Kidney Failure
The kidneys have many functions. They primarily work to remove waste products from the bloodstream, regulate levels of certain essential minerals like potassium and sodium, conserve water, and produce urine. Kidney failure is categorized into two types:
Acute Kidney Failure
This occurs when the kidneys suddenly sustain damage, typically within hours or days. This can be due to toxins or a rapidly acting infection.
Chronic Kidney Failure
This is referred to as the final stage of kidney failure, known as stage 4. In chronic kidney disease (CKD), gradual loss of kidney tissue occurs over months or years due to underlying genetic factors, chronic infections, age, cancer, or other underlying medical conditions. Clinical signs of chronic kidney disease appear when approximately two-thirds of normal kidney tissue is lost.
Clinical Signs of Acute Kidney Failure in Cats:
- Sudden onset of decreased appetite
- Lethargy or weakness
- Vomiting
- Diarrhea or bloody diarrhea
- Ammonia-like breath odor (due to accumulated uremic toxins in the blood)
- Changes in urine
- Abdominal pain due to kidney swelling (seen in acute kidney failure cases)
- Seizures
Clinical Signs of End-Stage Kidney Failure in Cats with Chronic Kidney Disease:
- Anorexia
- Vomiting
- Lethargy/excessive sleepiness
- Dehydration
- Behavioral changes (withdrawal, irritability)
- Uncontrolled urination or defecation
- Ammonia-like breath odor
- Seizures
- Decreased body temperature
- Fur texture changes or oiliness
Causes of Kidney Failure:
- Exposure to toxins
- Ingestion
Underlying Medical Issues:
- Urethral obstructions (inability to urinate)
- Low blood pressure
- Coagulation disorders
- Heart disease
- Pyelonephritis (infection in the kidneys)
- Parasitic infections (toxoplasmosis or kidney worms)
- Tick-borne diseases
- Feline Infectious Peritonitis (FIP)
- Trauma or severe allergic reactions resulting in shock
Other Risk Factors Include:
- Tumors and cancers (like lymphoma)
- Cat-specific viruses (like feline leukemia virus or feline immunodeficiency virus)
- Chronic pyelonephritis (slowly developing kidney infection)
- Underlying genetic disorders like polycystic kidney disease or amyloidosis
- Immune-mediated disorders
- Previous acute kidney failures/acute kidney injuries that did not respond fully to treatment
- Underlying medical conditions like hyperthyroidism
How is it Diagnosed?
Urinalysis
Complete blood count (CBC)
Serum biochemical values
X-rays
Ultrasound
How is it Treated?
Kidney disease is mostly managed with medications, diet, and fluid therapy. Specific management depends on the stage of the disease as well as the underlying cause (if known). A cat with increased urine protein-to-creatinine ratio (UPC) or high blood pressure is likely to be treated with medication.
Depending on the cause, additional treatments may include:
- Aggressive IV antibiotics if an infection is present
- Deworming medication for parasites
- Immunosuppressive drugs for autoimmune diseases
- Antithrombotics (to prevent blood clot formation)
- Chemotherapy and/or surgery (if applicable)
If urinary obstruction is diagnosed, relieving the obstruction is the preferred treatment.
How Can We Prevent It?
Keeping away from plants and cleaning products that can cause poisoning.
Regularly treating for internal and dental parasites.
Using high-quality, clean food that does not contain excessive fat and salt.
