Kidney failure in cats in the terminal phase: An incurable disease
What is chronic renal impairment?
Kidney failure, which is synonymous with kidney disease or renal impairment, can occur in an acute manner, when the kidney fails quickly after previously being healthy, or in a progressive, silent and stealthy manner
This latter presentation is referred to as chronic as failure usually occurs over a longer period and is constant and progressive. Given its progressive and degenerative nature, this disease usually occurs in older cats. It is estimated that one out of every three cats older than 10 years, and over half of cats aged 15 years or more, have this disease.
As the kidneys are responsible for filtering the blood to remove toxins and maintain a correct water balance, significant kidney failure (the final stage of which is terminal kidney failure) represents a life-threatening risk for the cat.
What symptoms does it cause?
Kidney failure in cats is a silent disease that advances progressively without causing any clear signs, so a diagnostic suspicion is key to its detection. When present, the signs of kidney failure are usually non-specific and often go unnoticed.
The most common signs are related to loss of kidney function, with cats drinking more water and urinating more frequently. They may also exhibit weight loss, loss of appetite and vomiting with no obvious explanation. In the final and terminal phase, kidney failure in cats results in a build-up of toxins and urea, which in turn leads to lethargy and uraemic coma.
All these symptoms appear in the advanced and terminal phase of a disease that is indolent in its earlier stages.
How is it diagnosed?
A blood analysis that shows maintained renal impairment and urine analysis showing its incorrect concentration are currently the only diagnostic tests available1. Given that the symptoms appear at an advanced stage, routine check-ups from 8 years of age onwards are the most effective means of detecting the disease.
How is it treated?
The treatment of chronic kidney failure in cats is supportive, with the multimodal approach being the most appropriate for this disease. The treatment of predisposing factors, such as hypertension, with drugs, the use of a diet that helps to improve the cat’s nutritional status and the kidney, together with increased water consumption are just some of the measures in this multimodal approach.
Diet is a key aspect. It should be low in proteins and phosphorus, while also maintaining blood pH and must contain sufficient calorie content to overcome the reduced intake due to lack of appetite.
Although it is difficult to increase water consumption, MEMO (multimodal environmental modification) measures will allow the cat to better adapt to its situation and drink more water. Some of these measures include providing various drinking bowls with fresh water that is changed often and keeping these bowls in quiet places far away from the litter box.