Blood test - high creatinine?

[chromecat]

Hi all,

We took our beloved cat to the vet yesterday for his annual vaccination. Since he is already 2 years old and 6 months he had tested slightly high in creatinine during a routine blood test, I asked for creatinine to be retested. It came up slightly high, at 2.5 (normal range is within 2.4). He is not dehydrated, not drinking more than usual, not peeing more than usual.

The slightly high creatinine seem to be consistent with the previous test (no worsening in the last 6 months). The vet suggested we monitor his water intake and output for the next 4 months, and we do a urine test and ultrasound in April. She also checked his kidneys, at touch they do not have lumps but seem on the smaller side.

Does anyone have experience with slightly higher creatinine levels, and should we proceed straight away in January with tests rather than waiting for April? The reasons why the vet suggested we wait are:

- the value is only slightly high
- he hates every kind of manipulation and test, he gets SO stressed out by the simplest procedure

To which I add:
- we have a baby on the way expected for February, and the cat will already have to deal with something new and stressful for him

All inputs/views are much appreciated.

 

[Antonio65]

Hi chromecat ,

I had a similar experience with the cat in my avatar. She was tested, and slightly high kidney levels came out. In my case, though, she started drinking more than her usual. My vet dismissed all doubts because it was July and was really hot, but the cat kept drinking more even during a much fresher week in the same month. So the test was done and these were the results, the cat was diagnosed with a CKD at the age of 5 years and few months.

Of course an ultrasound scan was also done and this was to confirm an early damage to her kidneys. In those days (2005) a special test for CKD wasn't available yet, now it is, so it could be nice to talk to your vet and ask if a SDMA test is viable.
This new test allows vets and owners to assess the stages of the CKD, and also allows to detect very early stages of the disease, even when other levels don't seem to be affected.

It is uncommon for a very young cat to have CKD, but not impossible.
My cat received early treatments and her diet was changed accordingly, and along with other precautions and expedients we were able to keep her CKD under control for 11 years. She died a few weeks shy of her 17th birthday to a different disease. When she died, her kidney levels were still borderline, as they had been for her whole life.

I'm a fan of early tests, diagnoses, treatments. They do save our cats' life!

 

[BlackCatOp]

Hello, sorry to hear about your kitty.

I see you are from Australia so I don’t know how the recommendations differ but in the US, veterinarians are being encouraged to ignore the upper reference interval of 2.4 mg/dL for creatinine and use 1.6mg/dL as the upper reference interval instead. This recommendation is supported by the IRIS Kidney Foundation.

Also, I would recommend SDMA testing if your veterinarian has access. The thought is that SDMA is a more sensitive biomarker for detection of early CKD compared with creatinine.

Finally, what was your kitty's BUN value?

Best wishes for your kitty!


IRIS Kidney - Education - Diets for Cats with Chronic Kidney Disease (CKD)


Medical Disclaimer: My comments are not intended to be a substitute for professional veterinary advice, diagnosis, or treatment. Always seek the advice of your veterinarian with any questions you may have regarding your cat’s medical condition. Never disregard your veterinarian’s treatment or delay obtaining help because of something I have posted.

 

[FeebysOwner]

Hi. I agree with Antonio65 , especially about the SDMA. The only other thing to note, that I have previously read, is that highly muscular cats can routinely have a higher creatinine reading So, hopefully that applies to your cat!!!

I also wanted to offer this TCS article for you to read, in case it might help with getting your cat ready for the upcoming baby!
Cats And Babies: All Your Questions Answered! – Cat Articles

 

[lisahe]

Hi. I agree with Antonio65 , especially about the SDMA. The only other thing to note, that I have previously read, is that highly muscular cats can routinely have a higher creatinine reading So, hopefully that applies to your cat!!!

Yes to this! Also: diets high in protein (particularly raw diets, something I've seen mentioned quite a few times) can also result in higher creatinine numbers. Our cat's creatinine appeared slightly high (though only 1.8, which I thought was fairly normal!) just before she had her dental cleaning a couple weeks ago but the vet ran other tests and concluded that, given all her data, everything was fine. Our cat is lean and muscular.

