Pole’s visit to the vet’s (not so good)

Okay, now, for the not-so-good news….

Pole’s.

Some background first: Pole is hyperthyroid and is on life-long transdermal Methimazole. This brought her hyperthyroidism under good control. She has kidney insufficiency as evidenced by her kidney readings and her previous urine SG of 1.019 (normal is 1.035), but her UPC was normal (no protein leak in urine). Pole is 14 years old.

Pole was very well-behaved in the car.

We will start with the blood test results. It was rather shocking.

Her creatinine is now 368. In March 2019, it was 155, then to 251, to 274, to 281 in December 2019. Creatinine normal range (71 – 212). So that is definitely high, but the vet said it’s not alarmingly high.

Her urea is now 22.6 (Normal range is 5.7 – 12.9) so that’s high too. Her urea was 9.8 in March 2019, went to 15.2, 19.9 and 17.4 in December 2019.

The above readings suggest, sadly, that her kidney disease is progressing.

Her phosphate, however, improved a lot, from 1.89 to 1.17. Pole is on Pronefra which is a kidney supplement with phosphate-binding function.

Pole’s liver readings are all okay which suggests her hyperthyroidism is under control.

After getting these results, the vet decided to take Pole’s blood pressure. Previously it was normal at 140. Today, it was 165 (the upper limit is 160), so Pole has high blood pressure. This explains a little as high blood can cause damage to the kidneys too. It is a contributory factor.

So, Pole was prescribed a high blood pressure medicine, Amlodipine (which is cut up into very tiny pieces). I was worried about how to give it to her as I cannot open her mouth but since it’s so tiny, the vet says it can be hidden in the food. Let’s hope so.

The vet said I could also give Pole fish oil, but again, she does not like the taste of fish oil in her food. So, the vet suggested that I syringe out the fish oil from the capsule with a needle and give it to her with a syringe (what an excellent idea – why hadn’t I thought of doing this before?).

Pole is FIV/FeLV negative – so that’s a comfort.

Her subcut will be increased to every alternate day, still at 150ml. This is not a problem as I can handle Pole all by myself for subcut.

I was very worried about Pole’s readings but the vet said not to be unduly alarmed. It isn’t as bad, but yes, her unlike Cleo and Indy who seemed to have improved (it’s a miracle), Pole’s is progressing.

But the vet said Pole is clinically alright, so she would not be too worried at this point. The vet asked if there has been any vomiting. There hasn’t been. No weight loss too. Everything appears to be as “normal” as can be.

So, now you see why I said that Cleo’s subcut war that day was a blessing in disguise. If not for Cleo’s subcut, I would not have even thought of taking Pole to the vet’s as she seemed absolutely fine and is actually not even as dehydrated as Cleo (from the pinch test) and yet, there you are….her disease is progressing and I didn’t even know.

Numbers vs clinical signs – it’s not which is more correct. It’s both taken together to be interpreted. I agree because it’s the quality of life that matters, not what the numbers say. And yet, we have to rely on numbers so that we know what is going on and can take preemptive measures to prolong the quality of life.

Waiting to go home.

The first thing I did was to hide the tiny Amlodipine into a little bit of AD. It worked – Pole ate it all up without even knowing it’s there. Phew!

You’ll be okay, Pole.

Next, to syringe out the fish oil.

Goodness me, WHY hadn’t I thought of doing this before? It’s amazing! The needle is so fine, so none leaks out. As the oil is being syringed out, the capsule collapse as the near-vacuum is created inside. It’s perfect!

I used to cut with a scissors and mix it into the food. There was so much wastage on the scissors and on my fingers and they sometimes don’t like the taste of the oil too.

So, for Pole, her progression is exacerbated by her hyperthyroid condition which resulted in high blood pressure that also hastens kidney damage. I hope the Amlodipine can help. I’m glad I took Pole today, else, I would not have known at all.

So, for Pole, the vet says the once-daily Pronefra can continue as it is doing a fine job on her phosphate level. But Cleo’s phosphate also improved without Pronefra – the vet said for Cleo’s case, it is probably the subcut.

And yes, remember the rotten tooth that Pole supposedly had (identified during the 1st day of CNY)?  This story warrants a separate post, so here it is: https://myanimalcare.org/2020/04/14/by-the-way-what-rotten-tooth-again/

There is NO rotten tooth…..again!  This goes to show that for dental diagnosis, please get a second opinion from an experienced vet! Otherwise, your cat goes through anaesthesia for nothing.

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