5 Things Vets Hate About Kidney Disease in Cats … And How That’s About to Change


Chronic kidney disease (CKD), or a slow decline in kidney function over time, is really common. In fact, it has been commonly accepted that 1 in 3 cats will develop some form of kidney disease in their lifetime. And a recent study has found that it is likely even more common, with 40% of cats less than 15 years of age impacted. If you are fortunate enough for your kitty to live past 15 years, then there is an 80% likelihood that he or she will have some kidney health concerns. So, it is not surprising that veterinarians speak about CKD frequently with cat parents. It’s a problem that often comes with a mixture of good news and bad news.

First, the most important piece of good news about CKD to is that many cats do well for years after diagnosis. The bad news about CKD is that classic veterinary medicine has limitations that can be frustrating when battling the condition. But another, brand new piece of good news is that at least some of that could be about to change. I’ll touch more on this in a little bit.

A new test is available to help detect kidney disease earlier,
ask your veterinarian about the new Laboratories, Inc. SDMA test.

Learn about
Laboratories, Inc. SDMA testing

But first, to understand why CKD is frustrating, let’s cover some of the reasons chronic kidney disease can be a headache today:

1) Chronic kidney disease can be stealthy until it’s fairly advanced
Kidney disease is easy to diagnose when it’s advanced, but it’s sometimes very hard to recognize in the early stages. Often it sneaks up on us veterinarians, even while we are looking for it. The reason is that cats don’t get visibly sick from CKD until their kidneys are very unhealthy (see the common signs of kidney disease here), so we rely on regular testing of blood and urine to screen for early indicators of kidney disease.

2) Early diagnosis of chronic kidney disease can be life-changing, but has been a challenge with available tests
One of the first things often noticed by cat parents whose cats have CKD is a change in their peeing or drinking habits. Kidney disease makes it harder for a cat’s body to conserve water and eliminate waste as efficiently, so you might notice that your cat is drinking more or peeing more. (Even to the point of “flooding” the litter because urine in cats with more advanced CKD is less concentrated.) So, to help see how a cat’s kidneys are doing, vets test the urine quality or appropriateness of urine concentration. This is an inexpensive and basic component of a complete urinalysis, but it often falls short: it tells us a lot of information, but only after about 2/3 of kidney function is lost. On that same urine test, your veterinarian will look for evidence that your kitty’s kidneys are leaking protein, which can be another indication of feline kidney disease, but often is a late finding.

The current blood tests for kidney disease are similarly problematic because they only become abnormal after about 3/4 of kidney function is lost. Both can be extremely important diagnostic tools, but I’d prefer to be earlier to the game – to be able to diagnose CKD before the disease has advanced this far.

Sometimes diseased kidneys change shape and become smaller which is something your veterinarian may feel when examining your cat, but these are usually later changes, as well.

3) Learning about chronic kidney disease that’s more advanced, after kitties are already clinically ill and dehydrated, can really discourage some cat parents
As I mentioned before, many cats can live with CKD for years. However, sometimes having such an advanced diagnosis can be overwhelming to a cat parent. The possibility of hospitalizing a sick kitty for a day or two to help with rehydration and to permit some testing to get their cat back on track (we hope) might make some cat owners shut down and decide not to try -- it just seems like too much bad news. I hate the fact that we sometimes don’t get the chance to try to help because we are figuring it out late in the game.

4) Functional kidney loss is usually permanent
Once a nephron, the functional unit of the kidney, is gone, it is gone for good. The kidney does have hundreds of thousands of them, for back up; and cats can feel great with only one kidney, provided it’s a healthy one, but as one nephron is lost to disease or injury, the other ones have to work harder. They can recover from injury, but the kidneys don’t get new nephrons so once a kidney problem is known, we need to save what function is left – another reason why we love being able to catch the disease as early as possible, is so we can search for any treatable or curable conditions causing the damage.

