A terrible diagnosis - the cat’s kidneys are failing, what should I do? My cat's kidneys are failing - what should I do? An old cat's kidneys are failing

Dr. Baker is a veterinarian with a PhD in comparative biomedical sciences. She graduated from the University of Wisconsin with a degree in Veterinary Medicine in 2016, then went on to earn her graduate degree in the Comparative Orthopedic Research Laboratory.

Number of sources used in this article: . You will find a list of them at the bottom of the page.

Unfortunately, many cats suffer from chronic kidney disease. Although kidney disease cannot be cured, there are many ways to slow it down if caught early enough. If your cat has become lethargic and has lost interest in food, take her to the vet. The doctor will likely order blood and urine tests, which will help him make the correct diagnosis. Then, work with your veterinarian to create a treatment plan that will help improve your pet's quality of life.

Steps

Signs of kidney problems

Watch your cat drink water. Check the water level in your cat's bowl every morning. Find out if your pet has started drinking more water. This can also be determined by whether you have recently had to clean your cat's wet litter box more often. As a rule, cats use moisture sparingly and do not need a lot of water, so if the animal begins to drink more and visit its litter box more often, it may have kidney problems.

• Kidney disease causes your cat to lose more fluid through urine and require more water to compensate for these losses. Diseased kidneys cannot concentrate urine properly and leave water in the blood.
• If a cat eats liquid food, it needs even less water compared to its counterparts who eat dry food. In this case, the animal receives part of the water along with food. Because of this, liquid food is usually preferable for those cats that may have kidney problems.

1. See if your cat is vomiting or showing interest in food. If your pet refuses to eat, it may be trying to avoid stomach pain. Kidney problems can lead to uremia, which is accompanied by painful inflammation of the stomach. In this case, cats often lose their appetite and may even vomit blood due to the formation of ulcers.

   • Uremia occurs in part because the kidneys are unable to effectively remove toxins from the blood.

2. Check to see if your cat's fur is dull or emitting a foul odor. Kidney problems may cause your cat to develop painful sores on her gums, in which case she may be less likely to want to brush her fur. The animal may completely refuse grooming. As a result, the coat may appear dull and dirty.

3. See if the cat seems lethargic. Cats love to sleep. However, take a closer look to see if your pet is sleeping more than usual, or if he has lost interest in his favorite games and entertainment. If your cat is acting too lethargic, she may have developed anemia or low potassium levels due to kidney disease. The accumulation of waste in the body can also worsen the animal’s well-being.

   • Kidney disease can cause blood problems because the kidneys help repair blood cells, regulate electrolytes, including potassium, and remove toxic substances from the body.
   • Anemia caused by kidney disease is also indicated by dull or white eyelids (in healthy cats they are pink).

4. Try interacting with your cat to assess its well-being. Sometimes it can be difficult to determine whether a cat is really unwell or if she just decided to lie down. Call your cat and see how she reacts to this. If your pet doesn't come to you, see if he raises his head or vocalizes in response. If your cat's gaze remains dull and she does not respond to your call, this may indicate that she has diseased kidneys.

   • Cats have a very heavy head compared to the rest of their body, and require considerable muscle effort to keep it straight. When potassium levels are low, cats tend to lower their head.
   • However, this sign is quite rare, and its absence does not mean that the cat does not have kidney problems.

5. Check for ulcers in your cat's mouth. If your cat's kidneys don't remove toxins from her body, she may develop ulcers in her stomach, throat, and gums. Gently hold the cat by the head and slowly open its mouth. Look inside and see if there are any red or irritated areas in your mouth. The sores may appear as white or gray dots. They can be on the gums and under the tongue.

   • Ulcers may cause your cat's breath to smell bad.

Establishing diagnosis

1. Ask your veterinarian to do a urine test. If you suspect your pet has kidney problems, the first step your veterinarian should order is a urine test. The doctor will take a sample of your cat's urine and send it to a laboratory, where they will test its density to see how dilute it is.

   • The same urine sample can also be used to detect other diseases, such as diabetes.
   • The veterinarian may also prescribe a biochemical test, which determines the protein-creatinine ratio in the urine. This test helps determine whether low urea concentrations in urine are actually due to kidney disease or due to shock.

2. Ask your veterinarian to take a blood test from your pet to rule out other possible diseases. Although a blood test may not always detect kidney problems in cats, it can help narrow down the list of possible health problems, such as diabetes or an infectious disease.

   • Your veterinarian may order serial blood tests to monitor the progression of kidney disease and make sure it hasn't led to other complications, such as anemia.

3. Visit your veterinarian regularly to have your pet's blood pressure checked. Kidney problems often lead to high blood pressure. Measure your blood pressure every 1-2 weeks - this will help monitor the progression of the disease and evaluate the effectiveness of treatment. Typically, this quick procedure does not require an appointment in advance.

   • It is important to monitor your blood pressure. High blood pressure can cause serious complications such as blindness. If necessary, your veterinarian will prescribe medications to help lower your pet's blood pressure.

It can be extremely difficult to distinguish acute from chronic renal failure at the first visit, especially if a middle-aged animal arrives without a detailed medical history.

Why is this so important? The prognosis for a given patient depends on this.

The structural unit of the kidney is the nephron. Acute renal failure is a temporary, reversible dysfunction of a large number of nephrons, which can lead to the rapid death of the animal, but if it was possible to overcome it, then the prognosis is favorable: kidney function can be restored. Chronic renal failure is an irreversible degenerative process in the kidneys; restoration of the function of lost nephrons should not be expected. It should be noted here that in the absence of adequate treatment for acute renal failure, nephrons can also be lost irrevocably, that is, acute renal failure can become the onset of chronic.

