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Simcoe’s 2 vet visits

Thursday morning we dropped off Simcoe at her primary care facility, All Pets Hospital, to complete the remaining testing to evaluate her health overall regardless of where we go from here and to see if she qualifies for the kidney transplant, this included:

  • Total Health Plus blood workup
  • Urine Prot/Creatinine Ratio
  • Radiographs – 2 Views
  • Cardiac Ultrasound
  • Blood Pressure

We picked her up Thursday evening.

Today we had a vet appointment for both her and Caligula at San Francisco Vet Specialists. Caligula was going in for a slightly early follow-up to some abnormal blood work results he had earlier in the year, we decided to do it early given Simcoe’s condition to make sure her kidney failure wasn’t something environmental that Caligula may have been exposed to as well. Simcoe’s visit was to get familiar with our local hospital vet and get his trusted opinion of her condition and the plans for transplant. We left the hospital feeling confident that we were going down the right track.

Shortly after the vet visit we received a call from her primary care doctor with results from her blood work on Thursday. Much of the blood work came good, and we got the exciting news about the direction in which her Creatine and BUN levels had gone.

12/10, first visit:
BUN: 93 (normal range: 14-36)
Creatine: 5.4 (normal range: .6-2.4)

12/13, after 2.5 days of fluids:
BUN: 90
Creatine: 5.8

At this point we were pretty much convinced that the hydration hadn’t helped and these values were true, she had stage 4 kidney failure.

However…. yesterday, 12/29, after at home care for 2 weeks:
BUN: 56
Creatine: 2.9

Much better! It points to a less severe stage kidney failure, which is good news because there are some other issues…

First is dental disease. She has one badly infected tooth that will need to come out and she could use a full cleaning. All of this requires anesthetic and needs to be done before the transplant so the infection doesn’t cause problems once she’s immunosuppressed. They are concerned about the risk of anesthetic on a sick cat, but the risks should be lower now that we know the realistic values surrounding her kidney disease.

Second was a slightly positive toxoplasmosis result. It’s unclear how she would have ended up with this (indoor cat, doesn’t eat raw meat), but at the very least they believe she’s had exposure to it at some point in her life. If it’s an active infection it needs to be treated with aggressive anti-biotics over 3 weeks before transplant is considered. There are 2 more tests we’ll need to do to determine if it’s obviously active, if those tests come out negative we’ll re-check her bloodwork in 3 weeks to see if the results have changed any, if it goes up we have a problem, otherwise we can probably plan to move forward with the transplant.

Phew! Today was certainly full of mixed news, but fortunately nothing deal-killing when it comes to the transplant and we have a path forward. We’ll be scheduling the follow-up toxoplasmosis appointment soon and then the dental work. For now we’re going to relax and enjoy our holiday weekend, we all earned it!