There has even been a study ("Effects of dietary protein content on renal parameters") that looks at this question.

 

[chromecat]

Of course an ultrasound scan was also done and this was to confirm an early damage to her kidneys. In those days (2005) a special test for CKD wasn't available yet, now it is, so it could be nice to talk to your vet and ask if a SDMA test is viable.

I will absolutely ask next time we're there.

I see you are from Australia so I don’t know how the recommendations differ but in the US, veterinarians are being encouraged to ignore the upper reference interval of 2.4 mg/dL for creatinine and use 1.6mg/dL as the upper reference interval instead. This recommendation is supported by the IRIS Kidney Foundation.
Also, I would recommend SDMA testing if your veterinarian has access. The thought is that SDMA is a more sensitive biomarker for detection of early CKD compared with creatinine.
Finally, what was your kitty's BUN value?

We're in Singapore actually - I am wondering why the intervals are SO different because 1.6 to 2.4 is such a huge gap. It's interesting to note that in May the value was exactly the same - it didn't go up. BUN value was within norm. The vet mentioned some results might be altered if the cat has had food before the test, but I read that it would be the case only with a raw meat diet.

The only other thing to note, that I have previously read, is that highly muscular cats can routinely have a higher creatinine reading So, hopefully that applies to your cat!!!
I also wanted to offer this TCS article for you to read, in case it might help with getting your cat ready for the upcoming baby!
Cats And Babies: All Your Questions Answered! – Cat Articles

Ahah yeah my vet also suggested that about muscular cats and then quickly added that Felipe is definitely not a muscular cat! Thanks for the article, yes I am trying to get ready to make sure the kitties don't feel neglected.

Thanks all for the replies, at this stage is not about IF but about when should I bring him in for more testing. The radiologist won't be back until January, baby comes in February, I am thinking it might make more sense to do it before baby comes rather than after. The vet was very positive and not worried about it so in her opinion we can wait until April, but the thought of delaying bothers me. I am also worried of making the cat go through unnecessary tests, this year in May he had a mild ear infection that the vet decided to treat and required a couple of visits and some medication in the ear, plus cleaning. He got so upset about it that he stopped eating and wouldn't react to anything, he just hid in the bathroom and refused any contact with us as he associated us with the treatment. My husband was crushed and in a horrible mood until the cat healed and became his normal self again, so my husband is now concerned every time there's a possibility that we might stress the cat with more visits. But we'll do what we have to do, no question about that!

 

[chromecat]

Hi everyone, my vet just sent me a list of tests he wants to do, any comments about this? It's a long list, I don't care a bit about the money but my poor baby will be so stressed out...

Package: Blood Tests, Chem 10 + CBC - NEEDED
Cystocentesis - NEEDED
IDEXX Urine Protein Creatine Ratio UPC - MIGHT NOT BE NEEDED
Urinalysis & Specific Gravity UA & USG - NEEDED
Urine Sediment Examination, w Stain - MIGHT NOT BE NEEDED
Urine, Bacteruria Test, RapidBac - MIGHT NOT BE NEEDED
Radiograph, 1st View - MIGHT NOT BE NEEDED
Radiograph, Subsequent View - MIGHT NOT BE NEEDED

 

[Antonio65]

Well, it's just three different tests in all.
With a blood sample they will do a Blood Tests, Chem 10 + CBC (NEEDED).
With a Urine sample (through Cystocentesis) they'll do UPC, UA & USG, Sediment, Bacteuria Test and RapidBac (NEEDED/NOT NEEDED)
In a few seconds they'll do 2 radiographs (MIGHT NOT NEEDED).

So, because two things are needed, all the rest will come as a consequence of the first two without further stress for your cat.

While you're there, with a blood sample already taken, don't forget the SDMA test, if you/the vet think it may be useful.

 

[chromecat]

Ok! He tends to be a ball of nerves when the vet performs tests and stuff, so we want to avoid him being terrified. But I also want to catch it on time, if there is anything to catch!