Chronic Kidney Insufficiency in Cats

Early kidney insufficiency is extremely common in older pets. Our goal is to keep the remaining kidney cells healthy and "stress free". The best way for us to do this is to keep your pet well hydrated, monitor laboratory work closely for changes that need to be addressed and feed your pet a diet that supports kidney function and minimizes toxin build-up.

A special diet. Diets that are formulated for kidney failure have very high quality protein and overall less protein than other diets; they are also very phosphorus restricted and are non-acidifying. Although somewhat controversial, low protein diets seem to permit the kidneys to work less, therefore last longer. These factors help to lower the amount of protein waste in the blood, control excessive phosphate buildup, and reduce pH imbalances; together this has proven to be the most effective tool in helping kidney failure cats to live longer than any other treatment. We can recommend a commercially prepared food that is formulated for kidney disease. These special diets are available in the Broadway Veterinary Nutrition Center. The diets we recommend for cats are Hills K/D, Purina NF or Royal Canin Renal LP diet for cats. All three come in dry and canned forms, and it is okay for you to mix and match these diets, as your cat likes.

When switching diets remember that cats are control freaks and they do not like to change foods. Offer the change over a very slow period of time. Try changing only a teaspoon of the canned food each day; remove a teaspoon of the old food and add a teaspoon of the new food. So that slowly over a month or so the old food is changed to the new kidney diet. Do the same for the dry kibbles. This way the diet will be mixed, and slowly, over time, change from the diet your kitty is familiar with, to the new kidney failure diet. Please be determined. This is the most important part of your kitty’s medical therapy and the thing about treating kidney disease that will make the biggest difference in longevity. Nothing else has been proven in studies to work as well.

Below is more information on what labwork is monitored and why:

The key is early detection for the best long term results! This is particularly true in cats which have a high incidence of renal disease.

Kidney disease is detected on bloodwork and urinalysis. Azotemia (elevated BUN and creatinine) in combination with low urine specific gravity indicates poor kidney function. Roughly 2/3 of kidney tissue must be lost or not functioning in order for azotemia to occur. This is why early detection is so important. Urine sediment may show signs of infection or crystals/stones that can cause or exacerbate renal disease.

Early kidney disease diagnosis is aided by serial bloodwork evaluations. Creatinine levels that are slowly creeping up may indicate a problem even if they still fall within normal range.　

Unhealthy kidneys often spill protein in the urine (proteinuria), so urine protein/creatinine ratios are useful if proteinuria occurs on a routine UA dipstick or creatinine levels are creeping upwards. A urine protein/creatinine ratio greater than 0.4 in cats is abnormal. If serial urine protein/creatinine ratios are measured, progressive increases are usually an indication to intervene.　

Blood pressure should be measured in animals if the urine protein/creatinine ratio is cresting 1.0. Hypertension can cause or exacerbate kidney disease.

You may also want to read the information on the Kidney Failure page to understand further stages of the disease.

More Information:

Glacier Point for Cats - This is an extraordinary water fountain that can help your cat drink more.

Effective Oct. 29, 2010, all Glacier Point Pet fountains will be shipped with a new patent pending filtration system using “clean room” technology. Sierra BioScience believes the NanoPetTec™ is the most important advancement in pet waterers in over 30 years.
The Glacier Point fountains are the first and only fountains with the ability to reduce the bioburden such as from E. coli and Salmonella that are dispersed into the air when a toilet is flushed. The NanoPetTec™ can also trap the viral biofilm released from saliva and nasal secretions of infected pets. The NanoPetTec™ will also protect the pump which will now extend the pump warranty to 5 years. Obviously, the micro filter that effectively protects the pump will also protect a pet’s kidneys!

The need for a 0.5 micron filter to trap many types of airborne toxins found in the home can best be found in the “Polluted Pets” studies funded by the Environmental Working Group.

Cat Owner's Guide to Kidney Disease - from Cornell University
Vocabulary of the Disease - Information from the Veterinary Information Network (VIN) about Chronic Renal Failure/Insufficiency
Understanding Kidney Disease - Great video from Cornell University