5) There are many different causes of kidney disease, some treatable, some not, so having time to find them is key
While it is true that many cats with CKD will have kidney disease that does not have a defined cause or treatment, we always want to look for the “good” diseases that may cause or complicate kidney disease, such as infection or obstruction. And, of course, we want to find the treatable diseases early. Prompt treatment of bacterial kidney infection, termed pyelonephritis, or relieving an upper urinary obstruction caused by kidney stones and fragments that lodge in the ureters, can help spare the kidneys’ remaining nephrons. Kidney stones and chronic pyelonephritis might not make cats feel bad consistently, or their signs can be subtle and attributed to other health problems that are already diagnosed. Or it may seem that Kitty is slowing down with age and starting to have a few bad days here and there. Certainly, if we don’t know that the kidneys are challenged, then we don’t know to look for (and can’t treat) these contributing causes, either.

So, in summary, a big reason we can sometimes hate CKD is we hate to be late:

  • Late to recognize
  • Late to diagnose
  • Late to treat
  • Late to manage optimally

These are all circumstances that can force veterinarians to focus on the bad news rather than the good news of keeping a cat healthy and with their families as long as possible.

But now for the good news for at least 1 in 3 cats: A simple new blood test, the Laboratories, Inc. SDMA screening, will be available this summer to help identify kidney disease on average 17 months earlier than was possible previously. Included as part of your cat’s regular blood screening during his checkup, this brand new marker can indicate a decline in kidney health at an average of 40% of kidney loss versus the 66%-75% loss from other tests. This can help veterinarians start looking for the good diseases earlier, when there’s possibly more to gain, and they can customize a plan to optimize your kitty’s kidney health. Now that certainly gives us – and our cats – something to purr about.

For more information about kidney disease in cats, your veterinarian is your best resource.

If you have any questions or concerns, you should always visit or call your veterinarian -- they are your best resource to ensure the health and well-being of your pets.

Resources:

  1. Lulich JP et al. Feline renal failure: questions, answers, questions. Compend Contin Educ Pract Vet. 1992;14(2):127–153
  2. J Feline Med Surg. 2014 Jun;16(6):465-72. doi: 10.1177/1098612X13511446. Epub 2013 Nov 11. Accessed June 24, 2015.

5 Things Vets Hate About Kidney Disease in Cats … And How That’s About to Change - pets

Cats are notoriously plagued by urinary problems. Kidney disease, chronic bladder inflammation, and urethral obstruction are common feline medical conditions, and many owners want to know how they can maintain their cat’s urinary health and keep these problems at bay. Whether your cat has a history of urinary trouble, or you hope to prevent disease development, use these five tips:

#1: Increase Your Cat’s Water Intake

A higher urine water content dilutes the toxins, minerals, and urinary irritants that can lead to problems. Concentrated urine is more likely to form crystals and urinary stones, and irritants can contribute to chronic bladder inflammation. Increasing your cat’s water intake is one of the most important steps toward keeping her urinary tract healthy. More water also means your cat will stay hydrated and urinate more frequently, which will flush out toxins and maintain kidney function.

Try incorporating these ideas into your cat’s daily routine to increase her water intake:

  • Fresh water — Cats love fresh water, and your cat will likely drink more if you clean and fill her water bowl daily.
  • Canned food — Canned diets contain more water than dry varieties, and feeding wet food is an easy way to incorporate more water into your cat’s daily diet.
  • Flavored water — Adding tuna juice or sodium-free chicken broth can tempt your cat to spend more time at her water bowl.
  • Fountains — Most cats are drawn to running water, and a battery-operated fountain may be more interesting than your cat’s regular water bowl.

#2: Reevaluate Your Cat’s Diet

If your cat has had previous urinary health problems, she may benefit from one of the many available urinary diets, which contain specific amounts of minerals, protein, and bladder protectants to help maintain a healthy urinary tract. Urinary diets have restricted amounts of minerals, such as magnesium, phosphorus, and calcium, which can contribute to urinary crystal and stone formation. They are also formulated to make your cat’s urine slightly acidic, which discourages crystal formation. Some diets contain glycosaminoglycans, which naturally protects the bladder lining.

Before changing your cat’s diet, consult your family veterinarian. Many urinary diets are available, and she can help you choose one that is appropriate for your cat’s needs. She can also counsel you about gradually changing your cat to a new food so she will accept it. Cats are creatures of habit and may not do well with a sudden switch.

