Chronic kidney disease, or CKD, is one of the most common diseases in older cats. It affects 40% of cats 10+ years old and 80% of cats 15+ years old. And while a new chronic kidney disease diagnosis can be stressful, with proper monitoring and management, cats with CKD can continue to live happy, comfortable lives. Learn more about this disease process, warning signs to watch for, and what to expect after your cat’s diagnosis.
What Is Chronic Kidney Disease?
Kidneys are the body’s built-in filtration system. Other important roles that the kidneys fill include:
- Filtering waste from the blood
- Maintaining hydration
- Maintaining electrolyte balance
- Maintaining the pH balance of the body
- Maintaining normal blood pressure
- Producing hormones
- Maintaining a normal red blood cell count
Over time, the kidneys lose their ability to efficiently complete these tasks. Chronic kidney disease (CKD) often develops gradually. It is non-reversible and often goes undetected until ⅔ to ¾ of the total functioning kidney tissue is lost.
Signs of Chronic Kidney Disease in Cats
One of the earliest warning signs of CKD is increased water consumption and urination. As the kidneys lose their ability to concentrate urine effectively, cats urinate in higher volume. This leads them to compensate by drinking more water. Other early warning signs can look a lot like normal aging: weight loss, sleeping more, less time spent grooming, and reduced appetite.
As kidney disease progresses, you may start to see more obvious symptoms. These include:
- Weight loss, decreased appetite, and vomiting due to waste build-up and irritation in the stomach and digestive tract
- Lethargy or weakness, often caused by disease-related anemia
- High blood pressure, which can affect vision or lead to bouts of disorientation and weakness
- Bad breath that may be associated with mouth ulcers
Stages of Kidney Disease in Cats
The International Renal Interest Society outlines four stages of kidney disease in cats. The stage is determined both by the individual cat’s lab values and by the symptoms they’re showing. While kidney disease cannot be reversed, proper management and care can help slow its progression.
Stage 1: Mild/Early
There’s minor damage to the kidneys, but no clinical signs or symptoms yet. Stage 1 kidney disease is usually found by accident during routine blood work or urine testing.
Stage 2: Mild-to-Moderate
The kidneys have lost 25% to 34% of normal function. At this stage, clinical signs start to appear. The urine starts to become more diluted (containing more water) from poor kidney function, and there may be blood pressure changes. Most cats will show mild (if any) symptoms in Stage 2, which is why routine labs for senior pets are so important!
Stage 3: Moderate
The kidneys have lost 76% to 90% of kidney function. More waste stays concentrated in the blood as the kidneys’ filtering abilities worsen. At this point, many cats will begin to show the clinical signs listed above.
Stage 4: Severe/End-Stage
This is the most severe, or end-stage, kidney disease and precedes acute kidney failure. At this stage, cats begin to feel and act very sick. Most efforts focus on relieving symptoms through palliative and hospice care. Have a discussion with your veterinarian about quality-of-life and whether or not to euthanize before acute kidney failure.
Managing CKD in Cats
While chronic kidney disease eventually progresses to end-stage kidney disease and kidney failure, medical management can help your cat live many long, happy years. The goal of treatment is to slow progressive damage to the kidneys, manage symptoms, and support normal bodily functions (hydration, electrolyte balance, appetite, etc.).
Therapeutic diet. Diet is one of the first and most important pieces of treating a cat with CKD. A kidney-specific prescription diet will have less protein, phosphorus, and sodium content and more water-soluble vitamins, fiber, and antioxidant concentrations. This helps reduce waste products in the bloodstream and decrease the workload on the kidneys. Some studies show that cats with CKD eating a prescription kidney diet live 2-3 times longer than those that stick with a commercial cat food.
Medications. Depending on your cat’s symptoms and lab values, your veterinarian may recommend medications to lower blood pressure and/or reduce protein in the urine. Cats with nausea and appetite loss may be prescribed anti-nauseants, antacids, or appetite stimulants.
Supplementation. Cats with CKD may struggle to maintain healthy levels of electrolytes (salt, potassium) and certain water-soluble vitamins (B12). Vet-recommended supplements can help offset these losses.
Subcutaneous or IV fluids. Especially in later stages of CKD, cats cannot drink enough water to maintain healthy hydration. Fluids may be administered subcutaneously (under the skin) or intravenously (directly into the vein) to support hydration or help “flush” the kidneys.
What To Expect After Diagnosis
The most important thing after a CKD diagnosis is staging the disease—AKA figuring out how severely kidney function is impaired—to create a tailored treatment plan. In addition to the treatment options listed above, cats with CKD need regular check-ups and lab value rechecks to make sure the kidneys are stable.
Expect periodic follow-up veterinary visits that include repeat blood panels, urine tests, weight checks, and blood pressure measurements. Depending on your cat’s health status and disease progression, they may need to be seen every 3-6 months.
You’ll also need to pay careful attention to symptoms at home! Consider keeping a written log of your cat’s daily appetite, water consumption, litter box habits, energy levels, and weight. Any sudden changes in weight, appetite, or behavior should be addressed immediately!
Pine Point Animal Hospital Is Here To Support You!
Discovering that your cat has kidney disease can be overwhelming. You may be wondering what happens next and what you can do to help. The good news is: while chronic kidney disease can’t be cured, many cats continue to enjoy a good quality of life with the right treatment and ongoing veterinary care. Many cats live comfortably for years after being diagnosed. At Pine Point Animal Hospital, we work with pet owners to provide the best veterinary care possible. As your cat’s treatment plan evolves, we’re with you every step of the way!