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New question for Peanut

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  • DH
    Dear Friends, I am posting on Feline Anemia now as well, given the new development in Peanut s condition. The visit to the vet yesterday showed a decrease in
    Message 1 of 11 , Feb 7, 2012
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      Dear Friends,

      I am posting on Feline Anemia now as well, given the new development in Peanut's condition. The visit to the vet yesterday showed a decrease in chest and lung fluid, and her kidneys are holding against the Lasix (and she's only getting 50-60 ml sub-q lactated ringers a day now). Being that she is anemic (which I discovered Saturday by her litter ingesting), I was trying to decided whether to treat the anemia (current HCT is 23%) with diet and B vitamins, or go for one of the ESAs (Epogen or Aranesp). She's been on B vitamins since Sunday, but today she hasn't urinated at all (and it's 20-24 hours since the last one). Her appetite is down, but she's still drinking water. I don't know if this is the stress of yesterday's visit or a deeper spiraling downwards. I gave her sub-q's, and am waiting to see if she will eat on her own, and urinate within the next 6 hours. Yesterday's xrays did not show any signs of bladder blockage or kidney stones.

      So I'm wondering, would the anemia at 23% cause her kidneys to shut down? --and would Epogen be a "Hail Mary Pass" at this point? The only other option I see is to help her pass on.

      Diane & Peanut
    • elfinmyst@aol.com
      Hi Diane I wish I could help but I can t say whether you should use B vitamins or a drug for anaemia as I have no experience of cats with anaemia. Normal
      Message 2 of 11 , Feb 7, 2012
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        Hi Diane

        I wish I could help but I can't say whether you should use B vitamins or a
        drug for anaemia as I have no experience of cats with anaemia. Normal range
        is 29-48%. I think the best person to advise on that would be the vet
        unless others here have personal experience. Can you feel Peanut's bladder? Is
        it hard and full and is she straining at all? If not, I wouldn't let her go
        more than 24 hours or so without passing water, and if her bladder feels
        small then I`d be worried about the kidneys and possible build up of urea in
        the blood.

        I had a girl go 26 hours once, took her to the vet and of course she weed
        on the table! However, with diuretics I`d expect them to wee more often.
        Kidney failure can only be diagnosed with a blood test.

        Lyn:)

        _www.myfurkids.co.uk_ (http://www.myfurkids.co.uk/)

        [Non-text portions of this message have been removed]
      • joanne marbut
        I may not quite understand but unless she s showing physical signs or signs in the blood work of being dehydrated, why are they giving her sub-q fluids when
        Message 3 of 11 , Feb 7, 2012
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          I may not quite understand but unless she's showing physical signs or signs in the blood work of being dehydrated, why are they giving her sub-q fluids when she is also showing fluid buildup in the lungs and heart (unless I'm reading this wrong?)  That's counterproductive.  She shouldn't receive fluids if she has fluid buildup.  

          This issue is complex because the body is complex.  Anemia is generally caused by a lack of a hormone EPO that the kidneys produce. A lack of EPO is caused by malfunctioning or diseased kidneys that are unable to produce sufficient EPO. EPO creates the red blood cells that are produced in the bone marrow. Decreased kidney function decreases the hormone thereby decreasing the red blood cells whose function it is to carry oxygen in the blood to organs and tissue. Without red blood cells, one becomes anemic. Anemia effects the heart and thickens the walls and makes the heart work harder.  A loss or destruction of red blood cells due to other diseases or illnesses can also make one anemic. A lack of vitamin B and folic acid can also decrease the body's ability to produce sufficient red blood cells. Ingesting meds or onions or such things that are toxic to the body damages red blood cells and therefore creates anemia.  To combat anemia, a cat needs to
          receive more protein and iron in meats. Maybe try to feed it beef. Cooked liver will provide needed iron. Vitamin B and other vitamins, iron, and folic acid are necessary supplements.  Drugs such as erythropoietin (EPO) might help. Severe anemia might need blood transfusions. Ask about safe appetite simulants that might get the cat to eat the protein it so needs.  So, to answer your question, no-anemia hasn't caused the kidneys to stop functioning. It's the other way around. The fault may be with the kidneys.

          If the kidneys are diseased, they are not functioning correctly and the cat isn't able to urinate as it once did.  But the kidneys or bladder can seem to stop functioning well if the cat is on meds that have a side effect of urine retention-pain meds, Prozac, etc. There may not be an issue with a med for weeks or months then suddenly it seems as if the cat has stopped being able to go.  Check urine retention in humans as a possible side effect for any drug that the cat is taking and see if a decrease of that med is possible over the course of a week. Then see if the cat urinates more. I have been through this with a cat that is on Prozac and when he was on Amitriptyline-which we took him off of because of severe urine retention.  We have also seen it recently with two cats on Buprenex and I've decreased those amounts and now they seem to be urinating at more normal intervals. 

