Nephrectomy Kitty

[SofiesMumma]

Greetings all! I am new to this site. Proud mom of Sofie, my name is Laura. She is the love if my life. Found behind a dumpster abandoned at 4 weeks old. She is almost 12 years now!

Sofie just had a nephrectomy about 1 week ago, July 9th. We opted for it as we discovered a tumor that was contained to one kidney. Her appetite was not great for a couple days on Mother's Day weekend, and having lost 2 babies already in my life, I've learned not to mess with sudden appetite changes. That is when they found slightly elevated creatine (2, after nephrectomy it was surprisingly back to 1.6) and BUN (37, since down to 30-33 steadily since that night) and recommend ultrasound discovered one kidney was very small and has the tumor. They also discovered high blood pressure, which Amlodipine has been treating great and her appetite improved quickly after that treatment started. The tumor came back as cancerous, but very UNLIKELY lymphoma. We have a fantastic referral hospital in our state. Oncology and Cardiology screened her very thoroughly. She is rather healthy in every other way, and they are not extremely concerned about her other working kidney at this point. It seems clear, especially after the surgery, that the tiny tumor covered kidney has not functioned in a bit.

1 week post op, and our baby (she has a great Dad that has been with us for 8 years ) is doing good I think! Eating very well, drinking, doing her 2-3 pees a day. Finally pooped giant on day 5 post op (which is common to take 3-5 days) and another big one on her every other day schedule yesterday. She seems to be getting antsy and getting her spice back. Incision seems to look good, healing nice/quick. I feel hopeful.

I joined this forum as it seems very supportive and was wondering by chance if anyone else here has a similar story, or any experience with a nephrectomy in a cat in general. I know our future entails monitoring of kidneys and heart from here on out. Already armed with lots of knowledge on CKD thanks to Tanya's CKD page. We are not there yet, but know it may come. Would love to hear from this community! ‍

 

[silent meowlook]

Hi, welcome to the forum!!!

I am not a veterinarian and do not hold any veterinary license. Anything I write is just my personal opinions based on my personal experiences. I have worked at an animal internal medicine specialist and feline only hospital, as well as GP and ER.

I have not had my own cat with a nephrectomy, but I have assisted in surgery and after care of a few. They routinely do quite well.

When you think about it, the kidney donor cats are able to lead normal lives after their kidney donation. Also, kidney values in bloodwork don’t elevate with chronic kidney disease until there is over 70% loss of kidney function. So cats can survive with one kidney.

Of course the situation with your cat is a little different due to the nature of the reason for removal.

Is there any way you can post a copy of your cats histopathology report? Just black out the hospital name and your personal information.
If you ask your veterinarian that submitted the kidney for pathology, the should send you a copy.

For aftercare, how much time has elapsed since the surgery?

 

[SofiesMumma]

Thank you so much for your reply! I am glad to hear that professionally you have seen the kiddos do quite well! I did have a bit of time to research as much as I could before the procedure, hard to find exact cases to my Sofie. Also all the specialty vets at the hospital really have been amazing about explaining everything and answering questions. So I felt okay going into it.

We are 1 week into recovery! Honestly, she was eating, drinking and peeing good right away. She even ate during her overnight stay at the hospital! Not a ton, but surprising for her as she is very picky. Was glad she pooped on day 5, cutting it close to that window lol.

We have not gotten a call with the results of the removed kidney yet. I hope the hospital got them back today and the oncologist can review and call me before the week is out.

 

[mrsgreenjeens]

I just did a search and only found two threads on nephrectomy, and both of them were people asking about whether or not anyone had done this procedure or not. Didn't find anyone who had actually had it done.

I just want to say that kidneys often can have an effect on blood pressure, so now that the problem kidney has been removed, her BP could go back to normal without medication. Did anyone bring that up? Not sure how you are monitoring it, but something to be aware of.

I'm so glad she is doing so well this soon after surgery!

