Does my senior cat's bloodwork show kidney issues? What about diet?

Hello, I am sorry I misunderstood your question earlier. I hope this response helps you. In order to stage renal failure, we need to know the urine specific gravity, blood pressure, and urine protein to creatinine ratio. Based on the values you provided, she has chronic kidney disease but I cannot stage it without further information. If the free T4 was elevated that is consistent with hyperthyroidism which often masks underlying kidney disease. Therefore, her kidney disease could be worse than we suspect based on the info you provided above. Realistically, she has two diseases and fortunately both are treatable. Ultimately, the prognosis depends on response to therapy. It is not uncommon for some patients to do well for a few years with appropriate therapy and kidney diet. Prior to treating her hyperthyroidism, her kidney disease should be treated (at home) with subcutaneous fluid therapy, antibiotics to cover for an underlying kidney infection, and vitamin B12 supplementation. After she feels better and begins eating consistently, discuss treatment for hyperthyroidism.

Unfortunately kidney values can not be interpreted without a urinalysis and specific gravity. Elevated BUN is not always CKD but this would be more likely in the face of poorly concentrated urine ( pred will also effect this). CKD is staged via what is called IRIS. This takes in to account creatinine, protein in the urine, and blood prressure. SDMA is newer and thought to be an earlier indicator then BUN/creatinine as these as insensitive markers of kidney function. This has now been incorporated in to the new IRIS scheme. What i would recommend for your kitty is a urinalysis and blood pressure to better stage. For early stage CKD kitties a renal diet is recommended. It is also important to treat any high blood preesure or significant protein in the urine as these can worsen kidney function. I hope this helps and thank you for using Petco Pet Education Center, formerly Petcoach!

Even though Annie's SDMA is at the upper end of normal, I don't see evidence of early kidney disease due to her normal BUN and creatinine values. A urinalysis will help to determine how well her kidneys are functioning to concentrate urine. It looks as though she has a few extra red blood cells (mildly increased hematocrit) and is making some extra red blood cells (slightly increased reticulocyte count), as well as a mild drop in her neutrophils (a type of white blood cell). All of these fluctuations could be associated with a relatively recent mild infection or illness that she's since recovered from. If she's clinically doing well, I wouldn't otherwise think too much of these values. I see that she also has a bit of hyperkalemia (high potassium), which is increasing her Na/K (sodium to potassium ratio). While hyperkalemia can occur with kidney disease, I would also expect to see at least moderate increases in BUN and creatinine at the same time. Other issues, like stomach upset, parasites, or certain medications can also increase the potassium values. I would still check a urinalysis to help get a complete picture. If your vet also recommends doing so, repeating this bloodwork in another month or two is a reasonable idea to track any changes. I hope that everything goes well!

Poor guy. I see elevate liver enzymes (ALT,AST) and kidney values on the paperwork you have attached here. Low hgb means that the red blood cells are not oxygenating well, but if the RBC count is also low (anemic) then that is a sign of chronic kidney failure. Cats can recover from kidney disease depending on the underlying cause. An abdominal ultrasound is needed to determine the cause of the kidney failure exactly, or a positive response to bloodwork is used as a means of determining a positive outcome. In most situations we treat the pet with fluid therapy to help idurese (flush out) the harmful toxins (BUN, CREA), get the pet started on a prescription kidney diet (ie. Hill's K/D, Royal Canin Renal) and also a supplement (Azodyl- which helps to remove toxins from the gut) can be given as well. The most concerning values for me on this bloodwork are the liver values (AST, ALT). It is not common for a cat to be in both kidney failure and to have abnormal liver values concurrently. THis raises suspicions for infectious diseases such as any number of tick diseases. I would recommend discussing with your vet about possibly doing a tick panel, if the history indicates tick exposure is probable. Also a FeLV/FIV test may also be indicated, depending on the complete CBC results, which you didn't post here. At the very least a liver protectant medication should be started, which is typically a medicine called Denamarin. Additional treatment may be needed depending on the underlying cause for the liver abnormalities. If you would like to discuss Toby's case further, then please feel free to request a consultatoin with either myself or another expert here. Toby's case is definitely a more complicated case where it is best to have a complete dialogue back and forth to get all the information you need to make the best decision moving forward with his care. I wish you all the best moving forward with Toby's care and I hope that he makes a full and speedy recovery. Take care.

I don’t think this shows renal disease. His creatine is normal with a slightly elevated BUN. To me this is more an indication of mild dehydration than kidney disease. He is slightly anemic also which is not uncommon in senior animals but may indicate a chronic medical problem. The eosinophils are slightly elevated which can be due to allergies or intestinal parasites. Basically for a thirteen year old cat there is nothing here that is overly concerning. Bloodwork is just a moment in time though so if you’re concerned I would repeat it again in a month or two so you can see if there is a trend indicating progression of a medical problem or kidney disease. Thanks for using Petco Pet Education Center, formerly Petcoach to help you care for Beau.

Hello. It is difficult to comment on Beau's kidney function because there is some vital information missing. I would need to see his BUN value, an SDMA analysis, & a urinalysis. SubQ fluids are always a good idea for cats with kidney insufficiency, but without the urinalysis, I cannot say if there is any azotemia ( a term used to describe kidney function abnormalities ). The same goes with the Azodyl, which may help pets with azotemia. With a creatinine of 2.5, & according to the International Renal Interest Society ( IRIS ), Beau's kidney insufficiency is a class 2, or mild, but we really need to see the SDMA to truly classify things. If his T4 is indeed 1.0, I would definitely decrease the methimazole, only you do want to keep the doses the same morning & night. Your vet should recheck the T4 in 2 weeks to see if the Methimazole needs to be decreased further. If the prednisolone is helping the bronchitis, then it is not necessary to stop it. His liver is perfectly fine, & depending on the dose, it too may be titrated down to the very lowest dose to keep him comfortable & control his symptoms. Thanks for using Petco Pet Education Center, formerly Petcoach.

This should not make a difference. Please check with your veterinarian if in view of the renal disease, it is advisable to change to a raw diet, as this means a lot of protein is being fed which can negatively influence your cat's kidneys, It would be ok in a healthy cat, but a cat with renal disease may not be the right candidate . lso, please do not , under any circumstances, feed beef neck parts or poultry necks, as they contain thyroid glands and your cat would be eating thyroid hormones which would make his hyperthyroidism much worse.