Causes

What causes can cause acute renal failure? Shock as a result of injury, acute systemic and local viral and bacterial infections, poisoning with nephrotoxic substances, including medications, cystitis and acute urinary retention in cats. All these conditions require therapy aimed at maintaining kidney function.

The initial episode of kidney damage may be subclinical (unnoticeable). The reserve capacity of this organ is quite large, so with completely healthy kidneys, the nephrons work at no more than 25% of their capacity. During primary damage, part of the nephrons dies; the remaining nephrons take over their function, but work with greater strain. The kidneys are the main excretory organ; all toxins that enter the body and are produced during metabolism pass through the nephrons. The greater the load on an individual nephron, the more vulnerable it is. Nephrons under increased load are more often damaged and die, their function is transferred to the remaining nephrons, which work even harder. Thus, chronic kidney disease does not become clinically apparent until more than 70% of the nephrons have been lost, at which point the animal will appear completely healthy.

When no more than 30% of functioning nephrons remain, the compensatory reserves of the kidneys are exhausted, the kidneys cannot filter the blood effectively enough, and toxic metabolic products accumulate in the blood. From this moment we can talk about chronic renal failure.

Is treatment possible?

Since most of the nephrons are lost permanently, chronic renal failure cannot be treated by a veterinarian; it is an irreversible condition and, moreover, a progressive condition. The prognosis of chronic renal failure is always unfavorable. The doctor’s efforts in this case are aimed at improving the patient’s quality of life and prolonging life.

To do this, it is necessary, if possible, to reduce the factors damaging the remaining nephrons: normalize high blood pressure, reduce the intake of protein, the metabolic products of which increase the load on the nephrons, eliminate or reduce the dosage of drugs that can be toxic to the kidneys. To stimulate the excretory function of the remaining nephrons and cleanse the blood of metabolic products and toxins, infusion therapy is necessary, which is carried out with extreme caution and under the control of diuresis, given that the nephrons are already working at their limit. In addition, renal failure is accompanied by a number of concomitant diseases and pathological conditions that require correction. These are inflammatory diseases of the gastrointestinal tract, arterial hypertension, hypo and hyperkalemia, hypocalcemia, hyperphosphatemia, non-regenerative anemia. Thus, all these measures, although they cannot cure the animal, can significantly alleviate its condition and affect its life expectancy.

Forecast

How long it will be possible to maintain the animal in this way depends on how good and long-lasting a response can be obtained to therapeutic measures; a veterinarian can give a prognosis only by observing the dynamics of this process.

If the animal’s body stops giving a positive response to therapy, the only way to prolong its life is hemodialysis. This method in cats is extremely difficult due to the small size of the patients; dialysis machines are designed for humans, and besides, it has little prospects, given that kidney transplants have not yet been performed in cats.

veterinarian-therapist "MEDVET"
© 2016 SEC "MEDVET"

The kidneys perform an important function in the body - they cleanse the blood and, together with urine, remove a huge amount of waste and toxins. If a cat drinks little water, then harmful substances gradually accumulate in them, which provokes a violation of their function. Every cat experiences kidney failure at least once in its life. Some kittens are born with kidney problems, and since they work under increased stress, the animals live no more than 3 years. In healthy cats, kidney disease develops as they age. Cats are especially susceptible to them due to their narrow urethra. If there are diseases of the urethra, it narrows to a minimum size and the animal’s kidneys may fail.

There are 2 forms of kidney failure: acute and chronic. The first is associated with disruption of the nephrons (kidney tissue cells), which develops quickly and, if measures are not taken in time, can lead to the death of the animal. The disease can be cured if you quickly consult a doctor. Chronic renal failure develops gradually. From time to time, the animal experiences mild symptoms of acute renal failure, while the attacks progress. In this case, it is no longer possible to cure the animal. Kidneys begin to fail in cats in old age if they have other diseases.

The reasons why a cat’s kidneys fail may be as follows:

1. injuries, falls from height;
2. chronic kidney disease;
3. violation of the drinking regime, incorrectly selected food, abuse of dry food and raw fish;
4. diabetes, obesity, hepatitis and pancreatitis;
5. fever, poisoning and infectious diseases;
6. blood pressure disorders;
7. age over 8 years.

There are also breeds that are at risk of developing kidney disease. Persian cats, Angora cats, and short-legged cats are more susceptible to kidney diseases than outbred cats. These animals require a special diet; they cannot be fed from the table what their owners eat.

Acute renal failure is divided into 3 types:

• Perenal. Occurs due to injury, dehydration or shock. Associated with impaired renal function and a sharp decrease in blood pressure. If you consult a specialist in time, the disease can be cured quite quickly;
• Postrenal. It is formed if the urinary tract is compressed due to a tumor or urolithiasis. It develops in older cats and often leads to death, although in some cases it can be treated. Sometimes surgery is required;
• Renal. It is associated with inflammatory processes in the body, past infectious diseases, and the effects of anesthesia and medications on the animal’s body. It develops due to improper treatment of diseases, drug overdose or indolent chronic inflammatory disease. It is treatable if toxins are removed in time and the underlying inflammatory disease is cured.

Symptoms of the disease

Symptoms of kidney failure in a cat may resemble poisoning:

• vomiting, nausea;
• lethargy, apathy, drowsiness;
• reduction of lobe separation;
• appetite either increases sharply or disappears completely;
• mucous membranes become either pale or very bright, depending on high or low blood pressure;
• the appearance of swelling and rare urine output, despite the fact that the cat can drink a lot.