#3: Reduce Your Cat’s Environmental Stress

Cats are sensitive to environmental stressors, which have been linked to inappropriate elimination and feline lower urinary tract disease (FLUTD), a condition that causes chronic bladder inflammation. Affected cats suffer from bladder pain and are at risk of developing a life-threatening urethral obstruction. Environmental changes, such as a new roommate or baby, a new pet, or a different litter brand, can trigger internalized stress that manifests as urinary problems.

Eliminating simple stressors and providing an escape when your cat is fearful or anxious can keep her urinary tract healthy, so try these stress-reducing tactics:

  • Scoop litter daily — Some cats hate a soiled litter box and refuse to use dirty litter, so keep your cat’s box as clean as possible.
  • Don’t switch litter brands — Cats can be picky about their litter, and a sudden brand change may prompt her to use your floor instead of the new, flower-scented brand in her box.
  • Provide a refuge — Your cat will appreciate her own space, particularly if your home contains rowdy children or other pets, or she is timid and enjoys time alone. Choose a quiet, low-traffic area of your home and include all your cat’s necessities—food and water bowls, litter, a scratching post, a perch, and toys—so she can get away and de-stress when she feels the need.
  • Add feline pheromones — Feliway® products contain feline pheromones that reduce stress and encourage calmness in cats. Add diffusers to home areas where your cat spends most of her time, and spray her blankets and bedding. Houseguests can also be sprayed to make new introductions less stressful.

#4: Provide Environmental Enrichment for Your Cat

An indoor life is safest for your cat, but a bored cat more likely will develop stress-related urinary conditions. Cats are natural predators, and your cat will enjoy toys and interactions that bring out her inner lioness, such as:

  • Perches — Cats love to safely watch household activity from above, and an elevated perch, such as a cat tree, can provide her hours of entertainment. She may also love a window perch that will let her observe the birds and squirrels in your backyard.
  • Videos — Videos of mice scurrying or birds flying can keep a bored cat entertained while you are at work, or busy with household chores.
  • Food puzzles — In the wild, cats hunt for their food. Making your cat work for her dinner will appeal to her primitive side, and the added activity will help her stay fit. You can purchase food puzzles for hiding food, or you can simply hide pieces of food around your home and let your cat’s nose lead her on a hunt.
  • Moving toys — Your cat may love to chase battery-operated toy mice or insects zooming around the floor. A feather on a string can keep her moving and entertained, as well.

#5: Schedule Regular Veterinary Appointments for Your Cat

Cats need regular veterinary care, and your family veterinarian can detect signs of underlying urinary conditions during your cat’s annual wellness visit. Cats over 8 years of age should see a veterinarian more frequently to maintain good health. A urinalysis can be performed at each visit to analyze your cat’s urine for signs of inflammation, infection, and kidney dysfunction. Blood work will evaluate your cat’s kidney function, and can detect kidney failure, a leading cause of death in cats, in its early stages when treatment can be helpful.

If you have questions about your cat’s urinary health, speak with your family veterinarian. If your cat has been diagnosed with a urinary condition that requires specialty care, contact us to speak with our internal medicine department.


Best Food To Prevent Kidney Disease In The Future

Gldustwm

TCS Member
Thread starter

Hi,
I am new here. I have had one cat who succumbed to kidney disease at age 8 and now my 12 year old kitty was just diagnosed with renal failure. It really is heartbreaking and makes me wonder what I could have done to prevent this. The conclusion I have made is it's the food I feed them (Science Diet Dry).

I now have one healthy 5 year old kitty. I'm asking what is the best possible food to feed him combination of wet and dry that I can feed him to hopefully prevent him from getting this horrible disease. Yes, I am aware that wet food is healthier for cats, however, we do travel quite a bit and sometimes can't have someone to check on the cats every day so they must be able to eat some dry food. Also, my current kitty is very large and is overweight. I would like to put him on a diet. Thanks for any help!

