Kidney Disease In Cats
For pet parents, the health and longevity of their pets are always a concern and their wellbeing is the highest priority. This necessitates being watchful of their health and aware of potential illnesses they may be prone to developing. There are many factors that can cause kidney disease in cats, especially as they age. An owner may not immediately know what’s wrong, but can easily identify a change in their ailing kitty from their struggle in doing many activities they normally wouldn’t have a problem with and a general lethargy/listlessness which goes far beyond cats’ stereotypical laziness.

Among cats, kidney disease is one of the most worrisome ailments causing morbidity and mortality. In cats, chronic kidney disease (CKD) is rampant among aging cats and a delayed response can cut their lifespans dramatically short. An acute version of CKD is known as an Acute Kidney Injury (AKI). However, early detection and care can avoid complications and the pet can be nursed back to health, with the appropriate medications.

Kidneys are tasked with managing important physiological functions such as maintaining blood pressure, production of hormones, stimulating the bone marrow to generate more red blood cells, and removal of waste from the blood. The kidneys filter the blood and discharge toxins from the bloodstream. With advancing age, this process slows down and filtration becomes inefficient. This results in more production of urine.

Although chronic kidney failure has no major cure, early-stage diagnosis can address the issues affecting the pet’s life span and health. Timely diagnosis and therapies can enable a cat to experience a comfortable life as long as possible. There are many case studies of cats having survived CKD and the treatment having increased their lifespan by taking special care in areas of proper diet, foods, and medicines.

Causes of kidney problems in cats
The treatment for CKD depends on the stage it has reached. They include dietary changes and fluid therapy like intravenous fluids (IV fluids). Drugs will also be administered to ameliorate the clinical signs.

Symptoms of kidney disease in cats
The early signs of kidney disease are increased water consumption and increased urine production.

Other clinical signs of kidney failure include the following.

• Loss of appetite
• Frequent urination
• Weight loss
• Vomiting
• Diarrhea
• Bad breath
• Ulcers in mouth

Frequent urinating is a sign that your cat is not able to hold water. Urinating outside the litter box is another signal.

Ancillary symptoms also include brownish-colored tongue, constipation, fatigue and indifference (moreso than usual). There are several types of kidney conditions they may be susceptible to, including: Polyelonephritis or infection of the kidney tissues caused by bacteria or fungus. This causes inflammation and a bacterial urine culture will be able to verify the infection.

Nephrolithiasis, also known as kidney stones, is caused by bacteria altering the characteristics of blood or urine. Kidney stones block the kidney’s ducts and escalate the ailment.

Kidney stones also damage the ureter, the long narrow tube connecting kidneys to the urinary bladder. When stones are stuck in the ureter, the cat will experience intense pain. When the path of urine is blocked, the kidney swells leading to hydronephrosis and the damage gets compounded.

When Kidney tubules are affected the condition is called Tubulointerstitial disease, while Glomerular disease refers to damage of kidney filters from infections such as FIP, FeLV, cancer, and other problems. When cats get into household items they ought not to and harmful outside substances like anti-freeze, petals of certain flowers, the leaves of certain plants and pollen or vase water there can be a problem of toxic intake. Cats also have a tendency to consume pills from the counter or floor. Even a single ibuprofen can badly damage the kidneys forever.

Risk factors contributing to CKD
Clinical studies have also gone into the phenotypic, environmental, and lifestyle risk factors that develop CKD in felines. One factor is the breed. Certain breeds of dogs and cats are reportedly predisposed to CKD.

Among cats, breeds that are vulnerable to CKD include Abyssinian, Siamese, Maine Coon, Burmese, Persian, Ragdoll and Russian Blue. Although the sex-based risk of CKD has not been confirmed, idiopathic membranous glomerulopathy has been cited as being more common in male cats.

Some dietary formulations are also blamed for CKD in cats. Potassium-deficient and phosphorus-laden higher protein diets are especially harmful to the kidneys and can increase risk factor for developing CKD.

