Port St. Lucie, Florida - Kidney failure is a common disease in cats. Fortunately, it is often very manageable once diagnosed. A simple diet change, and sometimes medication, may able to manage your cat's kidney disease for years.
In this article we'll talk about common signs of kidney disease in cats, tests your veterinarian may perform to make a diagnosis of kidney disease, managing kidney disease in your cat, and things to watch for to help know when it might be time to put your cat to sleep.
Common Signs of Kidney Disease in Cats
The first signs of kidney disease in cats may simply be that your cat is drinking or urinating more than normal. As the disease progresses, you may notice weight loss, vomiting, a drop in appetite, or lethargy.
It is important that you seek veterinary care when you notice any of these signs, as early diagnosis and treatment gives your cat the best of chance of living a long life with kidney disease.
Common signs of kidney disease in cats:
Drinking more than normal
Urinating (peeing) more than normal
Losing weight
Decreased appetite
Vomiting
Lethargy (less active)
These common signs of kidney disease can also overlap with other diseases, including diabetes, cancer, hyperthyroidism, gastrointestinal disease and others. This overlap in disease processes is another reason it's important to seek early veterinary care when something seems off with your pet.
Testing for Kidney Disease in Cats
If your cat is showing any of the above signs of a health issue, your veterinarian will likely perform the following tests to make a diagnosis.
Physical examination: A physical examination allows your veterinarian to assess your pet's weight and body condition, listen to their heart for a murmur or arrhythmia, feel for thyroid enlargement, feel for small/firm kidneys, feel for abnormal lumps in their abdomen, and assess their mouth for ulcers. The information obtained from your cat's physical examination can help your veterinarian to make recommendations for tests to confirm the cause of your cat's illness.
Bloodwork: A complete blood count, blood chemistry, electrolyte level and thyroid (T4) level will help your veterinarian understand more about your cat's health. Common bloodwork changes in a cat with kidney disease can include:
A mild or moderate decrease in red blood cell count.
Increased creatinine, blood urea nitrogen (BUN) and phosphorous levels.
Decreased or increased potassium level.
Something that can be quite frustrating for owners and veterinarians is that bloodwork values will be normal until your cat has lost 70% of their kidney function. So once we see increases in blood kidney values, your cat has somewhere less than 30% of their kidney function left.
A relatively newer test called an SDMA test can help identify cats with early kidney dysfunction before we start to see increases in creatinine and BUN. It is important that this value be interpreted in light of your cat's hydration status, as a dehydrated pet will show an increased SDMA level and may lead to an incorrect diagnosis of early kidney disease.
Urinalysis: A urinalysis will allow your veterinarian to confirm a suspicion of kidney disease. If bloodwork shows signs of kidney disease, a urinalysis is critical to confirm that the cause of elevated kidney values is due to kidney disease, and not due to dehydration or some other cause. Specifically, your veterinarian will be looking at how concentrated your cat's urine is. This is done by looking at the urine specific gravity (USG) of your cat's urine. A cat with good kidney function will have a USG of 1.045 or greater. A USG between 1.008-1.012 means your cat's kidneys have no concentrating ability left (kidneys have failed). A USG between 1.012 to 1.045 means your cat's kidneys are not working well, but still have some function left.
Blood Pressure: Once a diagnosis of kidney disease is made in your cat, it is important that your cat's blood pressure be checked. The kidneys play an important role in your cat's blood pressure management, and even very early kidney disease can result in your cat developing high blood pressure. If your cat has high blood pressure, your veterinarian will likely start your cat on a blood pressure medication called amlodipine. If high blood pressure is not managed, it can lead to more rapid damage of your cat's kidneys, damage to your cat's heart, brain, and even the eyes.
A common side-effect of high blood pressure in the cat is sudden blindness. If your cat has kidney disease and you suddenly notice your cat can't see, or your cat's eyes look dilated, take them to the veterinarian immediately (this is an emergency) as rapid treatment can often allow your cat's vision to return.
Urine Protein:Creatinine Ratio: If your cat has been diagnosed with kidney disease, your veterinarian will perform a test called a urine protein:creatinine ratio (UPC). This let's your veterinarian know if there is protein leaking into the urine from the kidneys. If an elevated UPC level is detected, your veterinarian will likely start your cat on a medication called telmisartan to help reduce the amount of protein leaking through the kidneys. A decrease in protein leakage through the kidneys will help slow the progression of disease.
Managing Kidney Disease in Your Cat
Once your cat has been diagnosed with kidney disease, your veterinarian will work with you to start them on treatments to help managed their condition. And while kidney disease can't be reversed, it's progression can be slowed. Your veterinarian will help you to make changes in the care of your cat to help them feel as good as possible for as long as possible.
Common Treatments for Kidney Disease in Cats
Diet: A prescription diet designed specifically for kidney disease in the cat is the number one way to help keep your cat feeling good for as long as possible. These diets are specifically designed to help decrease the number of toxins that your cat's kidneys have to excrete, which in turn keeps the toxin levels lower in your cat's bloodstream. Strict compliance with a prescription kidney diet will help keep your cat feeling better, longer.
Common prescription kidney diets used in the cat include: Hill's Kidney Care K/D Feline, Royal Canin Feline Renal Support, and Purina NF Feline. These diets come in wet and dry versions. If your cat will eat wet food, it is preferred over dry as wet food has a high water content, which helps keep your cat better hydrated and flush more toxins from their body.
Fatty Acid Supplement: Newer prescription kidney diets are supplemented with a fatty acid, but if the diet your cat is using isn't, it is important to discuss having your veterinarian start them on a quality EPA/DHA fatty acid supplement. There is data that shows cat's with kidney disease who take a fatty acid supplement live longer than those that don't.
