Explaining kidney disease

Talk about their pet’s disease

  • Cats have two kidneys that work as filters, removing waste products from the bloodstream, which are then eliminated from the body via urine
  • When a cat develops chronic kidney disease (CKD), their kidneys stop working properly and toxins build up in the blood, making the cat unwell
  • In most cases, the initial cause of CKD remains unknown
  • CKD is difficult to diagnose until the disease is already quite advanced
  • Manage expectations by saying that, because of the difficulty in early diagnosis, CKD is one of the main causes of death in cats, especially as they get older
  • Explain that with the right care, however, the cat can live a longer, happy life with the owner

How to answer the question, “Why is this happening to my cat?”

  • Kidney disease is a common health problem in cats
  • CKD is common in elderly cats, but may also affect younger cats
  • CKD can be acquired during the course of the cat’s life, for example, due to infections, exposure to toxins or injury
  • Cats can also be born with kidney problems, which they may or may not have inherited from their parents – this is called congenital CKD

Talk about treatment

  • Explain that CKD can often be managed with drugs that improve and extend the cat’s life
  • Make it clear that, as there is no cure for CKD, lifelong treatment will probably be necessary, which the owner must adhere to if they want to help their pet get the most out of life
  • Talk about how the owner can help monitor their pet’s health by checking their cat’s weight, appetite and general behaviour
  • Explain that even if the owner notices an improvement in their cat’s symptoms, they shouldn’t stop treatment without asking for veterinary advice
  • Stress the importance of regular visits to the vet for treatment success
  • Demonstrate techniques for giving tablet medication to cats
  • Explain that even if the owner notices an improvement in their cat’s signs, they shouldn’t stop treatment without asking for veterinary advice
  • Stress the importance of regular visits to the vet to optimise the chance of treatment success
  • Demonstrate techniques for giving tablet medication to cats

Explaining the drugs

  • ACE inhibitors are recommended. First developed for use in man after it was found that they reduce excessive amounts of protein in the urine (which is thought to be toxic to the kidneys), reduce blood pressure and may increase lifespan
  • Fluid therapy, to prevent the cat becoming dehydrated, can be achieved with simple lifestyle changes (see below), or sometimes requires an intravenous drip at the veterinary surgery

Talk about hydration

  • Explain that cats with CKD are vulnerable to becoming dehydrated, partly because they may not be drinking or eating sufficient fluids, but also because damaged kidneys are prone to losing excess fluids in the urine. Dehydration worsens kidney function and can quickly worsen the cat's clinical condition. Therefore, it’s important to keep the cat hydrated:
    1. by making sure it has free access to a fresh supply of water. Provide several bowls of water within ready access
    2. if possible, by offering moist rather than dry renal diets
    3. by supplementing the diet with flavoured water or broths. For example, liquidise a few prawns in some water and offer this as a drink to the cat. Alternatively, poach some chicken or fish in water, and offer the water to the cat
    4. by not offering salty liquids (such as fish in brine), as this increases the risk of high blood pressure developing
    5. by not offering milk, as this contains large amounts of phosphate, a mineral which many cats with CKD are vulnerable to accumulating in excess
    6. some cats will enjoy drinking from water fountains, which can be obtained from pet shops or veterinary surgeries

Talk about diet

  • Introduce the special 'renal' diets that are available for cats with CKD. There is now good scientific evidence to show that cats with CKD eating these diets live longer (on average twice as long) than those not fed the diets
  • Explain that the diets should be introduced gradually to encourage acceptance by the cat
  • Recommend an appropriate diet