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Cat Forum / Health and Behavior / March 2005More questions for Phil (or anyone who can help)
My cat was admitted AGAIN to hospital last night. It's now the 4th time in as many months. She is (or up until now been diagnosed a CRF cat). The symptons last night were that she vomitted once. What alarmed me was the excessive drooling an hour later. She had vomitted just the once 2 days ago but seemed to be recovered by the next day. On both these occasions, unlike the others, she had no hind leg weakness. She has been on the potassuum supplement since last time she was ill, although refusing to eat her food with it on (so I've had to dab it on her paws). The vet rang me last night to say her usual kidney blood tests were now reading NORMAL. It has never shown normal since she was diagnosed last June. She has been on a renal diet and 2.5mg of Fortekor daily. After the last vomitting episode, we cut the dose to half a tablet daily which I think may have helped. The vet is extremely puzzled as to why her blood tests for her kidneys are now normal as if he had not known her previous history he would never have thought there was a renal problem. Last night upon being admitted to hospital - her electrolytes, blood pressure, all kidney blood tests were all normal as was her temperature. However, she did have a very slow heart rate and they gave her atropine. My questions are these - 1. Can a CRF cat recover fully from the renal problem as the blood tests seem to indicate? 2. I have told the vet that before she was on the medication and special renal diet we never had any of these episodes of vomitting and that I feel she should go back to a normal diet and no medication to see how she goes. He agrees. I know already to look for signs of excessive drinking/urination so could switch her back again if this starts. I would appreciate your thoughts on this. 3. What could be causing the slow heart rate? The vet is guessing that she 'may' have had a mini siezure but not a siezue in the conventional sense where you can see it happen. I have asked him about testing her heart but he says any test would not show WHY she's having these episode. I am in the UK and now trying to find a cat specialist. I really need a diagnosis as we cannot continue to treat the sypmtoms and not the cause. She is an indoor cat with no access to any chemicals, unauthorised food etc... My partner has put forward one possible theory which I would also appreciate your thoughts on - our cat is a rescue cat and we do not know her history prior to last May. He is wondering if, before she was rescued, she could have eaten something poisonous which damaged her kidneys or weakened them. The diet and medication may have been all it needed for them to recover? By continuing on the diet and medication now when she seems not to need it, is it causing her these other problems? Sorry this is so long. Thanks regards Sarah > My cat was admitted AGAIN to hospital last night. It's now the 4th time in > as many months. [quoted text clipped - 64 lines] > > Sarah Eating something that causes damage is always possible. It's interesting aobut the exessive drooling. Right away, I wondered if she ate something. I'm sure it is a terrible worry. My best to you. Karen The drooling could be related to dental disease and her teeth should be thoroughly checked. Sometimes there can be serious problems that aren't visible on the surface and can only be seen on xray. As to the low heart rate, it probably has to do with the heart medication she's on for the renal failure. I would take her off that since her kidney values are looking good. It's quite possible that a health issue cause her to have elevated kidney values and whatever it was resolved which in turn brought the values back to normal. In any case, I think you're wise to seek a specialist. Megan  Signature"The only thing necessary for the triumph of evil is for good men to do nothing." -Edmund Burke Learn The TRUTH About Declawing http://www.stopdeclaw.com Zuzu's Cats Photo Album: http://www.PictureTrail.com/zuzu22 "Concerning all acts of initiative (and creation), there is one elementary truth the ignorance of which kills countless ideas and splendid plans: that the moment one definitely commits oneself, then providence moves too. A whole stream of events issues from the decision, raising in one's favor all manner of unforeseen incidents, meetings and material assistance, which no man could have dreamt would have come his way." - W.H. Murray Thanks for the replies. Still no news yet though. The vet rang this morning and said she was brighter as she was a bit grumpy! He has suggested X-rays today and I think, a scan. I'm just waiting for the phone to ring with some update. sarah Well the vet has just phoned through the results - but unfortunately still no definite diagnosis! I'm totally totally fed up with it all now. My nerves are shot to pieces. Last night my partner and I were were even discussing having her put to sleep! Today, although sleepy from a sedative, she's back to being better again. Until next time! It would appear from the abdominal scan she has only one working kidney. This kidney appears to be normal and functioning well. The other