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Cat Kidney Failure: Symptoms, Diet, and Treatment for CKD

Kidney failure in a cat

It is currently assumed that approx 30% of cats over the age of 7, suffering from renal failure.

Kidney failure is one of the most common conditions.

What is kidney failure? How to heal her? Is it a death sentence for your cat?

I will try to answer these and other questions in this article.

  • What is kidney failure?
  • The causes of kidney failure
    • The age of the cat
    • Race
    • Incorrect feeding of the cat
    • Other medical conditions and treatment
    • Cat stress
  • Acute kidney failure in a cat
  • Acute kidney failure symptoms in a cat
    • Level 1
    • Stage 2
    • Stage 3
    • Stage 4
  • But how does it work in practice?
  • Chronic renal failure in cats (CHF)
  • Chronic renal failure in cats symptoms
    • What should worry you?
  • Chronic kidney failure in a cat does it hurt?
  • Diagnosis of kidney disease in cats
    • Blood tests
    • What blood test results may indicate kidney failure?
    • Urine test
    • Ultrasound and X-ray examinations
    • Sample results in a cat with PNN
  • Treatment of acute renal failure in cats
    • What if, despite the drips, your cat's condition does not improve?
  • Treatment of Chronic Kidney Failure in Cat
    • What will the doctor do when diagnosed with PNN?
  • Difficult decision when to consider euthanizing a cat with PNN?
  • Prevention of kidney disease in cats
  • Renal failure in a cat's diet
  • Can anesthesia damage the kidneys?
  • Diseases that can harm the kidneys
  • The role of drips in the treatment of renal failure
  • My cat has PNN - how to deal with him?

What is kidney failure?

Imagine that your cat's kidneys are an efficient filter for detoxification.

When the operation of this filter is impaired - the kidney is not able to properly purify the blood and then produce your pet's urine.

As a result of the failure, the body is poisoned with harmful metabolites.

The amount of urine is also reduced. In advanced stages of kidney failure, you may stop urinating completely.

There are three forms of kidney failure:

  1. Acute kidney failure ONN - it usually occurs as a result of poisoning, prolonged vomiting.
  2. Chronic renal failure PNN - the most common form of failure in cats. It is often the result of acute kidney failure, but it can also be caused by:
    • some viral diseases (FIP or FeLV),
    • urinary tract infections,
    • kidney tumors,
    • some autoimmune diseases,
    • often the problem is idiopathic - we do not know what caused it.
  3. Congenital renal failure - associated with defects such as narrowing of the ureters, cystic kidney disease, or changes in embryonic development - often such kittens die at a young age, but can live even 5 - 6 years without symptoms.

You already know what the forms of the disease are. But what causes it?

Read on to find out what causes kidney failure.

The causes of kidney failure

What animals are predisposed and whether your cat is at risk?

The occurrence of kidney failure is influenced by factors such as:

The age of the cat

The older the cats are, the more sensitive they are to kidney failure.

The risk of developing kidney failure is greatest in aged cats over 7 years of age.

Although kidney failure it mainly affects old cats, but this does not mean that the disease cannot occur in a young kitten.


Kidney diseases in Persian cats

Certain breeds of cats are predisposed to kidney failure:

  • Maine Coon,
  • Abyssinian,
  • Siamese,
  • Persians,
  • Russian blue.

Incorrect feeding of the cat

A cat's diet is extremely important in the prevention and treatment of the disease.

Kidney failure is favored by too little water in the diet, too much protein or poor quality protein.

Other medical conditions and treatment

Certain medical conditions can contribute to a decrease in kidney function.

These include frequent bacterial infections, immune disorders, pancreatitis, and diabetes in a cat.

The administration of certain classes of drugs can also induce disease:

these include non-steroidal anti-inflammatory drugs (NSAIDs) and steroids.

Cat stress

Due to the conditions and density, animals living in shelters and shelters are more vulnerable to the disease.

Acute kidney failure in a cat

As I mentioned before, acute renal failure in a cat (ONN) is an emergency.