These symptoms are characteristic of acute renal failure. Since the symptoms resemble poisoning or other diseases, an accurate diagnosis and tests are required, which the doctor will recommend. If your cat's kidneys begin to fail, the symptoms of the disease may be as follows:

• weight loss and muscle mass;
• The cat urinates frequently, drinks a lot of fluids, or is unable to empty its bladder. Urine may be excreted with blood;
• increased body temperature - the ears become hot and the nose becomes dry;
• the fur becomes ugly and falls out in some places;
• along with vomiting and nausea, increased salivation appears;
• smell of ammonia from the mouth;
• the tongue, tip of the nose and ears become white or pale.

These symptoms should alert the owner. Kidney failure in a cat requires immediate veterinary attention, especially if the cat's condition worsens. In some cases, if you contact a specialist in a timely manner, the problem can be solved and the animal will continue to live. The main thing is to seek help in time and complete all necessary procedures.

Diagnosis and treatment

At the veterinary clinic, the doctor will examine the animal and ask for tests. To diagnose kidney failure, you need to take a urine test, blood test, biochemistry, and in some cases a kidney biopsy may be required. In the chronic form of renal failure, an increased number of leukocytes and lymphocytes in the blood is observed, and protein, renal epithelium, cylinders and glucose are present in the urine. To accurately diagnose the cause of the disease, the doctor may prescribe ultrasound and x-ray diagnostics. An ultrasound will be required to identify polycystic disease and tumors in the kidneys, and an x-ray will show the presence of stones that provoke the development of the disease.

Only after conducting the necessary examination can a doctor tell whether the disease is fatal and prescribe treatment. Kidney diseases in pets that are detected in time can be successfully treated, especially in young cats. In acute renal failure, intensive therapy is prescribed. A urinary catheter is inserted into the animal to remove toxic fluid from the body. The doctor prescribes blood purifying drugs. The main focus is on cleansing the body and treating the underlying disease.

With progressive kidney failure, dialysis is performed - the introduction of a medical fluid into the abdominal cavity, restoring the water balance in the body. It cleanses the body and removes harmful substances. The disease cannot be completely cured, but kidney function can be partially restored with proper nutrition and treatment. The animal can live for a year or more. For cats with chronic renal failure, a diet low in protein, salt and phosphorus is important. There are special foods for animals with unhealthy kidneys. If your cat is used to eating dry food, you should not give it to him often.

Prevention

Kidney disease is easier to prevent than to cure, especially in its advanced form. In order not to think about what to do if a cat’s kidneys fail, it is worth taking a set of the following preventive measures:

• Monitor the water-salt balance of the animal. The water should be purified, not hard and free of lime. It needs to be changed regularly once a day;
• Do not give your cat raw or over-salted fish from the table or salty and over-salted food;
• Avoid the development of obesity, do not try to give the cat more than it should be according to its age norm;
• Choose high-quality food without artificial colors and harmful substances. Sterilized cats need special food, just like purebred animals, especially those at risk of developing urolithiasis;
• Once a year it is necessary to take blood and urine tests for timely detection of the disease;
• Cats over 5 years old need an annual kidney ultrasound to detect diseases.

Simple preventive measures will help you notice and treat kidney disease in time. And, if you notice symptoms of trouble, timely treatment can not only quickly stop the attack, but also save the life of your pet.

The statistics on the incidence of urological pathologies in pets is not reassuring. About 15% of cats are susceptible to serious problems with the excretory system, and when a cat’s kidneys fail, what to do, is it really possible to help the animal? Renal failure can develop quickly in the case of an acute form and over a long period of time, in the form of a chronic course of the disease. The disease manifests itself in the severe condition of the animal, often leading to death.

Why is an organ so important to an animal?

Representing a paired organ, the kidneys carry out the work of purifying the blood. Healthy organs contribute to the elimination of metabolic products and toxic substances formed in the body of carnivores. The kidneys are also involved in hematopoiesis. Therefore, nephrological diseases are accompanied by severe intoxication of the animal, disturbances in electrolyte, water and protein metabolism and are the cause of death in 20% of furry pets.

Anatomy of the cat's urinary systemFeatures of the anatomy of the cat's genitourinary system

It is believed that domestic cats are susceptible to kidney pathology due to genetic predisposition. In addition, cats have a long but narrow urinary canal, which often contributes to blockage and inflammation. This especially affects cats, whose urinary system is even narrower than that of females.

Kidney tissue, unlike the liver, does not recover when damaged. The remaining functional kidney cells cope with the load for some time, which makes it difficult to diagnose kidney failure in the early stages.

Causes of kidney problems

As a rule, the following reasons lead to a situation where a cat’s kidneys fail:

• Obstruction of the urinary tract. This phenomenon is caused by urolithiasis, the development of tumors in the pelvic organs.

• Renal pathologies: polycystic kidney disease, amyloidosis, pyelonephritis, glomerulonephritis, interstitial nephritis.

• Phenomena of sepsis. Infectious diseases associated with the development of septic processes.

• Pressure drop in the vascular system of the kidneys due to injuries, bleeding, sunstroke and cardiovascular pathologies.

• Nephropathic effect of poisons, toxins, drugs. There are often situations when a cat’s kidneys fail after anesthesia. General anesthesia drugs are eliminated by the kidneys, and there is a risk of acute renal failure with every surgical procedure.

• Systemic diseases of internal organs: diabetes mellitus, hypothyroidism, adrenal dysfunction, pancreatitis, gout.

As a rule, older animals who develop chronic renal failure due to nephrosclerosis are susceptible to kidney disease. This pathology is the main reason why kidneys fail in old cats. Older animals develop chronic interstitial nephritis because the kidneys become scarred and no longer effectively filter blood.

