Chronic kidney disease in cats. Metabolic acidosis in the clinical practice of a veterinarian

Diseases of the urinary system in pets are quite common, and each such case is a reason for an immediate visit to the veterinarian. The fact is that with kidney pathologies the most dangerous consequence is renal coma. As a rule, it is no longer possible to remove the animal from it.

Actually, coma is the “vegetable” state of an animal, in which only general functional systems body. That is, the “carcass” breathes, defecates and urinates, but the pet remains in “anabiosis.” IN in this case a similar result is caused by the accumulation of nitrogenous bases in the blood, including urea. The main reason -. Therefore, consideration of pathology should begin with its development, predisposing factors and symptoms.

Kidney failure is defined as the inability of the kidneys to remove waste products from the blood. The accumulation of toxins leads to the development of symptoms of uremic poisoning, which, in turn, leads to renal coma.

It can appear either suddenly (acute renal failure), as a result of poisoning, or gradually ( chronic form illnesses). The last type is more typical for many infectious diseases and chronic poisoning.

The main sign of kidney problems is increased and sharply increased thirst. Moreover, in some cases, sick dogs and cats may spontaneously urinate while walking. These signs indicate extreme serious problems with kidneys that are unable to concentrate and store urine. Control over the process of urination weakens, the urinary system practically stops working normally.

All the ammonia, nitrogenous bases, acids and other chemical “waste” accumulate in the tissues and blood. This is called uremia. The degree of uremia is determined by measuring blood urea nitrogen (BUN), creatinine and electrolytes. The higher they are, the closer the animals are to renal coma.

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Signs of uremia are apathy and depression, loss of appetite and weight, “drying out” of the coat, which becomes brittle and stiff. The tongue acquires a brownish tint, and the exhaled air noticeably “gives off” pure ammonia. At this stage, the animal begins to urinate rarely, signs of intoxication increase in geometric progression. On the mucous surface oral cavity and even pronounced, deep ulcers appear on the tongue. IN severe cases chronic kidney destruction (nephritis and nephrosclerosis) develops (edropsy of the abdominal cavity).

An extremely alarming symptom is “rubber jaw.” This phenomenon is characterized by the weakening of the “fasteners” of the teeth and the formation of ulcers of the mouth and gums. The pathology develops against the background of completely disrupted calcium-phosphorus metabolism. Bone begins to quickly degrade, as it does not receive the necessary “feeding” in the form of vital micro- and macroelements.

Due to severe intoxication, the pet begins to vomit frequently, uncontrollably, and also smell of ammonia. IN terminal stages renal failure the pet falls into a coma.

Main reasons

Causes of acute kidney failure include:

• Complete obstruction urinary tract stones or sand. Because of this, by the way, renal coma often occurs in cats. This is less common in dogs.

• Perforation Bladder when urine begins to be “etched” into the abdominal cavity in small portions. This is an extremely unpleasant pathology, since the animal can be treated for kidney diseases for a very long time, which only worsens the course of the disease. The released urine is absorbed by the peritoneum and enters directly into the blood.

• Shock. For severe injuries it can lead to a short-term cessation of blood supply to the kidneys, which leads to massive death of nephrons and non-viability of the organ.

• Stagnant With low blood pressure and reduced blood flow to the kidneys. The same as in the previous case.

• Poisoning, especially salts of heavy metals.

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Dogs with kidney failure do not show signs of uremia until more than 75% of all the nephrons present in the kidneys have been destroyed. Thus, everything is very sad - when symptoms appear, and a coma is not far off, there is little left of the kidneys. That is why advanced renal failure can no longer be treated - the animal is doomed to “sit” on maintenance medications for life. Because of this, we do not talk about treatment as such - it does not exist. There is only supportive therapy that allows you to maintain a more or less adequate quality of life for your pet.

Diagnosis and treatment

As we have already written, blood and urine tests are taken. In doubtful cases, a renal tissue biopsy is recommended. It helps prescribe treatment and determine whether the disease is curable in principle.

Important! Animals with renal failure require constant monitoring and weekly blood tests (ideally daily). It is very important to carefully select a diet that covers the pet’s body’s needs for potassium, phosphorus and calcium, as well as protein.

