# Cat with a high BUN level question about CRF



## evansvillegirl26

My 8 yr old cat was jsut diagnosed with CRF. His BUN level is 135!! Normal is 30. He has been on IV fluids for several days and they are going to redo his labwork soon. I know some cats can manage with SubQ fluids and special diet but my question is has anyone gone thru this with a cat with such high BUN levels??? Does he have a fighting chance? I will do whatever it takes to help him.


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## laurief

I am very sorry for your cat's diagnosis. May I ask how your vet reached the diagnosis of chronic versus acute renal failure? If the onset of his condition was sudden, and if it resolves with IV fluids, then it would seem to be acute renal failure. Cats can sometimes recover fully from ARF. But if his renal values don't return to normal after the IV fluid treatment, then yes, it does seem he has developed CRF.

That said, BUN is not the most reliable indicator of kidney function. Elevated BUN _may_ indicate a renal problem, but BUN can also elevate for non-kidney related reasons. The more important renal value is creatinine, which is kidney-specific. Do you know your cat's creatinine level? Is it elevated?

You need to get copies of all of your cat's test results (past, current, and future) so that you can research the results online and gain a better understanding of your cat's condition. Once you have the test results in hand, the following links will help you make sense of them:

Tanya's Feline Chronic Renal Failure/diagnosis
Tanya's Feline CRF Information Centre - how bad is it

Again, the creatinine is a much more significant value in diagnosing renal failure, so don't get too worked up over the elevated BUN until you know his creat. Let's assume that both the BUN and creat are elevated. That would indicate some degree of renal insufficiency, either ARF or CRF. Some cats can and do present with BUN readings much higher than your cat, only to stabilize with significantly lower BUN values after IV fluid treatment. Other cats are diagnosed when the disease is just too far advanced to stabilize successfully. 

Renal failure is a very complex and unpredictable disease. With proper supportive care, many cats can live reasonably healthy, happy lives for years after diagnosis. Others fail quickly. There's just no way of knowing exactly how your cat will respond to his current IV treatment or any continuing supportive treatment he may require. It's a day by day thing with this disease. Your boy is a big step ahead of the game, however, having such a devoted caretaker at his side.

The best thing you can do for your cat is to educate yourself about feline renal failure and its associated conditions, and the best place to do that is the website I linked above. It is the "bible" of feline CRF. Read that website until your eyes go blurry, then take a nap and come back and read it again. Rinse and repeat. The more times you read through those pages, the more of its essential information will sink in and "stick".

Your cat has a chance of full recovery if he has ARF. He has a chance of years of relative health with proper management if he has CRF. Either way, it'll help both you and your boy is you maintain as positive and happy an outlook for him as possible.

Please post again if you have any additional questions or just need some support.

Take care,

Laurie


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## evansvillegirl26

Thanks for the reply. I will check out the sites!!! His creatinine is very high too. He gets more labwork tomorrow. His xray showed a enlarged kidney and the vet thought he was going to have cancer. We called in a specialist that does ultrasounds and his ultrasound showed one enlarged kidney and one shrunken one. He did not kind any kidney stones though. The specialist basically said to keep up the IV fluids then start the subQ fluids and change his diet. I guess heard him mention CRF with as bad as he is. He has been acting alot better since we started IV fluids but he still won't eat. I guess I will no more after his labs. I'm afraid the number will not be good and they will just say to put him down. How do I know when I really should or if I should keep trying?? I think vets sometime assume you won't spend the time or money to help but I am willing to do this. I just don't want to prolong my cats suffering though because i'm trying to "help" him.


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## laurief

evansvillegirl26 said:


> He gets more labwork tomorrow.


I hope that you get good news from the new bloodwork, but don't get discouraged if there hasn't been much change. There is a saying among CRF caretakers, "Treat the cat, not the numbers." Sometimes even high-numbers kitties can lead reasonably healthy, happy lives with proper supportive care. Numbers don't tell the whole story.



> The specialist basically said to keep up the IV fluids then start the subQ fluids and change his diet.


A diet change may or may not be advisable, depending on how far advanced his CRF is. You'll know more about that after the new bloodwork. Current thinking is that low protein diets should be fed only to cats in the later stages of the disease. Restricting protein in early stage CRF may lead to muscle wasting and overall weakening.

He has been acting alot better since we started IV fluids but he still won't eat. I guess I will no more after his labs. I'm afraid the number will not be good and they will just say to put him down. How do I know when I really should or if I should keep trying?? I think vets sometime assume you won't spend the time or money to help but I am willing to do this. I just don't want to prolong my cats suffering though because i'm trying to "help" him.[/QUOTE]


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## laurief

evansvillegirl26 said:


> He gets more labwork tomorrow.


I hope that you get good news from the new bloodwork, but don't get discouraged if there hasn't been much change. There is a saying among CRF caretakers, "Treat the cat, not the numbers." Sometimes even high-numbers kitties can lead reasonably healthy, happy lives with proper supportive care. Numbers don't tell the whole story.



> The specialist basically said to keep up the IV fluids then start the subQ fluids and change his diet.


A diet change may or may not be advisable, depending on how far advanced his CRF is. You'll know more about that after the new bloodwork. Current thinking is that low protein diets should be fed only to cats in the later stages of the disease. Restricting protein in early stage CRF may lead to muscle wasting and overall weakening.



