Uric Acid

[asterroc]

Originally posted by zandperl at Uric Acid

Got some bloodwork done on Kappa last month. My vet isn't avian certified (the closest AAV certified avian vet to me is more than 2 hrs drive away), but I've had good luck with VCA Animal Hospitals in the past, my vet does do birds, and she's been consulting with other vets to make sure she learns more as needed. She told me after the bloodwork last month that she needed to consult with other vets on Kappa's uric acid test. We finally talked on the phone yesterday, and, well, let's start with this: partway through the conversation I felt the need to ask her right out "Should I be concerned or panicking?" and she replied "Concerned." I'm not convinced she's right.

Kappa's uric acid (which tests kidney function) is at 17 (I didn't catch the units, but for this test in humans the units are mg/dL). Normal healthy birds are supposed to be in the range of 2-10. Kidney disease is diagnosed if it's at a level of 20. The vet recommended two things: since Kappa's currently boarding with them for a week and a half anyway, they're going to give her sub-cutaneous fluids daily; and although I already give her Sunshine factor (palm fruit oil, for the Omega-3 fatty acids), she recommended I apply it to her veggie mix daily rather than when I make the mix. They're also going to take two more blood samples: a tiny one partway through her stay and do a test in-house on the hematocrit (I think it was), which tells about her red blood cell levels, which can tell if she's having problems rapidly; and another full blood panel at the end of her stay (which needs to be sent away) to see if the sub-cu fluids have made any significant change.

Basically, the vet was talking about extending Kappa's life, that in some cases something like this can be fatal quickly, or it could only shorten the bird's life by a year. I'm trying not to be devastated (my first cockatiel passed away from kidney failure). I'm definitely worried. Kappa's only 6 years old (if I'm counting right), and dusky conures have a normal life expectancy of 25-30 years. I got her after I lost two cockatiels in a relatively short time span, and I picked her species partly due to the longer life span than 'tiels.

*sigh* Anyone else have experience in this situation, where you have warning signs of a disease and have to manage it for the rest of the bird's life?

Comments

[rosefox]

Not for a bird, but for a cat--would that perspective be useful?

[zandperl.livejournal.com]

Yes, part of what I'm looking for is just how people handle this sort of thing emotionally. Thanks.

[rosefox]

Our cat Java has needed daily medication for nearly three years. He has pancreatitis, and steroids help to keep the inflammation down. He looks like a normal, healthy, happy cat, albeit an elderly one who's getting a bit arthritic. You'd never know to look at him that he had a life-threatening condition.

Practical considerations:

We have a calendar on the tin with the medication, and we make sure to check off each day so that he doesn't either get double-dosed or miss a dose. I also have a monthly reminder on my phone to refill the prescription.

We had to find a form of medication he could tolerate. He hates getting pills. If we'd had to pill him every night for years it would have been awful for him and for us. Fortunately he's fine with having medicated ointment rubbed into his ears; he doesn't love it, but he tolerates it with good grace, and it's quick and easy.

Whenever we travel we have to have someone stay over at our house who can medicate him and keep an eye on him, ideally someone who knows him and his mannerisms well and can tell when he's under the weather. It is possible that someday the steroids will stop working and he'll get sick again, and if that happens when we're away, we want somebody on hand who will take good care of him.

Emotional considerations:

The three of us handle this differently. Java is Josh's cat; the two of them are very closely bonded. Josh isn't in denial about Java's condition, but he doesn't let himself think about it much. Instead, he focuses on spending time with Java and doting on him (sneaking him bits of roast chicken, etc.). He also handles all the vet checkups and provides a good calm balance to anxiety-inclined me and X. He knows Java really well and is usually the first to spot signs of illness.

X tends to be very pragmatic and vigilant, keeping a close eye on Java to make sure he's not developing symptoms of illness and talking occasionally with me about how we'll all cope when he dies. We visited a friend who had kittens up for adoption and X subtly nudged us in the direction of adopting a large, rambunctious male kitten who was likely to grow up into a large, friendly male cat--on the theory that sometime in the next few years our household will really be missing having a large, friendly male cat around. I think X also keeps a bit of emotional distance from Java, in hopes of not being absolutely devastated by his eventual death. (X takes pet deaths very very hard.)

I'm somewhere in the middle; I fuss over Java and cuddle and indulge him, and then I have those practical conversations with X both to brace myself and to spare Josh from having to think about it. I also focus a lot on how glad I am to have had the past three years with Java. He could easily have died when the pancreatitis first manifested, and we're very fortunate that our vet knew how to diagnose and treat the problem. While I do a bit of planning and bracing for the future, mostly I try to make sure the kitty knows he's cherished and loved, and to savor every moment we have together.

I hope that's helpful. Best of luck to you and Kappa.

[zandperl.livejournal.com]

There were two times in Kappa's life where I had to give her oral antibiotics from a syringe injected into the back of her mouth for a couple weeks. The first time it was just based on routine tests that showed she had some gram negative (bad) bacteria, but the second time she was sick enough that she was actually showing symptoms. That time, after three days of giving her the antibiotics, she decided to take them willingly, so that I was able to actually just hold out the syringe in front of her mouth and she'd lick at it as I slowly squirted it out. I don't know whether she decided she liked the flavor, or if she was actually using her brain and either realized she couldn't prevent me from giving it to her so she might as well do it willingly, or if she realized that it was helping her to feel better. But I'm hopeful that if I have to give her any medicine that she'll be as good about it as that time. I just hope I don't have to inject sub-cu fluids myself, that'd be a pain to do daily.

Thanks for your thoughts, it helps to see how others deal with pet illness.

[cosmicwonder.livejournal.com]

I'm really sorry that you're going through this.

