Chronic Kidney Failure in Cats

Chronic renal (kidney) failure (CRF) is a common problem in all cat breeds. The digestion of food produces waste products, which are carried by blood to the kidneys to be filtered and excreted in the form of urine. When the kidneys fail, they are no longer able to remove these waste products, and toxins build up in the blood producing clinical signs of kidney disease.

CRF affects all breeds of any age, although older pets tend to be more commonly affected. The average age of diagnosis in cats is 9 years. Breeds thought to be more susceptible include Abyssinians and Persians. CRF affects almost every body system causing many changes throughout the body and usually results in the following:

• Abnormal filtration of blood and retention of waste materials
• Disturbance of fluid, electrolyte and acid-base balance
• Failure of hormone production (including substances that stimulate the production of red blood cells [erythropoeitin])

CRF can be caused by several different processes. These may include diseases, some of which can be secondary to other disease processes or trauma, that may have caused acute kidney failure such as:

• Toxins
• Poor blood flow and lack of oxygen (ischemia)
• Inflammatory disease
• Infections
• Cancer (neoplasia)
• Immune system abnormalities

What to Watch For

Several symptoms are present when your cat begins to suffer from CRF. These include:

• Lethargy
• Vomiting
• Bad breath
• Anorexia
• Weakness
• Lack of coordination when walking
• Depression
• Increased thirst/excessive drinking
• Increased urination (sometimes noted as pet using the litter box more frequently, urinating in abnormal places in the house or increased weight of the litter box)

Diagnosis

Diagnostic tests are needed to recognize CRF and exclude other diseases. These tests may include:

• Complete medical history
• Complete physical examination
• Blood tests
• Urinalysis
• X-rays

Treatment

Although there is no cure, early detection can slow the progression of the disease. CRF can be a life-threatening condition that requires hospitalization and treatment for stabilization in extremely ill pets. Treatments may include:

• Fluid therapy for dehydrated pets
• Dietary therapy with a protein/phosphorus restriction
• Free access to water
• Supportive care and careful monitoring of urine output
• Control of vomiting with diet and drug therapy as needed
• Management of anemia if needed (with Epogen)
• Management of blood abnormalities such as high potassium levels, low potassium levels, metabolic acidosis and high phosphorus levels

Home Care

Chronic renal failure is life-threatening, and if you suspect your pet has this condition, you should see your veterinarian as soon as possible. Follow-up with your veterinarian for examinations, laboratory work and urinalysis. Blood and urine analysis should be repeated within 5 to 7 days after discharge.

Feed your pet the diet recommended by your veterinarian. Provide free access to fresh clean water at all times. Some owners can administer subcutaneous (under the skin) fluid to their pets at home, if necessary. Your veterinarian can provide instructions when indicated.

Administer any prescribed medications as directed by your veterinarian. Drug therapy may include: phosphate binders; potassium supplementation; or drugs for vomiting (such as Tagamet or Pepcid); or anabolic steroids for some patients. Epogen may be given for anemia two to three times weekly.

Preventive Care

There are no specific recommendations for prevention of chronic renal failure. However, general suggestions include:

• Providing frequent attempts to urinate and free access to fresh clean water.
• Avoiding exposure to ethylene glycol and toxic plants (such as Easter lily) that can cause acute kidney damage.

To learn more about chronic kidney failure, please click on Chronic Kidney Failure In-depth.