What is Chronic Kidney Disease in Cats? A Vet Explains Causes, Treatments, and Prevention

Winter is a season when urinary problems in cats occur frequently. While cystitis and urolithiasis are common, older cats may develop or suffer from worsening kidney disease during the winter. There are two types of feline kidney disease: acute kidney disease and chronic kidney disease.

In this article, we will explain the causes, treatments, and prevention methods for feline kidney disease.

What are the causes of feline kidney disease?

Feline kidney disease consists of acute kidney disease and chronic kidney disease. The causes of these two conditions differ significantly. We will explain each below.

Acute Kidney Disease

Acute kidney disease is a condition where kidney function rapidly declines due to some cause, leading to kidney failure. Because it progresses rapidly, renal function can drop within a matter of hours. When renal function declines, the body cannot properly eliminate waste products, causing toxins to accumulate.

Major causes include dehydration, hemorrhage, surgery, urinary obstruction due to conditions like urolithiasis, and exposure to toxins, drugs, or poisonous plants that affect the kidneys.

Winter is a time when cases of cystitis and urolithiasis increase. Cystitis and urolithiasis can lead to a sudden inability to urinate, causing urine to build up in the body. When a cat cannot urinate, the kidneys suffer damage, resulting in acute kidney disease.

If left untreated, acute kidney disease can be fatal within 1 to 2 days, but if the underlying cause is removed, the cat can recover quickly.

Chronic Kidney Disease

Chronic kidney disease is common in older cats; 30-40% of cats over age 7 and 80% of cats over age 15 suffer from it, and kidney disease is the number one cause of death in cats.

Unlike acute kidney disease, chronic kidney disease occurs when the kidneys are impaired over a period of several months or longer. Chronic kidney disease cannot be cured even with treatment. It continues to progress gradually, eventually leading to end-stage renal failure or uremia.

For many years, the primary cause remained unclear, but in recent years, a substance called "AIM" has been linked to kidney aging. It is now believed that chronic kidney disease occurs in cats because AIM does not function properly.

Abyssinians, Persians, and Exotic Shorthairs have a genetic predisposition to kidney disease. Additionally, urinary stones or bladder stones in older cats can significantly accelerate the progression of chronic kidney disease.

What symptoms occur when a cat has kidney problems?

The symptoms of acute and chronic kidney disease are very similar. Acute kidney disease causes sudden symptoms, whereas symptoms of chronic kidney disease appear slowly. Because chronic kidney disease progresses gradually, the disease may already be in an advanced stage by the time symptoms become apparent.

Acute kidney disease causes sudden loss of energy, loss of appetite, vomiting, diarrhea, reduced urine output, and low body temperature. Because it progresses rapidly, it can be fatal in just a few days if left untreated.

Chronic kidney disease is divided into early, middle, late, and end-stage phases, with almost no symptoms appearing during the early stage. Symptoms emerge from the middle stage onwards, including increased thirst and urination, dehydration, anemia, stomatitis, vomiting, loss of appetite, lethargy, weight loss, and seizures. The end stage is also known as the uremic phase, where symptoms of uremia appear. The cat may lose its appetite completely and vomit frequently. Because toxins accumulate in the body, the cat may even emit the smell of urine from its body.

Can feline kidney disease be cured? What are the treatments?

Treatments differ between acute and chronic kidney disease. Both conditions are dangerous if left untreated, so seek veterinary care immediately if you notice any signs.

Acute Kidney Disease

Since acute kidney disease always has a cause, it may improve quickly once that cause is resolved. Therefore, the first step is to perform thorough tests to identify the cause.

Treatment for acute kidney disease is tailored to the cause. IV fluids may be administered to treat dehydration or neutralize toxins. If urinary obstruction has occurred due to urolithiasis, a catheter may be inserted into the urethra to drain the urine. In some cases, surgery is required to remove the stones from the blockage site.

If acute kidney disease progresses and significant kidney function is lost, there is little hope for recovery. In some cases, it may transition into chronic kidney disease.

Chronic Kidney Disease

Unfortunately, there is no definitive cure for chronic kidney disease at this stage. The goal of treatment is to slow its progression and manage symptoms.

Chronic kidney disease treatment centers on dietary therapy, medication, and subcutaneous fluid therapy. While treatments vary by stage, they are essentially life-prolonging measures.

