The Real Deal: Managing Kidney Disease

Chronic renal failure, if caught early, can be managed through careful attention to a cat's lifestyle.

By Arnold Plotnick, DVM

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Although most cats with CRF can maintain a normal blood level of potassium, some cats lose too much potassium through their urine. Excessive potassium loss contributes to the progression of kidney failure. Fortunately, a variety of palatable potassium supplements are available for cats. 

There are ways to encourage additional water intake once the cat is home, such as feeding canned food rather than dry and adding water or broth to the food. Often, however, the fluid intake is inadequate, and some cats with CRF may require subcutaneous fluid administration. Most cats tolerate this very well and owners can easily be taught how to perform this procedure. Many CRF cats can be maintained on subcutaneous fluids applied two or three times a week or more as needed.

Cats with CRF should receive a good daily multi-vitamin. For cats battling intermittent nausea, a quarter of a 10 milligram tablet of famotidine can be administered once daily.

High blood pressure is seen in about 20 percent of cats with CRF, which will accelerate the progression of kidney failure, as well as cause damage to the brain, eyes and heart if uncontrolled. Cats with CRF should have their blood pressure evaluated. If hypertension is detected, treatment with amlodipine is recommended. Hypertensive cats need life-long therapy. Identifying and controlling hypertension helps in successful CRF management, not only by slowing the progression of kidney disease, but also by preventing deterioration of other body systems, Crystal said.

Many cats with CRF become anemic over time. Anemia contributes to lethargy and poor appetite. When genetically engineered human erythropoietin is given to cats, it dramatically reverses the anemia.  However, because the hormone is of human origin and not feline origin, approximately 25 percent of cats develop antibodies against it. These antibodies not only attack the human erythropoietin being administered, but will attack whatever remaining feline erythropoietin is present. Cats can develop sudden, severe anemia as a result and require blood transfusions to keep them alive.

It is usually at this point that owners elect euthanasia. This is an appropriate decision, because it is ethically questionable to use blood from a feline donor for a serious complication for which there is no effective long-term treatment or cure.

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Janet    Bethlehem, PA

7/17/2010 9:07:43 AM

good article, thank you very much

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