second update on Sebastian- renal insufficiency

[Maggiesmom]

My vet just called with the blood test results...not as bad as he was expecting. He did say Sebastian was in renal compromise. He stressed "renal insuffiency" rather than "renal failure", although he said his kidneys are operating at less than 25% (which sounds pretty bad to me). He suggested Sub-Q fluids at home every second or third day for about a month and go from there.

As for the arthritis, he is reluctant to try any anti-inflammatories in light of the kidney problems. He recommended Tramadol liquid for pain relief at a low dose.

I'd like to know what to expect in the short and long term. What questions would be suitable to ask the vet when I take Sebastian in for them to show me the Sub-Q procedure?

[slvrwhispr]

I'm not sure there are any UNsuitable questions. Others with more experience can probably mention some things you might not otherwise have thought of, but my best advice would be to make sure you DO NOT leave the office until you feel completely comfortable with the procedure. You don't want to get all the way home and then not be totally sure of what you're doing.

[Maggiesmom]

I want to know of suggestions of any questions in general, not only the procedure. I really do want to knwo how to assess quality of life for him.

[Maggiesmom]

In my haste to post initially, I neglected to add Sebastian's lab values. I apologize. Here they are:

BUN: 42 (14-36)
Creatinine: 3.3 (0.6-2.4)
Phosphorus: 4.5 (2.4-8.2)
Potassium: 4.7 (3.4-5.6)
Calcium: 10.4 (8.2-10.
Hematocrit: 35 (29-48)


Other values out of the normal range were:
Sodium: 159 (145-158)
Amylase: 1585 (100-1200)
Platelet count: 164 (200-500)
Lymphocytes: 602 (1200-8000)


Thanks again for any input.

Kristin

[Traci]

Ask your vet about risk for anemia, the hematology may be a bit concerning, did your vet adress this at all? Did he address appropriate dietary restriction with you? (i.e., low protein diet, veterinary-prescribed)

Are you sure your vet didn't mean 25% loss of renal function? While renal failure is typically indicated with around 75% loss of renal function, I'm a bit confused with your vet's comments there. Both renal insufficiency and renal failure can be treated, that is, to slow the progression of the disease (not cure)...it depends on the cat, age, concurrent health status, or secondary conditions that make it a bit more difficult to treat. If this is early renal disease, you may have caught it early enough to treat for the long term, giving Sebastian a good quality of life.

Sub-q fluid therapy is relatively easy to do at home. My best advise is first having your vet or his tech show you the procedure, have you practice once or twice at the clinic, determine your comfort for the procedure, and take it from there. The key is appropriate needle size, easy flow of the fluids, and keeping kitty comfortable during the procedure. Your vet will tell you more, but as slvrwhispr mentions, don't leave the clinic without having all your questions answered (jot down notes before the appointment). Also, your vet will want to monitor Sebastian's bloodwork in another couple weeks or a month, to determine if improvement is being made, etc.

Don't fret about anti-inflammatories, but do discuss the option for Cosequin (it's not an antiinflammatory, not like an NSAID)...it is safer than antiinflammatories.

[Maggiesmom]

Thanks, Traci. We are going in Saturday so my vet can show me how to do the fluids. I only spoke to him on the phone regarding the test results, so he very well may have said 25% loss instead of meaning 25% function left. I will clarify that with him. I can also ask about the threat of anemia. We are also going to discuss diet. Do you think he should be on a special diet for kidney problems?

As for the Cosequin for cats, it arrived today in the mail (ordered it a few days ago). My vet agreed it would be good for him, so I started him on it tonight.

Thanks again,
Kristin

[Traci]

Caution on the Cosequin, please make sure it is from a reputable retailer. Also, the doseage varies, so let your vet look at the product and determine the appropriate dose for Sebastian. He may suggest starting at the high dose and if improvement is noted at some point, he may suggest to decrease the doseage for a maintenance dose.

Most renal-impaired cats fair much better on a restricted low-protein diet, I'm surprised your vet didn't suggest this immediately. There are several veterinary diets for this purpose.

[Maggiesmom]

Thanks, Traci. He did mention diet briefly on the phone, but said we will discuss everything in detail when we go in for the Sub-Q fluid lessons.