Blood test- how often?

[Catfan5]

Bailey has been taking one prednicare tablet a day for nearly a year and she had a blood test last December to check kidney and liver function. All was fine. The vet called last week to say she should have a blood test every three months, so she is booked in for this morning.The problem is that Bailey has to be sedated when she has a blood test as she absolutely refuses to let them do it, and she growls even then! Does anyone know if it is necessary to have the blood test so often or could it be left longer? I know there is a risk of developing certain conditions with long term steroid medication but she gets so stressed with these vet visits. I can't find anything regarding repeated blood tests online. She has chronic bronchitis which is well controlled with prednicare and the only alternative is to use a spacer daily and I can't see her tolerating a mask on her face either.
Does anyone know? Also does does anyone have a cat who has to use a spacer and how do they get on with it?

[meriad]

When Molly first started showing signs of age related kidney degeneration I'm fairly certain we did the repeat bloods every six month only. And if those levels were drastically changed then it was 3 months and vice versa, if those results were fairly steady it was back up to a six month interval

I would speak to the vet about the pro's and con's of 3 month tests vs the stress possibly causing more issues and see what he / she says. Maybe you could compromise to every 4 months which would really only mean two extra vet visits in a year as you'd be going once a year for vaccinations anyway?

[Kay]

just a thought, but when my Trigger had to have several blood tests to check his HyperT meds were working, it was the attempts to shave his neck which distressed him, as he hated the noise of the battery shaver - once the vet switched to clipping the fur with scissors he was much calmer, even though the process took longer - any chance Bailey is the same?

[Catfan5]

Thanks for your replies. Bailey didn't need sedation after all, a new lady vet and vn managed to take blood without it! The first time ever so I was pleased about that and Bailey was fine. I hope the vet is there long term for future tests! There was a note about her being a 'naughty cat' which the vet mentioned so had to point out that poor Bailey was simply scared and stressed, not naughty on previous occasions. Slightly annoyed about that..
Ria, the vet agreed that if the results came back clear again then we would check her six monthly instead of three. Just have to keep an eye on her for any symptoms. The dosage has also been halved too as advised by the specialist vet as Bailey rarely coughs now.
Kay, I hadn't thought of that! It's definitely worth asking next time, it's the sort of thing that would upset her- thanks.

[Catfan5]

Update on Bailey: the blood test showed that her creatinine (sp?) levels are raised to the upper end of the normal scale compared to the previous test three months ago which was at the lower end. So the vet wants to start her on some RC wet kidney food- not sure of the name yet. Also repeat the blood test in one month. Bailey is eight so hopefully with the right diet we can control it. I've yet to find out more about it though. Or is this an overreaction at this early stage? The vet doesn't think it's the steroids causing it. Just a thought, Bailey and her brother love Thrive freeze dried chicken and have some sprinkled on their food every day, also Porta21 sensible dry to graze so I'm wondering if this is way too much protein which has caused a problem?

[Crewella]

More modern thinking on feeding cats with renal problems is tending towards feeding higher protein diets, and looking at the quality of the protein rather than the amount. If you've not seen them before it might be worth having a read of these:

http://www.veterinarypracticenews.com/W ... -to-Treat/

http://www.felinecrf.org/which_foods.htm

[Catfan5]

Thanks so much for the links Crewella, very informative. Bailey loves the rc wet renal food but now I see it has very low protein so have been adding a little of it to her normal hilife wet until I speak to the vet regarding this. There's a lot to take in from all this info but it's so useful. I read that if a cat is really stressed when having blood taken it can affect the results and give false readings, and how the tests shouldn't be done too often due to the effect on the vein in the neck and so on.. I'm rambling here so I'll carry on reading. Thanks again. If anyone has experience with early diagnosis and what tests were done, and which food (prescription or supermarket) you feed I would be interested to know.

[Jan]

We were lucky enough to catch Blackie's CKD at a very early stage (Stage 1) due to him having to undergo blood + urine tests before an anaesthetic to have an upper canine removed.

We were then advised to put him RC renal food per week - the problem with that was Blackie would only eat it in 'fits + starts'.

Another vet had a different approach. She felt based on his test results and the fact that she wasn't altogether convinced that cats should have a 'low protein' diet, because of muscle loss, it would be fine at Blackie's Stage I CKD to feed him what he liked as long as a phosphate binder was added to his food. The one she recommended was Ipakitine She advised that Blackie should have a blood test every 6 months and a urine test every 3 months.

The next blood test done last October revealed there was an improvement in some of the results so she was satisfied that Blackie could go on eating his favourite food with added Ipakitine. He should have had a urine test at the same time, but Blackie wouldn't co-operate with using the non-absorbent litter

We finally got a sample in early January. I queried the fact that his USG was 1.028 but the vet said she wasn't concerned about this as Blackie has so much added water to his food and this can affect the results. Her main concern was keeping an eye on the amount of protein in his urine as the result showed he was 'borderline proteinuric'. Another blood/urine test is due next month.