Diagnostics

The kidneys are designed in such a way that only half of the nephrons are damaged in an animal showing signs of renal failure. Such a hidden course of the initial stages of renal pathology significantly complicates timely diagnosis. Signs that should alert the owner are the following:

• loss of appetite up to complete refusal of food;

• increased thirst (polydipsia);

• dehydration of the body;

• frequent urination;

• violation of the act of urination: uncharacteristic postures, meowing and screaming when visiting the toilet;

• the animal does not urinate in the tray;

• possible blood in the urine;

• lethargy, weakness, apathy, prolonged sleep;

• vomiting, diarrhea;

• presence of edema;

• ammonia odor from the mouth;

• stomatitis, gingivitis.

If a cat's kidneys fail, the symptoms may be supplemented by convulsions due to severe intoxication of the body, pain, paresis and paralysis of the hind limbs, and their swelling. Body temperature can either increase or decrease. This condition is life-threatening for the animal and requires immediate help.

For early diagnosis of renal failure, it is necessary to regularly donate the animal’s urine and blood for general and biochemical analysis.

In order to accurately diagnose kidney failure, ultrasound and x-ray examination methods are used. In some cases, a kidney biopsy is resorted to.

Is it possible to cure an animal?

One of the main questions tormenting owners if a cat has kidney failure is whether the animal can be saved. It is impossible to answer this unequivocally, since the outcome of the disease depends on many factors: the age of the pet, the severity of the process and its neglect, concomitant diseases, timeliness of seeking veterinary help, etc. Due to the fact that when the kidneys fail, the water balance is disturbed, the first step is to use intravenous and subcutaneous infusions of special solutions.

If a cat's kidneys fail, how long the animal will live depends on its response to treatment. Infusion therapy helps reduce intoxication. As a rule, after stabilization of the condition with intravenous injections, they switch to continuous subcutaneous infusions.

As additional drugs, heart medications, diuretics (if indicated), and agents that stimulate hematopoiesis are used. The choice of antibiotics should be approached with caution, as many drugs can worsen the condition.

A diet low in phosphorus and protein is also important. A good effect is achieved by artificial supplementary feeding of the pet and lifelong subcutaneous injections to facilitate kidney function. In order to prevent exacerbations and relapses, diet and therapeutic measures are carried out regularly throughout the animal’s life.

Forecast

If a cat's kidneys fail, whether the pet will survive also depends on a number of factors. Equally important is the timeliness of seeking help and the age of the animal. Renal failure in older individuals is more severe, and the prognosis is often cautious.

The initial cause that led to kidney failure is of no small importance. For systemic diseases (diabetes mellitus, pancreatitis, etc.), the underlying disease is treated, and the outcome depends on the timeliness of the diagnosis.

If the cause of kidney failure is poisoning by poisons, toxins, or drugs, then the prognosis depends on the degree of damage to the kidneys, liver and the toxicity of the substances that enter the body.

Poor prognosis for renal causes of kidney failure. In pathologies such as polycystic disease, amyloidosis usually affects 90 - 100% of the kidney tissue, which becomes incompatible with life.

Given the seriousness of kidney failure, owners of pet cats should closely monitor the slightest change in the animal's condition. For early diagnosis of pathology, it is necessary to donate blood once a year for urea and creatinine levels, and once every six months - urine for biochemical analysis. Once the pet reaches 5-6 years of age, it is recommended to perform an ultrasound of the kidneys once a year.

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Update: April 2019

Kidney failure is an insidious disease that affects the functioning of almost all body systems, and clinically manifests itself only when 65-80% of the kidney tissue is already affected. The sooner the diagnosis is made, the longer your beloved mustachioed pet will live after appropriate therapy.

Causes of kidney failure and its types

Renal failure is a pathological condition in which the kidneys perform their excretory function poorly or stop performing it altogether. Due to disturbances in the functioning of the excretory system, the balances in the body are disturbed: acid-base, water-salt and osmotic. It is these disorders that eventually lead to problems in the condition of other internal organs.

Renal failure in its course and external manifestations can be:

• acute (API);
• chronic (CRF).

The disease is considered completely incurable, and in some cases can lead to the death of the cat. But timely prescribed therapy allows you to slow down its development and progression, prolonging the relatively normal life of your pet.

The most important reason for the development of renal failure is diseases accompanied by direct damage to the kidneys. Once clinical signs appear, it is almost impossible to identify the exact cause of its appearance. Any additional studies after making a clinical diagnosis reveal damage or degeneration of renal tissue, which is characteristic of almost all existing kidney pathologies.

The most common causes of kidney pathologies:

• frequent inflammation of the kidneys, as well as improper or incomplete healing;
• toxic or mechanical damage to the kidneys;
• glomerulonephritis (damage to the zona glomerulosa);
• congenital pathologies;
• infectious diseases and bacterial lesions (pyelonephritis);
• tumor processes (both benign and malignant) that impair the excretory function of the kidneys;
• renal polycystic disease (a genetic disease common to many exotic cat breeds, accompanied by the formation of cavities in the kidneys filled with fluid);
• autoimmune glomerulonephritis (genetic predisposition);
• unilateral hypoplasia (when one kidney significantly lags behind the other in development, and in old age the organ affected by the pathology simply fails - occurs only in cats).

There are breeds of cats that are predisposed to kidney failure:

Classic symptoms

The symptoms of acute and chronic kidney failure are different. Moreover, the diagnosis of chronic renal failure can only be made by laboratory tests of blood and urine. However, there are a number of signs by which the cat owner can clearly understand that the pet has health problems due to impaired kidney function.

