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Chronic kidney disease in cats can’t be cured or reversed, merely treated and monitored. Even so, if an owner commits to a program of attentive care, the cat may have a happy life after the diagnosis.
Chronic Kidney Disease in Cats – A Common Phenomenon
The disease affects all breeds and both genders. (Some studies suggest Persians and Abyssinians may be more prone to it.) Causes are often unknown. Theories include chronic inflammation, hereditary conditions, injury from medications or dehydration, high or low blood pressure and cancer, often in the form of renal lymphoma.
CKD occurs infrequently in young cats, too. For instance, polycystic kidney disease affects up to one in three Persians. In these cases, a genetic flaw in kidney cell development leads to the formation of multiple cysts, whose growth causes kidney failure.
Early signs of CKD
Cats hide discomfort much better than dogs and like to eat and drink privately, so it may be difficult for an owner to detect changes in behavior. Also, a drop in the water level of a bowl or fountain could be attributable to any pet in a multi-cat household.
So, early signs of chronic kidney disease in cats may be intermittent, non-specific and hard to catch. Owners should look for increased water intake, increased urination, weight loss, decreased or suddenly selective appetite, or occasional lethargy and/or vomiting.
Your vet should perform a blood panel annually on otherwise healthy cats between 1 and 7 years old and twice a year for cats who are 8 or older. Markers for kidney health include levels of BUN and creatinine, plus testing for the amino acid SDMA. The vet should also perform a urinalysis at that time.
Strategies for Slowing CKD
The disease is progressive, but the rate of progression varies. The four stages of chronic kidney disease are rated on a scale created by the International Renal Interest Society. This IRIS scale provides management guidelines based on the level of disease.
Your veterinarian cannot easily predict in the early stages how long a cat might live. As a rule, cats in stages 1 to 3 can have a relatively good quality of life for years. One study from 2008 showed an IRIS stage 2 median survival of 1151 days and a stage 3 median survival of 778 days. The stage 4 median survival was just 103 days, though the ranges were wide in all stages.
Veterinarians commonly prescribe a prescription kidney diet in the last three stages to restrict phosphorus and protein intake while supplementing omega-3 fatty acids. They also may need to address related conditions, such as high blood pressure, proteinuria or anemia.
Other forms of management vary with individual cats, such as giving them a phosphate binder with food or making sure they’re hydrated with canned food and subcutaneous fluid administration at home. Subcutaneous fluid administration involves delivering fluids (from an IV fluid bag) to the space under the skin on the cat’s back by insertion of a needle, Many dogs and cats actually tolerate this procedure once they get used to the routine.
Side Effects of CKD
As kidneys fail to filter the blood properly, and toxins build up in the cat’s system, it may stop eating. That creates health problems of a different kind, such as liver failure when the cat’s body starts to break down stored fat.
Both the kidneys and the heart are involved in regulation of blood pressure and blood volume, so disease in one organ can affect the other. Primary diseases in the kidney and the heart can complicate the treatment of both.
In extreme cases, an owner with a younger cat might seek a kidney transplant. However, these are expensive, performed only in selective tertiary referral centers (usually universities), and often require lifelong immunosuppressive therapy to prevent rejection of the transplant.
Think of Charlotte Animal Referral and Emergency as a human-style medical center for pets, operating 24 hours a day, 365 days a year. CARE provides all types of treatment, from emergency attention to board-certified specialty work like Internal Medicine after a referral from a primary care veterinarian. Please take a visual tour of the practice at carecharlotte.com/tour.
