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Dr. B.
Dr. B., Cat Veterinarian
Category: Cat
Satisfied Customers: 18321
Experience:  I am a small animal veterinarian with a special interest in cats and am happy to discuss any questions you have.
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My 7 month old siamese kitten has just been diagnosed with

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My 7 month old siamese kitten has just been diagnosed with dilute urine, this was discovered during having her spayed, what will happen next, will she gradually suffer or with perscription food will she recover, plus I am worried about the cost as a pensioner on pension credit, I know money shouldn' t come into it but if I haven' t got it I can't pay, I love the little sweetheart, I promised my friend who's kitten it belong to, that I would take care of her for him as he was dying, please help me my head is in a whirl. Thank you Maxine.
Submitted: 3 years ago.
Category: Cat
Expert:  Dr. B. replied 3 years ago.

Hello & welcome, I am Dr. B, a licensed veterinarian and I would like to help you with your wee one today.

 

Poor wee Angel.

 

Can you tell if they only found the urine to be dilute?

Or did the bloods show any abnormalities (ie elevated kidney values, liver values, etc)?

 

Have you noticed that she drinks quite a bit?

Perhaps soaks her litter quicker then other cats you may have had in the past?

 

Did the vet mention any issues with her heart?

Or any abnormalities with her on examination?

 

How is her appetite?

Is her weight stable?

 

Customer: replied 3 years ago.

Hi Dr B, they have only found the urine to be dilute,I think he said one kidney was slightly enlarged, because I mostly feed her wet food I haven't noticed any excess drinking,the litter does not seem any different , and he did not mention any other problems. She is eating very well and still has mad bouts of playing and running around.Her weight seems ok, but she has always been very thin and sleek being Siamese. Maxine.

Expert:  Dr. B. replied 3 years ago.
Thank you Maxine,

I know what you mean about the model thin Siamese physique. Still I am glad to see that she is otherwise well in herself and that her bloods show no changes. Since the blood shows no changes, it does mean we can be less worried that she is already in a state of severe kidney dysfunction (since we see blood changes when >75% of kidney function is gone) and issues like liver disease, diabetes, thyroid issues (less likely at her age) and infection are ruled out.

Just a few more quick questions, just since you mentioned that one kidney was larger, did the vet scan her kidney to look at it internally? Did they mention any if there was protein or whote blood cells in the urine test?
Customer: replied 3 years ago.

Nothing has been said about a scan or protein and white blood cells in urine test?

Customer: replied 3 years ago.

They never mentioned any scan, or of any protein or white blood cells in urine test.

Expert:  Dr. B. replied 3 years ago.

Thank you again,

That is fine, Maxine.
I was just trying to see if I could get a few more hints about what is specifically amiss in Angel's enlarged kidney. If there had been protein or white blood cells in her urine, then that could have been a hint of bladder or kidney infection which would be something treatable. And the reason I asked about an ultrasound is just because this would be a non-invasive way (since kitties will often not even need sedation to scan) for the vet to look inside the kidney and appreciate if the dilute urine is a side effect of Angel having been born with cysts in her kidney (which reduces the amount of natural functioning kidney tissue) or if there was something more sinister (like kidney stones, infection, or even kidney cancer).

Now if we assume that since her bloods were normal, we have this slightly enlarged kidney, and we know that her kidneys are not functioning quite as well as they should (since their job is to produce urine and we aren't seeing it properly concentrated), this means we can focus on the kidney and not those other conditions that can influence urine concentration indirectly (like those I mentioned before). In that case, if we were to try to determine which kidney based issue was bothering Angel, I would say that an ultrasound would be a good idea if possible to help you determine which of the above was playing a role and give you a real idea of her prognosis and how to manage this for her (since kidney stones can be removed, infections treated, and the other two managed). And just to note, in cases where we see cysts in kitty kidneys, we do find that they will struggling with kidney signs (starting with the dilute urine) but can be supported and treated to help maintain the best level of kidney function possible for them and kept comfortable for a good period of time.

