Sunday, February 23, 2014

2/23/2014

Today is: 

 Winter Olympics closing ceremony

Today in History:

Walter Wingfield of Pimlico, England, patented the game of lawn tennis. (1874)
The Tootsie Roll rolls into stores in America. (1896)
U.S. marines raise the America flag in Iwo Jima (1945)


Boxes

Thank you so much for the gifts from our wishlists!
http://blindcatrescue.com/wishlist.htm

Amazon often does not tell us your names and they NEVER tell us your contact information so we are not able to contact you to personally thank you.  We are so grateful to you for your kindness and generosity helping the cats!!


Thank you Sabrina Holme for the Revolution Flea Treatments!
Thank you for the Scott Lile for the Young Again food, Freshsteps and Life Abundance food!!


Thank you Sharon Harvey for the bed!
Thank you Emily Tester for the cat litter!
Thank you Daynya Quigley for the carrier!
Thank you Anita Wright for the cat litters!


Thank you Margaret Patterson for the foods!
Thank you unnamed for the toys, food and play cube!
Thank you unnamed for the carrier!
Thank you unnamed for the litter!


We will do boxes tonight LIVE on http://ustream.tv/blindcatrescue


Feline Chronic Renal Failure
 by Jill Anne Sparapany

The kidney structure is very complex and contains 200,000 tiny specialized tubes, called nephrons. If the nephrons begin to die, then waste products cannot be removed and acid-base-electrolyte balance cannot be maintained.  The waste products accumulate in the blood stream, slowly poisoning the cat’s body. Anemia, blood pressure and electrolyte imbalances occur as the kidneys deteriorate.

The kidneys primary functions are to (1) filter waste products, primarily urea and creatinine, (2) regulate electrolytes – potassium, calcium, phosphorus, sodium - and water balance, (3) produce erythropoietin (EPO) which stimulates the bone marrow to produce red blood cells, (4) produce renin, an enzyme that controls blood pressure and (5) the production and concentration of urine.

Only 30% of kidney filtration capacity is needed for normal functioning, therefore, no symptoms will be observed until 70% of renal function is lost! Cats that are older than 7 years of age lose some of their kidney function, called chronic renal insufficiency, which may gradually progress to kidney failure. Chronic renal failure is a leading cause of death in older cats but can also affect younger cats.

Renal failure can be chronic or acute.
**  Chronic renal failure (CRF) is a progressive, irreversible deterioration of kidney function. Since cats hide illnesses and early stages of CRF are subtle, the disease may not be recognized until 70% kidney function has been lost and the severe symptoms manifest. This may appear as acute renal failure but it is usually the crisis point of CRF. Once kidney function is lost due to chronic disease, it can never be restored.
**  Acute renal failure (ARF) is an abrupt shutdown of kidney function, most often seen with reduced urine output. Primary causes of ARF in cats are urinary obstructions, infectious diseases, trauma and the ingestion of toxins. The most common ingested toxic substance is ethylene glycol contained in antifreeze. ARF is quickly fatal if not treated with emergent veterinarian intervention. Prognosis is generally poor. If damage is not severe and medical treatment is aggressive, it may be possible to have normal kidney function restored.



CRF is one of the leading causes of illness and death in older cats. Be sure your vet checks your cat’s urinalysis, blood work which includes a complete blood count (check for anemia) and chemistry panel (BUN and creatinine check for renal function) and blood pressure during annual physical exams, especially if they are a senior cat.

  


Contributing Factors for Development of CRF:
Age, environment and genetics play an important role in determining if your cat will develop CRF.
Certain breeds are more prone to develop CRF – Abyssinian, Burmese, Balinese, Russian Blue, Siamese and Maine Coon.
Hypertension and dental disease are related to development of renal disease.
There are several congenital and acquired kidney diseases that affect renal function and may lead to CRF. We will limit this to renal failure symptoms and treatment.

