CKD Cat - Ultrasound, yes or no?

My 14 yo cat was recently diagnosed with CKD. Unfortunately, her kidney values have continued to get significantly worse in a short period of time.

My vet said one diagnostic option is to do an ultrasound, but that she doesn't recommend it because the treatment is always the same regardless of the results.

It worries me not to do the ultrasound, because I keep thinking, "What if we could find something that would help her treatment?" However, I do trust this vet, and my cat HATES having procedures done & would be stressed and require opiates if we were to do it.

Does anyone have any experience with ultrasound for a diagnostic tool for CKD?

I have a kidney cat, and my Vet has never suggested an Ultra Sound for diagnosing anything regarding her kidney's.   And i agree, as far as I know, there really is only one way to treat kidney disease, and that is as each symptom arises.  (sub-q fluids for dehydration, ant-acids for THAT issues, etc.)

Have you seen this website?  It's my "go to" for anything kidney related, even has listings of the best foods to try to feed in relation to hos much phosphorus in in the food.  It's truly a wonderful resourse, aside from being able to answer questions   www.felinecrf.org

Thanks so much for the response! I guess I should also mention that her kidney values are getting worse extremely quickly, not sure if that's unusual or not, but maybe that's why the vet mentioned the ultrasound option?

You did mention that in your original post.  What were her values when she was first diagnosed, and when was that, and what are they now?  AND, have you made any changes since her original diagnosis...changes in diet, started fluid therapy, etc.? 

As you stated, you Vet doesn't recommend it, anything found regarding her kidneys wouldn't change the treatment, so basically why do it, UNLESS your Vet thinks there may be another issue lurking that is unrelated to her kidneys...kidney stones or something like that?  Is there any reason to suspect that?  

To piggyback off of @mrsgreenjeens questions about changes to your cat's regime, I also wanted to ask if you started her on any new medications or supplements. While it's certainly possible for kidney disease to cause numbers to jump, my initial thoughts for it happening so quickly would be toxins, kidney stones (as already mentioned) or renal neoplasia (cancer). An ultrasound would look for tumors and stones as well as changes to the kidneys and lymph nodes that might indicate neoplasia. 

If an ultrasound would be really stressful and traumatic for your cat and the opiates dangerous to her health, I can understand the hesitation and questions regarding it's benefit to treatment.

2 months ago she was borderline between Stage 2/3, and now she is borderline between Stage 3/4. The only thing that has changed was that she was prescribed an antibiotic a few weeks ago due to a high white blood count found in her bloodwork. After the antibiotic, the white cell count decreased, but the kidney values increased.

The vet did not specifically mention any concerns about stones or cancer, and I'm not sure what the symptoms for those issues would be, but as of right now she is presenting with weight loss, PU/PD and the high kidney values. Do you know if kidney stones or non-cancerous tumors are treatable? The vet made it seem like an ultrasound could not detect anything that would be treatable.

I started her on fluids, every other day, this week & I'm hoping it will help stabilize her! The vet said we need to recheck blood in one month.

The fluids should help her feel better, and possibly stabilize her, but depending on what is causing this rapid increase in values.  When I asked if you had changed anything since the original diagnosis, I was wondering if you had changed foods, added any kidney supplements, that type of thing, fluids, that type of thing, as well as the above mentioned antibiotic.  So....no change in food?  Usually that's the very first thing that is recommended.  What are you feeding her?  Brand, flavor, type (canned or kibble). 

As far as what can be treated or not, kidney stones can usually be treated, and non cancerous tumors I would say might or might not be treated, depending on where they were.  That would be a question for your Vet.  I am going to once again,though, refer you to that website I referred you to above, this time to a specific area within the website, where they discuss ultrasounds.  Just scroll down the page about 1/3 of the way:  http://www.felinecrf.org/diagnosis_other_tests.htm

I still think, though, that you just need to really talk this over with your Vet and ask why she suggested it to you in the first place, only to then discourage you from having it done.   Ask if there would be ANY benefits to it, etc.  BTW, according to the aforementioned website, most times the cats don't need ANY pre-medication for an ultrasound.  Do you think if you were there to soothe your little one during the procedure she would be ok?  (IF you decided to have it done)  Or maybe you could just give her some Rescue Remedy for Pets to calm her down or something?  Another thing to discuss with your Vet. 

We haven't changed her food, but my kitty also has IBD, so just getting her to eat anything has been a challenge for many years! She currently eats Canidae Chicken Grain Free Pure canned food.

Thank you so much for the link to the website. For some reason I was getting an error when I tried to access it the last two days, but today it worked

I think you are right that this is worth asking a follow up question to my vet. I will try to contact her this week.

I had a CKD cat that was progressing through the stages very quickly even with the normal treatments. My vet recommended an ultrasound to rule out stones or cancer. Apparently kidney cancer can be managed with a certain drug (I can't remember what it was called) and stones can sometimes be flushed out. I went ahead with the ultrasound and it was confirmed he just had rapidly advancing CKD but I was glad I did it because otherwise I would have kept wondering. The actual ultrasound was pretty quick and I got to stay with him for it and the radiologist explained everything he was seeing. No drugs were used but he was a pretty calm cat.

Thanks so much for sharing your experience JDollPrincess! That information is very helpful!

I contacted my veterinarian again, and I felt like her attitude about the ultrasound was different this time. She said "it couldn't hurt to take a look". She said she could use a mild sedative for the procedure and that it would not damage Tigger's kidneys.

I decided to go ahead and have it done on Friday. The results did not show inflammation of the kidneys (which the vet was suspecting), but did show a number of small cysts. However, the vet said that the cysts would be large if she had polycystic kidney disease.

They did see that her pancreas looked abnormal, which could be caused by chronic inflammation, or there is the possibility of cancer. Obviously, I am really hoping that is not the case.

Her blood work showed remarkably improved kidney values after starting fluid therapy. She is now back down to lower Stage 3! However, she had a high white blood cell count, which the vet is guessing could be caused by the inflamed pancreas.

The vet is recommending switching from Budesonide (which she was on for IBD) to Prednisolone & starting an antibiotic. Tigger is not eating well, so I am hopeful that this turns her around!

Glad that her kidney values are down again, and  hoping the issue with the pancreas is resolved quickly.