What Is Chronic Kidney Disease?

Chronic kidney disease (CKD) is a progressive condition that occurs when a cat’s kidneys no longer function properly, predominantly affecting cats aged 7 years and older. Kidneys play a crucial role in eliminating metabolic waste and regulating the body’s fluid balance. When kidney function declines, toxins accumulate in the bloodstream (uremia), causing symptoms such as:

• Weight loss
• Lethargy and weakness
• Reduced appetite
• Nausea and vomiting
• Dehydration despite increased water intake
• Increased urine production

Although the primary cause often remains unknown, several factors can accelerate CKD progression, including dehydration, kidney-toxic medications, urinary infections, kidney stones, hypertension, and proteinuria (protein in urine).

Diagnosing Chronic Kidney Disease in Cats

Veterinarians may suspect CKD based on clinical signs and physical examination findings, such as significant weight loss, marked dehydration, smaller and irregular kidneys, and heart murmurs related to anemia or hypertension.

Diagnostic Tests

Blood Tests:

• Elevated urea and creatinine levels indicate toxin buildup.
• Hyperphosphatemia (high phosphorus levels), which accelerates kidney damage.
• Electrolyte imbalances (sodium, chloride, potassium).
• Anemia due to reduced kidney production of erythropoietin.
• Metabolic acidosis, affecting heart function and blood pressure.

Urinalysis:

• Assessing kidney’s urine concentration capability.
• Detecting infections, urinary crystals, blood, or protein.
• Urine protein-to-creatinine ratio to evaluate prognosis.

Radiography and Ultrasound:

• Evaluating kidney size and shape.
• Detecting kidney stones or structural abnormalities.

Blood Pressure Measurement:

• Identifying hypertension commonly associated with CKD.

Treatments for Chronic Kidney Disease in Cats

Though CKD is incurable, proper treatment can slow disease progression, alleviate symptoms, and improve quality of life. Treatment choices depend on disease severity, categorized into four stages. The primary goals are controlling uremia, minimizing electrolyte and nutritional imbalances, and reducing complications.

Specialized Diet

Kidney diets are specifically formulated for cats with CKD, offering multiple benefits:

• Low phosphorus content to slow disease progression.
• Reduced protein levels while maintaining high biological value.
• Rich in omega-3 fatty acids for anti-inflammatory benefits.

As these diets might be less appetizing, gradual introduction is recommended. Wet food is preferable for enhanced hydration. If a cat refuses these diets, consider:

• Adding water to dry food.
• Providing multiple sources of fresh water.
• Testing different bowl materials (glass, ceramic, metal).
• Using a water fountain.
• Adding tuna juice to drinking water.

Supplements and Medication

• Appetite stimulants: If food intake decreases significantly.
• Phosphate binders: Prevent excessive phosphate absorption.
• Renal probiotics: Enhance toxin elimination via intestines (natural intestinal dialysis).
• Potassium supplements: Correct CKD-related deficiencies.
• Anti-nausea and gastrointestinal protectants: Reduce digestive symptoms.
• Antihypertensive drugs: Manage hypertension resulting from CKD.
• Erythropoietin: For severe anemia, noting possible side effects.

Maintaining Hydration

Diseased kidneys lose the ability to retain fluids, causing polyuria (increased urine production) and dehydration. Administering subcutaneous fluids at home may be recommended. In advanced stages, intravenous fluid therapy might be required in the clinic.

Follow-up and Reassessments

Regular monitoring is essential for treatment adjustments based on disease progression. Periodic blood and urine tests, along with blood pressure measurements, help track CKD evolution and adapt care accordingly.

Conclusion

Chronic kidney disease is common in older cats, but appropriate management significantly improves their quality of life. With a tailored diet, adequate hydration, and regular veterinary follow-ups, it is possible to slow disease progression. If you notice any concerning symptoms, consult your veterinarian promptly.