is better) and he is well hydrated. But raw diet will always account for a high creatinine value, it's pretty normal.
We once tested Merlin a couple hours after a kibble meal and his creatinine was really high. Proteins and scarce hydration were the culprits.

 

[PushPurrCatPaws]

... Then I started thinking it might be related to her treats, Vital Essentials freeze-dried rabbit bites. Normally she loves these treats, but I do have to say that the treats themselves are a slightly different color/consistency/appearance everytime I buy a new bag. One time my cat wouldn't touch them at all, so I e-mailed the company and gave them the batch number and they told me that that particular batch had higher liver content than normal. ...

harrylime
I don't have any input on the blood test results, and I hope your kitty is okay!

But I am very interested in the above info you gave about the VE freeze-dried Rabbit Bites. My cat usually loves these treats too, and normally gobbles them right up. Lately, she's gone so far as to get them in her mouth but spits them right back out, walking away. I've gotten bags that look inconsistent from one another, too, like you. (current batch she won't eat- #20200408 16866 ... may I ask the batch number you checked on? Maybe I should write to them)

 

[kittyluv387]

Yes, but age 5 seems to be quite young for this. I'm feeding Alnutrin with egg shell calcium so that should keep the phosphorous quite low.

Agreed. And good! You know what you're doing. Another tip is that you can keep skin on for half of the meat you're using. I emailed alnutrin and they said if I keep skin on a higher percentage, the phosphorus will dip below the AAFCO minimum.

 

[movinintime]

Same concerns here but vet said that high creatinine & raw food w/ all the protein is normal -- unless way off the charts. Also, testing every 6 mos. can look for a trend. Our cat has up & down creatinine levels each test but the fluctuation is on minor & never yet over the high norm.

2.8 is over a tad but again, raw diets can do this & most vets never learned re nutriton & raw diets in vet school, so often mistake this for kidney decline. I would agree w/ all above & retest in 6 mos. or even less time, if you really are worried & can afford bld work that often, just to keep close eye on it.

 

[harrylime]

harrylime
But I am very interested in the above info you gave about the VE freeze-dried Rabbit Bites. My cat usually loves these treats too, and normally gobbles them right up. Lately, she's gone so far as to get them in her mouth but spits them right back out, walking away. I've gotten bags that look inconsistent from one another, too, like you. (current batch she won't eat- #20200408 16866 ... may I ask the batch number you checked on? Maybe I should write to them)

I'll check the package and let you know. I noticed she was only vomiting after getting some of these treats... the treats were the only thing I could clearly see in her vomit (ew) since they had been most recently consumed. Also realized that she never vomits when I'm not home... and always at night... which is exactly when she gets the treats. Anyway I'll check the bag when I get home... it's definitely the same bag that's been open for the entirety of this episode!

 

[harrylime]

Another tip is that you can keep skin on for half of the meat you're using. I emailed alnutrin and they said if I keep skin on a higher percentage, the phosphorus will dip below the AAFCO minimum.

Ah, good idea but I use venison grinds from Hare-Today. Also she doesn't get any poultry because of an allergy scare.

 

[Antonio65]

Yes, but age 5 seems to be quite young for this.

My cat was diagnosed with CKD at the age of 6.
It was a surprise for the vet too. Anyway we managed to keep everything under control for the following 11 years.
So, it's uncommon but not impossible.

I had her checked every 4 months for the rest of her life.

 

[MissClouseau]

Oh man. I hate it when there's an abnormality in the blood test but without showing the reason with proof they downlook at it. Any abnormality could be a sign of the beginning of a health issue we CAN prevent by taking precautions early on.

With that beind said, reading blood tests is incredibly difficult for those who are not veterinarian. (Yes, vet techs included.) My cat recently got a blood test too and she has very low WBC (white blood cells), high urea nitrogen but normal createnine. The vet suggested something for WBC but about the other abnormalities said "not to worry about." Annoyed, I then showed the results to two other vets, one local in Turkey, one from the USA online. They both said things like dehydration that morning, or even making the test to full stomach could change results to some level. The second vet suggested to do the test again after making sure the cat is fully hydrated and peed. I'm sharing this story because unfortunately sometimes vets don't say "not to worry about BECAUSE I think this elevation is likely the result of the pee I'm feeling inside the cat" then we start to go through all nightmare scenarios what the elevation might have happened.

re: raw diet. I am on the "the best diet also depends on the individual cat" camp so I cannot dismiss a raw diet for all cats everywhere but, just like grain-free foods (and my cat is mostly on them) there isn't much and LONG-TIMED research on them. Cats in the wild do not live as long as house cats. Making "they eat like this in the wild" not a good explanation. They are more likely to catch nasty bacterias and infections from uncooked meat. Also, a animal-protein-rich diet has its place but it's also hard on kidneys and heart for some (most?) cats. There are so many other factors but the point is it's easier to make mistakes with a raw diet.

tl;dr Personally I would get the test done again sooner than 6 months and if you see abnormalities again, ask for explanation and re-examine her diet and/or water intake.