It is usually caused by toxic substances, be change in blood flow in the kidneys.

So, if your cat is the type eating flowers on the balcony and you suddenly notice her acting weird, go to your vet immediately. Causes of acute kidney failure in a cat

In most cases, because, quick reaction guarantees the recovery of the pet.

However, if the character turns into a chronic form - and this unfortunately happens in many cases of too late reaction of the owners - damage to kidney cells cannot be undone.

The animal may be condemned to death for the rest of its life taking medicines and nephrological feed.

Acute kidney failure symptoms in a cat

As you study kidney failure, you must realize how complex the process is.

Symptoms of acute ONN failure can be divided into 4 stages.

Level 1

In the first stage that continues 12 days there are no symptoms.

This is the time in which the so-called decreases glomerular filtration and the process of kidney damage begins.

In short:

Your purr will not let you know that something is happening to him, but that does not mean that everything is fine.

Stage 2

The second stage - symptoms such as:

  • oliguria,
  • azotaemia / uremia,
  • decreased levels of renal markers.
So if your cat passes less urine than usual and its mouth smells of urine, see your doctor immediately for blood tests.

Stage 3

The third stage is the period of polyuria, which is the period of excretion of large amounts of diluted urine.

Stage 4

The fourth stage is the period of the kidney's recovery.

However, you must remember that in some cases the kidney will never fully regain its functions:

Your cat may have urinary problems for the rest of its life

But how does it work in practice?

Usually, the owner reports to the veterinarian, who describes his little purr as terrible lethargic and apathetic.

Symptoms that you may notice often are:

  • the cat eats less,
  • there is vomiting in the cat,
  • there is diarrhea in the cat,
  • the kitten is dehydrated,
  • his mouth smells bad.

Symptoms appear in the pet suddenly and they are very sharp in the course.

Chronic renal failure in cats (CHF)

Chronic renal failure it is one of the most common diseases that caregivers of domestic cats report to their doctors.

Unfortunately, it is a medical condition incurable.

Adequate treatment can extend your cat's life by approx 3 years.

But what exactly is PNN?

It is a dysfunction of the kidneys that causes them to stop fulfilling their most important functions:

  • Purification of the blood from harmful metabolic products.
  • Regulating the body's water and electrolyte balance.
  • Production of hormones erythropoietin (responsible for the production of red blood cells) i renin (responsible for proper blood pressure).
  • Keeping fit blood pH.

As you can see, cat kidney disease is a very serious disease.

Below you will find information on how you can identify them in your pet.

Chronic renal failure in cats symptoms

Symptoms of cat kidney failure

Symptoms of chronic kidney failure can even develop several years.

Usually, the owners of such cats report to the doctor - "because the cat is strange, and it has recently lost weight terribly".

Often cats like this they drink more than usual, they expel too more diluted urine, and the frequency of visits to the litter box increases.

Only additional tests carried out in the veterinary office give the final diagnosis.

It also happens that the owners see some problems with their cat, but do not suspect that they may have a kidney problem.

Chronic renal failure may manifest itself in the form of:

  1. Digestive System:
    • mouth infection,
    • diarrhea,
    • vomiting,
    • lack of appetite,
    • losing weight.
  2. Blood system:
    • anemia,
    • bleeding tendencies.
  3. Nervous system:
    • somnolence,
    • seizures,
    • disturbance of consciousness (even coma),
    • limb sensation disorders.
  4. Bone structure:
    • soft tissue calcinosis (hard nodules in the soft tissues of a cat),
    • decalcification,
    • bone degeneration.
  5. Internal Secretion:
    • insulin resistance,
    • secondary hypoparathyroidism,
    • high blood pressure.
  6. Leather:
    • itching,
    • dehydration,
    • swelling.

Chronic kidney failure in a cat is a disease that can go on over a long period of time without any symptoms.

Unfortunately, it is not uncommon for a kidney disease to be detected when the changes in the body are significant.

