Monitoring chronic renal disease

Re: Monitoring chronic renal disease

Rob Loxley — Fri, 17 May 2013 22:35:12 GMT

[quote user="Martin Atkinson"]The problem with doing urine cultures every time starts to make it all rather expensive especially if we are seeing them every 3 months[/quote]

Lots of the labs will add urinalysis/culture/P:C ratio to the blood work for not a lot more.

Others might say costs somewhat less than the fortekor

Re: Monitoring chronic renal disease

Yantha Smyth — Fri, 17 May 2013 21:20:09 GMT

I think I found a page on the iris guidelines that also covered the recommended monitoring schedules, test type and frequency for each of the iris stages on their site.

Re: Monitoring chronic renal disease

Martin Atkinson — Fri, 17 May 2013 13:25:40 GMT

The problem with doing urine cultures every time starts to make it all rather expensive especially if we are seeing them every 3 months, doing a cysto adds to this and is not without risk. Despite concerns about 'white coat effect' I don't find cat's BP varies significantly (maybe 5-10 at most) due to normal stress so I will repeat it 2-3 times in succession, and then it is usually roughly the same. I might repeat in a few days if it seems spurious. IME the biggest problem is the variation in ease of finding a pulse with exactly the same technique in different cats - I find some cats are consistently easy and others almost impossible to record anything.

Re: Monitoring chronic renal disease

Bibs — Fri, 17 May 2013 12:42:52 GMT

Thanks for the useful replies. When you are doing the BP what time period are you taking your 3 measurements over (to average)? Are we talking just repeating 3 times in quick succession or over different days? Also with the urine samples are you taking cysto samples?

Re: Monitoring chronic renal disease

Kate Richardson — Fri, 17 May 2013 12:17:05 GMT

Every 3 months would be the ideal frequency in clinically 'well' cats with renal disease, obviously sooner should a complication arise. If funds allow I personally would do a urine culture every time as well as UPC as a lot of cats with renal disease have sub clinical urine infections which can cause faster deterioration should it track up to the kidneys. Other than that, BP, biochem (urea/creat/phos/Caand electrolytes especially potassium as a minimum) and PCV as you suggest. I don't put cats onto an ACE inhibitor unless they have an elevated UPC, but have argued with Martin about this before!

Re: Monitoring chronic renal disease

Kirsten Simpson — Fri, 17 May 2013 12:11:04 GMT

There was a Bayer Webinar on this just last night with Sarah Caney. Very good stuff, its on their webinar site (cannae mind it just now) but a quick google should help.

Re: Monitoring chronic renal disease

Martin Atkinson — Fri, 17 May 2013 12:10:08 GMT

I get them back every 3 months for renal profile, electrolytes, CBC and BP. I wouldn't normally do urine culture unless there was an obvious indication and only measure urine protein and SG if I can get a sample easily. As I put all my renal cases on renal diet and Fortekor as soon as they hit stage 2 CKD according to IRIS guidelines it is not going alter my approach if the last 2 are abnormal.