In the early stage, the condition is managed with a therapeutic renal diet.

In the middle stage, dietary therapy remains the mainstay. Additionally, antihypertensive drugs may be used to slow the progression of kidney disease. Supplements with antioxidant properties are also considered effective.

In the late stage, appetite often decreases due to nausea and other factors. While dietary therapy remains the foundation, fluid therapy becomes necessary, typically administered on a daily basis. Since anemia can also occur, hematopoietic agents may be used. Oral activated charcoal may also be given to help absorb toxins in the body.

In the end stage, fluid therapy is the primary treatment. Since infusions are required daily, instructions for home subcutaneous fluid therapy will be provided. In the end stage, appetite is almost non-existent. Forcing the cat to eat or providing nutritional support via a feeding tube may also be necessary.

How to prevent feline kidney disease

Because acute kidney disease has specific causes, it can often be prevented by avoiding those triggers. Unfortunately, chronic kidney disease cannot be prevented. However, providing hydration and maintaining a proper litter box environment may help slow the decline in renal function.

Make water easier to drink

Because cats are descended from desert-dwelling ancestors, their bodies are designed to survive on minimal amounts of water. However, this is thought to put a strain on their kidneys. To reduce this strain, it is important to always provide plenty of fresh drinking water. Set up multiple water stations. As cats age, they tend to only drink water within their specific activity range, so be sure to place water stations where your cat can easily see them.

Cats also have preferences regarding containers. They tend to prefer ceramic or glass bowls. Changing the bowl might encourage your cat to drink more.

Some cats are also particular about the type of water they drink. Try offering different kinds of water to see what they prefer.

Reassess the litter box

If a cat doesn't like its litter box, it may hold its urine. This can lead to urolithiasis and puts unnecessary strain on the kidneys. The ideal number of litter boxes is the number of cats plus one. Ideally, the box should be 1.5 times the length of the cat (from head to tail). This size allows the cat to step inside completely and turn around comfortably. If the box is too small, the cat might leave parts of its body outside or perch on the edge to eliminate. If you see this behavior, the box is likely difficult for your cat to use—please provide a larger one.

Cats may also reject a litter box if they don't like the litter itself. Cats generally prefer sand-like, fine-grained litter. If your cat has had urinary problems in the past, pay extra attention to the type of litter you choose.

Even humans dislike dirty bathrooms, and it's the same for cats. Basically, you should clean the litter box immediately after use.

Prevent obesity

Many domesticated cats today are obese. Obesity reduces activity levels, which in turn leads to less water intake. Consequently, obese cats are thought to be more prone to urolithiasis.

Try to help your cat lose weight gradually by controlling food portions and playing together. Cats are extremely sensitive to fasting. If an obese cat stops eating, it can develop a life-threatening liver condition called hepatic lipidosis. Cat dieting requires professional knowledge, so we recommend consulting your veterinarian.

Keep harmful substances out of reach

Ingesting substances that damage the kidneys can trigger kidney disease. Some common toxins that cause acute kidney disease are surprisingly close at hand. Examples include ethylene glycol in old antifreeze, arsenic in rodenticides, grapes, and lilies. Never leave such items out, and ensure they are stored where your cat cannot access them.

Get regular health checks

Taking a cat to the vet can be quite a challenge. Data shows that many owners avoid visits unless it's for vaccinations or when the cat is feeling unwell. In the case of feline chronic kidney disease, a decline in renal function can be detected in some cats as early as age 5.

Veterinary clinics recommend annual or bi-annual check-ups, especially for older cats. Regular health checks allow for early diagnosis and treatment, helping you stay with your beloved cat for as long as possible. Don't skip visits just because it might stress your cat; prioritize regular health check-ups.

Summary

Kidney disease is a leading cause of death in cats. There is no established curative treatment for chronic kidney disease, and it is no exaggeration to say that most elderly cats will eventually succumb to it. In the early stages, chronic kidney disease presents almost no symptoms and is often discovered by chance during health check-ups. By the time symptoms appear and you visit the vet, the disease is often quite advanced. To detect kidney disease early, 1-2 health check-ups a year and your day-to-day observational skills are crucial.

As for acute kidney disease, it is highly likely that it can be prevented through careful management by the owner. Why not take this opportunity to reassess your cat's living environment so that your beloved companion can live a long and healthy life?