Blood Signs and Starting Treatment - Part 1

July 2009 - Tests

When I took Simone to get examined for the first time near the end of July 2009, the vet surmised that kidney failure could be the cause of her illness.  However, the final determination was made using a blood panel.  The vet labored intensively to get enough blood from an underweight, dehydrated, and crying Simone.  After several tries in several places, she finally got the bare minimum.  I took Simone home and waited for the hospital lab results.  Of course, when the results came in, it was confirmed that Simone had an advance case of CRF, with some numbers off the chart.  Here are the key blood factors that were tested for:

Blood Urea Nitrogen

This measure is often called BUN for short.  It measures the amount of urea formed from the breakdown of protein.  This is a waste product which with good kidneys should be flushed out in the urine.  The normal range is 12 to 34 mg/dl (milligrams per deciliter).  Simone's result was 181 mg/dl.  Ouch!  Obviously, the higher the number the worse the kidneys are functioning.

Creatinine

This measure is for another waste product.  If both the BUN and creatinine values are high, then that is a sure sign of chronic renal failure.  The normal range is 0.00 to 1.50 mg/dl.  Simone's result was 12.6 mg/dl.  Ouch!

Phosphorus

A cat with chronic renal failure (CRF) will have trouble excreting phosphorus (as phosphate).  A buildup of phosphorus can lead to calcium depletion.  The normal range is 4.0 to 7.0 mg/dl.  Simone's result was 15.5 mg/dl.  Ouch!

Calcium

As mentioned above, calcium is tied to phosphate.  Normally, the calcium level should be 100 to 200% of the phosphorus.  The normal range is 8.4 to 10.8 mg/dl.  Simone's result was 11.9 mg/dl.  Her little body was trying to keep up with the high phosphorus content.

Potassium

This electrolyte in cells is needed to keep muscles functioning properly.  An imbalance causes weakness, twitching, and possibly seizures.  A cat with CRF is subject to increased urination and vomiting, which can lower potassium levels.  The normal range is 3.8 to 5.0 mg/dl.  Simone's result was 2.9 mg/dl.  Ouch!

Other factors were measured, but the ones mentioned above were the most critical for diagnosing CRF.  First and foremost, Simone was dehydrated and not eating well, so we had to correct those conditions right away as her body was not properly eliminating waste products and she wasn't getting enough nourishment.  The only way to adequately hydrate Simone was to give her subcutaneous fluids, i.e. hypodermic needle injections of an electrolyte solution under the skin several times a day.  The vet's assistant showed me how to do it.  It was my choice:  either have them do it at great expense or administer the fluids myself.  I reluctantly chose the latter.  Ugh!  I had no medical training and no clinical experience, but I resolved that Simone and I could do this together.

Next, Simone had to start eating more food.  The vet prescribed cyproheptadine (cypro) as an appetite enhancer.  Then we had to get the phosphorus (phosphate) and electrolytes under control.  Aluminum hydroxide (found in some antacids) is a good phosphate binder, so that was added to her regimen.  To get her potassium up, Tumil-K (or RenaKare), a potassium gluconate supplement, was added.  To help with her diet, the supplements were given to Simone with Hills Prescription Diet a/d which is described as a critical care food.  It's a meat and fish based product packed with minerals and vitamins.  The soft consistency of this food allows for syringe feeding.

That's it for today.  In part 2 of this post, I'll talk more about supplements, the daily regimen, and the results of the second blood panel.   Purr on!

Simone & Me

"There are two means of refuge from the miseries of life: music and cats."
><Albert Schweitzer