Mika's Labs (Something is wrong, but what?)

Mika had a dental on Friday. Because I'm sure that there is something wrong with this kitty, we had a full blood panel run (including viral panel). She has always had skin problems and her back legs don't work quite right. She does pee a lot, so I was considering some type of kidney problem. I never considered diabetes because she hasn't lost any weight. In fact, she's a large cat - huge feet, over 14 lbs and she's only 2 years old.

I just got Mika's labs back.
Glucose: 266; However, glucose stip was negative
Microalbuminaria 6.6 (Range <2.5). However, Protein strip was negative
Why would the blood tests show positive but the urine tests negative?

Cholesterol: 335 (High, but reasonable considering high w/ high protein, high fat diet)

Triglycerides: 1363 (Range 56-529!!!)
CPK: 711 (Range 56-529).

Any insight from people who understand this stuff?
Can vet-stress cause glucose to be that high (because she was definitely stressed)? This was even after a fast! Obviously, I will test her when I get home.

I'm not worried about the cholesterol because Boo's is similar. However, the triglycerides & CPK are very out of range. Would this somehow fit into her skin problems?

I haven't talked to my vet yet (probably this afternoon), but I would sure value any insight.

Here's a link to pictures of her face and legs: viewtopic.php?f=28&t=18303

 

no idea but marvistavet often has good explanations for lab values...good luck!

 

Also ask your vet about the USG, it looks like the urine specific gravity is a little low. I wish I could help you figure this stuff out, but hopefully your vet will have some good information for you.

 

As Tucker's mom hinted, the urine specific gravity is 1.012 which indicates that the kidney function is compromised to s significant degree. It really should be above 1.030. The kidney have a lot of reserve capacity and elevated BUN and Creatinine do not occur until about 25% or so kidney function remain. This would tend to explain the elevated Microalbuminaria. The elevated glucose is probably the result of vet stress. I would not be concerned with the high Cholesterol, Triglycerides or CPK.

 

What would cause kidney damage in such a young cat? She is only 2 years old.

 

I missed that Mika was only two. Kidney problems can be due to a kidney infection (not just a bladder infection), ingesting some poisons (e.g., regular antifreeze), and kidney cancer (not that likely for a young cat). The normal white blood cell count is NOT indicative of an infection. However, about a month ago my Mitten had normal blood values but did have lots of bacteria swimming in her urine.

 

was the USG taken before or after dental? was she on IV fluids during the procedure? i'm wondering if that may have affected her USG.

 

Good question. It must have been afterwards and she WAS on fluids during the procedure.

I spoke with vettybean. She wants a full GI panel as well as a biopsy of the "threads" running down her legs. Her blood was very, very fatty and this was after a 12-hour fast. Her x-rays showed arthritis. They had a very difficult time waking her up after the procedure.

Only good news - Mika's BG was 40 one hour after eating, so at least diabetes is not a worry. Bad news is vetty is concerned about lymphoma, but wants the GI panel first.

 

Hi Heather

How was the urine sample obtained? There was a lot of bacteria in it, esp. given the dilution. If the urien was obtained by cysto, have it cultured.
CPK is fine -- that is a very mild elevation.
Microalbuminuria -- invalid because of bacteria in urine.

Triglycerides are pretty high, high enough to make me wonder about her face. There is something called a xanthoma, basically facial sores associated with high triglycerides and, in cats, with pancreatitis (some cats with pancreatitis can have high levels of fat in the blood). It's uncommon and I don't know much about it, but I would ask your vet when you speak to her today. The cure is a modified-fat diet that you can buy, like r/d, or you might have to make if you want to avoid rx food as most of the low fat foods are going to be lower quality too. Fish oils are also generally indicated in high-blood-fat-disorders.

I am assuming that you are absolutely certain she could NOT have eaten anything at all for 12 hrs before her test, no getting into the dog's food, etc.?

Regarding her rear end, sounds like if her hips are arthritic, you have yoru answer for the mobility issues. WHy not try adequan and dasuquin? I am not certain about the tracks on her skin -- I'm not sure what you mean, what they are made of. This is a line of hard scabs or something? Generally speaking, cats with skin issues should first have food allergies ruled out and this means (and it's a pain to do) making sure that no other food crosses her lips for at least 6 weeks. No treats, no other cats' or dog's food, etc. It is difficult in a mulit-pet household but it is the only way to rule out food allergy.

 

Urine was obtained via cysto. Mika got a shot of Covenia for the skin issues; vetty hopes it will clear up the UTI as well.

There's no way she got into any food. After I found Boo sneaking dog food last year, I make sure that all food is stored in containers. All food was eaten before I went to bed.

Vetty wants to do a bunch more expensive tests...biopsy of leg things (there is a link to pictures in my OP) and GI panel. I'm starting to feel poor and am wondering what is really needed and what is just nice.

 

Xanthoma is actually really interesting. Those bumps look very similar to what she gets on her face and ears. Additionally, vettybean had a very hard time with the blood - it was very, very fatty. She also mentioned that Mika had a very large fat-pocket on her belly, even though if you look at her from the top, she has a nice waist. I'm still reading, but just wanted to post what I've seen so far.

 

http://www.newmanveterinary.com/Hyperlipidemia.html
in cats, clinical signs are usually cutaneous (xanthomas) or peripheral neuropathy. (X-rays showed some arthritis, but she's always walked funny)

Serum triglycerides:
* normal is 100-150 mg/dl
* hyperlipidemia frequently produces tiglycerides in excess of 1000 mg/dl (Mika's Triglycerides: 1363)

http://www.hotspringsvillagevet.com/cholesterol.htm
An excess of fat in your friends’ bloodstream is called hyperlipidemia, or high amounts of fat. This condition occurs normally after each of the one or more meals and fatty treats of the day. Of course, a high amount of fat in the system cannot all be utilized or stored immediately, so it circulates. If a blood sample is drawn after a meal (post prandial), your friends’ blood sample will have a layer of fat in it that looks like the cream that used to be on milk. This is called primary, or postprandial hyperlipidemia. ( I did not make this up) A blood sample drawn from your friend after a twelve hour fast should have no fat in it. If it is lipemic (fat-containing), it may indicate a medical problem. If the high fat level is due to a disease, it is called secondary hyperlipidemia. Diseases that can cause a fasting blood sample to contain a significant amount of fat are:

Diabetes Mellitus (sugar diabetes) in both your feline and canine friends. In your canine friends only: hypothyroidism (low thyroid hormone), hyperadrenalcorticism (Cushing disease), and protein-losing nephropathy (filtering or absorbing deficiency in the kidney).

http://en.wikipedia.org/wiki/Feline_eos ... _granuloma
The third form of the EGC is the collagenolytic granuloma. This is a firm swelling that may be ulcerated. The lesions may form on the skin, especially of the face, in the mouth, or on the feet, or may form linear flat-topped raised hairless lesions on the back of the hind legs, also called linear granuloma.

 

Hi Heather

I thought of EGC but the facial lesions aren't classic, and I wasn't sure what the HL lesions looked like. I have never seen the HLs affected, but then again most ppl don't shave their cat's butts

A miminally invasive "punch" biopsy can be done of the lesion to diagnose it. The treatment for EGC is usually immunosuppressants so you may want to have a firm diagnosis before blasting her with steroids or Atopica. And I'd still ask your vet about the possibility of xanthoma. You might also just start by taking her in for another fasting blood draw to see if the results are repeatable as anything can happen 'once'.

Keep us posted!