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Old October 15th, 2009, 02:05 AM
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Quote:
Originally Posted by Tommy Cuddles View Post
Hey everyone. Sorry for the delay. We had taken Tommy to the vet. He hadn;t looked good at all. We did blood work, see results below. The vet thinks something is wrong, but tommy is to weak to have any tests done and even then what can be done to treat. We have started on sub-q fluid and he seems to perk up after and even eats hi shard food. He is still only licking his soft food. We are also syrige feeding him. He has probably gained 1/2 pound since monday. Here are the results of the blood work. The glaring thing is his iron levels. Also, can anyone answer why his CRF levels look great, especially his creatin levels.
Since he's visibly perked up & ate after the fluids that shows he was definately dehydrated.

Creatinine is a waste by product of muscle mass and is less affected by diet, stress and dehydration than the BUN is, however if BUN levels are high and creatinine is only slightly elevated, it usually means the cat is dehydrated, has gastro-intestinal bleeding, or is eating a high protein diet. Since creatinine is produced in the body, and does naturally increase with the increase in muscle mass, one possible reason for the drop is a loss of muscle mass. See more below


Quote:
Originally Posted by Tommy Cuddles View Post
ALK Phosphate - 17 (0-62)
ALT - 28 (28-100)
AST - 28 (5-55)
Albumin - 3.5 (2.3-3.9)
Total Protein - 7.6 (5.9-8.5)
These numbers all look good.

Quote:
Originally Posted by Tommy Cuddles View Post
BUN 46 (15-34)
Creatinine 1.4 (0.8 - 2.3)

THe weird thing is the creatinine, which 3 months ago was 2.2.
What was the BUN on the last test?

Here are a few reasons that may explain the drop in creatinine:

Quote:
http://www.felinecrf.org/diagnosis.h...creatinine_low
If BUN (urea) levels and phosphorus levels are high yet creatinine is normal or only a little elevated, it can mean that there is a pre-renal factor at work, for example:

the cat is dehydrated;

the cat has gastro-intestinal bleeding;

the cat is eating a high protein diet;

the cat has severe metabolic acidosis; or

in some cases it may indicate heart failure.

In end stage CRF, creatinine levels may fall (although this is pretty rare). This occurs because creatinine is a by-product of muscle, and towards the end CRF cats may lose a lot of muscle, and therefore cannot produce as much creatinine.
Has Tommy Cuddles lost more weight in the last 3 months or lost muscle mass? That is also one possible explaination for the creatinine dropping.

Amlodipine does have the very rare side effect of raising renal blood values, though given that it relaxes the muscles in order to allow the arteries to dilate passing blood faster & there by reducing blood pressure, I would speculate that is might also have a slight lowering effect on creatinine given that the muscles are not working quite so hard to push blood through

Quote:
Originally Posted by Tommy Cuddles View Post
Glucose 195 (70-150)

Calcium 9.8 (8,2-11.5)
TCO2 (bicarbonate) 27 (13-25)
B/C ratio 32.9
High glucose is common in cats that get very stressed at the vets, however it may also indicate secondary hyperparathyroidism - not to be confused with hyperthyroidism.

What's the phosphorus level?

Quote:
Originally Posted by Tommy Cuddles View Post
RBC 5.32 (6-10)
HGB 6.5 (9.5 -15)
HCT 22.2 (29-45)
These numbers are indicative of anaemia http://www.felinecrf.org/anaemia.htm#why_anaemia

Did they check the reticulocytes level when they did the blood test?

Has the vet raised the possibility of pancreatitis? When the creatinine is normal or fairly low ~in the 2s~ but the cat is more lethargic or showing symptoms of being sicker than mild kidney failure would, you should consider the possiblility he might also have pancreas issues. Amylase and lipase can indicate pancreas issues but they are not necessarily reliable for diagnosis http://www.manhattancats.com/Article...itis_test.html
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