Treatment for CKD
Confirming a cat has CKD comes only after a series of tests are performed. Not only blood biochemistry data will be taken to trace renal abnormality, but also other tests to cover renal imaging, and the problems of persistent renal proteinuria or reduced urinary concentrating ability. These can all grant some insight into your cat’s kidney disease status.

This will ensure any indication of disease is picked up on even without a surge in serum SDMA. The disease factor will be further evaluated by a renal biopsy. If the renal abnormality persists, the cat will be diagnosed as having CKD and assessment of the stage of the disease can follow.

Therapies for CKD
If a cat has confirmed renal disorder, the therapy for CKD will include medications and supplements intended to reduce blood pressure, raise potassium levels, lower phosphorous levels, promote kidney function, cure anemia, heal gastrointestinal ulcers and stop of vomiting.

Among the therapies, Calcitriol therapy is important. Cats receiving calcitriol therapy have reported better outcomes, often exhibiting signs of better energy and a more alert nature. Other positive benefits include improved appetites, more physical activity and longer lifespan per the survey of veterinarians who used calcitriol. But concerns on the potential side effects like hypercalcemia also exist.

Kidneys convert 25-hydroxycholecalciferol to the most active metabolite, 1,25-dihydroxycholecalciferol, or calcitriol that is crucial as a major renal hormone for calcium metabolism.

The core functions of calcitriol include the modulation of parathyroid hormone. But calcitriol production suffers during renal failure and calcitriol deficiency promotes renal secondary hyperparathyroidism.

Calcitriol supplementation can regulate hyperparathyroidism as the Parathyroid hormone acts as a “uremic” toxin. In extreme cases, surgery is also resorted to including, a kidney transplant.

New advancements in treatment
An innovative liquid treatment, Semintra by Boehringer Ingelheim Vetmedica for CKD-infected cats has also been reported as being a potentially successful option.

Semintra carries a vital ingredient called Telmisartan, which is an angiotensin receptor blocker. Just like Benazepril, Semintra can reduce proteinuria associated with CKD. Semintra is an oral solution.

This was also endorsed by Martha Cannon, RCVS Specialist at the Oxford Cat Clinics in their Feline Medicine department.

Cat kidney disease stages
Regarding CKD, the International Renal Interest Society (IRIS) has a set of established guidelines based on the severity of the renal disease.

The IRIS has identified 4 stages based on the creatinine levels. CKD detection follows important tests such as the blood urea nitrogen level test known as the BUN test and creatinine plus evaluation of urine-specific gravity. The following stages describe the disease’s progression:

Stage 1: Theserum creatinine will be less than 1.6 mg/dl (milligram per decilitre). Also, stage 1 will not exhibit any major clinical signs. Here the urine’s specific gravity will be less than 1.025. Bacteriuria, Cylindruria and Hypertension can be traced from lab testing.

In stage 2, serum creatinine levels will be in the range of 1.6-2.8 mg/dl and clinical signs will include mild polyuria and inappropriate urination. Hypertension will also be noticed.

During stage 3, serum creatinine will rise to 2.9-5 mg/dl. Symptoms include decreased appetite, weight loss, vomiting and anemia, plus urine changes.

At stage 4, serum creatinine will be greater than 5 mg/dl with marked polyuria and anorexia accompanied by rapid weight loss, frequent vomiting, dehydration, constipation, depression and falling skin turgor.

Survival rate
There are records of cats in stage II kidney disease having survived an average of 1000 days after treatment. In stage III, cats expanded their lifespans by an average of 800 days and stage IV cats survived for another 100 days with treatment.

Recovery or death from CKD depends on the response to the initial stage of treatment and follow-up. A timely treatment ensures positive changes and the probability is high for recovery, a better quality of life and longer overall lifespan.

Treatment proceeds in phases. In the first phase, the effort is to “restart” the dormant kidneys using intravenous fluids to “flush out” the kidneys and to stimulate the kidney cells to activate again.

