Understanding Kidney Disease in Cats
Kidney disease is a common condition in cats, especially as they age. According to research, the prevalence of kidney disease in cats ranges from 1.6-20% depending on the study population [1]. The kidneys play a vital role in filtering waste products from the blood, regulating hydration status and blood pressure, and producing urine. When the kidneys become damaged, they are unable to properly perform these important functions.
There are two main categories of kidney disease in cats: acute kidney injury, which comes on suddenly, and chronic kidney disease (CKD), which progresses slowly over months or years. CKD is more common and accounts for most kidney disease cases in cats. Some potential causes of CKD include:
- Chronic interstitial nephritis
- Glomerulonephritis
- Congenital malformations
- Toxins
- Infections
- Cancer
Common signs of kidney disease in cats include increased thirst and urination, weight loss, poor appetite, lethargy, vomiting, and bad breath. Diagnosis involves blood and urine tests to assess kidney function and look for abnormalities. Staging the disease from early to end-stage helps determine treatment options and prognosis.
Dietary Changes
Making dietary changes is one of the most important things you can do for a cat with kidney disease. Since damaged kidneys have difficulty processing phosphorus, protein, and maintaining hydration, adjusting the diet is critical.
Veterinarians typically recommend switching to a low phosphorus, low protein prescription kidney diet. These diets contain reduced minerals that healthy kidneys would normally excrete. According to VCA Hospitals, kidney support diets have less protein, sodium, and phosphorus, and increased omega-3 fatty acids compared to normal cat foods.
To help the kidneys function optimally, increased water consumption is also recommended. This dilutes the toxins in blood that damaged kidneys cannot filter out efficiently. Cats with kidney disease should always have fresh water available. Adding more moisture to the diet through wet food or broths can encourage drinking. Iris Kidney recommends gradually transitioning to the kidney diet over a few weeks to improve acceptance.
Supplements like fish oil, potassium citrate, vitamin B-complex, and antioxidants can provide additional nutritional support. Check with your veterinarian before starting any supplements.
Medications
There are several types of medications that may be prescribed for cats with kidney disease:
ACE inhibitors and antihypertensives: These help control high blood pressure, which is common in cats with kidney disease. Examples include enalapril, amlodipine, and telmisartan. Controlling hypertension helps reduce further kidney damage. PetCareRx has good information on blood pressure here.
Antacids: Kidney disease can cause nausea and gastrointestinal ulcers. Antacids like famotidine help reduce stomach acid and relieve these symptoms.
Phosphate binders: As kidney function declines, phosphorus builds up in the blood. This can cause bone disease and worsen kidney damage. Phosphate binders like aluminum hydroxide bind to excess phosphorus so it can be removed from the body.
It’s important to follow your vet’s recommendations closely when giving medications for kidney disease. Monitor for side effects and be sure to give the medications as prescribed. Proper management with medications can significantly improve quality of life.
At-home Care
Caring for a cat with kidney disease at home involves several important daily tasks. This helps support kidney function and maintain quality of life.
One crucial component is administering subcutaneous fluids. This means injecting fluids under the skin to provide hydration. Your vet will advise on the amount and frequency. Giving subcutaneous fluids at home can help prevent dehydration and flush toxins from the body.
You should also encourage your cat to drink more water. Leave multiple fresh bowls around the house. Consider getting a cat water fountain, which provides flowing water that many cats prefer. Avoid giving milk, which can further stress the kidneys.
Pay close attention to the litter box. Cats with kidney disease urinate more frequently. Scoop the litter box at least twice a day and completely replace the litter weekly. Look for signs of straining, discomfort, or blood, which requires vet attention.
Overall, monitor your cat closely each day for any changes that may warrant discussion with your veterinarian. Providing attentive at-home care helps support cats with kidney disease.
Regular Vet Visits
Regular vet visits are crucial for cats with kidney disease. The vet will monitor lab work like BUN (blood urea nitrogen), creatinine, phosphorus, and SDMA levels to assess kidney function and watch for any worsening trends. Changes in these lab values may prompt medication adjustments. The vet will also check blood pressure, weight, hydration status, and other physical parameters. At each visit, the vet will evaluate if your cat is showing any new clinical signs or symptoms such as increased thirst, weight loss, poor appetite, vomiting, diarrhea, or lethargy. New symptoms may indicate progression of the kidney disease or other problems to address.
Your vet will continually adjust the treatment plan based on your cat’s evolving condition. Medication dosages, dietary modifications, subcutaneous fluids, or other interventions may be tapered up or down as needed. More aggressive treatment may become necessary if your cat declines into more advanced stages of kidney disease. Your vet will monitor quality of life and discuss options if your cat stops responding to treatment. Regular vet check-ups every 1-3 months, or more frequently when symptoms flare, are key for optimizing care of your cat with kidney disease.
Sources:
https://www.avma.org/javma-news/2021-02-01/creating-brighter-futures-cats-chronic-kidney-disease
https://www.clarkroadanimalclinic.com/services/cats/blog/kidney-disease-cats
Managing Comorbidities
Cats with kidney disease often suffer from other concurrent illnesses, known as comorbidities. Properly managing these additional conditions is key to preserving quality of life and slowing CKD progression. Three of the most common comorbidities are hypertension, anemia, and urinary tract infections (UTIs).
