kitty kidney's

[Guest]

So I just give Rocky the parsley water in his mouth? Really?

[Traci]

Absolutely NOT, not without your vet's direct supervision.

I am not aware of parsely water being effective (let alone safe) for a cat for any reason.....do not attempt this without your vet's advice please. If someone else's vet by chance ok'd this for their pet, that doesn't mean this is appropriate for Rocky nor any other pet without the direct supervision of your vet.

Rocky had many diagnostics done yesterday, reason enough for stress and depending on how long he was under anesthesia depends on the grogginess. Call your vet if Rocky is still exhibiting signs of stress from anesthesia or other procedures performed yesterday.

[LisaLisa]

Maria,

I hope things go well with Rocky....he (and you) are in my thoughts and prayers.

Poor little guy...sounds like he is going through alot...

[Guest]

Thank you guys. Rock is back to his affectionate self again.

Over the next couple of weeks/months I will do my best to make his life as pleasant as possible! He is my bud.

Thanks again for all of the response/concern.

Traci, if anything changes I will keep you posted.

Maria

[Guest]

I do need some more advice. I wanted to start taking Rocky to the vet I saw at the University. He seemed to know a lot and I felt comfortable with him. Rocky's original vet called today to talk about Rocky's prognosis and to see if I had questions. When I mentioned that the University vet wanted to monitor Rocky's blood pressure and urination, he said that it was unnessary for me to continue with the University that he could perform all of these things and thinks Rocky would be better off in his care. The University put Rocky on a low-protien diet, but his original vet thinks that he should be on the low magnesium diet to manage crytals. I thought since I was administering fluids, Rocky's intake of water was much greater.. making his urine clearer.

I want to do what is best for Rocky. At this point I am very confused. His original vet thinks that Rocky had the start of renal failure all along and it is just starting to progress (he thinks it was an underlying problem). The university vet feels that with what Rocky has been through in the last couple of months (surgery to remove stones, tear in his urethra) is the cause of his early kidney problems. I know that when Rocky was in the hospital for those 10 days, his kidney levels were normal, not until they took out the cathadyr did the problems get worse.

Do I continue with his current vet who knows Rocky's history or do I take him to the new vet who has more experience and a different perspective on things?

[Traci]

Maria, I think the first thing I would do is ask your vet why he feels you should not be working further with the university, don't settle for his comments that he could be "doing the same" procedures or diagnostics, gauging by your posts, he didn't and couldn't earlier. Not to say your vet is wrong, or didn't do the right thing, but he did consult with the university on your behalf, and he did recommend the ultrasound done by them. I can't speak for your vet because I don't know what he's thinking, if he feels toes were stepped on (sometimes a thorn in a vet's side) or if he is genuinely concerned and feels confident he can treat Rocky appropriately.

For this reason, I would urge you to trust your instincts. You said you were comfortable with the new vet, and felt he was more experienced. If the new vet truly has more experience and knowledge in feline urology and nephrology, then by all means, utilize his services, after all, that would be to yours and Rocky's favor for treatment. If you choose the new vet, simply tell your current vet that you feel you want to get all opinions on Rocky's case and your vet ethically has no reason to discourage you. There's no harm in having both opinions, and your vet should be happy to remain your current vet for other intents and purposes.

I can see how the new vet recommended a low protein diet as opposed to the oxalate management diet prescribed by your current vet. But, the problem seems to be that neither vet can confirm either way IF this is renal disease or not. One thing that comes to mind is the potential of polycystic kidney disease, was this ever mentioned by either vet? This is a condition that affects the kidney function, in that, cysts or a number of cysts, variable size, etc are filled with infection and will indeed alter renal function and would probably alter lab results. Since most of the values at least reached normal at some point, polycystic kidney disease would be one thing I would be discussing with both vets right away in the event it was missed or not ruled out.

It could also be you have a multiple condition going on. That being a ruptured urethra due to the initial blockage (and going by your current vet's assumption it was ruptured, torn) that is causing inflammation and excess scar tissue, or, that there is still a stone higher up in the urethra that must come out. Again, if dietary management is not dissolving this crystal (if in fact it exists), then both vets are obligated to try another diet to see if it will help. The culture might give you a better idea, as well as taking a closer look at the urine pH. You said the second vet saw a stricture in the urethra, but how did he classify it.....did he indeed think it was a stone, or did he think it was scar tissue or inflammation?

When I say multiple condition, it could be a combination of urethral tear combined with early renal failure, and one could be unrelated to the other. The important thing is managing the crystals and confirming one way or another if renal failure is a concern. Lab work should be telling your vets the latter, they might also test again using the feline ERD test (not 100% accurate, but may be helpful in this case).

For now, discuss potential polycystic kidney disease, at least get it ruled out....ask both vets their opinion about using the ERD test, if possible, ask the second vet if he feels the low protein diet is more warranted at this point as opposed to the oxalate diet, or ask for a suitable happy medium. I'm assuming the second vet wants to try the low protein in the hopes it will alter the kidney enzymes upon the next recheck on bloodwork. On the otherhand, you can't risk Rocky blocking again, so it's important to find that happy medium and initiate the correct diet for the purpose.

I can understand how confusing this must be for you, but I think it's important to trust your instincts, act upon them, and don't be afraid to utilize both vet's opinions in the form that will best benefit Rocky. Be thorough in your questions of both of them, then weigh the options. Whichever vet seems to be more experienced, genuinely concerned, and able to answer your questions in detail would be the one I would utilize foremost.

[Guest]

Wow Traci, I must say I appreciate all you have done for me and Rocky. You've really helped me make some tough decisions for a very stressful situation. You are very dedicated.

I met with my existing vet and told him at this point I am going to have Rocky see the specialist but would like his input. Rocky goes in this Thursday to have blood pressure checked and also to make sure when he urinates he is emptying his bladder. He actually agreed that he felt more comfortable having a second opinion because during the whole situation he was uncertain.. there's my answer about which vet.

The 2nd vet did not see any more stones when he ran the ultrasound. He does think the stricture is scar tissue. I am going to ask at his appt. about polycystic kidney disease. This could be a possibility.

As for diet, I was reading the label on the canned food the 2nd vet is having me try out. It did say that not only was it for kidney's but also management of crystals. I am going to bring up this topic, after all it is an ongoing problem for Rocky.

Thanks again for the advice/knowledge.

maria

[Traci]

Maria, just want to make note that there are only a few veterinary diets that are formulated for oxalate crystals and can be used for kidney disease. The remaining diets specifically are for one or the other, and it is SO important to note the diet is for managing oxalates rather than struvites. Again, I am assuming your vet has indeed diagnosed the crystals as oxalates, can you please humor me and confrim that...

Don't want to confuse you, but there is a large difference in managing oxalates as opposed to struvites when it comes to the diet. I'm sure the university vet has prescribed the appropriate diet, I just prefer that is established here (for my peace of mind).

[Guest]

Correct, they are oxalate. The food I noticed it on was the purina NF kidney function. It states it is for kidney failure, congestive heart failure and history of calcium oxalate stones.. although Rocky is not a big fan of the food... I will email after I meet with the specialist tomorrow.

thanks