Thursday, May 12, 2022

End Stage Renal Failure In Cats

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Kidney Failure, End Stage Kidney, Chronic Interstitial Nephritis in the Cat

There are two types of kidney failure in cats. Each type differs in causes, treatment options and prognosis.

Acute Renal Failure

If your cat is suffering from acute kidney failure, it means that their kidneys are suddenly unable to function properly. This type of kidney failure occurs suddenly, within days or weeks. If diagnosed in time, acute renal failure can often be reversed.

It can happen in cats of any age and typically results from poisons, trauma, infection, organ failure, urethral blockages, dehydration and other causes. Poisons, such as toxic plants, pesticides, cleaning fluids and human medications, are the most common cause of acute renal failure.

Chronic Kidney Failure

Chronic kidney failure in cats is a gradual condition that typically develops over several months or even years. This type of kidney failure is typically caused by autoimmune diseases, cysts in the kidneys, and genetics.

Chronic kidney failure is a progressive illness that can lead to total kidney failure, where the kidneys gradually stop working as they lose the ability to filter toxins out of the blood.

Several Changes On The Bloodwork Suggest Kidney Failure:

  • Increased blood urea nitrogen and creatinine levels: BUN and creatinine are waste products that normal-functioning kidneys easily eliminate.
  • Reduced potassium
  • Elevated phosphorus
  • Anemia

A relatively new blood test that measures a substance called SDMA helps to diagnose kidney failure even earlier than can be done with routine bloodwork.

On a urinalysis, dilute urine would suggest kidney failure, especially if the bloodwork shows elevated BUN and creatinine. Protein may also be present in the urine.

Because hypertension can cause kidney failure, a veterinarian may also take a cats blood pressure to help confirm a kidney failure diagnosis.

What Causes Kidney Disease In Cats

The causes of renal failure in felines range from hereditary to environmental and everything in between.

Kidneys are delicate and prone to injury, infection, and problems with diet. Sometimes, there is no real reason behind kidney issues other than age. Unfortunately, some veterinary medications can also cause kidney damage over time.

Common causes of kidney disease include:

  • ages greater than 7 years old
  • infection

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Referral To A Nephrologist

Guidelines for referral to a nephrologist vary between countries. Most agree that nephrology referral is required by Stage 4 CKD .

It may also be useful at an earlier stage when urine albumin-to-creatinine ratio is more than 30 mg/mmol, when blood pressure is difficult to control, or when hematuria or other findings suggest either a primarily glomerular disorder or secondary disease amenable to specific treatment. Other benefits of early nephrology referral include proper education regarding options for kidney replacement therapy as well as pre-emptive transplantation, and timely workup and placement of an arteriovenous fistula in those people with chronic kidney disease opting for future hemodialysis.

What Kind Of Food I Should Give To My Cat With A Kidney Problem

Feline Kidney disease  a common problem that even more ...

Diet plays an important role in the overall well-being of your cat. Always select a kidney-friendly diet for your beloved cat. This is a great idea to offer a cat with a low phosphorous, protein, and high vitamin D diet. Also, remember that a diet high in omega-3 fatty acids also helps a cat with kidney problems.

Note: High salt diets are never recommended for a cat with kidney problems. As high sodium increases blood pressure and worsens kidney damage.

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Treating Your Cats End Stage Renal Failure:

The kidney disease encompass ranges and stages right from

Stage 1 whose symptoms are sluggishness and lethargy in cats.

Stage 2 whose symptoms are dysfunction of kidney due to nephron damage.

Stage 3 where the previous stage symptoms exacerbate damaging 50% of the kidney and its operation drastically lessens.

Stage 4 where the excretory system almost disables, and the last

Stage 5 where kidney completely fails.

On the onset, strict and subtle evaluation and analysis of cats become mandatory.

  • Urinalysis- Kidney processing, functioning and the blood & protein level is analysed.
  • Serum Creatinine test- Creatinine is a must excreted waste product from the body and its build-up & excretion analysis is important to detect kidney failure.
  • Highly recommended treatment for end-stage kidney failure in cats is dialysis or kidney transplantation.

