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Old July 4th, 2011, 08:19 PM
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dbg10 dbg10 is offline
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Join Date: May 2008
Location: Ajax, Ontario
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My oldest cat diagnosed with Chronic Renal Insufficiency

About a month ago, the oldest of my 4 cats, Sam, now a week short of being 14 years old, was having spasms of his abdominal muscles that were definitely painful for him. Some of his background story is here Food for Senior Cat with long history of crystals in his urine. I started giving him Buscopan again which has been an off again on again medication for Sam since he was diagnosed with struvite crystals about 6 years ago. It relieves his pain and usually stops the spasms, as well as allowing him to pass the crystals.

I also took him to the vet. She did extensive blood work and it appears he has CRI about Stage 2 CRF. He is also wheezy at times, which my vet is very concerned about. We started him on a new diet, MediCal low protein canned which he's not particularly fond of but he is much better now. She wanted him off the Urinary SO and on Hill's KD but he loves the stuff and I've tried to give him Wellness Chicken and Wellness Turkey kibble in its place and he refuses to eat any other kibble than the SO. So I've got my work cut out for me switching his kibble to anything else.

We also started Fortekor to increase the blood flow to his kidneys and she recommended that I put him on a Flovent inhaler. However since I altered his wet food I haven;t heard him wheezing at all. I have a feeling he is going to freak out when I put a mask over his face, and so I've hesitated to pick up the inhaler and Flovent, especially since he hasn't been wheezing. He "asks" for his Buscopan every night and refuses it on the nights he doesn't need it. What he does is come immediately when I shake the pill bottle and sits in front of me waiting for his pill and then takes it without any hassle at all. The nights he won;t take it, he spits it out when I try to give it to him and avoids me trying to open his mouth to put it in. So I've decided he knows when he needs it and when he doesn't...amazing animals they are!

To make a long story short, he is back to himself again, loving, cuddly, asking for attention all the time and coming for food when he's hungry. He has been very slow eating the MC low protein, about 1/8 of a can a day at the most until last night when he ate about 2/3 of the can. I plan to change him to grain free wet, either Innova or Wellness wet. He likes the Innova Senior but none of the flavours of Wellness so far. So time will tell what I end up feeding him. Obviously something of better quality than the low protein food but I need to experiment to find what he'll eat. What I'm aiming for is a low phosphorus food with animal protein, My next trial will be Nature's Variety Instinct to see if that appeals to him

BIOCHEMISTRY
Total Protein 78 (norm 60-85 g/L)
Albumin 37 (norm 28-43 g/L)
Globulin 41 (norm 25-51 g/L)
A/G Ratio 0.9 (norm 0.6-1.3)
ALP 42 (norm 10-85 IU/L)
ALT 63 (norm 5-110 IU/L)
glucose 5.2 (norm 3.9-8.0 mmol/L)
Urea 11.1 (norm (norm 5.0-13.0 mmol/L)
creatinine 224 (norm 50-177 umol/L)
Sodium 157 (norm 145-158 mmol/L)
Potassium 4.8 (norm 3.7-5.8 mmol/L)
Na/K Ratio 33 (norm 25-40)
Chloride 118 (norm 109-130 mmol/L)
Calcium 2.83 (norm 2.00 - 2.90 mmol/L)
Phosphorus 1.4 (norm 0.8 - 2.5 mmol/L)
Hemolysis 2+
Icterus normal
Lipemia normal

HEMATOLOGY
WBC 7.7 (norm 5.5-19.5 x10E9/L)
RBC 9.9 (norm 6.0-11.0 x10E12/L)
Hemoglobin 154 (norm 80 - 150 g/L)
Hematocrit .47 (norm 0.24-0.45 L/L)
MCV 48 (norm 39-55 fl)
MCH 16 (norm 13-18 pg)
MCHC 327 (norm 290-360 g/L)
Platelets 265 (norm 120-600 x10E9/L)

DIFFERENTIAL
Bands 0.0% 0.0 abs (norm 0.0-0.3 x10E9/L)
Neutrophils 58.5% 4.5 abs (norm 2.5-12.5 x10E9/L)
Lymphocytes 30.7% 2.4 abs (norm 1.5-7.0 x10E9/L)
Monocytes 3.5% 0.3 abs (norm 0.0-0.9 x10E9/L)
Eosinophils 7.2% 0.6 abs (norm 0.0-1.5 x10E9/L)
Basophils 0.1% 0.0% (norm 0.0-0.2 x10E9/L)

MORPHOLOGY

WBC Morphology - normal
RBC Morphology - normal
PLT Morphology - normal

ENDOCRINOLOGY
T4 22.2 (norm - 10.0-60.0 nmol/L)

IMMUNOLOGY
Cardiopet proBNP Feline 69 (norm pmol/L)
Interpretation: proBNP measure NTproBNP which is released from heart muscle in proportion to the severity of the heart disease and detects the presence of cardiomyopathy in cats with or without clinical signs. If the reading is <100 pmo/L it indicates that clinically significant cardiomyopathy is highly unlikely.
If the reading is between 100-270 pmo/L it indicates clinically significant cardiomyopathy is unlikely but early disease may be present. Consider repeat NT proBNP in 3 to 6 months or an echocardiogram. If the cat has clinical signs, it is unlikely that these signs are associated with cardiomyopathy,

NOTES
There are signs of renal insufficiency. Diet should be changed to low protein RC MediCal or K/D as well as Fortekor 2.5mg x1 OD

There you have it, the blood work wasn't really bad, he was dehydrated so that could account for some of the abnormal results and there was no urinalysis done due to the fact his bladder was totally empty. He goes back for another check in a few weeks and we'll see how he is then. He had lost 2 1/2 lbs since his last visit so that is a good thing as every bit he loses makes him more likely to improve.
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Last edited by dbg10; July 4th, 2011 at 08:45 PM.
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