With the latter, everything is worse, since with diseased kidneys, 90% of proteins are “thrown out” into external environment with urine. At the same time, giving a dog or cat a lot of meat is strictly prohibited.– the “heavy” protein contained in them gives more heavy load on the excretory system, which does not lead to anything good. Moreover, a good piece of meat thrown to a cat or dog with kidney failure is an almost 100% guarantee that the animal will fall into a uremic (renal) coma. Thus, everything is very complicated with the diet, and its preparation should be done by a professional, experienced veterinarian.

Based on materials from the website www.icatcare.org

Chronic renal failure(CRF) is one of the most common diseases that develops in older cats and gradually progresses over time. The rate at which changes occur varies widely in each cat.

The kidneys are important body responsible for maintaining fluid balance in the body, producing certain hormones, regulating the concentration of many electrolytes in the cat's body, and removing waste products (in urine). With chronic renal failure, all these processes can be disrupted, which leads to the appearance of many clinical signs.

Although chronic kidney failure is incurable and irreversible, appropriate care and treatment can significantly improve the quality of life and prolong a cat's life by slowing the progression of the disease.

The role of the kidneys in the cat's body.

Like all mammals, a cat has two kidneys located in abdominal cavity, which perform a number of important tasks:

• Removing toxins from the blood;
• Maintaining fluid balance;
• Regulation salt balance(and concentrations of other electrolytes);
• Regulation of acid balance;
• Blood pressure management;
• Hormone production;

The blood is constantly filtered by the kidneys to remove toxic substances, formed in the metabolic processes of the body, forming urine. The kidneys also concentrate urine, returning water to the cat's body, which prevents dehydration.

Fortunately, the kidneys have a significant margin of safety. It is well known that healthy people and animals, one kidney can be removed without fatal consequences. In fact, signs of chronic renal failure in cats only begin to appear when two-thirds to three-quarters of the functional kidney tissue is lost.

Causes of chronic renal failure in cats.

CRF begins to develop in cats if there are long-term, irreversible changes in the kidneys, which limit their functionality and ability to remove waste products from the blood. In most cases, the trigger for the development of renal failure remains unknown. Biopsies of diseased kidney samples often show the presence of both fibrosis and inflammation. This condition is referred to as chronic interstitial nephritis . This is a nonspecific condition that does not allow us to judge the cause that caused it. Although most cases are idiopathic (have unknown reason occurrence), in some cases the cause can be determined. It can be:

• Polycystic kidney disease. Hereditary disease, characteristic mainly of cats of Persian and related breeds, in which normal kidney tissue is gradually replaced by several fluid-filled cysts.
• Kidney tumors. Tumors (such as lymphoma, a tumor of white blood cells) can attack a cat's kidneys, replacing tissue.
• Infectious diseases. Bacterial infection kidneys (pyelonephritis) significantly increase the likelihood of developing chronic renal failure in cats.
• Poisoning. Certain toxic substances and medications can be harmful to the kidneys.
• Glomerulonephritis. Inflammation of the glomeruli (glomeruli) that filter the blood. Inflammation can occur due to various reasons. If treatment is not started on time, chronic renal failure may develop.

Other reasons such as birth defects kidney disease, trauma, hypokalemia (low concentration of potassium ions in the blood) can also lead to chronic renal failure, but in most cases it is impossible to accurately determine the cause of the disease.

If it is possible to determine the cause of the disease, sometimes with the help of appropriate treatment it is possible to stop the development of chronic renal failure. In most cases, however, treatment is aimed at maintaining the cat and eliminating any complications that arise.

How common is chronic renal failure in cats?

CRF can occur in cats of any age, although it is more common in mature and older animals (over 7 years of age). With age, the likelihood of the disease increases. It has been established that from 20 to 50% of cats over 15 years of age suffer from chronic renal failure. varying degrees. Chronic renal failure occurs three times more often in cats than in dogs.

Symptoms of chronic renal failure in cats.

Typically, chronic renal failure develops gradually. Often at first Clinical signs invisible or weak, they gradually intensify over a long time. Much less often, symptoms appear and quickly intensify (often as a result of decompensation or sharp deterioration condition, for example, if a cat with chronic renal failure does not have enough water).