 

[SofiesMumma]

Thank you mrsgreenjeens for bringing this up! Yes it was lightly mentioned. We know what to watch for as far as low blood pressure goes. Her PCP vet has been able to take over the blood pressure part, and will also be doing the kidney monitoring moving forward. Everyone wants us to get through this recovery first before more checks. BUT, I have no idea what time frame those need to occur yet. She is doing well so far, which is my current day to day monitoring right now.

No call from oncology yet, hoping it's like human medicine when no news is usually good news when waiting for results.

I couldn't find much in general online about this. Hopefully this thread will help another cat parent in the future

 

[SofiesMumma]

So little update. Called the hospital and the results are not in. They sent the 'kidney' (I quote, cause it really was just a tumor at this point) for histopathology. They said depending on the lab load it can be 1-2 weeks. So next week. Ugh.

Sofie seems to be doing good!! Getting spicy. Last night she tried to break through the gate I have set up. Thankfully the nights will be cool enough next few evenings to have windows open and I can close the door and not rely on the AC to cool us. She just wants to get back to kitty life, clearly. Which I think is a good sign!

 

[mrsgreenjeens]

A very good sign! Hoping the report, when it finally comes in, will be good news

 

[SofiesMumma]

A very good sign! Hoping the report, when it finally comes in, will be good news

I don't know how to do the hug reaction! So me too!!!!

 

[SofiesMumma]

Sofie peed 5 times yesterday, her norm is 2-3. So I got nervous that her kidney was not doing good being about 10 days post op. We took her in, good news that her levels have remained unchanged since pre-op! Also another sign that the 'kidney' removed was really probably not doing anything. They did a quick ultrasound which showed nothing concerning at all anywhere. They think she likely is in early stages of a UTI, which I guess can be relatively common to a degree after surgeries. So we got the kitty version of Augmentin and got home around 1am and we all rested pretty easy. Her incision looks 'fantastic' and almost all healed, so we already got the thumbs up to remove the cone/flower donut type collar (she only wears during day when we can supervise) at the 2 week mark. Good news for my spicy baby lol.

 

[SofiesMumma]

Sofie recently underwent a nephrectomy to remove a tumor that had over taken one kidney. She is recovering very well! Especially today because it was cone off day finally

Her histopathology came back, carcinoma. No surprises there, we knew it was not lymphoma. However the oncologist says the mitotic count is a bit higher than she would've liked to see, she did not give the number. But she gave some options, one is carboplatin every 3 weeks for 5 treatments to slow progression or really just kill anything on a cellular level.

We have a follow up ultrasound on Aug 14th to get a baseline post-op and to discuss details. She assured me we do not need to make a decision this moment. So I thought I would see who here has had any experience with carboplatin? I've gotten some clinical explanation, but would love to hear personal stories from furr parents! Thank you

 

[silent meowlook]

https://www.researchgate.net/public..._undergoing_nephrectomy_A_retrospective_study

https://www.aaha.org/wp-content/upl...aha_oncology_guidelines_for_dogs_and_cats.pdf

Hi. I am sorry for the diagnosis. The above are two links that might be helpful. I didn’t have time to read them both.

I am sure they did chest X-rays prior to surgery and that they were clear.

I have seen Carboplatin used in cats, but it was a long time ago, 10+ years, when I worked internal medicine. I don’t remember any extreme side effects. Of course there are some, but your oncologist is best to help with that.

I have seen people have good luck incorporating a holistic, integrative veterinarian with their chemotherapy in pets. Kind of mixing the eastern and western medicines together.

I hope some of this helps and that your cat is insured.

How is your kitty doing after surgery now?

 

[SofiesMumma]

Thank you for the links! I have read the first study prob 50 times by now. But really like that second link, another thing to read 50 times now

Sofie did have ultrasound and chest scan and aspirate (along with ECHO and blood test, urinalysis) and everything was clear and good, her slightly elevated creatine was not a concern, just a sign the tumor kidney was no longer functioning, and of course her high blood pressure (secondary to all this kidney stuff) which we now have controlled quickly and easily, will continue to monitor. Because the aspirate came back very unlikely lymphoma and there was no spread on scans/ultrasound, the nephrectomy was first line/best outcome treatment. Oncologist said due to the mitotic count, it is possible the cancer could be on an undetectable cellular level, hence the 5 treatment chemo suggestion. She also present a kinda sit and wait option with close monitoring. Cancer is cancer, never know what it's gunna do and when/if.

