Tiger - bad news

"Elizabeth Blake" wrote in message
...
Back in December I took Tiger to the vet because she was urinating on
everything a lot. She's had a problem with that pretty much most of her
life, but it got out of control. Her blood work in December showed that
she
was just starting to have problems with her kidneys. One of her numbers
were just out of the normal range.

Between then & now she was doing well. Thursday evening I got home late
and
she didn't come to the door to greet me. I searched all over for her and
found her sleeping under the kitchen table. She finally came out to
briefly
say hello. She didn't want any dinner, just went back under the table to
sleep. Friday morning she seemed a little perkier. She woke up when I
did
and she took a few bites of breakfast and drank some. I brought her to
the
vet yesterday afternoon and they took more blood & urine. Friday night
she
ate some, but not much. She would take a couple of bites and then go lay
down again, but she kept getting up to go back to the kitchen. She's
having
trouble walking, she just seems weak, or like a drunk. Oh, the vet gave
me
an appetite stimulant yesterday but she's only had it twice so far and I'm
not sure if it's doing anything. I also give her sub-q fluids at home,
and
the vet said to do it every day now.

I had been closing my bedroom door at all times after she started peeing
late last year but I left it open last night. This morning she woke me up
meowing, she had made it up onto the little cat condo by my bed. I picked
her up and she cuddled next to me which was nice, since she had been
keeping
out of sight for the most part. She also followed me into the bathroom
when
I went in and used the box.

The vet just called me with her blood test results:
In December, her creatinine (sp?) was 2.4 and now it's 3.6. He said that
shows she's still in the mild-moderate stage of kidney disease.
In December, her white blood cell count was normal and now it's high,
25,000. Her red blood cell count was normal in December, and now it's low
(14%).

He said that she's very anemic and her cell counts could be because of her
kidneys or it could be cancer. He said the white blood cell count could
be
in infection or could also be caused by cancer. In October 2004, Tiger
had
a mammary tumor removed that was benign.

I'm going to pick up an antibiotic for her tomorrow, Clavamox.

The vet said the only way to know if her numbers are abnormal due to
cancer
is to do an abdominal ultrasound (she had
x-rays yesterday, those were fine). He also recommended leaving her for a
couple of nights to get IV fluids and IV antibiotics.

I'm torn about what to do. I am very short on money and my credit cards
are
both mostly maxed out. Tiger will be 16 years old next month, so I know
she
doesn't have a long life ahead of her if cancer is detected and treated.
Yesterday's bill was $485. The ultrasound will be another $330. Two days
of hospitalization will be around $250. Tiger's my first cat and I love
her
dearly. If she was younger, I wouldn't hesitate to do whatever needed to
be
done. But, she's 16 with failing kidneys. If cancer is detected, do they
put cats through chemo? I don't know if she'd be able to handle it. And
what about her kidneys, would any cancer treatment make them worse even
faster?

I've got to think it about it over the rest of the weekend and call them
Monday to make a decision.



I don't think its cancer- just a hunch. All the symptoms you've mentioned-
anorexia, lethargy, depression, weakness, cold intolerance, and changes in
her personality- are all classic symptoms of CRF anemia. Before you make a
irreversible decision, speak to you vet about epogen. I've seen CRF cats
make dramatic turnarounds after epo therapy. If your vet isn't familiar
with epo therapy, please seek a second opinion.

Keep the faith.

Phil

"Anna via CatKB.com" u18214@uwe wrote in message news:5d77441005f3f@uwe...
down again, but she kept getting up to go back to the kitchen. She's
having
trouble walking, she just seems weak, or like a drunk. Oh, the vet gave
me

This could be a sign of low potassium or high phosphorus. I trust the vet
did a full blood profile?

I assume he did. I know that her thyroid levels were also checked and those
were fine.

The vet just called me with her blood test results:
In December, her creatinine (sp?) was 2.4 and now it's 3.6. He said that
shows she's still in the mild-moderate stage of kidney disease.

Did he do a urine test too. That helps determine at which stage she's at
too.
A crf cat will have low urine specific gravity.

Yes. He said the urine shows that she's still in mild-moderate kidney
failure. They also did a urine culture but those results aren't back yet.

