Along with your cat’s frame, possibly their coat has also thinned a bit over time—they’ve made the most of their nine lives, may even have three or four left, but there is little doubt that your precious kitty is changing, growing older, but no matter how bad the wear and tear, the love continues.
And at first look, it appears as just time doing its job, chipping away. But, again, often dismissed as the normal aging process, manifestations of an underlying quite serious condition may be present: kidney disease (failure).
Cats are just unluckily prone to kidney failure. As much as 50% of the older cat population (10 years or older) reportedly have some form of kidney disease from many different possible causes.
The kidneys do a lot for the body. Among the many of their life-giving functions, waste filtration of the bloodstream is paramount. They control essential vitamins and minerals (such as sodium and potassium), regulate water, stimulate red blood cell creation, and make urine. They are tough, so much so that if one is lost, the other, if healthy, can run things on its own, which is why it is crucial to monitor any red flags that arise.
When the kidneys fail, they will do their best to deal with the situation by removing the waste at a lower capacity through more, i.e., pee with less and less in it (waste). Your beloved feline will do its best to compensate for the constant water loss and thirst by drinking more to suffice renal failure (kidneys unable to do their job).
Kidneys also have a lot of extra space to do their duties, so at least two-thirds or 67 to 70% of the kidney tissue injuries before diagnosable signs will start to appear; failure may not show for months, if not years. Unfortunately, this means that once clinical symptoms manifest, much time may have passed since the kidneys began slowly breaking down.
Acute vs. Chronic Kidney Failure
Acute renal failure (ARF) or acute kidney failure (AKF) is when the kidneys suddenly pause the performance of regular functions, different from chronic, as it signifies a sudden (toxic) failure rather than long-term (chronic) dissipation of the filtration functions.
The onset of sudden kidney failure leads to lethargy, vomiting, and diarrhea, often containing blood, exhibiting putrid breath (ammonia-like stink), severe weight loss, mouth sores on tongue or lips, constipation, and seizures. In addition, a cat may urinate more than usual, or not at all. Acute differs from Chronic as it is usually brought on by consuming a toxin, such as antifreeze, after a traumatic incident, an illness, or maybe a hospital procedure that went awry.
In turn, toxins have built up so much in the bloodstream, with remaining metabolic waste that has not been adequately excreted, electrolyte levels off, the balance between acidity and alkalinity (acid-base balance) in the blood is also off.
Some of the more common causes may include:
- Blood clotting disorders
- Heart problems
- Low blood sugar, hypotension
- Ethylene glycol toxicity (antifreeze poisoning)
- Blockage of the urethra or kidney tubes (ureters)
- Ingestion of potentially deadly metals like lead, arsenic, mercury, thallium
- Consumption of poisonous plant(s), Lily flowers
- Ingestion of pesticides or rat poison, cholecalciferol (vitamin D) prevalent in many and highly dangerous to animals
- Snake or insect bite
- Infection of the stomach lining (peritonitis)
- Bacterial infection of the kidney
- Possible ingestion of nonsteroidal anti-inflammatory painkillers or antibiotics (one ibuprofen can shut down a cat’s kidneys!)
- Total system shock
One significant difference between acute and chronic kidney failure is the possibility of altering and possibly reversing the problem if caught and aggressively treated early on by appropriately diagnosing the former.
Chronic renal failure (CRF), also referred to as chronic kidney disease (CKD), while mainly a problem for older cats, 10% of cases may appear as young as three or less.
The busy kidneys do many things, but removing blood waste and regulating specific vitamins and minerals is at the top of the list. They will take a beating for years until they start to show signs of failure; thus, it’s common for even early symptoms to show up far into a chronic, dysfunctional situation. Chronic damage to the kidney tissue is irreversible; what’s left is preventing more deterioration and working to remedy and assist with treatment.
Sadly, chronic renal failure is the last dance of a series of disease activities over one specific problem. Some of the conditions that might over time lead to CRF are:
- Bacteria from a urinary tract infection gets into kidneys (pyelonephritis)
- Tumors about the kidney (neoplasia), often lymphosarcoma (blood cancer common in cats)
- Glomerulonephritis, inflammation of blood filtration structures in the kidney
- Ureter (tubes carry pee from kidney to bladder) or kidney stones
- Feline leukemia virus (FeLV), or other viral infections such as peritonitis (stomach lining inflammation)
- Build up the abnormal protein in the kidney blocking proper function (called amyloidosis); however, this is uncommon in most cats except for Burmese, Siamese, Tonkinese, Devon Rex, Oriental Shorthair breeds, and Abyssinians.
- Polycystic kidney disease (PKD) is hereditary, and cats are born with myriad cists in the kidneys. As a result, they can grow larger and potentially cause problems with the kidneys, failing.