The main symptoms of kidney dysfunction:

Kidney problems almost always begin in cats after 8 years of age. Usually the owner notices:

• decreased activity, but chalks it all up to old age, so doesn’t pay much attention to it;
• when a cat breathes, you can smell an ammonia smell from the cat’s mouth, and drooling almost constantly;
• The animal noticeably drinks a lot and at the same time urinates frequently and a lot. Normally, a cat goes to the toilet a maximum of 3 times a day; with renal pathology, the frequency can reach up to 8-10 times (on average, 5 times is no longer the norm). Excess urine excretion is determined by the excessively wet perineum, because During urination, she manages to get very wet. Because of this, the perineum is constantly licked;
• the appetite disappears, and the cat loses a lot of weight - the ribs begin to be visible or palpable, the abdomen in the iliac region collapses;
• pink mucous membranes become clearly pale;
• swelling appears, starting from the lower parts of the paws, gradually spreading upward to the body (the paws increase in volume, become excessively soft, then soft swelling appears in the chest and abdominal cavities);
• The temperature begins to jump, both upward and downward.

In more complex cases:

• there is general lethargy;
• signs of severe dehydration (dull coat, skin does not straighten after pinching, dry mucous membranes of the mouth and eyes);
• the cat stops urinating completely (the animal never walks “smallly” once during the day);
• sudden and unexplained vomiting becomes more frequent, and blood may be present in the vomit;
• stool changes - the cat is either constipated or has bloody diarrhea;
• The nervous system is affected - convulsions or tics (single muscle twitches) may appear.

Photos of signs of acute renal failure and chronic renal failure

Swelling of the collar area	Sores in the mouth	Swelling of the front paws

Acute renal failure

Depending on the stage at which the dysfunction occurred, acute pathology is classified into the following types:

Prerenal insufficiency

It is associated with a decrease in the volume of circulating blood through the kidneys, and not with their direct damage. The condition is often preceded by any shock conditions, which are necessarily accompanied by a sharp drop in blood pressure. This is the very first (initial) stage of acute renal failure.

Main causes:

• acute cardiovascular failure;
• sun or heat stroke;
• hemorrhagic shock due to sudden massive bleeding;
• traumatic shock after extensive and severe injuries;
• hypovolemic shock due to severe dehydration of the cat;
• severe infections;
• intoxication.

Renal failure

It occurs when kidney tissues and structures are damaged.

Main provoking reasons

• bacterial or viral kidney damage (glomerulonephritis, pyelonephritis, interstitial nephritis);
• drug intoxication (use of non-steroidal anti-inflammatory drugs or aminoglycosides);
• poisoning by snake venoms;
• severe infections involving the kidneys (viral immunodeficiencies or, for example, leptospirosis);
• DIC syndrome (increased blood clotting) in severe sepsis, toxoplasmosis or intoxication with hemolytic poisons, when massive destruction of red blood cells is observed, and the renal tubules are clogged with free hemoglobin (a rare and life-threatening condition for the animal);
• kidney damage from aniline, ethylene glycol or salts of some heavy metals.

Postrenal failure

also does not lead to direct breakdown of kidney tissue, but is caused by mechanical blockage or compression of the urinary parts of the urinary system (bladder, ureter, urethra).

Causes:

• injuries to the internal organs of the pelvis;
• urolithiasis with blockage of the urinary tract with stones;
• tumors.

A favorable prognosis can be made in the first and third cases, in the second - from cautious to unfavorable.

How does it manifest?

Symptoms are distinguished by their suddenness, as well as the speed of development over a short period of time.

What owners see:

• the cat suddenly becomes lethargic and inactive;
• strong thirst appears;
• appetite completely disappears, zero reaction even to treats;
• frequent vomiting, which does not make the cat feel better;
• urine turns pink with blood;
• if the excretory tract is blocked, the cat will go to the toilet, but when trying to go to the toilet there will be no urine or it will be released in drops;
• fluctuations in the volume of urine excreted, both up and down;
• convulsions and tics (single muscle twitches) may occur;
• the cat may fall into a coma - for 2-3 days the animal supposedly sleeps, but the body is somewhat colder than usual. The condition differs from death by weak respiratory activity and no rigor mortis.

What does the vet see?

• detects the smell of acetone or ammonia from the cat’s mouth;
• notes a decrease in blood pressure (with prerenal type);
• Body temperature when measured is usually below normal, but during infections it is often elevated;
• when palpating the lumbar region, enlarged kidneys and severe pain are detected (the cat meows and tries to avoid examination);
• a bladder enlarged from urine overflow is detected, as well as free fluid in the abdominal cavity or subcutaneous tissue due to rupture of the urinary organs.

What the tests show:

• blood biochemistry: increase in creatinine, glucose and phosphates;
• urine: high protein, low specific gravity, presence of red blood cells and glucose, sediment from blood cells (neutrophils, casts, epithelial cells, lymphocytes).

Chronic renal failure

Impaired kidney function in this form of progression takes a very long time to develop and is due to the fact that this organ is gradually deprived of its excretory functions. Nephrons (structural kidney units) are replaced by connective tissue, scars form, the kidney shrinks and loses its working abilities. Often found in older animals.

Veterinarians practically distinguish the following main stages of renal failure:

• Latent (hidden). This is a period when the functioning of the kidneys is already impaired, but the pathology does not manifest itself in any way. It is possible to identify some deviations in the analyzes, but they are rarely done, because there is no clear evidence for this.
• Initial.
• This period lasts up to several months and is accompanied by vague symptoms that are usually not attributed to the kidneys. Blood counts indicate obvious pathology. Most often, the diagnosis of chronic renal failure is made precisely during this period - the history of the disease and life, direct examination and indicators of nitrogen and creatinine in the blood give every reason for this.
• Terminal. Deviations in the functioning of some other organs begin to appear, the levels of creatinine and urea in the blood go off scale. The animal will die without hemodialysis or surgery.

At stages 3 and 4, the diagnosis is easiest to make, however, this is already a reason for a cautious and unfavorable prognosis. Symptoms of chronic renal failure begin to appear when the kidneys are damaged to at least 65-70% (sometimes up to 80%).

