Kidney Failure ~ Blood Results

[Kipcha]

As some know, Ty has been going through Kidney Failure for the past year and a half. We became aware of it when he suffered from a stroke and had increased water intake. He's getting to the point now when we are going to have to make a decision very soon. The vet is thinking it is going to be sooner rather then later, due to his condition, and we were going to do it today but after putting Macleod down and coming home to see him trying to run around and sticking his head in the treat bag and being cuddly, I just couldn't do it today. Not two in one day...

We're going to give it another day or two, since he seems to have improved just a little from yesterday and he seems okay, but I am not deluded. I know his condition is very serious and within the next few days, we're going to have to do it.

However, I am curious as to if someone can give me a better picture on his blood work. I know some of his numbers are insanely high (Particularily Creatinine, with his being 653 while a high normal is 159) but I do not really know what they mean. The vet was trying to describe, but we were just sending poor Macleod back to be PTS and I wasn't really paying attention to words. I was just distraught and not really taking in what she was saying.

His muscles are wasting and it's gotten to the point where the tips of his toes drag slightly and he has a hard time keeping his balance due to muscle wasting. His pees nearly constantly and he drinks 2 big bowls of water a day minimum. Apparently he has Edema too, which from what I understand is retaining too much fluid and it's going places it shouldn't, something we didn't even know about until they went to take blood from him yesterday. He's gotten so skinny too... But I've been having a hard time with it because despite it all, he's seemed happy up until a few days ago. He's always had a huge appetite and is so happy to see anyone coming over to the pen. But in the last few days his mood has plummeted, hence the vet visits, until today where he seemed okay again.

So if someone could just explain what the numbers mean and just how uncommon numbers like that are, it would be appreciated.

We do feel a little lucky since most bunnies in renal failure seem to last about a year and the vet didn't think he would last to Christmas 2011, but he seemed like a normal bunny until the last few months where it started to show.

 

[missyscove]

I'll admit that we didn't cover rabbits specifically, but we're just wrapping up our kidney block so hopefully I can help a bit.
Azotemia ia defined as increased blood urea nitrogen (BUN) and createnine. When azotemia is accompanied by clinical signs (anorexia, vomiting, diarrhea, gastrointestinal hemorrhage, ulcerative stomatitis, weakness, lethargy, muscle tremors, convusions and coma), it's considered uremia.
Azotemia and uremia can be localized as pre-renal, renal, or post-renal. A urinalysis with a urine specific gravity is key. A healthy kidney can concentrate urine but a diseased kidney (more than 2/3 of the nephrons are lost before you see clinical signs) will just pump out a lot of dilute urine. Pre-renal examples include starvation, high -protein diet or poor perfusion (blood flow) to the kidney. Post-renal causes include obstruction or leakage.

Urea is either absorbed from the large intestine or synthesized from ammonia n the liver. It then diffuses into blood and is excreted by the kidney. Createnine is made at a fairly constant rate from creatine which is stored in the muscle (or obtained from muscle in the diet, but not in herbivores). In renal azotemia, ~3/4 nephrons have been lost whith decreases the glomerular filtration rate in the kidney leading to insufficient excretion of urea and createnine and therefore higher levels in the blood.

The hematocrit is how much of the blood is composed of red blood cells. A low hematocrit is associated with anemia. High hematocrit is most often associated with dehydration (the same amount of red blood cells are there, but the fluid has been pulled out so what's left is a higher concentration of red blood cells relative to the fluid).

My source on these notes is mostly Duncan & Prasse's Veterinary Laboratory Medicine Clinical Pathology.

I hope that helped somewhat.

 

[Kipcha]

Thank you for explaining, that does help clear things up a little.