Tabs to the vet's (follow-up on PCKD)

Backstory:

According to the vet, Tabs has probably had PKD (polycystic kidney disease) all her life (they are normally born with it) but since all her blood tests during earlier years showed normal kidney readings, no ultrasound was done. It was only in December 2023 that a routine blood test suddenly showed elevated an creatinine reading. The ultrasound showed the presence of many cysts in both kidneys, more on the left. It was only then that we discovered Tabs had PCKD (by now, polycystic chronic kidney disease). PKD would not display signs in the early years but would eventually progress to PCKD and it will show up in the kidney readings. Even if we had known that Tabs had PKD, there was absolutely nothing we could have done to reverse it. It is a terminal condition.

PKD is more prevalent in pedigree or mixed pedigree cats, but our vet has seen it in local cats too. Tabs has some British shorthair in her. She came on her own wearing a red collar to adopt us in December 2011. She is estimated to be 15 years old now.

Today:

So I had been feeling so nervous about Tabs’ follow-up today. I kept waking up last night, worrying. I know worrying doesn’t help, but it’s easier said than done.

This morning, I braved myself and drove Tabs and Robin to the vet’s. Let’s face it together, come what may.

Every time I take Tabs to the vet, the vet will always remark what a good cat she is. Yes, Tabs is a very good cat.

First, the vet detected some flea dirt under Tabs’ chin (rubbed with a cotton pad and it was reddish – this shows the presence of flea dirt). So, Tabs needs Advocate spot-on for two months, but the vet says to use the one for below 4kg as it’s milder on the kidneys. Tabs weight is 4.2kg (more or less the same as last check-up in November 2024).

Second, blood was drawn for the blood test.

Third, the ultrasound. Actually, the ultrasound showed pretty much the same as it did in December 2023 with larger cysts in the left kidney. The right kidney has multiple cysts but these were of a smaller size. The liver has big cysts, but the vet says to wait for the liver readings to see if any FNA to draw out the fluids is necessary.

The blood tests results were ready and we were all pleasantly surprised that Tabs’ SDMA and creatinine readings have remained the same as those in November 2024! Her SDMA is still 17 and her creatinine is 268 (previously, 260). Only her urea has increased quite a bit to 21.2 and her phosphate has increased a bit too, but it is still within the normal range. But Tabs’ PCV is 32% which is good.

Tabs’ liver readings are all normal so there was no necessity to extract the fluids from her liver. This means her liver function is good despite the presence of those large cysts. FNA in any organ is risky and should not be done unless it is absolutely necessary.

The vet checked Tabs’ proBNP too and the reading is 80.8% (previously 79.3% in December 2023), so that’s quite good. The vet also checked Tabs’ heart using ultrasound and it’s pretty much the same with slight enlargement of the left side, but generally good enough.

So, Tabs is to maintain all her kidney supplements, try to give her a kidney diet (as much as possible) and the only change would be the reduce the subcut from 150ml to 120-125ml each day. But if the pinch test shows dehydration, I would have to increase it back to 150ml. Besides her kidney supplements, Tabs is also on Fortekor and Amlodipine.

Tabs hasn’t really been on a 100% kidney diet too. She doesn’t quite like Hill’s canned KD, RC renal kibble or RC renal pouch, but I do my best to give her renal food whenever possible. The vet also agreed that Tabs would also want to have variety in her diet, and that’s okay too, she cannot be eating the same old thing every day. But I will try harder to give her more renal food. The canned food that I give her has no added salt (I already checked with the manufacturer on this).

I had expected worse results today, knowing fully well that PCKD will only progress. We had also felt a lump on Tabs’ side and the vet says that’s the cyst in the kidney. Best not to press on it in case it is painful.

Today’s results were unexpected and I could only say a silent thank you prayer to all cat guardians, seen or unseen, for looking after Tabs. Even our vet was surprised and very happy too. She says perhaps the stemcell treatment did help. I asked repeatedly if another stemcell treatment would help Tabs further, but she doesn’t recommend it. She says when it was done previously, there were still enough kidney tissue to regenerate, but now, the amount of kidney tissue has decreased, so there would not be significant improvement. I do understand this.

As we drove home (luckily Robin was quiet on the trip home), we sat quietly in the car, all three of us, and Julie Andrews’ voice rang loud and clear in my head, “So somewhere in my youth of childhood, I must have done something good…”

I am so, so thankful.

I know PCKD (or for that matter, CKD) will progress and nothing can stop it, but a slow progression is a good thing. In fact, the best we can hope for.

Life is a result of effort and luck. We give it our 100% effort (I really, really do), but there is still the element of luck which is beyond our control.

So, let’s just live for today and be very, very thankful for anything and everything that has gone right.