Cat Kidney Disease

A common disease seen in elderly cats is kidney disease or chronic renal failure (CRF), sometimes also called chronic renal insufficiency. The kidneys are a pair of organs located in the abdomen that are responsible for filtering the blood to remove byproducts and toxins, create urine, regulate electrolytes and minerals such as sodium, potassium, phosphorous, calcium, vitamin D, and produce the hormone that helps promote red blood cell production.

If the kidneys start to fail or become diseased, they often begin to not filter as well, and the byproducts and toxins begin to build up in the bloodstream. This can be caused by damage to the cells in the kidneys such as the nephrons or glomeruli, toxin ingestion such as lilies, raisins, grapes, or antifreeze, infections (in dogs these can include Lyme disease and leptospirosis), polycystic kidney disease or other congenital issues, urinary obstruction,  or pyelonephritis (kidney infection). 

Signs that your cat may have kidney dysfunction resulting in the buildup of toxins in the bloodstream called azotemia, may include vomiting, inappetance, weight loss, changes in urination, and sometimes a bad odor to the breath. Since these symptoms can also be signs of other serious diseases, please call to schedule an appointment if you notice any of these in your pet. 

An examination may reveal abnormal shaped or sized kidneys, weight loss, changes in heart rate, elevated blood pressures, changes in the retina of the eyes, or other signs which may make kidney disease a likely culprit. Likely a blood sample will be taken to look at kidney functions such as the BUN (blood urea nitrogen) and creatinine. 

If your pet does indeed have elevations in BUN and/or creatinine levels, a diagnosis of kidney dysfunction will likely be made. These values can also be elevated due to other illnesses, so they will be interpreted by the doctor in light of clinical signs and the examination. If kidney dysfunction is most likely, further workup which may include a urinalysis to look for urine specific gravity, signs of an infection, or evidence of crystals or bladder stones may be recommended. A second urine test called a urine protein: creatinine ratio may be recommended as well to look for protein loss through the kidneys. Imaging of the kidneys and urinary tract such as x-rays or ultrasound may also be recommended.

If it is determined that your pet has kidney disease, there are a number of ways that we manage this. Kidney disease is not reversible and cannot be stopped from progressing, but with careful management we are often able to control and slow down the progression to help your pet feel more comfortable and minimize the symptoms they may have been exhibiting. Depending on the severity and the situation, some of our recommendations may include:

  • Fluid therapy, which could consist of hospitalization for IV (intravenous) fluids, subcutaneous (SQ) fluids given here, or subcutaneous fluids given at home
  • Diet change to a kidney diet such as Hill’s k/d®, Purina NF®, or Royal Canin Renal LP®
  • Azodyl® a medication used to help the GI tract remove some of the nitrogen byproducts to reduce the load on the kidneys
  • Epakitin® a product to bind phosphorous
  • Renal K® a product to supplement potassium
Other possible treatments can include appetite stimulants, anti-vomiting medications, antibiotics for concurrent infections, erythropoietin injections to help stimulate red blood cell production, and more. There are even referral centers performing dialysis and kidney transplants for pets. If you think your pet has kidney disease or is showing any of the symptoms of kidney disease, please schedule an appointment today to diagnose and discuss the treatment options that are right for your pet. 
 
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