> He has been acting alot better since we started IV fluids but he still won't eat.


Proper hydration can do wonderful things for a CRF cat, so it's no wonder that he's feeling better. As far as eating is concerned, he may just not have any interest in eating while in the hospital, or they may be feeding him renal foods that he finds repugnant (many cats refuse to eat the renal diets). You should bring him some of his favorite foods from home and see if you can get him to eat for you at the hospital. Don't let your vet pressure you into feeding only renal diets. It is MUCH more important that your cat eats SOMETHING than that he eats the prescribed renal diet.

If he won't eat normal foods even after he comes home, you should ask your vet about an appetite stimulant. I used cyproheptadine successfully with my last CRF cat. You can get a lot of tips, tricks, and options to help get your boy eating at the following link:

http://www.felinecrf.org/persuading_cat_to_eat.htm

It is essential to get food into your boy to avoid a potentially fatal liver disease, so if he won't eat on his own, insist that your vet syringe feeds him until you bring him home.



> I'm afraid the number will not be good and they will just say to put him down.


Don't allow your vet to persuade you to make an irreversible decision until you are convinced that it is best for your cat. It's not your vet's decision to make. It's yours and yours alone. Take whatever time you need to research your options and make an informed decision that you'll be able to live with.



> How do I know when I really should or if I should keep trying??


I've said it before and I'll say it again - educate yourself about this disease and the treatment and management options that your vet may or may not offer you. The more you know, the more reasoned and reasonable a decision you'll be able to make when the time comes. You might also find it very helpful to join the CRF Support Mailing List. It is a very large and active list filled with incredibly knowledgeable and supportive people who can offer you a tremendous amount of information, guidance, and insight about your cat's illness. They can help you make sense of your cat's current condition and suggest treatment or management options. They will also support you when there is nothing left to be done but say a gentle goodbye. You can join the group through this link:

http://groups.yahoo.com/group/Feline-CRF-Support/



> I think vets sometime assume you won't spend the time or money to help but I am willing to do this.


Many of us have had those feeling about our vets. You need to have a frank and honest discussion with your vet about this and make sure you're on the same page regarding your cat's care. If you're not on the same page, find another vet now. There's nothing worse than having to do battle with your vet over the care of a chronically ill animal companion. You need a vet who will partner with you, not one who will try to dictate to you.

As far as allowing your cat to suffer is concerned, you just need to trust yourself. I can tell from your posts that you love your cat too much to allow him to suffer on your account. You will do everything you can to return him to an acceptable level of health, and if it turns out that you can not achieve that for him, you will let him go. 

Take a deep breath and prepare yourself for the roller coaster that is CRF. It can be a scary ride, but it can also have some great peaks that bond you and your cat more closely than you can imagine.

I hope for you many good days ahead.

Laurie


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## Clutch

Hi,

My 6-year-old cat had crazy-high BUN and creatinine levels when I realized he was sick last February. I don't remember the numbers but he was in renal failure and I checked Tanya's CRF site and the numbers corresponded with over 75% of kidney function lost. 
Through the care of my vet, he has done very well and regained several pounds.

I guess what I'm saying is don't panic, because I cried for a week straight. There are plenty of things to manage your cat's health and I'm sure your vet will steer you in the right direction!


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## evansvillegirl26

Sorry for the late reply. It's been a crazy week. We after 3 days on IV fliuds his numbers came down. His BUN went from 135 to 75 and his Creatinine went from 9.8 to 6.6. His other numbers came down too. He had 3 more days of IV fluids and now we are doing subQ fluids every day for 5 days then every other day. We go back for labs on Dec 30. He has been acting sooooo much better. He is on Hills K/D prescription diet. He's been eating and playing again which is great. I hope he puts back on some weight that he lost. Thanks for the reply's it REALLY did help me to stay positive!


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## laurief

evansvillegirl26 said:


> His BUN went from 135 to 75 and his Creatinine went from 9.8 to 6.6. His other numbers came down too. He had 3 more days of IV fluids and now we are doing subQ fluids every day for 5 days then every other day.


It sounds like your boy's been making good progress. That's terrific! His numbers are still quite high, though. If I had a CRF cat with numbers that high, I sure wouldn't be quick to reduce him to every other day unless he was retaining fluid or had a heart condition of some sort. I'd continue to admin subQ fluids daily if he's absorbing fluids properly and his heart is healthy. How much fluid are you administering daily, and how much did your vet prescribe administering after you switch to EOD?

Of course if his numbers come down into normal range again, then daily subQ's will no longer be necessary.



> He is on Hills K/D prescription diet.


Canned or kibble? I'm sure your vet explained to you that CRF cats should be eating canned food to help support proper hydration. Kibble is dehydrating, so it is not advisable for CRF cats unless it is the only food that they will eat.

Do you have copies of his bloodwork? If so, what were his potassium and phosphorus values on his most recent test? How's his HCT (aka PCV)?



> He's been eating and playing again which is great.


That IS great!



> I hope he puts back on some weight that he lost.


KD isn't the greatest food for weight gain, but hopefully your boy will regain some of what he lost when he wasn't eating.

Laurie


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