Wednesday, August 11, 2010

Case of the Week: Rascal

Rascal is a 17-year-old Maine Coon cat. He was brought into the clinic in March of this year because his owner suspected he might have kidney disease. When Dr. Karnia examined him, he was thin and seemed sensitive to touch over his hips. His blood tests showed a mile increase in his kidney values indicating the early stage of Chronic Kidney Failure. Due to the sensitivity in his hips, we took some radiographs (x-rays) which showed moderate arthritis. He was started on the medications Dasuquin and Adequan for his arthritis and vitamin B and calcitriol for his kidney disease. Dr. Karnia also recommended he return for a progress exam in 3 months.

Five weeks later, Rascal came back in because he was not eating well and had lost weight. His blood tests were very concerning - his kidney values had tripled in that time. In addition, his white blood cell count was elevated indicating an infection. Even though Dr. Karnia was not sure where the infection was in his body, she started him on antibiotics. We also taught his owner to give him electrolyte fluids under the skin which she began to do daily. To help with the weight loss, he was prescribed an appetite stimulant.

Two weeks later, his appetite had picked up some and his white blood cell count was back to normal. However, his kidney values had increased a little more and now his phosphorus level showed an increase. Dr. Karnia prescribed a medication that binds the phosphorus in the food and continued his fluids and other medications. His prognosis at this time was not good, as it appeared his kidney disease was progressing rapidly.

At his progress exam three weeks later, Rascal showed some improvement. His kidney values were improved by thirty percent and his phosphorus level had decreased by half. However, his red blood cell count was decreased a little and his white blood cell count was elevated again. He had lost more weight and was under seven pounds. Dr. Karnia switched him to a different appetite stimulant, started him on antibiotics again and vitamin B injections replaced the oral supplement. Even though his kidney values were better, he did not seem to be doing well overall.

A month later Rascal - and his owner - were feeling much better. His kidney values had changed very little but he had gained over a half pound, his white blood cell count was normal and his red blood cell count had increased. He was scheduled to return in two months for a progress exam. Although he wasn't completely out of the woods yet, we were finally getting ahead of the disease and able to give Rascal back a good quality life.

Chronic Renal (kidney) Failure is a common finding in older cats. The symptoms can be subtle at first but generally progress to weight loss, loss of appetite, and vomiting. The progression of the disease is variable in every cat with different symptoms developing at different times and intensities. There can be periods of increased symptoms due to infection, stomach upset, or other factors. There are many treatments that can be utilized to alleviate symptoms, treat underlying causes, and slow the progression of the kidney disease. Chronic Renal Failure cannot be cured, but with proper care, it can be managed and its effects minimized. A dedicated owner and improve and prolong her cat's life in spite of the disease.

For more information on Chronic Renal Failure (CRF), please visit the Links and Resources page of our website. There are several quality websites about this disease there, as well as a link to the Lifelearn Veterinary Library. Please also feel free to contact us by phone at 480.970.1175 or by email at if you have more questions or would like more information.

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