CRF - Speed of deterioration

"Liz" wrote in message
m...
No, not necessarily. A cat (or person) can have a severe infection and
still
have a normal temp.

Absolutely. A friend of mine had pneumonia and didn't have a fever.

There are a bunch of pneumonias, & as I understand it, there is one kind of
pneumonia which is not associated w/ a fever. However, most pneumonias are.

Cathy

--
"Staccato signals of constant information..."
("The Boy in the Bubble") Paul Simon

There are a bunch of pneumonias, & as I understand it, there is one kind of
pneumonia which is not associated w/ a fever. However, most pneumonias are.

Cathy

Yep, pneumonias can be caused by an array of things. She had
pneumococcus. She said she never had a fever in her life and doctors
have told her that some people in fact do not have fever ever. Instead
of fever, she has an emotional breakdown - she cries and cries and
doesn't know why she's crying (she does not have depression, that's
just the way she is). Once the underlying cause is taken care of, she
stops crying. Weird, isn't it?

There are a bunch of pneumonias, & as I understand it, there is one kind of
pneumonia which is not associated w/ a fever. However, most pneumonias are.

Cathy

Yep, pneumonias can be caused by an array of things. She had
pneumococcus. She said she never had a fever in her life and doctors
have told her that some people in fact do not have fever ever. Instead
of fever, she has an emotional breakdown - she cries and cries and
doesn't know why she's crying (she does not have depression, that's
just the way she is). Once the underlying cause is taken care of, she
stops crying. Weird, isn't it?

"Liz" wrote in message
om...

Are his blood
levels of calcium and phosphorus within normal range?

They'll test again on Monday...I'll request a printout of the results.

Most feeds today
are acidified to prevent struvites. So you'd need to switch him to a
neutral food like a kidney diet or a canned diet that is not acidified
(IMO, canned is a must for CRF, ARF (acute RF), or a cat with history
of uroliths). What are you feeding him now?

He's been on dry food only since I got him, but I've been giving him some
wet for the past few days. He seems to prefer dry.

You did not mention if you are giving him any meds. Some meds can
cause ARF or anemia.

He's not on any meds. He's always been pretty healthy (he's only 6!)

Has he been holding out his right paw at times
since he became lethargic? Has the vet examined his paw or x-rayed it?

No, it's something that seems to have gotten worse over the past few days.
I'll have to get him to walk for the vet. He "sprained" his paw in a fight
with the neighbourhood bully cat last year. He hopped around on three legs
no problem

Does he limp when he walks? The lethargy may be primarily because of
the paw - he may be feeling more pain than he shows.

I found a very nice text discussing feline anemia and possible causes.
It's at
http://www.drpetra.com/Cats/Anemia%20in%20Cats.htm

I believe you took him in again today. Any news?

I didn't take him in yesterday because he used his litter box. I deferred
it to Monday, when the vet opens at 8:30 instead of 10. I don't want to
traumatise the cat any more than necessary by not letting him go pee
whenever he wants! Plus there was a sign of improvement....Timothy jumped up
on my bed and started purring loudly, and seemed very alert. Today, it's
back to the way it was. So Monday at 8:30 it is. I'll get them to do the
full blood work. do you think this list of things to look into is complete
enough?

blood pH
calcium and phosphate levels
creatinine
urea
potassium
PCV
CBC

Is there anything I should add?

Toni

"Liz" wrote in message
om...

Are his blood
levels of calcium and phosphorus within normal range?

They'll test again on Monday...I'll request a printout of the results.

Most feeds today
are acidified to prevent struvites. So you'd need to switch him to a
neutral food like a kidney diet or a canned diet that is not acidified
(IMO, canned is a must for CRF, ARF (acute RF), or a cat with history
of uroliths). What are you feeding him now?

He's been on dry food only since I got him, but I've been giving him some
wet for the past few days. He seems to prefer dry.

You did not mention if you are giving him any meds. Some meds can
cause ARF or anemia.

He's not on any meds. He's always been pretty healthy (he's only 6!)

Has he been holding out his right paw at times
since he became lethargic? Has the vet examined his paw or x-rayed it?

No, it's something that seems to have gotten worse over the past few days.
I'll have to get him to walk for the vet. He "sprained" his paw in a fight
with the neighbourhood bully cat last year. He hopped around on three legs
no problem

Does he limp when he walks? The lethargy may be primarily because of
the paw - he may be feeling more pain than he shows.

I found a very nice text discussing feline anemia and possible causes.
It's at
http://www.drpetra.com/Cats/Anemia%20in%20Cats.htm

I believe you took him in again today. Any news?

I didn't take him in yesterday because he used his litter box. I deferred
it to Monday, when the vet opens at 8:30 instead of 10. I don't want to
traumatise the cat any more than necessary by not letting him go pee
whenever he wants! Plus there was a sign of improvement....Timothy jumped up
on my bed and started purring loudly, and seemed very alert. Today, it's
back to the way it was. So Monday at 8:30 it is. I'll get them to do the
full blood work. do you think this list of things to look into is complete
enough?

blood pH
calcium and phosphate levels
creatinine
urea
potassium
PCV
CBC

Is there anything I should add?

Toni

"Phil P." wrote in message
...

"Toni from T.O." wrote in message
.. .

How? H. felis isn't easy to rule in or out. Parasitemia is cyclic, so
the
absence of the organisms from blood doesn't rule out haemobart. We didn't
catch it in the blood until the *fourth* consecutive day's smear.

