Chronic Kidney Disease in Cats

IMG 4268 300x199 Chronic kidney disease is one of the most common geriatric conditions to occur in cats.  This condition can often times be treated if recognized in its early stages.  As chronic kidney disease progresses the prognosis worsens and the treatment options become limited.  It is important for owners to be able to recognize the clinical signs (external symptoms) of chronic kidney disease in cats before it is too late for their cats to be treated.

Clinical Signs of Chronic Kidney Disease in Cats

One of the first clinical signs that a cat with chronic kidney disease will exhibit is drinking more water and urinating more.  Sometimes this is detected by the need to fill the water bowl more frequently, or the litter box seeming heavier. When there are multiple cats in one household, these changes are of course more difficult to detect.  As the kidney disease progresses, cats will have a decreased appetite, weight loss, and possibly vomiting. This is due to a build up of kidney toxins (uremia) in the body.  Also, chronic kidney disease in cats can cause anemia (low red blood cell count) due to a lack of erythropoietin production, which is a hormone produced by the kidneys that stimulates the bone marrow to produce red blood cells.  Click here to learn more about symptoms of kidney disease in cats.

Diagnosis of Chronic Kidney Disease in Cats

The diagnosis of chronic kidney disease in cats is made by physical examination, blood work, and urinalysis. The presence of an elevation of blood urea nitrogen and creatinine (azotemia) and urine that is not concentrated (isosthenuria) confirms the diagnosis of kidney disease.  The presence of a urinary tract infection by urine culture, and urinary protein loss (proteinuria) by a urine protein/creatinine ratio help determine the type of kidney disease.  Abdominal x-rays and ultrasound are used to image the kidneys to determine if there are kidney stones  or tumors. It is also important to measure the cat’s blood pressure because it is commonly elevated in cats with chronic kidney disease.

Treatment of Chronic Kidney Disease  in Cats

It is ideal to feed a cat with chronic kidney disease a low-protein diet. There are several prescription kidney diets for cats that are low in protein. Studies have shown that changing the diet of a cat with chronic kidney disease to a low protein kidney diet can increase their lifespan considerably.  Omega-3 fatty acids have been shown to help slow kidney disease by minimizing inflammation. These supplements can be added directly to food by breaking an omega-3 fatty acid capsule directly onto food twice daily.   Cats with kidney disease are more susceptible to urinary tract infections then cats with normal kidney function.  If a cat has a positive urine culture then antibiotics should be prescribed for many weeks to clear the infection from the kidneys.  Hypertension is common in cats with chronic kidney disease and it is recommended to treat with anti-hypertensive medication.  Hypertension can cause blindness, heart disease, and progression of kidney disease.  Proteinuria can occur in chronic kidney disease and the addition of drugs (angiotensin converting enzyme inhibitors) are recommended to reduce the amount of protein loss through the kidneys.   If anemia develops cats can be give synthetic erythropoietin and iron to regenerate red blood cells.  Cats with chronic kidney disease can also develop low potassium levels and need potassium supplementation, develop elevated phosphorous levels and need phosphate binders, become dehydrated and require injections of fluid and electrolyte solutions under their skin, and develop nausea and require medication to suppress nausea and gastric acid.

Click here to learn about acute kidney disease in cats.

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Dr Peter Nurre

Peter Nurre, DVM, Diplomate ACVIM (internal medicine) is a board- certified veterinary internal medicine specialist. His professional interests include internal medicine and cardiology.

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