The kidneys play a major role in maintaining a cat’s health and well-being, and when chronic kidney disease (CKD) compromises organ function, problems occur. CKD is common in cats, and the condition can be frustrating to manage. Our South Shores Pet Clinic team wants to help by providing CKD management guidelines for cats.

Chronic kidney disease in cats

The kidneys are responsible for many important tasks, including removing toxins from the blood, producing certain hormones, and maintaining water and electrolyte balance, acid-base balance, and normal blood pressure. When irreversible damage inhibits the kidneys’ ability to function, CKD occurs. In many cases, the underlying reason is never identified, but potential causes include infection, toxins, kidney tumors, persistent inflammation, and inherited conditions such as polycystic kidney disease. Known risk factors include obesity, diabetes, previously diagnosed dental disease, and eating a dry diet. Typically, CKD is a progressive disease, and clinical signs often don’t occur until the condition is advanced. When initial signs do appear, they are usually subtle and non-specific and include weight loss, decreased appetite, lethargy, halitosis, and increased thirst and urination. Once CKD is diagnosed, the cat’s condition is staged to determine a proper management strategy. Stages include:

  • Stage one — Stage one CKD cats have normal or mildly increased kidney values—including symmetric dimethylarginine (SDMA)—observed on blood work, mildly abnormal kidney palpation or imaging findings, and no clinical signs. 
  • Stage two — Stage two CKD cats have mildly increased kidney values, and clinical signs are usually mild or absent.
  • Stage three — Stage three CKD cats have moderate elevations in their kidney values, and clinical signs are usually present but vary in severity.
  • Stage four — Stage four CKD cats have high kidney values and evident clinical signs, and are at increased risk for a crisis situation.

Dietary management for chronic kidney disease in cats

Dietary considerations are critical when managing CKD cats. Factors include:

  • Water intake — CKD cats are more likely to become dehydrated because their kidneys have a decreased ability to conserve water. This makes maintaining fluid intake crucial to slow the disease’s progression. Measures to encourage fluid intake include:
    • Feeding wet food, and, if your cat tolerates the addition, adding water to their food. 
    • Providing several water bowls throughout your house, and cleaning the bowls and refreshing the water at least once a day.
    • Using water fountains to encourage your cat to drink.
    • When needed, administering subcutaneous fluid therapy to maintain your cat’s hydration.

  • Energy requirements — CKD cats should consume enough calories to prevent fat and muscle loss. You may need to provide your finicky feline with a variety of foods to tempt them, and you can offer several small meals a day to help encourage consumption and minimize nausea.
  • Restricted protein — Many toxic products that accumulate in a CKD cat’s blood are the result of protein breakdown, and feeding them a reduced protein diet can help minimize this and improve their quality of life. However, enough high-quality protein must be provided to maintain the cat’s muscle mass and general health.
  • Restricted phosphate — Reduced kidney function typically leads to phosphate retention, which can lead to significant health complications. Decreased dietary phosphate intake can help slow CKD progression. 
  • Potassium supplementation — CKD cats tend to lose potassium in their urine, which can lead to muscle weakness, stiffness, lack of appetite, and poor hair quality, and also may contribute to worsening CKD. When warranted, our veterinary team will implement potassium supplementation.
  • Water soluble vitamins — CKD cats are unable to concentrate their urine, and they lose water soluble vitamins such as vitamin B and C. Affected cats need daily supplementation.

Medical management for chronic kidney disease in cats

In some cases, medications are needed in addition to dietary changes to manage CKD cats. Potential medications include:

  • Phosphate binders — If phosphate levels remain high despite reduced dietary phosphate, our veterinary team may prescribe oral phosphate binders to lower the amount of phosphorus absorbed through the intestinal wall.
  • Blood pressure lowering medications — CKD cats are at risk for high blood pressure, which can exacerbate kidney damage. Our veterinary team will monitor your cat’s blood pressure and prescribe medications to lower it if necessary.
  • Anti-nausea medications — CKD cats frequently experience nausea and vomiting, which can lead to a lack of appetite and negatively affect their quality of life. Our veterinary team may recommend anti-nausea medications if your cat is affected.
  • Anemia treatment — The kidneys initiate red blood cell production in the bone marrow, and many CKD cats develop anemia. Our veterinary team may prescribe medications to stimulate bone marrow production if your cat is anemic.

Monitoring chronic kidney disease in cats

CKD cats need frequent monitoring to track their condition. Diagnostics to evaluate CKD cats include:

  • Blood work — Our veterinary team will measure values, including creatinine, blood urea nitrogen (BUN), SDMA, red blood cells, and protein, to determine your cat’s CKD status.
  • Blood pressure — We will monitor your cat’s blood pressure to ensure they don’t require blood pressure lowering medications.
  • Urinalysis — We may perform urinalysis to monitor your CKD cat’s progress.
  • Imaging — In some cases, X-rays or ultrasound may be necessary to evaluate your cat’s kidney health. 

Many cats affected by CKD can live long, happy lives if their condition is monitored carefully and managed appropriately. Detecting CKD in the early stages provides the best prognosis for affected cats. If you would like your cat screened for CKD, contact our South Shores Pet Clinic to schedule an appointment.