Q: My oldest cat of six is 12 years old and she suddenly started vomiting and hiding under bed, and stopped eating. I took her to my vet and she says she has gone into kidney failure. She recommended several days in the hospital on IV fluids and treatment. We gave her some fluids under her skin and I brought her home. What quality of life can we expect if we treat her and could we have prevented this?
A: Unfortunately kidney disease is very common in cats beginning at 8-9 years of age and older. It is very high on the list of causes of death in older cats. This is one of the reasons we recommend at least annual blood work on all cats beginning at about 7-8 years of age. The earlier kidney compromise can be detected, the sooner we can make adjustments in their diet, add medications and plan for a longer, healthier life.
We look at blood work to determine the level of blood urinary nitrogen (BUN) and creatinine among other things and do a urinalysis of the urine to look at other parameters, most especially the specific gravity (SG) of the urine. Specific gravity measures the solutes, or things that are in the urine as a function of the water content of the urine. It tells us whether or not the kidneys are able to concentrate or dilute the urine, which is a very important physiologic function for the body. It helps us to balance our water intake vs. usage as we perform our daily functions.
All the proteins we eat in our diets contain nitrogen which must be removed from the protein and taken out of the body to waste because it is toxic if retained. If the kidneys are not working well, they cannot rid the body of the nitrogen. The molecule BUN that is supposed to carry nitrogen out of the body begins to back up in the blood. This is toxic to the body and causes vomiting among other things.
By the time your kitty begins to show signs of kidney disease we know she has already lost 65 percent to 75 percent of her kidney function. We now have 25 percent to 35 percent function left to work with. Thus it is urgent that we essentially do a “dialysis” of her blood to remove the BUN as quickly as possible. This is the reason your veterinarian wanted to place an IV and keep her in the hospital. Once the overload of toxins are removed from her body you can begin to see whether or nor her kidneys can maintain her.
She will need to be fed a special diet, Hill’s prescription diet k/d is ideal. It is formulated specifically for this purpose, having much lower protein and salt levels, and lower phosphorous, which helps to slow the progression of the disease. It also has a dietary buffering capacity to counteract metabolic acidosis and decrease muscle washing. K/d also has added antioxidants, non-protein calories for energy.
Several research groups are working to develop a test that can detect kidney disease very early on, so animals, both cats and dogs, that are known to have a tendency to develop kidney disease can begin early treatments. The earlier we can begin to treat kidney disease, the better we can protect our pets and add many quality years to their lives.
Your kitty will also likely be given a prescription for a blood pressure medicine after her blood pressure is checked to help with efficient blood flow through her kidneys and further protect them. Several other products are being marketed to help support kidney function such as Epikatin and Azodyl to help support kidney function.
As with most diseases, early detection is key to early treatment and a longer survival time of a quality life. Only time will tell you how she responds to treatment and whether or not she is a good candidate for long-term care.
As your other cats reach 7-8 years of age, get them checked at least annually so if needed, early treatment can begin. Annual blood work at any age can be worth everything when it comes to lengthening our cats’ survival times. Try to get your kitty on treatment as soon as possible and you and she may have several good years left. There are several stages of kidney disease and each one may require more attention on your part to testing and medicating, but you can reap the blessings in having her feel good as she ages. Your veterinarian can also show you how to give her sub-cutaneous (under the skin) fluids at home so she can maybe have yet another year with just a little help.
DR. M. MARGARET KING, a longtime Edmond veterinarian, is a guest columnist. If you have any questions for her, email them to email@example.com.