Common Dog Illnesses
- 1. Canine Parvovirus
- 2. Canine Self-Mutilating Behavior
- 3. Tracheal Collapse
- 4. Hypothyroidism in Dogs
Renal Transplant in Dogs
Kate Reilly
North Carolina's renal transplant program saves two lives...sometimes three.
Tobi was down on her luck when she arrived on Judy Benrud's doorstep. The little cat with the Siamese good looks had already been abandoned twice. Her second owner left her in a neighbor's care while he traveled for a week. But a month passed, and the neighbor sadly realized that Tobi's owner was not coming back. Tobi was brought to Second Chance Pet Adoptions, a nonprofit organization founded by Benrud in 1989.
Almost a thousand miles away, a big black and white cat named Zeus lay quietly in Susan de Lucca's arms. Diagnosed with chronic renal failure (CRF), he had just undergone another round of fluid therapy. CRF is fatal in cats, and Zeus's owners knew that he didn't have much longer to live. Zeus was running out of time, and they were running out of options.
Although the future looked bleak for both cats, Tobi and Zeus were about to cross paths, and each would save the other's life.
Zeus's story
Zeus, a charming black and white tom, met Susan and Maurice de
Lucca in 1996 while making his rounds as a stray in their Alabama
neighborhood. He was the neighborhood boy, recalls Susan, who
offered him food and shelter. One day that summer, however, Zeus
abruptly disappeared. The de Luccas kept a watchful eye trained
toward his usual haunts, but Zeus didn't reappear for three
weeks. When he did return, the strong young cat was a different
animalweak and in danger of dying. Someone had locked him in a
shedby mistake or design, the de Luccas never learnedduring the
sweltering heat of the Alabama summer. Dehydrated and starved,
Zeus was beginning to show signs of kidney failure.
The de Luccas rushed the cat to their local veterinarian, where he made a qualified recovery (his kidneys regained functionality, although subcutaneous fluids continued to be needed), and the de Luccas took Zeus into their home, determined to keep him safe. Zeus found his place in the household, cohabiting peacefully indoors with the other household petstwo cats, a poodle named Shiloh and the patriarchs of the house, two raucous parrots. His days as a stray were over, which suited him just fine.
Four years passed. Then Zeus began to show signs of illness. He began losing weight and vigor. Another trip to the veterinarian revealed that Zeus's kidneys were failing again. This time, there would be no turning back.
Chronic Renal Failure
Chronic renal failure is a terminal condition that affects many
thousands of cats every year. It is one of the leading causes of
death in older cats. The kidneys of CRF cats begin to lose their
effectiveness in filtering the cat's wastes. Although in many
cats CRF can be successfully managed for a time, the kidneys
cannot recover fully, and the cat is ultimately overcome by an
accumulation of his or her own toxins.
While irreversible, CRF can be treated temporarily by a combination of medication, diet and hydration therapy. The de Luccas began weekly trips to the veterinarian to administer subcutaneous fluids to Zeus. But before long, even this treatment stopped offering results. The de Luccas watched as their once robust cat withered away. In a conversation with Zeus's veterinarian, de Lucca asked, Why can't they give cats kidney transplants like [they do] people? The veterinarian surprised her by responding that, in fact, a feline transplant procedure did exist. That was all the de Luccas needed to hear. They sprang into action, and the search was on.
The de Luccas learned that the renal transplant procedure had originated at the University of California at Davis in 1987. Over the years, the procedure has been improved, and success rates have increased, but the high cost of the surgery is the first hurdle owners must overcome. The procedure itself runs $5,000, and first-year medicines can run $600 or more. The recipient feline requires anti-rejection pills twice a day for the rest of his or her life and regular trips to a veterinarian for close monitoring.
Maurice de Lucca scoured the Internet and spent hours on the phone searching for veterinary practices that offered the transplant procedure. Susan conducted countless interviews, determined to find Zeus the best care. Finally, they found Dr. Kyle Mathews at the North Carolina College of Veterinary Medicine in Raleigh.
De Lucca was instantly impressed with Mathews. If you've got to go through something like this, she says, you would want to go through it with him. Mathews had been a member of the team that had pioneered the procedure at UC Davis, and had performed it successfully in North Carolina for almost two years. He spent time with the de Luccas, outlining the events that were about to unfold and preparing them to meet the cat who had been selected to save Zeus's life.
