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Norwich Bulletin - 5/18/2008

Some Truths About CRF

Everyone has their favorite pets whether we want to admit it to ourselves or not. My Milo was one of those special cats and when he died last August I felt that my heart was taken as well. If Milo was the cat of my heart, my Merlot is the cat of my soul.

My first Abyssinian, he taught us to love and cherish the breed. His little mannerisms and his devious looks as he plans his next strike on the figurines on my window sills, or his slowly egging on the other cats to come near me, so he can bop them on the head when they least expect it and then dash away.

You get the feeling he is laughing every time he is successful. We have paintings that we had commissioned to show his spirit and while Milo was everyone's cat, there is no doubt in anyone's mind, Merlot belongs to me. My husband always wanted an Abyssinian and eight years ago I gave him an adorable little ruddy kitten for his birthday. From his first night in our home Merlot became mommy's boy, and he remains so to this day.

Over this past Easter I noticed that he was having problems eating and he seemed to have lost a little weight. I wasn't particularly worried because only a week prior he had gone to a "retired" show cat's show and everyone was teasing him about being a bit overweight. So I figured he had a bad tooth and called Monday morning to schedule an appointment.

I cannot describe what I went through when I received a call on Tuesday morning that Merlot was in Chronic Renal Failure. My whole world crashed. He is not even eight years old and has always been a healthy cat. And yet in one week he lost over a pound and his creatinine levels were dangerously high.

My heart was breaking because there is no cure for Chronic Renal Failure and the end result is death, whether in days or months. I have been in rescue long enough to know that this death sentence usually means if you are lucky, you may have six months with your beloved cat (or dog).

I am the type of person that needs to know how, what, where and why and I also realize that if I do not advocate for my animals, no-one will. And so, between my tears, I started to do some research. I first needed to know how it happened so quickly.

It seems that only 30% of kidney capacity is needed for normal functioning so Merlot has been in CRF for quite a while, but no symptoms are seen until over 70% of renal function is lost. So that means it is imperative to start treatment as soon as the first symptoms appear. These are usually increased thirst and excessive urination, leading to appetite loss, weight loss, mouth ulcers and poor hair coat. And it happens quickly.

Exactly what is Chronic Renal Failure? It is a progressive, irreversible deterioration of kidney function and by the time it is recognized in cats, who hide their illnesses until the end, the cat is usually in a crisis point of the disease. CRF is one of the leading causes of illness and death in older cats.

I knew that, but I did not know that the medical field deems cats aged seven and up, as older. There are also several causes for this disease. Age, genetics, environment, and disease. High blood pressure, low potassium levels, acidified diets and dental disease are also contributors to the development of CRF. Abyssinians, as do Maine Coons, Siamese, Russian Blues and Burmese, have a higher rate of CRF than other breeds and domestics.

Once blood tests determine the levels of creatinine and blood urea nitrogen, the disease can be confirmed. There is no cure for CRF, but the condition may be managed for a time. The cornerstone of management of this disease is to control the amount of waste products that are sent through the kidneys. Since the remaining nephrons are limited in their ability to process waste, the idea is to reduce the amount of waste to a level that the nephrons can accommodate. This is done through a combination of diet, medication, and hydration therapy.

I know that CRF is a terminal disease, hence the reason for my strong reaction at Merlot's diagnosis. The only questions to be answered are how long and how well the patient will live until the end. With proper treatment, they say that the cat could live years of relatively high-quality life. Giving the cat subcutaneous fluids will hydrate the cat and make the animal much more comfortable. My mind was reeling with all of this information because I still did not know if I could come up with a viable plan to lengthen Merlot's life.

And then I found it. During my research I discovered that the Veterinary Information Network is conducting a trial involving the use of the drug Azodyl for Renal Failure in cats. It is a placebo-controlled clinical trial examining the efficacy of Azodyl in reducing azotemia and uremia in cats with chronic renal failure. I didn't actually understand anything I just wrote, but I knew my vet would and I wanted to find out if Merlot could be a candidate for this drug.

It turns out he is - and that the Colchester Veterinary Hospital was familiar with the drug. It was described as having a good effect on the cats that were presently taking the drug. And so I know have a protocol to follow to get Merlot ready to start treatment next week. He is presently on pain medication, IV fluid treatment during the day, antibiotics and special food. He has gained back pound and I know he is feeling better.

I know that Axodyl is not a cure, but there is hope now that he will be able to live another two or three years. Yes, it is a definite commitment on my part to make sure he has his medication twice a day, and that I give him fluids (which I will learn to do) a few times a week to keep his hydration up - but to me it is worth it to keep from losing my soul.

The moral of this column is to never give up - never just accept the devastating news that you may learn about your pet's medical condition. Either at home or at the library, do some research on the internet, or ask someone to help you if you are not computer savy.

Look at all the options, write down the questions and ask your pet's medical provider if any of the possible treatments or solutions might work for your pet. I am hoping that this November when I write my "what I am thankful for" column, I will be able to say that I am thankful that Merlot is still sleeping by my side.

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