Early Stage Kidney Failure in Cat

[growler~GateKeeper]

My mum also thought it was pretty funny me being dragged up into & through the large raised planter thingy so Duffy could pee right in the middle by the tree instead of allowing me to walk around it to the other side

[growler~GateKeeper]

In late January Duffy had been showing some signs of a UTI just 2 weeks before her scheduled 3 month kidney recheck on 7 Feb so in for a visit she went, UTI confirmed through urinalysis and a culture & sensitivity test, given her history of kidney disease the lab vet had questioned the possibility of pyelonephritis (kidney infection). Pyelonephritis can happen as a result of, among other causes, a bacterial UTI ascending into the kidneys. Pyelonephritis is a bit tougher to overcome than a UTI but far more so for one with already compromised kidney function. She was given a homeopathic remedy of Phosphorus which started working right away, as the next morning she was no longer peeing little bits every ten minutes Within a week and a half she was only showing a couple of signs that the UTI was still present.

A few days later during Duffy's 3 month kidney check we ran bloodwork and another urinalysis with a culture if indicated, the inflammation showed as still present so a C & S was done again and the lab vet still had the question of pyelo, with an ultrasound as the only way to diagnose. Once the lab results came in & I spoke to my homeopathic vet, he mentioned again having the ultrasound done and I got his recommendation for the antiboitic he would use of the 5-6 the E. Coli was shown to be sensitive to. The amount of bacteria present was still listed as the same but the WBC in the urine had dropped significantly (from 40-60 down to 3-6) after the remedy.

Since being on Azodyl starting December 2009 Duffy's blood kidney numbers have dropped nicely BUN went from 17 in Nov to the current 13 *she's only 0.5 above the high normal for this lab 5-12.5* and her Creatinine (which is the one that is harder to get to drop because it is not affected by diet, stress or dehydration) went from 243.4 in Nov to the current 235 (ref for this lab is 83-181)

Her USG number can't be considered accurate at this point because of the urinary inflammation as that affects the reading.

Also urinary inflammation with sepsis a "generalized inflammation" noted in the comments, which is reflected in the ultrasound results below.

I got her for an ultrasound in the day after getting the tests results in, the good news is there is no indication of pyelonephritits , definate inflammation in the urethra (UTI). There is also some localized thickening/inflammation in the ileocolic (beginning of the colon) region which will need to be watched for the very early potential for cancer - but it is not right now. As well her pancreas, liver and gallbladder are showing some signs of mild inflammation. Mild chronic changes in her kidneys, but they look pretty good overall. She'll go in for a repeat ultrasound in 2-3 months to check on the status of the various points of inflammation & progression of the kidneys etc.

After the ultrasound they didn't even bother to offer a litterbox as they all know by now Duffy won't use the one in clinic. I took her outside on leash & harness to the lot to go, there was a guy walking across the parking lot & asked "how is kitty today" so I said "she's doing pretty good" I was a bit surprised when Duffy walked towards & right upto him & stretched her nose up to say hi He then complimented her on her colouring & went on his way, after which she did find an acceptable spot to pee

Duffy was given a remedy of Thuja which is good for cancer, I have also found out that it is good for urinary inflammation among other things. I also asked for a prescription for Clavamox, the antibiotic that was recommended by my vet for the UTI to ensure the bacteria doesn't rise into her kidneys in the near future. Unfortunately the vet (not my regular) who called in the script to the pharmacy didn't know it comes in pill form - as a vet working with homeopathy as a primary modality antibiotics are not often used, so I got raspberry/orange flavoured liquid Clavamox to give Duffy. Duffy being the she is, is tolerating it remarkably well providing I syringe it directly down her throat, not into her mouth (which causes profuse foaming, drooling & vomiting) & of course I must treat profusely afterwards

A note to anyone who has to give antibiotics to their cat, it doesn't matter how hard your cat is to pill - trust me the kid-flavoured liquids will be a far worse experience for them, unless your cat is really weird .

There are no contra-indications of using the combination of homeopathic remedies along with antibiotics so she has both modalities working for her right now. Duffy's on Clavamox for 14 days with a repeat urinalysis at day 10 (next Wed) to check if the bacterial infection is cleared up . If not we'll likely repeat a remedy and extend the Clavamox prescription.