The vet said the only way to know if her numbers are abnormal due to
cancer
is to do an abdominal ultrasound (she had
x-rays yesterday, those were fine). He also recommended leaving her for a
couple of nights to get IV fluids and IV antibiotics.
But, she's 16 with failing kidneys. If cancer is detected, do they
put cats through chemo? I don't know if she'd be able to handle it. And
what about her kidneys, would any cancer treatment make them worse even

I have no experience with cancer so I can't give you any advice about
that.
But if it turns out to be just crf, that is treatable and she could still
lives for years with it.

Thanks, Anna. She's already 16 years old and I've heard of CRF cats that
can live for quite awhile after diagnosis. If she has other problems that
makes my decision even harder.

--
Liz

"PawsForThought" wrote in message
oups.com...

Elizabeth Blake wrote:
She's been moving slowly and is a
little unsteady on her feet so I was amazed she got up as high as she
did.

Hi Liz,
I'm so sorry to hear about Tiger. I know how difficult it is having an
elderly beloved kitty with CRF.
Was she having the unsteadiness problem before or after the appetite
stimulant? If he's giving her Periactin, it can make the cat act
drugged. That's what we used with my CRF cat and it did have that
effect on her. Also, I'm curious about the antibiotics. Does she have
an infection she's being treated for? I was just wondering why the vet
prescribed them.

I think the antibiotic is as a precaution. He said that her abnormal blood
test results could be due to cancer or could be due to an infection, so he
wanted to start an antibiotic. They did a urine culture but the results
aren't back yet. As she's gotten older she's become less steady on her feet
but nothing like now. I noticed it Thursday night, when she was hiding and
not wanting to eat. She started the stimulant on Friday so it's not due to
that. She's taking 1/4 tablet of Cyproheptadine 4mg. Doesn't seem to be
doing anything for her appetite though.


Personally, it if were my cat, I would do everything I could to treat
her as long as the quality of her life was good. I don't think I would
put the cat through chemo or anything invasive if she were mine. It's
an extremely difficult decision I know. Best wishes with whatever you
decide and I hope your Tiger feels better soon.

Lauren

The more I think about it, the more I'm sure that I wouldn't want to put her
through anything like chemo, or surgery. If she was a young cat I'd
consider it but she's a senior and had already slowed down considerably the
past few years.

--
Liz

"Phil P." wrote in message
news:Eh3Tf.1484$Vx4.440@trnddc06...

I don't think its cancer- just a hunch. All the symptoms you've
mentioned-
anorexia, lethargy, depression, weakness, cold intolerance, and changes in
her personality- are all classic symptoms of CRF anemia. Before you make
a
irreversible decision, speak to you vet about epogen. I've seen CRF cats
make dramatic turnarounds after epo therapy. If your vet isn't familiar
with epo therapy, please seek a second opinion.

Keep the faith.

Phil

Thanks, Phil. I Googled epogen and what I read describes Tiger. I'll call
the vet on Monday and ask about it. On Friday, he mentioned that her
heartbeat sounded off, I think he called it galloping. Other than epogen,
are there any other treatments for feline anemia? Special diet? He said
that she doesn't need to be on a prescription food yet for the kidneys.

She got all the way on the bed by herself this morning. When Otto got too
close she even smacked him, which was nice to see. Otto is still hissing &
growling at her when he remembers. Last night I cut open a box for her,
because she loves sleeping in boxes. She spent a long time rubbing her face
against the edges like old times, before settling down for a nap. Otto's
entire being is consumed with evicting her from the box so he can have it
for himself, and she pretty much lets him. She's now back under the end
table by the radiator. She used the litterbox last night and looked like
she was going to go again this morning but decided against it. I'm going to
put her in anyway. She's been going twice a day most days, after a lifetime
of urinating only once every 24 hours. The vet said she doesn't have any
blockage, which is what every other vet has said when she was checked. Her
urine culture results should be back in a couple of days.

I'm pretty sure that I'm not going to have the abdominal ultrasound done.
Even if they find cancer, I don't think I'd put her through any invasive
procedures or chemo. I always thought that she'd live to at least 18 but
she has slowed down a lot in the last couple of years. I just want her to
see her Sweet 16 on April 12th, and hopefully months to come after that.

--
Liz

No special diet??? That's strange, the first thing our vet did for our
CRF boy was to prescribe high moisture, low protein food. And then of
course fluids.

Like Phil said, anemia as a result of the CRF can be treated. When our
boy was first dx, I thought it was a death sentence. Since his original
crash though, with TLC, diet and fluids, he has rebounded and is more
lively than ever.

