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  1. #1
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    Default Kidney disease experience?

    Hi, does anyone have experience with kidney disease in an adult squirrel - and can help analyze a blood panel? I'm working with a lovely vet who treats exotics, but is admittedly not all that familiar with squirrels. She diagnosed possible/probable kidney disease based on normal panels for rats -- but we both agree we need a second opinion(s).

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    Default Re: Kidney disease experience?

    Hi again, does anyone have experience with renal failure/kidney issues that can advise me? I'd love to talk with someone - I can't find much online. Also, if there's a resource for normal squirrel bloodwork levels, please point me in the right direction. Thank you.

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    Default Re: Kidney disease experience?

    Quote Originally Posted by tgramsey View Post
    Hi again, does anyone have experience with renal failure/kidney issues that can advise me? I'd love to talk with someone - I can't find much online. Also, if there's a resource for normal squirrel bloodwork levels, please point me in the right direction. Thank you.
    Hi Tgramsy:
    I have not had direct experience treating a Squirrel with kidney "failure" and I wanted to make that known to you beforehand as this was mentioned in you post as being a possible requirement for response. I know that this particular bit of experience would be ideal but if you would like some general commentary about kidney issues or potential kidney issues with of course, a focus on Squirrels; I would be glad to try to be of at least some help! If that would be ok with you, I have a couple of questions first off: 1) what is your Squirrel's name? 2) What is the history of your Squirrel; age, prior medical history, symptoms, etc, and in particular why was a "blood panel" performed on this Squirrel? 3) where any other lab tests or other diagnostic studies performed? 4) do you have access to the lab reports and can you post them?
    Regards,
    SamtheSquirrel

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    Default Re: Kidney disease experience?

    I sent you a PM.

    Diggie's Friend

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    Default Re: Kidney disease experience?

    https://thesquirrelboard.com/forums/...18#post1225018

    See easy links for PDF file to be able to enlarge and copy to send to vet if you need to.

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    Default Re: Kidney disease experience?

    Thank you so much! I'll send these over to my vet on Monday.


    Quote Originally Posted by Diggie's Friend View Post
    https://thesquirrelboard.com/forums/...18#post1225018

    See easy links for PDF file to be able to enlarge and copy to send to vet if you need to.

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    Default Re: Kidney disease experience?

    Thank you, DF!


    QUOTE=Diggie's Friend;1363962]https://thesquirrelboard.com/forums/...18#post1225018

    See easy links for PDF file to be able to enlarge and copy to send to vet if you need to.[/QUOTE]

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    Default Re: Kidney disease experience?

    Hi STS,
    Thank you for the response. It's a bit of a long story. The squirrel's name is Atticus. He is an 8-year-old male Fox squirrel, 636 grams currently. Atticus was my first rehab baby. He fell from a tree in my backyard in 2015. I raised and then released Atticus in the spring of 2016. He has been a constant visitor all these years and is very special to me.

    Around Labor Day Atticus showed up looking very thin and lethargic. Surprising since I'd just seen and even photographed him the week before - looked totally normal and healthy. I caught him pretty easily, brought him in and discovered an abscess near his penis and the lymth nodes around his anus felt like marbles. He saw two different vets trying to get to the bottom of it. First three antibiotics failed and the situation got worse. Finally the fourth antibiotic, Doxycycline, worked and resolved the abscess. Nodes are not back to normal, but much improved. Still, Atticus wasn't/isn't himself, so the vet ran bloodwork and here we are. She suspects chronic renal disease based on a comparison to healthy rat values. She couldn't locate a reliable resource for healthy Fox squirrel values. I'll post the lab results with handwritten rat values on the side.

    She thinks Atticus' immune system was probably down due to the kidney issue, which led to the more obvious infection we battled for over two months.

    I haven't done a uralysis yet but the vet is willing to do that if I want.

    I can go on with more details, but I'll stop here for now. Let me know what other questions come to mind.

    Thank you and any advice is much appreciated.







    Quote Originally Posted by SamtheSquirrel2018 View Post
    Hi Tgramsy:
    I have not had direct experience treating a Squirrel with kidney "failure" and I wanted to make that known to you beforehand as this was mentioned in you post as being a possible requirement for response. I know that this particular bit of experience would be ideal but if you would like some general commentary about kidney issues or potential kidney issues with of course, a focus on Squirrels; I would be glad to try to be of at least some help! If that would be ok with you, I have a couple of questions first off: 1) what is your Squirrel's name? 2) What is the history of your Squirrel; age, prior medical history, symptoms, etc, and in particular why was a "blood panel" performed on this Squirrel? 3) where any other lab tests or other diagnostic studies performed? 4) do you have access to the lab reports and can you post them?
    Regards,
    SamtheSquirrel
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    Default Re: Kidney disease experience?

