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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Vet
Satisfied Customers: 29824
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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After a routine blood test prior to having dental treatment

Resolved Question:

After a routine blood test prior to having dental treatment it was discovered that our 8 year old cat Thomas has polycystic kidney disease and AIDS. We were told his kidneys were enlarged and the disease was quite advanced. He was given several blood tests and prescribed blood pressure tablets, it was suggested he attended the surgery every month for further blood tests to monitor his progress.
The most difficult thing about this was that prior to booking his dental treatment he was a very fit and healthy looking cat and we found it hard to conceive what we were being told.
Thomas was given the tablets for a couple of days and we noticed a change in him immediately. He didn't look the same cat. We made a decision to stop the treatment and not put him through the trauma of constant trips to the vets for further blood tests.
That was more than a year ago! He appears to be coping well with the kidney disease, we have noticed he drinks a lot more water but otherwise fine.
Our biggest concern at the moment is what he originally went to the vets with and that's his teeth. He struggles to eat certain food and grinds his teeth a lot. We hate to see him looking distressed with this but are in a dilemma due to being told originally that he could not be given anaesthetic due to the kidney problem.
Can you please advise us what options we have to deal with this situation.
Submitted: 11 months ago.
Category: Vet
Expert:  Dr. Michael Salkin replied 11 months ago.

You're speaking with Dr. Michael Salkin. Welcome to JustAnswer. I'm currently typing up my reply.

Expert:  Dr. Michael Salkin replied 11 months ago.

I'm sorry to hear of this with Thomas. His kidney problem doesn't preclude anesthesia. It does, however, dictate that an anesthetic agent(s) be chosen that isn't excreted through the kidneys and that Thomas is rigorously monitored during anesthesia. This is a patient who should be admitted early in the day, have an indwelling catheter placed for the purpose of administering intravenous fluids prior to, during, and following anesthesia, and have his blood pressure, blood saturation of both oxygen and carbon dioxide, and EKG assessed continuously throughout the day. If his vet is uncomfortable doing this, Thomas can be attended to by a specialist veterinary dentist - in particular, one associated with a specialty clinic or veterinary school teaching hospital in which a specialist anesthesiologist is available.

Please respond with further questions or concerns if you wish.

Customer: replied 11 months ago.
This was not suggested by our vet as an option at the time but we will speak to them about it.
Is it common for cats to live a number of years with this disease?
Expert:  Dr. Michael Salkin replied 11 months ago.

You're welcome to share out conversation with your vet. Longevity is predicated upon the severity of his polycystic kidney disease (PKD). Cats can have normal lifespans with FIV (feline immunosuppressive virus). It's important to note that not all cats with PKD will develop azotemia (uremia) and that PKD tends to progress more slowly than many other types of chronic kidney disease. Once azotemia develops, however, long-term prognosis is poor. I would be please to review Thomas's most recent diagnostic test results. I understand that you might not have a copy at home but Thomas's vet can give you one which you can scan into your computer and then give me the file link or you can photograph the pages and upload them by using the paperclip icon (if you can see that icon) or by using an external app such as dropbox.com/

Please continue our conversation if you wish.

Customer: replied 11 months ago.
Can gum disease make his kidney problem worse?
Expert:  Dr. Michael Salkin replied 11 months ago.

Yes, the bacteria colonizing his gums can seed his other organs - heart valves and kidneys to be sure.

Customer: replied 11 months ago.
Thank you for your advice, it has been very informative.
Expert:  Dr. Michael Salkin replied 11 months ago.

You're quite welcome. I can't set a follow-up in this venue so please return to our conversation - even after rating - with an update at your convenience. You can bookmark this page for ease of return.

Dr. Michael Salkin and other Vet Specialists are ready to help you
Expert:  Dr. Michael Salkin replied 11 months ago.

Thank you for your kind accept. I appreciate it.