Cat with Kidney Troubles

[pihlaja]

Hey guys,

A woman I know on another forum just recently found out that her 9-year-old cat, Oliver, has kidney failure. Blood work revealed that his kidneys were only at about half power. The vet gave her some instructions concerning his diet (special food and nothing else, etc.), but I was wondering if you guys might have some advice for her, too?

Thanks in advance. I gave her the link to Paw-Talk, but just in case she doesn't come join, I can show her this thread with everyone's comments.

[Jade]

This is our client handout on CRF (Chronic Renal Failure).

Quote: Chronic Renal Failure in Cats Client Information What is the function of the kidney? A kidney’s primary function is to remove waste products from the blood stream. The kidney also acts to retain essential nutrients such as potassium at the correct level, maintain hydration, and produce urine. What is chronic renal failure? The kidneys have a large amount of spare capacity to perform their various functions. At least 70% of the kidneys must not be functioning correctly before clinical signs are seen. Often, this means kidney damage has been occurring over a span of several years before failure is evident. Older cats are most frequently affected by chronic renal falure, but 10% of cases occur in cats less than the age of three. Symptoms commonly seen as indicators of kidney disease, such as weight loss and poor coat quality, are often incorrectly dismissed as normal aging changes. In the first stages of disease, the kidneys compensate for their inability to concentrate waste products by excreting them at a lower concentration over a larger volume. This is known as compensated renal failure. Once approximately 70% of kidney tissues are destroyed, there is a rapid increase in waste products found in the bloodstream and an apparent sudden onset of severe renal disease. What causes chronic renal failure? Many different disease processes can ultimately lead to CRF, including: 1. Bacterial kidney infections (pyelonephritis) 2. Congenital (from birth) malformations of the kidneys, such as polycystic kidneys in long haired cats 3. Neoplasia - various tumors of the kidney, most commonly lymphosarcoma 4. Glomerulonephritis, which is damage to the filtration membrane of the kidney 5. Amyloidosis, which is the build-up of an unusual protein in the kidney that prevents the kidney from functioning normally. 6. Viral infections such as feline leukemia virus or feline infectious peritonitis virus. How do you diagnose CRF? Renal failure is typically diagnosed by determining the level of two waste products found in the bloodstream, blood urea nitrogen (BUN) and creatinine, along with urine specific gravity (USpG). Tests to measure the blood levels of other substances such as potassium, phosphorus, calcium, and the red and white blood cell counts can also help determine the best treatment course for a patient. Could renal failure have been diagnosed earlier? Early diagnosis is very difficult, as neither clinical signs nor rises in BUN and creatinine are evident until significant loss of function in the kidneys has occurred. In earlier stages of renal disease there are no clinical signs to indicate sophisticated renal function tests, which can detect early renal damage, are necessary. We recommend that all senior pets have at least an annual urinalysis to help diagnosis of kidney disease at the earliest detectable point. A low urine specific gravity may indicate that at least two thirds of the kidney tissues are damaged. How does CRF affect my cat? Clinical signs can differ in cats, due to the kidneys performing a variety of different functions. Common symptoms are weight loss, halitosis (bad breath), poor coat quality, lethargy, decreased appetite which may be associated with oral ulcers, and depression. Less commonly, cats are seen to drink and urinate more. Some will also have vomiting and diarrhea. Rarely, renal failure can cause sudden onset blindness. What treatments are available for CRF? Depending upon the outcome of the bloodwork the veterinarian has performed, there may be several different problems that require treatment. The list below may seem overwhelming, but the majority of cases can be effectively managed with diet change along with supplementation and one or two other treatments. 1. Low protein and low phosphorus diets will lower the level of waste products in the bloodstream. These can be prepared at home or are available from your family veterinarian. Cats tend not to like reduced protein diets as well as normal cat food, so perseverance may be the key for a while before your cat begins to eat it solely. 2. In spite of low phosphate in the diet, blood phosphorus levels may remain above normal in some cats. Reducing blood phosphorus can have a major effect on improving your cat’s quality of life and helping to slow disease progression. Phosphate binders such as aluminum hydroxide are given orally to help lower the amount of phosphorus absorbed via the gastrointestinal tract. 3. Antibiotics may be given, as many cats seem to respond well to them. The reason for the response is not always clear, however. 4. Cats in renal failure tend to lose too much potassium in the urine, which leads to stiffness, muscle weakness, and poor coat quality. Low potassium levels may contribute to the worsening of the kidney failure as well. Potassium supplementation may help to replace that which is lost in the urine. 5. Cats who experience vomiting may be given anti-emetics to reduce nausea and thus improve appetite. 6. High blood pressure is seen in a significant number of cats with renal failure. In some cases, lowering their blood pressure using hypo-tensive drugs may be necessary. 7. The kidneys initiate the production of red blood cells in the bone marrow. Many cats with CRF are anemic due to a lack of this stimulation to the blood marrow. Newer drugs have been developed to help stimulate bone marrow production and may be prescribed for your cat if anemia is a factor. 8. Cats with renal failure will dehydrate very quickly as compared to normal cats. It is vitally important that fresh water is available at all times to prevent this. How much does treatment of CRF cost? Each individual case is different, and as such treatment costs will vary. In most cases, long term management is not likely to be prohibitively expensive.

[CTChin]

Great info. Jade. Unfortunately the vet I work for isn't as up to date on kidney disease in cats as he should be. He never recommends phosphorus binders.

When my 9 1/2 year old cat, Bones, was diagnosed early last dec., I had to find out a lot of info. on my own. A fantastic site for info:

http://www.felinecrf.com

The site above is the best of the best for info. There are also crf yahoo groups to join for support and additional advice.

My cat has been doing great on kidney diets, all natural canned food, phosphorus binders and fluids every other day. I give the fluids at home. I would have to say out of everything, the fluids have had the most positive effect. My cat is back to being playful and happy. I know he isn't cured but the goal here is to get as much quality of life as possible.

[Mygala]

Does anyone know why cats have such problems with their kidneys as they age? I've seen this even in big cats. In my time at the zoo, I've seen us lose 3 very old cats, two lions and a tiger. In the end, one succumbed to kidney disease, and the other two we had to put them down because of it.

I have an elderly cat here that is also in the early stages of renal failure and have on special diet.

Also, in order to get her and the other cats to drink more water I built them a tabletop recirculating fountain. The moving water really stimulates them to drink more. I can't believe how much they use it.