From:
"Meryl Faulkner"
Date: 2009-02-01 03:40:47 UTC
Subject: [ferrethealth] Xena: kidney failure : history, symptoms, chemistry, questions
To: ferrethealth@yahoogroups.com
Xena,
Long post, but maybe get some feedback and help others with ferrets in
renal failure.
Female, Xena, came in to my vet as a rescue on 10/17/2006 and I took
her in. Estimated age 3 +. No history, except found on a road. They do
a health screen on "rescues" and she seemed normal. History: On
7-20-07 a Superchem CBC D-2 profile - apparently normal values.
Developed (over the next few months) enlarged spleen, hair loss, mast
cell tumors, so exploratory surgery 2/28/08 resulted in removal of
left adrenal and part of the right, along with the spleen (v.big),
pancreatic nodules/tumors, and partial left pancreas. Histopath. was
done on spleen, liver biopsy, portions of partial left pancreas tumor,
lumpectomies of mast cell tumors, and lymph nodes. No lymphoma. She
did well post surgery, coat was never great. On 8-8-08 she had a
physical and blood work - Superchem CBC D2. I can't find a reference
to any abnormal results, but I know I remarked (and my veterinarian
agreed) that she had rather squinty eyes and a rough coat. Vet
suggested that she might again have adrenal probs but was reluctant to
remove the remaining portion of the one adrenal. 10-23-08 she received
a Lupron implant. I noticed she was still squinty eyed, veterinarian
made sure I could check blood glucose.
I think in retrospect Xena continued to get quieter, but problems with
another ferret side-tracked me. In December she started drinking large
quantities of water, urinating a lot, was kind of slow. I mentioned to
my vet by phone, she said might be kidney problems give sub cu fluids,
try baby food, and add in Epakitin. Xena is unusual since she likes to
go for a little walk outside, and we noticed she drank thirstily from
our swimming pool =96 it's slightly chlorinated, but not much, but the
bubbles in the spa (where the filtration occurs) seemed to attract
her. She seemed to really like the bubbles. I did sc twice a week, and
then missed 4days in a row two weeks ago. Took her in for check on
1-21-08, and veterinarian took blood for adrenal panel and chemistry.
We gave her a melatonin implant at that time to help with coat. Vet
called me early 1/22 and said bring her in 1/22 for iv fluids and an
ultrasound because of lab results - BUN high. Ultrasound specialist
who does a lot of ferrets said her kidneys showed chronic renal
failure. Her BUN was 162, Creatinine 7.4, phosphorus 14.0, calcium
6.7, ALT AST and bilirubin normal, only other abnormal results RBC
4.1, HGB 8.0, HCT 23. Triglycerides were 1196 (oops too much oil?). My
blood pressure went up at this news and I anticipated that nothing
could be done, but vet mentioned possibility of bringing the BUN,CR,
Phos values down by keeping her on iv all day at the clinic 1/21, 1/22
and then Sat morning, and include bolus saline every 2-3 hours at
night (groan although age makes me get up at night once at least to go
to the bathroom so what the heck!). Sat noon they rechecked her blood
work in house. BUN 115, Creatinine 6.0, Phos 10.9. Lipemia 3+. Vet
thought fluids definitely helping and she suggested: 1. Give subcu
fluids 25 mls every day. 2. Add in 1/4 to =BD of capsule of Azodyl.
Continue with Epakitin. 3. Switch from Gerber's chicken (which I have
been giving approx =BC jar 3-4x daily) to A/D (more balanced) - She ate
some A/D while at the clinic (however she had no alternative).
>From 1/23, I only had a little trouble 2 days subcuing her - only 15,
20ccs on 1/27 (think I either did not get needle in butterfly parallel
or was between layers or not in good spot). She did not like AD, so
mixed a little of it in to the chicken and fed her (she laps it)
approx 4xday =96 about 1-1.5 jars chicken. Cut back on the oil except as
an incentive to lap while I'm subcuing.
On Friday 1/30) vet still encouraged by continued lower levels =96
however I noticed that now although Creat still 6.0, phosph up a bit
to 11.9, and BUN crept back to 139 (groan). She suggested checking in
two weeks time and giving more fluids. We decided I'd try to get 50
mls in daily =96 two sub cues, which I managed today. Keep her fed (she
had gained wt on 1/30)very slightly and actually feels warm and has a
little more heft =96 although I guess that could be fluids in belly
perhaps? Her eyes seem to be a little brighter occasionally (fluid
effects?), My roommate feeds her at about 5-6am I feed her at about
11am, again at 3pm, and then again 7pm. If she emerges to go potty we
always offer Gerber "thick soup'. If I mix the Gerber's with AD plus
some water in about a 3 to 1 ratio, she will drink it but prefers
Gerber's alone. I looked at the labels, and AD has not that much of
different content except it has liver. AD: Protein 8.5%, Fat 5.25%
Fiber 0.5%. Gerber's has protein 11.2% Fat 1.4% Carbs 2.8%. I have to
tell you, I did a tasting just to see why none of my ferrets ever like
AD. AD tastes moderately awful =96 liver flavor, with granular sandy
overtones (I hated liver and have been a vegetarian for 15 years so
the ferrets owe me for this), Gerber's tastes slightly less awful and
has a chicken taste I guess, but the texture is much creamier. If I
were a ferret I would prefer Gerber's. However I assume the AD is more
"balanced".
My question is, is her BUN level a record? My vet seemed very
surprised that she is functioning, so I imagine this might be unusual.
Xena does have an occasional head twitchy episode, and seems to
scratch the air with her hind foot =96 misses her belly by about an
inch. Neurological effects of kidney failure? She does come to her
name if we call at feeding time, and she comes out of her carrier to
go potty. She does hump her back and strain slightly when she
defecates and urinates. Since there is not much that can be done other
than what I am doing, I'm wondering if this is going to be a slow
downhill path. I've read in the archives (and I think on Dr Bruce
Williams's site) that animals have been fed Gerber's for months and
also given sc fluids for goodly lengths of time. However I'm wondering
because of the BUN values whether this is going to be a slow decline,
or a rapid one, or are ferrets unpredictable as individuals in their
response to renal disease? Sorry long post, but may help someone else
with similar problem with a ferret. Any comments are welcome.
Meryl
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