While there is treatment, the affliction must be diagnosable. However, a blood test recently became available to detect early problems before the bloodstream rises in blood urea nitrogen (BUN) or creatinine are noticeable, signifying damage having already begun and nearing the end of its destructive cycle.
The blood test can detect early, chronic kidney failure by evaluating the levels of SDMA (symmetric dimethylarginine), a naturally occurring amino acid produced when protein is processed and then released by the kidneys. When SDMA concentrations rise above average, it signifies stunted kidney function or disease well before creatinine increase in the blood is high enough to detect (high levels of creatinine, waste produced by the muscles, are a good indicator of kidney failure). Such an early discovery can help your vet diagnose and adequately treat the issue sooner than in the past.
Treatments
Acute Treatment
Once the ever-spreading toxin(s) are identified, clearing it out of the body as fast as can be done, along with a balance boost in electrolytes given intravenously for 24 hours, but maybe needed for up to four days if required.
If the toxin(s) is due to a drug of some sort, the stomach most likely will be pumped of its contents right away and then supported with activated charcoal to keep any existing toxins from being absorbed.
Two dialysis methods, peritoneal and hemodialysis, exist for blood-filtering processes and can be administered to clean the blood of any toxins. Like what one might go through while awaiting a kidney transplant, unfortunately, it is rare for cats and not readily available, so it may be challenging to locate service in your area.
Peritoneal dialysis is a form of renal replacement therapy mostly practiced in people with late-stage kidney failure and treating chronic kidney diseases. Renal replacement therapy does precisely that; it replaces the kidney’s blood-filtering process when the organ(s) cannot do the job correctly due to failure, from acute kidney injury or chronic condition.
Hemodialysis is the exchange of toxins, solutes (salts, sugars, etc.), and water via an artificial kidney or semipermeable membrane. This process removes toxins and any waste products from the blood while restoring electrolytes and acid-base balance via the dialysis water. During the treatment, specific solutes, extra water, and toxins (from inside or outside the body) go through the small openings of the artificial kidney. Still, proteins, cells, and greater solutes remain.
If your cat has continuous vomiting, it may need further nutritional support. In addition, your trusted vet should administer a viable treatment strategy to allow your beloved kitty to get the best chance of bouncing back from the acute kidney condition.
Chronic Treatment
Treatment and the best recovery plan are based on kidney damage once the toxin is discovered or possibly an infection. Unlike the liver, the kidney does very little to regenerate and heal itself. Once the testing results have diagnosed your furry one’s particular condition, your vet will decide the final prognosis and treatment.
To determine the best course for your cat, your trusted vet uses The International Renal Society staging system (IRIS), which detects serum creatinine levels, protein in the urine and measures blood pressure. Through the process known as staging, your vet can discover the best plan of attack on how to begin with, treat and monitor your cat’s progress and figure the entire scenario of all that may be going on.
Treatment of Chronic Renal Failure varies after blood tests are complete, as crucial ways to fix your baby’s issues become more evident. Many cats recover with a managed diet, along with supplementation and possibly more simultaneous treatments. Your trusted vet will work with you, however long it takes, to get your kitty back to its best.
Some treatments for chronic kidney disease may include:
- Antibiotics – many felines respond well to antibiotic therapy, although it is a bit of scientific mystery as to why? However, kitties with CRF do get bladder infections from bacteria. Thus, doing regular urine cultures to monitor the condition is recommended.
- Vitamin A and B supplementation due to the amount of loss when the kidneys cannot process the vitamins and are lost, and cats need daily doses.
- Diets low in protein and phosphorus work to lower the level of waste in the blood flow. Your trusted vet can give you these or train you on how to prepare them at home.
- Losing too much potassium in the urine due to renal failure is a significant problem for such cats. Although the low potassium contributes to the kidney condition, it also leads to poor coat quality and weak, stiff muscles.
- Many cats with kidney failure have dangerously high blood pressure levels that can hurt the kidneys even further. Thus, administering blood-pressure-lowering meds can have a positive impact on the condition.
- Even with low phosphate in your cat’s diet, the phosphorus levels in the blood still may remain high. Oral phosphate binders like aluminum hydroxide work to lower the amount absorbed by your furry’s tummy wall and help hinder the disease’s progression.
- Cats with CRF are often anemic because of the lack of production in the red blood cells in the bone marrow. However, there are now drugs to help kick up bone marrow creation to help your cat’s output.
The costs of treatment will vary depending on the feline and their particular case. However, in most situations, more comprehensive monitoring and medicine are not too expensive.
Sadly, damage to the kidneys is permanent, as they do not fully recover from chronic conditions with their inability to regenerate; it is limited. Although, with proper diagnosis and the best care and management possible, the CRF case will slow its progress, and your beloved furry friend can still enjoy many joyful and active days to come.
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