Managing Kidney Disease

Renal Insufficiency and Failure

Renal insufficiency refers to the progressive loss of functional kidney tissue, resulting in the inability to maintain water balance and the loss of potassium- necessary for muscle strength and retention of toxic kidney products like nitrogen in the bloodstream that cause nausea and vomiting.

Kidney disease is a slowly degenerative process common in older cats for which there is no cure.  There are, however, some very effective steps that can be taken in slowing down this process.

Some signs that your cat is suffering from kidney disease:

1.      A sustained, significant increase in water consumption (>1 ½ cups per day for a 9lb cat)

2.      A sustained, significant increase in urination.

3.      Weight loss

4.      Appetite loss

There are 3 stages of Kidney Disease:

Level 1- mild insufficiency  (Urine Specific Gravity < 1.035)

1. Ensure good nutrition and water intake. Decrease stress - this is NOT a good time to add another  

    pet to the family.

2. Feed a high quality senior formulated canned food, such as Medi-cal® Feline Mature Formula, 

    with controlled amounts of sodium (salt) and plenty of moisture.

Level 2- moderate insufficiency  (Urine Specific Gravity < 1.025) Azotemia

1. Start feeding your cat a protein reduced diet designed for cats with renal failure such as

    MediCal® Reduced Protein.

2. Add a phosphate binder (such as Epakitin™) if phosphate levels are elevated.

3. Add Fortekor® medication if your cat has high blood pressure or protein is leaking into the urine.

Level 3- renal(kidney) failure

1. Observe recommendations for Level 1 and Level 2.

2. Supplement with fluids under the skin as necessary. 

3. Add appetite stimulants such as Remeron as necessary to maintain body weight

Kidney Disease Management Program

Kidney disease tends to be a disease that affects older cats. This is a time when other problems can occur and complicate treatment. Also, because your cat cannot talk, we have to look at other means to assess the success of a treatment program.

We recommend a progress exam and mini panel bloodwork after the first 4 weeks of treatment, so we can monitor the stage of kidney disease your cat is currently at and adjust treatment accordingly. Once your cat is stable, he/she needs regular weigh-ins every 1 to 3 months with the nurse. This is a complimentary service and helps us to ensure your pet is managing well. A happy, well managed cat eats well and maintains a stable weight.

Your pet will also need to see the doctor twice a year. At this time a full physical exam will be performed and you can discuss treatment and progression with the doctor. Blood and urine tests will be performed yearly, as needed to make sure the kidneys are coping and don't become infected.

Remember, every cat is different and experiences different amounts of stress with medications and hospital visits.  Our aim is to respect every cat’s treatment threshold and keep them at home for as long as they are comfortable and enjoying a good quality of life.  We will work with you to ensure your older cat lives a long and happy life.