The damage must concern approx 75% of the kidney parenchyma, that the effects of failure give any signs.

The first symptoms the concerned owner reports to the doctor are: reduced amount of urine and increased thirst.

A healthy cat should give up approx 30-50 ml / kg body weight urine during the day.

If your cat's urine seems to be thicker than usual or less urine, see your vet immediately.

Other symptoms of kidney disease can include:

  • lack of appetite,
  • apathy,
  • frequent urination,
  • often persistent vomiting,
  • polydipsia - increased thirst,
  • an unpleasant smell from the mouth,
  • unpleasant smell of a kitten's fur,
  • change in the quality and color of the coat,
  • inflammation, mouth ulcers,
  • gingivitis,
  • diarrhea in a cat,
  • weight loss and excessive emaciation,
  • neurological disorders: body tremors, convulsions, difficulty moving, changes in the behavior of the animal.

If your cat visits the litter box more than usual, it may be a sign of kidney failure

Black cat peeing long time
Watch this video on YouTube

What should worry you?

Since chronic nephritis does not give symptoms for a long time, I have often confronted with diagnoses "by the way " of other diseases.

So if your cat has:

  • gastritis, bleeding from its mucous membranes,
  • anemia,
  • endocrine disorders (mainly parathyroid glands),
  • blood pressure disorders (hypertension),
  • blood acidosis,

it is worth checking whether the cause of these diseases is not PNN.

Chronic kidney failure in a cat does it hurt?

A cat's kidney failure does not make itself felt for a long time.

The animal functions normally, eats, drinks and plays.

Only when the number of functional nephrons decreases less than 25% the cat is getting more and more weakened, gets tired quickly and needs more and more time to regenerate.

Does it hurt him then?

It is difficult to answer this question unequivocally

Malaise is caused by a lack of appetite, vomiting and general apathy rather than pain itself.

When the cat shows symptoms of pain in the area of ​​the kidneys, it may be a sign of far-reaching degenerative processes and necrotic kidney.

Diagnosis of kidney disease in cats

Cat blood test

When the doctor suspects that your pet has kidney failure, he or she will probably decide to do so first Blood tests and urine test.

Often, research such as Ultrasound and X-ray. They are made to find the cause of failure (cancer) or to assess kidney damage (cortex-to-core ratio).

Blood tests

In the standard kidney profile, there may be indicators such as:

  • morphology,
  • creatinine level,
  • urea level,
  • total protein,
  • potassium level,
  • sodium level,
  • chloride level,
  • phosphorus level.

However, please note that creatinine level and urea only changes when 3/4 of the cells will already be damaged.

Recently, veterinarians also have a new weapon in the fight against kidney failure:

This is a new laboratory parameter - SDMA.

It is an indicator that is measured in serum or blood plasma.

And why is it a good weapon in the fight against kidney failure?

First, it allows the diagnosis of chronic kidney disease before full clinical symptoms develop and the often irreversible damage to the kidneys occurs.

It is therefore much more sensitive than testing the level of creatinine and other indicators - a change in their level indicates an advanced state of the disease, and an abnormality in the level of SDMA - about the onset of failure.

What blood test results may indicate kidney failure?

Blood chemistry allow to detect the first abnormalities in the functioning of the kidneys.

Increased urea and creatinine may indicate emerging problems with the urinary system.

The appearance is also a disturbing symptom a large amount of protein in the urine, because healthy kidneys should not allow him to pass.

Below are the blood test results for a cat with kidney failure.

Cat with renal insufficiency - research results

Urine test

In a standard urine test, your doctor, suspecting kidney failure, will first check:

  • density,
  • color,
  • protein content,
  • glucose content.

Urine that is too diluted or concentrated may be a sign of kidney failure.

The presence of glucose, a protein, can also mean that it has occurred disturbance of renal filtration.

The level of creatinine is also important. The reduction in its excretion may be evidence of failure.

