Chronic Kidney Disease in Cats, Part 2: After you Receive the Diagnosis

Dr. Laci Schaible

As we learned in part one of our spotlight on chronic kidney disease in cats, when many cats are diagnosed, the majority of their kidneys have already been destroyed. This causes a rapid rise in waste products in the bloodstream and an apparent sudden onset of severe disease, making the patient appear acutely ill.

Determining the Extent of the Progression

While you may be tempted to jump in to treatment after lab work indicates that your cat suffers from chronic kidney disease, there are a few things you must consider first. A few diseases and conditions can mimic or contribute to chronic kidney disease’s lab results, so you will need to rule out the following: urinary tract infection, hyperthyroidism, and heartworm infection.

An eye exam and eye pressure check should also be performed as many cats with chronic kidney disease will develop high blood pressure throughout their course with the disease. Constant high blood pressure in cats can damage their eyes and cause retinal detachment and blindness.

Once you determine the stage of kidney disease your cat is in, whether early or late, frequent blood tests and monitoring of urine and blood pressure is necessary to ensure the long-term medical treatment plan is appropriate for each stage of the disease.

Available Treatments

While there are a seemingly overwhelming number of treatments available, for the majority of cats in early chronic kidney failure, the disease can be effectively managed with diet change, including supplementation, and one or two other treatments.

  • Diet: Lowering the level of waste products in the bloodstream by feeding low protein and low phosphorus diets is very useful. These can be prepared at home or are available ready-prepared from your veterinary practice. While this is ideal for most patients, some cats do find the diets formulated for kidney disease unappetizing and it is more important that the patient eat anything rather than nothing. If your cat won’t eat the diet prescribed by your veterinarian, please try another brand!
  • Maintaining proper electrolytes and water balances: Because cats with kidney disease can dehydrate easily, fresh water should be available at all times. Subcutaneous fluids may also be administered as the disease progresses. Phosphate binders can have a major effect on improving your cat's well being and slowing disease progression. Potassium supplementation may be needed as cats in kidney failure lose excessive potassium in the urine, which contributes to feeling of malaise. Vitamins B and C are lost by the failing kidneys and daily supplementation may be beneficial.
  • Others: Medications can be useful based upon an individual patient’s needs. These can include anti-emetics for cats that are experiencing vomiting and blood-pressure lowering drugs for cats suffering from systemic hypertension.
  • Advanced options: More drastic treatments, such as blood transfusions, feeding tubes, hemodialysis, and even organ transplant, may be options to research for progressive kidney disease. This is something to discuss with your veterinarian who best knows if your cat is a good candidate for these more aggressive modalities of treatment.

Outlook

With early detection, frequent monitoring, and attentive at-home care, many cats with early stage chronic kidney disease go on to lead normal, active lives for many years. Slowing the progression of the disease and preventing complications such as dehydration, gastric ulcers, urinary tract infections, and high blood pressure help keep your cat comfortable. It is equally important to discuss signs that chronic kidney disease is progressing and therapies for late to end-stage kidney failure in advance so you can decide if more drastic treatment is of interest to you. 

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