What tests and care for my senior cat with kidney and pancreatitis?

Pancreatitis is difficult to diagnose and is done by analyzing compatible clinical signs and lab test results. Cats with pancreatitis commonly experience lethargy, loss of appetite and occasionally vomit, but these clinical signs can also be caused by a variety of other conditions. Typical blood testing includes a CBC (red & white blood cell count and platelets), chemistry (to evaluate overall organ function, blood glucose and electrolytes), T4 (thyroid hormone), as well as a urinalysis (to evaluate kidney function and look for infection). If pancreatitis is still suspected, a blood test called an fPL can be done to either rule pancreatitis out or make you more suspicious of that as the diagnosis (this is not a conclusive test). Abdominal ultrasounds can be helpful to determine if the pancreas is inflamed or if other abnormalities are present, but these are not performed in all cases. Cats with pancreatitis commonly also have concurrent diseases - such as inflammatory bowel disease, cholangitis (inflammation of the gallbladder) or cholangiohepatitis (inflammation of the gallbladder and liver). Uncommonly, cats with pancreatitis can become diabetic if there is enough damage to the endocrine portion of the pancreas. There is no definitive treatment for pancreatitis. The goal is to manage Bella's clinical signs supportively (i.e. IV fluids, anti nausea medications, pain medications, etc.) as needed. If you are concerned about the treatment plan that your vet has started for Bella, call her to discuss the options. Odds are that she has a reason for starting or not starting certain medications or diagnostics. If you feel uncomfortable with this plan after speaking with her, it is always reasonable to get another opinion. I hope that Bella is feeling better soon!

Increased thirst and urination can be commom symptoms of many disease processes and you are right that the first things we check for are metabolic (kidney disease, diabetes, etc.). The answer to your question is both. A urinalysis should always be performed as part of a blood panel, otherwise you are missing crucial information. Your vet will likely order a senior kitty wellness panel from an outside lab which will include cbc, chemistry panel, thyroid testing, and urinalysis. I hope this helps and thank you for using Petco Pet Education Center, formerly Petcoach!

I forgot to mention that they will also require a urinalysis in addition to the blood test in order to confirm kidney malfunction exists, before proceeding with the recommended treatments that you mentioned.

I would opt for a prescription kidney diet (Hill's K/D or Royal Canin renal) instead of any over the counter option if he has kidney disease especially, because the mainstay of treatment for this is the diet alone. This is also ok for his pancreatitis for now and hopefully he will get over this pancreatitis episode soon with the treatment recommendations through your vet. Pancreatitis in cats is often associated with a triaditis (3 disease) condition affecting both their intestines (IBD), pancrease (pancreatitis) and liver (cholangitis), so its imperative to follow your vets instructions on follow-up care as well. Here is more information on this condition in cats --> https://veterinarypartner.vin.com/default.aspx?pid=19239&id=4952234 I do hope that your pet Cat is going to be ok moving forward. Best of luck and take care.

I'm so glad that Mr B is feeling better. A prescription diet would be ideal, if he will eat it. However, it is more important that he be consistently eating something. Regular food intake and meals keeps the pancreas working at a steady pace to help digest food, rather than going from 0 to 60 so to speak; meaning not needing to work, then working really hard. Since he is an older guy, he is just more likely to start to have health problems. If he does have a recurrence of pancreatitis, it would be a good idea to talk to your vet about an abdominal ultrasound (sonogram of the abdomen) if that was not preformed yet, to see if there are any other issues going on, such as an obvious tumor, etc. I hope that information is helpful. Thank you for asking 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!

Yes, please have her reevaluated. The blindness likely is caused by high blood pressure and the high blood pressure is likely caused by the kidney disease. Your cat will need to be evaluated and then put on blood pressure medication. Subcutaneous fluid giving should not stress her, if it is done right. You may want to have your vet show you again, how it is done. Please take Kitkat for a recheck today.