SPECIFIC ISSUES RELATING TO FELINE KIDNEY TRANSPLANTATION AT THE UNIVERSITY OF WISCONSIN
In addition to the general information presented elsewhere in this website, this section will address some common questions presented to us by both owners of cats with chronic renal failure and by referring veterinarians.
- WHAT IS THE COST OF A FELINE KIDNEY TRANSPLANT AT THE UNIVERSITY OF WISCONSIN?
- Due to the continually rising nature of the cost of medical supplies and care as well as the fact that no two patients follow the same course of recovery in the hospital, it is difficult to provide specific costs of this procedure. I am unable to list a price for this procedure on a web page which may not be updated frequently enough to keep pace with rising costs. Serious inquiries about kidney transplantation should be made at the contacts listed below and an estimate of current prices can be given to you. The University of Wisconsin Veterinary Medical Teaching Hospital prices its care by computerized itemization of materials used and services performed. As such, costs will be somewhat dependent on the course of events during the patients hospital stay and development of complications, if any.
- The other primary consideration in the cost of the procedure is the cost of maintaining the cat. Immunosuppressive drugs are expensive. For most cats, annual drug costs will be between about $500 to $1500. The actual cost of these drugs depends on the drug regimen used and the amount of drug an individual cat requires to attain the target blood levels. There is also the need for laboratory blood testing and clinic visits. These will be most frequent in the first year and are fewer thereafter so the costs associated with this monitoring will decrease somewhat over time.
- WILL MY CAT BE EXCLUDED AS A TRANSPLANT CANDIDATE BASED ON HIS EXTREMELY ELEVATED SERUM CREATININE LEVELS OR ADVANCED AGE?
- At the University of Wisconsin, we set no upper limits on the renal function-related blood values (ie. serum creatinine) that define a renal transplant candidate. In addition, since some cats live to be extremely old, it is impossible to know how long any individual cat may live after transplantation. For this reason, we do not limit the AGE at which a cat may receive a transplant but use only the animal's health status to decide if a cat should be excluded as a candidate for a kidney transplant. However, it has to be recognized that a very elderly cat is more likely to develop other diseases associated with old age and thus is at greater risk for having a shortened life span after transplantation compared to a younger animal.
- HOW LONG WILL MY CAT BE IN THE HOSPITAL?
- The average hospital stay after a transplant is 3 to 4 weeks. Most of this time is spent monitoring cyclosporine A blood levels and adjusting the drug dosages. As the levels become stable enough to monitor once-a-week, the cat is discharged. The donor cat can go home 1-2 days after the surgery.
- WHAT IS THE SUCCESS RATE OF FELINE KIDNEY TRANSPLANTS AT THE UNIVERSITY OF WISCONSIN?
- Currently, our overall success rate (survival until discharge) is about 85% (as of 2/1/2001)
- HOW LONG WILL MY CAT SURVIVE WITH A TRANSPLANT?
- This, of course, is impossible to know without a crystal ball. However, our longest survivor to date (2/1/2001) has been 4.5 years and is still going. We have many that have survived for 3 years. Very few of our patients die of renal failure. They will most often die due to disease unrelated to the kidney transplant. Since our program has not been active much longer than this it is hard to say what our maximum or even average survivals will be. UC Davis, which has been performing transplants longer than the UW, has reported survivals of 6 years or more.
- SHOULD MY CAT BE ON ERYTHROPOIETIN THERAPY FOR ANEMIA PRIOR TO TRANSPLANTATION?
- The erythropoietin that is used in cats is a human recombinant product. As such, it is foreign to cats and a few cats can develop antibodies to the product, rendering it useless. Since this drug may be of value in the postoperative period, our recommendation is to delay erythropoietin therapy until the cat is significantly anemic (PCV in the mid-teens). We prefer to perform the transplant surgery not too long after erythropoietin therapy has begun to have a beneficial effect. It is best to strictly avoid blood transfusions altogether before the cat comes to us for transplant.
- HOW DOES THE PROCESS OF OBTAINING A TRANSPLANT WORK AT THE UNIVERSITY OF WISCONSIN?
- It is easiest to consider the process in each of its steps. First, a diagnosis of chronic renal failure is made. If you are considering a transplant, your cat is then worked up by your veterinarian as described in the section on Recipient Testing. After obtaining these results, either you or your veterinarian calls the UW VMTH and contacts the General Surgery Service at the University of Wisconsin Veterinary Medical Teaching Hospital for consultation. At that time, we determine if further testing is needed or if we can start the donor cat search. Donor cats will then be identified and blood will be sent to the UW for crossmatching. You will be notified and will send a fresh blood sample from the recipient cat by overnight mail to the UW to arrive the same day as the donor blood. If a compatible crossmatch is obtained, we will purchase the donor, have it shipped to UW and work it up for any health problems. We then call you to bring your cat in. Based on the clients personal scheduling needs, the recipient cat is often brought in on a Saturday or Sunday. Your cat is then examined, admitted and a deposit is left with the clinic reception desk. Your cat would then start drug pretreatment on Sun., receive a transfusion if needed on Mon. and have the transplant performed on Tues.
- WHO DO I CONTACT AT THE UNIVERSITY OF WISCONSIN REGARDING FELINE KIDNEY TRANSPLANTATION?
- For further information you can contact the Transplant Coordinator, Gerianne Holzman, CVT at 608-262-6512. Much of our initial contact and assistance with information or evaluation of your cats workup is done through our surgery residents. You may also contact Dr. McAnulty at email@example.com.