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Dr. B.
Dr. B., Board Certified Veterinarian
Category: Vet
Satisfied Customers: 19668
Experience:  General practice veterinary surgeon with extensive experience in a wide range of species.
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My cat is 18. She has had CRF for three years but has been

Resolved Question:

My cat is 18. She has had CRF for three years but has been responding to treatment and has been very healthy until recently. She sees a vet every 3-4 weeks. Lately we know that her tests results have not been so good and the CRF is probably getting the better of her. I am writing now because she has some other, newer, symptoms and I am wondering if this is just the CRF or if there is something else she needs treatment for? The symptoms are:
Weak back legs (we don't think it is arthritis)
Gums a little pink
She is licking the has effect gas fire
Any ideas?
***** *****
Submitted: 2 years ago.
Category: Vet
Expert:  Dr. B. replied 2 years ago.

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

Now if Misty is showing paling of her gums, hindlimb weakness, and is licking the gas fire (a sign of pica), then I'd be concerned that she has a secondary anemia. We see anemia in CRF cats because not only is the kidney a filter for the body's wastes and concentrator of their urine, it also secretes Erythropoietin (the hormone that tells the bone marrow to produce red blood cells). So, it is not uncommon to see red blood levels drop in these cats over time until they develop a secondary non-regenerative anemia.

In this case, if her vet is testing blood samples when monitoring her kidney disease progression, they will want to check a hematology. This can confirm the presence of anemia and determine if it the characteristic non-regenerative anemia associated with CRF. If this is confirmed, then there are synthetic erythropoietin treatments or Laurabolin that can get the body producing red blood cells again. Further to checking this, I would also just advise checking a potassium level on that blood sample. While it doesn't account for her pica behavior or her gum color; CRF cats can develop low potassium levels and this can lead to weakness signs with the disease.

Overall, Misty's signs are most suggestive of anemia and this is often linked to CRF. Therefore, we'd want to check her red blood cell parameters first and foremost and her potassium levels as well. If either is found to be amiss, her vet can start treatment to address these. If a different picture of anemia arises, then they can help you determine there is nothing further giving Misty issue at her age.


I hope this information is helpful.

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

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! : )

Dr. B., Board Certified Veterinarian
Category: Vet
Satisfied Customers: 19668
Experience: General practice veterinary surgeon with extensive experience in a wide range of species.
Dr. B. and other Vet Specialists are ready to help you
Customer: replied 2 years ago.
I wondered about anaemia but Misty has regular EPO injections so assumed that her blood reading would be fine? Does she maybe need a higher dose?
Expert:  Dr. B. replied 2 years ago.

Hi again Amanda,

If she is on EPO, we would hope this would keep the anemia from arising but with her signs it is a concern. It may be that she is developing a tolerance to the drug or her kidney function decline means she is personally producing an all time low volume of the hormone herself. Often it is a case of adjusting her dose as needed.

So in her situation, it is worth updating her vet on these signs. If they haven't checked a hematology (since it is not uncommon to check a chemistry or individual parameters -urea/creatnine/phosphorus with chronic CRF cases to keep costs down) recently, it'd be worth doing so now. Or you could even just have them check a packed cell volume (PCV) in the practice to tell you if her blood levels are on the decline and guide you to whether this is an issue and the EPO treatment needs adjusting.

All the best,

Dr. B.

-----------------------------------------------------------------------------------------------------------------

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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