You may want to join the feline crf group on yahoo.com. There are a lot of
people there dealing with cats with crf. Also, check out the felinecrf.com
site. Lots of useful info. I'm surprised your vet didn't recommend a
special diet. While there is some differences in opinion about feeding a
cat with crf a low protein diet, you should be feeding your cat food low in
phosphorous.

Hope all goes well for Tiger.

Sue
"Elizabeth Blake" wrote in message
link.net...
"Phil P." wrote in message
news:Eh3Tf.1484$Vx4.440@trnddc06...

I don't think its cancer- just a hunch. All the symptoms you've
mentioned-
anorexia, lethargy, depression, weakness, cold intolerance, and changes
in
her personality- are all classic symptoms of CRF anemia. Before you make
a
irreversible decision, speak to you vet about epogen. I've seen CRF cats
make dramatic turnarounds after epo therapy. If your vet isn't familiar
with epo therapy, please seek a second opinion.

Keep the faith.

Phil

Thanks, Phil. I Googled epogen and what I read describes Tiger. I'll
call the vet on Monday and ask about it. On Friday, he mentioned that her
heartbeat sounded off, I think he called it galloping. Other than epogen,
are there any other treatments for feline anemia? Special diet? He said
that she doesn't need to be on a prescription food yet for the kidneys.

She got all the way on the bed by herself this morning. When Otto got too
close she even smacked him, which was nice to see. Otto is still hissing
& growling at her when he remembers. Last night I cut open a box for her,
because she loves sleeping in boxes. She spent a long time rubbing her
face against the edges like old times, before settling down for a nap.
Otto's entire being is consumed with evicting her from the box so he can
have it for himself, and she pretty much lets him. She's now back under
the end table by the radiator. She used the litterbox last night and
looked like she was going to go again this morning but decided against it.
I'm going to put her in anyway. She's been going twice a day most days,
after a lifetime of urinating only once every 24 hours. The vet said she
doesn't have any blockage, which is what every other vet has said when she
was checked. Her urine culture results should be back in a couple of
days.

I'm pretty sure that I'm not going to have the abdominal ultrasound done.
Even if they find cancer, I don't think I'd put her through any invasive
procedures or chemo. I always thought that she'd live to at least 18 but
she has slowed down a lot in the last couple of years. I just want her to
see her Sweet 16 on April 12th, and hopefully months to come after that.

--
Liz

"Elizabeth Blake" wrote in message
link.net...
"Phil P." wrote in message
news:Eh3Tf.1484$Vx4.440@trnddc06...

I don't think its cancer- just a hunch. All the symptoms you've
mentioned-
anorexia, lethargy, depression, weakness, cold intolerance, and changes
in
her personality- are all classic symptoms of CRF anemia. Before you
make
a
irreversible decision, speak to you vet about epogen. I've seen CRF
cats
make dramatic turnarounds after epo therapy. If your vet isn't familiar
with epo therapy, please seek a second opinion.

Keep the faith.

Phil

Thanks, Phil. I Googled epogen and what I read describes Tiger. I'll
call
the vet on Monday and ask about it. On Friday, he mentioned that her
heartbeat sounded off, I think he called it galloping.


If she's anemic, the murmur is probably *physiologic*- and not due to heart
disease. Anemia can *easily* cause a heart murmur because the blood is
thinner
.. Most murmurs are caused by turbulence- its much easier to produce
turbulence in thin blood than normal blood which
is much thicker (e.g., water vs. honey). Also, since the blood contains
less RBCs that carry the oxygen, the stroke volume (velocity) must increase
to compensate. So, the combination of decreased blood viscosity plus the
increased stroke volume (increased velocity) can cause a *physiologic* heart
murmur without any heart disease whatsoever. The stress and excitement from
the trip and vet's office- not to mention restraint and drawing blood, also
increased her heart rate which would make an anemic murmur even louder.
Usually the murmur resolves automatically as soon as the anemia is
corrected. So, don't worry too much about the murmur just yet- see what
shows up on the ultrasound.



Other than epogen,
are there any other treatments for feline anemia?


Depends on the type of anemia-- but usually iron- especially if she gets
epogen. The stimulated RBC production puts a heavy drain on the body iron
stores. You might want to ask your vet to check her stool for blood
(melena) to make
sure her anemia isn't caused by blood loss through the GI tract.



