Tag: meredith gibbs

Well that’s not good. With intravenous fluids reduced to 1.5x maintenance levels for two days, Artemis’ blood test results headed in the wrong direction. We now need to discover if there’s some reason for the kidneys not working other than, well, failed kidneys.

Dr Meredith Gibbs from Pet Vets phoned through the results a short time ago. Compared with the positive signs 48 hours ago, it’s “disappointing”.

Creatin levels climbed back to 690. Urea was back up to 22.7, although that’s not the worst it’s been. Red blood cell count is still low, in the mid-20s instead of the 30+ it should be in a cat — although that’s possibly just a symptom of the high fluid levels. Electrolytes are still a bit whacky.

So Artemis goes back on the 2x maintenance levels of intravenous fluids — the poor man’s dialysis — until we figure out what’s going on.

And yet, Artemis has reportedly been “even more feisty” than she was on Sunday. She’s been eating overnight, she’s interacting with staff, and she’s showing all the signs of simply being frustrated with having to be in a cage.

After consultations with a specialist at the University of Sydney, a plan has been agreed upon. Ultrasound, X-rays and attempts to culture potential infectious agents to see if there’s some treatable cause of the kidneys not working. That’ll begin tomorrow and we’ll have news of the ultrasound and X-rays around 24 hours from now.

If none of those procedures reveal anything treatable, then we’re looking at untreatable kidney failure. It may not be that. But it’s a distinct possibility, despite Artemis’ apparent external health.

As for exploring the options, there is a veterinary surgeon in Melbourne who does kidney transplants. Enquiries have been made, and we’ll see what the requirements are, but… you know… We’ll see.

I’ve just spent half an hour with Artemis, and here’s a picture. While she’s showing marked improvement, she’s still on fluids at twice the normal maintenance level to flush out any toxins — think of it as poor man’s dialysis — and it’ll still be some days yet before we really know what’s going on.

First the good news. Artemis has been eating. While she was obviously annoyed at still being connected to the drip, she was exhibiting her normal behaviours. I’m friendly, but don’t touch me. Yes, I want attention, but don’t pick me up. How can I escape from this table? How can I get my leg out of this uncomfortable bandage? This is a great sign.

However she needs to stay in this stable state without being on intravenous fluids.

As I mentioned earlier, the blood tests done on Friday afternoon showed that the enzymes associated with kidney problems had been declining, although they were still way above normal levels. Urea levels, for example, had dropped from 113 during the crisis night to 36, but they should be below 12.9. Creatin levels were at 416 on Friday, when they should be below 212. On crisis night they were so high that the measurement technique didn’t even work, even with the blood sample being diluted.

Curiously, certain blood tests showed indications of acute kidney problems, but others were associated with chronic problems.

In brief, as I discussed with Dr Meredith Gibbs today, Artemis was so profoundly ill — so near death! — that everything was very different from normal. We shouldn’t read too much into any of this, but simply take everything one step at a time.

And the next step is further blood tests this afternoon, 48 hours after the last batch. If all these enzyme levels are returning to normal, then the intravenous fluids will be reduced slowly to see what happens — to see whether Artemis’ kidneys can now sustain their function or not. If the blood tests are not showing sufficient movement towards normal today, well, she stays on the high-level fluids for another 48 hours. And then we try again.

So what’s the longer-term view?

Continue reading “Artemis improves, but it’s early days yet”