Re: Vet Report!
We are back from the vet . First, her UTI isn't clearing up at all, so we've switched antibiotics to zeniquin, which has worked very well for her in the past on stubborn ones. Second, her anemia has gotten a little worse. That was the most worrying thing today, actually. It could be a GI bleed we can't detect, from chronic infection, or it just could be that the anemia that started last year after the leukeran just isn't allowing sufficient regeneration for it to get better. Her HCT was only 17.9% today, a drop from 18.7% on 4/27 (and a continuation of a very slow drop from 21% in January). I plan to start giving sucralfate an hour before her meals to see if that helps any just in case it is a bleed . If she's no better by next week we'll send out blood for a reticulocyte count to see if she's regenerating sufficiently but the adjusted retic counts using his machine are way below 1% which isn't a good thing given how anemic she is (they should be way higher if she's capable of regeneration). If she turns out to have nonregenerative anemia, then we'll probably have to consider using a drug like aranesp. That worries me because my GA Tabriz developed antibodies to epogen and that led to a long struggle with repeated blood transfusions to keep him alive. Aranesp at least anecdoctally seems to result in less chance of antibodies, but it is a concern to even think I may be going down that road with another cat. Then again, when these drugs work they do wonders and without treatment there isn't much we could do other than transfusions. We'll see what the retic counts show and we'll know more what is going on there.
Finally, she does appear to have early stage kidney disease. :sad: Her creatinine has been slowly rising over the past 6 months or so. The last time we checked it was 2.8, which was outside normal range. This time it was 3.1, and the way the scale works that is a significant jump (normal range is 0.8-2.4). Though her BUN was normal at 32 (normal 16-36), the creatinine is a much more specific item for kidney problems. We've started her on phosphorus binders and will continue to monitor. He's hoping that if we can get the anemia and diabetes under control that she'll improve some, since diabetes can throw off numbers but it can also lead to kidney disease too. At this point though I'm far more worried about the anemia than the kidney disease! We've got to get her anemia under control, but am not sure how we'll do that.
One good piece of news wast that she was spilling far less sugar in her urine. She was off the charts the last few times (>1000) but this time only registered 50 mg/dL so that was good at least. Better control of her sugar levels will help with the UTIs. Her BG was 119 when he tested it at +4.5, so that was also good. A much better number than we've seen there for a low.
Not very happy news today, but I do have plenty of experience dealing with both anemia and CRF, so at least I know what to do. My vet sent me home with the big jar of binders I'd taken there. We'll get through this, but I'm a little sad right now.
