Your Cat — November 2017

http://www.yourcat.co.uk 39

CAT CARE

Eventually, the cat will

refuse to eat altogether, may

start to have convulsions, and

will inevitably die if he is not

put to sleep first.

It’s possible to rule out CKD

by checking a urine sample: if

the cat is able to concentrate

his urine, he is not suffering

from the disease, but there are

many other possible causes of

a cat producing dilute urine.

If kidney disease is

suspected, blood tests are

required to confirm the

diagnosis, primarily looking at

the levels of two substances,

urea and creatinine, which are

increased when the kidneys

are not functioning properly.

Other tests, such as ultrasound

imaging, X-rays, or even

a surgical biopsy of the kidney,

may be needed to try to

identify the cause.

Newer tests are being

developed to try to diagnose

kidney disease reliably at an

earlier stage. One called SDMA

(symmetric dimethylarginine)

has recently become available

and is reputed to identify

impending chronic kidney

disease an average 17 months

sooner in cats, enabling

treatment to be started

early, and before the patient

becomes unwell.

TREATING CKD

Although CKD cannot be

cured, it can be controlled, and

life expectancy dramatically

improved, using a combination

of treatments:

●Diet — cats with kidney

disease need to go on a diet

containing restricted levels

of good-quality protein, and

limited amounts of minerals

known as phosphates. Great

care must be taken when

formulating this type of

diet, as cats cannot manage

without moderately high

levels of protein intake.

A range of different renal diets

are available, and it is worth

experimenting with different

brands if a patient does not

immediately take to one.

A lot of evidence

demonstrates that successfully

and permanently changing

a cat on to a veterinary

prescribed diet is the most

important factor in prolonging

life expectancy for cats with

CKD, so it needs to be done

early, before a cat starts to

lose his appetite.

●Drugs — the most

commonly used are ACE

inhibitors, so called because

they block the activity of

a group of hormones which

cause fluid retention and a rise

in blood pressure in animals

suffering from kidney disease,

which in turn causes further

damage to the kidneys.

●Supplements — as cats with

nephritis (inflammation of

the kidneys) will tend to lose

vitamins through their kidneys,

there is a strong rationale for

boosting the intake of

water-soluble B vitamins.

Some cats will develop low

blood potassium levels, which

will cause severe lethargy and

weakness, and extra levels can

also be given in a supplement

to these cases.

● Fluid therapy — cats quite

often get dehydrated in the

more chronic phase of this

disease, and if owners are

not able to encourage them

to take enough fluids orally,

subcutaneous fluids can also

be given. Some vets will

show owners how to do this

at home.

MONITORING

PROGRESS

Some cats with CKD that

is diagnosed early can live

for years with the help of

careful management, which

should include regular health

checks to monitor weight and

body condition. Your vet will

probably want to re-test your

cat’s blood at least twice

a year, to monitor his response

to treatment and check for

the build-up of substances

such as phosphorus.

It is also possible to measure

a cat’s blood pressure with

a cuff that fits over his leg

or tail. Controlling blood

pressure is essential to

improve life expectancy and

reduce the chances of serious

secondary complications, such

as blindness.

POLYCYSTIC

KIDNEY DISEASE

Polycystic kidney disease

(PKD) is an inherited condition

which has become very

common in some breeds, with

around 39 per cent of Persians

having abnormal cysts in their

kidneys, and 31 per cent of

Exotics. The main reason it

has become so common is

that PKD often does not cause

signs of kidney failure until

quite late in life, so an affected

cat may have produced many

offspring before he or she

becomes ill.

PKD causes multiple

fluid-filled cysts to form in

the kidneys. They are present

from birth, but start out very

small and gradually get bigger,

until they eventually seriously

interfere with the normal

functioning of the kidneys.

As PKD is an inherited

kidney disease, it can be

prevented by not breeding

from affected cats. When the

disease was first recognised,

the only practical way to

identify the affected cats was

by ultrasound scanning of the

kidneys, but a genetic test is

now available, performed on

a blood sample or cheek swab,

and this is generally the test of

choice for most breeders.

International Cat Care

maintains a register of

PKD-negative cats which can

be viewed on its website;

http://www.icatcare.org. Now that

we have a reliable and simple

test for this troublesome

disease, we should start to

see a significant reduction in

its incidence. —

ARE KIDNEY

TRANSPLANTS AN

OPTION?

Transplantation of kidneys

is technically possible,

but poses some very

significant challenges.

The long-term treatment

required to prevent

rejection is expensive,

can be challenging to

administer, and may cause

severe side effects.

Harvesting an organ

from a living feline

donor also poses a very

significant ethical dilemma,

as the animal cannot

give consent in the same

way that a human can.

Because of this, feline

renal transplantation is

currently not carried out

in the UK. At some point

in the future, we may be

able to grow kidneys in

the laboratory which could

be implanted without the

risk of rejection, but at

the moment this is in the

realms of science fiction

rather than reality.

Ev

refu

start

will

put

It’

by c

the

PKD poses

a problem for

breeds such as

Persians and

Exotics.

Bradley looks at how owners

can handle traumas and injuries

in their cats.

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38-39 YC Health CSEH(SW).indd 39 29/09/2017 12:27