Ask any senior cat owner what feline disease they fear most, and the answer is likely the same—chronic kidney disease (i.e., kidney failure, renal insufficiency).
Their fear is not unfounded. Approximately 30% of cats older than age 10 have chronic kidney disease (CKD), a condition in which the kidneys slowly but progressively lose their ability to filter harmful toxins and maintain the body’s internal balance. CKD management requires a dedicated owner-caregiver who can provide veterinary-prescribed care and ensure the cat maintains a good quality of life throughout the disease’s progression—which may be months or years.
Processing the enormity of CKD can be mentally and emotionally daunting, and you’ll likely have many questions—including some that you’ll likely forget during your cat’s appointment. So, we answer the most common CKD questions we encounter at Neighborhood Veterinary Centers.
Question: Why are my cat’s kidneys failing?
Answer: Of course, the first thing we all want to know is “Why,” but a definitive cause for CKD is not often known. However, several risk factors have been shown to increase CKD’s likelihood, including:
- Thin body condition
- Previous or current illness (e.g., infection, periodontal disease, viruses)
- Kidney trauma or damage
- Toxin exposure
- Kidney stones
- Genetic predisposition or malformations (e.g., polycystic kidney disease)
- Abnormal protein deposits in the kidney tissue (i.e., amyloidosis)
Each kidney has more than a million microscopic filtration sites known as nephrons, which each include a glomerulus (i.e., the filter) and a tubule that moves the blood through the filtration process and ultimately returns the blood to circulation or redirects it to become waste (i.e., urine). During CKD, the nephrons are damaged, but because they are so numerous, illness is not visible until at least 60% to 70% of the kidney has been destroyed.
Question: My cat seems fine. What are kidney disease signs in cats?
Answer: Cats are masterful at hiding illness and pain, so you probably will not notice changes during early CKD. But, as previously filtered toxins and waste products build up in your cat’s blood, disease signs caused by nausea and dehydration will become more apparent. After diagnosis, you may see the following signs, despite treatment, that indicate disease progression:
- Frequent vomiting
- Appetite loss
- Increased thirst
- Increased urination frequency and volume
- Poor or unkempt haircoat
- Weight loss
- Muscle loss
- Pale gums
- High blood pressure
When clinical signs appear, veterinary treatment, which involves medical management, is necessary to prevent life-threatening dehydration, anorexia, anemia, and blood pressure-related eye and heart damage.
Q: How long will my cat with CKD survive?
A: Survival times for cats with CKD can vary from weeks to years, depending on their timing of diagnosis, disease stage, and whether the owner elects to pursue medical management.
Q: Can treatment repair the damaged kidney tissue?
A: Unlike the liver, which can regenerate to an extent, damaged nephrons do not regrow. Therefore, CKD treatment focuses on minimizing the kidney’s workload through a low-protein diet, maintaining adequate hydration through fluid therapy, supporting red blood cell production (i.e., preventing anemia) with medication, and reducing unpleasant clinical signs (i.e., nausea, vomiting). If these goals can be met, CKD cats can enjoy a relatively good quality of life.
Q: My cat is drinking a lot of water—do they really need fluid therapy?
A: Yes. CKD cats are perpetually thirsty, because during filtration their kidneys no longer preserve water, which is instead wasted through the urine—the reason why their urine is diluted or colorless. In an attempt to compensate for the water loss and prevent further dehydration, cats naturally increase their water intake.
Subcutaneous (SQ) fluids (i.e., under the skin)—or intravenous (IV) fluids if the pet is hospitalized—help support appropriate hydration and also promote a dialysis-like effect, helping to flush excess toxins from the blood.
When we recommend SQ fluids for your cat, the Neighborhood Veterinary Centers team will walk you through the process step-by-step to ensure you are comfortable and confident. Most cat owners are surprised at how well their cat tolerates the treatment.
Q: Why is diet so important for cats with CKD?
A: Nutritional support for cats with CKD is crucial in slowing kidney deterioration while providing healthy energy and supporting the body’s normal processes. Veterinary renal diets are generally low in protein, sodium, and phosphorus, to reduce the damaged kidneys’ workload and prevent further strain, with omega-3 fatty acids added for their anti-inflammatory properties. Renal diets are also designed with enhanced palatability and smell, because many cats with CKD experience food aversions and inappetence.
Q: How will I know when it’s time to say “Goodbye” to my cat?
A: Although successful management can extend your cat’s life, most cats ultimately succumb to their CKD. Chronic conditions can make end-of-life decisions especially difficult, as pets often experience lows followed by dramatic rebounds that keep owners hopeful, making the “when” decision rarely straightforward, unless the pet is in severe distress.
Keeping a journal of your pet’s condition can help you identify changes or trends that suggest a decline in their quality of life. When your cat is having more bad days than good days, you should speak with your veterinarian about humane euthanasia.
No one wants to hear that their cat has chronic kidney disease, but early detection and medical management allow many cats to enjoy a better quality of life for longer. If your cat is showing CKD signs, or you have additional questions about caring for cats with CKD, contact Neighborhood Veterinary Centers.
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