Probable Causes

• metabolic pathologies (diabetes mellitus, amyloidosis - a disorder of protein metabolism in the body);
• tumor process in the kidneys;
• conversion from acute renal failure;
• against the background of chronic pancreatitis (inflammation of the pancreas);
• urolithiasis of the kidneys;
• any chronic kidney disease associated with viruses or bacteria (pyelonephritis);
• congenitally underdeveloped kidneys and their structures;
• renal polycystic disease (limited cavities with fluid form throughout the “body” of the kidney. Persian cats are most often affected).

With all the variety of causes that provoke chronic renal failure, it is almost impossible to find out exactly due to the profound degeneration of the renal structures at the time of diagnosis

How does it manifest?

The degree of manifestation of symptoms directly depends on the degree of kidney damage at the time of detection of abnormalities.

What owners see:

• the cat stopped eating completely;
• depressed and lethargic, sleeping most of the time;
• the animal is clearly losing weight, the costal arches begin to appear and the stomach begins to fall in;
• almost constant drooling, nausea (manifested by constant licking of the lips and nose), periodic vomiting not associated with food or water intake;
• perversion of taste preferences - the cat may begin to eat inedible objects (for example, toilet filler granules);
• the animal often begins to go to the toilet (up to 6-8 times a day), and the amount of urine may increase or decrease;
• increased nervous excitability, inadequate reactions to loud sounds (the cat gets scared even when called loudly - it twitches, presses itself to the floor or runs away);
• constipation appears, bowel movements are observed every few days;
• at the terminal stage, confusion, twitching of individual parts of the body or paws (tics), convulsions, and coma may be noted.

What does the vet see?

• extensive swelling starting from the paws and moving to the chest and abdomen;
• slow heart rate (bradycardia);
• blood pressure jumps up (hypertension);
• the coat is dull, brittle, cannot be laid evenly, with areas of alopecia;
• noticeable softening of the facial bones when palpated (due to a lack of calcium and excess phosphorus);
• pallor of the mucous membranes in the mouth;
• stomatitis with ulcerations on the tip of the cat's tongue (an important clinical sign);
• the kidneys can be easily felt and a change in their size in any direction (enlargement or shrinkage) is detected.

What do the tests show?

• obvious anemia;
• the level of creatinine and glucose in the blood rises;
• Sugar and protein are detected in the urine, and its specific gravity decreases.
• Ultrasound:
  • changes in the contours of the kidneys (often becoming uneven when wrinkled);
  • change in size (usually decrease, but can also increase).

Diagnostic features

A condition in which there are disturbances in the functioning of the excretory system is rarely determined by external signs - the symptoms can suggest or suspect the disease. This is also explained by the fact that the symptoms are “masked” as other diseases, which are excluded only with the help of additional research methods.

An accurate diagnosis of renal failure is made only based on the results of a comprehensive examination with the obligatory implementation of:

• examination and collection of a detailed medical history (medical history and lifestyle);
• laboratory tests of urine and blood;
• Ultrasound of the kidneys and abdominal organs;
• fluoroscopy of the kidneys.

The diagnosis of chronic renal failure is made ONLY after laboratory tests of blood and urine.

When analyzing urine it is noted:

• increased protein levels (proteinuria);
• the presence of leukocytes and erythrocytes;
• presence of sediment;
• decrease in its density (isosthenuria);
• pH shift to the acidic side.

Blood chemistry:

• increased urea;
• increase in creatinine level;
• fluctuations in the amount of protein in either direction;
• decreased potassium levels;
• increase in the level of calcium, magnesium and phosphorus (with chronic renal failure);
• increased sodium levels.

General blood analysis:

• decrease in hematocrit values;
• decreased hemoglobin levels;
• increase in the number of leukocytes;
• drop in platelet and lymphocyte levels.

Differentiation of acute renal failure and chronic renal failure:

• in case of acute renal failure, anemia does not have time to develop due to the transience of movement, in case of chronic renal failure it is clearly expressed;
• CRF begins smoothly and lasts a long time; at the time of diagnosis, the prognosis is most often unfavorable; AKI manifests suddenly with a lightning-fast course, the prognosis is favorable with timely diagnosis and proper treatment;
• when palpating the kidneys in chronic renal failure, they are almost always painless, while in acute renal failure the pain syndrome is clearly expressed;
• in case of acute renal failure the clinic is bright, in case of chronic renal failure it is not or is very blurry.

Are there preventive measures?

Although most diseases can be prevented, kidney failure can only be detected at an early stage of development with regular annual medical examinations, and in older cats - with blood and urine tests every six months. If these procedures are not performed on the animal, then the disease will be detected in a state where there is a high risk of not curing it.

Regular examinations should be supplemented by proper and balanced nutrition (ideally, commercially produced “wet” food). There is nothing more that owners can do to prevent kidney failure in cats.

Treatment

It should be repeated that this pathology is not completely eliminated. The kidneys return to a state of maximum functionality, to the extent possible for a particular degree of damage. You will have to monitor your kidney function for life, at regular intervals determined by your doctor, taking the necessary tests. Treatment will directly depend on the course - acute or chronic.

Procedure for treating acute renal failure

1. Identifying and eliminating the root cause.
2. Removing the animal from a state of dehydration.
3. Elimination of hemolysis.
4. Removing intoxication.
5. Hemodialysis (in especially severe cases).
6. Recovery diet.

Treatment procedure for chronic renal failure

1. Maintenance diet and appetite stimulation.
2. Normalization of blood pressure and compensation of heart failure.
3. Restoration of water-salt balance, acid-base and mineral.
4. Elimination of signs of anemia.
5. Fortification.
6. Hemodialysis.

