Kidney Failure in Cats
Your
cat’s kidneys play a central role in almost all of its bodily processes. They
help to control the blood pressure and regulate the amount and
chemical consistency of fluid in the bloodstream. They produce a variety of
vitally needed hormones and enzymes, and they contribute to the production of
red blood cells. They also remove metabolic waste, such as urea, mineral salts
and poisonous substances, from its blood.
Unfortunately,
feline kidneys are susceptible to potentially life threatening diseases. While
there are cases of congenital (present at birth) renal (kidney) disease, the
majority of cases are acquired. Acquired
renal diseases are divided into 2 categories:
Acute and Chronic renal failure.
Acute
Renal Failure
has a sudden onset of a week to a month. Common causes of acute renal failure
include urethral blockages (a “blocked” cat) that interfere with the flow of
blood to the kidney or the flow of urine from it. Other causes are ingesting toxins such as
antifreeze, pesticides, and cleaning fluids.
Ingestion of ibuprofen can cause severe acute kidney failure and
death. Ingestion or even just contact
with any of the Lily family of flowers can cause acute renal failure. Signs
of acute renal failure will be non specific.
Acute onset of vomiting and decreased or no appetite should be
investigated quickly. It can occur in a
cat of any age. If it is diagnosed quickly and treated immediately, kidney
damage resulting from acute renal failure is potentially reversible. Very early treatment makes the prognosis for
full recovery excellent, and a cat often can go on to enjoy a normal life span. Acute renal failure must be given emergency
treatment. If caused by any type of urinary-tract blockage, for example, the
obstruction must be removed immediately. Intravenous solution infusions must be
administered without delay in order to correct fluid and electrolyte imbalances
in the blood.
In cats
over seven years of age, chronic kidney disease is one of the most frequent causes of
illness. Up to 50% of elderly cats are
affected with some degree of kidney disease.
Early signs of disease such as weight loss and poor coat quality are
often dismissed as normal aging changes, delaying the diagnosis and treatment
until the cat is in later stages of the disease. In some cases, little can be
done to prolong the life of a cat diagnosed with late-stage chronic renal
failure. However, following EARLY diagnosis, it is quite common for some cats
to live for one to three years or even longer.
So it is very important to identify chronic kidney disease early.
Indication that the kidneys are failing include an increase in water consumption (polydipsia) and in urination (polyuria). Sometimes these signs are insidious in their onset and can be missed in early stages: weight loss; apparent decline in appetite; and, in some cases, occasional vomiting. As soon as any of these signs are observed, you should immediately seek veterinary care.
Treating Kidney Failure
In the vast majority of chronic renal failure case, treatment is symptomatic and supportive. Some cats may require initial intravenous fluid therapy to correct dehydration (and perhaps electrolyte abnormalities), but once stable, treatment is aimed at supporting kidney function and decreasing the complications of CKD. Despite therapy, CKD cannot be reversed and in most cases will also progress over time, although sometimes very slowly.
Optimal management of renal failure
usually requires repeat diagnostics at regular intervals (including blood
pressure assessment, blood and urine tests) to identify treatable complications
as they arise, such as anemia, low potassium, high phosphate, urinary
infections, and hypertension. Dietary modification is important in cats with
CKD to improve quality of life and slow progression of disease, but a variety
of other treatments may be valuable also, depending on individual needs.
Dietary management is critical in cats with CKD, and there are three main aspects to this:
Water intake: Cats with CKD
are more likely to become dehydrated (due to the reduced ability of the kidneys
to conserve water). Maintaining a good fluid intake is therefore very
important, and may help to slow progression of CKD. As cats obtain most of
their water intake from their food, whenever possible, cats with CKD should be
fed canned foods rather than dry foods.
Protein content: A diet that
is restricted in protein may be recommended for your cat. Many of
the toxic products that accumulate in the blood in CKD are a result of protein
breakdown, and feeding a reduced protein diet will help to minimize this and
improve quality of life. Protein restriction has to be performed with care
though as too little protein can lead to muscle atrophy and weight loss and be
detrimental to your cat’s health.
Low phosphorus content: Restricting the phosphorus content of the diet appears to be
very beneficial in protecting the kidneys from further damage in cats with CKD.
It is important to remember that
EARLY DIAGNOSIS is the key to your cat’s longevity. Your cat’s ability to concentrate urine will
often be affected prior to detecting abnormalities in the blood, especially if
monitored routinely. We recommend annual urinalysis and blood work, especially
in cats over 7 years of age, in order to detect changes in kidney function at
the earliest possible time. In that way,
we can make the necessary changes to ensure your cat lives the longest life
possible.
Online CE, Dr Quimby, CSU internal medicine, on the
Veterinary Internet Network.
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