Chronic Kidney Disease in Cats (2013)
Hi I’m Terry Daly. I’d like to give abrief overview of kidney disease in cats. This is intended mostly as a review forclients with whom I’ve already spoken. Chronic kidney disease is fairly commonin cats it is probably the most commonthing that we find when we run annualroutine blood and urine tests onhealthy-appearing cats. It is a conditionwhere the kidneys ability to perform oneor more of their many functions isdiminished. There are a lot of thingsthat normal kidneys do the thing wethink about the most is that kidneysremove waste products from the blood butthey also help regulate a variety ofthings including hydration and fluidbalance, hormonal balance, electrolytes,acid-base balance, blood pressure and redblood cell production. As a cat ages avariety of things happen that causedamage to the cells of the kidneys. Aswith most other animals cats do have alot of reserve kidney function they canlose half their kidney cells they canlose the equivalent of a full kidney andthey still do fine. They lose half ofthose functioning cells and they arestill able to perform all of the normalfunctions of kidneys but when cats loseabout two thirds of the function of thekidneys they start to lose the abilityto conserve water this is usually thefirst sign that we see and it causes thefirst change we see on our laboratorytests. When this happens the cats startproducing more urine. A lot of timespeople notice more urine in the litterbox and they will notice that their catis drinking more water, something to keepin mind is that they are not producingmore urine because they aredrinking more water, they are drinkingmore water because they are producingmore urine. They are drinking morebecause they have to. That means that themost important treatment for kidneydisease is simple. At this stage and inthe future it is important to ensurethat your cat always has plenty of water. Water is the most important treatment ifthey have only one bowl of it and theyspill it they can become dehydrated veryquickly. As kidney disease progresses we startto see the effects of other functionsbeing lost. For example toxins may startto build up in the blood causing thecats to act sick, or electrolytes maybecome imbalanced, or the cats mightbecome acidotic, or anemic, or they mightbecome hypertensive. With kidney diseasecats are also predisposed to kidneyinfections which cause further damage tothe kidneys. With all of these things youmay not see any noticeable signs untilthe disease has progressed so werecommend looking for things before theybecome a problem. Realize that doing everything that werecommend does get expensive but it does end up being a lot less costly than afew days at the emergency hospitalbecause of acute decompensation of thekidneys. Our main goal with cats withkidney disease is to maintain quality oflife for as long as we can. Our goal isnot to extend the life of a cat who issuffering; and we do ask everyone to keepthis goal in mind. If we recommend thatyou give your cat a pill twice a day andthey are hiding under the bed all day infear of those pills we aren’t accomplishing our goal. That medication maybe important but it is also importantthat you let us know if it’s a problemcommunication is really important here. So what do we do for kidney disease. Alot of people think that we sell you abag of special food and that’s about itbut there’s a lot more that we can do. There’s a set of things that I generallyrecommend doing for cats with kidneydisease every four to six months to lookfor problems before those problems havea negative effect on the cat. Every sixmonths in any cat with kidney disease Iusually recommend a thorough examination,a blood panel, a urinalysis, a urineculture, and a blood pressure measurement. Radiographs can also be helpful. Withthese tests we are looking for anythingthat the kidneys might be failing at oranything that might be harmful to thekidneys and then decide the best way toaddress these things. At the same time weare also looking for problems unrelatedto the kidneys. This sounds complicatedand hard but a lot of times it’s simple. For example if a cat’s potassium is low wesupplement it, if they have high bloodpressure we treat it, if they have kidneyinfection we put them on antibiotics. All of these things are relativelysimple but can help a lot when they areneeded; there’s a lot that we can do withkidney disease and cats to help themlive a long and healthy life. Withrespect to food it’s been pretty muchshown that a low protein diet does nothelp prevent kidney disease in cats andthat it can be harmful. Renal diets are not sold over thecounter this is because they are notnutritionally complete they aredeficient in protein. There isn’t anygood evidence that changing to a specialdiet helps in the early course of thedisease and the few diet studies thathave been done in cats in the second andthird stages of renal disease are in myopinion questionable. The most commonlycited study compares renal diets tounidentified over-the-counter mostly dryfoods which I never recommend feeding to cats anyway. I’m not aware of any studies to datethat compare the benefits of a renaldiet to a high quality over-the-countercanned food and my experience is thatcats on renal diets lose a lot of musclemass and generally look unthrifty, butrealize that each cat is an individualand needs to be treated as such. Someof my patients with kidney disease areon special diets some are not. If yourcat is on a renal diet I am NOTrecommended changing that in this video. There’s one other treatment for catswith kidney disease that I often timesdiscuss with my clients and that iscalcitriol I’m going to save that foranother video. Thank you for watching!