Stage 2 Kidney issues...

[FeralHearts]

So White Label (W.L) went for her Annual check up yesterday and it came back with a little bit of an alarm. Possible Stage 2 Kidney issues. I say possible because as the Doctor explained it to me the tests are flawed when it comes to staging. So while there are Kidney issues, it may not be stage 2.

There are no planned changes ATM save to watch her and to increase water for now.

She says she's not concerned yet but that next year we will check her blood pressure before the tests etc and that will help. (Unless of course I need to bring her in before then.)

Being me however, I am concerned and am now in research, gather info mode.

I have her blood and urine results and will post.

I've read the number of reasons this can happen, but, in her case, the sad truth is that it's most likely caused by past poisoning. (Although we can't rule out other things.)

Should I just relax and wait? Are there are tests etc I should look into? Where do I go from here? Other than waiting and seeing. (Not my strong suit when there is a problem. I trust the vet however - sitting back and waiting - yeah really not my strong suit.)
Even though this is year two she has been in - could this still be a result of the poisoning?

Any help - thoughts are appreciated.


History:
She is 7.5 years old retired Feral.
She was brought in two years ago this summer when she couldn't breath. We figured out that is was most likely an accidentally poisoning by a neighbour.


For those here that don't know her Story - here is the short Version.

The neighbours were trying to deter a skunk from living underneath their deck and placed down, moth balls, Apple cider vinegar, bleach, ammonia and other items. Within 24 hours of this she had trouble -what I thought was eating dry food. Wet food and water were fine. She would hack a bit like a hairball. At first glance I thought maybe she had a bad tooth and made plans to get it looked at.

It wasn't until the following morning when I saw she could breath properly and saw her venture onto their property that it dawn on me that "OMG she might be poisoned!" I tried to get her and couldn't. That night when she came it was bad - she could barely fight me or breath and I rushed her to the ER. We through everything but the kitchen sink at her and she has recovered thanks to you all here that kept me calm, focused and gave me advised and help between ER visits and regular vet Visits.

A NOTE ABOTUT THE TESTS:

Her NEUTROPHILs Were like this last year as well. No one is worried about it as could be stress?
The value the Doctor was looking at was of course the Creatinine for sure - I'm not sure what else lead her to the Kidney issue to be honest other than that one level.

 

[Furballsmom]

Hi!
Did the vet think the items used would have a lasting effect, given that you don't know if she actually ingested something, breathed the fumes, got it on her skin...?

 

[FeralHearts]

Hi!
Did the vet think the items used would have a lasting effect, given that you don't know if she actually ingested something, breathed the fumes, got it on her skin...?

HI lovely! I think you might remember her story from when I was freaking out back then.

I didn't ask - good question. I kinda went into shock a bit when she called with the results since she's been fine since that poisoning and because we don't actually know if she was poisoned - though all logic and reason points to that - I know there is always a chance it was something else that caused her to not be able to breath. We will never be 100% sure that's what happened.

I would think poisoning could have long term effects for later. I'm going to pull up her previous blood test for the ER and last years annual visit and see if I can see a raise in levels (however slight) each year. I'll add that question to my list.
XOXO

 

[movinintime]

Her SDMA is fine! NO sign of even early kidney there. The creatinine is fine too, well in normal. Where's the kidney worry he sees??

 

[stephanietx]

It's very possible that her kidneys are slightly damaged from the feral life she lived, not knowing what she's ingested. The kidneys filter out all the bad stuff in the body, along with the liver, so it's possible. For now, I would work on finding a low phosphorus food and increase water intake. We like to add water to wet food so it's like oatmeal just to get more water into our kitties.

Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Which Foods to Feed, and Which to Avoid

Updated food list. Start with the starter food list.
www.ckdcatfoods.xyz

More info on CKD/CRF in cats: INTRODUCTION | Feline CKD

 

[FeralHearts]

BTW this isn't her normal vet as her normal vet is on Matt leave. It's another one from the practise though.

Her SDMA is fine! NO sign of even early kidney there. The creatinine is fine too, well in normal. Where's the kidney worry he sees??

Thank you! XO

I honestly don't know how she came to that conclusion either. Looking at those results I see the staging question (but that's it):

Stage 2 Mild Renal Azotemia

1.6 to 2.8

140 to 250

and WL is at 153.

