Introduction
- Chronic kidney disease (kidney failure) is a permanent loss of kidney function.
- Diseased kidneys cannot perform normal tasks, such as filtering the blood of toxins, maintaining hydration, balancing minerals, and stimulating red blood cell production.
- Approximately 50% of cats will develop kidney disease in their life.
Signs of Kidney Failure
- Cats may not show any signs of kidney failure at early stages.
- The earliest clinical sign may be an increase in drinking and/or urination.
- In later disease, cats display vague signs such as vomiting, decreased appetite, weight loss, lethargy, and poor coat.
- Cats may present with sudden and severe illness if undetected kidney disease worsens rapidly.
Causes of Kidney Failure
- Most cats with kidney disease have an unknown
underlying cause.
- There may be an underlying immune problem or degeneration of kidney cells.
- Congenital malformations of the kidneys are
occasionally seen.
- Persians with polycystic kidney disease.
- An untreated or chronic infection of the kidneys may cause failure over time.
- Other causes of kidney failure include obstructions and cancer.
Diagnosis
- Routine blood and urine sampling can detect an
increase in toxins or dilute urine that is consistent with early kidney
disease.
- Blood values analyzed include BUN (blood urea nitrogen) and creatinine.
- The degree of elevation of these values is useful for categorizing the severity of kidney disease to provide the best treatment options.
- Imaging of the kidneys with x-rays or an ultrasound may be recommended to look for conditions that worsen kidney disease, including infections and stones.
Common Treatments
- Chronic kidney disease is not reversible and is progressive over time.
- A prescription diet is important to slow progression of kidney disease.
- Phosphorus is toxic to the kidneys.
- Diet is the best way to control high phosphorus.
- A phosphate binder is added when diet is not enough to control the phosphorus level.
- High blood pressure is common in cats with
kidney disease.
- Hypertension can be measured in cats and requires treatment.
- Uncontrolled hypertension causes progression of kidney disease.
- Symptomatic medications are often used in cats
with clinical signs of kidney disease.
- These include appetite stimulants and anti-nausea medications.
- Maintenance of hydration is important to prevent
worsening of kidney function.
- Fluids under the skin are prescribed to maintain water balance.
- Cats with late stage disease often have a low
red blood cell count.
- Blood transfusions and injections are used to improve anemia.
Prognosis
- Prognosis of depends on the severity of the disease at diagnosis.
- Cats with early disease can live 3 or more years.
- Cats with late disease may only live a few months.
- Prescribed treatments help slow down progression of disease and improve survival.
