Kidney Failure In Cats: Stroke Risk And Prevention

Kidney failure in cats is a life-threatening condition that can be caused by a number of factors, including infections, tumours, or ingestion of toxins. It is characterised by the sudden inability of the kidneys to function properly, leading to a build-up of toxins in the blood. While kidney failure can occur suddenly, it can also develop gradually over months or years. The immediate risk of failing kidneys is the accumulation of dangerous toxins in the blood, which can affect other organs in the body. This can lead to a range of symptoms, including increased water consumption, nausea, lethargy, and weight loss. In some cases, kidney failure may also increase the risk of stroke in cats, which is typically diagnosed in older cats and can be caused by underlying illnesses or conditions such as cancer, parasites, or heart disease.

Kidney failure in cats: causes and symptoms

Overview

Cats have two kidneys, one on each side of the abdomen, that play a vital role in filtering waste from the body and regulating fluid balance, minerals, and electrolytes. Kidney failure, also known as renal failure, occurs when the kidneys are no longer functioning efficiently due to various conditions or diseases.

Types of Kidney Failure

There are two types of kidney failure in cats: acute renal failure and chronic kidney failure. Acute renal failure develops suddenly within days or weeks and can happen to cats of any age. It is often caused by poisons, trauma, infection, or ingestion of toxic substances. Chronic kidney failure, on the other hand, is a gradual condition that develops over several months or years and is typically caused by autoimmune diseases, cysts, or genetics.

Causes of Kidney Failure

The immediate cause of kidney failure in cats is the inability of the kidneys to clear the blood of dangerous toxins. This can be due to a variety of factors, including ingestion of toxins, bacterial infections, trauma, shock, low blood pressure, blockages, and certain medications.

Symptoms of Kidney Failure

General symptoms of kidney failure in cats include diarrhea and vomiting, which may contain blood. For acute kidney failure, additional symptoms include an arched back and stiff-legged gait, indicating pain in the kidneys. Cats may also exhibit frequent or no urination.

Chronic kidney failure may go unnoticed until the disease has progressed significantly. Symptoms of end-stage kidney failure include dull sunken eyes, inability to walk, body odour, incontinence, seizures, confusion, refusal to eat or drink, twitching, blindness, pacing, restlessness, withdrawing, hiding, and running away.

Treatment and Management

The goal of treating kidney failure is to slow the progression of the disease and manage symptoms. Treatment options may include intravenous fluids, vitamin injections, medication, and dietary changes. A kidney-friendly diet is typically low in phosphorus and protein and enriched with vitamin D and omega-3 fatty acids.

Prevention

While some causes of kidney disease may be preventable, such as limiting exposure to toxins, many causes are not. Heritable conditions, for example, are not preventable, but affected cats should not be bred. Early diagnosis and intervention are critical to maintaining the quality of life for cats with kidney disease.

How kidney failure affects a cat's body

Kidney failure can have a devastating effect on a cat's body and its related organs and bodily functions.

Healthy kidneys are vital for a cat's health. They remove waste products from the bloodstream, regulate essential minerals such as potassium and sodium, conserve water, produce urine, manage blood pressure, and stimulate the production of red blood cells.

When a cat experiences kidney failure, the kidneys are no longer functioning efficiently, and the immediate risk is that dangerous toxins are not cleared from the blood. This can lead to a build-up of toxins in the body, causing the cat to feel nauseous and stop eating. The cat will generally appear lethargic and unwell.

There are two types of kidney failure in cats: acute and chronic. Acute kidney failure occurs suddenly, within days or weeks, and can happen to cats of any age. It is usually caused by poisons, trauma, infection, organ failure, urethral blockages, dehydration, or other factors. If diagnosed in time, it can often be reversed.

Chronic kidney failure, on the other hand, is a gradual condition that typically develops over several months or years. It is often caused by autoimmune diseases, cysts in the kidneys, or genetics. This type of kidney failure can lead to total kidney failure, where the kidneys gradually stop working as they lose the ability to filter toxins from the blood.

Symptoms of kidney failure in cats can include increased drinking and urination, weight loss, decreased appetite, vomiting, diarrhea, mouth ulcers, bad breath, a brownish-colored tongue, weakness, indifference, and abdominal pain.

In the end stages of kidney failure, cats may experience more severe symptoms such as sunken eyes, inability to walk, body odor, incontinence, seizures, confusion, refusal to eat or drink, twitching, blindness, pacing, restlessness, withdrawing, hiding, and running away.

While kidney failure in cats can be life-threatening and treatment options are limited, early diagnosis and proper management can help improve a cat's longevity and quality of life.

Treatment options for cats with kidney failure

While there is no cure for chronic kidney disease, if it’s detected and treated early, your cat’s longevity and quality of life can be improved. The goal of treating kidney failure is to slow the progression of the disease and manage symptoms.

