CRF - Speed of deterioration

Hi again!

I posted earlier about my cat's extreme lethargy. My vet has ruled out
hemobartonella as a cause of Timothy's decline, and is now thinking that it
is probably kidney related. My question is, would it be unusual to see a
cat go from perky/chasing birds to practically immobile within *one* week if
the condition were CRF?

Thanks.

Toni

In your earlier post I believe you wrote that blood tests and x-ray
did not reveal anything wrong with his kidneys - is that right? How is
the cat? Does he have a fever? Is he eating? Did you get the result
for bartonella? Is lethargy his only symptom? Problem with lethargy is
that it can be too many things. I don't like guessing games. If this
vet does not know what he has, why not try another vet? Is he getting
worse or is he stable? Are you giving him any meds at all?

Meanwhile, see if you find any cuts on his skin. It's not easy to see
cuts so give him a gentle massage to see if you feel any swollen or
hardened area on or under his skin. Check if he feels any pain as you
go.

"Liz" wrote in message
om...
In your earlier post I believe you wrote that blood tests and x-ray
did not reveal anything wrong with his kidneys - is that right?

He has one kidney much smaller than the other, with a possible stone. Plus
elevated urea and creatinine levels, though not critical.

How is
the cat? Does he have a fever?

No fever, not that I can feel anyway (his ears are cool)

Is he eating?

Yes, though I have to bring his food bowl to him.

Did you get the result
for bartonella?

It was negative. I found this out right after I picked up his prescription
for tetracycline! I have to say I was disappointed, that would have made
things more definite. The vet said his prognosis is guarded.

Is lethargy his only symptom?

He is also anemic...PCV of 20

Problem with lethargy is
that it can be too many things. I don't like guessing games. If this
vet does not know what he has, why not try another vet?

I do like this vet. He's investigating many avenues, talking to the people
in pathology. It may be that his kidney isn't releasing the hormone to
create red blood cells. They're going to culture his urine, if I can get
him to the vet before he has his morning visit to the litterbox (not likely,
since they only open at 10:00 am on a Saturday!)

Is he getting
worse or is he stable? Are you giving him any meds at all?

He seems pretty stable...there was some loud purring tonight (yay!), which I
haven't heard in a couple of days. I'm praying it's a reaction to the
vaccine. He looks fine, alert, he's just not moving.

Meanwhile, see if you find any cuts on his skin. It's not easy to see
cuts so give him a gentle massage to see if you feel any swollen or
hardened area on or under his skin. Check if he feels any pain as you
go.

he's kind of holding his right paw out at times. But if he had an
infection, wouldn't he have a fever?

Thanks for the input. It's nice to have somewhere to ask questions and get
support and feedback.

Toni

He has one kidney much smaller than the other, with a possible stone. Plus
elevated urea and creatinine levels, though not critical.
He is also anemic...PCV of 20
I do like this vet. He's investigating many avenues, talking to the people
in pathology. It may be that his kidney isn't releasing the hormone to
create red blood cells. They're going to culture his urine, if I can get
him to the vet before he has his morning visit to the litterbox (not likely,
since they only open at 10:00 am on a Saturday!)
he's kind of holding his right paw out at times. But if he had an
infection, wouldn't he have a fever?
Toni

If his urea and creatine are elevated, it's a good idea to check his
blood pH. If the pH is low (7.8), you need to fix that urgently.
Lower blood pH causes protein catabolism (elevating urea) and bone
dissolution - probably interfering with production of new red blood
cells (anemia) and increasing mineral load on kidneys. Are his blood
levels of calcium and phosphorus within normal range? 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?

You did not mention if you are giving him any meds. Some meds can
cause ARF or anemia. Has he been holding out his right paw at times
since he became lethargic? Has the vet examined his paw or x-rayed it?
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?

"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

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.

"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

He has one kidney much smaller than the other, with a possible stone. Plus
elevated urea and creatinine levels, though not critical.
He is also anemic...PCV of 20
I do like this vet. He's investigating many avenues, talking to the people
in pathology. It may be that his kidney isn't releasing the hormone to
create red blood cells. They're going to culture his urine, if I can get
him to the vet before he has his morning visit to the litterbox (not likely,
since they only open at 10:00 am on a Saturday!)
he's kind of holding his right paw out at times. But if he had an
infection, wouldn't he have a fever?
Toni

If his urea and creatine are elevated, it's a good idea to check his
blood pH. If the pH is low (7.8), you need to fix that urgently.
Lower blood pH causes protein catabolism (elevating urea) and bone
dissolution - probably interfering with production of new red blood
cells (anemia) and increasing mineral load on kidneys. Are his blood
levels of calcium and phosphorus within normal range? 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?

You did not mention if you are giving him any meds. Some meds can
cause ARF or anemia. Has he been holding out his right paw at times
since he became lethargic? Has the vet examined his paw or x-rayed it?
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?

"Liz" wrote in message
om...
In your earlier post I believe you wrote that blood tests and x-ray
did not reveal anything wrong with his kidneys - is that right?

He has one kidney much smaller than the other, with a possible stone. Plus
elevated urea and creatinine levels, though not critical.

How is
the cat? Does he have a fever?

No fever, not that I can feel anyway (his ears are cool)

Is he eating?

Yes, though I have to bring his food bowl to him.

Did you get the result
for bartonella?

It was negative. I found this out right after I picked up his prescription
for tetracycline! I have to say I was disappointed, that would have made
things more definite. The vet said his prognosis is guarded.

Is lethargy his only symptom?

He is also anemic...PCV of 20

Problem with lethargy is
that it can be too many things. I don't like guessing games. If this
vet does not know what he has, why not try another vet?

I do like this vet. He's investigating many avenues, talking to the people
in pathology. It may be that his kidney isn't releasing the hormone to
create red blood cells. They're going to culture his urine, if I can get
him to the vet before he has his morning visit to the litterbox (not likely,
since they only open at 10:00 am on a Saturday!)

Is he getting
worse or is he stable? Are you giving him any meds at all?

He seems pretty stable...there was some loud purring tonight (yay!), which I
haven't heard in a couple of days. I'm praying it's a reaction to the
vaccine. He looks fine, alert, he's just not moving.

Meanwhile, see if you find any cuts on his skin. It's not easy to see
cuts so give him a gentle massage to see if you feel any swollen or
hardened area on or under his skin. Check if he feels any pain as you
go.

he's kind of holding his right paw out at times. But if he had an
infection, wouldn't he have a fever?

Thanks for the input. It's nice to have somewhere to ask questions and get
support and feedback.

Toni