FELINE CHRONIC KIDNEY FAILURE FACT SHEET

INTRODUCTION
Kidney failure is one of the most common health problems suffered by cats, particularly as they grow older. There have,
however, been a number of exciting scientific developments in recent years and there are now ways of slowing the progression
of the disease. Perhaps more importantly, new treatments can significantly improve the quality of life for a loved pet suffering
from kidney failure.
WHAT DO THE KIDNEYS DO?
The kidneys are highly complex and important organs responsible for filtering the blood to remove toxic waste products such as
urea and creatinine, and regulating blood composition and pressure.
They control the amount of the following electrolytes in the blood; potassium, magnesium and calcium which regulate heart
contractions, sodium which regulates the amount of water in the blood and phosphorus, an important constituent of bones and
teeth. The kidneys also produce the hormone erythropoietin, which stimulates the bone marrow to produce red blood cells and
the enzyme renin, which maintains and controls blood pressure.
WHAT HAPPENS IF THE KIDNEYS ARE DAMAGED?
Any failure of the kidneys has a knock on effect on every other organ in the body, making them every bit as important to your
cats wellbeing as, say, their heart or lungs. However, where heart or lung failure tends to have more immediately noticeable
effects, the kidneys have a considerable amount of overcapacity. You probably know that most people can survive with only one
kidney. In fact, it is not until 75% of kidney function has been lost through disease that outward clinical symptoms start to
be seen.
WHAT SIGNS CAN BE SEEN IN CATS?
There are many signs of renal failure: weight loss, drinking more and urinating more than usual, lethargy, a poor coat,
dehydration, anorexia and sickness are some of the more commonly seen symptoms.
HOW IS CHRONIC KIDNEY FAILURE DIAGNOSED?
A physical examination of your cat by a vet is simple, quick, non-invasive and can be carried out at low cost. Checks include:
A weight check; weight loss can be an early indicator of kidney failure.

A general physical examination; this provides information on whether or not the cat is dehydrated, anaemic or whether the
kidneys feel abnormal

Further diagnostic techniques may be used as follows:

Blood pressure measurement. High blood pressure is a common consequence of kidney failure in cats.

Urine testing. Cats normally produce concentrated urine (they evolved as desert-living creatures); dilute urine can be an
early sign of kidney disease. Urine can be collected from your cat at home using non-absorbant litter provided by your vet.
Alternatively urine can be collected via a procedure called cystocentesis (where urine is sampled using a needle inserted into
the bladder).

Blood testing.
Once two thirds to three quarters of renal function is lost, the kidney becomes less effective at
excreting waste products produced by the body as it breaks down protein. Consequently, these waste products build up in
the bloodstream. In combination with the results of a urine test, vets can confirm a diagnosis of kidney failure by analysing
blood for increased levels of two waste products: urea and creatinine.

HOW IS IT MANAGED?
Any damage to the kidneys is irreversible so it is important to have realistic expectations about what can be achieved once this
condition is diagnosed, however a number of therapies and drugs are available and the long term prognosis is relatively good in
many cases. Treatments aim to improve quality of life and life expectancy and include the following:
Special 'renal' diets there is plenty of good scientific evidence to show that cats eating these diets live longer (on average
twice as long) as those not fed the diets. By reducing the amount of protein in the diet, the amount of waste needing to be
processed by the ailing kidneys can be limited or reduced so reducing their workload. Diets also have positive effects on
potassium, phosphate, sodium and acid/base balance and are of high density calorific content.
ACE (angiotensin converting enzyme) inhibitors trial work has also shown great benefits to the use of these drugs in
treating kidney failure. Owners of cats treated with an ACE inhibitor noted an improvement in their cat's quality of life which
was double that when diets alone were used. Furthermore, the survival times for cats suffering from severe kidney disease
increased by a factor of three after treatment with an ACE inhibitor. In another study amongst healthy cats, an ACE inhibitor
was shown to increase appetite and body weight. They also lower blood pressure, useful as high blood pressure is found as a
consequence of chronic kidney failure in around 20% of cats.
Fluid therapy - Cats with chronic renal failure are vulnerable to becoming dehydrated; they may not be drinking or

eating properly and damaged kidneys are prone to losing excess fluids in the urine. Dehydration worsens renal function
and can quickly worsen the cat's clinical condition. In some cats this is a recurrent problem, necessitating frequent visits
to a veterinary surgery for additional fluids (e.g. via an intravenous drip); encouraging fluid intake at home is essential.
Please speak to your Vet to clarify and explain which treatments will be most suitable for your cat.