Scratchings-and-Sniffings

Posted by Animals at 6:00 PM Tuesday, August 11, 2009

Scratchings-and-Sniffings

CRF and Urinary Tract Disease in a Cat

Posted: 11 Aug 2009 05:51 AM PDT

Good-dog-Miles-with-DrLarry I had an interesting comment from Edwenna on a recent post. This comment/ question deserves a post all its own as opposed to a simple reply. The question was two fold and involves a cat with Chronic Renal Failure (CRF) and a recently diagnosed urinary tract infection. This cat is 18 years old and has been dealing with CRF for a while now.

I did a post back in March on the general topic of CRF in cats. It's pretty common and with cats living longer these days the incidence in older cats seems to be increasing. I'll refer you back to that post for the basics and again recommend a site devoted to the management of CRF for a very detailed look at the problem.
 
Edwenna wants to know how long she can expect her cat to hang in there with CRF. That is a very tough question to answer and the general response is months to years. I know that is not very helpful but there is no good single predictor of impending kidney failure. Testing is important and Edwenna's cat has a creatinine level of 3.3 which is above normal and indicates some level of kidney damage.
 
However one reading alone is not predictive and at 3.3, this cat's creatinine level is only moderately elevated.
 
A series of tests taken at appropriate intervals is more indicative of the progression of renal disease. Since a visit to the vet with blood samples being taken is highly stressful I'd do it every six months at most, especially considering that Edwenna's cat is doing pretty well. 
 
As the CRF site advises the important thing to remember is to treat the cat and his symptoms as opposed to the lab tests. They can vary for a number of reasons but symptoms really tell the tale.
The other problem for this kitty is that he has been diagnosed with a bacterial urinary tract infection. Bacterial urinary tract infections are uncommon in cats under ten. With older cats afflicted with CRF they are much more common. Edwenna's veterinarian did the right thing with a urinary tract culture. It's the only real way to diagnose this condition and has to be done carefully. I did not hear whether an antibiotic sensitivity test was done but the kitty is on amoxicillin. That is usually a good choice and most of these infections can be cleared up in two weeks. 
 
Edwenna is concerned that her kitty is going to be on antibiotics for an entire month and wondered whether this is par for the course.Sleepy-baily
 
 There are a couple of good reasons to treat longer in this particular case. First we can't be positive that this infection is limited to the bladder. It may affect the kidney as well and kidney infections can be more difficult to treat and can complicate the existing CRF. Kidney infections may require 4 to 6 weeks of antibiotic therapy. 
 
The second reason to treat longer is that these infections can become chronic and recurrent in cats with CRF. It would be more of a mistake to treat for too little time. Since these infections can complicate the whole management plan for CRF it is best to deal with them aggressively at the onset.
 
The only other thing I would mention is the role of diet. If this kitty is really just eating mice he might be getting too much protein and phosphorus in his diet. He may benefit from a special kidney diet. The only caveat is that some cats won't eat these diets specifically because they are lower in protein and cats find protein very tasty. If they will eat them they may be effective in extending the functional life of the kidney. If they won't, it's more important that the cat eat something. Even free range mice.

0 comments:

Post a Comment

Subscribe to: Post Comments (Atom)