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Transplants now treat feline kidney disease

Tuesday, October 01, 2002

By Deborah Weisberg

Mr. Saul may look like any other black domestic shorthair, but the 5-year-old North Huntingdon cat is perhaps the only feline in Western Pennsylvania living with a transplanted kidney.

Andy Hummell of North Huntingdon with lucky Mr. Saul on the back of the sofa and kidney donor Oscar in his arms. (Annie O'Neill, Post-Gazette)

He received a healthy organ from a shelter cat -- who might otherwise have been euthanized -- in a $7,000 operation at the Veterinary Hospital of the University of Pennsylvania. The school has done 70 such procedures in the past five years.

Mr. Saul's owner, Andrew Hummell, a 34-year-old sales engineer, chose the surgery in May 2001 when kidney failure was about to wipe out Mr. Saul's ninth life.

So far, Mr. Saul is among the majority of cats doing well more than a year after transplantation. Another local cat, the only other that Penn has transplanted, was 11 at the time of the transplant and lived a little more than a year afterward before dying of liver cancer.

Transplant-recipient cats are more prone to infection and, possibly, certain cancers, such as lymphoma and squamous cell carcinoma, because the drugs they are given to prevent organ rejection also suppress their immune systems, said Dr. Dorothy Brown, a Penn veterinary surgeon. But many continue to live to 12 or 13 years.

"Except for the little shaved area on his neck where they draw blood, you'd never know Mr. Saul had ever been sick," said Hummell, who has spent thousands on regular blood draws to check Mr. Saul's immune and kidney function, and on anti-rejection drugs.

"I've had people say to me, you spent 'What?,' but I don't try to explain myself. These cats are my family," said Hummell, who is single. "I think of them as my children."

He also has Samuel Perry, a 5-year-old tiger cat and Oscar, the donor tabby he agreed to adopt as a condition of surgery. "I'm devoted to them."

"Transplants are not for every case," said Dr. Harvey Bendix, the Norwin veterinarian who had suggested transplantation to Hummell when he first saw him in March 2001. "It takes a certain kind of owner, a cooperative cat, a lot of time and a lot of money."

Only cats with renal failure who are otherwise healthy are candidates. Transplants are not "last-ditch procedures," Brown said. If a cat is extremely depleted, it may be directed to the nation's only feline dialysis facility in New York City, where another $4,000 or so may be spent in preparing for the transplant. And a $7,000 transplant can become considerably more expensive if there are complications.

 
   

More info

If your cat is showing the following symptoms, it could have a urinary tract infection or a kidney infection, according to Dr. Harvey Bendix, a Norwin veterinarian.

Increased thirst

Diminished appetite and weight loss

Changes in bladder habits, including more frequent urination, urination in strange places, strain when urinating and/or blood in the urine

Tender-to-the touch abdomen

If untreated, urinary tract infections can lead to uremic poisoning, which means the kidney isn't filtering toxins from the body.

Infections or kidney problems can be diagnosed through blood tests, urinalysis and ultrasound.

-- Deborah Weisberg

 
 

Urinary tract infections, often bacterial, are common in cats. Chronic cases can lead to kidney failure, as can stone formation, a congenital abnormality or degeneration of the organ with aging.

There is even some speculation, said Brown, that commercial cat foods may cause kidney stones, which are becoming increasingly common in younger cats.

Kidney disease can be managed for months or even years with low-protein feed, antibiotics, fluids and surgery, if stones are the problem. But when medicine no longer works and the kidneys start to fail, transplantation may offer the only hope.

Mr. Saul was thin and anemic because his kidneys had stopped producing red blood cells when he was evaluated by Penn surgeons in Philadelphia. Both Hummell and Mr. Saul made the first cut -- "we evaluate owners for temperament, too," said Brown -- and were asked to return the next week. Using blood samples, vets matched Mr. Saul to a kitten from their donor colony and he was scheduled for surgery three weeks later.

"He was so weak, they wouldn't let me see him right after his operation," said Hummell of the six-hour procedure. "I was a wreck.

"The next day, he was hooked up to intravenous tubes. He was skin and bones. But, when I walked into the room, he jumped at me, pulling the tubes with him. All he wanted was to sit on my lap."

Hummell also got to meet the donor cat he'd be taking home. "He was this big groggy fur ball, and I was told he was very shy because he'd never had human affection," Hummell recalled.

A Penn ethics committee cleared the concept of harvesting shelter cats' organs and even animal rights groups have given transplantation their blessing, said Brown, because it takes a kidney but spares a life.

"Think of the alternative for most of these cats. Any who aren't candidates for surgery, we adopt out," Brown said.

The longest a transplant recipient has survived surgery is 12 years, said Brown, and that animal received its organ at the University of California at Davis, which developed transplantation about 15 years ago.

So far, Mr. Saul has had a smooth recovery.

The odds of survival keep improving. Ninety percent of transplanted cats come through the critical month following surgery, said Brown, while about 70 percent are living at least a year. Bendix examines Mr. Saul every three months.

Oscar, meanwhile, has slowly adapted to life in his new home.

"For the first month, he would hide and only come out at night," said Hummell. "He still doesn't like to be held, but he's getting friendlier, more social. Samuel Perry still gives him a hard time, but he's coming around."

Kidney transplants are not options for dogs because just 40 percent survive the month after surgery. Penn will transplant a dog if both a blood and a tissue match can be found, which almost requires that a littermate be the donor, said Brown. But there's a high rate of organ rejection because anti-rejection medications, for unknown reasons, are seldom effective.

For more about feline kidney transplants, visit the Feline Chronic Renal Failure Information Center, at www.felinecrf.com


Deborah Weisberg is a free-lance writer who covers health issues.

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