The Donor Cat
The transplant program in North Carolina is a joint effort of the
College of Veterinary Medicine (CVM) at Raleigh and Second Chance
Pet Adoptions. Second Chance cofounder Benrud, a clinical
technician for the internal medicine service at the CVM, helps
match homeless cats as donors for the recipient cats with CRF. In
return, the recipient's owners agree to adopt the donor cat for
life.
Originally, the board members of Second Chance deliberated for some time before agreeing to participate in the transplant program. Were the donor cats being done a disservice? Benrud remembers asking. The board wanted to ensure that the donor cats would not only assist the cats who were dying, but would benefit from the agreement themselves.
After long consideration, the organization went forward with the program. It realized that the donor cats were being guaranteed not just an ordinary home. Benrud pointed out that by virtue of shouldering the high costs and lifetime obligations of the transplant operation, the donor cats were entering a home that has proven that it has a high level of commitment to its pets. In addition, Second Chance established safety nets to retrieve an animal in the event that the situation was not successful. In the history of the program, Second Chance has only retrieved one cat.
Most owners are so grateful to the donor cat that even in the unlikely event that the two cats cannot coexist peacefully, they have found a way to keep the donor. In one rare situation, Benrud recalls, the two cats did not get along, and the owners did not want to cause the sick cat additional stress. They asked if they could temporarily place the donor cat with a relative until the recipient cat passed away. They found a solution, she emphasizes. They remained dedicated to the donor cat.
While donor cats need to meet strict physical requirements in order to be considered for the program, Second Chance prescreens the cats for adoptability. We don't place renegade animals, Benrud says. The cats must be considered adoptable first, then be accepted into the transplant program.
The first cat selected to be Zeus's donor was Willow. Willow had arrived at Second Chance as a bedraggled stray, and had earned her name from her appearance. But under Benrud's care, Willow blossomed into a beauty, reminiscent of a Maine Coon cat with the matching sweet and gentle spirit.
The de Luccas met Willow on their trip to North Carolina. When testing was completed on Willow, however, she was found to be a poor candidate for the transplant; the health of her own kidneys was questionable. The de Luccas were disappointed, but they had already given their hearts to the cat. Willow might not be their donor cat, but she became their cat nevertheless.
The next cat up for consideration was Tobi. After the tests were run, she was considered a good match for Zeus, and the surgery was scheduled. The de Luccas returned to Alabama to wait.
The Surgery
On the day of the surgery, the de Luccas' experience took a
dreadful turn. Maurice de Lucca suffered a heart attack and was
admitted to an Alabama hospital for emergency surgery. His wife
was frantic, worrying about her husband's health while juggling
the long-distance calls about Zeus and Tobi. I had two sets of
surgeons calling. Your husband did fine,' said one, and Your
cat's kidney is working beautifully,' said the other, and I was
half out of my mind with worry. The North Carolina team sent
flowers to Maurice in the hospital.
Thankfully, Maurice recovered, and Zeus and Tobi began their recovery, as well. One week after the surgery, Susan flew up to North Carolina to retrieve all three catsthe former stray, Zeus, and his North Carolina friends Tobi and Willow.
The cats began settling into their new arrangement in Alabama. As a kidney recipient, Zeus's constant care is a responsibility that the de Luccas have accepted as part of their daily life. Zeus needs cyclosporin twice a day, every day, or risks rejection of the transplanted kidney. The de Luccas accept it matter-of-factly. If we're out at dinner, we excuse ourselves and go home to give the cat a pill, Susan says. It's a commitment. You've got to be prepared to take the time. It's all or nothing.
The de Luccas remain in close contact with North Carolina, even sending Christmas cards to the North Carolina team. We also hear from the referring vets [in Alabama] every month or every other month over the phone or by e-mail, Mathews says. His team runs the cyclosporin levels on the cats and makes recommendations for the local veterinarians who are caring for the recipient cats. They know how to reach us 24 hours a day.
Willow's straying days are over now, too; she is content to curl up on Susan's lap and watch the world go by. And Tobi, the cat who had been abandoned twice before meeting the de Luccas? Tobi was fine from the word go, Susan remembers, like nothing had ever happened.
But something had happened. In a world where stray and abandoned animals are common and forgotten, one homeless little cat had saved another cat's life. And grateful new owners have brought her home to stay.
Kate Reilly is a freelance writer living in North Carolina.
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...Frequently Asked Questions... Is my cat a candidate for renal
transplantation? Where can I get more information? Where is the procedure performed?
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© 2002 ASPCA
ASPCA Animal Watch - Spring 2002
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