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Early Signs of Kidney Disease: Part 1

The kidneys are hard-working organs that play an integral role in the health of dogs and cats. They help to produce urine, regulate blood pressure, create hormones, make red blood cells, balance water, salt and acid concentrations, and remove protein wastes from the bloodstream. If a pet’s kidney were to fail, a whole cascade of other health issues could arise; for this reason, it is important to monitor kidney health in our pets so that we can catch any problems early-on. Pets with kidney disease that are diagnosed early and receive proper care are more likely to live longer and have a higher quality of life than those who go undiagnosed. Today we will discuss early signs of kidney disease in cats, and we’ll follow this up next week with information about the disease in dogs.

Types of Kidney Disease

The kidneys are more likely to fail as cats age, but older cats aren’t the only ones who develop kidney disease. Some cats are born with kidney problems, and others can develop issues secondary to trauma, toxins, or infection.

There are two types of kidney failure in cats: acute and chronic. Acute kidney disease is much less common and develops quickly. It is usually the result of poisons, trauma, infection, blockages (such as a ureter blockage), or heart failure. Despite the quick onset of acute kidney failure, this condition can be corrected if caught in time.

Chronic kidney disease (CKD) is more common in middle-aged and senior cats and develops over time. We typically start to monitor kidney function in cats that are 7 years of age and older, so that we can detect any changes in organ health. CKD typically develops slowly but can progress more rapidly if underlying problems (such as dental disease, high blood pressure, and thyroid disease) are not monitored and corrected.

Early Signs of Kidney Disease

Click each symptom for more information.

The kidneys are responsible for concentrating urine to keep the body hydrated. Cats with kidney disease urinate more often because their kidneys aren’t able to concentrate urine as effectively. This results in more water leaving the body. Cats that are losing extra fluid through urine will drink more water in an attempt to replace lost fluid.

As kidney function declines, the kidneys aren’t able to filter blood as effectively which results in a buildup of toxins in the bloodstream. These toxins can trigger increased drinking as a means of trying to flush those toxins out of the body and keep the body hydrated.
Healthy kidneys produce urine that is acidic, which helps to control bacterial growth. Failing kidneys produce more dilute urine. If the urine is more dilute and less acidic, bacteria are more likely to grow and reproduce, contributing to infections in the bladder and/or kidneys.
Cats with CKD aren’t able to filter out toxins as readily as healthy cats. The build-up of toxins in their blood stream make them feel sick, and sick cats don’t usually feel like eating.
This is a side effect of toxin build-up and feeling sick.
Cats with CKD aren’t eating as much, and they’re losing fluid. These two factors contribute to a decline in weight.
These are both signs of an infection. Bacteria in the urine cause a cloudy appearance, and blood is a side effect of a kidney infection and/or irritation of the bladder lining.
Cats with advanced kidney disease can develop oral ulcers, which are painful. Pets with ulcers may drool more often or paw at their mouth to express their discomfort. This usually only occurs in more advanced stages of CKD.
As we mentioned before, a decrease in kidney function causes toxins to build up in the body. This is what causes cats to develop bad breath. Cats with advanced kidney disease may have breath that smells like ammonia. Bad breath can also be due to gingivitis (dental disease).
Failing kidneys redirect fluid from the GI tract to the kidneys in an attempt to filter out toxins. A decrease in GI fluid results in constipation.
These symptoms occur for a multitude of reasons, including the buildup of waste in the bloodstream, an imbalance of electrolytes, a decrease in red blood cell production, a lack of appetite, and an increase in high blood pressure.

Our Recommendations

We recommend screening for kidney disease in all middle-aged cats by the age of seven. Once kidney disease is detected, we recommend bloodwork every three to six months, depending on the stage of the kidney disease. Lab work usually involves a chemistry panel that includes kidney values, electrolytes, and blood protein levels; a urinalysis to rule out infection, check urine concentration, and monitor for protein loss; and a blood pressure check to make sure there is no hypertension, which can damage the kidneys and cause more rapid progression of the disease.

Many cats experience kidney disease at some point in time. The signs they exhibit as the disease progresses without treatment is often excused by owners as “normal” for an old cat. It is important to evaluate bloodwork because cats cannot tell us how they are feeling. With a few basic treatment options like a diet change and increased fluid intake, cats with kidney disease can live longer and have a good quality of life. 

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