Loki’s Complex Clinical Case With a Successful Outcome

Loki’s Complex Clinical Case With a Successful Outcome.

Loki, a 5-year-old Scottish Fold, was brought to Veterinarium with a 2-day history of vomiting, lethargy, and loss of appetite. During the physical examination, the clinic’s internist, Nino Kushitashvili, observed that he was urinating blood (hematuria).

Following an abdominal ultrasound examination, the clinic’s ultrasonographer, Nutsa Besashvili, identified a large amount of sediment and uroliths in Loki’s urinary bladder, which were causing obstruction. Hydronephrosis within one of the kidneys, was also noted and was secondary to urinary retention. A urinary catheter was placed the same day and infusion therapy was initiated.

The next day, complete blood count, biochemical profile, and electrolyte analysis revealed severe abnormalities:

• Creatinine: 935 (approximately 6 times above the upper limit)
• Blood Urea Nitrogen: >50 (about 5 times above the upper limit; so high the analyzer could not read the exact value)
• Phosphorus: >4.84
• Leukocytosis: 30.7
• Hyperkalemia, hypocalcemia, and other imbalances

Based on the clinical findings and laboratory data, Nino Kushitashvili diagnosed Grade V Acute Kidney Injury (AKI). AKI is a critical condition characterized by a rapid decline in renal function. Typical clinical signs include lethargy, increased thirst, alterations in urination (either increased or decreased), vomiting and dehydration.

Common causes of AKI in small animals include toxin ingestion (for example: lilies in cats, grapes in dogs), dehydration, infections, urinary tract obstruction, and neoplasia. In Loki’s case, the underlying cause was obstructive uropathy.

Loki underwent 3 days of intensive inpatient treatment, including continuous intravenous fluid therapy, antiemetic medications, antibiotic therapy, and comprehensive supportive care.

He improved steadily each day: his appetite returned, regained energy, and even started showing a bit of his usual attitude toward the staff.

After completing the 3-day treatment course, repeat bloodwork demonstrated full normalization of renal parameters:

• Creatinine: 96 (previously 935)
• Blood Urea Nitrogen: 10.54 (previously >50)
• Phosphorus: 1.86 (previously 4.84)

Loki is now feeling well and has returned home, where he continues treatment for underlying lower urinary tract disease and urolithiasis.