But that was all I saw too. Everything else looked okay save for those NEUTROPHILs like last year and her calcium being high. So I'm puzzled and once I digest everything I may very well ask where the conclusion came from as the only mention was those numbers above.

She was concerned because she dropped weight and I did mention; when they asked at the start of the annual check up, if I had any concerns - I asked if her weight was okay as she always looks skinny to me. According to her exam records though she is still slightly overweight at 11.7 pounds. Last year I was told she could lose a bit of weight as she was at 12.5 pounds but looked good.

The other thing is that her appetite is rarely ever good - except for dry food - which she gets in very limited amounts, more as a treat / supplementary feeding as she is mostly on wet food. This cat would much rather play and cuddle than eat. I sometimes have to put her in front of the wetfood and say "eat kiddo" as she'd much rather be on someone's lap. (and I limit dry because it appears to be kitty crack to my cats. They like the dry too much - and momma wants them on wet.)

The more I think of it she may have come to that conclusion based on her weight, the creatinine and the fact that she 's never really shown interest in food. People always are first with this cat.

It's very possible that her kidneys are slightly damaged from the feral life she lived, not knowing what she's ingested. The kidneys filter out all the bad stuff in the body, along with the liver, so it's possible. For now, I would work on finding a low phosphorus food and increase water intake. We like to add water to wet food so it's like oatmeal just to get more water into our kitties.

Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Which Foods to Feed, and Which to Avoid

Updated food list. Start with the starter food list.
www.ckdcatfoods.xyz

More info on CKD/CRF in cats: INTRODUCTION | Feline CKD

Thank you! XO I will dive into some reading. I am getting the feeling the vet might have jumped though. Still I will research until I can conclusively say she jumped. :-)

 

[FeralHearts]

Okay so I pulled her file. (If you want to see the full bloodwork I'm happy to post.) I've focused on the issue areas for this:

Blood work for 2019:

Neutrophils 1.9 2.6 - 15.2 x10^9/L this one was low just like this year all my research says probably stress.

The only other low was this:
ALP 10 Normal range being 12 - 59 U/L

IDEXX SDMA a 9 normal range is 0 - 14 μg/dL - this was in the normal range
Creatinine 131 Normal range is 80 - 221 μmol/L - this was in normal

Her Calcium was on the high side last year too:
Calcium 2.6 - Normal being 2.2 - 2.7 mmol/L

Urine for last year is pretty much the same, PH was a bit lower, a 6 instead of 6.5, no cells and a tinge of proteins like this year.

In 2018, much to my surprise no one did bloodwork. Lots of x-rays, lots of meds, emema at one point, puffers etc but no blood. I swore we did blood but the chart notes don't even mention it. Just the FIV tests and the other other test. A SNAP test. She was clean for both.

 

[Furballsmom]

I'm of no value regarding those numbers, but I was wondering if you'd had a chance to try some cat music for the stress?

Would bonito flakes be something you could use as a topper to tempt her if you're thinking she's losing more weight than you like, or maybe fortiflora?

 

[FeralHearts]

I'm of no value regarding those numbers, but I was wondering if you'd had a chance to try some cat music for the stress?

You know it. They love that harp! I've been playing that when I go to work - very softly in the backgound. Her stress is - you guess it - Charlie related.

Charlie's always a problem lol though the music does help him too. He still bullies W.L.I remember it took a good year before he stopped bulling Mia. Once that was done - it became W.L's. turn. Braveheart he has very little luck with. She just tells him where to go and what direction to take to get there. He's actually a little scared of her even though she is 1/2 his size. Funny and sad at the same time.

 

[Furballsmom]

She just tells him where to go and what direction to take to get there.

 

[stephanietx]

What was her potatssium level?

 

[FeralHearts]

What was her potatssium level?

This visit (2020)
POTASSIUM 4.5 Normal range3.7 to 5.2 mmol/L showing as being near right in the middle on the chart, so normal.

Let's look at 2019

No record of Potassium. Dang.

I'm doing some reading on this high calcium in cats and that's a bit freaky in relation to Kidney and other things.

