GardenFoundation
LLC
Feline Chronic Renal
Failure (CRF)
Judy J. Crawford
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GardenFoundation
LLC |
Back in May/June 1999 I was home sick but bored. So, I spent many, many hours on the Internet researching CRF, and getting some info on interpreting Jolie's test results. Here's what I came up with. Since I'm not a vet, nor do I play one on TV, this list isn't comprehensive, and should NOT be used as a replacement to consulting with a vet. However, I'm hoping it will help you have an overview on this whole CRF blood test thing! BTW, where this list states “=”, it actually means “suggests.” Also, please realize that there are other things that these numbers could mean, but I only digested the info that could possibly pertain to Jolie.
Of utmost importance is to "treat the cat, not the numbers". Some cats will react differently to certain blood imbalances than another cat will.
A/G ratio albumin / globulin suggested ratio is 1:1? Albumin (A) liver H = dehydration; L = starvation, liver disease Alk. Phosphatase liver enzyme frequently high in CRF ALT (SGPT) liver enzyme H - hyperthyroidism, iron overload, liver disease; frequently high in CRF Amylase pancreas H = pancreatic inflammation; frequently high in CRF Anion gap cell electrical activity H = dehydration; assoc. w/ metabolic acidosis, TC02 value AST (SGOT) liver frequently high in CRF B/C ratio BUN / Creatinine Bilirubin, Direct liver bile assoc. w/ red blood cells Bilirubin, Indirect liver bile assoc. w/ red blood cells Bilirubin, Total liver bile assoc. w/ red blood cells BUN (blood urea nitrogen) end product of protein metab. H = renal failure, dehydration, high protein diet Calcium (Ca) kidney H = common in CRF cats; L = hypocalcemia; too high Ca combined with too high P can cause calcification of internal organs & tissues Chloride electrolyte H = metabolic acidosis, renal failure; assoc. w/ sodium Cholesterol liver steroid CK (creatinine kinase) muscle enzyme helps muscle contractions; assoc. w/ monocytes Creatinine end product of protein metab H = renal failure, urinary tract infection, recent meat meal GGT liver enzyme frequently high in CRF Globulin (G) liver persistent H = chronic inflammation; L = infectious diseases Glucose energy lowered by insulin, liver disease Lipase pancreas NA/K ratio sodium / potassium Phosphorus (P) H = extreme malaise, will cause loss of appetite; even slightly elevated levels of P cause symptoms Potassium (K) electrolyte H = heart arrhythmia; L = vomiting, diarrhea; causes muscle weakness, constipation Sodium (Na) electrolyte H = dehydration, renal failure, vomiting, diarrhea T4 thyroid gray zone = 2.7-5.0, hyperthyroidism = above 5.0 TCO2 (bicarbonate) kidney L = metabolic acidosis Total Protein H = dehydration; assoc. w/ albumin & globulin Eosinophil bone marrow H = immune response, allergic reaction Eosinophil, Absolute bone marrow H = immune response, allergic reaction Free T4 (equil. dialysis) thyroid HCT (or PCV) hematocrit (packed cell volume) lowered in anemia. B12 deficiency; HCT is a measure of the volume of blood which is composed of the RBC HGB hemoglobin lowered in anemia; HGB measures the oxygen-carrying protein found in the RBC Lymphocytes lymph glands L = immune deficiency; part of WBC; often lowered in CRF cats Lymphocytes, Absolute lymph glands L = immune deficiency; part of WBC; often lowered in CRF cats MCH mean corpus. hemoglobin MCHC mean corpus. hemoglobin concentrate MCV mean corpuscular volume decreased in anemia, liver disease MCH, MCHC, and MCV collectively indicate size & characteristics of RBC. They can define probable cause of anemia or suggest certain nutritional deficiencies
Monocytes bone marrow associated w/ neutrophils Monocytes, Absolute bone marrow Neutrophil SEG bone marrow H = extreme stress Neutrophil SEG, Absolute bone marrow Platelets bone marrow Adequate is good enough RBC oxygen-carrying red blood cells lowered in anemia Reticulocytes Adequate amounts of these indicate bone marrow is creating new RBC L = nonregenerative anemia WBC white blood cells part of the immune system lowered in anemia, B12 deficiency, immune deficiency Okay, the things that are most commonly tracked and monitored for CRF cats are BUN, Creatinine, Calcium, Phosphorus, Potassium, HCT/PCV, and RBC.
Creatinine is the most important indicator. It may go up fractionally if you grab the cat while it's eating and draw it's blood. Most people don't consider a recent meat meal truly affects this value, and therefore, if this value is above normal, it is usually not good news, if you know what I mean.
I'm not sure how high calcium affects a cat, but it is common for CRF cats to start showing high normal on the tests. Low calcium can cause muscle twitches and spasms. However, high calcium combined with high phorphorus can calcify internal organs, and is considered a condition needing immediate correction.
If the phosphorus is even trending towards high normal, the cat will start to feel an incredible malaise, will probably lose it's appetite, be lethargic, and may lose an interest in it's surroundings or interacting with it's owner. This happened to Jolie towards the end of her disease process, and it was heart-wrenching to observe.
If the potassium is even a little towards low normal, then the cat may get wobbly on it's legs, it may start to lose muscle mass in it's hindquarters, and it very likely may start to get constipated, because it's muscles can no longer contract enough to expel the feces. If the potassium is very high (not so common), heart arrythmias may result. Low potassium is very common in CRF cats.
You want the HCT/PCV to be in it's range, but it's probably okay if it's at low normal. You want the RBC also to be within it's range. If both indicators are low, then the issue of anemia needs to be discussed.
Other things that are of concern are the T4 value, which monitors the thyroid.
Also, keep tabs on your cats' TC02 or C02 values, as metabolic acidosis can cause serious problems. You don't want that to even start getting low normal.
It's not uncommon for the liver values to be high, by the way, and seems to go with the territory.
Also, it's not uncommon for the immune response indicators to be out of whack.
Head spinning yet???
I know your heart is breaking at the thought of your kitty not being his old self, all spunky and full of vim & vigor. I can tell you there are many, many cats that have lived YEARS with CRF. If it's determined that your cat has CRF, then all hope is NOT lost. It's very possible that you two can continue to have quality time together for a long time, providing treatment begins now.
The biggest issue most CRF folks face at one time or another is NOT having to administer treatment to their cats. It's having to deal with their vets. Most vets refuse to discuss the blood test results with the owners. They do not volunteer any information, and avoid giving straight answers. They only tell you half the information you need to know. If you try to have a discussion with them about something you've learned (via the Internet, or books, or whatever), they poo-poo it and tell you not to believe anything other than what they tell you. Sadly, many vets don't believe you can treat a cat with CRF, and assume the cat should be put to sleep (PTS). Others know it can be done, but don't want to teach the owner how to do procedures. Others WILL help the owner, but then inflate the price of supplies shamefully. Some vets will go for treatment, but will NOT consider any alternative method or approach if it wasnt their idea first. Many vets are very insulting to the owners, as if the owners are simply too dumb to comprehend anything medical. Do not put up with this kind of treatment! Your cat is going to rely on you for any & all health decisions. It is imperative that you be a partner with your vet.
How Jolie & I found each other
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If you live in the Portland, Oregon, area, and are looking for a vet, please consider mine. She is knowledgable, compassionate, and very gentle with your pets. She takes the time to make sure that pet owners are fully aware of their pet's state of health, as well as all treatment options available (when necessary). Please call the Valley Vet Hospital at 503-649-6900, and ask for an appointment with Dr. Jennifer Leddy.