          Good luck!

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        • Carol
          I believe Peanut on fluids because she is also a CRF kitty and needs some fluids for her kidneys. Having a kitty with both CRF and CHF is difficult to
          Message 4 of 11 , Feb 7, 2012
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            I believe Peanut on fluids because she is also a CRF kitty and needs some fluids for her kidneys. Having a kitty with both CRF and CHF is difficult to balance, but the kidneys still do need hydration, though the heart shouldn't have it. You have to find a balance for both. My angel Sweetie was both and I used to give her just a minimal amount of subQ's (25ml twice daily) in the times when her CHF was flaring up, because her kidneys still needed to be treated too. It's not a good compromise, but you have to choose which to treat, the heart or kidneys and just do the best you can with both.

            Carol and the gang





            -----Original Message-----
            From: joanne marbut <jomarbut@...





            I may not quite understand but unless she's showing physical signs or signs in the blood work of being dehydrated, why are they giving her sub-q fluids when she is also showing fluid buildup in the lungs and heart (unless I'm reading this wrong?) That's counterproductive. She shouldn't receive fluids if she has fluid buildup






            [Non-text portions of this message have been removed]
          • Kim Thompson
            My angel Tanner was CHF and CRF too. When he needed subq the vet said the lasix would take care of it. It was the renal lymphoma that took him away, but it
            Message 5 of 11 , Feb 7, 2012
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              My angel Tanner was CHF and CRF too. When he needed subq the vet said the lasix would take care of it. It was the renal lymphoma that took him away, but it was a razor's edge to walk, thats for sure.

              Sent from my iPhone

              On Feb 7, 2012, at 7:36 PM, Carol <carolroar@...> wrote:

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              > I believe Peanut on fluids because she is also a CRF kitty and needs some fluids for her kidneys. Having a kitty with both CRF and CHF is difficult to balance, but the kidneys still do need hydration, though the heart shouldn't have it. You have to find a balance for both. My angel Sweetie was both and I used to give her just a minimal amount of subQ's (25ml twice daily) in the times when her CHF was flaring up, because her kidneys still needed to be treated too. It's not a good compromise, but you have to choose which to treat, the heart or kidneys and just do the best you can with both.
              >
              > Carol and the gang
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              > -----Original Message-----
              > From: joanne marbut <jomarbut@...
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              > I may not quite understand but unless she's showing physical signs or signs in the blood work of being dehydrated, why are they giving her sub-q fluids when she is also showing fluid buildup in the lungs and heart (unless I'm reading this wrong?) That's counterproductive. She shouldn't receive fluids if she has fluid buildup
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              > [Non-text portions of this message have been removed]
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              > Your reply will go to the author of this message. If you feel your reply will benefit the entire group, please change the "To:" line to feline-heart@yahoogroups.comYahoo! Groups Links
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            • acrocat@rocketmail.com
              Hi Diane Do you know if her anemia is non-regenerative? If it is regenerative, you needn t use anything. If it is non-regenerative, you may want to use
              Message 6 of 11 , Feb 9, 2012
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                Hi Diane

                Do you know if her anemia is non-regenerative? If it is regenerative, you needn't use anything. If it is non-regenerative, you may want to use Aranesp when you feel she has symptoms from her anemia.

                A lack of vit B12 can cause a specific type of anemia ("pernicious anemia") , seen in humans but not in animals AFAIK. B vitamins will not help a cat with anemia unless it was due to a deficiency. Aranesp should be used as a last resort, in general, as the cat will always need it and the side effects, though rare, can be severe. In my own cat I used it when he was clearly at the end of the road. His anemia was slowly progressive, so he was not obviously symptomatic for it.

                Adriann
              • DH
                Dear all, Firstly, thanks for the input. We are attempting to remedy Peanut s anemia with B-vitamins (esp. Methyl B-12), and iron. She is urinating more, and
                Message 7 of 11 , Feb 9, 2012
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                  Dear all,
                  Firstly, thanks for the input. We are attempting to remedy Peanut's anemia with B-vitamins (esp. Methyl B-12), and iron. She is urinating more, and eating litter less (yay!). Her appetite is slightly improved, but not much. I guess it will take time for the vitamins and iron to kick in, but I'm hoping she'll become more mobile and have more muscle stability (she falls over if left standing for too long, but she walks okay for short distances...I guess the pleural effusion and ascites are still taking their toll). We've reduced her sub-Qs to 50 ml a day, continued with the lasix, and her kidneys are holding. Time will tell, and we judge her prognosis from day to day.

