CHRONIC RENAL FAILURE IN CATS

MORNINGSIDE VET CLINIC

560 Wynnum Road (Cnr Lawson St) Morningside, Queensland 4170

Ph (07) 3399 7055 Fax (07) 3399 5906 info@

CHRONIC RENAL FAILURE IN CATS

What do my cat's kidneys do ? The main function of the kidneys is to remove waste products from the blood and eliminate them in the urine. They are also responsible for regulating the body's salt and water levels, and producing hormones responsible for red blood cell production and calcium balance.

What is chronic renal failure ? Renal (or kidney) failure is a very common disease in older cats. Its is the second biggest killer of cats worldwide, responsible for the premature death of up to 30% of cats. When the kidneys are damaged and start to fail they become less efficient at doing their many jobs, such as removal of waste products. These waste products can build up in the body effectively "poisoning" your cat.

The kideys have an immense reserve capacity ? your cat can survive with only one-third of its kidney capacity! This means that often a significant amount of kidney damage has already occurred before any signs of disease are noticed. When only one third of the kidney capacity remains the kidneys lose their ability to concentrate urine adequately and compensate by producing a large volume of dilute urine ? this stage is called compensated kidney failure.

However, when kidney capacity drops to only one quarter, the kidneys can no longer compensate. Affected cats will become dehydrated, toxins will build up in the body, electrolyte balances are upset and red blood cell numbers may start to drop resulting in anaemia. This is called decompensated renal failure or Chronic Renal Failure. Due to the capacity of the kidneys to cope for a long time as damage is occurring, the signs of kidney failure may appear to come on suddenly. However, it is likely that the damage to the kidneys has been occurring for months or even years.

What are the causes of renal failure? A large number of different disease processes can eventually lead to Chronic Renal Failure. These include inflammation, infections, toxins, cancer, congenital (birth) defects and nutritional factors. In most cases no underlying condition can be identified as the culprit.

What are the signs of renal failure? Renal failure usually occurs in middle-aged and older cats. Early signs of disease can be easily missed and are often confused with "normal ageing". Clinical signs may include:

? Reduced appetite and weight loss ? Dehydration, increased thirst and urination ? A dull coat ? Lethargy, depression and weakness ? Vomiting ? Bad breath, dental problems and mouth ulcers ? Anaemia and pale gums

How is the disease diagnosed? Your vet may suspect renal failure based on your cat's history and their physical examination findings. By this stage, the disease will probably already be quite advanced.

A small blood sample and a urine sample are all that's required. The blood test is used to check the levels of kidney waste products, electrolyte levels and red cell counts. The urine is used to check the concentration (and therefore the kidney's ability to concentrate urine properly) and protein levels. Based on the results of these tests, your vet will then be able to recommend the most approptirate treatment for you cat's individual needs, or if more diagnostics may be necessary.

We strongly recommend that all cats over the age of seven years have their blood and urine tested at least annually, perhaps at the time of vaccination. These tests will detect early stage renal disease long before any signs become apparent. Early diagnosis is vital in slowing the progression and improving your cat's quality of life.

Prognosis Unfortunately, once renal failure starts to occur the damage is progressive. There is no cure for Chronic Renal Failure as damaged kidney cells can't regenerate.

However, if Chronic Renal Failure is detected early, there is a lot that can be done to assist the remaining functional parts of the kidney, which may slow the progression of the disease and help your cat to lead a longer healthier life.

Treatment There are many different treatments available for renal failure. The necessary treatment is determined by a cat's clinical signs, test results, stage of the disease and lifestyle. In many cases, cats can live for years after a diagnosis of renal failure.

? Regular monitoring ? Initially after diagnosis, your vet will probably want to check your cat every 2 to 4 weeks. Once they are stabilised, visits every 3 months for a check up and often further blood and urine tests are usually recommended

? Fluids ? If you cat is ill when first diagnosed with renal failure they will often be dehydrated. A short stay in hospital on an IV fluids may be necessary to correct this. We can often stabilise electrolyte disorders at the same time and help to flush toxins out of the system.

? Diet ? Your vet may start your cat on a special kidney diet which has been formulated to meet the needs of a cat in renal failure. There are several commercial forms of these diets available in both canned and dry forms. These include Hills Prescription Diet ? Feline K/D and Royal Canin Renal. Your vet will recommend the most appropriate diet for your cat. The most important thing though is to keep you cat eating. If you cat is reluctant to accept kidney diets, ask you vet for advice.

? Control blood pressure ? Renal failure will commonly lead to high blood pressure, which will worsen the kidney damage and also may cause eye problems such as blindness. Tablets for hypertension (high blood pressure) are often prescribed to help with this problem.

? Dental treatment ? Rotten teeth and mouth ulcers are very common in cats with renal disease. These can often make it painful for a cat to eat and lead to inappetence, anorexia or reluctance to accept the prescribed diet. Dental treatment under anaesthetic and antibiotic treatment may be necessary.

? Other symptomatic treatment ? Treatments such as anti-nausea drugs or appetite stimulants may also be necessary in some cases.

Unfortunately, there are still situations where the disease is too advanced for any treatment to work. In these cases you should discuss your cat's prognosis with your vet and decided together when it is time to consider euthanasia. It is not advisable to let a cat with renal failure die of its own accord. This will be

an extremely long and painful process ? once your cat's quality of life had deteriorated, the decision to euthanase is the kindest choice.

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