The Real Deal: Managing Kidney Disease

Chronic renal failure, if caught early, can be managed through careful attention to a cat's lifestyle.

Chronic renal (kidney) failure (CRF) is a common illness in cats. With the exception of a kidney transplant, it is currently impossible to improve kidney function in cats with CRF. However, several things can be done to slow the progression of the disorder, and a new test has become available with the potential to detect renal damage earlier than ever.

The kidneys filter toxins from the bloodstream, creating urine in the process. Often, and for no apparent reason, kidney function will gradually decline as cats age.  Eventually, the kidneys reach a point where they can no longer maintain their normal function, and toxins accumulate in the bloodstream. Cats then show a variety of clinical signs, including excessive urination and thirst, poor appetite, weight loss and occasional vomiting. 

Diagnosing kidney failure is relatively straightforward, and the prognosis for cats with renal failure depends on many factors. The degree of elevation of the toxins in the bloodstream is important, however, it doesn’t tell the entire story. There have been cats with frighteningly high toxin levels that show few clinical signs. This indicates that the deterioration of kidney function has occurred slowly, over many months, giving the body time to adapt. In general, however, the more elevated the toxin levels, the more guarded the prognosis.

Mitchell Crystal, DVM, chief of Medicine at North Florida Veterinary Specialists in Jacksonville, Fla., treats many cats with renal failure at his specialty practice. While chronic renal failure is a progressive and eventually fatal disease, with early detection and appropriate monitoring and management, many cats can live a good quality life for several years, Crystal said.

Veterinary Care
Treatment for CRF can run the gamut, from a simple dietary change to a hospital stay of several days, depending on the severity and how early the disease is detected. For hospitalized cats, fluid therapy is an important part of the treatment.

The ability to establish and maintain normal hydration is crucial to CRF management, Crystal said. If hydration is compromised, then fluid therapy is needed. For moderate to severe dehydration, hospitalization and intravenous fluids are necessary.  For mild to moderate dehydration, subcutaneous fluids can be given at home intermittently or as often as every day.

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