Many signs are subtle and non-specific - some appear due to the accumulation of toxins in the blood, others as a consequence of the body's attempts to adapt to the disease. The most commonly observed symptoms are:

• Weight loss ;
• Poor appetite;
• Lethargy;
• Increased thirst (polydipsia);
• Frequent urination (polyuria);

Urine production increases because chronic kidney disease causes the cat's kidneys to lose their ability to concentrate urine. To compensate for the loss of fluid, the cat begins to drink more.

In addition, the following symptoms may be observed:

• Poor condition of wool;
• Hypertension ( high pressure blood);
• Nausea;
• Bad breath (halitosis)
• Weakness;

Diagnosis of chronic renal failure in cats.

CRF in cats is usually diagnosed by testing blood and urine samples. Two substances found in the blood are analyzed - urea and creatinine, since they are metabolic products excreted by the kidneys. In chronic renal failure, their concentration in the blood increases. However, some other diseases can also increase their levels in the blood, and urine tests are performed at the same time. Chronic renal failure is characterized by an increase in the concentration of urea and creatinine in the blood and at the same time a decrease in their concentration in the urine. Specific gravity measurement ( in the original - specific gravity) to estimate concentrations for cats with kidney disease usually gives a value below 1.030.

A blood test can also identify abnormalities that develop as a result of chronic renal failure, such as hypokalemia (low concentration of potassium ions in the blood), anemia and hyperphosphatemia (increased blood phosphate concentration). Because high blood pressure is a relatively common consequence of chronic kidney failure in cats, your veterinarian may measure your blood pressure. Sometimes x-rays, ultrasound or even a biopsy are additionally performed to clarify individual characteristics cat diseases.

Measuring the urinary protein to creatinine ratio may be important for cats suffering from ESRD. Increased content protein (proteinuria) may serve as a marker of progressive renal failure. In humans, taking drugs that reduce proteinuria can significantly slow the progression of chronic kidney disease - this is probably true for cats, although there is no reliable evidence yet.

Early diagnosis of chronic renal failure in cats.

Since CRF is quite common in cats, periodic screening of adult and older animals may help. early detection diseases. This, in turn, will help maintain good quality life. One or two visits to the veterinarian per year, urine testing and weighing will allow you to monitor changes in the cat's condition. A decrease in urine concentration or weight loss may be early signals of the incipient development of chronic renal failure and the need for in-depth examination.

Uremic syndrome (uremia)- is a collection clinical symptoms and abnormal biochemical parameters that are present in all cats with chronic renal failure, regardless of the underlying cause of the disease. These symptoms include depression, lethargy, weakness, the cat's reluctance to socialize, and weight loss; as well as decreased or absent appetite, vomiting and tartar formation.

At laboratory research discover:
● Azotemia
● Hyperphosphatemia and secondary renal hyperparathyroidism
● Hypokalemia
● Metabolic acidosis
● Systemic arterial hypertension
● Anemia
● Progressive decline in renal function.
Care and therapy involve identifying and advising treatment of any abnormalities.