Would bonito flakes be something you could use as a topper to tempt her if you're thinking she's losing more weight than you like, or maybe fortiflora?

Sorry, I missed this.

According to her charts she is still listed as over weight. Her normal vet said fine but could lose a bit and still be good. Her fill in listed in her chart she was over weight, even though she dropped. She is a small cat with high energy. I'll try to get a pic of her to show her body. So I wasn't over concerned with her weight. I was more - hmm "she looks a bit thin to me can you check her weight" type thing.

I would like her to eat more wet food though so I'll certainly try the tricks you've taught me. I have to keep Mia away though lol as she's overly plump and needs to lose weight badly.

 

[FeralHearts]

Okay so here are some pics she let me take just now. Two from above, two her laying down. She doesn't look overtly skinny - just thin but as I have big cats and one that is a chubster I'm never sure about weight.

 

[stephanietx]

She's a cutie! I'm a sucker for those tabby and white pawed kitties. I wouldn't say she's overweight, but she could probably lose a pound or so, but not too much and not too quickly. Moving to a mostly wet food diet will be good for both of your kitties.

 

[FeralHearts]

She's a cutie! I'm a sucker for those tabby and white pawed kitties. I wouldn't say she's overweight, but she could probably lose a pound or so, but not too much and not too quickly. Moving to a mostly wet food diet will be good for both of your kitties.

Thank you :-) W.L. Says ty too.

Her twin sister is *cough* a little overweight *cough* okay A LOT 17 pounds of needs-to-lose-weight now. I'm working on her for that. Not freaking easy.

It's good to know W.L is not to thin and could lose a tiny bit more and still be okay. I won't try to get her down yet if she's okay. I was actually worried she was too thin which is why I asked the vet about her weight lol. Mind you I'm comparing her again a very large cat (Charlie) and her sister Mia who is the 17 pounds of love.

They are mostly on wet food atm. 2 - 3 meals of wet per day and a small amount of dry at night. She eats very daintily - like a princess. I almost expect her to ask me for utensils she's so dainty.

 

[Furballsmom]

Okay so here are some pics she let me take just now.

Honestly, to me she looks absolutely perfect body condition-wise and her coat looks great, she's engaged with the activity...what a little doll

 

[FeralHearts]

Honestly, to me she looks absolutely perfect body condition-wise and her coat looks great, she's engaged with the activity...what a little doll

Her hips are a tiny bit thinner than what you can see, but not bad. Oh her coat is like silk.

Yes, she plays, plays and plays, she can't get enough of playing and people. Food is something she "has to do" in her mind. I literally, even when she lived outdoors, pick her up and place her in front of the food as she just wanted to be petted, loved and snuggled. She has such a soft, loving personality.

 

[FeralHearts]

Okay I read and pondered all night.

The creatinine and Calcium seem to be where the conclusion may have some from though I'm not sure. I've a few more questions for a Doctor, not many, but a few.

I will be adding some UroMAXX to her food and extra water. I'm not sure about doing anything dramatic on her diet just yet but this I know for sure...

... not waiting a year for her to be seen. Not happening. I'm not okay with that.

I'm going to put some money aside, as vets are not cheap here at all, and she's going back in 6 months for another of the bloodwork and see where she is at. Her normal Vet should be returning by then too. (Not that this vet isn't good or anything but I think she should see her normal Doctor.) Though I loath the idea of putting her through additional stress for vet visits - I don't think this is something you wait to check on an annual visit.

Maybe I'm over reacting but I think this is one of those things that if there is an issue it's handled asap.

 

[furdoctor]

for the info about stress leukogram. it makes neutrophilia and lenfopenia. 15-25k range. stress is not cause of neutropenia.

 

[FeralHearts]

for the info about stress leukogram. it makes neutrophilia and lenfopenia. 15-25k range. stress is not cause of neutropenia.

Hi there! Welcome to the forum! Thanks for that.

Stress was mentioned on one of the research papers I was reviewing as I couldn't figure out why all three Ferals had such low Neutrophils but otherwise great blood work. Very little was said about the correlation in the Merick Manual about it, at least not anything that would seem to apply to them all. If I can find that research paper I'll post it. It was an interesting read.

I'm lucky they have really good vets to take care of them and don't mind questions - but I still do homework too.