Chronic Kidney Disease (CKD) in Cats

Feline chronic kidney disease is a type of debilitating disease where the kidneys start to shut down and lose their function to get rid of certain toxins, absorb or get rid of certain electrolytes, and produce certain enzymes that are important the for daily functioning of a cat’s body.

A veterinarian may not know the initial cause of why a cat’s kidneys have started to lose their ability to work, but certain risk factors that can cause a cat to be predisposed to this disease include old age, chronic urinary tract infections, certain genetic breeds (Maine Coon, Abyssinian, Siamese, Russian Blue, and Burmese cats), toxins that can damage the kidneys (such as the ingestion of lilies or ethylene glycol), kidney stones or any stones that may obstruct the urinary tract, cancer within the kidneys or urinary tract, or certain immune mediated diseases that can attack the kidneys. Please note, however, that cats of any age or of any breed can be affected by chronic kidney disease.

Early on in this disease, some cats may not show signs of illness. This is in part due to the fact that either one kidney has started to take over the job that the other kidney has not been doing or for the fact that toxic metabolites that are normally excreted by the kidneys have not built up at high enough levels to cause a cat to feel sick. In the later stages of the disease process, however, a cat that has been experiencing chronic kidney disease for several months may show signs of illness that can include not eating, vomiting, weight loss, increased volumes of urination, drinking a lot more water than usual, appear lethargic or very weak (like in the picture illustrated), have foul breath, or have seizures. If your cat has been experiencing any of these clinical signs, it is extremely important that he or she gets checked out by a veterinarian for further assessment.

If a veterinarian thinks that a cat has chronic kidney disease, he or she will run blood work and will obtain a urine sample in order to provide incite as to the extent and/or cause of why of the kidneys have started to lose their functioning. The blood work may show elevations in certain kidney enzymes and electrolytes. This is due to the fact that as the kidneys lose their function, they also lose their ability to excrete these enzymes or electrolytes from the body and therefore, they start to build up in larger, toxic levels in the blood. The build-up of these enzymes and electrolytes can cause a cat to feel very sick. This is why once a diagnosis is made of chronic kidney disease; a veterinarian will typically recommend immediate treatment within the hospital in order to help the cat’s kidneys get rid of these toxic metabolites that are building up at high levels within the blood.

The mainstay treatment that is recommended by most veterinarians is to provide fluids through a catheter that is placed into a cat’s vein. This route at which these fluids are administered provide the best means of helping the cat’s kidneys to flush out the toxic metabolites in the blood as quickly as possible and it will provide fluids to the cat’s body that maybe dehydrated. A veterinarian may also elect to administer antibiotics that can help to treat any infectious causes within the urinary tract that may have been the initial cause of the disease. They may also elect to administer some medications that can help to prevent a cat from vomiting if the cat has been experiencing this clinical sign prior to presentation into the hospital. Cats with chronic kidney disease can also develop anemia or low red blood cell numbers as a result of the kidneys not producing a certain enzyme that is responsible for telling the bone marrow to make more red blood cells. A veterinarian can help to treat this anemia with either injections of this enzyme once a month or with blood transfusions in severe cases of anemia.

Although chronic kidney disease is a treatable disease, please be aware that it can take several days in the hospital in order to bring these toxic metabolites in the blood down into or close to normal blood levels. Therefore, a veterinarian will discuss with the owners the progress that a cat with chronic kidney disease makes on a daily basis while in the hospital. In addition, not every owner can afford several days in the hospital for the treatment of this disease and therefore, a veterinarian can work with the owner to discuss other options for treatment in order to help make their cat feel less sick and provide a better quality of life for as long as possible.

In general, the relative outcome for recovery from chronic kidney disease after treatment really all depends on how severely damaged the kidneys are and on the ability of the kidneys to continue to perform their job. This means that if a kidney is too severely damaged to the point where it cannot perform its job correctly, the less likely that a cat is to survive for a prolong period of time. However, if the disease process is caught early enough and if it can be appropriately managed in conjunction with the supervision of a veterinarian, many cats can live normal, healthy, happy lives for several years.

Chronic kidney disease is a debilitating disease that is not a fun disease to have for cats, because it can make them feel very ill. This is why it is important that cats get checked regularly during annual examinations and especially when they get of old age for any signs of this disease. Because the sooner that this disease process is caught, the easier it is for a veterinarian to help a cat feel better and to help to prevent future progression of this disease.

Jonathan MacStay, DVM