UREMIA: DIETARY AND COMPLEMENTARY THERAPY
First of all, when the concentration of urea in the blood serum increases to the range of 10-15 mmol/l, it is necessary to limit protein intake from food. The diet should contain approximately 26% - 32% protein of dry matter (approximately 3.8-4.5 g/kg/day). Supplementation with a balanced electrolyte solution (eg, 20 to 40 mL Ringer's solution/kg subcutaneously every 24 to 72 hours) is sometimes helpful.
Hyperphosphatemia is very common and is directly related to the degree of renal dysfunction and the amount of phosphorus taken from food. To delay the development of kidney problems, all cats with azotemia need to limit the amount of phosphorus in their diet. The feed should contain 0.5% phosphate of dry matter (65-85 mg/kg/day). It is necessary to achieve normophosphatemia.
A low-phosphorus diet is used for 2-4 weeks, and then, if normophosphatemia is not achieved, it is necessary to begin adding phosphorus binders at an initial dose of 30 - 180 mg/kg/day with food. Aluminum and calcium salts can be used as phosphorus binders in the same initial doses. Although aluminum has been associated with osteodystrophy or encephalopathy in humans, there is little evidence for the development of these side effects in cats. Calcium-containing phosphorus absorption limiters can cause hypercalcemia. Add phosphorus binders to wet food or canned food and gradually change the dose to reduce food aversions.
Hyperphosphatemia and decreased renal production of calcitriol contribute to the genesis of secondary hyperparathyroidism. Some pathologies found in animals with uremic syndrome are caused by excess amounts of the hormone parathyroid gland. Such pathologies include uremic osteodystrophy, anemia, arthritis, cardiomyopathy, encephalopathy, glucose intolerance, hyperlipidemia, immunosuppression, myopathy, pancreatitis, pruritus, skin ulceration and soft tissue calcification. The role of excess parathyroid hormone in the pathogenesis of uremic osteodystrophy is considered to be central; its significance in the development of other pathologies in uremia remains unclear.
Dietary phosphorus restriction and use of phosphate binders usually result in decreased hormone concentrations parathyroid glands, but do not normalize it completely. There is some evidence to support the use of calcitriol to further lower PTH concentrations: 2.5-5.0 ng/kg per day orally every 24 hours, without food. Calcitriol lowers parathyroid hormone concentrations in most dogs with chronic renal failure. A similar effect is observed in cats. Animals receiving this therapy should have calcium levels monitored closely (every 2 to 4 weeks) as calcitriol may cause hypercalcemia in some cats and lead to hypercalcemic nephropathy.

VOMIT
It is necessary to eliminate nausea and vomiting in cats with uremic syndrome, as these symptoms greatly worsen the quality of life of animals, reduce the supply of essential substances with food (appetite with nausea is absent or reduced), and lead to loss of electrolytes and fluids. To control vomiting, H2 blockers such as Tagamet (4 mg/kg orally every 6 to 8 hours), ranitidine (1 to 2 mg/kg orally every 12 hours), or famotidine (1 mg/kg orally every 24 hours) are used. ). Centrally acting antiemetics may be used intermittently, especially when vomiting is prolonged.

POTASSIUM DISORDERS
Hypokalemia is often present in cats with polyuria. This indicates insufficient potassium intake and/or the effect of an acidified diet, which may cause potassium loss. Hyperkalemia is rare, occurs mainly in the terminal phase of chronic renal failure and is often associated with oliguria or anuria.
Hypokalemia is extremely harmful; Among other problems, it also leads to further deterioration of kidney function. First of all, cats with hypokalemia need to be switched to a diet with high content potassium and low acidity. Giving potassium (1-3 mEq/kg per day) orally (preferably potassium gluconate) mixed with food will help increase blood potassium levels. Other potassium compounds are generally less well tolerated. Once potassium levels are normalized, potassium supplements can be reduced or eliminated.

METABOLIC ACIDOSIS
Proteins, especially animal proteins, are rich in sulfur-containing amino acids; the metabolism of these amino acids leads to the formation of hydrogen ions - hence an even greater acid load that must be produced by the kidneys to achieve acid-base balance. Cats with reduced renal function are less able to excrete acid, potentially resulting in metabolic acidosis. Acidosis can cause lethargy and lack of appetite.
Adequate monitoring of acid-base status includes constant monitoring of serum carbon dioxide and bicarbonate concentrations. Therapeutic goal is to keep the patient's readings within the normal range. Sodium bicarbonate (initial dosage 15 mg/kg 2-3 times a day) or potassium citrate (30 mg/kg 2-3 times a day) can be added to food. The latter additionally supplies potassium, which is beneficial for many cats with chronic renal failure.