Hope this helps.

[Catfan5]

Hi Jan, thank you for your post. Pleased to hear Blackie is doing well, sounds as if you have a good vet. I'm not so sure about ours I was interested to hear about protein levels in food, I hadn't looked to see how low it is in the rc renal food. I will be talking to the vet on Tuesday regarding the blood test results and will ask about Ipatikine. She said Bailey was stage 2 but she hasn't had any other diagnostic tests yet ie urinalysis but is having another blood test in a months time. Knowing how stressed and difficult she gets at the vets I hope this isn't too soon after the last one for her. Looking at the blood test results from December and the latest ones, I can't see much difference between them re the kidney values. She highlighted the creatinine and bun results on both but to me with my limited knowledge they look much the same! So will ask about that too.
Thanks again for sharing your experience and that Blackie continues to do well.

[Catfan5]

Feeling very uneasy this morning after talking to the vet. I like to ask a lot of questions when one of my cats is diagnosed with a condition and in the past they have said call us if you have any queries. One vet knew I was on a forum and was interested in what was being talked about re diabetes which our old Ginger had. The vet today admitted that the blood results were virtually the same as before but still insisted that Bailey should start on the rc renal diet as she's certain that she has early stage 2 kidney problems. But when I asked her opinion on the latest findings re keeping protein levels up and using a binder to keep phosphates low in Baileys regular food she was very put out. She said Baileys phosphorus was low anyway (1.21 M mol/1 range 0.70-2.10) and didn't see what good a binder would do and they were unpalatable like putting talcum powder on the food! and it's the protein in urine they measure. My old vet would have been open to new findings and research it herself.I said I didn't want to offend her but I do like to do a bit of research into these things and this is what some vets are saying as Jan said in her post. She also said the steroids have nothing to do with the increased drinking and possible kidney issues which is contrary to what I've read. Bailey has been on prednicare for over a year now. Last week the vet scoffed at looking things up on the Internet and forums. She is young but not open to any outside ideas/opinions only what she's learned in training it seems.
Bailey is a sweet but difficult stressy cat and I want to do the right thing by her. The vets are all new here having changed over twice in less than two years, my old vet of thirty years experience is too far away now.
Can anyone tell me if the creatinine result here is high: 156 umol/l (44-194)? And bun: 11.36 mmol/l (6.10-12.50) and can these levels be affected by long term steroids and extreme stress? Help, anyone?

[Crewella]

There is a point that if the phosphorus levels are low anyway, then there is little point in giving phosphorus binders, I've had a 'renal' cat in that situation and my vet said the same - there is no one treatment as it's a multi-issue problem. You vet is right to look closely at the blood test results - there is a page on Tanya's website that helps you to do the same.

[Catfan5]

Thanks Crewella, that makes sense. I'll take another look at the website. I'm one of those annoying people who doesn't fully understand the condition, searches the Internet and likes to pepper the vet with questions which she clearly didn't appreciate.

[Jan]

I'd certainly agree with the vet about measuring protein in the urine because it was this measurement in Blackie's last urine test that came back not as good as the previous test 6 months earlier, even though the blood test stated 'no abnormalities found'. Our vet may well change her diet advice when he has his next blood/urine test in a couple of weeks or so if the c/p ratio has gone up again.

As far as the creatinine level for Bailey of 156, that doesn't seem out of the normal range of 45-170 umol/l and the urea level of 11.36 seems within tolerance of 6.1 - 12.5 mmol/l - perhaps both towards the higher end. Blackie's were creatinine 128 and urea 9.7 - which is why it came as a bit of an upset to learn that his urine c/p ratio of 0.28 had him at borderline proteinuric.

I have never had any problem at all with Blackie accepting Ipakitine on his food - though it is well mixed in with plenty of added warmed water to his food.

Our vet won't prescribe any steroid injection/tablet treatment for Blackie who has been licking fur off his belly/hind legs for some while now. When I asked why, she said 'because of his kidneys'. In the end she prescribed a steroid spray for 7 day use only and dries immediately on his skin.

Don't worry Catfan5 - its been a year since I was told Blackie had early stage CKD. I've found the more you read on the internet, the more confused you can become.

[Catfan5]

"Don't worry Catfan5 - its been a year since I was told Blackie had early stage CKD. I've found the more you read on the internet, the more confused you can become." Too true Jan! I found it interesting re your vet not prescribing steroid treatment for Blackie's fur licking except for a spray. I would really like to know for sure whether steroids affect kidneys or not..

[Crewella]

Thanks Crewella, that makes sense. I'll take another look at the website. I'm one of those annoying people who doesn't fully understand the condition, searches the Internet and likes to pepper the vet with questions which she clearly didn't appreciate.

It IS confusing, but all you're trying to do is learn about it, understand the issues and do the best you can for Bailey. Your vet should understand and respect that.

And don't worry - useful as Tanya's and the other sites are, the 'information overload' feeling can be overwhelming! You do start to get a basic understanding after a while though, promise!