Kidney Failure in Cats

Like humans, cats have two kidneys that perform many vital functions. They filter out and get rid of waste through urine. They help to keep cats properly hydrated, play an integral part in red blood cell production, and play a part in regulating blood pressure.

Kidney failure in cats typically happens due to kidney disease – and both are potentially life-threatening conditions.

Read on to find out more about some of the most common kidney problems cats can suffer from.

What is Kidney Failure in Cats?

We describe kidney failure as either acute or chronic.

Acute Kidney Injury (AKI) – also known as Acute Renal Failure (ARF) – usually happens shortly after the kidneys getting damaged. Cats may recover some kidney function with treatment, time, and loving care. However, it will depend on the underlying reason behind the issue. 

Even with treatment, true ARF is terminal in around half of cases. However, when cats do survive what caused the initial issue, they tend to have a better prognosis than cats with Chronic Kidney Disease (CKD).

Chronic Kidney Disease

In CKD the damage to the kidneys occurs slowly over time – as opposed to AKI where the damage occurs quickly. In many cases there will be a steady loss of kidney tissue over months and years. Even with all the treatment in the world, CKD often leads to final-stage renal failure.

Cats will start to display clinical signs of CKD once they lose around two-thirds of their normal kidney tissue. As their condition deteriorates, medical intervention becomes more and more difficult.

Types of Kidney Disease in Cats

AKI can happen in cats of any age and is typically the result of:

• Poison (the most common cause of AKI) e.g. from anti-freeze, pesticides, toxic plants like lilies, or human medication like ibuprofen
• Trauma to the bladder or pelvis, tick-borne diseases, and parasitic infections
• A shock from blood loss or dehydration, and clotting disorders
• Kidney infections or blockages
• Heart failure along with low blood pressure

If diagnosed in time, it’s often possible to reverse AKI.

Other kidney problems can be more difficult to treat. Mainly found in older cats over 7, these kidney problems develop over months and sometimes even years. Some breeds such as Persians, Burmese, Siamese, Abyssinians, and Burmese are more prone to Chronic Kidney Disease. While in many cases CKD can begin without a specific reason, causes of CKD include:

• Kidney infections and blockages
• Advanced dental disease, thyroid problems, cancer, and high blood pressure

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Signs Your Cat’s Kidneys May Be Failing

Clinical signs of kidney failure vary, and will depend on whether the condition is acute or in the last stages of CKD. In cats with AKI clinical symptoms can include:

• Lethargy and sudden loss of appetite
• Vomiting and diarrhea, sometimes containing blood
• Drinking more water than usual
• Ammonia-like smell to the breath
• Fluctuations in urination from large quantities to stopping altogether
• Abdominal pain and seizures

In cats in the final stages of renal failure associated with CKD, clinical symptoms include:

• Anorexia or a refusal to eat 
• Drinking more than usual
• Confusion and uncontrolled urination
• Vomiting, dehydration, and lethargy
• An unkempt and greasy coat
• Ammonia-like smell to the breath and mouth ulcers

Diagnosis of Kidney Failure in Cats

As well as looking for the signs we’ve just listed, your vet will typically perform bloodwork and take urine samples in order to diagnose the condition. All this will help to determine the best course of treatment. Your vet will check for signs of:

• Anemia (low number of red blood cells)
• Raised levels of creatinine and blood urea nitrogen 
• Abnormal electrolyte concentration 

When a cat’s kidneys begin to fail, anemia, dehydration, and the build-up of uremic toxins will happen. Ulcers may spring up on the gums, tongue, and along the digestive tract. A cat may suffer seizures and respiratory distress. 

Treatment for Kidney Failure in Cats

There are limited choices available for treating final-stage kidney failure. They include plans to manage the disease like:

• A specially formulated kidney diet
• Anti-nausea medication
• A period of hospitalization using IV fluids
• Supplements to correct electrolyte and other chemical imbalances

More intensive treatments include hemodialysis to filter a cat’s blood. Although this won’t cure kidney failure, it may improve their quality of life.  Very few veterinary clinics will have the right equipment necessary for this and, even if they do, the cost may be prohibitive.

Recovery From Kidney Disease

Many cases of AKI can be fatal – and it all depends on the severity of the underlying injury in combination with the speed of treatment.

Cats can live with earlier-stage CKD for years in some cases – it all depends on the speed of advancement of the disease. In cats with CKD that’s progressed to its final stages (stage 4), the average survival time is just over a month.

Acute Kidney Injury and Chronic Kidney Disease are serious. There will come a time when medical intervention will not be the best option. You will therefore need to discuss end-of-life planning.

Tough Choices

These decisions are never easy but what matters most is the quality of life your cat has and whether they are in pain. Talking to a vet is one of the best ways to help make up your mind about what the right course of action is.

When they start failing completely, the kidneys may swell and become painful. In the case of final-stage renal failure, there tends to be no pain associated with the kidneys. Rather than feeling pain, a cat may feel nauseous and weak because of the buildup of uremic toxins.

When to Call a Vet

If you think your cat may have a kidney infection or be suffering from kidney disease, it’s always a good time to consult a vet. 
You may also be struggling with how to make your cat as comfortable as possible when they’re experiencing kidney failure. If so, book a consultation with one of our experienced team now. They’re on hand to help you process your decision.