List of medications used

Below is a list of the most commonly used medications for kidney failure. Only a veterinarian can combine medications and draw up therapeutic treatment regimens from them! It is strictly forbidden to try to self-medicate your pet!

Antibiotics

To eliminate the primary factors of kidney failure (pyelonephritis), fluoroquinolone antibiotics are prescribed, which do not put additional stress on the kidneys:

• enrofloxacin: intramuscularly 5 mg/kg cat body weight for 5 days. In rare cases, you can extend the course to 7-10 days;
• ciprofloxacin: 5-15 mg/kg body weight for up to 5 days.

Hormonal drugs

The use of glucocorticoids helps suppress immune reactions that provoke glomerulonephritis, increase diuresis (while suppressing antidiuretic hormone), relieve swelling directly in the renal tissues, and also increase appetite in cats.

• In acute illness, it is best to start with:
  • dexamethasone: 0.2 mg/kg intramuscularly or intravenously until the general condition is stabilized and the water balance is normalized.
• Then you can go to:
  • methylprednisolone: ​​3 mg/kg intravenously once daily for 4-5 days;
  • prednisolone: ​​0.5-3 mg/kg, depending on the condition of the cat, twice a day, with further transition to a maintenance course in a similar dosage, but once and every other day.

Diuretics

They are prescribed in any case: furosemide (considered best for renal failure): 0.1 ml/kg twice daily into the muscle. Monitor the effect. In its absence, the permissible increase in dosage is 2-3-4 times.

The loss of potassium is replenished with special potassium-containing preparations, but always under laboratory control of its content in the blood: panangin (asparkam). Application: orally, 1 tablet/10 kg of weight up to 3 times a day until the condition stabilizes.

Laxatives

Laxatives for stool retention and prolonged constipation:

• lactulose (Duphalac), lactusan: orally 0.5 ml/kg until stool normalization. Can be taken until the end of the entire treatment therapy, because is not addictive;
• bifidum 791 BAG - live bacteria that improve intestinal digestion and speed up bowel movements: 1 dose per 1 cat orally with a small amount of chilled boiled water throughout the entire course of treatment.

Rehydration and nutrient solutions

Intravenous or subcutaneous drips with rehydrating and nutrient solutions that restore salt and mineral metabolism, as well as eliminate dehydration:

• Ringer-Locke solution + glucose 40%: 500 ml + 50 ml;
• trisol: calculated 7% of total body weight once;
• rehydration mixture of glucose solution 40% + vitamin C 5% + saline: 15-55 ml/kg by slow dropper, depending on the severity of dehydration.

Antiemetic therapy

• metoclopramide: 0.5-0.7 mg/10 kg body weight subcutaneously or intramuscularly as vomiting occurs, but not longer than 5 days;
• ondansetron: 0.5 mg/kg into muscle symptomatically.

Reduced pressure

Reducing blood pressure is achieved with ACE inhibitors:

• enalapril: the dosage is selected individually for each sick animal. The target (maximum) effective dose is 0.5 mg/kg of the cat’s body weight – you cannot give it all at once, so as not to provoke a sharp drop in blood pressure and collapse. You need to start with 1/8-1/9 of the target dose to give the body time to get used to the hypotensive effect. Increase the dose gradually until the condition normalizes. Maintenance dose: ½ part of the target dose;
• Ramipril (inactive prodrug): 0.125 mg/kg body weight once daily.

For the cardiovascular system

Cardiogenic drugs to support the condition of the cardiovascular system:

• cocarboxylase: 1-1.5 ml per cat (5 mg/kg) once or twice a day intramuscularly (sometimes done subcutaneously or intravenously);
• Riboxin: 0.1-0.2 g/10 kg intramuscularly or intravenously;
• sulfocamphocaine: 0.1 ml/kg body weight subcutaneously until the condition normalizes.

Detoxification products

• enterosgel: 20 g/10 kg of pet’s weight once a day;
• liarsine: 0.5-2 ml per animal 1-2 times a day for 10-14 days;
• plasmapheresis (removal of toxins from the bloodstream by purifying blood plasma using protein-saline solutions);
• sirepar: 1.5-3 ml every day until signs of intoxication subside;
• Lespenefril (to remove nitrogenous substances from the blood): ½ tsp. per animal with a small amount of water inside 1 time/day for a month.

To eliminate anemia

Maintaining the hematopoietic process to eliminate anemia is achieved with hematopoietic drugs:

• Recormon: 25-50 IU/kg 1-3 times a week until the hematocrit level reaches 30%. The drug is taken continuously if it is not possible to achieve the desired level;
• ursoferran: once in a dose of up to 0.5 ml per animal into the muscle or subcutaneously;
• hemobalance: for a cat weighing up to 5 kg - 0.25 ml, over 5 kg - 0.5 ml intravenously or intramuscularly 1-3 times a week for a course of 7-10 injections.

Hemostatic drugs

In acute renal failure, it is necessary to use hemostatic agents to prevent gastrointestinal bleeding;

• dicinone: 0.5 ml up to two times a day for 5-7 days;
• Vikasol: 1-2 mg/kg once a day. Average course: 3-5 days.
• aminocaproic acid: 8-10 mg/kg orally (by mouth).

With complete lack of appetite

A nutrient mixture is prepared, which is given hourly in 5 ml doses using a syringe without a needle or a small rubber bulb. Mixture composition: 100 ml milk and water, 1 tsp. starch, 2 tsp. sugar - bring to a boil. Then a whole raw chicken egg and 1 crushed mezim tablet are added to the cooled solution. As appetite appears, the time interval decreases and the amount of mixture increases.

