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16 year old maine coon cat had AST of 652, everything else

within limits, vet diagnosed CRD...
16 year old maine coon cat had AST of 652, everything else within limits, vet diagnosed CRD stage II for creatinine of 2.0, BUN 32 and specific gravity levels 1.027, no meds prescribed, return in 6 months; only other abnormality was RBC in urine of 30, I had been carrying him around and walking with him which may account for it

Don't know what AST being high means, vet said nothing abou tit
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Answered in 50 minutes by:
11/10/2013
FelineMed
FelineMed, Licensed Veterinary Technician
Category: Cat
Satisfied Customers: 386
Experience: Accomplished LVT for over 10 years with a BS in Biology as well. Experience working in 2 feline specific hospitals.
Verified
Hi! I am a Licensed Veterinary Technician and have worked in 2 different cat hospitals for well over 10 years. I'm looking forward to assisting you!

You must be taking great care of your kitty to get him to 16 years of age!

Unfortunately kidney disease is pretty common in senior cats, though his urine is not quite as concentrated as we would like, those blood kidney values are actually pretty good for a 16 year old cat!

AST stands for Aspartate aminotransferase, which is a liver enzyme. ALT (Alanine aminotransferase) is another liver enzyme and I'm assuming that was in the normal range, which is good news. While it is true that AST can indicate a liver issue, it is not a liver specific enzyme...ALT is more liver specific, so it is good news that they are not both elevated.

Reasons for just the AST (not ALT) being elevated would be from red blood cell destruction. This can be due to muscle trauma as well as heart disease. Although that sounds pretty bad, it is usually just an innocent artifact due to hemolysis from the way the blood was drawn. Such as through too small of a needle or if it was a difficult stick or the patient was not still, etc. Usually if it was due to muscle trauma or heart disease, the CK (muscle enzyme) will be elevated as well, which I'm assuming was normal.

However, Maine Coon cats are genetically at high risk for heart disease...so I would definitely have your vet keep a close eye on his values as well as how his heart sounds. I'm assuming his heart sounded ok at the last visit. There is a great new blood test called the ProBNP which is very useful in diagnosing a Maine Coon's chance of having heart disease if you were at all interested.

Also, just want to mention a few great kidney supplements that can be started if his kidney disease starts to progress:

1) Epakitin:

http://www.vetoquinolusa.com/CoreProducts/RenalUrologySupport/Epakitin.html

2) Azodyl:

http://www.vetoquinolusa.com/CoreProducts/RenalUrologySupport/RenalUrologySupport.html

3) Prescription kidney diets (all come in can and dry, though can food is ideal for renal patients):

http://www.hillspet.com/products/pd-feline-kd-feline-renal-health-with-chicken-canned.html

http://www.purinaveterinarydiets.com/Product/NFKidneyFunctionCatFood.aspx

I hope all of this information has been helpful!

Please do not hesitate to ask any further questions. I aim to provide you with the best service possible. If you feel I have done so, then
an excellent rating is greatly appreciated! If not, please let me know how I can better assist you. Thanks! XXXXX
FelineMed


FelineMed
FelineMed, Licensed Veterinary Technician
Category: Cat
Satisfied Customers: 386
Experience: Accomplished LVT for over 10 years with a BS in Biology as well. Experience working in 2 feline specific hospitals.
Verified
FelineMed and 87 other Cat Specialists are ready to help you
Ask your own question now
Thank you for the excellent rating, it is greatly appreciated!

Please let me know if I can assist you at all in the future : )

FelineMed
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Customer reply replied 4 years ago

Sorry, my info was incomplete and wrong due to a bad fax and misunderstanding with person at office when I called about it.


 


AST/ALT are fine, both midrange. All else normal including T4.


 


CPK was what was 652, vet said they noted distinct heart murmur.