    The kidney of a cat is replaced by an artificial kidney. This is then linked with a semi-permeable pipe. The urine and excretory matter travel out of the body via pipe inserted in veins, gets treated, purified and then the clean fluid is sent back in the body.

    This is called hemodialysis.

    Veterinarians also suggest peritoneal dialysis wherein the blood does not reach the kidney but the lining of the abdomen is used to filter the blood.

    Kidney transplantation, again, involves replacing the old kidney with the donated organ permanently. This can lead to normal kidney functioning again.

    Treatment For Kidney Disease In Cats Focuses On Slowing Deterioration

    Treatment is aimed at tackling these complications, resting the kidney and slowing deterioration. The sooner the problem is diagnosed and treated, the longer the cat’s survival time. Inevitably, deterioration happens to a point where kidney function fails and the cat becomes ill with her final illness. This is known as end stage feline renal disease.

    “Our cat, not quite 14, is at his final stage too. He is still eating a lot and drinks water. However he is having trouble walking. He still is there mentally and wants to be around us. We are worried we are going to lose him soon.” — Reader comment from Edwin Sinnott

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    Is There A Difference Between Kidney Disease And Kidney Failure

    Though the two are tied together, there is a major difference between kidney disease and kidney failure.

    Kidney disease is the chronic decline of kidney function over time, while kidney failure is the actual failing of the kidneys to the point where they cannot function properly any longer.

    The kidneys are an impressive set of organs, as they can continue to function until 65-70% of the kidneys have been impaired by chronic disease.

    Kidney failure would be the period in time of where the cats kidneys have already experienced severe damage, and can no longer function properly.

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    What are the natural treatments, the phytotherapy to lower the levels of creatinine?

    Nettle

    nettle has hemostatic properties , hypoglycemic, depurative, diuretic.

    Cynara scolymus L. is a diuretic and hepato-protector, it favours the depurative processes of the organism, it lowers the azotemia because it favours the elimination of the urea and the uric acids through the stimulation of the hepatic transformation of molecules of nitrogen imperfectly elaborated by the liver, it lowers the cholesterol and the glycaemia. It contains high levels of antioxidants, including quercetin, rutin, cynarin, silymarin, improves digestion when there is a hepatic dysfunction and helps in case of constipation.

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    Feline Kidney Disease Stages

    The International Renal Interest Society divides renal disease into different stages. These range from mild, early disease to end stage. According to these IRIS guidelines a cat is technically in end stage failure when they have less than 10 percent of normal renal function. Markers of kidney function which predict when she has entered end stage include:

    • Extremely high blood creatinine levels
    • Excessive amounts of protein in the urine
    • Very weak urine
    • High blood pressure
    • Anemia

    However, as Prof. Johnathan Elliott advises, test results are only ever a guide to the cat’s health and it’s important to treat the cat rather than the numbers. For example, some cats have shocking blood results but are relatively well, while others have OK results on paper, but are very sick in reality.

    What Are The Symptoms Of Kidney Failure In Cats

    If your cats kidneys arent removing waste from his or her body, you may notice that your cat is drinking more water and attempting to urinate more. Because the toxins build up in the cats body, they may feel nauseous and stop eating their food. In general your cat will appear to be lethargic and not very happy.

    General symptoms of kidney failure in cats can include:

    • Depression

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    Signs To Watch Out For

    While cats with chronic kidney disease can live for years while undergoing treatment, there may come a point where their kidneys have become too damaged to keep them stable. When this happens, you might observe a few symptoms that are different from the minor ones your cat was displaying before.