kidney is shrivelled and calcified. He is not sure why this is - whether it was a previous trauma or what. The X-rays of her chest show a slight thickening of the heart wall but not enough to give any cause for concern although he feels keeping her on the Fortekor may be helping her. We have decided at home now that the vets are merely guessing, happy to take the hundreds of pounds we are continuing to pay as each crisis occurs - so we are going to take her off the Fortekor and the renal diet and see how she fares. In the absence of any other suggestions I feel it is all we can do. She was not having this episodic vomitting and collapse before the Fortekor and the opportunity for her to eat what she enjoys in terms of normal cat food may just give her body chance to put on much needed weight and perhaps help her. If it's the wrong thing to do then we'll never know I suppose. She seems like she's on borrowed time. She may as well enjoy her food at least. a very unhappy sarah > Well the vet has just phoned through the results - but unfortunately still > no definite diagnosis! I'm totally totally fed up with it all now. My nerves [quoted text clipped - 27 lines] > > a very unhappy sarah Please do not stop the Fortekor suddenly, particularly in view of her thickened heart. Her body could well have got used to it, so it's always better to reduce heart meds gradually, plus in her case, she might actually be benefiting from it. If you can afford it, I'd recommend a visit to a veterinary cardiologist (there is one in Kenilworth), to clarify the heart situation - heart disease is very serious in cats but fortunately it is also usually very treatable. HTH Helen SignatureThe answers to 99.9% of your CRF questions can be found here: http://www.felinecrf.org > In the absence of any other suggestions I feel it is all we can do. She was > not having this episodic vomitting and collapse before the Fortekor and the > opportunity for her to eat what she enjoys in terms of normal cat food may > just give her body chance to put on much needed weight and perhaps help her. Have you tried giving her pepcid-AC? We were giving it to one of our CRF cats once a day to eliminate her vomiting. 1/4 of a tablet daily. I'd say ask your vet about it, but I don't have a whole lot of faith in your vet. Is there a vet in your area who has experience with cats who have kidney damage? Trish Hi, Can cats recover from chronic renal failure? No, but they can recover from acute renal failure, which could occur as a result of poisoning/intoxication. Anti-freeze would be a possibility. It is sometimes difficult to distinguish ARF from CRF. We look for things like weight loss prior to the diagnosis and anemia, which are indications of CRF. ARF cats tend to have very high kidney enzymes that respond well to IV fluids. It's possible your cat had ARF and has finally recovered. If the kidney values are now normal, I wouldn't see a problem with discontinuing the medication and monitoring for any changes in the bloodwork. The slow heart rate may be due to some kind of vagal nerve stimulation. The atropine may help a little, but I don't think it's very reliable. You may want to get an EKG done and have a cardiologist look at it. The potassium and blood pressure were normal, so it's not those. Chest x-rays and an echocardiogram are nice also. Best wishes, MK DVM >> In the absence of any other suggestions I feel it is all we can do. She > was [quoted text clipped - 13 lines] > > Trish Many thanks for the replies. I went to collect my cat last night and spent about 15 mins with the vet. He showed me the scans and x-rays and he actually spent time with me trying to bottom out what was going on. He is wondering if she has a rare form of epilepsy where she has a mild blackout which is not noticeable but which affects the 'control' nerves in her brain - the nerves that control heart rate. The scan of her kidneys showed one kidney shrunken and calcified. The other kidney appears ok although there is a very early indication that it 'may' have a slight bit of calcium (or whatever the white bit was) in it. Her heart x-ray just shows a slight thickening of the wall which the vet feels is not relevant to her vomitting problem. He has suggested keeping her on the Fortekor (I wanted to take her off it) and putting her back onto normal food. I have decided to keep her on the Fortekor (1/2 a tablet daily) as he is certain it will be helping both heart and kidneys. Apart from 4 shaved patches she is back to herself again with the added bonus of now enjoying her food. I'm slightly reluctant to take her completely off the renal diet so have been mixing half and half with the Whiskas. Already she is drinking more however so this may not work. I've put the extra drinking down to the fact that she always comes back thirsty from being in hospital but I'll closely monitor her and see how she goes. She really does need to fatten up so I'm glad to see her tucking in instead of picking. The vet also did suggest referring her to a specialist but he feels that unless they see her in an ill state they will probably be as much at a loss as he is. Also, they are some distance away and when she is ill - she is too ill for a long journey. I'm loathe to put her through