 


At end of report wrote, "R/O FIC, CRD stage II (IRIS)"


 


So now apparently they were ruling out FIC and CRD as possibilities, I am guessing only because it is common and they look for it. According to a web page his values are in range for stage II. BUN 32, creatinine 2.0, sp. gravity 1.027


 


I took him in because his fur was matting and I had been clipping it with scissors but cut his skin and there was a wound, plus he had an ingrown nail on one paw. I am guessing one or both of these could have caused the high CPK, as apparently lots of things including wounds can cause it. They did not even mention it when discussing the labs. They only said to try to get him to drink more water and switch to wet food.


 


Abnormal lab levels:


 


30-50 RBC in urine, Blood "3+", Moncytes high at 4.2%, MCHC marginally low at 28.2


 


Thanks for all your help.


 

Oh ok thanks for the clarification...that could change the situation a bit as far as heart disease being more of a possibility since it was the CK (CPK) that was indeed elevated. Being a muscle enzyme, CK can be elevated as you mentioned due to trauma (such as cutting him accidentally with scissors if cut fairly deep)....however I'm more concerned that it could be elevated due to heart disease due to his breed and due to the heart murmur that was heard. Also, the matting fur is an indication that he is not grooming himself as well as he used to...of course this can just be due to him aging, but it can also be due to illness and is a sign that they are not feeling quite right.

Was this heart murmur a new finding? Or has he had it for awhile...also usually we will grade a heart murmur 1-6...6 being the worst. Did your vet happen to mention the grade?

Either way, as a Maine Coon with a heart murmur, it would be good to have some chest radiographs done if not done so recently. This will allow your vet to have a good view of his heart silhouette. If his heart does appear abnormal on radiographs, then referral for an ultrasound of his heart would be needed. Thankfully there are some great heart medications out there that work well in cats and can give a cat plenty of years to live with heart disease.

As far as the ingrown nail, we do see this often in elderly cats because they no longer shed or groom their nails as much as previously and they tend to grow more curved and into the paw pad. Once cut and cleaned, they usually heal just fine though.

As far as the blood in the urine, this can be caused by the actual cystocentesis performed to retrieve the urine via a needle...however 3+ blood is a fair amount. It is hard to know how much could be from the needle insertion and how much isn't. If they somehow were able to get a free catch sample, where your kitty urinated for one reason or another and was obtained that way, then the 3+ blood is truly all present from within and is not just an artifact. Is he showing any urinary issues, such as crying in the litter box or urinating small frequent amounts?

Here is a link about idiopathic cystitis(FIC):

http://www.petmd.com/blogs/fullyvetted/2011/dec/treating_feline_idiopathic_cystitis#.Un_dInCOQxE

One easy way to decrease a cat's stress level is to start using Feliway diffusers, which are similar to plug in air fresheners, but release synthetic happy cat pheromones instead:

http://www.feliway.us/

These can be bought at your local pet store or your vet as well. Of course as your vet mentioned increasing water intake (buying a cat water fountain can help) as well as by feeding can food is good for kidney disease as well as urinary issues and is great for all senior cats.

I would not be very concerned right now with the Monocyte or the MCHC readings with where they are right now. However, if he is not showing any urinary signs, I think your biggest concern would be the
possibility of heart disease and I would take further steps to ensure that this is not an issue for him.

I hope this further information has been helpful!

Please do not hesitate to ask any further questions. I aim to provide you with the best service possible. If you feel I have done so, then
an excellent rating is greatly appreciated! If not, please let me know how I can better assist you. Thanks! XXXXX
FelineMed

FelineMed
FelineMed, Licensed Veterinary Technician
Category: Cat
Satisfied Customers: 386
Experience: Accomplished LVT for over 10 years with a BS in Biology as well. Experience working in 2 feline specific hospitals.
Verified
FelineMed and 87 other Cat Specialists are ready to help you
Ask your own question now
Thank you again for the excellent rating, it is greatly appreciated : )

I hope everything turns out well for your boy!

FelineMed
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FelineMed
FelineMed
FelineMed, Licensed Veterinary Technician
Category: Cat
Satisfied Customers: 386
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Experience: Accomplished LVT for over 10 years with a BS in Biology as well. Experience working in 2 feline specific hospitals.

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