A cat’s urinary system consists of the two kidneys, bladder, the ureters (small tubes) that connect them, and the urethra that empties the urine from the bladder. There are two serious conditions that commonly affect the urinary system of cats. In a case of renal failure the two kidneys – despite the in-built spare working capacity they have – are so affected by disease that they cannot carry out their normal functions, while feline lower urinary tract disease (known as FLUTD) involves a cats bladder & urethra.
The two kidneys have several vital functions, including removal of the waste products, and a role in maintaining the body’s water levels and of the chemical substances dissolved in that water.
The filter-like working parts of a kidney are called nephrons, each of which consists of a blood filter attached to a complex piece of pipe work called a tubule.
Both kidneys contain hundreds of thousands of nephrons. When a significant number of them become damaged or are destroyed by disease, such that the remaining nephrons cannot cope, the cat will start to suffer from renal failure
Only 30% of kidney capacity is needed for normal functioning. Therefore, no symptoms will be seen until approximately 70% of renal function is lost. It is important to begin treatment as soon as the first symptoms appear. As CRF is primarily a degenerative disease, it is most common in old cats. It has been estimated that around 16 per cent of cats over 15 years of age have significant renal dysfunction.
Common Symptoms
May include any of the following:
• Weight loss
• Increased urine production
• Pale gums
• Reluctance to eat
• Depression/lethargy
• Gingivitis/oral ulcers
• Vomiting
• Bad breath
• Poor coat condition
• Increased drinking
Diagnosis and Treatment
Renal failure is a life-threatening condition. The long-term outlook for most cats with CRF is poor, but many can enjoy a good quality of life if treatment is initiated promptly, and is diligently carried out by yourself with assistance from your vet.
We generally diagnose CRF by carrying out blood and urine tests, however we may also recommend x-rays and ultrasound investigations.
Warning: If your cat has been diagnosed with CRF but suddenly shows new symptoms contact us immediately. Other conditions, which may seem trivial in a healthy cat could affect a CRF cat more seriously, and may require prompt treatment. In most cases of CRF the cause is not identified, so your vet may only be able to begin treatment aimed at alleviating the symptoms:
- Intensive care/hospitalisation – If your cat is very ill, we will suggest admission to hospital to allow administration of intravenous fluids. This is required to correct dehydration and helps flush toxins out of the bloodstream. We will also assess the need for additional investigations or medications for your cat.
- Dietary management - Specially designed Prescription Renal diets are highly recommended and studies prove that they can significantly increase life expectancy after diagnosis. Available diets include wet food (canned and pouches) and biscuits. Introduce gradually to increase acceptance.
- Medications – Fortekor is a drug licensed for use in cats with CRF. It helps to reduce blood pressure, stimulate appetite and reduces the amount of protein lost into the urine. The use of other more specific medications may help to resolve any associated problems such as vomiting, anaemia, constipation and lack of appetite.
- Provide adequate fluid intake - At home, you must ensure your cat has permanent access to fresh water. It can be helpful to add water into the food to increase water intake. Alternatively, your vet may suggest home fluid therapy once to twice weekly. This involves injecting warmed sterile fluids under the skin with a sterile needle and syringe. This should only be done with specific instruction by your vet – do not attempt without advice from your vet. (Equipment and fluids available through the clinic)
Diagnosis and treatment of systemic hypertension
Ongoing monitoring. Your vet can recommend the best course of action for ongoing monitoring for your cat – this will include regular check ups, blood pressure monitoring & weigh-ins, and in addition to this she or he may suggest repeat blood and urine tests, and blood pressure checks.
