"Princess" McClain - Chronic Renal Failure - Case of the Month
Princess is an eighteen-year old spayed female Domestic Short Haired cat. Princess has been treated for chronic kidney failure since 12/20/2006. Her initial symptoms of kidney disease were; weight loss, drinking excessively, urinating excessively, vomiting, and a decreased appetite. Her initial blood profile showed elevations in the kidney values (BUN, Creatinine) and a decrease in the urine specific gravity. (These changes are called azotemia). She also had a bladder infection (cystitis) at that time. She was in Stage 2 kidney failure at this time.
(See the links at the bottom of the page for a discussion on kidney disease/failure and the terms used when dealing with this disease.)
Princess responded well to a change in her diet. She was started on a special diet to help her kidneys (Hills Prescription k/d diet). This diet has a reduced amount of protein, decreased sodium, decreased phosphorus, increased fat, and additional B-vitamins and anti-oxidants which are all needed to help a cat with kidney disease. She was also treated with antibiotics to cure the bladder infection. Link to dietary treatment of kidney disease.
Princess did well for a few months and then had a set back. She began losing weight, she stopped eating, and she was vomiting. Her kidney enzymes had again increased (she progressed to stage 3 kidney failure) and she was treated with intravenous fluids, anti-nausea medicine, and appetite stimulants. Princess responded well and began eating and drinking. She was sent home and her owner's also administered subcutaneous fluids a few time a week to help flush her kidneys. Link to fluid therapy in the treatment of kidney disease.
Her bloodwork this time showed that she was anemic. This is a common sequel to kidney disease as the kidneys produce a hormone called erythropoietin which stimulates the bone marrow to produce red blood cells. As the function of the kidneys decreases, so does the amount of erythropoietin and therefore not as many red blood cells are produced. We started her on twice weekly injections of Epogen (human erythropoietin) which her owner was able to give by subcutaneous injection at home. We also needed to supply her body with iron so she could build the red blood cells and she received a once a month injection of iron dextran. Link to anemia/epogen treatment in kidney disease.
For the last 10 months, Princess has been very stable. Her red blood cell count is back to normal (she is down to an epogen shot once a month) and her kidney enzymes are stable and stay slightly elevated. She is eating well and gaining weight. She is a petite girl with an all time high weight of 5 lbs 9 ounces. Her lowest weight had been 4 lbs 5 ounces. She continues to eat her kidney diet and does not need anti-nausea medication nor appetite stimulants at this time.
Best of all, Princess's feisty nature has returned. She loves to be carried around on a shoulder and she lets us know that she really would prefer if we didn't test her blood anymore!
Princess is the pet of the month because:
- she is old but spunky!
- she has gotten through some rough times and is living comfortably with chronic kidney (renal) failure.
Kidney disease/Failure terms and stages
Links to other sites on renal failure (including step by step directions on giving your cat subcutaneous fluids)