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Dr. Drew
Dr. Drew, Veterinarian
Category: Veterinary
Satisfied Customers: 16311
Experience:  Small Animal Medicine and Surgery
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Cat with suddenly presenting kidney symptoms. Hx of coughing,

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Cat with suddenly presenting kidney symptoms. Hx of coughing, exacerbated 8 wks ago, vet cleared her. Last week vomiting. Hx of feline stomatitis with full dental extraction (resolved). BUN went from 82 to 60, Creat from 5.6 to 4.3, Glucose was 291 but Flucosamine levels not back yet (has not been exhibiting diabetes symptoms at home), WBC 19.98. Urine culture pending; red blood cells and protein urine. Both kidneys show minor changes on ultrasound, abdominal x-ray indicates mild asthma. No fever. Very low positive bartonella test around time of dental extraction. Indoor cat, sits on an outside deck but cannot get off. Right now at an emergency hospital for last 44 hours, on IV fluids and IV ABX. Costs $1000 a day to keep her there, internist is saying that additional days on IV fluids may hold off the need for sub Q fluids in the near future, and I should keep her there until BUN/Crea levels are normal or plateaued. Any advice?
Submitted: 1 year ago.
Category: Veterinary
Expert:  Dr. Drew replied 1 year ago.

Drew :

Hello, thanks for your question today! I am Dr. Drew, and I am a licensed veterinarian. I'll be happy to help you in any way I can.

Drew :

with a sudden onset of signs of kidney problems, it might be more likely that there's acute renal failure, rather than chronic renal failure, which is typically associated with weight loss over a longer period of time,

Drew :

and a longer pattern of increased thirst and urination for several weeks or more.

Drew :

In either case, if the BUN and creatinine are continuing to decrease, it may be worthwhile to continue --

Drew :

however,

Drew :

$1000 per day seems like a lot of money,

Drew :

and your regular veterinarian may be able to provide the same intravenous fluids for much less cost.

Drew :

in order to give Sydney the best chance at getting through this issue, with (hopefully) minimal long-term kidney damage.

Drew :

it is quite possible that the elevated glucose was due to stress,

Drew :

I've seen levels that high simply due to stress, not diabetes, in cats.

Drew :

If the kidney values plateau and are failing to improve further, then additional IV fluids would not be expected to yield any improvement in the long term prognosis.

Customer:

I don't think she has diabetes. I can't get hold of either my previous vet or the vet I'm going to switch to because of the weekend. I have to switch because my previous vet is too far away and this cat is a terrible traveler.

Customer:

So I'm trying to figure out what to do, the weekend is causing the most problem.

Drew :

Understandable,

Drew :

the weekend is a tough time, given the lack of round the clock care at most local vet clinics.

Customer:

The emergency hospital keeps saying they are waiting for blood and urine results.

Customer:

And a good decision is hard without that info.

Drew :

they should be running those in-house.

Drew :

most emergency clinics have in house lab equipment

Drew :

so other than fructosamine,

Drew :

they should not have to wait long at all!

Customer:

Blood is in house, urine is not. Yes fructosamine is the one we're waiting on, and the urine culture.

Drew :

yes, urine culture typically sent out,

Drew :

but if she is on antibiotics already, that too could be provided at a less-intensive-care location.

Drew :

so you might want to make some calls to local vet clinics to see if any are willing/able to provide similar care.

Customer:

I think I have no choice but to keep her there until the morning and try again to reach either of the vets. See what the numbers are tomorrow. All the vets are out of the office for today already...must be nice.

Customer:

But I will try calling some other vets around here.

Drew :

I wish I was able to leave the office at 3PM!

Drew :

certainly no "banker's hours" at this clinic.

Customer:

Ok, thanks, XXXXX XXXXX I will try other clinics and transfer her asap.

Drew :

you're very welcome -- I wish you both the best of luck!

Dr. Drew, Veterinarian
Category: Veterinary
Satisfied Customers: 16311
Experience: Small Animal Medicine and Surgery
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