ANEMIA
Anemia in chronic renal failure is normocytic, normochromic, and nonregenerative, and occurs primarily due to decreased generation of erythropoietin in the kidneys. Although the accumulation of toxins and endocrinopathies (eg, renal secondary hyperparathyroidism), reduces the production of red blood cells and shortens their life expectancy, these factors have a small contribution to the pathogenesis of anemia.
With an increase in hematocrit in cats, the manifestations of depression often decrease - lack of appetite, inertia, reluctance to communicate. Unfortunately, anabolic steroid and blood transfusions have limited use in treating anemia in such patients. Recombinant erythropoietin (50-100 units/kg SC 2-3 times per week) will increase the hematocrit in most animals. When using erythropoietin, cats should receive supplemental ferrous sulfate (50-100 mg orally every 24 hours). When using recombinant erythropoietin, hematocrit levels must be carefully monitored to avoid polycythemia. Therapeutic goal - lower levels normal hematocrit range (30%-35%).
U significant amount cats (approximately 25-40%) develop antibodies to this human glycoprotein, which manifests as resistance to therapy. Other reasons must also be considered unsuccessful treatment, such as leukemia, viral infection or iron deficiency. If antibodies appear, further use of this medicine impossible. Erythropoietin should be used with caution, judiciously, only in animals with hematocrit<20% и клиническими симптомами анемии.

SYSTEMIC ARTERIAL HYPERTENSION
Cats with renal failure usually have systemic arterial hypertension. Severe systemic hypertension can lead to retinal hemorrhages and/or retinal detachment, seizures, and cardiac hypertrophy. Mild to moderate hypertension can also be quite harmful, but this claim remains to be investigated.
Treatment for hypertension should be based on measuring blood pressure or identifying damage that hypertension may cause (eg, retinal detachment). Measurements should be taken by an experienced technician in a quiet place until a minimum of five consistent readings are obtained. Treatment is usually prescribed if systolic pressure exceeds 200 mm Hg. Art. or 170 mm Hg. Art. in cats with complications related to arterial hypertension, and the diastolic pressure exceeds 110 mmHg. Art. and there are clinical pathologies caused by hypertension. The goal of therapy is to reduce blood pressure by at least 25-50 mm Hg. Art., maintaining adequate renal function. Ideally, the pressure should be maintained in the normal range (systolic 100-140 mm Hg; diastolic 60-100 mm Hg; average 80-120 mm Hg).
Antihypertensive therapy should include the use of a sodium-low diet combined with either an ACE inhibitor (enalapril 0.5-2.0 mg/kg orally every 12-24 hours or benazepril 0.25-2.0 mg/kg orally every 12-24 hours) or calcium channel blockers ( amlodipine 0.625-1.25 mg per cat orally every 24 hours). These substances can be combined as needed to achieve the desired blood pressure reduction.
Therapy for systemic arterial hypertension is selected based on effectiveness. Efficacy is assessed by measuring blood pressure initially weekly, and after titrating the dose every 3 to 6 months. It is possible to change the dosage during treatment. Adverse effects of antihypertensive therapy include decreased renal function and weakness or syncope due to hypotension.

PROGRESSION OF RENAL DISEASE
Chronic renal failure is irreversible and progresses until end-stage uremia develops. Possible causes of this progression include exacerbation of primary renal disease and secondary factors: excess phosphorus in the diet or hypertension in the systemic and glomerular vessels.
To delay the onset of the terminal stage of uremia, it is necessary to control both the primary disease and secondary damaging factors. For example, cats with azotemia require dietary phosphate restriction, supplemented by intestinal phosphorus-binding agents (see above). Dietary protein restriction (see above) may be recommended for cats with mild azotemia, although this remains a controversial treatment option. Dietary protein restriction to reduce the effects of uremia is indicated for moderate to severe azotemia. Based on studies in other animal species, the use of ACE inhibitors may reduce systemic blood pressure and glomerular blood pressure, reduce the degree of glomerular hypertrophy, and slow the progression of gromelurosclerosis and interstitial fibrosis.

PATIENT CONTROL
All cats with azotemia should have urinalysis, urine culture, blood electrolytes, hematocrit, serum creatinine, and blood pressure monitored every 2 to 6 months. Monitoring should be performed more frequently if renal function is unstable, if creatinine is >4 mg/dL, or if systemic hypertension is observed. Biochemistry and full analysis blood should be drawn annually.

Domestic cats are prone to kidney disease. To prevent the disease, or eliminate its symptoms in sick pets, owners need to know all the information about kidney failure, which in its advanced state is a deadly threat. To understand the scale of the problem, it is worth understanding the functions that the kidneys perform in the animal’s body. This organ is part of the excretory system and is involved in many vital processes.

