Thursday, April 30, 2015

1183. **How to treat kidney failure in an old cat

May 1, 2105

Most Singapore owners do not comply with instructions on home treatment of the cat with kidney diseases.

CASE
Fatty, female spayed, 10 years old.

April 29, 2015
Anorexia 3 days. Not drinking 3 days. Diarrhoea (dark chocolate stools) 4 days.
Fever 40.5C.


I review the medical records today

HISTORY
Feb 2, 2015. 
Mastectomy. Left mammary gland 1 (MG1) tumour with left axillary lymph node enlarged. Histology -  Invasive ductal carcinoma (malignant tumour).  Blood test - Urea 5.3 (7.2-10.8), creatinine76 (71-160).  No leucocytosis. Platelets low  60 (300-800).
However, the cat had been vomiting for the past 2 weeks and the "left" kidney was painful on palpation.

Feb 28, 2015. Vomiting. Treated by Dr Daniel.




Mar 7, 2015
Has vomiting for the past 7 days. Thin but no fever. Kidneys painful on palpation.
Blood test - kidneys normal.  Urea 7.3 (7.2 - 10.8), creatinine 93 (71-160). Total white cell count 2.3 (5.5 - 19.5). Neutrophils 24% (35-75), Absolute 0.55 (2.5-12.5). Platelets low 78 (300-800).
Tiger Balm ointment smell in apartment.  Not to use Tiger Balm ointment which might have been inadvertently rubbed onto the cat.

PRESENT CONSULTATION
Apr 29, 2015
X-rays as kidneys are painful on palpation and enlarged with the cat growling during palpation.
Kidneys enlarged  No blood or urine tests to reduce medical costs. Given drip + baytril before going home.
Advised dialysis 200 ml Hartmann's Solution/day, next 4 days. Fortekor 5 (1/2 tab/day),, Baytril and Prescription K/D for 5 days.

FOLLOW UP
May 1, 2015
Cat is his normal self. No diarrhoea. Eating the usual Friskie dry food.
Did not accept Fortekor and K/D.

CONCLUSION
Although the blood test did not show kidney disorder so far, it is possible that the kidney failure has just started. Probably the cancer cells had gone to the kidneys, causing pain and enlargement. Owing to the need to reduce medical costs, no further are done to check on the kidneys.

I advised crushing the Fortekor dose into 4 portions of powder. Mix with honey and feed the cat. The K/D is to be fed by hand at 5% till 100% or switch to the dry K/D. The owner had given one SC drip. It is difficult to do it.  Wrap the towel around the cat to prevent clawing.

VIDEO

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