    Quote Originally Posted by tgramsey View Post
    Hi STS,
    Thank you for the response. It's a bit of a long story. The squirrel's name is Atticus. He is an 8-year-old male Fox squirrel, 636 grams currently. Atticus was my first rehab baby. He fell from a tree in my backyard in 2015. I raised and then released Atticus in the spring of 2016. He has been a constant visitor all these years and is very special to me.

    Around Labor Day Atticus showed up looking very thin and lethargic. Surprising since I'd just seen and even photographed him the week before - looked totally normal and healthy. I caught him pretty easily, brought him in and discovered an abscess near his penis and the lymth nodes around his anus felt like marbles. He saw two different vets trying to get to the bottom of it. First three antibiotics failed and the situation got worse. Finally the fourth antibiotic, Doxycycline, worked and resolved the abscess. Nodes are not back to normal, but much improved. Still, Atticus wasn't/isn't himself, so the vet ran bloodwork and here we are. She suspects chronic renal disease based on a comparison to healthy rat values. She couldn't locate a reliable resource for healthy Fox squirrel values. I'll post the lab results with handwritten rat values on the side.

    She thinks Atticus' immune system was probably down due to the kidney issue, which led to the more obvious infection we battled for over two months.

    I haven't done a uralysis yet but the vet is willing to do that if I want.

    I can go on with more details, but I'll stop here for now. Let me know what other questions come to mind.

    Thank you and any advice is much appreciated.
    Hi Tgramsy:
    I'm so sorry about Atticus's change in status! I hope he will quickly recover and my best wishes and hopes are with him!

    As far as the lab report goes, I can only give you my humble opinions and suggestions. As I've pointed out before, I am not a Veterinarian! I do see where your Veterinarian has concerns about kidney disease. Variations from the "normal" ranges of the lab report for BUN, creatinine and phosphorus are certainly consistent with renal dysfunction (kidney disease) of some degree BUT these "normal" ranges are NOT for Squirrels, per se!

    I have found that there are very limited data regarding "normal" chemistry values for Squirrels and certainly there is even more of a paucity of data pertaining to specific species of Squirrel!

    I want thank DF for sending some lab studies to you! One of my primary but certainly not all-inclusive sources of laboratory parameters that I use is the Exotic Animal Laboratory Diagnosis published originally in 2020. It even has a chapter on Squirrels! No specific Fox Squirrel data is listed but they do tabulate Persian Squirrels (Sciurus anomalus) and Gray Squirrels (Sciurus carolinensis). The BUN which is one of the primary indices that is used in evaluating kidney status is actually cited from another reference and is listed for Grays as ranging from 4-70 mg/dl and the Creatinine which is another primary index is listed only for Persian Squirrels and ranges from 4/036-4.75 mg/dl.

    One of my primary concerns with the lab report that you posted has nothing really to do with the choice of tests performed but what must be inferred from at least one of the values and that is the value for Glucose which is listed as being<10! This is simply an impossible value for Glucose in an active and interactive mammal (not just Squirrels) and being even more blunt to illustrate the degree of error, a value of <10 is in fact incompatible with life!

    There are three main types of laboratory errors based upon where in the total lab process they originate. By far the largest number of errors occur during the Pre-Analytical phase which is prior to the actual testing performed by the lab. There are a multitude of possibilities such as (for illustration purposes only) using the wrong tube, keeping a tourniquet on for excessive times, keeping the specimen warm when it should be kept cold (or vice versa), not rocking the tube when it should be rocked, not spinning the tube in a centrifuge when it should have been and many, many more.

    The fact that there is an obvious error of at least one parameter and that being the value for Glucose; even if there seems to be a likely explanation for this, actually puts the entire specimen and report in question. It is expected that an experienced clinician (veterinarian or physician) will recognize obvious errors as your Veterinarian has done but it is also human nature to still utilize the remainder of the lab report if this can be done and often, any remaining values especially if they are at all plausible are still utilized for diagnosis. This isn't necessarily wrong but with one utterly impossible lab value, I would humbly recommend rejecting the entire specimen and lab report and start anew!

    My suggestion would be for Atticus to be adequately sedated for another blood draw and being restrained, agitated and frightened can actually effect certain lab parameters and of course, we should be as kind as possible and sedation is usually the very best road to take for invasive procedures, even for relatively simple ones such as a blood draw.

    Also, with the sedation (usually with an inhaled anesthetic), a specimen for urinalysis can be obtained via a catheter passed through the urethra into the bladder or if the bladder is full and the Vet is experienced with this it can be obtained by what is called Cystocentesis which is where a a small needle is passed from the outside of the lower abdomen directly into the bladder to obtain a urine specimen.

    If another specimen and/or the urinalysis is going to be performed, especially if looking for renal disease; I would suggest that Atticus have at least a day or two of you actively ensuring that he is adequately hydrated before the new testing is performed!

    Again, what I have posted are only my personal comments, impressions and suggestions! I do wish Atticus my very best!

    Sorry for another one of my "books!"