  • Loss of appetite: The first sign cat owners usually notice is a complete loss of appetite. Cats with end-stage kidney failure often lose interest in eating any food you give themeven treats and their favorite wet food. They completely avoid their food bowls and wont drink from the water dish. Cats who dont get enough fluids from wet food and fresh water will become severely dehydrated, causing skin tenting and infrequent urination.
  • Weight loss: A loss of appetite is closely followed by severe weight loss and muscle wasting. Cats with end-stage kidney failure lose weight despite their lack of exercise. Unlike the other possible symptoms, weight loss usually develops over a long period of time and might go unnoticed at first. However, by the final stage of kidney disease, your cat may appear extremely thin and unhealthy.
  • End Stage Feline Kidney Disease How To Help The Cat

    Kidney Failure in Cats: Knowing the Right Time to Euthanize

    The International Renal Interest Society CLASSES chronic renal failure in cats in four stages: the third and fourth stages are considered final and terminal stages of the disease, the kidneys are very compromised and can no longer filter toxins.

    Stage III : the symptoms are: loss of appetite, dehydration, increased amount of urine produced, increased thirst, weight loss, pile hair, the cat is more prone to develop urinary infections, the animal is lethargic and anemic.

    Stage III : blood values and the SDMA test

    Creatinine 251 440 micromol / l Moderately insufficient

    Azotemia: moderate

    SDMA test result> 45 g / dl

    Proteinuria> 0.4

    Hypertension 160179

    Stage IV to the symptoms described above are added the typical symptoms of uremia: uremic gastritis , stomatitis , phosphorus levels are high, metabolic acidosis takes over.

    Stage IV : blood values and the SDMA test

    Creatinine> 440 micromol / l Seriously insufficient

    Azotemia: very high

    SDMA test result> 45 g / dl

    Proteinuria> 0.4

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    What Are The Signs Of Ckd

    In most cases CKD is a progressive disease. Initially, clinical signs are often very subtle and mild, but will gradually get worse over a long period of time. More rarely, signs may appear to develop quite suddenly .

    Many of the signs are vague and non-specific some arise from the accumulation of toxins in the blood while others may arise as complications from the body trying to adapt to the disease. The most common signs are:

    • Weight loss

    Helping Your Cat With Kidney Disease

    You love your cat and it breaks your heart to see her so sick. By all means, do everything possible to comfort her, but know sometimes it is kinder to say goodbye than battle on. Euthanasia is hard for an owner, but know you are putting the cat’s best interests first and preventing suffering. Ultimately, saying goodbye is a brave decision made from a sense of self-sacrifice. It is not what you want, but what the cat needs, that is of paramount importance in the end.

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    What Are The Stages Of Kidney Failure

    An official staging system, developed by the International Renal Interest Society , assigns a stage to chronic kidney failure according to fasting blood creatinine levels. There are also sub-stages, which consider blood pressure and protein in the urine.

    The main stages are 1 to 4 . Your cats stage of kidney failure will guide treatment.

    You can find the most recent IRIS staging guidelines here.

    What Is Chronic Renal Failure Is It The Same As Chronic Kidney Disease

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    The kidneys have a large amount of spare capacity to perform their various functions so at least two-thirds of the kidneys must be dysfunctional before any clinical signs are seen. In many cases, this means that the damage to the kidneys has been occurring over a number of months or years before failure is evident. Chronic renal failure , or chronic kidney disease is mainly a problem in older cats. Only about 10% of the cases occur in cats less than three years old.

    “Damage to the kidneys has been occurring over a number of months or years before failure is evident.”

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    Feline Renal Failure Stages

    Chronic feline renal failure isa progressive, degenerative disease that affects primarily older cats. This condition is one in which the kidneys are damaged more and more over an extended period of time. As they become damaged, they can no longer completely execute their task of purifying and filtering the liquids of the body. When feline renal failure reaches a certain crucialpoint, your pet will begin to develop outward symptoms. Left unmoderated, this condition can quickly become deadly. Chronic renal failure is not curable, but you and your vet can work together to help manage it, so that your pet can continue to lead a relatively normal, healthy life. According to the International Renal Interest Society, there are three primary stages of feline renal failure.