Special diet? He said
that she doesn't need to be on a prescription food yet for the kidneys.


A high protein diet is probably best for anemia- but since she might be in
early-stage CRF, that type of diet might raise her BUN which could make her
feel sick. Higher protein diets are also usually higher in phosphorus-
which wouldn't be good for her (or any cat). I would go with a regular
moderate protein, meat-based diet.



She got all the way on the bed by herself this morning. When Otto got too
close she even smacked him, which was nice to see. Otto is still hissing
&
growling at her when he remembers. Last night I cut open a box for her,
because she loves sleeping in boxes. She spent a long time rubbing her
face
against the edges like old times, before settling down for a nap. Otto's
entire being is consumed with evicting her from the box so he can have it
for himself, and she pretty much lets him. She's now back under the end
table by the radiator.


How about setting up another box under the table near the radiator?



She used the litterbox last night and looked like
she was going to go again this morning but decided against it. I'm going
to
put her in anyway. She's been going twice a day most days, after a
lifetime
of urinating only once every 24 hours. The vet said she doesn't have any
blockage, which is what every other vet has said when she was checked.
Her
urine culture results should be back in a couple of days.


If she's in early CRF, her urine might be a little dilute- which makes her
more susceptible to UTIs. So, its a good idea to keep the litterbox
exceptionally clean.



I'm pretty sure that I'm not going to have the abdominal ultrasound done.

Even if they find cancer, I don't think I'd put her through any invasive
procedures or chemo.


I've had cats treated with chemo- they tolerate it quite well- *much* better
than humans- So, if I were you, I'd keep that option open.



I always thought that she'd live to at least 18 but
she has slowed down a lot in the last couple of years. I just want her to
see her Sweet 16 on April 12th, and hopefully months to come after that.


I've had cats that lived 6 years post CRF diagnosis. With proper treatment
and a lot of TLC (of which I know you have an abundance), she'll probably
live a lot longer than 16!

Keep the faith.

Best of luck,

Phil

Elizabeth Blake wrote:

"PawsForThought" wrote in message
oups.com...

Elizabeth Blake wrote:
She's been moving slowly and is a
little unsteady on her feet so I was amazed she got up as high as she
did.

Hi Liz,
I'm so sorry to hear about Tiger. I know how difficult it is having an
elderly beloved kitty with CRF.
Was she having the unsteadiness problem before or after the appetite
stimulant? If he's giving her Periactin, it can make the cat act
drugged. That's what we used with my CRF cat and it did have that
effect on her. Also, I'm curious about the antibiotics. Does she have
an infection she's being treated for? I was just wondering why the vet
prescribed them.

I think the antibiotic is as a precaution. He said that her abnormal blood
test results could be due to cancer or could be due to an infection, so he
wanted to start an antibiotic. They did a urine culture but the results
aren't back yet. As she's gotten older she's become less steady on her feet
but nothing like now. I noticed it Thursday night, when she was hiding and
not wanting to eat. She started the stimulant on Friday so it's not due to
that. She's taking 1/4 tablet of Cyproheptadine 4mg. Doesn't seem to be
doing anything for her appetite though.

When we had Queenie on Periactin, it really perked up her appetite for
a couple of days, but then stopped working. I do recall she had some
wobliness but now that I think of it, it was before she took the
appetite stimulant. I think it's just a symptom of the CRF that cats
get weak hind quarters.

Arubalisa wrote:
No special diet??? That's strange, the first thing our vet did for our
CRF boy was to prescribe high moisture, low protein food. And then of
course fluids.

Like Phil said, anemia as a result of the CRF can be treated. When our
boy was first dx, I thought it was a death sentence. Since his original
crash though, with TLC, diet and fluids, he has rebounded and is more
lively than ever.

Fluids helped a great deal with my CRF cat. Another thing that helped
was joining one of the CRF support groups. Here are a couple of them
if you're interested:

http://groups.yahoo.com/group/FelineCRF/
http://groups.yahoo.com/group/Caring-for-CRF-Felines/

Take care,
Lauren

are there any other treatments for feline anemia? Special diet? He said
that she doesn't need to be on a prescription food yet for the kidneys.

Wow, really? At 16 years old with a creatinine of 3.6, your vet should
absolutely have her put on a kidney diet. My cat is 13 and has a creatinine
of 3.1 and is on it.



Anna

--
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