There are also other indicators that can be assessed from urinalysis:

  • 24 hour urine secretion,
  • determining the rate of glomerular filtration,
  • protein / creatinine ratio - it determines the loss of protein in the urine in a single, preferably in the morning, portion of the urine, is more reliable than the determination of the protein itself,
  • urine protein electrophoresis - evaluation of protein types.

Below you will find the results of a urine test from a cat with renal insufficiency.

Urine test result from a cat with renal insufficiency

Ultrasound and X-ray examinations

During the ultrasound or X-ray examination, the veterinarian assesses:

  • structure of the kidneys,
  • morphology,
  • the possible presence of tumors,
  • patency of the ureters,
  • the ratio of the cortex to the core of the kidney.

This serves to determine the causes and severity of the disease.

Sample results in a cat with PNN

Urine general examination:

  • low specific gravity
  • proteinuria (elevated protein / creatinine ratio)
  • rollers
  • possibly. bacteria and pyuria

Blood test (complete blood count):

  • anemia,
  • symptoms of inflammation.

Blood test (biochemistry):

  • azotaemia (increased urea, creatinine),
  • hyperphosphatemia,
  • disturbed levels of sodium, potassium,
  • possibly.hypoalbuminemia.

Blood pressure:

  • elevated

Urine culture:

  • possibly. positive

X-ray / ultrasound examination:

  • reduction, enlargement of the kidneys,
  • disturbed cortex / core ratio,
  • soft tissue calcinosis,
  • osteodystrophy.

If the symptoms of kidney disease are confirmed by the test, start treatment as soon as possible.

Treatment of acute renal failure in cats

Treatment of acute failure is intended to help the organ heal itself.

The key here is to administer antitoxic drugs as soon as possible (in case of poisoning) and fluid therapy.

You must remember that this is a form of failure that requires immediate response. The key is the first 6 hours of therapy.

Hence, frequent (even 2-3 times a day) intravenous infusions are used.

The amount of fluid administered is determined by the formula:

amount of fluid (ml) =% dehydration * body weight (kg) x 1000.

The infusion fluid should be isotonic, which is why doctors, taking into account the ionogram, often decide on Ringer's fluid with lactates, be 0.9% NaCl.

With metabolic acidosis, i.e. blood pH , can enrich the treatment sodium bicarbonate.

However, in acute hyperkalemia, calcium gluconate, which must be given as a very slow intravenous infusion.

Often, however, during the treatment of acute renal failure, the opposite situation occurs - i.e. potassium deficiency (hypokalemia), associated with the excretion of too much of this element from the body.

Then the application becomes helpful sodium bicarbonate or glucose, served with insulin or without it.

Assessment is also helpful in treating ARF phosphorus and when the level of this element is too high, pass binders.

To limit further dehydration is also given antiemetic drugs and reducing gastroenteritis, such as:

  • maropitant (Cerenia),
  • metoclopramide,
  • chlorpromazine.

Hyperacidity in the stomach is also treated by administering so-called H2 receptor blockers such as ranitidine (Ranigast, Solvertyl).

If the cat still produces less than 1-2 ml of urine per kg of body weight / hour despite watering - we may have renal failure associated with oliguria.

The veterinarian may then choose to administer diuretics - osmotic (mannitol, dextrose), looping how popular Furrosemide, be dopamine by slow, careful infusion into a vein.

What if, despite the drips, your cat's condition does not improve?

If the symptoms of nitrogen poisoning do not resolve within 24 hours, then it may become necessary peritoneal dialysis.

It consists in the fact that a fluid is poured into the abdominal (peritoneal) cavity of the cat, the task of which is to absorb toxic substances.

The dialysis solution is administered for 10 min, left for 30-40 min and then discarded.

On the following days of treatment, the time, number of cycles and the composition of the dialysis fluid are adapted to the condition of the animal.

Chronic renal failure treatment in cats

Cats found PNN, they will probably be treated for the rest of their lives.

They should be submitted first fluid therapy - to hydrate the purr.

The doctor may also choose to do symptomatic treatment depending on the severity of your cat's disease.

