From:
Lynn McIntosh
Date: 2002-05-19 02:38:00 UTC
Subject: Minnie urinating blood! Panel results?
Minnie is a cute little albino runt who is now eight years old. She is a late neuter, non
Marshall. She presented very late night before last urinating blood (and I mean it
looked like blood!), and she urinated blood the next morning (yes, I freaked!). But
by the next (yesterday) afternoon her urine was clear and light yellow! This was
prior to starting an antibiotic. I had never seen signs of a UTI (and I have had cats
and ferrets with them before) nor at any point did Minnie appear abnormal or sick.
She seemed fine all day today, Saturday, after being at the vet all day yesterday.
During this episode Minnie was seen by a new vet, who is not familiar with her case,
and her blood panel was read today by another vet who had not seen her nor was he
familiar with her case. I am hoping to get opinions about the blood panel and/or this
episode in general, what is concerning and ideas for next steps. I am supposed to
leave Tuesday for a nine-day trip for work and am concerned about leaving her,
though my husband will certainly keep an eye out and is the master medicine
dispenser.
Minnie is our little "miracle girl". She has a congenital heart murmur, which was first
diagnosed when she was about a year old as 3 on a scale of 6, the last non-
symptomatic stage. We were told to look for symptoms at four or four and a half and
she is now eight! Her heart has for years sounded like a little washing machine, but
until she was diagnosed with insulinoma a year ago she kept extremely active and
bouncy. This winter she was diagnosed with pneumonia, via x-ray, but she also had
grown very fat from pediapred. The x-ray showed her heart slightly enlarged, but vet
wasn't sure that was abnormal for her age. She had begun coughing and I worried so
for her heart. She received Baytril for the pneumonia, and when she coughed, about
once per week I would give her a low dose of lasix, which relieved the coughing.
The coughing has completely cleared up and been gone for months now during which
she has not had lasix! I also nursed her back to a normal weight (from 2'2" to 1'7"),
thanks to cutting pediapred back and adding diazoxide. Due to weight loss she gets
around much, much better. And her breathing is quite smooth and easy.
For insulinoma, Minnie has been on pediapred for a year, diazoxide for about four
months. Current doses are .23 pediapred 6.7 mg/5 ml and .08 diazoxide of 50 mg/1
ml. She is appearing adrenal (fur loss only) so we will address that soon.
During the vet visit Minnie had a UA, which revealed some white cells, but less than
expected for the amount of blood, so the vet thought maybe she had ruptured a blood
vessel in her urinary tract, but concluded she had a UTI. I sure had very little
warning (she lives in my room, free roam, so I can listen for coughing, and she goes
the bathroom on newspaper and I saw nothing at all unusual before the blood
appeared bright red on the paper). Plus the blood went away the day after it showed
up!
Interestingly, the blood panel reading for white cells was slightly low.
The vet's blood panel results, those deemed significant, are noted below. In
comparison I have listed readings for a panel done 5/5/01:
Norm 5/5/01 5/17/02
BUN 12-40 mg/dl 25 36 (said this
was
high)
Creatine .4 to .9 mg/dl .8 1.2 (high)
Total protein 5.2-7.5 g/dl 8.5 (high) 7.8 (high)
Albumin 2.9 to 4.4 g/dl 3.3 2.7 (low- said
could from blood
loss)
Globulin 1.8 to 3.1 g/dl 5.2 (high) 5.1 (high)
Alk phos 10-72 u/L 35 75 (high)
ALT 64-250 u/L 215 330 (high)
AST 23-99 u/L 96 285 (high)
Except for slightly low potassium and calcium on 5/5/01 the rest of both the blood
panels were normal, except for blood glucose of course. It wasn't spun 5/17/02 so
was very, very low. It was very low 5/5/01 when she was diagnosed but has since
been tested (always fasting) at 85 and 90 on treament; in-house fasting BGs on
5/17/02 were 56 and 56. The vet did say low potassium has been linked to liver
problems in cats, and her potassium was 3.8L (4.0 - 5.7 meq/l is norm) on 5/5/01.
5/17/02 blood panel didn't test for potassium.
The vet who read the test was concerned about Minnie's kidneys, heart, and liver.
Minnie had been put on Clavomox for 10 days and he extended it to 3 weeks based
on kidney readings, worried that the UA infection had spread to them. I am a little
baffled that the urinating of blood came and went so fast, and white cells on panel
were slightly low. Plus is the kidney reading that high?
He also noted the liver enzymes are high. But I am wondering if they are awfully bad
for a ferret that's been on pediapred for a year. She gets homemade turkey soup and
doesn't drink water on her own, so I giver her water with a dropper and put lots of
water in her soup, but still worry about slight dehydration. He also worried about
current loss of function of the heart causing damage to one of these organs and
recommended an x-ray as next step to look at the organs, particularly kidney, liver,
and heart. I asked about ultrasound but he said x-ray would be better for looking for
size/swelling of liver, heart, kidneys, whereas ultrasound is better for looking at
structure of organs. He said generally we would see coughing if we were at the place
where the heart's loss of function could damage other organs.
We'll go back for a UA after three weeks on clavamox. Minnie is her normal self. I
am due to be gone come Tuesday until 5/30. He recommended x-ray next week but
said we could wait. I don't want any damage to occur, but on the other hand Minnie
seems to be doing pretty darn well.
Minnie and I would appreciate info, opinions, and insight into what others think is
worrisome or not, and what next steps might be helpful! Thank you!!
Lynn and the Girls, Minnie and Lucy