any more tests and always said I would not subject her to lots of them. She's only had the ones she has 'cos she was already very ill and we needed answers. I know we still need answers - but I need her to settle down and recover again and enjoy what time she has left. regards to all and thanks again sarah > Many thanks for the replies. > [quoted text clipped - 8 lines] > kidney appears ok although there is a very early indication that it 'may' > have a slight bit of calcium (or whatever the white bit was) in it. Hi Sarah, Sorry for not responding sooner - kitten season started a littler early and caught me off guard and my ferals are running me ragged.... Kidney values can improve with medication and nutritional support without actual physical improvement in the kidneys themselves. However, I agree with MK. Your cat may have been in the maintenance phase of acute renal failure and is now in the recovery phase - The calcium deposits would lead me suspect ethylene glycol (antifreeze) poisoning. Cats with ethylene glycol toxicosis usually develop calcium oxalate. The only problem with my guess is that I don't think ethylene glycol is used in the UK as antifreeze. You might want to drop a urine sample off with your vet to check for calcium oxalate. > Her heart x-ray just shows a slight thickening of the wall which the vet > feels is not relevant to her vomitting problem. > > He has suggested keeping her on the Fortekor (I wanted to take her off it) > and putting her back onto normal food. She shouldn't have been on a renal diet unless her BUN was 60 mg/dl or greater. Low-protein diets can cause a myriad of problems in cats and should be used *only* to control azotemia. > I have decided to keep her on the Fortekor (1/2 a tablet daily) as he is > certain it will be helping both heart and kidneys. [quoted text clipped - 3 lines] > completely off the renal diet so have been mixing half and half with the > Whiskas. Whiskas isn't the greatest and I don't think she should be eating a renal diet. I don't know which foods are available, but I'd go with Hill's Prescription x/d - its low phosphorus, normal protein, and non-acidified (easier on the kidneys) and might help prevent further calcium oxalate build up. Of course speak to to your vet before making any changes. > Already she is drinking more however so this may not work. I've put the > extra drinking down to the fact that she always comes back thirsty from [quoted text clipped - 11 lines] > already very ill and we needed answers. I know we still need answers - but I > need her to settle down and recover again and enjoy what time she has left. If my guess that's she in the recovery phase of acute renal failure is right, she should have a *lot* of time left! ;-) Best wishes, Phil. (...) > with ethylene glycol toxicosis usually develop calcium oxalate. The only > problem with my guess is that I don't think ethylene glycol is used in the > UK as antifreeze. It is used in the UK - more commonly than propylene glycol, AFAIK. S. Hi Phil Thanks for the reply. Funnily enough my other half had said to me the other day that he wondered if she had been poisoned before we got her. I suppose we'll never know for sure. The good news is that she's already put on a little weight and is trying different foods. She does still seem to get bit thirsty so we're giving her little sachets of cat food in jelly. She's back to the vet for a check up on Thursday so I'll also ask about the urine test for calcium oxalate. Hope the kittens are now running you too ragged. many thanks regards Sarah Quick question for Trish.... Did the Pepcid_AC work? How often was the cat vomitting? Was it periodically or at certain times etc? sarah > Quick question for Trish.... > > Did the Pepcid_AC work? How often was the cat vomitting? Was it periodically > or at certain times etc? > > sarah I have the OK from my vet to give 1/4 pill of ac to Sugar when she needs it. She has always tended to get nauseated from hair and/or stress which puts her off eating. If I see her licking her lips and not eating, I will give her one which seems to break the cycle. After Grant passed away, a few days later she started doing this. After giving her the pepcid, her appetite picked right up and she has not exhibited the symptoms since and been more playful. It truly also helped Grant that last week. At least it kept him from vomiting more than he would have been, which I think kept him more comfortable. Sometimes, I think you have to just break the vomitting cycle. It becomes a physical habit in some way. > Quick question for Trish.... > > Did the Pepcid_AC work? How often was the cat vomitting? Was it periodically > or at certain times etc? > > sarah She was vomitting daily, the pepcid-AC worked perfexctly, although she hated the taste of it. There was much bile in her vomit until we gave her the pepcid. Oh btw, we gave it to her in the morning about 30 mins prior to her first meal I'll definitely ask the vet on Thursday when we go back for the check up. Thanks for suggesting it. I'm happy to try anything if the vet agrees it will not harm her. As her vomiting problem is so intermittent maybe he'll let her try a small daily dose. regards sarah |
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