Renal Failure in Cats

Chronic renal failure, also known as kidney failure, is one of the most common conditions affecting older cats. In fact one out of every five cats over fifteen years of age suffers from it. The disease is essentially characterized by a gradual decrease in the ability of kidneys to purify the blood and remove waste products from it. The disease usually has a slow insidious course and is usually irreversible unless a specific cause for the kidney failure is identified and treated (that often include tumors, infections and polycystic disease of the kidneys). In most cases though a cause is not identified and the usual course of the ailment is a slow terminal progression.

As the disease advances symptoms develop in cats that include loss of weight, energy and appetite, depression, altered thirst and urination, poor coat, elevated blood pressure and anemia. Diagnosis is usually reached after analysis of blood and urine along with clinical correlation. Initial treatment is then to correct the fluid and electrolyte balance in cats with administration of intravenous fluids. Blood and urine tests are then periodically done to monitor the course of disease.

Dietary control is of significance once the diagnosis has been reached:

The protein content of diet should be ideally low since most of the waste products that accumulate in blood after kidneys stop working are breakdown products of proteins. However this regulation has to be done with care - too little protein and the cat's health may worsen. Similarly phosphate content of the diet has to be regulated since lowering the phosphate content appears to protect kidneys from further damage. Since it may be difficult to accurately calculate the ideal amount of these nutrients in diet, I would recommend a commercial diet specially designed for the kidney ailment. Initially it may be mixed with the feline's favorite food to help the cat adjust to it. Another important element in treatment is adequate water intake. Cats with kidney failure frequently become dehydrated and there should always be an adequate water source available (water flavored with chicken or tuna often helps if the cat is not drinking). Similarly tinned or sachet food is preferable than dry food since cats generally get most of their water from their meals.

Other treatment measures include potassium supplementation (through tablets or powder), control of blood pressure (relatively straight forward in cats - through tablets) and correction of anemia by iron, and in advanced cases, hormonal supplementation.

Don't feel overwhelmed by all this info - the vet will be able to offer the exact dosage and treatment. If you find all this confusing and hard to undertake ~ there is one procedure that will most likely bring the cat's health to near normal if not totally normal ~ that is kidney transplantation. However that is not a simple undertaking. The procedure costs around $ 4500 to $ 8000 in my understanding and requires a lot of emotional commitment.

Regarding the question about euthanasia --- when I graduated I took a personal oath to never aid or abet euthanasia. I vowed to save everybody I treat - but sadly that has not been completely possible. Through my young career as a doctor for humans so far I've already seen many die - in front of me, literally in my arms - the old ones with cancer who are terminal with all hope lost and the young ones with trauma or the occasional gunshot, reaching the hospital when they are beyond help - and I've had to bear the loss of a kitten after she hunted and consumed a poisonous lizard and died soon thereafter - and I've learned one thing from all the hours of gloom ~ the timing of death is not for us to know or conjecture ~ Nature has its own ways and trust me - as I have learned through experience - there is nothing we can do about it. Each individual is different and is destined to a different fate. All we can offer is our best support. For pets though, there is a slight shade to the philosophy - they can't express themselves in our language. They can't show their pain nor their suffering in our terms. Cats are known to suppress lots of pain without obvious display. So we are their principal caregivers and decision makers. We have to make these difficult decisions for them and we have to live with these decisions for the rest of our lives.

If it helps: when I lost my cat I was younger - devastated and beyond consolation. I kept thinking of her and her memories and there could be no way forward for me - but soon afterwards I learned there is always a cat in need - an abandoned kitten who needs our help - a feral waiting for adoption or starvation - whose love we can share to move forward in our lives - every kitty cuter and more adorable than next ~ and it is only through this knowledge that I have relived ~ to be a proud owner of two new cats - learning to cope with loss and grief and growing to relish life when it is - and looking for new life when it is gone!