Razzeratz is going to the vets today

[Auntie Debbie]

Nope, no insert. Just instructions to administer every twelve hours. So far he's doing well; just getting vetry uncooperative comer med time, LOL! I'll let you know tomorrow how he's doing. Thanks for your help and concern.

[Auntie Debbie]

i just got back from the vets for Razzeratz HyperT retest. I'll get those results on Monday. I also had them do the blood pressure test and it was 135/140...Traci what is considered normal for both healthy and a Hyper T kitty?

[Traci]

Systolic range from 110 to 160 mmHg and most diastolic range from 55 to 100 mmHg. Hypertension is defined as pressures > 170/110 mmHg. HypOtension can be pressures < 90/50 mmHg in resting state.

But, as always, this is just a guide, every cat is different with different stress levels when at the clinic. I think I'd talk to your vet about Razz' levels and ask what their opinion is at this point.

[Auntie Debbie]

The tech said it was considered good. Systolic would then be in a good range, but the diastolic is off the range considered good. What would that be considered as then?
I will ask the vet on Monday when I call fort the blood results, but in the meantime, what do you make of it?

[Traci]

It is the systolic you usually need to be concerned with most, if it goes over a range of say, 160-180 or even higher, with the diastolic higher than normal as well, then this should be considered hypertensive (taking into account conditions like heart problems or renal failure could be contributing). A high diastolic might be around 120 or so.

But, these values can naturally increase in an otherwise normal and healthy cat at or over the age of 14, due to age. When there is suspicion for hyperthyroidism, renal disease or heart disease, then you need to test and monitor blood pressure on a regular basis. Hypertension can also lead to blindness if not detected early on, monitored or treated appropriately. Sometimes the blindness is temporary and may resolve with treatment.

Ideally, the blood pressure should be measured at least 3-5 times consecutively at the time of the appointment, with 30 or so seconds between readings. You'd take the highest and lowest, discard them and use the median value. Then, you'd want to do this again a week later to determine accuracy. In any condition like hyperthyroidism, renal and heart disease, this should be monitored on a regular basis providing they are in a consistent range, and anytime the cat is on medication treatment.

Also of value would be a feline opthamologist exam. This enables you to keep an eye on retinas, hemorrhage, potential for blindness if hypertension is diagnosed.

I think on Monday, I'd call your vet (he/she should be calling you anyway to discuss the bloodwork results), and discuss getting another appointment to recheck the blood pressure as I described above. It's best to have a consecutive measurement in the initial blood pressure measurements, combined with Razz' thyroid retesting to get an idea of exactly where the blood pressure value is. Also during the appointment, you also want heart rate checked, because if it's racing, this could affect the blood pressure. This is why you want several measurements, the blood recirculates, and the cat eventually calms down, thereby giving you a more accurate reading. If the heart rate and blood pressure stay in consistently high ranges, then you'd want to listen for murmurs, gallop rythms and check heart function (ECG and xrays). Hopefully, it won't come to that.

[Auntie Debbie]

Thank you Traci, but just exactly what does 135/140 get me? Seems the 135 is in a good range but the 140 should be considered high???

[Traci]

That's why you need to have more than one measurement in a single appointment. I don't know who did it, or how, but technique and not waiting to try again for another (to allow circulation to return) reading can be very faulty. Maybe the cuff wasn't in the correct area, maybe the pressure was too high. How come your vet didn't talk to you about this when you were there? He should have, and should have told you what Razz' heart rate was too, so he could assure you everything appears normal.

[Auntie Debbie]

I just got Razzeratz blood results and spoke with the vet.
First, the blood pressure was done several times and he said the 135 was perfectly normal and given the stress he was under being at the vet the 140 was considered normal too.
He is concerned about the BUN and Creat though. I told him that I have been noticing he has been drinking more, has made that grinding noise a couple of times again. So we are going to have him retested in a monthk only then it will be for his kidney function as the main concern. The HyperT came out good.
His dental is on hold until we are more sure about what's going on with his bloodwork. He is eating just fine.

Here's his results...the=XX numbers are from last time, the numbers in ( ) are from Friday, and the numbers in @ @ are their reference range. Notice how some besides the BUN and Creat fluctuate and if you can Traci, please tell me what it all means. The vet said the other fluctating ones would be considered normal too, due to stress????