    Regards,
    SamtheSquirrel

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    Default Re: Kidney disease experience?

    Hello again Tgramsey:
    Another suggestion I have would be IF you are going to have Atticus sedated for further lag studies or whatever; that the "lymph nodes" near the anus be biopsied at the same time. This may further aid in understanding what has been going on with this little guy!
    Regards,
    SamtheSquirrel

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    tgramsey (11-05-2023)

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    Default Re: Kidney disease experience?

    Thank you so much for this great info. Yes, the vet did tell me and noted on the report that there is an error on glucose due to the sample sitting in the tube too long before the lab ran the test. You make an excellent point that if one value is off, they could all be off!

    FYI - Atticus was sedated to draw this blood sample -- drawn at the same time the vet performed the last lance/drain/flush from the abscess.

    I'm going to send the vet DF's research -hopefully she has time to look it over. I'll also mention the squirrel chapter in the Exotic Animal Laboratory Diagnosis. She specializes in exotics so I bet she has that one or is familiar. Ill just see what she suggests, but I'm leaning toward more bloodwork and a urine test.

    Thank you again.





    Quote Originally Posted by SamtheSquirrel2018 View Post
    Hi Tgramsy:
    I'm so sorry about Atticus's change in status! I hope he will quickly recover and my best wishes and hopes are with him!

    As far as the lab report goes, I can only give you my humble opinions and suggestions. As I've pointed out before, I am not a Veterinarian! I do see where your Veterinarian has concerns about kidney disease. Variations from the "normal" ranges of the lab report for BUN, creatinine and phosphorus are certainly consistent with renal dysfunction (kidney disease) of some degree BUT these "normal" ranges are NOT for Squirrels, per se!

    I have found that there are very limited data regarding "normal" chemistry values for Squirrels and certainly there is even more of a paucity of data pertaining to specific species of Squirrel!

    I want thank DF for sending some lab studies to you! One of my primary but certainly not all-inclusive sources of laboratory parameters that I use is the Exotic Animal Laboratory Diagnosis published originally in 2020. It even has a chapter on Squirrels! No specific Fox Squirrel data is listed but they do tabulate Persian Squirrels (Sciurus anomalus) and Gray Squirrels (Sciurus carolinensis). The BUN which is one of the primary indices that is used in evaluating kidney status is actually cited from another reference and is listed for Grays as ranging from 4-70 mg/dl and the Creatinine which is another primary index is listed only for Persian Squirrels and ranges from 4/036-4.75 mg/dl.

    One of my primary concerns with the lab report that you posted has nothing really to do with the choice of tests performed but what must be inferred from at least one of the values and that is the value for Glucose which is listed as being<10! This is simply an impossible value for Glucose in an active and interactive mammal (not just Squirrels) and being even more blunt to illustrate the degree of error, a value of <10 is in fact incompatible with life!

    There are three main types of laboratory errors based upon where in the total lab process they originate. By far the largest number of errors occur during the Pre-Analytical phase which is prior to the actual testing performed by the lab. There are a multitude of possibilities such as (for illustration purposes only) using the wrong tube, keeping a tourniquet on for excessive times, keeping the specimen warm when it should be kept cold (or vice versa), not rocking the tube when it should be rocked, not spinning the tube in a centrifuge when it should have been and many, many more.

    The fact that there is an obvious error of at least one parameter and that being the value for Glucose; even if there seems to be a likely explanation for this, actually puts the entire specimen and report in question. It is expected that an experienced clinician (veterinarian or physician) will recognize obvious errors as your Veterinarian has done but it is also human nature to still utilize the remainder of the lab report if this can be done and often, any remaining values especially if they are at all plausible are still utilized for diagnosis. This isn't necessarily wrong but with one utterly impossible lab value, I would humbly recommend rejecting the entire specimen and lab report and start anew!

    My suggestion would be for Atticus to be adequately sedated for another blood draw and being restrained, agitated and frightened can actually effect certain lab parameters and of course, we should be as kind as possible and sedation is usually the very best road to take for invasive procedures, even for relatively simple ones such as a blood draw.

    Also, with the sedation (usually with an inhaled anesthetic), a specimen for urinalysis can be obtained via a catheter passed through the urethra into the bladder or if the bladder is full and the Vet is experienced with this it can be obtained by what is called Cystocentesis which is where a a small needle is passed from the outside of the lower abdomen directly into the bladder to obtain a urine specimen.

    If another specimen and/or the urinalysis is going to be performed, especially if looking for renal disease; I would suggest that Atticus have at least a day or two of you actively ensuring that he is adequately hydrated before the new testing is performed!

    Again, what I have posted are only my personal comments, impressions and suggestions! I do wish Atticus my very best!

    Sorry for another one of my "books!"

    Regards,
    SamtheSquirrel

  16. Serious fuzzy thank you's to tgramsey from:

    SamtheSquirrel2018 (11-05-2023)

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