See how easy that was:)
Will look forward to reviewing the test results and x-rays. I have to step away from my computer for a little bit but will log back in shortly to see if you've been able to successfully post the information. Deb
If you sent a copy of bloodwork, I don't see it. Can you possibly resend?
I believe I may have mentioned this before, but my hospital rarely evaluates urine with just a dipstick in the hospital since several studies have shown them to be inaccurate. We almost always send them out to be evaluated. The downside is that the presence of crystals may simply reflect artifact because the urine wasn't evaluated within a short period of time. So, I try not to over interpret crystals when they're present in a patient's urinalysis.
It sounds as if her bladder may be a little irritated or she may be having an FIC episode. If a culture and sensitivity wasn't done, then we can't know for sure if she has a urinary tract infection or not. But, this would require having her rechecked, of course, and not necessarily something that I'd recommend since it will add to her stress level...which in turn could exacerbate FIC.
I've found that acidifying the urine with products which contain cranberry (such as Crananidin) may help to prevent future bacterial infections in dogs but it's not too effective once one has developed. To be honest, I've never used such products in cats. I'm not saying that she has a uti but just wanted to share this information with you.
She's not likely to drink apple cider vinegar on her own...not that I would suggest it anyway....and the risk of aspiration pneumonia not to mention the stress of giving it to her are other reasons why I wouldn't.
The only connection that I might make between her skin issue and what ever is going on with her bladder might be stress. Some cats will excessively overgroom (psychogenic alopecia) which can sometimes be directly related to stress...although it's not always easy to know what that stressor might be as I think I've probably said before.
I wish I had other helpful suggestions for you which might improve what ever might be going on with her bladder but, unfortunately, I don't.
If you have her rechecked, then I'd discuss an ultrasound with your vet to at least provide peace of mind.
Looks like this time it came through so thanks for resending. I have a doctor's appointment this morning so I won't be back home for several hours. But when I do log back on, I'll respond after I've analyzed the results.
Sorry that it's taken so long for me to respond back; everything took much longer than I expected.
I don't like to disagree with fellow professionals, but it looks as if I may have to in this case, unfortunately, now that I've seen Dolly's test results although it doesn't give me any pleasure to say so:(
I tend to follow the guidelines as outlined by the International Renal Interest Society (IRIS) when staging my feline patients with respect to kidney disease. (http://www.iris-kidney.com/pdf/staging-of-ckd.pdf). According to these guidelines, Dolly is in Stage 2 Chronic Kidney Disease (CKD) although an SDMA test (not done for her) may modify this categorization a bit. For example, if she is very thin, then her creatinine value may actually be falsely reduced; in other words, in reality there may be more renal dysfunction than is suspected.
Treatment options depend on which stage the patient is in. Rather than list what those options might be, it will probably be much easier for you to access the following link so that you can peruse the information at your leisure: http://www.iris-kidney.com/pdf/treatment-recommendation-cats.pdf
Many cats in Stage 2 CKD often don't show many, if any, signs and they can remain in this stage for a fairly long period of time; however, the goal of treatment is to identify any possible other issues (such as Hypertension) and address them to reduce as much as possible progression of the disease.
In order to more accurately stage her which will then help to dictate treatment options, several additional tests need to be done:
1. An SMDA blood test.
2. Urinalysis with Urine protein/Creatinine ratio (aka UPC) if protein is present.
3. Blood pressure measurements although as I think I mentioned before, these are sometimes difficult to interpret
I strongly suspect that I've added to your anxiety level which I hope you know is the last thing I want to do; however, the way I see it is that it's best to face these things head on. Looks like your instincts may have been right after all.
No question, it's beyond frustrating:(
I'm not necessarily suggesting you take Dolly to another vet but this may be something to consider if you have other options where you live.
Cats are notorious for being able to concentrate their urine even when their kidneys are damaged so I don't rely on this value alone.
Metacam is certainly one of the last drugs I would have dispensed for her; in fact, I avoid it like the plague in all of my older cats, even those with all values at the lower end of the reference range.
If you want to more accurately stage her, then one way to do so would be with an SMDA test. If she didn't have any protein in her urine, then the UPC test isn't needed.
Normal blood pressures are great but, then again, what are they calling "normal"???? Since they said they weren't concerned about her creatinine value....just saying.
Many older cats do experience issues with their kidneys but it's not considered a "normal" function of aging.
Personally, think she may have more than one issue going on but I can't say that with certainty. I'd probably like to run a culture and sensitivity on her urine in addition to the SDMA if she were my patient.
I've just now seen your rating and wanted to thank you for it; it's greatly appreciated. Deb