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I'm a 16 year old kitten who's had a few serious problems over the past few years.
First I was throwing up, losing weight and drinking gallons of water. I was diagnosed with hyperthyroidism. I had half of my thyroid removed and my vet prescribed methimazole. About a week later my liver had hardened and my vet gave me a week to live. My owner did some research and found out that a rare side effect of methimazole is liver damage and immediately took me off the medicine (my vet said that there was no possible correlation). I drank acidopholus milk (yum!) and cooked chicken breast and recovered very nicely.
About 7 months later, my numbers were back up again. The vet prescribed Tapazole and told my owner that it was a different drug than the methimazole. Luckily I only had two doses before my owner looked it up and found out that it was the same thing and got me off of it. I had my second surgery and I'm now thyroid-free and doing pretty well.
It's now been six months since the last surgery and I had a bout of throwing up. We went for followup and the vet took blood.
Here's the problem...my BUN is up from 51 pre-surgery to 57 post-surgery and my creatinine is up from 1.5 to 2.8
The vet has said that there's nothing that can be done except going onto a low-protein diet. "There's no treatment" and "they don't do kidney transplants for cats".
Again, my owner did some homework and found out that there is treatment (subQ fluids, probiotics, etc) and they *do* do kidney transplants. (we're less than an hour from UPenn).
I'm not having any problems with my appetite. I'm drinking well and I'm even playing with my string and little paper balls. You'd never know that I was 16 and you certainly wouldn't know that I was sick (except when I occassionally spit up water right after I gorge myself)
First question: Is it likely that my kidneys were damaged by the problems with my thyroid or by the followup problems with the methimazole/liver?
Second: Is there any point to restricting protein or should I just drink more and get a followup blood test in a couple of months? (Daddy bought me a really cool fountain and I'm emptying it. So I'm drinking much more water than I used to)
Third: How can you find a Vet that understands CRF and keeping it under control? Dad doesn't want to just pick names out of the phone book and hope for the best.
Hi, Pixel, and welcome! I too have both CRF and hyperthyroidism. These are two conditions that are tricky to have together, because an overactive thyroid can mask kidney insufficiency because it increases blood flow to the kidneys. Perhaps that's why your (very minor) kidney insufficiency showed up once your thyroid was under control. My vet explained to me that the hyperthyroidism needed to be treated (it can cause liver problems, heart problems, etc.), but if my T4 levels got too low, then my creatinine might go up. So...we have continually played around with my Methimazole dosage, trying to make sure that neither condition looks too bad on blood work, though often neither condition can be made as good as it would be if the other condition weren't present. I've been lucky and have been able to keep my bloodwork pretty much in the normal range for both conditions, so it's most definitely manageable. As you may have been told, the radioactive iodine cure for hyperthyroidism is not for CRF kitties, unfortunately. So...it's kind of a balancing act. Sounds like surgery was the option for you since you had that reaction to the Methimazole, and that was very wise to research tapazole, becuase yes, they are the same! And to be told there are no treatments??? There definitely are, as you've found out, and sub-q fluids have been GREAT for me. However, it sounds like your CRF is very minor right now, so changing food might be all you need for the time being (though if you don't like it, don't worry, because there is debate among vets as to how much difference restricting protein really makes). I wouldn't worry too much that you've gone too long without treatment for those kidneys. However, I don't blame you a bit for wanting to change vets. Wish I could tell you where to go, but being in NC (and near NC State who also does kidney transplants), I don't know where to direct you. If you have other friends with cats, you could certainly ask them, or of course you could check out the "local" section here on Catster and see if you see anything. If you do resort to the phone book, I personally would try the cat clinics first, because I would think they couldn't help but have more experience with feline CRF. I changed vets shortly after diagnosis as well, and you bet Mom didn't hesitate to say that I had just been diagnosed with CRF and asked if they were experienced in treating this condition. Best of luck to you! Let us know how it turns out!
Pixel! You're lucky to have such a savvy human. Did you teach your human to use the internet? Seems like you didn't have much luck training your vet.
Isn't Abbie just the cat's pyjamas or what! I'd ditto everything she said:
Get a 2nd opinion (My Meowkai found me a vet that would even come to our home.).