[Love4himies]

Wow, so glad to hear that Duffy's numbers are down a bit , way to go mom

Could the slight inflammation in her organs be due to the UTI?


Duffy the doggy like kitty I can't believe she will pee outside her vet office and greet strangers

[chico2]

Growler,Duffy must be an extraordinary girl for sure as are you,I wish my cats were only half as good at the vet.
our beautiful Duffy will be ok.

[hazelrunpack]

Other than the anomalous inflammation, those results are just amazing, growler! Those numbers are absolutely remarkable!

Good work, Mom! And good work, Duffy!!!

[growler~GateKeeper]

Thanks L4H, Chico & Hazel

Originally Posted by Love4himies

Could the slight inflammation in her organs be due to the UTI?

That's what I'm hoping the reason is and that the Clavamox in combination with the Thuja will stamp out all the inflammation

[Chris21711]

Growler you take such great care of Ms Duffy, the numbers are sounding good

[growler~GateKeeper]

Thanks Chris, yeah I'm pretty happy about the numbers & the ultrasound report has only mild chronic changes in her kidneys so fairly good there too

[growler~GateKeeper]

Duffy went in on Wed 24th (day 10 of ABs) for a urinalysis & culture to check if the Clavamox had cleared the bacterial UTI or if she needed to be on for longer than the prescribed 14 days.

I got a call tonight from the vet, her USG has risen which is great I don't have the actual number but will get it tomorrow and the bacteria has cleared up and nothing grew in the culture .

I asked if she should continue the Clavamox until tomorrow night as that would make it the full 14 days or if she could stop with the last having been this morning (day 13 am). Dr said stopping now was good, just keep watch that it doesn't re-occur and to bring her back in 4 weeks to recheck her urine just to be sure, plus that will test her USG again which was quite low w/the UTI.

Often conventional vets will put a CRF cat on a course of 4-5 weeks of antibiotics to clear up a UTI instead of the usual 2 weeks to ensure there is no relapse infection as the bacteria found in UTI go through a dormant stage often returning as a relapse. I think the Phos remedy Duffy was given should take care of that as it had also started working right away & remedies are long acting correcting the imbalances at the root of the issue.

Duffy has also gained 0.3kg in the week & a half since her ultrasound which is great . She's currently at 5.3kg / 11.68lbs, she is a bit chubby but it's a better weight for her than 5kg, plus it gives her a bit of wiggle room should she lose a bit of weight again, she is also still eating great. It is so hard for most CRF cats to gain any weight at all & they just get thinner & thinner as they eat less & less

[chico2]

Growler,although I don't understand most of the test-results,I am really happy for Duffy and you that she's doing better

[Love4himies]

I am so happy for you and Duffy . She has proven to be quite the fighter and not allowing that horrible poisoned food to overcome her. Of course it helps to have such a great mom and vet

[hazelrunpack]

Great results, growler! I hope the USP continues to go up! She's doing so well!

[Chris21711]

GREAT NEWS Growler

[growler~GateKeeper]

Duffy had a recheck urinalysis on 21 Mar 4 weeks post Clavamox to ensure the bacterial infection has not returned, and as I had suspected starting the 18-19th (less appetite, frequent litterbox visits) the infection has re-occured She had lost weight from last month & was 5 kgs. Once we got the confirmation there was bacteria in the urine the lab cultured it, and Duffy was given her usual monthly remedy Nat Mur (as it was time and also) to ease the UTI symptoms. Once the C&S results came in 24 Mar confirming once again it's e.coli Duffy was given a dosing of Phosphorus to counter the infection as it had helped before and I was given a nosode/remedy pair to give in sucessive treatments.

A nosode differing slightly from a regular remedy (prepared from herb/plant/flower etc) as nosodes are originally prepared using cells from which they are fighting but given the amount of dilution there is no risk of infection from the nosode itself. Morgan Bach being the e.coli Nosode given for 2 days, followed by 3 days of Cantharis (remedy for bladder infections etc) definately not showing signs of UTI at the moment . A recheck urinalysis is set for Thurs 8 Apr., 1 week post remedies.

