Prudence was examined from nose to tail by our Head Nurse
Sarah Whittaker and was found to be generally in very good
health for her age. She was showing early signs of her flea
allergy flaring up again, she had a bit or arthritic stiffness
in one elbow for which a glucosamine supplement was advised,
and she was perhaps a little on the thin side having lost
0.3kg since her weight was last recorded 18 months ago. She
proved an uncooperative patient in only two particulars
she purred so loudly that Sarah was unable to auscultate her
heart properly and she flatly declined to provide us with
a urine sample!
In view of the fact that we lacked all the useful information
a urine sample would have provided, it was agreed that a blood
sample should be taken and Prudence made no objection to this
at all. The blood results were available within hours and
showed only one abnormality her blood urea level was
slightly higher than the normal range for a cat of her age.
This could be an early warning sign of reduced kidney function
or it could indicate reduced circulation through the kidneys,
if the heart was not pumping as efficiently as it should.
We then decided that we really had to get a urine sample from
Prudence to distinguish between these two. We eventually achieved
this by admitting her for several hours until her bladder
had filled sufficiently that we could get a sample by cystocentesis.
The urine was very well concentrated (specific gravity 1.050)
which suggested that the kidneys were actually functioning
very well so we started to concentrate on her heart. We still
could not stop her purring for long enough to establish whether
she had a heart murmur but we could hear that it was beating
abnormally fast and this often leads to inefficient pumping
of blood. Above about 180 beats per minute the chambers within
the heart do not have sufficient time to fill completely before
they are emptying again and so each beat moves less blood
than it should and circulation is therefore poorer. A common
cause of an overfast heart or tacchycardia in
elderly cats is hyperthyroidism (an overactive thyroid gland)
so we then tested Prudence's thyroid levels on the remaining
blood that we had collected earlier. Bingo - we had our diagnosis!
Prudence is now on a small tablet twice a day to control
her thyroid hormone levels. This should control her metabolic
rate and thereby bring down her heart rate and so increase
cardiac efficiency. Thus we hope her heart muscle will not
get prematurely worn out by overwork, her kidneys will work
better and last longer because of improved circulation through
them and she should regain her lost weight and body condition.