To support the gastrointestinal tract

With kidney failure, the production of gastrin (the hormone that activates digestion) is inhibited, which causes a lot of stomach acid to form in the stomach. In this case, urea in the stomach turns into ammonia, irritates the gastric mucosa and can provoke a peptic ulcer. To maintain the functioning of the gastrointestinal tract and protect the gastric mucosa, the following is prescribed:

• ranitidine: 2 mg/kg by slow intravenous injection or 3.5 mg/kg orally twice daily at regular intervals;
• famotidine: 0.5-1 mg/kg intravenously or subcutaneously up to twice a day.

Diet

Diet plays a leading role in the treatment of any form of renal failure. Last for at least 6-9 months, it is prohibited to switch to regular cat food immediately after the symptoms pass!

You can't feed:

• dairy products;
• in excess of meat products;
• fish oil;
• foods containing excess vitamin A;
• add salt.

For cats, you can use ready-made industrially produced dietary food (with urea up to 20 mmol/l). In severe conditions, it is better to follow a strict protein-free diet (with urea from 30 mmol/l) with an increased amount of flour and sweet foods (“pancake” diet).

Food for cats with kidney failure should be limited not only in the amount of protein, but also in phosphorus. After eating, you can take almagel (1-2 ml for one cat), which will bind it and remove it.

The outcome of treatment for renal failure directly depends on how early the diagnosis was made and how quickly therapeutic and restorative therapy was started. Do not neglect preventive examinations of your pets and blood tests, because... sometimes these are the only ways to identify kidney pathologies.

Kidneys are very important for a cat's body, just as they are for humans. With the help of these organs, many substances harmful to the body are removed - waste products; they play a significant role in the functioning of metabolic processes. The presence of pathological processes in these organs is a serious metabolic disorder and the development of various diseases.

Kidney failure in a cat as a pathology

One of these pathologies is renal failure.

Renal failure is a complex of pathological processes that lead to disruption of the normal functioning of the entire genitourinary system, simply put, a disruption of homeostasis.

On the left is a healthy kidney in a cat, on the right is kidney failure.

Due to the inability to produce urine or remove it outside, water, salt, acid and alkaline balances are disturbed, which, in turn, is fraught with damage to all body systems.

Acute and chronic form

Highlight acute form and chronic . The development of the acute form occurs spontaneously, is accompanied by damage to the renal tissues, and first appears oliguria– a sharp decrease in the amount of urea, and subsequently its complete cessation – anuria .

With anuria, the cat's litter box remains empty.

Symptoms of kidney failure in cats

There are several stages of disease development.

1. At the onset of the disease, there is a decrease in the amount of urea and a sharp drop in blood pressure.
2. Further, the process of decline in urine levels alternates with its complete cessation.
3. There is an increase in the concentration of nitrogen metabolites in the blood.

After the start of treatment, urine output is restored, often even more is excreted than it was initially, but only liquid with a small content of salt and water comes out, and metabolic products remain in the body.

Intensive treatment leads to the normalization of metabolic processes, but this only happens if the intensity of therapy is not stopped and, after a sufficiently long period of its use, up to about three months.

Side effects

When the cat gets sick, it starts to feel nauseous.

Despite the many factors causing the pathology, the chronic form is characterized by a decrease in healthy kidney tissue capable of participating in normal metabolic processes.

It leads to increase in protein breakdown products in the blood – uric acid and creatinine. Due to the failure of the kidneys to perform their required functions, waste products are released into the mucous membranes of other organs - the digestive system or the respiratory system.

The organs of these systems are not intended to perform such functions, which fraught. This is expressed in attacks of nausea and vomiting, insatiable thirst. Yellowness of the skin is observed. Alternating amount of urine - increase and decrease.

Chronic renal failure

Exacerbation of the disease is more often observed in animals older than 8 years.

Reasons chronic renal failure may include:

• chronic renal pathological processes: glomerulonephritis, MBC, amyloidosis;
• systemic diseases: diabetes mellitus, gout;
• renal polycystic disease;
• poisoning with various substances: lead, mercury, drugs.

The above reasons guarantee the growth of connective tissues in the kidneys, replacing parenchymal ones.

The chronic process develops over a fairly long period of time, lasting years. Exacerbation occurs most often in animals older than eight years and the changes that have occurred in the kidneys are usually irreversible.

Due to the extensive internal reserve of organs, pathological processes are asymptomatic for a long time. The onset of symptoms occurs after more than seventy percent of the renal parenchyma is damaged and most functions are reduced.

Infections

If there is an infection, the cat will experience pain when palpated.

The presence of primary infections often becomes provoking factors for the occurrence of this disease. Characteristic signs are uremia, the presence of protein, red blood cells, various sediments in urine, and a decrease in the total density of urea. The affected organs become enlarged or reduced in size and lose their clear contours.

The cat experiences pain when palpated, and anemic or yellow mucous membranes appear.

Additional signs

Refusal to eat and lethargy are some of the symptoms of kidney failure.

Diagnostics

Based on the structure of the fundus, the veterinarian will be able to determine the disease.

It is impossible to accurately determine the diagnosis on your own due to the similarity of symptoms with other diseases.

Only a veterinarian can prescribe the correct treatment.

To eliminate hypertension, disorders of the cardiac and vascular systems, and reduce anemia. You may have to use blood purification – hemodialysis or even transplantation. The acute form first requires eliminating the primary cause. First of all, they fight shock, dehydration, and intoxication.

Diet and food

To gain weight, B vitamins are prescribed.

The animal is placed on a low-protein diet. Anabolic steroids are prescribed in combination with B vitamins for weight gain. It is recommended to use an angiotensin-converting enzyme inhibitor, which prolongs the life of a sick animal. Intravenous infusions of physiological solutions are used to eliminate intoxication.

conclusions

If the disease is detected early, the prognosis is favorable. An advanced case allows a cat to live for about a year.

It is important to detect the disease early!

Video about kidney failure in a cat