U healthy cat The kidneys provide the following functions:

• blood pressure stabilization;
• removing toxins and waste from the blood, mineral salts and other toxic substances;
• production of hormones and enzymes;
• Participates in the creation of red blood cells.

The main job of the kidneys is to filter blood. It happens as follows - all the blood flow passes through the nephrons located in the kidneys. During the circulation process, all harmful substances are separated from the blood, which are excreted from the body along with urine, and the purified blood flows back to the heart.

It is important for the pet owner to understand why kidney disease occurs in cats, symptoms and treatment of which are discussed with the veterinarian. In most cases, the risk of the disease is high for older pets who have reached the age of 8-10 years. In these animals, as a result of kidney failure, the filtration system is impaired, and toxic waste accumulates in the circulating blood. In the future, this leads to problems with other organs. However, chronic and acute renal failure in cats, the treatment of which is selected in individually, can also be diagnosed in young cats.

Several factors provoke the disease:

1. bad heredity;
2. genetic predisposition (noted high risk diseases in cats - Persians, Angoras, etc.);
3. improper conditions of detention;
4. violation of the drinking regime;
5. unbalanced or low-quality diet;
6. injuries;
7. infections;
8. formation of stones in the excretory organs.

Symptoms of the disease

Only a qualified veterinarian can correctly recognize the disease, prescribe a treatment package and recommend good medicinal food for cats with kidney failure. The owner’s task is to monitor the cat’s condition and record alarming symptoms, which may indicate the presence of kidney disease.

When found the following symptoms The owner should not postpone a visit to the veterinary clinic:

• loss of appetite;
• vomit;
• the cat rarely goes to the toilet in small quantities, and urination occurs in unusual places;
• the pet looks lethargic and apathetic;
• impaired coordination of movements;
• the cat experiences pain when urinating;
• the animal loses weight;
• disturbance of normal stool;
• refusal of water.

If the owner sees at least one symptom, for example, notices that the cat does not go to the toilet for a little while, he should contact the veterinarian for advice. The symptoms listed above can also be observed in other diseases, such as nephritis in cats, symptoms and treatment for different diseases are very different, so an accurate diagnosis of the disease should be entrusted to a veterinarian.

Diagnostic methods

Specialist in veterinary clinic will examine the animal and prescribe a series of tests. Traditionally, to identify kidney problems, cats are given a general chemical analysis blood and urine. The purpose of the tests is to detect the presence of toxins in the blood, which must be eliminated from the body in the urine. If the level of toxins is high, this is a detector that the animal's kidneys are not coping with filtering metabolic waste.

Additional clinical researches which will help identify the cause of the disease: ultrasound, kidney tissue biopsy, x-ray, urinolysis.

Treatment of kidney failure

If the diagnosis of renal failure is confirmed, then therapy is prescribed by a veterinarian in accordance with the stage of the disease. If the disease manifests itself in acute form, then treatment should occur immediately. Because acute kidney failure is caused by any type of blockage urinary tract, then the obstruction of the canals must be urgently eliminated. On early stage the course of the disease is reversible, and if the appropriate set of measures is taken, the cat can live a long and full life.

In the first stages of the disease, the animal owner should not engage in self-treatment cat and give her drugs with a dubious spectrum of action. A veterinarian will prescribe competent therapy. Therapy may consist of prescribing intravenous solutions, which will correct the imbalance of substances in the blood and help stabilize the pet’s condition. When diagnosing chronic renal failure - chronic kidney disease in cats, treatment by stages should be carried out under the supervision of a veterinarian.

It is worth understanding that chronic renal failure in cats, the treatment of which is very different from the treatment of the disease at an early stage, can haunt pets throughout their lives.

The disease at this stage is incurable and affects mainly adult and elderly cats. The diagnosis of chronic renal failure is made by a veterinarian if more than 70% of the kidney tissue is damaged or scarred.