I also got a call from the clinic regarding the ultrasound in Feb as it was stated to repeat in 2-3 months, the ultrasound vet was coming in on 3 Apr & wouldn't be back again this month. My vet really wanted Duffy in to check on the aforementioned "suspicious inflammation" areas, so I booked & in we went on Sat. Again I was able to sit in on the procedure, ask questions, get instant feedback from the ultrasound vet etc. I think all clinics that offer ultrasounds should have the clients in the room.

Duffy has lost more weight due to inappetitance and nausea and is now 4.7 kgs where she really should be 5.3 kg a bit chubby but that is a good weight for her frame/size. She is being finger fed/assist fed, tempted with yummy cooked chicken, it's hit & miss as to whether she will eat on her own right now. I've picked up a couple of small cans of Wellness Chicken and Turkey went over good when I first opened the can she will at least be inclined to eat that on her own for the most part.

So for the ultrasound results:
The inflammation in the area where the bladder meets the urethra is unchanged, which is good in the aspect it's not cancer right now and I asked the ultrasound vet if that is a common area for cancer she said not in cats, it is very common for dogs to get it there though. She suspects that area is just irritated from the UTI, pee sitting in her bladder, frequency/straining during the 2 UTIs. Her urine is also not concentrated, given the CRF, so there is a higher chance of bacterial growth as opposed to normal highly concentrated urine.

The ileocolic region where the colon meets the illieum/intestines has a distinct tumor and the adjacent lymph node is also inflamed The liver, spleen and their adjacent lymph nodes are markedly inflamed

Kidneys, pancreas, small intestines, stomach, bladder vary between little chronic change (known CRF, IBD, possible cholangiohepatits with mild periportal lymphadenopathy as per last US) to no change.

Diagnosis is lymphoma, cancer of the lymphatic system. Lymphoma and more specifically gastro-intestinal lymphoma is the most common cancer in cats.

I will be at the vets on Tues to pick up a copy of the ultrasound report and new cancer fighting remedies, Duffy's 2 homeopaths & 2 vets will confer regarding treatment.

Little eating victory today took her out to the back courtyard of the apt bldg for a wee leash 'n harness walk as I've done a couple of times now these last couple of weeks (weather permitting) & she willingly ate more of the canned food in her dish without any prompting at all, she does get a bit tired coming up the stairs & on the final stretch in the hallway but that's expected. She looks much better after eating & being out in the fresh air walking about a bit


There is some suggestion of a link between the inflammation associated with IBD and lymphoma http://www.vin.com/proceedings/Proce...2980&O=Generic

One well-recognized, but poorly defined, example of inflammation-associated neoplasia is the proposed progression from inflammatory bowel disease (IBD) to alimentary lymphoma. This progression is documented in human patients with coeliac disease, and although reported in both the dog and cat, this appears to be far more of an issue in the feline species. In fact, the distinction between IBD and alimentary lymphoma on histopathological examination of gut biopsies still provides one of the most challenging interpretations for the diagnostic pathologist

A bit off topic but along the Lymphoma lnes ~ I do not smoke but thought I'd add this in as there have also been studies linking passive exposure to cigarette smoke and the development of lymphoma in cats and a change in normal cancer behaviour to affect areas other than the lymphatic system. All the more reason to ensure people are not smoking around pets.

In the context of lymphoma, a recent epidemiological study has suggested an association between passive exposure to cigarette smoke and the development of feline lymphoma--which if confirmed may be an additional example of inflammation-associated neoplasia.6 It is also of note that feline lymphoma may arise in tissues which are often affected by chronic lymphoplasmacytic inflammation (e.g., nasal mucosa, intestine, renal interstitium)

[Love4himies]

Oh no, growler . Duffy is such a little fighter so I am sure she will fight this too

[chico2]

Growler,that was a lot to read and try to understand,but very thorough..
I know there is really no"safe"cancer in catsbut if anyone will have a chance to recover it's little Duffy and I for you and Duffy

[diandpat]

Growler, for you and Duffy. If there is a way to get through this, you and your always thorough research/knowledge will find the way.

All the best

[14+kitties]

Sending lots of for Duffy and lots of for you.

[hazelrunpack]

More and s coming your way for both of you, growler!

[mikischo]

Sending more for Duffy and for you, Growler.

[rainbow]

Duffy has the best mommy in the world.

Lots of coming from the rainbow house as well.

[krdahmer]

Originally Posted by rainbow

Duffy has the best mommy in the world.

