Belle

[Susan and the girls]

Hey y'all! I just wanted to update you on Belle.

As I mentioned before, I brought her home last week (Thursday) with orders to do 200 cc sub-q fluids per day. I was quite upset and even a bit "desperate"-feeling about her health because of the news about her bloodwork.

She has acted like she feels SOOOO good every day since we came home! She has been very purry, very talkative (chirp-y), and she has been grooming herself. Her fur looks better, and she's eating a little better. I am faithfully giving her 100 cc in the morning & 100 cc at night, and she doesn't even fight me with it anymore. I actually have to hold her still to keep her from walking around while she gets her fluids! HA! This morning, I had to follow her around with the bag as she jumped up onto the toilet seat while I was giving her fluids on the other side of the bathroom! (She jumps up onto the toilet seat to chirp at me while I'm in the shower or working on her litter box.)

Speaking of her litter box: she's still urinating a little more than what I consider "normal," but her urine is smaller amounts than when I first brought her home. I had compared her urine to that of the other two kitties. The other two did "golf-ball" sized clumps. She was doing HUGE amounts. Now, hers are golf-ball sized, maybe 5-8 a day. She's not lingering over the water bowl as much, but she drinks about 1/2 c a day.

One day over the weekend (before the Georgia pollen took my sense of smell, hearing, and made me have the sore throat from you-know-where), I was sure I smelled ammonia while cleaning out the litter box. Now, I can't tell. I just hope that her kidneys are working a little better now.

I'll have her bloodwork repeated on Monday. I hope to have better values to report. I really am happy that she seems to feel so good. She is such a precious friend. <3

[Traci]

I'm so glad she is feeling better, what wonderful news!!

[Tina B and crew]

Sue..I am hoping and praying that Belle continues to improve. I remember dealing with CRF with Frodo and Gizmo. I'd give anything to be able to go back and do more for them so I completely understand. Hang in there and give Belle some snuzzles for me!

Traci...I'm so sorry to hear about Cotton. That pain is still just too fresh for me

[Susan and the girls]

Another update on Belle.

First of all, she acts like she feels really good. I'm so pleased with her attitude and the way she behaves! She "chirps" at me when I enter the room, follows me around, rubs on my leg constantly, and purrs the moment I speak to her. She hops up (on anything she can get to) to be close to my face, and reaches/stretches out her paw to "touch" my face. Such a sweetheart.

I took her in on Monday for repeat bloodwork for her kidneys, including a urinalysis. She didn't have a full bladder that day, so I took her in on Tuesday for the cysto.

I heard back from the vet yesterday, and here are the values she gave me. (They're not "wonderful," but they're definitely an improvement!)

Creatinine: (normal range .8-2.3) 5.1 (down from 8.9 on 4/1, and 12.3 on 3/29)
BUN: (normal 16-34) 66 (down from 93 on 4/1 and 129 on 3/29)
Phosphorus (normal 3-7) 8.3 (down from 12 on 4/1 and >16 on 3/29)

The vet says her biggest concern (aside from the fact that her kidney values are hugely out of the normal range) is her hematocrit, which is 16. (Normal is 29-45). She's anemic. The vet said that with cats who are anemic, you'll see lethargy and fatigue -- something Belle (thankfully) doesn't really exhibit. She also said that different cats react or adjust differently to anemia. The urinalysis will help us understand the anemia a little better. She had leukocytes in her urine on 3/29 - so she may be continuing to pass blood through her kidneys. (I'll know more when they get those results back.)

We're going to continue on the same course - 200 cc fluids/day. Belle tolerates it very well. She seems to understand I'm trying to help her (and even the vet said that!). I love her so much and I'm going to do what I can to help her and keep her healthy!!

The last few days, Belle has insisted on rejoining the others in the rest of the house. (I've kept her in the master bathroom to monitor the litterbox.) I let her out for short periods and the others (Scarlett & Daisy) don't bother her. Yay!

Just wanted to give you an update!

OK - I've edited this because I just got a phone call from the vet about the urinalysis.

