Chronic kidney disease (CKD) is one of the most common diseases affecting older cats, with 20-50% over the age of 15 years being affected. One of the main functions of the kidneys is to clear waste products from the blood, and when damage occurs they are less able to do this so the toxins start to build up. In chronic kidney disease, this damage has occurred over a longer period of time and unfortunately the damage cannot be reversed. Even so, for most cats, managing the disease and its resulting complications can significantly slow down progression of the disease and increase both quality and length of life.
Signs of CKD can be quite vague at first, but they include weight loss, poor appetite, increased thirst, increased urination, and later on, reduced activity and sometimes vomiting. Diagnosis usually requires a blood sample, which shows an increase in urea and creatinine (waste products that are normally cleared by the kidneys) as well as a urine sample, which shows abnormally low urine concentration (watery urine). If the results of these initial blood and urine tests are not clear cut an additional blood test to measure SDMA may be useful. Once we know that there is kidney disease going on an ultrasound scan or x-ray of the kidneys may sometimes be recommended to try to determine an underlying cause, but this is not usually necessary in older cats with chronic kidney disease. The blood tests may also reveal complications resulting from CKD such as anaemia, low potassium levels or high phosphate levels, which can all be treated effectively if they are present. Cats with CKD can also develop high blood pressure (hypertension), so we also recommend checking their blood pressure. See related post below.
Management of CKD depends on the severity of disease, but may include dietary changes, and treatment to manage related complications such potassium supplementation, phosphate binders, management of hypertension, and treatment of anaemia, nausea and poor appetite. In more advanced cases fluid therapy can also be given at home to provide additional support and help to keep cats feeling well for longer.
Periodic monitoring, usually at between 3 to 6 month intervals, is important to assess disease progression and adjust treatment to maintain the best possible balance. Although CKD is usually progressive over time, supportive treatment can result in many cats having a good quality of life for several years, especially if it is identified early on. Regular health checks and wellness screening of older cats is particularly helpful in this regard, so if your cat is getting on a bit, ask our vets or nurses for more advice.