I have to agree there!

You've got me and all the kitties sending you and Duffy all our too.

[TeriM]

Another vote here for best mommy .

I wish you all the best healing vibes and loving thoughts to help you and Duffy.

.

[growler~GateKeeper]

Thank you everyone for your good wishes Duffy & I do appreciate them.

So instead of going in today I spoke to the homeopath on the phone & we are repeating a remedy I've used before for nausea/vomiting etc she'll get a divided dose of Nux Vomica today/tomorrow as that did have positive effects over the weekend and in the past for her, it's also very complimentary to the cancer remedies we will use.

Tomorrow will be another phone call to the clinic to give an update and then going in on Thurs for the cysto UA as previously mentioned to check for bacterial clearance. At that time I can pick up the cancer remedies & ultrasound report. The tumor doesn't appear to be a fast growing one so we have a couple of days to try to boost her appetite first.

A little tour of the back/courtyard again tonight proved to wake up her appetite a bit, she still isn't eating as much as I would like but she is doing so on her own

[chico2]

Growler,I would think Duffy,unlike my guys,is getting used to vets and poking,so not too stressful for her,although she's been through a lot.
She's kind of a mascot for overcoming problems for us here,so I she'll be able to fight this hurdle too

[growler~GateKeeper]

Thanks Chico, Duffy is very used to being poked as she gets fluids nightly at home, as for the vets ~ it's a homeopathic clinic so the environment & atmosphere is totally different from that of a conventional clinic.

Duffy's also at a point in her life where very little phases her, for example I brought her in today for a cysto to check on the uti (unfortunately she peed in her carrier when we were about 10 mins away, she just couldn't hold it any longer ), I had Duffy leashed & harnessed out of her carrier to clean up the mess & there was a shepherd mix in the clinic who was continually barking at her, he couldn't figure out why this cat was paying absolutely no attention to him, she wasn't even looking at him and the lady's 3-4 year old son came over & very gently pet the top of her head, it was quite cute as he was telling the dog not to bark at the kitty.

A few minutes after they left, a lady came in with her very calm Dogue de Bordeux they had to walk right past Duffy in order to come in the door as she was sitting infront of it - didn't phase her in the least

Of course Duffy did grow up with 2 large dogs, then later in adulthood had another large dog buddy but it has been 6 years now that she's had any consistant contact with a dog.

All in all I did pick up her remedies for the lymphoma treatment which we started today and the ultrasound report, she'll be back in on Sat for a try again at the cysto.

[hazelrunpack]

Bummer about the timing for the cysto! She'll probably enjoy being out and about again on Saturday, though, even if it's an extra trip.

When will you start the new treatments?

[growler~GateKeeper]

She was awake for the whole bus ride out there today so I guess that made her more aware of the need to pee. I'll get a truck ride on Sat & we'll be in an hour earlier than today so that'll help.

Started them already she'll be alternating between 2 remedies one per week.

On the way home I took a bus from the clinic to the bus loop to wait for the next bus, at the loop Duffy was getting a little antsy as she'd been couped up for a bit - so I took her out & she saunters around part of the bus loop like she owns the place bunch of people walking by were smiling at a leash/harnessed cat just wandering about not a care in the world No unfortuately no pics I only had 5 mins before the bus came

[hazelrunpack]

Bummer about the pics. You gotta do better next time, k?

How did she eat after her big trip into the excitement of the bus loop?

[growler~GateKeeper]

When we got home she had a bath to fully clean off any remaining pee, then she got fed in the sunshine, she did fairly well at first for licking off my finger after I smooshed some onto her mouth, after a bit she would just lick it off her mouth, then I had to resort to force feeding her the rest to make sure she gets enough food for the day.

Left her alone for a few hours to snooze & she came looking for dinner & her supplements. She acted like she was going to eat on her own, but still required finger feeding at first, same as earlier in the day ending with a bit of force feeding. Though she isn't pleased being force fed she does put up with it without fuss/stress & the more she eats the better she feels.

The ultrasound report showed mild hepatic lipidosis as she hadn't been eating sufficiently that week - which is where she lost the weight, it's imperative that she eats. Now that I'm on holidays I can ensure she eating in the middle of the day instead of sleeping right through as she had evidently been doing when I was at work.