Renal Insufficiency

Renal Insufficiency

The kidneys are one of the most important filtration organs in the body. In addition to maintaining water and electrolyte balance, they are also responsible for filtering out toxins which are subsequently excreted in the urine. As cats age, there is a gradual decrease in the functioning of the cells responsible for maintaining this balance. Because cats were originally a desert species they don’t seem to drink as much water as dogs or people until their kidneys begin to decline. Often, they show no signs of decreasing kidney function until 75% of the cells are no longer working. There are several symptoms that arise slowly which help us diagnose early kidney disease, or what we call renal insufficiency.

Clinical Signs

  • increased drinking and urination
  • decreased appetite and weight loss
  • bad breath

These signs are a result of the kidneys having a decreased ability to reabsorb water into the body and filter toxins out of the body. The consequence is increased thirst and urination, decreased appetite and decreased energy levels.

How do we diagnose renal insufficiency?

Clinical signs combined with bloodwork allow us to diagnose renal insufficiency.

  • Creatnine and BUN increase
  • Potassium decrease
  • Phosphorous increase

Creatnine is more specific for kidney functioning and the BUN level is an indicator of toxins in the bloodstream. As the values increase, it means the kidneys are functioning less efficiently. We also evaluate potassium and phosphorous levels, because these electrolytes are directly affected by the functioning of the kidneys. Too much potassium is excreted in the urine, and phosphorous levels increase because the kidneys don’t excrete enough.

What happens when my cat is diagnosed with Renal Insufficiency?

Fortunately there are several ways we can help support your cat when he/she is diagnosed with renal insufficiency. Diet- high quality balanced protein is helpful in decreasing the work load on the cells of the kidney. Wet food is preferable, but for cats who are kibble eaters, there are specific diets available (Hill’s kid, Royal Canin renal care).

Benazepril (Lotensin) – effectively lowers blood pressure within the kidneys and supports functioning of the cells. This is a daily medication that helps slow the progression of kidney disease. Cats on this mediCation often have a decrease in their creatine and BUN levels within the first 3 months of therapy.

Fluids – given under the skin at home help hydrate your cat and flush more toxins out of the body.

Potassium Supplementation – increases levels of potassium, an electrolyte that is important in all cells of the body. It comes in a powder formulation that can be mixed in wet food or capsules.

Phosphate Binders – bind with the excess phosphorous circulating in the bloodstream and help the kidneys filter it into the urine. It is most commonly in a powder formulation that can be mixed with wet food or sprinkled over dry food.

Depending on the stage of kidney insufficiency when your cat is diagnosed, will dictate which combination of the above treatments are warranted.

Maintenance

It is important to have your cat’s kidney values monitored every 3 months until they are stabilized. At the first recheck appointment, we will check your cat’s blood pressure before doing anything else to get a more accurate measure. If needed, we will start your cat on medications to lower the blood pressure. Once stable, we recommend recheck bloodwork every 6 months to evaluate any change in therapy that is indicated.

Renal Insufficiency is a condition that, when diagnosed early, can be easily managed at home. Treatment results in a slower progression of the disease and can add at least 1-2 years of quality life for you and your cat to enjoy!