Elevated Creatinine, Normal BUN/Phosphorus

[chris87]

In late October, my 16 year old cat had a couple of days where she wasn't feeling well. She wasn't eating much and was acting differently. After receiving fluids and Cerenia, I noticed a big difference. My vet said that everything looked fine on the labs, except that her creatinine was elevated (~3.1). Her BUN and phosphorus were normal. She had previous blood work in April 2021, and at that time, everything was normal. He thought that maybe due to the dehydration and vomiting earlier that morning, it was a skewed result. He suggested taking it again in a month or so. Fast forward to last week, and my cat again seemed to be off. She was giving me a lot of trouble with eating. She had no vomiting fortunately. I had to take her to a different vet, because my normal one couldn't fit her in. They again gave her fluids and a Cerenia injection, and the improvement was almost immediate. I took her back for a follow up appointment this morning, and they ran blood work to recheck the creatinine. The vibe I got from him is that he expects it to be high, since she has had two instances in 30 days where she needed fluids. He said if that's the case, she'll mostly likely need fluids 2x/week and we should consider a "renal diet." I've always tried to be very particular with her food. She previously ate raw, but as of late, it's been mostly canned Tiki/Weruva. I always like to research on my own and wanted to see if I'm missing anything. I would definitely like to avoid any type of prescription food, if at all possible. Is the elevated creatinine by itself a good indication of CKD, particularly when BUN and phosphorus are normal? Is there anything that I should ask or do to confirm anything? Is there any harm in giving fluids on an ongoing basis? If anyone has any advice, input, etc, I would definitely appreciate it. I just want to make sure that I'm getting her the best care possible.

 

[Furballsmom]

Hi
I can't answer all the questions but I've read that subq fluids are risky if the cat has heart issues.

Check into Weruva WX. It's new this year, its not prescription and is extremely low phosphorus. Evangers also has low phosphorus food as well.

This site has a lot of information that can help;

Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - What You Need to Know First

 

[fionasmom]

Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Blood Chemistry Panel.

Your cat is older and may have kidney involvement, so that definitely has to be investigated. Creatinine can be high for a number of reasons, including a raw or high protein diet.

If your cat has any heart condition, the use of sub Q fluids should be monitored, as was suggested.

Do you have access to an internal medicine vet in your area?

 

[Astragal14]

Pancreatitis can also lead to creatinine being the only elevated marker on a blood panel; this happened to my cat during a case of acute pancreatitis. This doesn't mean that CKD can be ruled out, rather it means you should rule out pancreatitis.

One of our veterinarians recommended my cats start taking a kidney support supplement when they became seniors just to help ward off future problems; you may want to discuss this with your vet as well, but it can wait a bit. You and your cat have more urgent issues to address without adding a new supplement into the mix. I chose a mushroom based supplement since my cats are not currently showing any kidney issues; stronger options like phosphorous binders can wait until they're needed. We're using Pet Wellbeing Kidney Support Gold.
PET WELLBEING Kidney Support GOLD Bacon Flavored Liquid Kidney Supplement for Dogs & Cats, 2-oz bottle - Chewy.com

Here's another quote from the amazing website Tanya's Comprehensive Guide to Feline Chronic Kidney Disease. It's a great resource for non-CKD issues as well. One of my cats has IBD and I learn new things from this site all the time.

Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Pancreatitis

CKD cats sometimes also have pancreatitis. To confuse matters, pancreatitis may sometimes cause elevated creatinine levels...

...In dogs with pancreatitis, amylase and lipase (pancreatic enzymes) are often elevated, but unfortunately these will not necessarily be elevated in cats with pancreatitis, so normal levels do not rule out pancreatitis.

(emphasis mine)