Fluid therapy also eliminates electrolytes, especially potassium. Other steps of initial treatment will include ensuring proper nutrition and the use of drugs to control vomiting and diarrhea.

Special diet
In recuperating from kidney disease, offering a well-modulated cat kidney diet to the pet has a big role. 

The diet will be low in phosphorus and protein and enriched with vitamin D and omega-3 fatty acids so that you can introduce the cat to new foods gradually.

The diet must also be accompanied by lots of clean, fresh water, a serene environment and regular check-ups to help the cat live longer. The kidney diet will have to be low in protein content, low in phosphorus and have no acidity.

Such a planned diet will keep the blood test parameters close to normal making the cat feel better. Also, a decreased protein diet will decrease the workload on the kidneys.

Scope for homemade cat kidney diet
Cat food for kidney disease can also be prepared at home, if pet parents balance the necessary nutrients properly. As a rule, cats can be fed with nose-to-tail animals that are smaller than itself. This includes bones, muscles and organs like the heart. But supplement them with the essential amino acid taurine if the food is not fresh.

Cats battling renal failure commonly undergo severe oral pain and low appetite. So, they will need highly palatable food. So, any special kidney diet must have palatability in mind. It must have EPA, DHA and antioxidants too. Alkalinizing agents will ensure better metabolic equilibrium

Expert tips to protect pet cats from CKD
Marc Ching, a Japanese herbalist and holistic nutritionist for pets and also the owner of the PetStaurant in Los Angeles says the main cause of kidney failure in cats is linked to the diet, “specifically dry cat food.” His outlet offers healthy foods and snacks that are gluten-free, organic and hypoallergenic.

For patrons looking to prevent kidney disease in their kitty or who have a cat suffering from kidney issues, Ching offers the following tips:

Remove dry kibble from cat’s diet: Since cats are sensitive and require moisture to live long, feeding dry food is a risk. Dry food soaks up moisture during the digestive process and adds to internal pressure on the kidneys, forcing them to work harder.

Give Milk Thistle: Add milk thistle to your cat’s diet as a preventative measure to keep the cat’s kidneys healthy. Silymarin is an active ingredient in milk thistle and it can protect the kidneys by aiding in the filtering process of toxins in the body.

Add fish/krill oil to food: Adding fish or krill oil slows the progression of renal failure and kidney disease. Fish or krill oil gives a nice taste which cats find palatable and is also rich in Astaxanthin and Omega-3 fatty acids. Our own Kidney Shield for Cats & Dogs is a superb addition!

Offer plenty of fresh water: Cat’s water intake is important. Most cats are finicky and don’t drink much. So, change the type of bowl and try to get a cat water fountain as they enjoy fountains where water is constantly circulated.

Add probiotics to the cat’s diet: This will reduce cat’s kidney-associated symptoms and stave off other diseases. A full spectrum of probiotics can compress toxins as they eat up beneficial bacteria in the body and reduce toxins. Kidney Restore for Cats & Dogs is one of the best on the market. 

Artificial intelligence-based CKD detection
Considering chronic kidney disease (CKD) is the number-one cause of death in cats, a new diagnostic tool blending artificial intelligence (AI), machine learning and big data on feline patients for over 20 years has been developed.

Named RenalTech, it can predict CKD in cats two years before its onset. The current detection methods are very weak as they can find the disease only when significant damage has occurred, making treatment very challenging.

David Aucoin, chief technology officer of Antech Diagnostic that developed RenalTech said that knowing a cat is going to get CKD means veterinarians can develop a personalized care plan to mitigate symptoms and slow the disease. It will also usher in a better owner engagement and improve compliance.

Calling RenalTech a new paradigm in CKD diagnostics Aucoin said its strength is that it can look at the patient’s future and come up with a real, qualified answer whether or not “this patient will or will not get this disease.”

The discourse makes it clear that the life expectancy of cats can be increased by taking good care of your pet with proper diet, supplements, hydration and medicines. There are many products on the market to help restore kidney function for cats (and dogs) and address concerns and open the gate for a joyful and quality life.