Hypertension frequently accompanies CKD and further damages the kidneys, so controlling high blood pressure is critical. Medications like amlodipine can help relax blood vessels and lower pressure in hypertensive cats (Lawson, 2021). Anemia stems from declining red blood cell production and requires supplements like erythropoietin to boost red blood cell counts. Recurrent UTIs are also common in CKD cats due to immune dysfunction; antibiotics clear infection while addressing predisposing factors like incomplete bladder emptying.
Other issues like dental disease and osteoarthritis cause significant pain that worsens clinical signs. Professional dental cleanings under anesthesia, anti-inflammatory medications, and joint supplements enhance comfort. Overall, proactively diagnosing and treating comorbid diseases enhances longevity and welfare for cats with CKD.
Quality of Life
Maintaining quality of life is crucial when caring for a cat with kidney disease. There are several things you can do to ensure your cat’s comfort, minimize stress, provide enrichment, and support their physical abilities.
Make your cat as comfortable as possible by providing soft and warm bedding in quiet areas of the home. Cats may appreciate heated beds or blankets to soothe achy joints. Ensure litter boxes are easily accessible. Consider adding ramps or steps to allow access to favorite sleeping spots. Feed appetizing food in a stress-free environment.
Physical therapy can help cats maintain muscle mass and joint health. Passive range of motion exercises, like gently flexing and extending legs, can improve mobility. Provide ramps and non-slip surfaces for traction. Massage may help relax muscles. Always check with your veterinarian before starting therapy.
Mental stimulation and environmental enrichment are important for quality of life. Engage your cat’s natural instincts with toys that encourage pouncing, chasing, and scratching. Rotate novel toys to prevent boredom. Consider food puzzles or hiding treats to stimulate their mind. Catnip, cat grass, and window perches can also enrich their environment.
Work closely with your veterinarian to minimize pain and discomfort. Medications may help manage anemia, nausea, among other symptoms. With attentive, loving care, your cat can still enjoy their twilight years.
End-of-Life Care
As kidney disease progresses to an advanced stage, cat owners face difficult decisions about end-of-life care. At this point, treatment is focused on keeping the cat comfortable through hospice care rather than extending life. Euthanasia may be considered to prevent further suffering when the cat has a poor quality of life.
Hospice care aims to maximize comfort and quality of life for cats with advanced kidney disease. This includes managing pain, nausea, and other symptoms. Appetite stimulants, antacids, and anti-nausea medications can make eating easier. Subcutaneous fluids, warming beds, and assistance with grooming can also help. Owners should monitor their cat’s condition closely and adjust care as needed. Some signs a cat is nearing the end stages of kidney disease include lethargy, weight loss, vomiting, and poor coat condition.
Euthanasia may be an option to consider when kidney disease has significantly impacted quality of life. This decision is very difficult emotionally. Key factors are if the cat is experiencing constant pain, struggling to breathe, having seizures, or no longer finding enjoyment in life. A veterinarian can provide guidance on when euthanasia would be humane. Owners should not feel guilty, as euthanasia can be the final act of love and care for a cherished cat.
Grieving the loss of a cat with kidney disease is painful. Allowing time to adjust and focusing on happy memories can help owners through this process. Support groups and counseling provide additional outlets. Creating a memorial, like a photo album or donation in the cat’s name, may also bring some comfort.
Coping as a Pet Owner
Caring for a cat with chronic kidney disease can be emotionally and financially difficult. As a pet owner, you may experience feelings of sadness, grief, guilt, and stress. Providing medical care and making dietary changes also comes at a significant cost. It’s important to take care of your own emotional and financial needs while caring for your sick cat.
Reach out to friends, family members, and support groups for emotional support. Share your feelings and let loved ones know how they can help you during this difficult time. Consider joining online groups like Feline CRF to connect with other cat owners going through similar experiences.
Explore financial assistance programs like grants from the Pet Peace of Mind Program that help with vet bills, medical supplies, prescription diets and more. Non-profits like the Feline Chronic Renal Failure Foundation also provide monetary aid for treatment costs.
Watch for signs of caregiver fatigue like irritability, social withdrawal, anxiety and exhaustion. Make time for self-care through stress management techniques, taking breaks when possible, and seeking respite care if needed. Your cat depends on you, so be sure to care for yourself as well.
Preventing Kidney Disease
There are several ways pet owners can help prevent kidney disease in cats:
Get annual exams to monitor your cat’s kidney values. Kidney disease is often caught through blood and urine tests at a veterinarian’s office. Catching it early makes treatment more effective.
Provide regular dental care for your cat. Dental disease can lead to kidney infections that may damage kidney tissues over time. Brushing your cat’s teeth daily or getting professional cleanings at the vet can protect kidney health.
Avoid exposing your cat to toxins like antifreeze, household cleaners, chemicals, and toxic plants [1]. Make sure all household toxins are sealed away and out of your cat’s reach. Research poisonous plants and remove any from your home or yard.
Feeding a high quality diet designed for kidney health, with increased antioxidants, can also help prevent kidney issues in cats. Talk to your vet about the best food for your cat’s needs.