Feline chronic kidney disease is defined as a structural or functional abnormality of the kidney/s that is continuously present for three months or longer. There is a permanent reduction in the number of functioning nephrons. CKD is progressive and irreversible. Older cats greater than 7  years of age are generally affected. Age is variable.

Clinical signs:

• Weight loss
• Increased drinking
• Increased urination
• Inappetence / lethargy/ weakness
• Vomiting/ diarrhea
• In severe case : oral ulcers and oral inflammation
• Halitosis
• Muscle wasting
• Altered behaviour

How is this disease diagnosed :

Your vet will often run bloods looking specifically at the following parameters should kidney disease be suspected

• Creatinine
• Urea
• SDMA
• Phosphorus
• A full blood count is checked for concurrent anemia due to chronic kidney disease and to sometimes asses the  white cell count should a secondary infectious process be suspected as in cases of pyelonephritis ( infection of the kidney).  
• Electrolytes are important as some of these cats are often not eating and vomiting and can have electrolyte abnormalities contributing to weakness specifically related to low potassium levels.

Should the above  values be significantly elevated it is an indication that the kidneys glomerular filtration rate has decreased by 75 % or more.

A urine analysis is performed to asses the kidneys ability to concentrate urine, determine protein lost via the kidney into the urine and to asses for urinary tract infections that often accompany cats with kidney disease. Should the urine be found to be dilute, any loss of protein noted is very significant. In order to quantify the loss of protein, one performs a test called the urine protein: creatinine ratio that provides a value and the amount of protein lost. This becomes important as ongoing protein loss not addressed can worsen kidney disease. Treatment may need to be instituted.

Blood pressures should be assessed in all CKD cats. Hypertension not addressed can lead to worsening renal function and protein loss including retinal detachment.

An abdominal ultrasound is indicated to assess the appearance of the kidneys. The kidneys are often small and shrunken  as lost nephrons are replaced by scar tissue and chronic inflammation. In other cases one kidney would be very large and the other very small as a result of compensation. Abdominal ultrasound can also asses for kidney stones that may be causing an obstruction within the ureter causing the kidney values to be significantly elevated acutely in a stable CKD cat or if there is any evidence of cancer affecting the kidneys.

Prognosis:

Is dependant on the underlying cause

• Severity and duration of clinical signs
• The possibility of improving renal function
• Patient age
• Degree of renal functional impairment
• Stage of renal disease of which there are 4

Treatment :

Patients need to be rehydrated with fluids, anti nausea medication and treatment of urinary tract infections, hypertension and proteinuria if present. Diet is very important in theses cats. Kidney diets are lower in phosphorus and aid in slowing progression of kidney disease. Early detection is key.

It’s recommend that yearly, older cats should have a geriatric screening to aid in identifying underlying disease processes.