Get some food in you (Check online (or with a good vet) for foods to avoid, but bottom line is you need to eat.).
Keep doing what you & your human are doing: homework!
Some online resources:
http://www.felinecrf.org/success_stories.htm - Meowkai thinks felinecrf.org is the most comprehensive site for our kidney condition. The success stories will give a good idea of what the BUN & creatinine numbers mean relative to our longevity, etc.
http://www.merckvetmanual.com/mvm/index.jsp - If you're the tech type, the Merck Veterinary Manual also has plenty of good info.
You'll see from my Catster site that my previous vet wanted to send me over the bridge right away last week. We are taking this one day at a time & treasuring our physical time together.
You may also remind your human that kitties don't necessarily follow traditional laws of physics. We put the meow in meowtaphysics... our alohas are always & forever.
Concerning finding another vet, I concur with looking for a "feline only" vet and checking Catster Local. You could also check Catster for cats who live in your area, see if any indicate they have CRF and send them a pawmail. (To search for cats in your city or any particular city, go to "See the Cats">> go to the right-hand side of the page that opens, to "See Cats Near You!">> fill in the "City and State">> click "Search").
Regardless if you get recommendations or resort to the phonebook, start by making calls. I think the quality of answers and attitude of the people who answer the phone gives huge clues to the quality of care Pixel will receive there. If they don't have time or don't care about answering your questions or finding someone who can, move on! (You might even be able to have the vet call you back so you can ask questions -- it's worth a try.)
When you find possibilities, ask whether you can tour the clinic, back rooms included (surgery may prevent this at times -- you should be able to find out the times not to come for a tour). Not receptive? I'd move on.
Take tours and see whether you want Pixel treated at that clinic. Bear in mind that a stay in the hospital may be necessary at some time. If not "feline-only," do cats have a separate area? Is there a soundproof isolation room for loud barking dogs? Is it CLEAN and orderly? Is the staff friendly or "stressed"?
Finally, after narrowing down the options, if you can afford it and have the time, make an appointment to meet the prospective vet -- without taking Pixel (be sure to let them know it's just you, for a "meet the vet" visit). Go armed with questions. They can't treat Pixel until they've examined her, but you can still get a good idea of how they would go about treating CRF.
I highly recommend that last step. It will make an impression on the vet by letting them know how much you care about Pixel receiving the best treatment, and you will get a feel for how receptive they are to questions, how well they explain things, etc. It also saves Pixel from a vet visit if this is not the right vet -- don't subject her until you've done your homework.
You can also check for mobile vets who'll come to your home (like Shasta is lucky enough to have).
Good for you for wanting the best care for Pixel. Good luck!
I'm a little late responding in this thread, but I wanted to add my support to what Scooter said. I go to a cats only vet - The Coast Cat Clinic - and anyone who knows me knows that my mum thinks Dr. Susanne is great. We changed to her for many reasons, the biggest being my declining health - I was down to 4.5 pounds. Also, a cat was killed by a dog in the waiting room of our old vet, hence the want for a cats only place!!
Scooter is so right about asking to tour the back rooms, though it wouldn't have helped what happened to me. My old vet took me in the back and told Mummy to stay in the exam room. Mummy didn't really like this, but she complied...for a few minutes. When she opened the door, she saw that they'd tied me up!! Granted, I am wiggly, but at Dr. Susanne's, I get put in a kitty baggy...lol.
Sorry...I'm getting a little off topic, I know.
Another thing you can check for is if the vet has experience with geriatric kitties. Dr. Susanne has attended several workshops and clinics devoted solely to us old guys.
It sure is hard to find a good feline V-E-T--my meomwy knows! She has looked for feline V-E-Ts on the AAFP (American Association of Feline Practitioners webpage). She recently used the felinecrf.com site and looked up vets that meowmies with chronically ill kitties have said good things about.
We went and saw a wonderful internal medicine specialist who put me on Calcitriol for my CRF...he gave us a packet of CRF kitty food (Royal Canin) to try, and when he heard that my meowmy is trying to get into V-E-T school, he gave her the exam fur free!!
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