Yes, that's plural. He not only got the full cardiac monty, but also a renal evaluation while we were there for good measure. Dr. Medinger asked us how Lars' renal failure was diagnosed--by short blood panel (abaxis it's called--I'm sure I'm butchering the spelling of it) and urinalysis--and he suggested that by doing a renal work-up we could really know for sure where Lars stood as far as his kidneys were concerned. No blood work this time, but urinalysis again and a urinary tract ultrasound to look at the actual physical condition of his renal system to see if anything had changed since his abdominal ultrasound back in the beginning of April. J and I talked about it and figured he'd have to get the renal work-up eventually anyway, so we decided to kill two birds with one vet visit.

First things first: cardiac exam. Physical exam still presented as stage IV/VI heart murmur, which was a good thing--it hasn't worsened at the very least. Electrocardiograph revealed normal cardiac structure and function. Based on that, Lars was Dxed with a physiologic murmur (no heart pathology or systemic cause present). This means that unless excited/stressed/too active it should cause no problems for Lars and he's good to go to eventually receive subcutaneous fluids for his renal failure, which was one of our primary motivators for investigating the heart murmur further in the first place. This is most excellent news. Dr. Medinger does recommend follow-up electrocardiographs every six months to make sure the murmur is not worsening, so he'll be back out there for that come winter time.

Renal exam was a mixed bag. Based on what results are currently back (we're waiting on a couple of urinalysis related tests, which will be back next week), he's still firmly in stage II out of VI of Chronic Renal Failure (CRF). This is good, as it's not worse than we thought. The urinary tract ultrasound revealed that his left kidney (the one that was found to be severely shrunken compared to the right back in April on his abdominal ultrasound) showed a mild increase in pelvic dilation compared to April's scan; I didn't ask about what that meant, which I should've, but I would think it has at least something to do with his recent renal failure Dx. Yesterday's ultrasound also found cellular debris and crystals in the urinary bladder, which could indicate infection of the urinary tract/bladder; they sent out urinary cultures to see what grows out and will let us know once those come back if anything grew out and/or if any antibiotics are needed. No subcutaneous fluids needed just yet, just continue with the renal Rx diet.

So yeah. That cost a small fortune, but it was worth it for the peace of mind and the knowledge it gave us.
Our poor, broken boy...
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