Case Study: Severe Kidney Infection

Cummings experts use two types of dialysis treatment to save a cats life.


[From Tufts August 2011 Issue]

Editor’s note: This is the second in an occasional series that spotlights cats treated for various medical conditions at Cummings School of Veterinary Medicine at Tufts University.

Michelle Downer was going into labor, but as she left the house, she noticed that her cat, Boots, had vomited. That was a little odd, but she wasn’t too concerned. Sometimes, cats throw up for no apparent reason. Downer’s stay in the hospital lasted three days, and at one point, her father commented that although Boots was eating his treats, he looked a little wobbly.

“I came home and I looked at Boots and thought, ‘There’s something really wrong with him.’ He was walking awkwardly and he wouldn’t eat tuna for me,” Downer says.

At midnight, having given birth to a premature infant three days prior and with a toddler and sick cat in tow, Downer found herself at the veterinary emergency room. They kept Boots overnight, gave him fluids intravenously and ran tests. Blood work showed that his blood urea nitrogen (BUN) and creatinine levels—indicators of kidney function—were through the roof. The veterinarians there recommended that Downer take Boots to Cummings School of Veterinary Medicine at Tufts University — about an hour away — where veterinary specialists could evaluate him.

“We had just gotten our infant out of the hospital and then we picked Boots up and took him to Tufts, where they admitted him to the ICU,” Downer says. “The next day, we met Dr. Mary Labato, who started him on dialysis.”

Although the cause was unclear, Boots had a severe kidney infection. The kidneys act as the body’s waste removal system, eliminating toxins from the body via the urine. When the kidneys aren’t working, toxins build up, causing illness.

Dialysis performs the kidneys’ job of waste removal and allows for the removal of excess water and electrolytes that develop when the kidney is not working, says Dr. Labato, DVM, DACVIM, an internal medicine specialist. With the help of dialysis, the kidneys have time to recuperate if they have not been too severely damaged.

After a week of treatment, Boots’ kidney values had improved, but not substantially. Downer and her husband were concerned that they might be putting him through too much, but after consulting Dr. Labato, they all agreed that the affectionate, people-oriented Boots had fight in him.

“Despite being very sick, he’d always be looking to get petted,” Downer says. “One of us would visit every day, and he’d get up, even with the IV and the central line and all that stuff, to see us. He was eating; he was drinking; he was trying.”

The reason for their cat’s illness was still unknown. Ultrasounds didn’t show a tumor, and a biopsy didn’t indicate cancer, either. A second biopsy uncovered an interesting fact, though: Boots had only one functional kidney, with the other being very small.

Dr. Labato started him on peritoneal dialysis and sent him home with a peritoneal dialysis catheter in place, instructions for giving fluids subcutaneously (under the skin), and prescriptions for antibiotics to combat his infection. Downer is an emergency room physician, so she was comfortable providing the care Boots needed at home. He received peritoneal dialysis twice a day and antibiotics and IV fluids three times a day.

Boots had been patient at the hospital, but when he came home, he seemed to think his trials should be over.

“He’d sometimes see me coming and trot away, but he wasn’t that fast at that point,” Downer says.

The two-week stay at Tufts, plus home care and follow-up visits, cost $26,000, but now, three years later, Downer says she would do it all over again. Her gray domestic shorthair with the white belly and white paws is almost 13 years old and back to normal. To make sure any recurrence is caught early, Downer takes Boots to her veterinarian every three months for blood work to make sure his kidney function hasn’t changed, but other than that he doesn’t need any special care.

“I don’t think I ever expected him to get back to normal,” Downer says. “He’s done so incredibly well that in a heartbeat, I’d do it again.”


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