Kidney Disease In The Cat

“Kidney Failure” is the term given to the condition wherein the kidneys begin to fail to remove the body’s waste products from the blood.

Kidney failure does not necessarily mean urine excretion ceases. Kidney failure takes two clinical forms:

• Urine production is continued, but does not contain the filtered waste products. Often urine production is actually increased.
• Urine production is decreased or is totally absent.

Kidney failure may occur from exposure to various chemicals or infectious agents, but the primary cause of chronic kidney failure is the process of aging. The kidneys just wear out! For most cats, the early signs of impending kidney failure occur at 10-14 years of age, although it can be seen earlier.

Kidney disease may be acute (occurring suddenly) or chronic (progressing over a period of time). Chronic kidney failure is the most common case in dogs and cats, and repeated acute episodes can result in chronic kidney failure also.

Symptoms Of Kidney Disease:

Early signs of chronic kidney failure include increased water consumption and increased urine production.

When aging decreases the ability of the kidneys to filter the blood efficiently and effectively, the cat’s body responds by increasing blood flow to the kidneys. More blood flow means more potential exposure of the blood to the kidneys for filtration. This results in the production of more urine, but not necessarily filled with any more waste products.

Thirst usually increases as the body’s way of replacing the additional urine being drained from the body.

As the kidneys become more ineffective at removing the waste products from the body, clinical signs of decreased appetite, vomiting, diarrhea, and bad breath will become evident.

In the late stages, mouth ulcers are commonly present.

Diagnosis Of Kidney Disease:

Diagnosis of chronic kidney failure is accomplished by several tests.

The first evidence of chronic kidney failure will be changes in the composition of the urine. Chemical analysis, measurement of specific gravity, and urine sediment examination are important in the evaluation of the urine and are part of a routine urinalysis. Urine cultures may also be necessary to rule out or identify infections within the urinary tract.

As the disease progresses, blood tests to measure the blood urea nitrogen (BUN) and blood creatinine become important diagnostic tools. These tests are normally part of a routine blood screen.

Kidney disease is also a frequent cause of hypertension (high blood pressure), so your cat's veterinarian may advise monitoring your cat's blood pressure on a regular basis if a diagnosis of kidney disease has been reached.

Treatment Of Kidney Disease:

Successful treatment requires early detection! The earlier signs of kidney failure are noted, the better the chance for prolonging your cat’s quality of life.

In most situations, treatment is directed at helping the kidneys “catch up” with its function of filtering the blood for the body. This is accomplished through the administration of large quantities of intravenous or subcutaneous (“under the skin”) fluids to “flush out” the blood, by running a lot more fluid through the kidney filtration system.

The body can still function adequately with only 10% active functioning kidney tissue. If the kidneys can be helped to “catch up,” hopefully they can then maintain adequate filtration with the help of medications.

This initial treatment may result in long-term kidney function, short-term functioning before problems return again, or no improvement at all.  Unfortunately, there is no test to determine which cat will or will not respond to treatment.

In cases of acute kidney disease, fluid therapy will likely be a cornerstone of treatment, serving to replace body fluid quantities lost through the urine and also to increase the blood flow to the kidneys in an attempt to allow them to filter more waste from the blood. Fluid therapy may be necessary for those animals suffering from chronic renal failure as well.

Often special diets, especially those low in protein, phosphorus, and sodium, are recommended to help ease the burden placed on the kidneys. However, in some situations, promoting nutrient intake (i.e. getting your cat to eat) may become more important than feeding a special diet, especially in cases where your cat is refusing most foods.

Your cat's individual physical condition will also bear on the diet recommended. Not all cats with kidney failure need special diets. Your cat's veterinarian will help you determine the diet which is optimal for your cat.

Other medications frequently used are medications, such as cimitedine, which reduce stomach irritation, and phosphate binders, which control the levels of phosphorus building up in the blood stream.

Calcitriol is another medication commonly used to control both calcium and phosphorus levels in the blood stream.

Various vitamins (B-complex, C, and E) may be recommended, along with omega three fatty acids, all of which may help to increase your cat's overall health condition and replenish supplies lost by the malfunctioning kidneys.

Hormones, such as androgens or erythropoiten may be recommended to control anemia caused by kidney disease.

Frequent monitoring of the various diagnostic tests related to kidney function is a must to evaluate the efficacy of treatment and to provide your cat with the longest and best quality of life possible.

In severe cases, procedures such as kidney dialysis and even kidney transplants have been utilized as a last resort. However, these methods are frequently not very practical and usually only performed by veterinary specialists.

If your cat is suffering from kidney disease, it is important to make certain that clean fresh water is available to your cat at all times. Limiting water availability can be fatal.

You should also try to establish an environment for your cat which is as stress-free as possible.

Making certain your cat is eating and drinking properly is important in treating kidney disease at home.