Bootsie is a 17 year old female spayed domestic medium hair cat who presented for examination at Oswego Animal Hospital for a second opinion of a sublingual mass (under the tongue) and halitosis. Bootsie had been previously seen at another veterinary hospital for the same clinical presentation. No diagnostics had been done at that time but squamous cell carcinoma and renal failure were suspected. Bootsie was started on subcutaneous fluids at home and the owner had been spraying incense in Bootsie’s mouth to help with the drooling and halitosis.
On physical examination, Bootsie was quiet but alert and responsive. Her gums were light pink and tacky. Moderate dental tartar, gingivitis and halitosis was noted on oral exam. A grape size fleshy mass was seen under the tongue but a thorough exam was difficult to do with Bootsie awake.
Bloodwork and a urinalysis were performed. On her bloodwork, Bootsie’s chemistry showed an elevation in BUN 52 mg/dL (reference range 14-36 mg/dL) and Creatinine 4.9 mg/dL (0.6-2.4 mg/dL) which are two kidney values that are assessed in kidney failure. Bootsie’s red blood cell count was low which was likely anemia of chronic disease (renal failure). Her urinalysis showed a low specific gravity which is used in the evaluation of kidney function and can aid in the diagnosis of kidney disease. There were also numerous rod bacteria seen but no white blood cells were noted.
Owner elected to hospitalize on IV fluids for 2 days (48 hours) to see if Bootsie’s kidney values would return to normal. Over the course of 48 hours Bootsie’s kidney values began to return to normal but were not within normal limits by the time she was discharged from the hospital. Owner elected, based on the kidney’s response to fluids, to continue subcutaneous fluids at home. Owner elected to continue to monitor the mass for changes in growth or difficulty eating/swallowing at this time.
Most elderly cats, if they live long enough, may have symptoms of kidney failure. Cats with kidney disease do not begin to show signs of kidney failure until about 65%-70% of their kidneys are destroyed. Therefore, yearly bloodwork and urinalysis are recommended to catch kidney disease in its early stages.