It is possible that your doctor will advise you to change to a so-called food nephrological feed.

In some advanced cases, force-feeding may also be necessary

In severe cases, multidimensional treatment should be undertaken as soon as possible. It consists of several basic activities:

  • lowering urea levels (fluid therapy),
  • if the cat refuses to eat - proper diet, appetite-enhancing drugs, sometimes force-feeding,
  • in the presence of vomiting or diarrhea - inhibiting them,
  • when the cat is thin, cachectic - the use of cat food,
  • irrigating the cat using intravenous and subcutaneous drips,
  • controlling anemia - if possible,
  • if there are inflammation of the mucous membranes (mainly of the mouth and stomach) - inhibition of inflammation (topical ointments, dentisept gels, anti-inflammatory agents),
  • combating acidosis - if it occurs,
  • administering drugs for renal failure (diuretics) - they force the kidneys to work more, which allows you to remove, at least partially, excess urea and other toxic substances in the blood, although you have to be very careful in their use - this is what the veterinarian decides,
  • lowering the level of phosphorus, increasing the level of potassium and calcium,
  • with hypertension - reduce it.

However, it should be remembered that each case is different and it is up to the doctor to decide on the treatment to be used.

What will the doctor do when diagnosed with PNN?

Considering the symptoms, their severity and the condition of the animal, the doctor will first:

  • Replenish the fluids - the number of which is required due to the increased amount of diluted urine. If the cat is unable to replenish its daily water intake, daily subcutaneous fluid administration becomes necessary. Usually it looks like the owner himself serves them at home. Over time, and as your cat's general condition improves, your doctor may also recommend that you reduce the frequency of drips, e.g. 1 - 2 times a week.
  • Complements vitamin C and B by giving them in the form of injection, or supplementing them with a kitten's diet.
  • If the cat has elevated blood pressure - he will try to lower it by giving it cardiological drugs, such as Lotensin, Enarenal, or other.
  • Possibly with an increased level of phosphorus - administration phosphate binders in the intestines.
  • Will antiemetic drugs, inhibiting gastroenteritis (mentioned above).
  • He will try to treat the anemia with anabolic steroids be erythropoietin.

In the further procedure, it will also be necessary to change the diet to one with a reduced level of protein and phosphorus.

Currently, there are many feeds on the market that meet these conditions, so there will be no problems with giving such food to your purr.

In some cases, the doctor will also apply dietary supplements for measures such as:

  • Renalvet,
  • Urinovet,
  • Ipakitine,
  • Rubenal.

To reduce the level of protein, measures such as Semintra.

Difficult decision when to consider euthanizing a cat with PNN?

If the cat does not feel better for a long time, creatinine will persist in the blood above 10 mg / dL with concurrent hyperphosphatemia (high phosphate levels), the prognosis for improvement may be poor

In the case of extremely chronic uremia, cat euthanasia should be considered.

Prevention of kidney disease in cats

It is very important to prevent kidney disease in cats performing blood and urine tests in cats over 5 - 7 years of age.

It is also important diet - older cats should be fed poorer in phosphorus and protein.

Prophylactically, you can also give them dietary supplements that affect the functioning of the kidneys.

You must not forget about the treatment of diseases of the urinary system and other diseases that may contribute to the development of failure.

Renal failure in a cat's diet

Food for a cat with kidney disease

A special diet is a very important part of treating kidney disease.

For a cat with renal insufficiency, a diet should be followed reduced protein content.

On the one hand, the food will support the treatment of the disease, and on the other hand, it will provide adequate nutrients, positively influencing the health of the whole body and the well-being of the kitten.

In the first phase of the disease, it is also worth taking care of the palatability of the feed - there are feeds with "increased palatability " available on the market.

In addition to being low in protein, food for cats with chronic renal failure should contain little phosphorus, take into account the correct proportion of acids omega-6 and omega-3 (5: 1 ratio).