Did your vet examine *fresh* blood or did he refrigerate the sample and
send
it to a lab? That can also produce a false negative because the organism
usually detaches from RBCs in refrigerated, anticoagulated blood. You'll
also get a false negative if you examine the blood while the cat is being
treated with a tetracyline because the organisms are absent while cats are
being treated with tetracyclines.

The blood was sent off to a lab, so I suppose it was refrigerated. He is
actually not on tetracycline, nor was he when the blood was drawn. I have
the prescription, but am waiting for the go ahead to start administering.

Also did your vet determine the *type* of
anemia? A nonregenerative (and normocytic, normochromic) anemia is
usually
associated with CRF -- a regenerative anemia is usually associated with
H-bart. Its very important to determine the type of anemia from the
*start*.

It's non-regenerative.

There are many causes of anemia - (e.g., hemolytic anemia from oxidative
damage [eating onions or other oxidative substance]. autoimmune hemolytic
anemia, Cytauxzoon, etc.) -- I can't go into all of the possible causes
now. Determining the cause can be very difficult - especially in outdoor
cats. In many cases, Epo or transfusions are necessary until the cause
can
be found and corrected - so make sure your vet is prepared.

His PCV is 22, same as last week.

His heart murmur is probably physiological and due to anemia. Anemia
reduces blood viscosity -- as the PCV decreases, blood becomes more like
water, making it easier for turbulence to develop. Its more difficult to
produce turbulence in normal blood because its more viscous Stroke volume
also increases in anemic cats to compensate for the loss of
oxygen-carrying
cells (RBCs). The combination of the reduced blood viscosity and the
increased stroke volume (increased velocity) can produce a heart murmur in
a
perfectly healthy heart..

The vet did say Tim's blood is thin.

One last note, if the anemia was due to CRF, your cat would probably have
a
dilute urine from the loss of the kidneys' ability to concentrate urine.
Also, a concentrated urine usually distinguishes prerenal azotemia from
primary renal azotemia. So the first order of business is determining
your
cat's urine specific gravity (USG).

Check. They're doing a culture today, and hopefully will check that too.

I understand your anxiety and frustration - I've been there too many
times -
but you gotta keep the faith!

Best of luck.

Phil

Wow, thanks for a very informative post. You're either a vet or an
extremely experienced cat owner!

Toni

"Phil P." wrote in message
...

"Toni from T.O." wrote in message
.. .

How? H. felis isn't easy to rule in or out. Parasitemia is cyclic, so
the
absence of the organisms from blood doesn't rule out haemobart. We didn't
catch it in the blood until the *fourth* consecutive day's smear.

Did your vet examine *fresh* blood or did he refrigerate the sample and
send
it to a lab? That can also produce a false negative because the organism
usually detaches from RBCs in refrigerated, anticoagulated blood. You'll
also get a false negative if you examine the blood while the cat is being
treated with a tetracyline because the organisms are absent while cats are
being treated with tetracyclines.

The blood was sent off to a lab, so I suppose it was refrigerated. He is
actually not on tetracycline, nor was he when the blood was drawn. I have
the prescription, but am waiting for the go ahead to start administering.

Also did your vet determine the *type* of
anemia? A nonregenerative (and normocytic, normochromic) anemia is
usually
associated with CRF -- a regenerative anemia is usually associated with
H-bart. Its very important to determine the type of anemia from the
*start*.

It's non-regenerative.

There are many causes of anemia - (e.g., hemolytic anemia from oxidative
damage [eating onions or other oxidative substance]. autoimmune hemolytic
anemia, Cytauxzoon, etc.) -- I can't go into all of the possible causes
now. Determining the cause can be very difficult - especially in outdoor
cats. In many cases, Epo or transfusions are necessary until the cause
can
be found and corrected - so make sure your vet is prepared.

His PCV is 22, same as last week.

His heart murmur is probably physiological and due to anemia. Anemia
reduces blood viscosity -- as the PCV decreases, blood becomes more like
water, making it easier for turbulence to develop. Its more difficult to
produce turbulence in normal blood because its more viscous Stroke volume
also increases in anemic cats to compensate for the loss of
oxygen-carrying
cells (RBCs). The combination of the reduced blood viscosity and the
increased stroke volume (increased velocity) can produce a heart murmur in
a
perfectly healthy heart..

The vet did say Tim's blood is thin.

One last note, if the anemia was due to CRF, your cat would probably have
a
dilute urine from the loss of the kidneys' ability to concentrate urine.
Also, a concentrated urine usually distinguishes prerenal azotemia from
primary renal azotemia. So the first order of business is determining
your
cat's urine specific gravity (USG).

Check. They're doing a culture today, and hopefully will check that too.

I understand your anxiety and frustration - I've been there too many
times -
but you gotta keep the faith!

Best of luck.

Phil

Wow, thanks for a very informative post. You're either a vet or an
extremely experienced cat owner!

Toni

do you think this list of things to look into is complete
enough?

blood pH
calcium and phosphate levels
creatinine
urea
potassium
PCV
CBC

Is there anything I should add?

Toni

Yes, the most important: total carbon dioxide. This will tell you if
his blood is acidic and correcting metabolic acidosis is critical.

do you think this list of things to look into is complete
enough?

blood pH
calcium and phosphate levels
creatinine
urea
potassium
PCV
CBC

Is there anything I should add?

Toni

Yes, the most important: total carbon dioxide. This will tell you if
his blood is acidic and correcting metabolic acidosis is critical.