Dietary Changes

A low-phosphorus and low-protein diet, enriched with vitamin D and omega-3 fatty acids, is often recommended for cats with kidney disease. Canned food is usually best due to its high water content. Prescription diets such as Hills® k/d or Royal Canin® Renal Support are restricted in protein and phosphorus to help decrease azotemia and low sodium to aid with hydration. These diets also contain amino acids to support muscle mass and omega-3 fatty acids to reduce inflammation and support kidney health.

Medication

Medications and supplements may be prescribed to lower blood pressure, raise potassium levels, lower phosphorus levels, promote kidney function, treat anemia, treat gastrointestinal ulcers, and reduce vomiting. For instance, anti-nausea medications such as Cerenia® and antacids like famotidine can help control stomach upset stemming from kidney disease. Medications like erythropoietin or darbepoetin may be used to treat anemia, while propranolol, atenolol, or enalapril can help lower blood pressure.

Fluid Therapy

Fluid therapy is often used to combat dehydration, which is common in cats with kidney disease. This can be achieved by increasing the water content of a cat's diet (e.g., by feeding canned food) and through subcutaneous fluid treatment (giving boluses of sterile fluid under the skin).

Hospitalization

Severely affected cats may need to be hospitalized to receive intravenous fluids and begin treatment for other symptoms.

Surgery

In rare cases, a kidney transplant may be considered. However, this is an experimental treatment option that is not widely available.

Monitoring and Quality of Life Management

Working closely with your veterinarian to monitor your cat's quality of life and discuss prognosis is crucial. This includes regular check-ups and lab tests to assess kidney function and guide treatment decisions.

Euthanasia

In some cases, when other treatments have failed and the cat is suffering, humane euthanasia may need to be considered.

Preventing kidney failure in cats

While it may not be possible to completely prevent kidney failure in cats, there are some measures you can take to reduce the risk and maintain your cat's kidney health.

Firstly, it is important to limit your cat's exposure to toxins, especially lilies, which are extremely toxic to cats. Keep your cat away from any harmful substances, such as antifreeze, pesticides, cleaning fluids, and certain human medications. Regularly check your home and garage for any potential poisons and ensure they are stored securely away from your cat.

Next, encourage your cat to drink plenty of water. Water is essential for kidney health, as it helps flush out toxins from the body. You can make water more appealing to your cat by using a fountain, adding ice cubes, or placing water bowls throughout your home, especially if your cat is older and may have arthritis. If your cat is fussy about drinking water, you can also provide moisture-rich food, such as canned or wet food.

Additionally, maintaining a healthy weight for your cat is crucial. Overweight cats are more prone to developing diabetes, which can increase the risk of kidney failure. Consult your veterinarian to determine your cat's ideal weight and diet.

Make sure the litter box is kept clean and placed in a quiet, comfortable spot for your cat. Cats can be particular about their litter box preferences, and a dirty or inconveniently located litter box may discourage them from urinating regularly. It is recommended to have one litter box per cat, plus an extra, and to scoop them daily and clean them weekly.

Finally, take your cat for regular check-ups with the veterinarian. Kidney disease often shows no signs until it has advanced, so routine examinations and laboratory tests can help detect any issues early on. These visits are crucial for early detection and can significantly improve your cat's quality of life and longevity.

Kidney failure in cats: prognosis and palliative care

Prognosis

There are two types of kidney failure in cats: acute kidney failure and chronic kidney failure. Acute kidney failure occurs suddenly, within days or weeks, and can happen to cats of any age. It is often caused by poisons, trauma, infection, organ failure, urethral blockages, dehydration, and other causes. If diagnosed in time, it can often be reversed.

Chronic kidney failure, on the other hand, is a gradual condition that typically develops over several months or years. It is usually caused by autoimmune diseases, cysts in the kidneys, and genetics. This type of kidney failure can lead to total kidney failure, where the kidneys stop functioning as they lose the ability to filter toxins out of the blood.

The prognosis for acute kidney failure is guarded and depends on the underlying cause. If the cause is an infection, the prognosis is better than if it is caused by a toxic substance. The long-term prognosis depends on the amount of kidney damage that has occurred, as the kidneys have very little capacity to regenerate or heal themselves.

For chronic kidney disease, the prognosis is also influenced by the stage of the disease at the time of diagnosis. The International Renal Interest Society (IRIS) has developed a staging system that helps veterinarians determine the options and prognosis for each stage of chronic kidney disease in cats.

Palliative Care

Palliative care for cats with kidney disease focuses on slowing the progression of the disease, reducing symptoms, and maximizing the cat's quality of life. This may include administering medications at home, frequent follow-up visits with the veterinarian, and providing a carefully managed diet and plenty of clean, fresh water.

For cats with end-stage kidney failure, palliative care in their final days will involve keeping them warm and comfortable, with food, water, and a litter box nearby, as well as plenty of loving human companionship. If the cat is in pain and experiencing seizures, regular vomiting, and soiling, euthanasia may need to be discussed with the veterinarian.

Frequently asked questions