Editor's note: This is the first in a trio of columns about issues faced by aging pets.
Cats can live to 20 years and sometimes more, but the weak link in their physiology is the kidneys. Chronic renal failure affects three times as many older cats as older dogs, and it’s the number one cause of death in geriatric cats.
If your older cat is drinking a lot of water and, naturally, peeing a lot more, he may be showing the signs of kidney disease, or chronic renal failure. Other signs of CRF may include weight loss, vomiting, or a poor appetite. These signs occur because toxins build up in the blood when kidney function begins to decrease.
To diagnose CRF and rule out other problems, a trip to the veterinarian for blood work and a urinalysis is in order. Blood work shows whether the levels of blood urea nitrogen (BUN) and creatinine are elevated, a sign that the kidneys are having trouble removing these waste products from the body. Urinalysis can indicate signs of infection, loss of protein, and inability to concentrate urine, meaning that the daily output of urine increases.
Although CRF can’t be cured, it can be managed. How well a cat with CRF does depends on the age at diagnosis, how advanced the disease is, and whether the cat has any side effects such as high blood pressure. If CRF progresses without treatment, weight loss continues, and the cat may develop behavior changes related to high blood pressure, lose energy and become nauseated. The goal of treatment is to slow the progression of those signs as much as possible. Fluids, diet and medications can all help to keep the disease under control.
Because cats with CRF become dehydrated easily—all that peeing—administering fluids subcutaneously (under the skin) becomes a daily or semi-weekly ritual. Fortunately, while inserting a large needle beneath a cat’s skin isn’t the way most of us would choose to spend our time, it’s something that cat owners can learn to do at home and that cats can come to accept because it makes them feel better. Giving fluids helps the body flush waste proteins out of the system. Your veterinarian or a vet tech can show you how to perform the procedure, which usually takes only two to five minutes either a couple of times a week or sometimes daily.
Ask your vet how to warm the fluids first to increase the cat’s comfort level. It never hurts to have an assistant if your cat is more twitchy than tranquil. Wrapping the cat in a towel can also be calming. Giving a treat after each session will ensure that your cat looks forward to the next one.
Dietary changes depend on the stage of the disease. Cats with mild to moderate renal failure need adequate protein and calories to maintain their body weight and avoid muscle wasting and anemia, says Susan Little, DVM, a board-certified feline specialist in Ottawa, Ontario, Canada.
Cats with moderate to severe CRF will do better on a food with reduced levels of protein and phosphorus. You can purchase a commercial food prescribed by your veterinarian or ask about a recipe that you can make at home. Most important, though, is providing a food that your cat will eat. Preventing weight loss is more important than feeding a special diet.
Medications are available that can stimulate your cat’s appetite, reduce nausea, maintain normal concentrations of phosphorus in the blood, and generally improve survival time and quality of life. Like all drugs, they have potential side effects, but for the most part they are more helpful than harmful. Discuss the risks and benefits with your veterinarian so you can make an informed decision.
Check Kidney Function Early
Cats with CRF progress at different rates. Some cats live for years with mild kidney disease, while others go downhill quickly, but in most cases you can do a lot if you find out what’s wrong and intervene in time.
Even if a cat isn’t showing signs of CRF, it’s always a good idea to run a senior profile—blood work and urinalysis—when he is 8 to 10 years old. This can help determine early on whether kidney function is in decline. That’s because by the time most cats are diagnosed with CRF, they’ve already lost 60 to 75 percent of their kidney function. A urine test is available that can detect small amounts of albumin in the urine, a sign that’s associated with kidney damage. If you want to catch CRF in its earliest stages, this test is something to consider as your cat approaches the golden years.
Pet of the Week
Rio, the 3-year-old neutered male domestic long hair is Orange County Animal Care's pet of the week. The gray-and-white cat is pictured to the right of this story. His Pet ID is A1189745.