Nikki's Kidneys, Redux

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I talked to the vet this morning in order to get a better sense of what is actually going on with Nikki's kidney values. It was a very instructive conversation, actually, and I'm glad she (this vet) is willing to actually go over technical details with me.

As for the nature of those details...apparently there IS actually some concern about her creatinine, even though it's technically within the normal range (2.1). The reason for this is the fact that her urinary specific gravity is lower than it should be.

The important lesson I'm taking from this is the fact that lab values can be kind of misleading if you just look at absolutes. Often you have to check and see how certain values relate to certain other values. Brodie's creatinine is actually higher than Nikki's (2.3) but since his urine was much more highly concentrated, this isn't indicative of a problem. The ability to concentrate urine is, it seems, a really significant function of feline biology and even an apparently small loss of this ability shouldn't be ignored.

...but all that said, the vet stopped short of actually officially diagnosing Nikki with chronic renal failure (CRF), though it certainly sounds to me like that's what we're looking at long-term. Which doesn't freak me out nearly as much as one would think it might, probably because I've known some cats-of-friends with the condition who've nonetheless gone on to live to ripe old ages. It's not a death sentence, nor is it the sort of thing that means the cat is going to be living for years in constant pain.

Moreover, there's no way to know how fast it will progress...the vet said she used to see a 23-year-old cat who had numbers very similar to Nikki's (and who'd had those same results for something like six years in a row). Of course I'm going to watch Nikki more carefully now for signs of discomfort and pay more attention to things like making sure she stays well-hydrated, but I don't see any reason to treat her with pity or what-have-you. She'd hate that, and it just doesn't seem logical besides.

As far as treatment goes...the vet did end up recommending I try offering Nikki some prescription food. There are different "levels" of RX for kidney trouble, apparently, and not all of them are extremely low in protein. She's going to leave me a can of Purina kidney diet this afternoon when I go and pick up the Panacur (giardia medication) for the younger kitties. Nikki is the pickiest eater I've ever met, so even if she's not at the stage yet where she absolutely needs a prescription diet I figure it's worth seeing how she reacts to it. And I was relieved to learn that there are other options if she refuses the RX food, e.g., mixing in a phosphorous-binding powder with her regular food.

She's not yet at the medication-needing stage, mind you, but when and if she gets to that point they will probably try an ACE inhibitor first. Either way, I'm just...really glad that veterinary care even exists, and that nobody is trying to pressure me to just "put her down". Nikki is a tough kitty and while she's never been much of a happy-go-lucky sort (except in case of copious sunbeams) I am absolutely certain that she has a whole slew of very important reasons for living all her own.

Beaver Fever, Dead Rats, and A Kidney Or Two

Note: the faint of stomach may not want to proceed with reading this post, which makes copious mention of fecal parasites and includes a cameo appearance by a dead rat.

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So, one of my cats (either Shadow or Brodie, as I can tell their poop from the girls', but not from each other's) just tested positive for giardia, otherwise known as "beaver fever" (I remember being warned not to drink from streams in the woods as a kid because of this very same entity). The vet sent the results today and I'm supposed to talk to her tomorrow about treatment options, which will likely include medicating all the cats here just to be on the safe side.

Mind you, nobody has any symptoms at present -- the positive test was due to the appearance of a very tiny number of cysts in the fecal sample -- but now I'm actually beginning to wonder if giardia could be the root cause of Brodie's twitchy stomach. Mainly it manifests these days in the form of "gets the runs and exudes gas that could knock out a rhino if any amount of corn is consumed", so it could just be a wholly separate thing, but who knows.

(Cats can harbor the parasite for years and my guys will be 3 next month. Giardia also apparently can be tricky to diagnose as it is not consistently shed in the poo; all the kitties here have had poo tests in the past and all were negative, but that doesn't necessarily mean there wasn't something there.)

...but all that said, while kind of gross, I'm not figuring this to be worth panicking over. Again, nobody is currently symptomatic, and it's not like giardia is super rare in cats. If Brodie didn't pick it up as a kitten I'm guessing Shadow managed to roll in something out in the back yard. He likes to flop on the ground and cover himself in dirt and we do sometimes get neighbour cats visiting the garden who could be leaving, er, "presents".

OH and Shadow did actually catch a RAT recently during one of his (supervised) evening yard-frolics. Thankfully he didn't eat it -- I mean, I'm all for raw feeding, but NOT when the "food" might have been poisoned. It was kind of weird, as he didn't even "play" with it -- he just ran straight at it, did the neck-bitey thing, and then proceeded to bring it to me and drop it in front of the kitchen door. I guess he figured he'd done his job (and he did look SO pleased with himself!). Given the life cycle of giardia and the fact that I'm pretty sure it's not actually transmitted from rodents to cats this probably wasn't the root of the beaver-fever, but I was definitely VERY glad Shadow was up to date on both shots and flea/tick/worm-prevention meds when he displayed his hunting prowess.

Needless to say, though, I really want to get this treatment over with. I'll happily treat all the kitties if that's what it'll take, though I'm a bit concerned over what I've read thus far about giardia sometimes being really hard to effectively get rid of in kitties.