    When To Euthanize Cats With End Stage Kidney Disease

    Sadly, leaving the cat to die naturally may cause suffering. Those high toxin levels often lead to seizures and her last few days are likely to be unpleasant. Instead, before this happens it is kinder to ease her distress by making the humane decision to say goodbye.

    Making the ultimate decision is less difficult if you have planned ahead and written down at what stage you consider it unfair to the cat to continue. To aid decision making, it is helpful to think of your cat in her prime and what you would consider unacceptable quality of life back then. For example, if your cat was a greedy eater, then a lack of appetite is a sure sign she is not herself. Weigh up factors such as:

    • Dignity – Does she soil herself?
    • Lack of pain or discomfort – Is she vomiting regularly?
    • Playfulness – Does she now hide away?

    These intangible factors often tell you a lot about how sick the cat has become.

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    About Joanna Pendergrass Dvm

    JoAnna Pendergrass, DVM, is a veterinarian and freelance medical writer in Atlanta, GA. After graduating from the Virginia-Maryland College of Veterinary Medicine with her veterinary degree, JoAnna completed a 2-year research fellowship in neuroscience at Emory University. During this fellowship, she learned that she could make a career out of combining her loves of science and writing.As a medical writer, JoAnna is passionate about providing pet parents with clear, concise, and engaging information about pet care. Through her writing, she strives not only to educate pet parents, but also empower them to make good health decisions for their pets. JoAnna is a member of the American Medical Writers Association and Dog Writers Association of America.

    How Is Ckd Diagnosed

    Chronic Kidney Disease in Cats

    A diagnosis of CKD is usually made by collection of blood sample and a urine sample at the same time for analysis.

    Traditionally, two substances in the blood urea and creatinine are commonly analysed, as these are by-products of metabolism that are normally excreted by the kidneys. In CKD the blood concentration of these two products will increase. However, as some other conditions can also cause elevation of these substances, a urine sample is usually analysed at the same time. Typically with CKD, there will increased urea and creatinine concentrations as well as poorly concentrated urine. The urine specific gravity is measured to assess its concentration, and in most cats with renal failure this is less than 1.030. More recently another blood test has also become available called SDMA which may be of value in diagnosing CKD in cats it may allow earlier detection of CKD in some cats and may also allow more accurate staging of CKD in some, although at present it is commonly used alongside urea and creatinine concenrtrations as measuring all three is likely to give most accurate information.

    Measuring the quantity of protein being lost in urine can be important in cats with CKD. Increased loss of protein in the urine may be a marker of progressive CKD. In humans, using drugs to reduce proteinuria may significantly slow down progression of the CKD it is not certain if the same is true in cats, but it could be.

    Early diagnosis of CKD

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    How To Deal With The Loss Of Your Cat

    I remember waking up the day after I said goodbye to my precious feline companion Garrus.

    It felt like my whole world had ended.

    I missed his good morning meow, his strangely loud purr, and his sweet little trilling when I poured my cereal.

    That morning, I stared at my bowl, my spoon perched on the edge, and I just cried. He was gone and I was lost.

    Dealing with the loss of a cat is never easy, but there are many things you can do to help you make it through the toughest days.

    One thing that helped me was talking with friends and family who knew Garrus. We shared stories and laughed at my silly little boys antics.

    We cried together and hugged.

    If youre not feeling social or like you can face other humans right now, thats okay, too.

    You can reach out to other pet parents on message boards and social media.

    Theyll listen to your story and offer support and kindness from afar.

    Look at pictures and videos of your angel kitty.

    It may be hard at first, but simply seeing them as they were in life can heal a broken heart.

    Did you know that the other pets in your household are grieving too?

    Spending some quality time with your other pets can soothe you both.

    Journaling or simply writing out your feelings is an incredibly therapeutic way to handle the loss of your cat.

    You can keep the writing or throw it out, but just getting it out on paper can help a lot.

    Did you have a ceremony for your cat?

    This is one of my familys ways of saying goodbye.

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