Overview of 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.
Below is an overview of Chronic Renal (Kidney) Failure in Cats followed by in-depth detailed information about the causes, diagnosis and treatment of this disease.
CRF affects all breeds of any age, although older pets are commonly affected, as the prevalence increases with age. The average age of diagnosis in cats is nine 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
Failure of hormone production (including substances that stimulates the production of red blood cells [erythropoeitin])
Disturbance of fluid, electrolyte and acid-base balance
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:
Poor blood flow and lack of oxygen (ischemia)
Immune system abnormalities
What to Watch For
Excessive drinking and urinating (Note – Increased urination is sometimes noted as pet using the litter box more frequently, urinating in abnormal places in the house or increased weight of the litter box)
Lethargy or fatigue
Halitosis (Bad Breath) in Cats
Lack of coordination when walking
Lethargy or fatigue
Diagnosis of Chronic Kidney Failure in Cats
Diagnostic tests are needed to recognize CRF and exclude other diseases. These tests may include:
Complete medical history
Complete physical examination
Blood tests such as biochemistry analysis and a complete blood count (CBC)
Abdominal radiographs (X-rays)
Treatment of Chronic Kidney Failure in Cats
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
Management of blood abnormalities such as hyperkalemia or hypokalemia (abnormal potassium blood levels), metabolic acidosis and hyperphosphatemia
Dietary therapy with protein a 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)
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 five to seven 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 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 cimetidine or famotidine); or anabolic steroids for some patients. Epogen may be given for anemia two to three times weekly.
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.
In-depth Information on Chronic Kidney Failure in Cats
Other medical problems can lead to symptoms similar to those encountered in CRF. Laboratory testing (blood work and urinalysis testing) will often diagnose CRF. Further diagnostic testing may be needed to determine the underlying cause.
Diseases that can appear similar to those with CRF include:
Acromegaly (abnormal enlargement of of the extremities of the skeleton due to overgrowth of connective tissue)
Acute Renal (Kidney) Failure (sudden onset of kidney failure)
Diabetes Mellitus(malfunction of the pancreas, whose function is the production and release of insulin)
Diuretic phase of acute renal failure (ARF)
Drugs (diuretics, corticosteroids)
Excessive parenteral fluid administration
Hyperadrenocorticism (Cushing’s Syndrome)
Hypercalcemia (High blood calcium)
Hyperthyroidism (excessive functional activity of the thyroid gland)
Hypokalemia (low blood potassium)
Multiple myeloma (cancer)
Nephrogenic (producing kidney tissue) diabetes insipidus (a metabolic disorder, which results in a deficient quantity of the hormone ADH being released or produced, resulting in failure of reabsorption of water in the kidney
Partial Urinary tract obstruction
Polycythemia (an increase in the circulating red blood cell mass)
Post-obstructive diuresis (an increased excretion of the urine due to the diuretic effect of urea and electrolytes retained during the period of obstruction)
Primary hyperparathyroidism (abnormally increased activity of the parathyroid gland)
Psychogenic polydipsia (excessive drinking caused by psychological causes, such as boredom)
Pyelonephritis (inflammation of the kidney and renal pelvis)
Pyometra (infection of the uterus)
Renal glucosuria (the presence of sugar in the urine)
Renal medullary (central or inner portion of an organ) washout of solute