Chronic Kidney Disease in Cats (2013)


Hi I’m Terry Daly. I’d like to give a
brief overview of kidney disease in cats. This is intended mostly as a review for
clients with whom I’ve already spoken. Chronic kidney disease is fairly common
in cats it is probably the most commonthing that we find when we run annual
routine blood and urine tests onhealthy-appearing cats. It is a condition
where the kidneys ability to perform oneor more of their many functions is
diminished. There are a lot of thingsthat normal kidneys do the thing we
think about the most is that kidneysremove waste products from the blood but
they also help regulate a variety ofthings including hydration and fluid
balance, hormonal balance, electrolytes,acid-base balance, blood pressure and red
blood cell production. As a cat ages avariety of things happen that cause
damage to the cells of the kidneys. Aswith most other animals cats do have a
lot of reserve kidney function they canlose half their kidney cells they can
lose the equivalent of a full kidney andthey still do fine. They lose half of
those functioning cells and they arestill able to perform all of the normal
functions of kidneys but when cats loseabout two thirds of the function of the
kidneys they start to lose the abilityto conserve water this is usually the
first sign that we see and it causes thefirst change we see on our laboratory
tests. When this happens the cats startproducing more urine. A lot of times
people notice more urine in the litterbox and they will notice that their cat
is drinking more water, something to keepin mind is that they are not producing
more urine because they aredrinking more water, they are drinking
more water because they are producingmore urine. They are drinking more
because they have to. That means that themost important treatment for kidney
disease is simple. At this stage and inthe future it is important to ensure
that your cat always has plenty of water. Water is the most important treatment if
they have only one bowl of it and theyspill it they can become dehydrated very
quickly. As kidney disease progresses we start
to see the effects of other functionsbeing lost. For example toxins may start
to build up in the blood causing thecats to act sick, or electrolytes may
become imbalanced, or the cats mightbecome acidotic, or anemic, or they might
become hypertensive. With kidney diseasecats are also predisposed to kidney
infections which cause further damage tothe kidneys. With all of these things you
may not see any noticeable signs untilthe disease has progressed so we
recommend 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 hospital
because of acute decompensation of thekidneys. Our main goal with cats with
kidney disease is to maintain quality oflife for as long as we can. Our goal is
not to extend the life of a cat who issuffering; and we do ask everyone to keep
this goal in mind. If we recommend thatyou give your cat a pill twice a day and
they 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 important
that 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 a
bag 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 kidney
disease every four to six months to lookfor problems before those problems have
a negative effect on the cat. Every sixmonths in any cat with kidney disease I
usually recommend a thorough examination,a blood panel, a urinalysis, a urine
culture, and a blood pressure measurement. Radiographs can also be helpful. With
these tests we are looking for anythingthat the kidneys might be failing at or
anything that might be harmful to thekidneys and then decide the best way to
address these things. At the same time weare also looking for problems unrelated
to 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 blood
pressure 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 are
needed; there’s a lot that we can do withkidney disease and cats to help them
live a long and healthy life. Withrespect to food it’s been pretty much
shown that a low protein diet does nothelp prevent kidney disease in cats and
that it can be harmful. Renal diets are not sold over the
counter this is because they are notnutritionally complete they are
deficient in protein. There isn’t anygood evidence that changing to a special
diet helps in the early course of thedisease and the few diet studies that
have been done in cats in the second andthird stages of renal disease are in my
opinion questionable. The most commonlycited study compares renal diets to
unidentified over-the-counter mostly dryfoods which I never recommend feeding to cats anyway. I’m not aware of any studies to date
that compare the benefits of a renaldiet to a high quality over-the-counter
canned food and my experience is thatcats on renal diets lose a lot of muscle
mass and generally look unthrifty, butrealize that each cat is an individual
and needs to be treated as such. Someof my patients with kidney disease are
on special diets some are not. If yourcat is on a renal diet I am NOT
recommended changing that in this video. There’s one other treatment for cats
with kidney disease that I often timesdiscuss with my clients and that is
calcitriol I’m going to save that foranother video. Thank you for watching!

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