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The most common causes of premature disease and sometimes death in cats are cancer and kidney failure. With regard to kidney disease, our discreet felines often exhibit only very subtle if any signs of early kidney problems, making early diagnosis sometimes difficult. While kidney disease can occur in a cat at any age, it’s most common in middle age and older cats. Causes of acute kidney failure most commonly include acute infections, toxic exposure and certain drugs such as the use of nonsteroidal anti-inflammatory drugs such as aspirin, Tylenol (which can kill a cat), and even on occasion prescription Metacam. |
These cats typically present acutely ill with recent history of drug exposure. The more common diagnosis of chronic kidney disease certainly presents a more difficult diagnostic challenge. While infections, reactions to drugs, chemicals and/or vaccinations can be involved, in the vast majority of cases, conventional veterinarians rarely find out the cause of chronic kidney failure, often leaving us with palliative management at attempting to preserve kidney function and slow down kidney decline. However, once elevations in blood creatinine and BUN (blood urea nitrogen) occur in cats with chronic renal failure, greater than 80% of kidney function has been irreversibly destroyed when the disease is often first detected, which makes long term management much more difficult.
The diagnosis of chronic kidney failure in cats is based on a combination of blood work, urine analysis, and potentially urine culture and ultrasound done at the veterinary office. Once diagnosed, attempts are made to slow down kidney decline and metabolic complications. Secondary urinary infections are treated with antibiotics. High blood pressure is treated with drugs like Amlodipine. Low protein and low phosphorus diets are fed to ease workload on the kidneys, preferably homemade, but there are commercially available diets as well. Some veterinarians will prescribe appetite stimulants and anti-nausea drugs such as Cyproheptadine, Pepcid AC, Metoclopromide, and Mirtazapine. Because elevations of blood phosphorus occur, many veterinarians will prescribe phosphate binders to be given at meal times such as Epakitin. There has been some excellent clinical responses of cats with kidney disease to the probiotic Azodyl, as well which seems to draw the toxins of kidney failure right out of the blood into the digestive tract.
Many cats with chronic kidney disease benefit from animal guardians administering subcutaneous fluids under the skin at home several times weekly, which can be easily taught to guardians by veterinarians or veterinary technicians. Rarely some animal guardians will see if their pet is a candidate for kidney transplants. Limitations here include limited facilities across the country that provide this service, VERY high cost, as well as risk of donor kidney organ rejection in the sick patient. Holistic veterinarians will often prescribe nutritional supplements, herbs and/or homeopathic remedies in helping the feline cope with this very difficult disease. The best thing guardians can do is be aware of the early signs of kidney disease in cats. These include:
- Increased thirst/urination
- Subtle weight loss
- Nausea, vomiting
- Drooling from oral ulcers
- Losses of appetite
With routine annual to semiannual exams, blood work/urine analyses and blood pressure measurements, kidney disease in cats can be detected early. And with early detection the disease can often be better managed for an improved and enhanced quality of life for your cat.
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3 Comments
Hi Dr. Dym,
Have you ever read this article about the controversy of protein restriction?: http://mousabilities.com/nutrition/crf/bovee_protein_RD.pdf
Protein restriction with kidney disease is controversial and may not always be beneficial, especially with cats. Reducing phosphorus (with binders), which can be found in higher levels in meat, can be helpful to cats with CRF. There are vets now who are questioning this whole “low protein” dietary approach to cats with kidney disease. Protein deficiencies can create more problems. Cats, especially, need protein to thrive, and during illness it’s needed for repair and recovery. I am speaking to cats here (my interest) – though the article I linked also points to issues with using low protein with dogs. This whole focus on low protein also seems to have made some people mistakenly assume that higher protein diets contribute to the development kidney disfunction/disease. Also wet food is always important for cats with kidney concerns and in general.
Just some thoughts I wanted to share. I enjoy reading your well-written articles.
http://www.pethealth101.com/http://www.pethealth101.com/
[Reply]
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[Reply]
Dr. Michael Dym, VMD veterinarian Reply:
June 11th, 2011 at 3:14 pm
You are very welcome. Spread the word about these blogs.
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Dr. Michael Dym, VMD veterinarian Reply:
November 23rd, 2011 at 11:36 pm
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[Reply]