Dear Most Esteemed and Knowledgeable Kitties:

My cat Zekey was diagnosed with sky-high creatinine phosphate levels. He constantly shakes and trembles. I’ve had him 10 years; he has never been sick, always been indoors, and everything else on his blood work and urine samples were perfect. We got a corticosteroid Saturday and his back legs quit trembling, but his neck and head still twitch and he seems to be acting lethargic and sneezing a lot. There has to be an answer without him needing muscle samples or a spinal tap. Please help me — he’s my baby!

~ Amanda

Sleepy cat, (CC-BY-SA) by Wikipedia user Thomas M.

Siouxsie: Well, let’s start out by explaining what creatinine phosphate is. It’s an organic compound that provides the initial quick burst of energy that allows muscle fibers to contract. When cells are resting, they store creatinine phosphate so that it’s available when it’s needed.

Thomas: High creatinine phosphate levels are generally considered an indication of temporary or permanent kidney damage. But creatinine levels can also be elevated in dehydrated cats.

Bella: Because all your cat’s other blood and urine tests yielded normal results, the odds are good that he doesn’t have chronic renal failure, diabetes, hyperthyroidism or other such illnesses.

Siouxsie: But the bad news is that you really can’t know what’s going on with your cat unless your vet does more tests.

Thomas: Just because the more common causes of your cat’s elevated creatinine levels have been eliminated, doesn’t mean he’s out of the woods yet.

Bella: We can’t even begin to speculate what might be going on — first of all, we’re not vets, and even if we were, we wouldn’t diagnose your Zekey without seeing him.

Siouxsie: Mama says if one of us were having those symptoms, she’d go back to the vet for more tests. You can’t treat a problem if you don’t know what that problem is.

Thomas: If your vet is recommending a muscle biopsy and a spinal tap, we’d suggest you discuss that with him or her.

Bella: You might ask if the tests could be done one at a time and if so, which one he or she would recommend first.

Siouxsie: Your vet will probably recommend doing both tests at the same time, though, because Zekey will need to be sedated, if not actually put under anesthesia, in order to keep him safe while they’re being done.

Thomas: We’d also suggest that you ask your vet if he or she has eliminated any diagnoses based on the blood and urine test results and what he or she will be looking for with the spinal tap and muscle biopsy.

Bella: You can also ask about what will happen if those tests are inconclusive.

Siouxsie: “Mystery illnesses” can be really frustrating for both vets and cat caretakers, and we hope your vet will be able to reach a diagnosis that will help Zekey feel better.

Thomas: Please let us know what happened as a result of the tests. We’re curious to find out what’s going on, too.