To eliminate the symptoms and reduce the suffering of the cat in such cases, veterinarians prescribe a complex palliative care. Drug treatment CRF in cats may consist of the following measures:

1. Introduced into the pet's diet medicinal food for cats with renal failure from a good manufacturer.
2. Infusion therapy is prescribed.
3. Are used conservative methods treatments that do not stop, but slow down the degradation of the kidneys.

In severe cases, therapy involves surgical removal a non-functioning kidney, but this decision is made by the veterinarian after tests confirm that a pet with one kidney can live life to the fullest. Also, if chronic kidney disease is diagnosed in cats, a kidney transplant may be performed. This complex procedure became available to veterinarians not so long ago and is currently performed only in a narrow circle of clinics that have the appropriate level of equipment.

Veterinary drugs

After the veterinarian has determined the cause of the disease, examined the medical history and assessed the general physical state cat, he can prescribe the use of a series medications. Therapy is prescribed on an individual basis, since all animals have their own body characteristics and need certain medications and appropriate dosages.

Basically, the following types of veterinary drugs are used to treat the disease:

Prednisolone for cats, a catabolic drug with immunosuppressive properties, may sometimes be prescribed. To treat metabolic disorders, your pet may be prescribed Ketosteril for cats, which must be taken in accordance with the instructions. This drug contains artificial analogues essential amino acids and helps in the fight against chronic kidney disease.

In addition to those listed above veterinary drugs, at treatment of chronic renal failure Can be used Ipaketin for cats which can be purchased at a veterinary pharmacy. The drug Ipaketine for cats, the price of which is about 300 rubles per 50 grams, is a nutraceutical drug. It improves functional state kidneys and allows you to achieve long-term remission.

Pet diet

In order for a cat with kidney failure to have the right to a full life, its diet must be properly balanced. Sick cats are recommended to eat a diet characterized by: low content phosphorus and protein. These products put a lot of strain on the excretory organs and can cause further deterioration of the pet’s condition.

The small amount of protein included in a cat's diet to maintain its muscles and tissues must be extracted from quality products. Optimal sources of lean protein include egg whites, liver, and chicken and turkey fillets. The diet of a pet struggling with an illness should contain an optimal balance of vitamin D and fatty acids omega-3.

Besides natural food, the owner can use in the cat's diet ready-made feed. There are currently many commercial brands on the market working on creating veterinary food lines. Among them, the owner can choose food for cats with kidney failure, which has a special low-fat recipe. The best choice would be products with low phosphorus content. This could be Renal cat food, developed by the Royal Canin brand, in which the composition is carefully selected and balanced, or other high-class food. Read about the Royal Canin veterinary food line.

The feed additive Renal for cats Advanced, which contains flavonoids, vitamins and medicinal plant extracts, has received good reviews. This supplement has an anti-inflammatory effect and helps animals cope with the symptoms of the disease. In addition to the main action, feed product has an antioxidant function, reduces hyperazotemia and controls non-regenerative anemia, and also contributes to the normalization of work digestive system. You can buy it at a specialized veterinary pharmacy.

The contents of your pet's bowl will not help him heal. serious illnesses kidneys, however, a well-designed diet with a minimum content of protein, phosphorus and sodium will reduce symptoms and improve general state pet's health. It is worth understanding that changes in a cat’s diet should not be drastic. It is advisable to specify the specifics of the transition to a new therapeutic diet with a veterinarian. The specialist will tell you how to properly prepare your cat for... new diet and not provoke complications.

Despite its serious nature, kidney disease in cats is not a death sentence for the animal. With the proper level of care, the owner can make the life of his pet as comfortable and long as possible. However, to do this, you should carefully consider the recommendations of veterinarians and take care of the proper maintenance of the cat.

It is important to strictly control your pet’s diet and provide him with access to drinking water, minimize the amount of stress and emotional trauma.

Sick animals need periodic veterinary examinations, so owners of cats with kidney disease should make an appointment at the veterinary clinic in advance.

Uremia is divided into two types. It can be acute or chronic. Acute develops at lightning speed and is caused by acute renal failure resulting from injuries, burns, intoxication or urinary retention. The development of chronic uremia occurs gradually and can take a long time. It depends on how long it takes to develop chronic renal failure resulting from pyelonephritis, urolithiasis, diabetes mellitus, congenital anatomical anomalies, intoxications and neoplasms. Symptoms of uremia may include vomiting, refusal to eat, weight loss, depression, a urea odor coming from the mouth, or failure to urinate.

