One of the leading causes of death in cats over 10 is kidney disease, and while this common problem is usually seen in geriatric cats, younger cats can also develop it. When caught in the early stages, the underlying cause gets treated, and additional management & lifestyle changes are applied, cats generally can live relatively normal lives. So let’s have a closer look at what kidney disease is, what the symptoms are, how it’s diagnosed, treated and managed.
The Kidneys
Cats have 2 kidneys, which are located in the abdomen, one on each side. They are part of the renal system, and have several important functions, such as maintaining the body’s balance of fluids, electrolytes, and minerals, and regulating the red blood cell production and blood pressure by producing a hormone called erythropoietin. The kidneys also filter waste material from the bloodstream and make urine, through which the filtered waste material leaves the body. Cats can’t survive without their kidneys, but just like humans, can live normal and healthy lives if they have 1 fully functioning kidney.
Kidney Disease
Kidney disease can be chronic or acute. We speak of acute kidney disease if the kidneys suddenly, often within days or weeks, are unable to function properly. Some of the reasons for acute kidney disease are tick borne diseases, viral infections like FIP and FIV, infections with parasites such as toxoplasmosis, ingestion of toxic materials such as lilies, low blood pressure, urethral obstruction, and bacterial infections. Acute kidney disease can develop into chronic kidney disease.
We speak of chronic kidney disease when the decline in kidney function is gradual, and happens over a longer period of time.. Chronic kidney issues are often seen with underlying conditions such as cancer, clotting disorders, high blood pressure, inherited conditions like polycystic kidney disease, and Congenital kidney dysplasia where the kidneys are small and underdeveloped. Chronic kidney disease is progressive, and will eventually lead to total kidney failure, where the kidneys will stop working and lose their ability to filter waste materials from the blood.
Kidney disease can be divided in 4 stages which are
- Stage 1: Less than 66% of the kidney functions have been lost. Cats are usually not showing any symptoms.
- Stage 2: Between 66% – 75% of the kidney functions have been lost. Usually cats are starting to show some symptoms.
- Stage 3: Between 76% – 90% of kidney functions have been lost. Cats are often unwell and are showing many symptoms.
- Stage 4: 90% of kidney functions have been lost. Cats are often critical and are showing many symptoms
Symptoms
- Polyuria- (PU)) and polydipsia (PD) – excessive water consumption and increased urination
- Dehydration
- Lack of Appetite
- Vomiting
- Diarrhea
- Mouth sores
- Weight Loss
- Bad breath
- Fever
- Decreased activity
- Incontinence
- Inability to urinate
- Swelling
- Lower Back Pain/Arched Back/Stiff Gait – often seen in acute kidney failure.
Diagnosis
Kidney disease can often be diagnosed through blood work by looking at the kidney markers and a urine test. Additional testing can be required through x-rays, kidney biopsies and blood pressure evaluation.
Treatment
If diagnosed in time, acute renal failure can often be reversed. This is sadly not the case for chronic kidney disease, and the treatment is often aimed at management. Management of kidney disease is done firstly by treating and managing the underlying cause of the kidney disease, if one is found. Secondly, additional treatment can be given to manage symptoms and slow down the progression of kidney disease. Cats that start treatment while in stage 1 or stage 2, can usually be managed with a renal diet and more frequent veterinary attention such as health checks including blood work. For cats that are in the 3th or 4th stages of kidney disease, more intervention may be needed such as dietary supplements, additional fluids either through IV or under the skin, medication to manage nausea and vomiting, phosphorus binders, or erythropoietin injections. Cats with kidney disease benefit from drinking a lot of water, and making this inviting will benefit them. This can be done through water fountains, and feeding them food that contains a lot of moisture.
While controversial due to ethics, kidney transplants in cats are possible and can offer long-term survival with a normal quality of life for cats. Kidney transplants are extremely costly, not only for the transplant itself, but also the aftercare (medication and checkups) and can only be done by specialised veterinarians and teams. Studies at several veterinary schools have shown that around 80% of cats survive for at least six months after the transplant, with approximately 65% still being alive three years later. Most donating cats (about 84%) had no associated long-term effects of donating 1 of their kidneys, however, 7% developed renal insufficiency or died of urinary tract disease.
Prevention
Kidney disease is rarely preventable, unless the cause are toxins such as the ingestion of lilies. Cats that have genetic conditions, such as polycystic kidney disease, should not be bred to prevent passing their hereditary disease to their offspring.
Conclusion
Being able to recognize kidney disease in your cat, and getting them the treatment required as soon as kidney disease is confirmed, is vital to their prognosis. With early intervention and proper management & lifestyle changes, most cats can lead relatively normal lives.
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