=XX from 3/18, (XX)from 4/4 @xx-xx@ is their reference range

T4-result=6.8 (0.5) @0.5-5.8 ug/dl@

CHEM 21 with Comprehensive CBC/CHEM 21

ALK PHOSPHATE=25 (12) @0-62U/L@
ALT (SGPT)=50 (52) @28-100 U/L@
AST (SGOT)=25 (37) @5-55U/L@
ALBUMIN=3.3 (3.0) @2.3-3.9 g/dl@
TOTAL PROTEIN=7.7 (7.3) @5.9-8.5 g/dl@
GLOBULIN=4.4 (4.3) @3.0-5.6 g/dl@
TOTAL BILIRUBIN=0.1 (0.0) @0.0-0.4 mg/dl@
DIRECT BILIRUBIN-0.0 (0.0) @0.0--.2 mg/dl@
BUN=43 (42) @15-34 mg/dl@
CREATINE=1.9 (2.8 ) @0.8-2.3 mg/dl@
CHOLESTEROL=190 (152) @82-218 mg/dl@
GLUCOSE=103 (109) @70-150 mg/dl@
CALCIUM=10.0 (9.6) @8.2-11.8 mg/dl@
PHOSPHORUS=4.5 (4.3) @3.0-7.0 mg/dl@
CHLORIDE=117 (121) @111-125 mEq/L@
POTASSIUM=4.3 (4.4) @3.9-5.3 mEq/L@
SODIUM=157 (154) @147-156 mEq/L@
A/G RATIO=0.8 (0.7) 0.4-0.8@
B/C RATIO=22.6 (15.0) @blank@
INDIRECT BILOIRUBIN=0.1 (0.0) @0-0.3 mg/dl@
NA/K RATIO=37 (35) @blank@
HEMOLYSIS INDEX=N (N) @blank@
LIPEMIA INDEX ++ (+) @blank@

CHEM 21 WITH COMPREHENSIVE CBC/CBC COMPREHENSIVE

WBC=5.7 (6.5) @4.2-15.6 THOUS./ul@
RBC=7.37 (7.03) @6.0-10.0 MILLION/ul@
HGB=11.6 (10.9) @9.5-15 g/dl@
HCT=33.2 (34.2) @29-45%@
MCV=45 (49) @41-58 fl@
MCH=15.7 (15.5) @11.0-17.5 pg@
MCHC=34.9 (31.9) @29-36 g/dl@
NEUTROPHIL SEG=40 (79) @35-75%@
LYMPHOCYTES=52 (12) @20-55%@
MONOCYTES=2 (3) @1-4%@
EOSINOPHIL=6 (6) @2-12%@
BASOPHIL=0 (0) @0-1%@
AUTO PLATELET=370 (435) @170-600 THOUS./ul@
POLYCHROMASIA=SLIGHT @blank@
ANISOCYTOSIS=MODERATE @blank@
REMARKS=SLIDE REVIEWED MICROSCOPICALLY
ABSOLUTE NEUTROPHIL SEG=2280 (5135) @2500-12500 /ul@
ABSOLUTE LYMPHOCYTE=2964 (780) @1500-7000 /ul@
ABSOLUTE MONOCYTE=114 (195) @0-850 /ul@
ABSOLUTE EOSINOPHIL=342 (390) @0-1500 /ul@
ABSOLUTE BASOPHIL=0 (0) @0-100 /ul@

[Traci]

The results look good to me, Debbie, but wonder if a urinalysis was also done? Was he slightly dehydrated before the blood draw?

While the BUN appears high, it may not be cause for alarm at this point, because the creatinine is still within normal range, but you DO want to keep an eye on both. It's also possible the hyperthyroid is causing the BUN to elevate.

Yes, you will often get fluctuating values when re-testing, it's impossible to assume the values will remain the same, but as long as they remain in normal range (which as you can see, is a wide margin), the fluctuations usually are of little significance, unless it is a particular enzyme or group of enzymes that relate to specific organ function (like liver or kidney or heart). The increased water consumption might be concerning, and next month, I would suggest you also get a urinalysis included with the kidney profile. If the water consumption continues or increases, don't wait until next month, at least get a urinalysis done to rule out potential developing infection, and ask the vet if he can break down a kidney profile for you if necessary.

May I ask what you're feeding him, and is it too high in protein, and did you discuss his diet with your vet?

Is Razz's urine output and color normal? (Concentrated, normal yellow color is good, dilute or clear urine is not so good).

Lastly, did the vet check Razz' heart rate and was it normal?

[Auntie Debbie]

Correction on the Creat...I typed in 2.8, not 2.smiley facve...and I typed it in a word doc and copied and pasted. So the BUN went down just one notch and the creat shot up from 1.9 to 2.8 with their normal range going up to 2.3. Plus some of the other values got weird too. No urinalysis was done and there's no way I could get one here or monitor what he's doing in the box unless I actually catch him in it. I can't even isolate him because I have Pregasouris in the spare room.
I have been feeding them Kit n Kaboodle. It's something they all like, along with a combo of Friskies canned or 9 Lives canned.
Just after the first testing I ran out of KnK so they got Something or other Healthy...but that was just a little bag. At the time of the retest I had just switched over to Purina Indoor dry.
The vet didn't mention anything about the heart rate, just did the blood pressure as far as I know.
Thanks for your help with my sweet little old man Traci.