                  --- In feline-heart@yahoogroups.com, Kim Thompson <kimalooney@...> wrote:
                  >
                  > My angel Tanner was CHF and CRF too. When he needed subq the vet said the lasix would take care of it. It was the renal lymphoma that took him away, but it was a razor's edge to walk, thats for sure.
                  >
                • DH
                  Thanks, Adriann. I m not sure at this point which it is, but didn t want to start down the ESA path (Epogen or Aranesp) without trying the less aggressive
                  Message 8 of 11 , Feb 9, 2012
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                    Thanks, Adriann. I'm not sure at this point which it is, but didn't want to start down the ESA path (Epogen or Aranesp) without trying the less aggressive choice first. If we don't see improvement soon, I'll have the vet check for regenerative/non-regenerative. Visits to the vet are very stressful for her at this stage.
                    Diane & Peanut

                    --- In feline-heart@yahoogroups.com, "acrocat@..." <acrocat@...> wrote:
                    >
                    >
                    > Hi Diane
                    >
                    > Do you know if her anemia is non-regenerative? If it is regenerative, you needn't use anything. If it is non-regenerative, you may want to use Aranesp when you feel she has symptoms from her anemia.
                  • acrocat@rocketmail.com
                    Hi Diane ... I bet they ve already checked. If she s had a blood sample in the past 7 days, they can add on the test--it s just a reticulocyte count. This
                    Message 9 of 11 , Feb 9, 2012
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                      Hi Diane


                      --- In feline-heart@yahoogroups.com, "DH" <dianelharrell@...> wrote:
                      >If we don't see improvement soon, I'll have the vet check for regenerative/non-regenerative. Visits to the vet are very stressful for her at this stage.

                      I bet they've already checked. If she's had a blood sample in the past 7 days, they can add on the test--it's just a reticulocyte count. This looks for immature red blood cells. If there are a lot of immature ones, it shows that the body "knows" there are too few blood cells and is trying to pump out more. If there's just a normal amount, it shows the body is not trying to correct it (non-regenerative).

                      Your vet didn't tell you that B vitamins will treat the anemia, right? Because it won't unless she has (not reported in cats AFAIK) pernicious anemia. The only 'cures' for anemia would be treating the cause (mycoplasma infection, GI bleed, etc.) if it was regenerative. If non-regenerative anemia is caused by a lack of erythropoetin, then darbe or epo might work to improve it.
                    • DH
                      The last blood test (2/6/12) shows RETIC = 25.1 K/uL (no values given for normal range), and &RETIC = 0.7% (no values given for normal range). Does anyone know
                      Message 10 of 11 , Feb 9, 2012
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                        The last blood test (2/6/12) shows RETIC = 25.1 K/uL (no values given for normal range), and &RETIC = 0.7% (no values given for normal range). Does anyone know if this represents regenerative or non-regenerative? I can call the vet and ask if I must.
                        Diane & Peanut

                        --- In feline-heart@yahoogroups.com, "acrocat@..." <acrocat@...> wrote:
                        >
                        > Hi Diane
                        >
                        >
                        > --- In feline-heart@yahoogroups.com, "DH" <dianelharrell@> wrote:
                        > >If we don't see improvement soon, I'll have the vet check for regenerative/non-regenerative. Visits to the vet are very stressful for her at this stage.
                        >
                        > I bet they've already checked. If she's had a blood sample in the past 7 days, they can add on the test--it's just a reticulocyte count.
                      • acrocat@rocketmail.com
                        Hi Diane There is usually a corrected reticulocyte count which takes a few other factors into account, do you have that number? Without the corrected count,
                        Message 11 of 11 , Feb 9, 2012
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                          Hi Diane

                          There is usually a "corrected reticulocyte" count which takes a few other factors into account, do you have that number? Without the corrected count, and assuming this was properly labeled as cat blood, and with no normal ranges for the lab, I'll still stick my neck out and say non-regenerative because the % is low. But you should ask your vet and discuss the meaning of this.

                          Adriann

                          --- In feline-heart@yahoogroups.com, "DH" <dianelharrell@...> wrote:
                          >
                          > The last blood test (2/6/12) shows RETIC = 25.1 K/uL (no values given for normal range), and &RETIC = 0.7% (no values given for normal range). Does anyone know if this represents regenerative or non-regenerative? I can call the vet and ask if I must.
                          > Diane & Peanut
                          >
                          > --- In feline-heart@yahoogroups.com, "acrocat@" <acrocat@> wrote:
                          > >
                          > > Hi Diane
                          > >
                          > >
                          > > --- In feline-heart@yahoogroups.com, "DH" <dianelharrell@> wrote:
                          > > >If we don't see improvement soon, I'll have the vet check for regenerative/non-regenerative. Visits to the vet are very stressful for her at this stage.
                          > >
                          > > I bet they've already checked. If she's had a blood sample in the past 7 days, they can add on the test--it's just a reticulocyte count.
                          >
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