Sofie is doing so good!!!! She has really enjoyed having cone off since yesterday. Cleaning her tiny body! She loves to be tidy and pretty, and her mood instantly improved with grooming! she had wild zoomies this morning. Food has not been fantastic past few days, but to be expected with antibiotics. She is meeting her 180-200 cal per day requirements, unfortunately 50% from temptation treats. But, I've been assured this is okay for the time being. She is doing well with water and toileting! It's hard to believe she is going thru this. She is just so purrfect! So happy! So pretty!

 

[silent meowlook]

I am glad she is doing so well. Of course this makes your decision to do chemotherapy a bit harder, because I am sure you don’t want to risk how well she feels now. At least, that is how I would be feeling.
Just curious, the histopathology came back as just carcinoma? Not Adenocarcinoma?

I am sure you understand that there can be cancer at a cellular level that cannot be detected. If so, always better to start treatment before it is visible.

When my cat was diagnosed (not officially with a biopsy, ultrasound only due to her being a high anesthetic risk), there was a blood test that could be done todetermine cancer. But, sadly, the test, at least the one I was looking into, was not very accurate. I chose not to do it. This was about 3+ years ago. I haven’t heard of any improvements in this area. Especially since we know the kidney was cancerous, even if the test was accurate, it wouldn’t help.

Sorry, thinking in print here.

When I worked in internal medicine, we saw allot of cats with cancer and had many undergoing chemotherapy. They, for the most part, responded very well to chemotherapy with many of them going into remission. Most of the cancer was lymphoma. But, there were others as well. I would have to say that almost all responded well.

I knew a cat there that I also cat sat for who had renal lymphoma. She did well for many years. Of course lymphoma is easier to get into remission.

It sounds like you are on the right tract with your medical team. You are using specialists, which is so important, and it seems as though they are being communicative with you. That is extremely important.

One thing I do have to mention is ghat if you have any concerns with her well being, never hesitate to contact your oncologist. Specialists get very well compensated for their knowledge and part of having your cat in the care of one means the office call or treatment doesn’t leave the moment you leave the hospital. It is a lifetime ( your cat’s ) commitment on their part and they expect you to reach out to them.

I sure hope she continues to do well and can eventually get off the temptation cat crack. I know they put a flavor enhancer in it but it’s ridiculous how much cats like it. I had to use them to get my cancer kitty to accept her SQ fluids and various treatments. She is ex- feral, very feral. For that, temptation treats worked great. But now she is seriously addicted and will bite my fingers when I am sleeping if she doesn’t get her “fix”.

 

[SofiesMumma]

So funny about your kitty being addicted too Sofie has always had temptations, but usually in much less quanties. She eats a 50/50 kibble and pate wet food. RX dental kibble and fancy feast. But right now while she is on the antibiotics I am just trying to make sure she gets food. She is so very picky, never ever food driven. So its frustrating when she doesn't wanna eat. She doesn't understand that her liver can't handle not eating!! So temptations it is.

The hospital we go to is INCREDIBLE! I definitely lean on them a lot. Calls or visits. They do prioritize our care, I truly feel they do for any baby who has been thru any major work up. It's a great team there. Our PCP is also great, just not as equipped obviously lol.

The oncologist did not say adenocarcinoma. She also seemed to make it seem like it's the type of cancer that if you can cut out (which we did) it gives the highest chance of survival. She said it was one of the best diagnosises she could give as far as cancer is concerned. I do like that we are just getting a baseline ultrasound on Aug 14th and having a good chat about all options.

I appreciate you sharing your experiences and that many kitties could get into remission and do so well on chemo. Oncologist said we can always give anti-nausea stuff if eating becomes an issue during treatment. That seemed to be the biggest side effect, but we did only speak briefly about it on the phone. I think the goal is to suppress or kill what could possibly be there, and she did say just cause the tumor came back that way, doesn't mean it has spread on a cellular level, just that it may have. Certainly good that nothing is seen and she isn't showing any symptoms.