I'm kind of going through a similar thing, but with my cat Johnny. He's been having allergic reactions to eating - he'll scratch his face until it bleeds and he tends to vomit frequently. He also has a couple cysts on his skin, and he's lost weight (although he was overweight before). I've brought him to the vet for tests, but they haven't found anything. The vet told me that if he does have a problem, such as cancer, it's going to be next to impossible to diagnose. We've been able to help him somewhat with a more limited diet, but he's recently started throwing up one of the flavors I usually give him. I'm almost at my wit's end as to what to feed him.

Johnny's 11, so he could still live for a few more years. But it really does scare me about how he's been the last year or so. It doesn't seem to be getting much better, although some of his fur has grown back and when the food combination is right, he doesn't throw up.

Overall, I try to keep remembering that I'm giving him the best life that he can have. In general he seems happy and isn't suffering - he still cuddles with me and plays with our other cat Athena. I keep focusing on enjoying the time that I have left with him. That's what really matters - not how long he lives.

[zandperl.livejournal.com]

That's how I felt when Peeper was diagnosed with kidney failure. Kappa's so young though, that I don't want to have to think that way. But yeah, I know intellectually that I'm doing everything I can to help her.

[cosmicwonder.livejournal.com]

Sorry. I feel like I got carried away in my comment about my current worries concerning Johnny, and the result was that I didn't give very good advice to you.

I agree with hfran and meig that it's too early to tell whether Kappa is actually ill. I think what's important is to stay as positive as possible. I've been amazed lately by how much positive energy can help in difficult situations. I'll keep my toes crossed for Kappa!

[ayashi.livejournal.com]

Aw I'm sorry :(

I've not yet had to deal with any issues that actually had to have constant treatment - with Sadie she had allergies that were rather severe but also taken care of by lots of food testing until we found something that worked. She was starting to develop a heart issue but it was too mild to do anything about it, and unfortunately liver cancer ended up getting her first and there was nothing we could do about that since surgery was not an option. Tcl has a knee problem but it has not get progressed to a point where she needs any treatment, and even then it isn't life threatening just a quality of life issue.

*hugs* I'm sorry, I wish I could help. I hope that while she's at the vet now she sees some improvement just from the treatment she is getting now!

[ayashi.livejournal.com]

Just remember the important thing is that she is comfortable and happy. While I haven't had to deal with any long term issues, I did care for both Sadie and Photo while they were sick (though both the cancer and the FIP were caught at a point where they only had a couple of weeks left anyway) and as long as they seemed happy, were eating etc, that was the important thing. And it seems like if this issue has been caught before it actually has reached a diagnosis of kidney disease, the chance of being able to keep her happy and healthy longer is better? ♥

[zandperl.livejournal.com]

Yeah, I know, but it makes me really sad and worried. Thanks for the kind words.

[hrafn.livejournal.com]

Oh, no :( I don't have any experience dealing with this sort of thing... I hope her levels will drop with just adjustments to diet, and that it's less of a "concern" than the vet is indicating now.

[zandperl.livejournal.com]

*Nods* And I'd rather be concerned about something that turns out to not be a big deal than not be concerned about something that was. I've got a list of food items I'm going to ask my vet about adding to her diet which're supposed to help with kidney issues and/or provide Omega-3 fatty acids.

[hrafn.livejournal.com]

Oh definitely!

[meig.livejournal.com]

How was the blood collected for the panel? Toenail clip or direct draw from a vein?

Also, what could be the common factor with your birds that could be disposing them to this issue?

[meig.livejournal.com]

Also, was this the first time her uric acid levels have been elevated or have you seen elevated levels previously?

[zandperl.livejournal.com]

This is the first time she had a full blood panel; I'm not sure why I never convinced my previous vet to do full bloodwork. They're going to monitor her hemo-something (hemocrit?) while she's there also, as apparently that's related to the uric acid and can be tested in-house, and then before I take her home from boarding they'll take another sample for a full blood panel. I'm looking at another $200-$300 for the sub-cu fluids and tests.

[meig.livejournal.com]

Sometimes there can be an aberration and the uric acid can be elevated once and then lower the next time, which is why it is recommended to test twice. I'm hoping this will be the case here.

[zandperl.livejournal.com]

My understanding is draw from a vein, b/c they needed more blood for a complete panel than could be gotten from a toenail clip. The vet also talked a lot about being careful not to traumatize her too much while holding her, so that also leads me to thinking vein. She seems to think that it's easy to essentially scare a bird to death, which I'd never heard of before, but even if it's weird it's the sort of weird that protects Kappa so it doesn't bother me.

With Peeper, my understanding was that it was due to a lifetime of being on seeds, that seeds predispose birds to kidney problems. FWIW Peeper was 16 when she passed away due to kidney failure, which is a respectable age (though I do know 'tiels can live longer). With Kappa, no clue. I've started a list of foods that are supposed to be good for kidney problems and/or have high Omega-3 fatty acids (which the vet said is good for this), and I'll ask about them all. I'll also ask if there are any foods we should be avoiding; she already mentioned meat, which I never give her.

[calzephyr77.livejournal.com]

Oh my gosh, somehow I missed this post last week :-(

The last year and a half of Moxie's life was more or less palliative care. I'm really not sure how he did so well or hung on so long. I think if he had not tried to fly a couple of days before he died, he might have lived longer. It's all there in LJ, if you care to read...although my perspective on it three years later might be a little different now. I looked after him as one might a person - giving him a bath almost daily where he couldn't preen and giving him all the things he loved and being very gentle of course. It was really a lot of work when he was having polyuria to keep everything clean. We did Sunshine Factor too.

I hope the new blood tests have more encouraging results, and of course I wish the best for you and Kappa!