Sunday, July 21, 2019

Feline hyperaldosteronism-Adnrenal Cancer, Cause of CKD/Hypertension/Low Potassium

There has been a lot going on in our house of cats. In June and July, I think I've been to the vet-regular vet, cardio, vet for check-ups, vet for illness, vet for rechecks, shots, etc.-about 25 times. There are some serious issues to discuss and I'm still working on the information. But-all of the cats have seen the cardio except Roxanne (she goes in Dec.) and all are fine and no HCM.
The siblings went through a virus in late June through July with mild vomiting and diarrhea presenting in almost all four but not at the same time. At first, I thought nothing of it, that if one vomited, and another had diarrhea, that it's not unusual for those things to randomly appear by chance. As long as the cat that vomited didn't continue and didn't appear lethargic and continued to eat, I let it go. The diarrhea I treated as needed with either less fiber, more Forta Flora (probiotic) or rice water (great binding agent.)
But then early in July, Bette Davis vomited violently and then decided she was going to spend the day sleeping and not eating. I took her to the vet the next day (while hand feeding her liquids the day before to keep up hydration and nutrition.) She didn't have a fever and her blood work CBC/chem panel and PLI (pancreas test) was normal. But she did present with pain reflexes in the gastro/bladder/kidney area of the body upon exam. So, three days of Buprenex (pain reliever, swelling reducer) twice a day (about .3ml or so each-the vet sent home syringes of the med so I have forgotten the exact amount) did the trick. They also gave her sub-q fluids.
BUT-Baby has had signs of CKD-kidney disease-which I reported weeks ago. I did not review all that the vet hospital was testing. She has hypertension and is on a calcium blocker and her pressure went from 240 in May to 130 in June and now 124. She's responding very well. She's on a diet for low phos kidney food and her SDMA went from 21 to 20, while her BUN and creatinine remain normal.
BUT the vet suspected that she could have hypertension and low potassium NOT because of CKD (although the SDMA is supposed to indicate CKD) but due to hyperaldosteronism, a possible cancer of the adnrenal gland connected to the kidneys. I'm still reading up on it. But her blood test this week came in at 829-NORMAL is about 100-350. What's next? Not sure. She might need an MRI (the ultrasound in May didn't show a lot of change or masses) and further tests to try to pinpoint the cause which apparently is one form of cancer or another, or idiopathic masses or tumors that are caused by other issues.
Since May, I've been trying to learn all I can about CKD to help her. But now, if it's cancer, CKD is more like a secondary response to the cancer and not a primary issue that can be itself treated. Here's a link to a site about the issue. I'll write more soon.
"Screening for this disease should be performed in any cat presenting with hypokalemia or hypertension, as well as the subset of cats presenting with mild azotemia, if preliminary minimum database diagnostics fail to identify other underlying disease processes. Diagnostic tests should include a complete physical examination, complete blood count, serum chemistry profile, total T4 measurement, urinalysis, and blood pressure measurement.

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