It is a tough choice, just cause she is doing well. Catching stuff early is good, also strangly hard!

 

[SofiesMumma]

***Update!!

Sofie had her follow up post-op baseline ultrasound and oncology consult yesterday. She looks AMAZING!! Inside and out, the doc and techs are so pleased to see how fantastically she has recovered from the surgery! NO SIGNS of progression in the ultrasound either! All organs look great! Sofie has gradually also made it back to her 8.55lb norm! She got down to 8.3 in Jan/Feb, and I thought it was generally related to loosing her sister in Dec, which could've been part of it. Who knows. I weigh her 1-2 times weekly and have seen this gradual gain. She was back to 8.42lb pretty steady for a month before surgery. Also BUN is 27 and creatine steady at 2.0! Another sign that tumor coveted kidney failed a while ago and she has been already living on one kidney.

I didn't get the mitotic count from oncologist, but I trust and adore her immensely and when she says it is higher than she would've liked to see, I just take it for that. We discussed benefits of chemo vs not. Sofie has an extremely rare cancer, it is renal carcinoma. Vet explained the 3 major parts of basic embryology. So since it is NOT round cell (lymphnodes, lymphoma) and NOT sarcoma (splenic/blood vessle) she can go off what treatments have worked well for other carcinomas. We decided Pallidia prob wasn't our best choice right now. And out of the 2 injections offered, carboplatin and mitoxantrone, we landed on mitoxantrone because it doesn't get eliminated as intensely via the kidney as carboplatin can. Also it is a bit more locked into a week after treatment that the WBC can go down, vs anywhere from 7-21 days with carbo. So easier to time blood draws with mitoxantrone too.

We have 5 appointments scheduled, 3 weeks apart. The doc really thinks Sofie will do well with the treatments as she is currently feeling great, looking great, medically stable, has a low disease burden, basically just thriving. Me and Dad also agree. Plus, she just seems to bounce back so quickly from these vet visits (she does hate them, but let's get real.... who, furr baby or human, loves going to the doctor!? ).

I would love anyone's feed back/opinion on our plan of action. The outcome goal is to suppress the possible cellular growth for as long as possible to hopefully get a few more years of quality life with our lil girl ‍ ... and yes, we know it's cancer and unpredictable. But hopeful that it's all been caught early enough to look at years vs months

 

[silent meowlook]

I am so happy to read this. Sounds like your oncologist knows her stuff.

 

[SofiesMumma]

I am so happy to read this. Sounds like your oncologist knows her stuff.

Oh yes she does!! All the specialists know their stuff at this hospital. We live in New England and call it 'The Boston Children's Hospital for furr babies' hehe.

I forgot to mention that the Pallidia was decided not an option now because she has no visible disease to monitor how it's working. Which is great news! Basically, if Sof went somewhere else for scans, ultrasounds and blood work, and we told them nothing of her history, she would get a mostly clean bill of health. Just missing a kidney and very mildly elevated creatine cause of it, treating the hypertension that is secondary to this kidney thing.

And our plan will also involve Cerenia day before and thru day 5 after each treatment and mirtazipine on hand for emergency use. Thank goodness Sofie is amazing to give meds to! She is so good about it!

 

[SofiesMumma]

The time approaches! Sofie begins chemo on Tuesday the 10th. I got all her meds in line on hand. Gunna select some special 'junk foods' at the store today to have on hand. She is just doing so good! I have read a lot of stories, on this site and the feline cancer group site where I am also a member. It really seems like for the most part that everyone's babies have done well. But obviously I am filled with nerves. Her birthday is on the 17th! She will be 12! And she also needs to go to our primary vet for her CBC draw. Ugh. What a way to spend a Bday! But my hope is that all this will help her have a handful more birthdays that we can make much more special.

 

[fionasmom]

Keep us posted as to how Sofie does!

 

[SofiesMumma]

Oh I sure will!! she has been chillin today. Snacking and playing crazy wild with her toys too. Just love my Tiny Honey so much!!