Questions regarding Lily's latest vet visit

Karen & Lily

Karen & Lily

Member Since 2015
Last week I took Lily to the vet because she had a respiratory infection. I also had them re-do her blood work from 2 months ago because at that time her liver values (GGT) were elevated. All else was normal on that blood work done in January. Now 2 months later the GGT levels are fine but she is now anemic, possibly has pancreatitis, and has stage 2 kidney disease. My vet also thought she felt a mass in her abdomen at this latest visit. Can it go from no problems to stage 2 kidney disease in just two months? She is having an ultrasound this Tuesday to see if anything looks abnormal. I attached her latest blood work....
 

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I’ve been told that cats on a raw diet often have elevated kidney values. My 3 year old was vomiting and her tests concerned me. My vet said we would watch it but could very well be diet. That being said I see her urine specific gravity is low so she is not concentrating her urine. My vet also never makes a diagnosis based upon one blood test. An ultrasound is a good idea. I’d also recheck the labs once the infection is gone. I hope the retest shows better numbers. Vetty vines for a normal ultrasound.
 
I agree with Elise, a repeat bloodwork and ultrasound are a good idea. Acromegaly is hard on the kidneys. CKD is fairly common with acros. Neko had it, but it was slow to progress. She didn’t get anemic for a couple years. Dehydration can also impact kidney values.
 
Neko didn't get anaemia until later stage kidney disease. She got some B vitamins. Part of her anaemia problem was an error by the oncologist on her leukeran dose (turns out I was right not him :banghead:). She recovered a bit from that error. All you want to know and more: https://felinecrf.org/anaemia.htm The whole website is a good read. Lily's really just at an early stage. Cats can go years with CKD.

What did your vet suggest?
 
Lily had her ultrasound this morning. Not the news I wanted to hear. She has a mass on both her pancreas and her liver. And intestines are enlarged, probably lymphoma. Please say a prayer for my baby if you are so inclined.
 
{{{Karen}}} Sending the strongest vines possible for dear Lily. These are for you. :bighug::bighug::bighug: I hope Lily is still feeling good and that you get some good results from the biopsy.

Small cell lymphoma (SCL) seems to be quite common in acros. Neko had it, as did Jeff's Leo, I could name a couple others that probably had it but weren't diagnosed. The one good thing about SCL if that is what you are dealing with, is that it is slow moving, fairly easily treated and most cats go into remission if following a good chemo protocol. I can give more info if your are interested. On my third cat with it. :rolleyes:
 
@Wendy&Neko , thank you for your very kind words. Yes I would be very much interested in whatever info or advice you could give if it is indeed SCL. Lily is not as perky as she used to be, mostly eating, sleeping, and using the litterbox. My vet did give her a B-12 injection today and I now have a vial of it to give her B-12 shots at home. Maybe that will make her feel better.
 
SCL kitties are often low on cobalamin (though not all), so the B12 may help. Did she have any diarrhea, vomiting, constipation or weight loss going on? Symptoms are ECID on SCL kitties but usually you see one of those. How is her appetite?

The chemo protocol for SCL consists of a steroid and chlormabucil (the Leukeran I mentioned above). Neko's heart could not take prednisolone, so she was on budesonide. It helped reduced her bowel thickness by 30% which helped quite a bit. Leukeran brand is expensive in the US, cheap in Canada. Most people in the US get compounded chlorambucil. You can also get the steroid compounded into a chew treat. Steroid is once a day. Budesonide did not impact Neko's BGs. There are a couple protocols for chlorambucil, the one I finally convinced the IM vet to follow was a larger dose every two weeks. You also have to give antinausea like ondansetron just before and a couple days after. The original protocol of smaller dose every 2 days never left any time for Neko to recover from nausea. There is a groups.io group for feline small cell lymphoma that has lots of information on it.

Is Lily on any pain meds at all? SCL doesn't cause pain, but the less active Lily sounds a bit like Neko when she was in pain from her arthritis. Buprenorphine really helped her. Anyway, worth a conversation with the vet. If you haven't already, might want a consult with an internal medicine vet. They are great at handling multiple conditions, and are often the ones that manage SCL

Give Lily a kiss on the top of her head from me. :bighug:
 
@Wendy&Neko, Lily has lost weight &muscle tone, and was vomiting but that has stopped. Seems the vomiting stopped since I started giving her Denamarin. Lily is not on any pain meds at the moment. The doctor who performed the ultrasound today is an internal medicine vet, it wasn't my regular vet.
 
Oh, just read Lily is going through tough times. I'm sorry. I'm trying to get Cleo regulated but insulin doses are not where I think they should be. I read Lily's SS and saw the high doses of Lantus. I think Cleo needs much higher doses now that she's on PZ, but my vet is taking it slow, and I think she needs to ramp it up quicker.
I hope Lily isn't suffering. Prayers for her.
 
I do not think Marje is available to look at Lily's bloodwork. Is there anyone else on this board who could help?
 
Any chance you can transfer the lab data to the Lab page of the spreadsheet? Including any changes to reference ranges if needed. That makes it easier to get help.
 
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