Overview
Chronic kidney disease, or CKD, is one of the most prevalent diseases in older cats, affecting up to 40% of cats over the age of 10 and 80% of cats over the age of 15.
The only known risk factor for the development of CKD in cats is age, so it is very important for all senior cats to be regularly monitored for this disease.
Clinical Signs
In the initial stages of kidney failure, the kidneys cope with their inability to efficiently remove waste products by excreting them at a lower concentration over a larger volume (in other words, by producing a larger amount of more dilute urine).
Cats will often drink more to compensate for this increased rate of body water loss. This is known as compensated renal failure. After approximately two-thirds of the kidney tissues have failed, there is a rapid rise in waste products in the bloodstream and an apparent sudden onset of severe disease. This makes them feel ill and appear lethargic, dehydrated, start vomiting or have diarrhea, appear unkempt, have bad breath and lose weight.
Diagnosis
To evaluate kidney function, veterinarians will most often turn to blood tests and urine analysis (urinalysis) to evaluate the concentrations of waste products and other components that healthy kidneys normally filter or regulate. Other studies that can be useful in evaluating a cat with suspected CKD include imaging studies such as abdominal ultrasound, radiographs (X-rays), and, in some cases, microscopic evaluation of biopsy samples. Approximately 60% of cats with CKD will also develop hypertension, so measurement of a cat’s blood pressure is an important part of the medical evaluation for this disease.
Treatment
CKD is a progressive disease with no definitive cure, so the goal of treatment is to slow its progression and maintain a good quality of life for the cat. Treatment involves
- Nutrition
- Hydration
- Management of complications and sequelae
Prognosis
Prognosis for cats with CKD is quite variable and can depend significantly on their response to treatment and the stage of disease at the time of diagnosis. There is evidence suggesting that the earlier CKD is diagnosed and treatment initiated, the better the outcome with respect to quality of life and survival.
