Where To Turn?

JMJimmy

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Mama has always had issues with vomiting, it was minor and nothing popped on his blood work when we got his teeth cleaned last year. The vomiting started to intensify and he was loosing weight so we took him to the vet. 0.5mg of Omeprazole and instead of running for the bedroom when we got home, he ran straight to the food bowl and returned 5 times within the hour. Later that night he started playing like a kitten out of nowhere (Mama is a 9 year old sexy grumpy cat not a playful kitten like cat). He hasn't vomited since. He also had a FORL which we dealt with/had the tooth extracted.

As part of the visit we got blood work done and it came back with low ALP levels (malnutrition) and high SDMA. This normally indicates kidney failure.

If that's what it is, we'll deal with it and give him the best we can, however, something is nagging at me. It's not the inability to accept that he might pass, something just seems off with the results and I can't put my finger on it. I trust my vet is interpreting the results as he's trained to and he's an excellent vet... yet here I am.

Where do you go to ask the questions your vet can't answer? Like what can influence SDMA tests? One thought keeps occurring to me: Wouldn't muscle tissue proteins breakdown and spike SDMA in the same way a kidney breaking down would? If a cat was starving himself to the point of muscle loss, there would be a flood of muscle proteins being passed through the system. Could that spike SDMA levels while leaving other kidney failure indicators well in the green?

He can't answer that type of question, it's too specific. The question is, who can?

Right now I feel like the decision is to blindly follow my vet or turn Mama into a test subject because I can't find the answers I need.
 

abyeb

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Hi Jmjimmy, I'm sorry that you and your kitty are going through this. I see you haven't gotten a response for a few days, so hopefully if I bump this up for you, you'll be able to get more answers.

I think higher protein can cause elevated SDMA tests, also dehydration, but I'm not an expert. You can always go to another vet to get a second opinion, though.

Keep us updated. Another poster might be able to give you more info.
 

babiesmom5

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I know that a cat's hydration status can influence SDMA. You said that your cat has always had issues with vomiting. Vomiting can definitely cause dehydration, both for cats and people.

You did not say exactly what your cat's SDMA value was. Do you know? Most cats with early kidney disease have a SDMA between 15-19 ug/dL. Since SDMA increases as kidney function decreases, SDMA >/= 20 ug/dL are typically seen in more advanced disease along with an increased creatinine. SDMA is a more sensitive test of kidney function in poorly muscled cats.

If I were you, I would get a complete urinalysis to evaluate for inappropriate specific gravity, proteinuria and other evidence of kidney disease. This will give you better insight than just SDMA alone.

I can tell you also, just based upon experience, that just because a cat's SDMA value reads high (or is increased) with one bloodwork, does not mean it will be the same next time. I had a cat whose SDMA values ranged from 4-15. He never had any sort of kidney disease.

A good Vet Internal Medicine Specialist would be better able to explain to you what influences SDMA tests and answer your specific questions. He would also be better able to advise what further tests are indicated, and or treatment options if your cat has kidney disease.
 
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JMJimmy

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Thanks babiesmom5 that was very helpful!

His reading was 21 ug/dL. Creatinine was only 147 though which is average. His last blood test was in 2016, it was just a pre-op set which I'm waiting for a copy for my vet currently. I'll definitely seek out a VIMS.

We've put off the urinalysis for now. My vet wanted to do one right away but it seemed more like he was looking to confirm what stage of kidney failure. Before we go back I'll be sure to be prepared to ask for the right tests and information to ensure he isn't jumping the gun.
 
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