Cheesycats

TCS Member

Furballsmom

Cat Fan especially Black Cats

Hi!
You've gotten good advice! Lots of play, and canned food when you're home will do a lot regarding the weight issue. Also, a pet water fountain and filtered water can help, along with even adding a little water to the wet food if your cat will still eat it that way.

Just be sure to weigh your kitty, and do not allow the weight loss to happen too fast.

You want to be able to feel a thin layer over the ribs.
Here's an adult cat body chart, and also some self-entertaining toys, etc that might help as well
https://www.petmd.com/sites/default/files/nestle_purina_cat_body_condition_chart_crop.jpg

1 bruce 1

TCS Member

Gldustwm

TCS Member
Thread starter

Thanks for all your replies. Does anyone know the Phosphorus levels listed in some of these foods that were suggested? They really only list the protein and carb content and whether protein is the first ingredient, lack of fillers etc. Should the phoshporus content not be something I should be concerned about right now anyway?

Also, as being more of an "expert" than me - what soft/canned food do YOU feed your cat? That would help me choose. Thanks

Name9335

TCS Member

Furballsmom

Cat Fan especially Black Cats

Hi!
Did you have a chance to see this regarding phosphorus?
It is something to be aware of
http://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

A couple of foods my big kitty gets are Merrick rabbit and tiki cat (it has menadione but he doesn't leave me a lot of choices )

Lisahe

TCS Member

Hi!
Did you have a chance to see this regarding phosphorus?
It is something to be aware of
http://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

A couple of foods my big kitty gets are Merrick rabbit and tiki cat (it has menadione but he doesn't leave me a lot of choices )

That chart is a great resource for checking phosphorus. Another good resource is this chart: Tanya's Comprehensive Guide to Feline Chronic Kidney Disease- Canned Food Data USA

I've asked two cat vets about phosphorus levels for relatively young cats and have been told not to worry about it. Cats need phosphorus and, particularly if the cat is eating wet food, there shouldn't be concerns. Even so, though, I don't like to feed a lot of foods with higher phosphorus. You'll see on the chart that some brands of food, like Weruva, tend to be lower in phosphorus than foods like, say, Fancy Feast. We feed a big variety of all wet foods, which is good for lots of things, including weight control! Among the canned brands: Weruva, Fancy Feast, Nutro Natural Choice, Wellness Core, Feline Natural, and Koha. The cats also eat a lot of homemade and raw food.

Our previous cat was a kidney cat so I understand your concern! I hope you're able to get your kidney cat's condition under control -- if it's early stage, sometimes a commercial diet of wet foods with lower phosphorus levels can help. Good luck.


RenalTech: New Diagnostic Tool Can Predict CKD in Cats Two Years Before Onset

Mars Inc. is a $35 billion empire that makes some of the world’s most popular candies, including Snickers, M&Ms, Milky Way, and Twix. It is also in the pet-health and pet-care business. And for the past several years, scientists at Mars Petcare have been working on developing predictive diagnostic tools using its vast repository of anonymized pet medical records and machine learning. RenalTech, which can predict chronic kidney disease (CKD) in cats 2 years prior to the patient showing any signs or symptoms of the disease, is the first one to be released. RenalTech was created through a collaboration led by the Mars Petcare family of companies, including the Waltham Centre for Pet Nutrition, Antech Diagnostics, Royal Canin, VCA Animal Hospital, Banfield Pet Hospitals, and the Mars Advanced Research Institute, along with several outside partners. Mars says RenalTech has been shown to be more than 95% accurate. Antech released the tool in September free of charge to its customers.

CKD is the number one cause of death for cats over the age of 5 and affects 30% to 40% of all cats over the age of 10. The associated nephron damage is progressive and irreversible, even though some cats with CKD have stable serum creatinine concentrations for months and, in some cases, years. Feline renal disease is usually diagnosed by looking at the level of two biochemical byproducts in the bloodstream, blood urea nitrogen (BUN) and creatinine, in conjunction with the urine specific gravity (USpG). Tests to measure the blood levels of other substances, such as potassium, phosphorus, and calcium, as well as the cat’s red and white blood cell counts, help to determine the extent of failure and the best course of treatment. A cat’s survival often depends on early diagnosis of CKD.