That said, with funds being an issue, there is no reason why you cannot just treat the problem at hand with supportive care and monitor urine samples periodically to give you an idea on how she is doing and whether her kidney is deteriorating. To do this, we often will start by using diets that are low in protein, sodium, and phosphorus. Examples of these diets are Royal Canin Renal (here), Purina NF (here), and Hill's K/D (here). Now that said, as a kitten, we'd likely not want to restrict her diet as severely as we would with an elderly cat (the most common kitty to have compromised kidney function) since she is still growing. Therefore, I have included those links for you to compare to her current diet and would suggest potentially aiming for a diet that is somewhere in the middle of the two. That way, she will still get adequate nutrition for growth without over doing it with these kidney straining components.

Further to this, many vets won't start using any treatments in this early stage of kidney compromise. Still you may want to speak to them about what stage they'd consider starting treating her and her options. For example, we often use medications like ACE inhibitors (ie Fortekor) or treatment like the newly marketed Semintra to support kidney function.


Finally, since you noted financial concerns (which are understandable and we do have to be realistic and consider that Angel is likely to have an ongoing issue with this through her life), I did just want to mention that if you are on a pension then you would be eligible for aid via the RSPCA. They do have some hospitals based through the UK (ie London, Birmingham, Salford) that they will see animals directly at a subsidized cost. Still even if you are too far from an RSPCA hospital, then some branches(LINK) will still help subsidize the if you require them so that may be an option.

Furthermore, while it does depend on your tax credit status (whether you get housing or council tax benefits), you may be eligible for the PDSA. To find the PDSA nearest to you and check your eligibility, you can check HERE. If there is one near by, then care would only cost what you could afford to give. And just to note, in case you aren’t in the catchment area for PDSA, they will still help eligible folks with their Pet Aid Scheme (where they will put some money towards her care)

Finally, just in case you are local to London or Grimsby and in their catchment area, the Blue Cross (HERE) may be an option. Or for Londoners,the Celia Hammond Trust (HERE) also provides low cost veterinary care to animals via their two clinics.

Overall, urine dilution is a subtle and early hint that her kidneys are not quite functioning as they should. It would be ideal to have an ultrasound to tell you "why" she is struggling and how severe that may be as this will give an the best idea of her long term prognosis and what we may see develop with time. Still, even if that is not an option, the mainstay will be supporting her kidneys by reducing those dietary components that can strain them, monitor the kidney's function over time (with urine samples), and considering supportive medications when the kidneys do start to require more help. As I noted before, infection sounds to be less likely here (though we don't know whether stones, cysts, or tumors could be present) so most of our concerns will require management through her life instead of cure. That said, many cats live comfortable significant lives with reduced kidney function, so even with this terrible discovery for Angel, please remember that even if we don't have a cure we need to look at Angel to appreciate if she is truly suffering with this condition.


I hope this information is helpful.

If you need any additional information, do not hesitate to ask!

All the best,

Dr. B.

Ps- Sorry for the wee delay in reply, as you can see I had quite a bit to say about wee Angel.

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If you have any other questions, please ask me – I’ll be happy to respond. Please remember to rate my service once you have all the information you need. Thank you and hope to see you again soon! : )

Customer: replied 3 years ago.

Thank you, XXXXX XXXXX ask if the cause is stones, cysts or tumors, and this is put right would her dilute urine be ok , and I should have said that occasionally she does vomit , but because I have not had her that long I thought this may be the change in food, Maxine.

Expert:  Dr. B. replied 3 years ago.
You are welcome, Maxine.

If Angel periodically vomits, I wouldn't assume its related to the urine issues. We can see vomiting with kidney troubles but it is often not an issue unless their urea/creatnine levels (what the bloods checked) are getting so high that it is making them nauseous.

In regards XXXXX XXXXX dilute urine, it itself is not the issue but only a side effect of one. So, on its own, dilute urine only really carries the risk of increased risk of dehydration. It is the underlying cause that may cause her future troubles and what we'd need to identify and potentially address. But as I said before, stones/crystals can be treated/managed but cysts and tumors (depending on the type) would likely require lifetime management and not be curable. And if they aren't curable, then we may see that dilut urine side effect for life.(where if the underlying problem was curable, we'd expect to see the urine normalize and not remain dilute).

All the best,

Dr. B.


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If you have any other questions, please ask me – I’ll be happy to respond. Please remember to rate my service once you have all the information you need. Thank you and hope to see you again soon! : )



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