The low phosphorus content of cat food prevents the appearance of hyperphosphatemia. This is a condition where the level of phosphate in the blood rises and can lead to problems with your absorption of calcium. Low phosphorus levels help to inhibit the disease.

The right ratio of acids omega-6 and omega-3 has a soothing effect on inflammation. It also helps to reduce the pressure in the glomeruli.

The above actions allow you to slow down the disease.

Ready food for cats with kidney problems contains the required ingredients to facilitate nitrogen excretion - among other things beet pulp or prebiotics (fructo-oligosaccharides - FOS).

Additionally, it is good if the food contains potassium citrate, which allows you to reduce the risk of metabolic acidosis.

Adequate water supply is also important.

Cats with renal insufficiency pass large amounts of urine, therefore their fluid requirements are greater.

Your cat's body must not become dehydrated.

Can anesthesia damage the kidneys?

Can anesthesia damage the kidneys?

Currently, in most veterinary clinics, before starting the procedures under anesthesia, the doctor informs the owner about the need to perform blood tests, because it allows the appropriate selection of anesthesia.

The lack of properly selected anesthesia, especially the associated drop in blood pressure, can contribute to worsening of the kidneys.

Currently, there are very good and relatively safe preparations for general anesthesia.

Remember, however, that it is the safest and least toxic to the kidneys inhalation anesthesia, if it is possible to apply it - it is worth doing.

Diseases that can harm the kidneys

Some of the diseases that your cat may face affect the later occurrence of PNN, while others are imps, making it difficult for us - doctors, diagnostics and treatment.

One such disease is liver failure, as it can mask kidney failure.

Urea is produced in the liver. If it is insufficient, we can observe the underestimated level of urea - the "kidney " indicator.

Other illnesses are similar to those of kidney failure. He is such a disease addison's disease.

An ailment that may have a direct impact on the development of renal failure is inflammation of the pancreas.

We do not know exactly what is causing it.

Symptoms may include:

  • diarrhea in a cat,
  • vomiting in a cat,
  • peculiar appearance of faeces (mushy, yellow).

These symptoms may disappear and the cat owner will judge that this was a temporary disorder. The inflammation may pass and the pancreas will regenerate but will leave a mark on the kidneys.

Treatment of certain diseases also has a negative effect on the kidneys.

Kidney tumors are rare because it's only about 1% all cancers, but alone chemotherapy other tumors in your cat can contribute to the development of kidney failure.

Too dehydration it is dangerous because then little blood reaches the kidneys and, as a result, they are hypoxic, and they increase urea level and creatinine.

This is where drip administration comes in handy, as long as there is no serious damage yet.

The role of drips in the treatment of renal failure

Fluid therapy is designed to keep your cat hydrated.

It should be remembered that the composition of the drip tubes varies and that it must be adapted to the needs of the animal.

And here again - we choose the drip based on your blood test results.

If, for example, we give a cat with a potassium deficiency a glucose drip, we will lower the potassium level even more and make him feel worse.

An hydrated cat is a cat that spends more urine, removing toxic products from the body.

My cat has PNN - how to deal with him?

How to deal with a cat suffering from Mon?

If you are a carer for a cat that suffers from PNN, you must remember the following:

  1. Adherence to strict diet!
  2. Providing your cat with peace - we avoid stress.
  3. Observation - Don't underestimate symptoms that could suggest worsening of your cat's performance, such as loss of appetite, vomiting, and somnolence. In the event of their appearance - an immediate visit to the doctor.
  4. Giving him the prescribed medications.
  5. Performing a minimum of blood checks once every six months.
  6. If in doubt - contact your doctor.


In conclusion, kidney failure is a very insidious disease that can lead to the death of your pet.

That is why it is so important to prevent and observe cats that are in the most vulnerable groups.

Hopefully, after reading this article, you already know how to prevent kidney failure and how to recognize the disease if your cat shows characteristic symptoms.

If you want to know more about the treatment of PNN, or the diet for a kidney disease cat, please add a comment under the article now, I will reply as soon as possible.

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