Management of CKD in Cats

Feline CKD: Early Detection, Management and Treatment

CHRONIC KIDNEY DISEASE (CKD): AN OVERVIEW

Chronic kidney disease (CKD), or a slow and progressive decline in kidney function over time, is common in older cats. The vital functions of the kidneys include:

• Filtering the blood and removing waste products
• Conserving water in the body
• Producing urine
• Regulating the levels of certain essential minerals, such as potassium and sodium
• Initiating the production of red blood cells in the bone marrow

A variety of health complications arise when the kidneys fail to function properly. There is no cure for kidney failure and damage is irreversible. However, treatment and management can improve the quality and prolong the life of a cat.

There is evidence suggesting that the earlier CKD is diagnosed and treatment is initiated, the better the outcome with respect to quality of life and slowing the progression of the disease.

SIGNS OF CKD DEVELOP ONLY IN LATER STAGES OF CKD

Stage 1 CKD

Specific blood tests are administered to detect kidney disease. When about 40% of kidney function has been damaged, the SDMA (symmetric dimethylarginine – an amino acid produced in the body when protein is broken down and then excreted through the kidneys) blood test will be higher than normal. This is stage 1 of CKD and is ideally when medication is begun to slow the deterioration of the kidneys and lengthen lifespan. However, often blood tests are not administered at this stage and kidney failure is not diagnosed until a later stage.

Stage 2 CKD

When about 65% of the kidneys’ tissues are damaged in Stage 2 CKD, signs of kidney failure appear. At this stage the kidneys can no longer conserve water and electrolytes (sodium, potassium, chloride etc.) to maintain the correct levels in the blood. The cat will usually produce larger quantities of urine and possibly consume more water.

Stage 3 CKD

At Stage 3 CKD about 75% of kidney function is gone. At this point the kidneys can no longer remove waste materials from the body properly, and the levels of these toxins start to rise in the bloodstream. More obvious symptoms, especially gradual weight loss, are noticeable. 

Stage 4 CKD

Stage 4 CKD is severe to end stage kidney failure. At this stage prevention of progression is less possible and less relevant. Treatment is mostly aimed at managing symptoms and improving quality of life.

MANAGEMENT RECOMMENDATIONS TO SLOW PROGRESSION OF CKD

Find out your cat’s specific needs. Several factors will determine the needs of a cat with CKD. They include:

• The cause of your cat’s CKD: Are there underlying factors or is it unknown? If present, underlying conditions should be addressed and treated along with clinical signs.
• Test results: Have certain vitamin, mineral or hormone imbalances been discovered? These need to be addressed and monitored moving forward.
• Health problems: Does your cat have an infection or inflammation? It’s a common complication so the possibility needs to be ruled out or confirmed and treated.

Maintain Adequate Hydration

Getting dehydrated is very dangerous in general and it’s much worse for cats with CKD. Therefore, keep asking yourself the question: Is my cat drinking enough water? If not, your veterinarian should be able to provide advice on how you can increase intake.

Support Adequate Nutrition

These questions provide some nutritional guidelines:

• Since being diagnosed, has your cat’s diet been adapted? It’s usually necessary.
• If yes, is your cat eating enough of his or her new food? It’s essential.
• Do you need help getting your cat to eat enough? Seek help.

Weight loss should always be a cause for concern and even more so in cats with CKD.

Monitor and Consult Your Veterinarian Regularly

Report symptoms, as you notice them, to your veterinarian. After a check-up and perhaps some tests, your veterinarian will likely prescribe medication to help your cat feel better. Things you may notice include vomiting, diarrhea and lethargy.

Commit to the Treatment Plan

To help ensure the best outcome for the reminder of your cat’s life (which may well be a couple of years), it’s important to remain consistent with regards to treatment. That means don’t skip check-ups and don’t forget to give your cat’s medication as instructed.

MANAGEMENT AND TREATMENT

• Early detection and control are the keys to maximizing the lifespan of a cat with kidney disease.
• Dietary management may slow the progression of CKD. You and your veterinarian can determine if your cat needs a dietary change and which diet to use.
• Medications are available to treat problems, such as low potassium levels and poor appetite.
• If your cat needs improved hydration, your veterinarian can teach you how to give supplemental fluids underneath the skin of your cat. This  can help extend the duration and quality of life.
• Treating CKD is a partnership between you and your veterinarian.
• Regular evaluations help refine treatments and identify new problems early when they are easier to resolve.
• Although CKD cannot be cured, many cats with CKD live with good quality of life for an extended period of time, often years.

REMAIN POSITIVE

Finding out your cat has CKD is usually devastating, but there’s hope yet. Armed with a positive attitude and a customized treatment plan provided by your veterinarian, it’s often possible to enjoy many more happy years together.