...and on another subject entirely, I'm also going to be discussing the matter of Nikki's kidneys with the vet. She's not officially in chronic renal failure at this point, though given her age (nearly 11) and breed (Siamese) it actually wouldn't be excessively surprising if she ended up with that diagnosis in a few years. I've done enough reading to know that this wouldn't be the end of the world, and since her numbers mostly look really good (her BUN/creatinine are perfect) I am not figuring much is due to be done in the short term other than step up efforts to keep her hydrated.

The vet's concern is due to a slightly low urinary specific gravity (which can indicate a diminished ability to concentrate urine) and a slightly elevated amylase reading. I'll of course take her recommendations into consideration, whatever they may be, but I am really hoping she doesn't try to insist on a low-protein diet right now. I know that used to be the go-to solution for feline kidney issues, but really it doesn't make sense to restrict protein in an obligate carnivore unless there is clear evidence that this will actually prolong health and life. And I'm pretty sure that unless a cat's kidneys are in extremely bad shape, protein restriction generally does more harm than good. (Though if anyone can point me at some good literature -- as in, NOT articles on some sort of "alternative new age happy health" site -- indicating either way, that'd be awesome).

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The Litter Box Is Not A Poop Storage Device. It Is Merely A Waystation.

The litter box is not a storage container for poop (or anything else that comes out of a cat).

The litter box is, rather, a place for cats to deposit their, er, business. After which said business should be removed in a timely manner. NOT allowed to accumulate until it becomes disgusting.

The fact of the matter is that a properly maintained litter box will not smell any more than a regularly flushed human toilet will. Which means it's best to scoop at least twice a day, and that if you have multiple cats, you should have multiple litter boxes.

I admit I've become a bit of a zealot about this, but only because I know how many cats are given up to shelters and subsequently killed due to "litter box issues". When in reality, I'm sure that many of those "issues" were probably either medical problems (undiagnosed UTIs, etc.) or matters of protest due to improper box maintenance.

That said, I realize sometimes people have problems cleaning the box due to illness, disability, etc. And if the box isn't getting cleaned in that sort of a situation, it's due to the cat's human not receiving adequate support. Which of course is a problem in and of itself. This post is NOT meant to denigrate anyone who cannot scoop litter themselves -- again, if you can't scoop, you should absolutely be getting assistance from someone who can -- but rather, to note a few things that might help whoever is supposed to be cleaning the box do it more often.

And it just occurred to me tonight that perhaps part of the reason litterboxen often get neglected far longer than is right or healthy is because too many people think of the box as a kind of....poop reservoir, or something, where basically you only clean it out when it fills up completely.

I've also met a number of people who believe that catboxes "just smell" and that this is normal/acceptable/okay. Even when their cats are suffering from ear ulcers due to having to enter a covered box reeking of ammonia fumes I've seen people baffled that I think something is wrong. And so I figured something like this post was in order.

In the interest of full disclosure, I should acknowledge that I am myself a reformed catbox-neglecter. When I was younger, I would basically wait until my parents nagged me to clean the box -- the consequence of which was that my poor cat Tim ended up with a box so nasty he eventually got fed up and decided to use my acid-washed-denim-look-neon-paint-splattered beanbag chair instead (seriously, I was all about to sit down and play Zelda one day when I was around thirteen, and very nearly sat in the middle of a tidy pile of feline feces!).

After that I got a little better about scooping, but it wasn't until I was an adult, with 4 cats of my own, that I figured out the actual meaning of litterbox cleanliness. And I am so glad I did figure it out because, well, my house doesn't stink, and my cats are so happy with their bathroom facilities that they use them regularly and perfectly. And I would never dream of going back to my preteen method of "wait until something bad happens, then clean the box". It's much, much more pleasant for everyone when the box is treated as a temporary waystation for waste as opposed to an accumulatorium (if that's even a real word) for same.

Brief update and kitten status!

Gah, I was posting more for a while there but these past few weeks have been ridiculously busy. That said, Bella's kittens are seven weeks old as of today! They are doing wonderfully, and Bella has an appointment to be spayed next week.

...but technical details aside, no post about kittens is complete without pictures! Observe below:

Above, the siblings snuggle-wrestling on a round cardboard scratcher toy thing. This here is a huge part of why I really REALLY hope someone can adopt them both together.

Here they are in play mode. Ella is checking out a feather, while Bruce is trying to climb me (these are very bold kitties!).

Bruce is a big fan of all things food-related. Here he is trying a bit of raw beef.

...and here is Bella (mom-cat!) watching the feather toy. She's a very energetic jumper but was taking a rest here to just watch. She's getting more comfortable having humans in the room with her but is still untouchable. Which is fine...I don't want strange humans petting me, either! I am just glad she's not panicking at this point from being cooped up. OH and see her ears? She has some *really* neat wild-looking ear markings. They almost resemble ocelli.

...and finally, at least for this picture set, here is tiny Ella sneaking around near the door. (The brown fuzzy thing next to her is a stuffed toy, not another cat!).