Zooey has Kidney problems... :(

[Yzma]

Hi Guys....
It's been a long long time since i last posted...
I moved from Dubai back to kl and brought my kitties with me

We took Zooey to the vet the other day as she was due for a check up for a lump that turned out to just be a fat deposit...

But while she was there the vet noticed she had lost 400gms after being a steady 5.5kg for most of her adult life.

Zooey is 5 this year.

He did a kidney function test and the results were as follows:
BUN 7.1 mg/dl
Creat 247 mg/dl
GBT 39



We are going back in a weeks time to test again to see if the levels have decreased...

Is the BUN level excessively low?

I am currently feeding her the renal diet. She is not drinking a lot....
She eats a little so i have to supplement that with hand feeding her...

How much water should i make sure she drinks per day?

[Traci]

What test exactly did he use? Was a full blood profile done, or did he simply use a pre-screen test with only the two enzymes tested?

We do not measure "GBT" in felines, did you mean GGT or something else?

Is the vet's blood analyzer properly calibrated? Was the blood serum properly handled? Was a urinalysis also done? What other diagnostics were done? Other than bloodwork, what else led him to believe kidney problems? Was one or both kidneys small upon palpation? Is Zooey dehydrated? Anemic? Weak? Was her thyroid checked? Did he do a CBC? Did he rule out acute as opposed to chronic renal disease or renal infection? (i.e., did she get into something, a toxin, etc?) A urinalysis should have been done as an additional diagnostic measure.

Did you mean to put a decimal in the creatinine, such as 2.47?

[Yzma]

Hi Tracy,

we went back again on friday and her creatinine was down to 250... i'm not sure why they didnt give us a decimal point....

they did do a full blood panel this time and there was nothing wrong except the creatinine levels....

we are going back on tuesday to do another test....
meanwhile she is on vitamin b complex and some anti bios....

[Traci]

250 is up from 247.

Can you answer the previous questions?

[Yzma]

Sorry, that was my mistake.
We were down from 247 to 200 on friday when we went in....

I'm not sure about the decimal point...

The vets keep talking to us in micrograms ....

i read this on one site "180 (US: 2.0) rather than at 210 (US: 2.4) as he previously stated. " so i'm guessing that here in KL they read the creatinine in 100's rather than with a decimal point...

we are going back on wednesday for another check/test... as of today she is back to normal... i'm still concerned though... seems odd that she would suddenly get ill like that.

[Traci]

I have no idea what your vet is testing with..if you could post an actual image of the lab results, or the real numbers, that would help.

She was only seen for a lipoma, assuming your vet knows how to diagnose properly. Only a small amount of weight has been lost. So, what is it he is suspecting renal disease? The weekly testing isn't helping if he doesn't know what he's doing. Again, please answer the questions above.

[Yzma]

We took zooey back to the vet yesterday and her creatinine is down to 168.

i double checked with the vet that 168 was for creatinine.
he then said that she was just slightly above normal.

she's now on the renal diet for a further 3 months to see if the level remains the same or comes down a bit...

[Traci]

Yzma, the conventional units for measurement of creatinine are mg/dl (normal range for cats: 1.2 - 2.1). SI units for measurement of creatinine are umol/l (normal range for cats: 106 - 186).

Is your vet using SI units?

[Yzma]

We took Zooey to the new vet for a second opinion today and he did another full blood panel of the kidneys the liver and the plates. Her kidney is back to 1.3 for creatinine... and the vet said that her liver and all the other level were normal ... the only ABNORMAL one was the reading to indicate diabetes. (sorry, cant recall the name) but that was at 157. He said that this is indicative of diabetes which, he said would be consistent with the fact that she is over weight... We are having the blood sent to a lab for a proper diabetes test so we are waiting for the results... I am so glad that her levels are all normal. Is it true that keeping cats on he renal diet causes muscle loss?

[Traci]

The glucose should be tested with blood AND urine glucose, that's the only way to affirm, and a followup blood glucose should be done about a week after the first one.

If she's diabetic, the vet is going to have to reconsider the current renal diet, because the renal diet is restricted in protein.....with diabetes, the diet must have a moderate protein content.

Also, don't attempt to get her to lose weight, on your own, if the vet feels she's obese, then a weight management program should be implemented, but this MUST be done slowly, cautiously, and very carefully. An appropriate diet, amount fed, and mild exercise are important, as well as monthly weight checks by the vet. Too much weight loss too soon or too drastically can cause diabetes, liver disease, etc. You said she had only lost a small amount of weight recently, but was it gradual or was it sudden? Is she still losing weight? If so, diabetes may not be the only thing your vet should be investigating. 5 years of age is a bit young to develop diabetes, although if there was a sudden weight loss, it's possible.

It's not the renal diet that is causing muscle loss, it's an underlying health condition -- UNLESS the diet has been fed long term to an otherwise healthy cat that didn't need a renal diet (since it is restricted in protein). If renal disease is present, then yes, lean body mass/muscle mass can be lost to some degree. Appropriate and steady treatment and proper nutrition can help this.