Sandy
A couple things that I can think of. I agree his kidneys don't appear to be an issue but you don't need an entire UA done. I've dealt with this many times and the best and least expensive thing to do is to find out if your vet has a refractometer at his/her clinic and if they keep it calibrated or will calibrate it before they use it. If so, I'd collect BK's
first urine sample of the day because it will be the most concentrated and then run it over to the vet and let them check his urine specific gravity (USG) with the refractometer. It's usually much cheaper than doing a whole UA especially to just see if he's concentrating his urine. You want the very first one of the day (and I know that might be a challenge since BK is in his own house) because USG changes during the day depending on how much water he might be drinking. Maybe he has a day that he's just a little thirstier than usual. If the first sample of the day is concentrated, than you don't need to worry that he's starting with kidney issues because a lower USG can be the first sign you might see of CKD before you even see a change to creatinine/BUN.
But also be aware that cats with liver issues will drink more water and so a lower USG could be tied to liver issues as well. We ran into this with Gracie.......she was drinking a lot more water because of her elevated liver values and the UA the lab did on a mid day specimen showed a lower USG but the first sample of the day was normal. Once the liver issues were ironed out, her USG has been normal.
We also have had issues with her liver values especially ALT but at one time, all of them were up including AST, ALP, GGT, and bilirubin. We had the bile assay test done and it is fairly simple. You don't feed them, you take them to the vet and they draw blood, then you feed them and bring them back a little later and they draw blood again. The bile assay test can tell you if there is an issue with his bile duct and whether there is a potential blockage but it can also give an idea of overall liver function. Usually if there is a physical dilation of the bile duct, it indicates a blockage and they are really sick. If there is more a functional dilation, it's usually an infection as bacteria can travel from the intestines to the liver and up the bile duct. He might have cholangitis or triaditis (which involves the pancreas) but I think you'd see anorexia, vomiting, etc. with the latter. Typically.
What we did was an ultrasound and there was initially some inflammation of the liver so she went on clavamox and all levels came down to normal except ALT. The denamarin never helped Gracie but ECID. What did help her and bring her ALT down to normal was water soluble liquid Vitamin E. She gets 75IU of
Aqua-E once a day.
This is the only one I could find that did not have any glycerin (which raises BG). She doesn't mind it at all...in fact, she rather thinks it is a treat. We just give it to her via syringe. The liver can be tricky because an elevated ALT is indicative, usually, of hepatocyte damage but it can be due to so many different things...even, as Sienne stated, eating something they shouldn't have. After Gracie's initial liver enzyme elevations came down, we continued to do ultrasounds and everything looked tiptop. Of course, the docs will say that you can't always tell completely and the only way to really dx liver disease is with a biopsy. We did not want to do that because, clinically, she was fine although she had lost a little bit of weight and was drinking/peeing more. Her weight is totally stable now and she's drinking/peeing normally.
I hope this helps. You know where to find me if you have any questions on what I wrote.
Please keep us posted. Black Kitty is a legend here!