Here's what she said: The urinalysis shows no UTI. There's a "+1" amount of blood, which she says is tiny, and no red blood cells in her urine. That apparently is good. No urinary tract infection, so the antibiotics (previously given for a UTI) have cleared it. No protein, no bacteria, and no white blood cells.

Her urine is very dilute -- 1.009. Ideally, we'd want 1.040 or more. We knew it was bad, since it was borderline dilute for sometime before this last crash. She says it will remain dilute because of the kidney disease and the fluids we're giving, but as long as I can keep her urinating a lot, she can maybe handle that dilute urine. I asked, and she agreed that the fluids (which are making her urinate a lot, in addition to the CRF) are helping clear out the toxins that would harm her with the kidney failure. The extra urination is to be expected with CRF, but also with the fluids, but that's better than not urinating enough. (Makes sense to me.)

She has what's considered basically nonregenerative anemia, even though she falls within the "15,000 - 50,000 reticulae" number they look for to indicate it's regenerative. (She is at just above 15,000. They still don't consider hers regenerative at this point.) She has slight regeneration.

The thing about anemia, she says, is that there *are* medicines for it, but they have awful side effects that you don't want to impose on a CRF cat unless absolutely necessary. Things like vomiting, anorexia, etc -- and since Belle really seems to feel good, we don't want to put her back in distress by giving her a medicine like that, when the main reason for giving the medicine (other than helping the anemia) would be to make her feel better. Almost seems like a contradiction in terms with a cat like her, you know? (She's feeling good even though she has a condition that should make her feel bad, so we'll treat the condition and make her feel bad.... no.)

We'll continue with 200 cc a day (100 x 2 per day) and recheck in 8 weeks.

So ... there's the update.

[Traci]

That's as good as to be expected, Susan, and yes, the urine may not be able to concentrate for some time (if it does at all), but the good news is that the urinalysis looks good.

Keep an eye on her behavior, her mucous membranes for pale coloring, keep a record of her weight, etc. Try placing an extra water dish or two, around the house, in those areas she most frequents, to keep her interested in drinking.

Hang in there, Belle is obviously a trooper, I'm thrilled that she seems to be feeling well - again, keep an eye on her coloring and/or any indication if she's lethargic, withdrawn, decreased appetite, rapid weight loss, severe dehydration....all of which demand a recheck on her blood levels.

[Susan and the girls]

Thanks Traci! Yes, I think she's a trooper.

About the coloring -- her little nose is very pale. It has always been a little pale because she has white on her face. (My gray Daisy has a gray nose....Scarlett, who is a brown/black/beige tabby, has a brown nose.) I have noticed that her nose is paler than usual, though. That was one thing they all remarked about when I took her in (at the end of March) when she was in such distress.

However..... I have noticed that sometimes, at various times of the day, her nose is actually a little pinker. It's so weird..... If she's particularly warm, from snuggling in her bed, or if she's particularly active - following me around, it's pinker. In the mornings, when it's cool in the house (my husband favors Arctic nights in Georgia), her nose is very white.

I think the best thing of all is that she seems to feel good. Trust me -- I'm keeping a CLOSE eye on her these days!! I want to make sure she's as healthy as I can help her be!!!

[Traci]

The nose is a good indicator but not the only indicator for checking coloring. The inside of the mouth, (gums, tongue, roof of mouth, inside of cheeks), inside of ears and upper/lower inside eyelids as well as third eyelids are also indicators.

At normal head level, the nose may appear normally pink, because the blood flow is adequate - when the cat tilts the head or neck, the blood flows back which can give the nose a pale color. Anemia is generally a steady pale, pallor, or grey or jaundiced coloring of the nose and other mucous membranes. Combined with very pale coloring, weakness, lethargy, reduced appetite, sometimes fever or reduced core temperature, dehydration are all signs to contact the vet immediately.

The fact that she sometimes has a healthy pink nose may be good news in that, the anemia may not be at a crisis point. But, also check her mucous membranes for a more accurate picture.