Chronic kidney disease cat
Kidneys have several essential functions, including a role in water management and the excretion of certain waste products. Kidneys have a huge reserve capacity, which is why we only see symptoms when more than 70% is lost. Kidney problems are seen more often in older animals. What causes it is usually impossible to determine. Kidney abnormalities are seen in some breeds, which are probably hereditary and where kidney failure can be seen at an early age.
It is difficult to determine exactly when damage to kidney tissue begins. It is usually a gradual process that can take weeks to months. In beginning kidney patients, you will not yet see any symptoms. Indications of a kidney problem in your pet are drinking a lot (it is normal if you hardly ever see your cat drinking!), urinating a lot, decreased appetite, increased vomiting, lethargy, smelling out of the mouth, bad fur, stiff walking and losing weight. With a blood screening in the cat (recommended from 8 years of age), we can find clues where some kidney tissue damage may already be suspected.
Several examinations are usually needed to get a good idea of the severity of the kidney failure and the prognosis. The examination of an (older) cat suspected of chronic kidney disease consists of:
- Physical examination Blood test
- Blood pressure measurement
- Physical examination
This involves checking your cat completely, but paying particular attention to weight, coat, kidney and bladder size, odor from the mouth and fluid balance.
Certain kidney values can be measured in the blood: urea and creatinine. These substances are only elevated if a considerable part (more than 70%) of the kidneys are already damaged. If your animal has elevated kidney values, it is sometimes necessary to "flush" him/her via an infusion. This depends on the underlying cause and the animal's condition. If the kidney values were elevated due to another underlying problem, they may return to normal after flushing. If they remain high after flushing, there is permanent damage.
It is also important to check the minerals in the blood (potassium, phosphate, calcium) and the red blood cell count. This is important because these blood levels may be increased or decreased because of the kidney failure. As a result, your cat may feel less well and/or the abnormal mineral levels may worsen the kidney failure.
A cat with kidney failure has watery urine because the kidneys can no longer concentrate properly. Some animals have leakage of protein in the urine due to damage to kidney tissue. We can measure this. The higher the amount of protein, the worse the kidney failure is. The proteins worsen the kidney failure. If there is too much protein in the urine, we prescribe a medicine that inhibits this protein leakage. This makes your cat feel better.
Finally, we often do bacteriological tests of the urine. Kidney failure is frequently accompanied by a urinary tract infection which may be the cause or worsen the kidney failure. Interestingly, cats with such a urinary tract infection usually have no complaints.
Blood pressure measurement
A cat with kidney failure is more likely (65%) to have high blood pressure. High blood pressure can be the cause of the kidney failure but a cat with kidney failure can also develop high blood pressure. Therefore, it is important to keep checking blood pressure regularly (twice a year). High blood pressure leads to faster deterioration of the kidneys. If the blood pressure is elevated, your cat will be given medication for this.
For a long time, you will not notice anything about high blood pressure. Only at a late stage, when there is already a lot of damage, symptoms such as haemorrhaging in the retina, blindness, heart problems and brain haemorrhages develop.
Your cat will be a kidney patient for the rest of his/her life. Kidney failure cannot be cured. Treatment is mainly to prevent the kidney failure from worsening and to make your cat feel and stay well.
The most important thing in a kidney patient is that he/she eats and drinks well! Depending on how sick your cat is, we may recommend kidney diet, your old food or high-energy canned food (temporarily).
Kidney diet contains less protein, making it less stressful for the kidneys. It also contains more potassium and less phosphate and calcium. Kidney diet gives a marked improvement in quality and quantity of life, but only if it is eaten sufficiently.
Fluid intake should be encouraged as much as possible to avoid becoming dehydrated. You can do this by placing extra water bowls in the house (cats drink little water if it is next to food), running water/water fountain, adding extra water with food and/or giving wet food (contains 70-80% water).
Further therapies depend on your cat's condition:
- If your animal is very dehydrated and apathetic, an infusion (into the blood vessel or subcutaneously) may be required.
- Medication if there is protein leakage from the kidneys (lifelong).
- Medication if there is high blood pressure (lifelong).
- Medication if minerals in the blood are abnormal.
- Antibiotic if there is bacterial cystitis (temporary).
- Medication to control vomiting (temporary).
- Medication to stimulate appetite. Appetite may be less due to nausea, abdominal pain due to constipation and/or stomach/intestinal ulcers. (temporary).
Once we have diagnosed kidney failure in your cat, your cat will be graded as having kidney failure (stage 1 to 4) depending on the blood and urine tests. A treatment plan will be drawn up. Regular check-ups are important to give your cat the best quality of life possible and to detect any complications quickly.
After 1 month, we recommend you come for a check-up. Then we repeat the clinical examination, blood and urine tests and blood pressure measurement. After that, we recommend having the urine checked every 3 months and the blood test and blood pressure measurement every 6 months. Of course, please contact us if things do not seem to be going well in the interim.
There is no predicting how long it will stay well. There are cats that live for years with elevated kidney values, while in other patients the treatment does not work. Of course, it also depends on how bad the kidney failure is at the time of diagnosis. By regularly checking kidney values, blood pressure, protein leakage and minerals, we keep a close eye on the kidney problem. Always contact us if your cat starts crawling away, stops eating or drinking or shows other signs of illness.
Do you have any questions following the above information? If so, please contact us.