"CHRONIC KIDNEY DISEASE (CKD)"
CHRONIC KIDNEY DISEASE (CKD) The kidneys have a high reserve capacity, which means that at the time of diagnosis, most cats will have only 25% or less of their kidneys functioning. The main treatment aims are to support the remaining function of the kidneys, and thereby maintaining a good quality of life for your cat. INVESTIGATIVE TESTS AND MONITORING: BLOOD TEST: Urea and creatinine are two waste products which normal kidneys do not allow to build up in the blood stream. The levels of these waste products initially help to help diagnose CKD, and later to monitor progression of the disease. Phosphorus levels may be elevated which can lead to nausea and decreased appetite. Electrolytes are sampled to monitor potassium levels: reduced amounts can lead to decreased appetite and weakness. Red blood cell levels are checked to assess whether anaemia is a problem, as normal kidneys produce a hormone to stimulate red blood cell production. URINE SAMPLE: A fresh urine sample (same day or refrigerated if collected overnight) allows us to interpret in particular, the concentration of urine and whether there is any abnormal protein leakage. Protein leakage can perpetuate kidney problems. Urinary infections are also common in dilute urine. BLOOD PRESSURE: High blood pressure is often associated with CKD, leading to damage of end organs such as the heart, brain, retinas, and further deterioration of the kidneys. Your cat needs to be hospitalised for the day to settle comfortably before we can take accurate serial blood pressure readings. MANAGEMENT: In addition to any specific requirements based on blood pressure, urine, and blood analysis, the following are general recommendations: RENAL SUPPORT DIET: This is a balanced diet that includes: Reduced protein of a high quality: this ensures fewer breakdown products from the protein, reducing the work load of the kidneys. Reduced phosphorus: reduces the build up of phosphorus which impaired kidneys do not clear well. Reduced salt: helping to manage the tendency for high blood pressure. The reduced salt will make this diet slightly less appetising than normal cat food, so diet changes are best made before your cat starts to loose it’s appetite. Any diet changes need to be made gradually over a week to improve acceptance and avoid gastric upsets. There are a few brands of renal support diets available for your cat to try if the first diet is rejected. INCREASE WATER INTAKE: Diseased kidneys do not concentrate urine as well as normal, and despite CKD cats frequently drinking excessively, they are often dehydrated. Measures to increase water intake include: Ensuring plenty of freely available fresh water Adding some warm water to the diet If your cat prefers to drink running water, consider a water drinking fountain for cats If water intake is still inadequate and your cat is dehydrated on clinical examination, consider adding some tuna in spring water to the normal drinking water.