Each season I try to remember to warn pet owners about risks associated with the season. Easter Lilies are one of the biggest risks associated with spring time. I know how lovely the plants are and after a long, grey winter season, it is nice to have some flowers in the house, but if you have cats, do not have Easter Lilies in your home. They are extremely toxic to cats, leading to kidney failure and death. Even just drinking the water out of the pot poses a risk.
Kidney disease in general is a problem commonly seen in cats year round, and while Easter lily intoxication causes immediate (acute) kidney disease, a more common diagnosis is long-term, progressive kidney insufficiency or chronic kidney disease (CKD). Chronic kidney disease is most often diagnosed in cats as they get older, but can be seen in cats of any age depending on the cause. CKD is number four on the top ten list of pet insurance claims. In one study 35% of mature cats examined had laboratory results indicating some level of CKD.
Early detection and treatment of CKD can significantly increase the affected cat’s quality and length of life. One of the classic symptoms seen is a change in thirst and urination. I often have owners ask me, if my cat is urinating more, how can his kidneys not be working? As the kidney function decreases, the ability to concentrate urine decreases and the cat will pass a larger amount of dilute urine. For some owner’s this can be difficult to assess if there are multiple cats in the household or the cat eliminates outside.
Lab testing is the mainstay of evaluating a cat’s kidney status. Baseline testing includes a general blood profile, complete blood count and urinalysis. Blood urea nitrogen (BUN) and creatinine are two indices in blood testing that can help us assess the status of the kidneys, if either is elevated further testing is indicated, but both can be normal in early stages of kidney disease. In fact, up to 75% of kidney function is lost before it causes the BUN to elevate. Urinalysis is a more sensitive test in early stages of renal function. A lot of clients wonder how we get urine out of a cat, it’s not as hard a one would think. The least stressful method is to draw the urine directly from the bladder with a sterile needle and syringe, we use an ultrasound to locate the bladder and also assess the bladder for abnormalities at the same time. I know that makes a lot of you cringe, but collecting a clean catch sample can be difficult (sometimes impossible) in a cat and pressing on the bladder until a cat urinates can be stressful and actually cause trauma. We have found that 95% of the cats don’t mind laying in the soft padded bed while we collect urine. Some even don’t want to get out of the bed when we are done, they are so comfy!
Once CKD is diagnosed further testing is done to evaluate the stage of the disease, which dictates the level of care that is recommended. These tests include; blood pressure measurement, a kidney function test: Urine Protein/Creatinine ratio and urine culture. Follow up testing frequency also depends on the stage of the disease, often every 3-6 months is recommended.
There are many treatment options available to slow the progression of CKD to kidney failure. Dietary management has been the first line therapy for many years. When making a dietary decision the most important thing to remember is the diet doesn’t do any good if the cat won’t eat it. Specially formulated renal diets address several issues that affect cats with CKD. They have a moderately lowered level of high quality protein, to decrease the workload on the kidneys. In addition, the phosphorous and sodium is restricted, since the kidneys lose their ability to keep these elements balanced. Finally the diet is supplemented with omega 3 fatty acids, which has shown to protect kidney cells. Making sure the cat is getting plenty of water is also important. I recommend a kitty drinking fountain and feeding a good portion of the diet as canned food. If you want to home cook, there are resources to find an appropriate recipe or you can consult a veterinary nutritionist. I have the links for both on wildernessvet.com.
CKD is a complicated disease process and there are many more treatment options that can’t be covered in the scope of this article. The most important take-home message for cat owners is if you think your cat is drinking or urinating more, get to the vet for further testing, it could be a myriad of diseases, many of which can be managed, especially if caught in the early stages.
As usual, please feel free to contact me with any questions or ideas for articles, firstname.lastname@example.org, or our Facebook page. Happy Spring, I look forward to seeing everyone at the Farmers’ Market this summer.