How Zee conquered Chronic Kidney Disease

Introduction

One in three cats will eventually suffer from Chronic Kidney Disease (CKD).  Conventional wisdom holds this to be a progressive disease, which is irreversible.  Treatment is geared toward making a cat feel better, and attempting to slow down the disease progression that eventually leads to death. 

When Zee became seriously ill, and diagnosed with CKD, I was not about to let her become another statistic.  I did my research, advocated for her survival, and sought out unconventional treatments.  Nearly two years later she is happy, healthy and active.  Her CKD has reversed, and is now in remission. 

This is the story of Zee’s battle and recovery.

Zee

We adopted Zee in early 2011, when she was just a year old.  She was our first cat, and we soon adopted several more.  Zee became best friends with Dublin, a six-month old kitten, and they were inseparable, until Dublin died of FIP.  Zee became depressed and uninterested in playing.  Though I brought her to the vet several times, they could find nothing wrong.  And because of her young age, the vet did not feel that bloodwork was necessary.  In retrospect, I believe that a silent disease was taking hold, and would not manifest itself until a few years later, when Zee rapidly met with death’s door.

Zee waiting to come home, April 2011

A Primer on Kidney Disease

Kidneys play a central role in keeping a body healthy.  They help regulate blood pressure, produce hormones needed by the body, and filter waste products from the bloodstream.  The kidneys contain hundreds of thousands of nephrons, which are the basic filtration units of the kidneys.  As nephrons begin to fail and die, the kidneys have less filtration ability. We are all born with a huge number of spare nephrons, and can afford to lose many without harmful effect.  But lose too many, and health will begin to suffer. 

Kidney disease is typically monitored by measuring Creatinine and BUN levels in a blood sample.  Unfortunately, these numbers will not begin to rise until two thirds of kidney function has been lost, often too late to diagnose and stop an ongoing disease process.  As additional kidney function is lost, these numbers can rise substantially.  A recently developed test, SDMA, promises to detect kidney disease far earlier, but is still in the early phases of use.

Zee’s Crisis

In June of 2014, Zee slowed down significantly.  She constantly asked me to hold her and started to look very unwell.  I brought her to a nearby emergency vet, who found she had a lacerated paw, likely from a fight with another cat.  She was dehydrated, and blood results showed her kidney values were dramatically elevated.  She spent two nights in the hospital receiving intravenous fluids.  Her kidney values came down, but were still well out of normal range.  

I came to visit Zee just after a repeat blood test, and was given devastating news.  Her red blood cell count was dangerously low, and she was misdiagnosed with Disseminated Intravascular Coagulation (DIC) and effectively given a death sentence.  Without sufficient red blood cells, oxygen could not be transported throughout her body, and she would soon die.  Her only chance at survival was an immediate blood transfusion, and to make matters worse, Zee was found to have type B blood, a rare blood type only seen in an extremely small percentage of cats.  None of this blood was available.  Zee was given less than a 5% chance of survival, and it was recommended that she be euthanized.  I decided I would not lose her without a fight.

I transferred Zee to DoveLewis, a state of the art animal hospital in Portland, Oregon.  They determined that Zee did not have DIC, and not in immediate need of a blood transfusion, but was still critically ill.  A battery of tests was performed, and chronic kidney disease was confirmed.  She remained in the hospital on intravenous fluids.  Her red blood cell count continued to drop, and by the third day, the blood transfusion was required.  A donor was found,I received updates throughout the night, and I visited Zee in the morning.  Zee tolerated the blood transfusion well, had no adverse reactions, and her red blood cell count has begun to rise.  Zee has survived her crisis, and will live to see another day, but our fight has just begun.

Visiting Zee at DoveLewis.  Her fur was shaved to perform an ultrasound exam

Zee at DoveLewis awaiting a lifesaving blood transfusion

Zee Returns Home

Zee was discharged from the hospital, provided with antibiotics and a prescription diet, and given a referral to an internal medicine specialist.It is two weeks before we can see the internal medicine specialist.  She examines Zee and diagnoses her with stage 3 kidney disease, with a median survival time of 778 days.  But when additional testing shows she is losing protein in her urine, median survival time is reduced to 276 days.  She also sees a slightly enlarged heart on x-ray, and refers Zee to a cardiologist.  After an echocardiogram, Zee has an additional diagnosis of hypertrophic cardiomyopathy, which is a thickening of the heart muscle.  Zee is prescribed Benazepril, which should both reduce her protein loss and decrease the load on her heart.  Zee's blood and urine are rechecked every few weeks.  Her labs are improving, and she is gaining a bit of weight.

An Alternate View of Kidney Disease

Standard treatment for kidney disease seems to presume that nephrons are either alive or dead, and that nephron death is irreversible.  The assumption is that nephrons will continue to die, and that the filtering ability of the kidneys will continue to decline.  I believe there is a middle ground, that a nephron can be impaired but not yet dead.  These impaired nephrons can be repaired and brought back to life, thus increasing kidney function.  Treatment must be quick and aggressive, to avoid the death of these impaired nephrons.  Based on this model of kidney disease, I sought out therapies for Zee that might bring some nephrons back to life.  I had nothing to lose, and everything to gain, and so began my research.

Zee’s Alternate Treatments

Zee’s alternate treatment began with Stem Cell therapy.  This involved a Stem Cell Harvest, a surgical procedure in which abdominal fat was removed.  This fat was sent to a biotech company that was able to extract stem cells from the fat.  These stem cells were processed into injectable doses.  My hope was that stem cells could help repair damaged nephrons.  Zee’s kidney function improved, but I wanted to do more.

Zee recovering after her stem cell harvest

Along the way, Zee’s vet felt she was in need of a dental cleaning. Because of her kidney disease, she was referred to an animal dental specialist.  This specialist was the first to notice that Zee had several small broken teeth, with infected root tips left behind.  Zee underwent treatment to clear up the infection, which may have prevented additional damage to her kidneys.

I next turned to acupuncture, which has been reported to have a positive effect on kidney function.  I also gave Zee a daily probiotic, and kidney supplement recommended by Zee’s acupuncturist.  Zee’s results were amazing.  After starting acupuncture, she was no longer anemic, her labs had further improvement, and she began to gain weight.  Zee began treatments every 4 weeks, and currently is treated every 6 weeks.

Zee during an acupuncture treatment

Zee’s Ultimate Recovery

It has been nearly two years since Zee was given a 5% chance of survival.  Today she is a happy, healthy, and active cat.  Her kidney disease has reversed from Stage 3 to Stage 2, and she is clinically in remission.  This means she is showing no signs of illness, and lab work demonstrates her kidney function is not deteriorating.  I have my cat, who has brought so much joy to my life, and am thankful to the team of doctors that brought her to this point. 

You can follow Zee on Twitter via @growingupzee , and you can read a more detailed account of Zee’s journey at http://gofundme.com/lovingzee.

Triumphant Zee, almost two years after refusing euthanasia

Steve Munt

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