A New Approach

“Traditionally, the cat is diagnosed when the owner notices their cat isn’t doing well and takes it to the vet,” says Kay O’Donnell, vice president of Waltham Centre for Pet Nutrition, a Mars Petcare science institute located in the UK. “The vet diagnoses CKD through blood and urine tests. The gold standard for diagnosis is GFR, which is glomerular filtration rate. By the time [CKD] has become noticeable, the cat is in trouble. Between 40% and 70% of kidney function can be lost. At that point, it is a place of management of the disease, making modifications to the diet to try and increase quality of life.

“The advantage to RenalTech is that you can pick it up much earlier,” says O’Donnell. “It gives us a chance to change the outcome.”

How It Was Developed

A research team evaluated 20 years of data from 150,000 cats treated at Banfield Pet Hospitals and looked at 35 possible parameters, such as age, sex, breed, signalment, and various lab values. In the end, the researchers narrowed it down to 6 laboratory parameters that appeared to be the most important for identifying cats at high risk of CKD development—BUN, creatinine, USpG, urine protein, urine pH, and white blood cell count—plus the cat’s age to predict whether a cat will develop CKD within the next 2 years. Essentially, researchers used artificial intelligence to develop a predictive modeling tool that indicates when CKD is in a cat’s future. “We are very fortunate that we can access this data,” says O’Donnell. “The data originally comes from 150,000 cats and 750,000 patient visits from those cats. Essentially, you’re looking at all the data you have and making associations. You’re looking at what happened with the cats that developed CKD and those that didn’t.”

How It Works

RenalTech measures the 6 lab values at 2 different time points and compares those values with each other (the tests should be run about 3 to 6 months apart). After Antech runs a complete blood cell count, chemistry panel, and urinalysis, RenalTech uses that information to determine whether a cat is likely to develop CKD in the future.

“By identifying those cats at very high risk of disease development, this will allow vets and owners to intervene early,” says O’Donnell. “[RenalTech] will allow us to take a more proactive approach. Treatment of disease is typically reactive. The pet gets sick, you take them to the vet, and the vet treats it. The approach is changing.”

“There is no downside to intervening early for cats identified as high risk,” says O’Donnell. “So far, the feedback [in pilot cases] has been very good.”

As additional patient information is added to the database, researchers should gain a better understanding of CKD and how to treat it in cats.

What’s Next?

“The key is having the data and being able to connect the data and integrate that data,” says O’Donnell. “What can we understand about early disease identification? My prediction is that we will see more tools developed that will assess the risk of disease development. We will be able to pick up diseases much earlier and then intervene earlier.”

As for applications for specific diseases, O’Donnell says there are a number of opportunities. “Diabetes is another area [where this type of tool could predict the development of diabetes] in cats and dogs,” she says. “It has a major impact on quality of life. It’s difficult to manage. Can we intervene earlier so the diabetic stage doesn’t ever develop?”

O’Donnell says that predicting disease isn’t the only application for a tool like RenalTech. “We should also start to be able to identify when things are going well, and the pet is in a healthy stage,” she says. “How can we monitor that over time to keep the pet in a healthy stage? We will see a world in the future where it is a standard part of wellness plans. We are on the edge of something quite remarkable that will increase the quality of life for the pets that we serve.”


Simply stated, kidney disease (also called "renal failure") is the loss of function of the kidneys. It can be chronic (slow and long-term) or acute (sudden). The kidneys filter blood and create urine, so a kidney malfunction can result in a number of medical issues. According to the Cornell Feline Health Center at Cornell University College of Veterinary Medicine, cats with kidney disease "may experience a buildup of the waste products and other compounds in the bloodstream that are normally removed or regulated by the kidneys." This buildup of toxins in turn can create other medical problems, including high blood pressure or anemia (when combined with other factors).

Stage 1 is the first level of chronic kidney disease in cats or the earliest that the disease can be diagnosed. Researchers cannot say for sure why cats develop it, but other medical issues can lead to kidney disease, such as an infection, a virus, gum disease, and dehydration. Some cats can inherit the disease from their parents. Typically, older cats develop kidney disease, but younger cats can be affected, too.


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