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A disease that frequently occurs in senior and geriatric cats is kidney (renal) disease. The most common form is called chronic renal insufficiency (which progresses to renal failure). This syndrome is a result of a cat’s kidneys becoming less and less effective. The disease typically starts once a cat is over the age of 8 years, but younger cats can become affected. The kidneys' primary function is to filter waste products out of the body and into the urine. These waste products are produced on a daily basis through normal eating and activity. The kidneys also play a role in regulating blood pressure and producing red blood cells. The result of kidney disease is that the kidneys become less able to filter natural waste products and toxins out of the bloodstream. Additionally, blood pressure may become unregulated and red blood cell production may decrease.
Symptoms of kidney disease can include increased drinking, increased urination, decreased appetite, failure to groom, weight loss, and vomiting. Some cats show absolutely NO signs of a problem (or signs go unnoticed as they are slowly progressive) until disease is severe. Diagnosis of kidney disease is often made by blood tests. There are two blood values known as BUN (blood urea nitrogen) and Creatinine which are often very important in the diagnosis, but other blood tests also help in making a diagnosis. See our blood work page for further information. Chronic renal disease can be further confirmed with a concurrent urine sample to determine the concentration level of the urine (urine specific gravity). Because urine concentrating ability decreases before the ability to clear blood waste products decreases, a urinalysis AND blood work at the same time should be performed to pick up early disease in the urine prior to changes in the blood. Please see the urinalysis page for further information.
Different cats live different lengths of time with kidney disease. This can vary from 1 day to several years, depending on the severity at the time of diagnosis. Early diagnosis of the disease can often help slow its progression and help provide good quality of life for whatever time is left. There are many steps that can be taken to help slow the disease. One of the foundations of treatment is providing the pet with a low protein, low phosphorus diet. Excess protein and phosphorus in diets can overwork the kidneys and cause further damage. There are a few prescription diets available that a veterinarian can recommend for treatment of kidney disease. Also, drinking water helps flush the kidneys and helps keep them working. Encouraging water intake by providing fresh clean water (or a pet water fountain) at all times is often helpful. One of the best ways to improve hydration and increase liquid intake is feeding canned food. Additionally, some cats will eat dry food that has soaked in warm water. Adding low-sodium chicken broth or tuna or clam juice to food or water can help. Some kitties prefer to drink out of a shallow bowl or even a human drinking cup. Some have water preferences in terms of filtered vs. tap or bottled; cold vs. room-temperature; with or without ice cubes; in non-reflective surfaces, etc and you have to experiment to find what will encourage your cat to drink more.
As kidney disease progresses, the cat may have a diminished appetite due to toxins building up in the bloodstream, causing nausea. They may also become lethargic because anemia (lack of red blood cells leading to decreased supply of oxygen in circulation) and/or hypertension (high blood pressure) can develop. There are methods to treat these problems as they arise. Frequent contact with your veterinarian is recommended as symptoms develop. Regular checkups every 2 to 3 months are helpful to assure the symptoms are controlled as much as possible. Even though kidney disease is progressive and there is no specific cure, a good relationship between an owner, the veterinarian, and the pet can provide the cat with the best opportunity for a good quality of life and keep the disease under control as long as possible. There are many treatments and medications to slow the progression of the syndrome as well as treat and prevent symptoms that decrease quality of life.
The kidneys play a role in blood pressure regulation, and cats with chronic kidney disease frequently develop elevated blood pressure. As in people, high blood pressure can affect organs (without causing symptoms at first) and can result in secondary problems like blindness. Since secondary problems can develop, it is wise to check blood pressure as well as lab work in senior and geriatric cats (see blood work page, senior wellness page, and blood pressure measurement page). Because organ problems can occur without overt symptoms, severe changes can occur inside the body that are not visible outside until they cause a noticeable problem.
If your cat has been diagnosed with kidney disease, his/her blood pressure should be measured. It is measured just like on a human but using a little bitty kitty cuff that goes around the tail or foot. We may need to shave just a little bit of fur for the procedure, and it only takes a few minutes as long as the kitty is cooperative. The blood pressure should be measured prior to exam, taking lab samples, and other stressful events. It is best for the owner to be present to help calm the cat and decrease "white coat syndrome."
For a more complete description and additional pictures about blood pressure monitoring, please visit our blood pressure measurement page.
For more information on chronic kidney disease, visit some of the links on our Links Page. Here are a few of them:
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