Diagnosis of uremia

1) Biochemical and general tests blood. With their help, you can evaluate the levels of creatinine, urea, phosphorus, identify changes in electrolyte composition, and also identify the presence of inflammation and anemia.

2) Ultrasound of the abdominal cavity. With its help, you can evaluate the anatomical structure of the kidneys, determine whether there are suspensions and stones in the kidneys, whether the ureters and urethra are dilated.

3) X-ray of the abdominal cavity to visualize radiopaque stones in the kidney, urethra or bladder. Chronic renal failure is usually detected in older animals. Young patients face uremia due to acute urinary retention or due to inherited pathologies - amyloidosis, polycystic kidney disease.

The effect of uremia on the animal's body

Chronic renal failure changes the structure of the kidneys gradually. Some nephrons stop working, intoxication (uremia) accumulates gradually. Due to the absence of symptoms, changes may not be noticed. The more nephrons die, the more clearly they appear: thirst and frequent urination, uremic and sometimes stomatitis. Often owners seek help too late, when most of the working nephrons have died.

The higher the level of intoxication, the more likely development secondary pathologies. These are non-regenerative anemia, electrolyte and endocrinological disorders, cardiological and neurological problems. The worst consequence is uremic coma.

Treatment of uremia and chronic renal failure

Treatment begins with intravenous drips, the purpose of which is to correct electrolyte balance, as well as combating dehydration. Treatment is accompanied by tests, including laboratory monitoring of blood gases. Dietary food with a low protein content is prescribed. Among the prescribed drugs are those that reduce the level of urea and phosphorus, as well as antihypertensive drugs and medications aimed at preventing anemia.

Disease prevention

A blood test to detect both renal failure and the early stages of uremia is recommended to be taken periodically when the child reaches 6-7 years of age.

What happens with acute urinary retention?

Consequence urolithiasis, prostatitis, injuries, cystitis and atony of the bladder can become acute urinary retention. It is easy to determine - it is enlarged, there is no urination or the urge to urinate turns out to be unproductive, vomiting appears, the animal refuses to eat. In this case it is required emergency help specialist aimed at restoring urine outflow with correction electrolyte disturbances using intravenous infusions. All this happens under the control of tests and ultrasound.

Uremia – serious condition. It requires immediate diagnosis and medical intervention. If detected at stages, it will not harm the pet.

Slogan " Dog“a friend of man” is considered something unshakable, like Ural Mountains. However, more and more appear on the streets stray dogs who regularly attack people. Dog fashion fighting breeds has led to the fact that dogs that require professional maintenance are bought by people who have no idea how to raise such a dog. And the beast, which in its destructive power is equal to a firearm, becomes practically uncontrollable. What to do if you are attacked by a dog?

You will need

• - plastic bottle;
• - bag;
• - cellular telephone;
• - stone;
• - keys;
• - a handful of sand.

Instructions

If the dog only threatens, but does not, there is a high probability that you have become an untrained victim. Most likely, the animal is simply defending its territory. Under no circumstances try to escape or scare the dog by screaming. This may prompt her to attack. While the dog is showing its teeth, slowly sit down and pick up something suitable from the ground: plastic bottle, a tin can, a handful of sand. If there is nothing similar nearby, remove the shoe.

Once up, swing. Dog will stop to assess the threat posed by you. Slowly, without turning your back to the animal, try to get around “its territory.” Most often this is a site near garages, or at a metro stop.

If the dog does, throw it what you have in your hands. Mobile phone, umbrella, bag, whatever you managed to pick up from the ground. There is a possibility that while concentrating on a nearby target, the dog will fall behind.

However, if, after grabbing the handout, the dog does not calm down and continues to attack, try to quickly grab another object. This time, don't throw it, but pick it up. The animal will definitely react to the new target and jump up to reach it. At this moment, kick in the lower abdomen - this is the most sensitive place. After this, the attack will stop.