Blood Pressure Medication: If your cat's kidney disease has resulted in high blood pressure, your veterinarian will start your cat on a blood pressure medication. The most common blood pressure medication used in the cat is called amlodipine. When first started on blood pressure medication, your veterinarian will likely check your cat's blood pressure every couple of weeks or so. Once your veterinarian is happy with your cat's blood pressure readings (goal in the clinic is that the systolic blood pressure is <160mmHg), then blood pressure checks can be less frequent (every 3 months or so is probably adequate). Keep in mind, some cats' temperaments can make blood pressure checks very difficult, so while there are things that might be in your cat's best interest, your cat's personal temperament may not allow it to be done.
Telmisartan Medication: If your cat has an elevated urine protein:creatinine level, your veterinarian will likely start them on a medication called telmisartan to help lower this level. The rationale being that less protein leakage through the kidneys will help slow the rate of disease by reducing inflammation in the kidneys (protein leakage through the kidneys causes inflammation.)
Potassium Supplement: Some cats with kidney disease have a low potassium level. If this is the case in your cat, your veterinarian will start them on a daily potassium supplement. This is usually a gel or could be a powder. One common brand used is called Renal K+, but there are others available. Your veterinarian will prescribe the one they prefer and advise you of the amount and frequency to give it.
Sub-Cutaneous Fluids: As your cat's kidney disease progresses, diet alone may not keep the toxin levels in their blood stream low enough. As the toxin levels rise, your cat will feel nauseated, their brain will feel fuzzy (like they are drunk), and they won't want to eat. When this starts to happen, your veterinarian may prescribe special fluids for you to administer under your cat's skin. Fluids administered under the skin will absorb into your cat's body and help flush the toxins from their blood stream. Your veterinarian will show you how to do this and will dispense the fluids they want you to use. They will provide you with instructions for how much and how often the fluids are to be given.
*Please note, do not use tap water for this - your veterinarian will dispense an IV bag of a sterile, balanced fluid solution to use as well as sterile IV tubing and needles.
Nausea Medication: As your cat's kidney disease progresses, the toxin levels in your cat's bloodstream will increase, which will in turn cause your cat to feel nauseated. Your veterinarian may prescribe nausea medication (e.g. Cerenia (maropitant), Zofran (ondansetron), or other) to help control vomiting and nausea in your cat. Controlling nausea will help your cat to eat better.
Appetite Stimulants: If your cat isn't eating well, your veterinarian may start your cat on an appetite stimulant. There are two common appetite stimulants used in the cat. The most common is mirtazapine, which comes as a pill that you give orally, or in a topical formulation called Mirataz, that you apply to the inside of the ear flap. Another appetite stimulant is called Entyce, which is a liquid you give orally. If one of these doesn't work, talk to your veterinarian about trying the other.
Managing Anemia (low red blood cell count): Many cats with chronic kidney disease have a low red blood cell count. Red blood cells are what carry oxygen through our body to our tissues. Cats with a low red blood cell count will feel weak and tired. If your cat has a low red blood cell count your veterinarian may prescribe a medication called Varenzin-CA1 which is a newer oral medication that stimulates the cat's body to produce erythropoietin, which is a hormone that helps regulate red blood cell production. Another medication your veterinarian may consider is darbepoetin.
When is it Time to Put my Cat with Kidney Disease to Sleep?
Many cat's with kidney disease can live for years after being diagnosed. Lifestyle changes, diet modification, and medication can help your cat with kidney disease to have a very good quality of life for a long time. At some point however, these interventions will no longer be enough to keep your cat feeling well.
When the changes you have made and treatments you are providing to your cat with kidney disease are no longer working, it may be time to consider putting your cat to sleep.
Things you may notice that could indicate it is time:
Vomiting
Not eating well
Nauseated (licking lips, drooling, turning away from food)
Lethargic and weak
Hiding or finding your cat in places they don't usually go
Spending more time lying outside by themselves
Foul smell from their mouth (can indicate ulcers are present in their mouth from the toxins in their body)
Hard feces (typically due to dehydration)
Weight loss (they look thin or feel bony)
They seem drunk or unsteady on their feet
They are breathing faster than normal
They stare off or seem less responsive to things
If your cat is showing any of the above signs, please have them seen by a veterinarian right away as these are signs of suffering. If changes in treatment have been made and you are still seeing these things, then it may be time to consider euthanasia (putting your cat to sleep) so that they don't suffer unnecessarily. You can discuss your cat's quality of life and questions you have about euthanasia with your veterinarian. We are also available to talk to you about how your cat is doing at any time.
When you are ready to put your cat to sleep, you can do this at your veterinarian's office, or a veterinarian can come to your home. Home euthanasia allows your cat to pass peacefully in their own environment where they are most comfortable and where you can grieve their loss without feeling rushed and without the distractions of a busy clinic. If you would like to discuss putting your cat to sleep at home, please contact us for more information.
Bridges Veterinary Care | In Home Pet Euthanasia
Bridges Veterinary Care and Dr. JP Shepherd are dedicated to providing compassionate, peaceful in home euthanasia for dogs, cats and other beloved pets of families in Martin County, St. Lucie County, southern Indian River County, northern Palm Beach County, and parts of Okeechobee County. If your family is in need of in-home euthanasia services for a beloved pet, we would be honored to assist you. Please call or text us at 772-272-1800 for more information or to schedule an appointment. Available appointment days for the upcoming week can be found here. Same day appointments are often available.
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