Symptoms of CRF:
Excessive urination*
Increased thirst*
Nausea and vomiting
Loss of appetite
Weight loss
Poor hair coat
Muscle wasting and emaciation
Dehydration
Constipation and IBS (Irritable Bowel Syndrome) **
Drooling, licking lips
Halitosis (bad breath with ammonia smell)
Weakness, depression and lethargy
Sensitivity to sound and noise
Oral ulcers and stomach irritation (uremic gastritis)
Detached retina
Seizures
End-stage: convulsions, low temperature and coma
*  The ‘drink a lot, pee a lot’ symptom can also occur with diabetes. Lab tests are necessary for diagnosis.
** See Feb. 13, 2014 blog for Irritable Bowel Syndrome

Dental Procedures:
Routine blood work done before dental procedures may reveal un-diagnosed CRF.
Anesthesia can exacerbate existing CRF, causing sudden appearance of symptoms.
Request anesthesia medications that does not place strain on the kidneys.
Oral surgery may endanger the kidneys with the release of bacteria and their toxins during the procedure.
Request administration of antibiotics prior to dental work.
Note:  The release of bacteria and toxins can also lead to sepsis (blood stream infection) and pancreatitis.

Hypertension:
The kidneys are important in regulating blood pressure. The higher the blood pressure, the more the nephrons need to work above normal capacity, causing faster deterioration of the nephrons.  Increased nephron damage accelerates the course of CRF.

Diagnosis of CRF:
Urinalysis - tested for dilution, kidneys are not filtering waste materials.
BUN (blood urea nitrogen) and Creatinine -  elevated creatinine indicates loss of kidney function.

Treatment of CRF:
Unfortunately, there is no cure for CRF but it may be managed at home and the cat can have relatively high quality life for months to years. It is up to the pet parent to determine when the quality of life has diminished and prolonging the cat’s life has little value or if the cat is suffering.
The focus of CRF management is to control the amount of waste products filtered through the kidneys, so the remaining nephrons can work efficiently. This is managed by diet, medication and hydration/fluid therapy (diuresis).
Medications used to slow the progression of CRF are ACE inhibitors and calcium channel blockers. They dilate blood vessels, decreasing blood pressure and increasing the blood flow through the kidneys with minimal stress on the nephrons.
Diet changes should limit salt and potassium. Lots of fresh drinking water should be available at all times.
Protein restricted diets remain controversial even though they have been standard treatment for years. No matter what diet recommendations are for your cat – protein restricted or not, low potassium and phosphorus, commercial renal diets vs. home prepared diet – if the cat won’t eat it, it won’t help the cat!
Weight loss is the biggest threat to your cat’s health so many recommend letting the cat eat what they want.
Water balance is also crucial. Feeding dry food limits the total amount of water intake and cats cannot drink enough water to compensate for the fluid loss through the kidneys. Giving supplemental fluids is well tolerated and a very beneficial treatment to keep toxins flushed out of the bloodstream.
Subcutaneous fluid administration. The easiest way to ensure adequate hydration in CRF is to administer intravenous fluids in the loose subcutaneous ‘pocket’ under the skin by the shoulder blades. Usually, 300 ml. or more of IV fluids are given three times a week. The amount of IV fluid and frequency will be determined by the cat’s weight, lab work and response to treatment.
A large bore IV needle is inserted into the subcutaneous pocket and connected to the IV fluids and tubing. The fluid is allowed to run in by gravity or gently pushed into the SQ space. Cats tolerate the needle insertion and fluid administration very well (it is not painful) and they will feel much better after each administration.
** Occasionally, your cat may need to be hospitalized and receive fluids intravenously.

There are many nutritional supplements, omega-3 fatty acids, antioxidants and renal diets advertised to help cats with CRF. You need to discuss all prescribed and ‘home remedy’ treatments with your vet.
Ultimately, CRF is a terminal disease and fighting CRF is a losing battle. Your cat will let you know when it is time. 
  
How to administer SQ fluids to your pet.  Veterinary Specialty Hospitals video demonstration.
http://www.youtube.com/watch?v=mxAAyISHRk8




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