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Neil the vetKidney disease is the second most common fatal disease of cats, killing 1 in 5 of our feline friends. It is also responsible for slow, progressive loss of the quality of life of affected individuals. The symptoms can be slow and insidious, making it hard for owners to notice there is a problem. Most cats will drink and urinate excessively. Indeed, if you regularly notice your cat drinking then something is probably wrong. Many will have a poor appetite. Weight loss and muscle weakness are common. Nausea, tummy upsets and mouth ulcers are sometimes seen and, occasionally, sudden blindness can occur.

Unfortunately, even though kidney failure can develop over a long period, owners frequently don’t take action until the condition is very advanced. There are reasons for this, of course. Many merely believe that their cat is getting old. Others sense that something is wrong, but are frightened of a visit to the vet in case of bad news. Some have experienced kidney failure in previous cats and think that little can be done. They are wrong. They forget that it was thirteen years or more since their last cat was affected and much has changed about our understanding of kidney disease and our ability to treat it over this period.

The disease process, however, remains the same. Cats, like us, have two kidneys and significant symptoms don’t occur until nearly two thirds of their function has been lost. By this point the kidneys are finding it hard to carry out their main job of removing toxic waste products from the blood. They respond to this by increasing the blood pressure within the kidney so that the same amount of blood can be processed and, despite this working for a while, the increased blood pressure results in even more kidney damage. The damaged kidney is unable to act properly as a filter and so protein, which would normally be retained for use by the body, is passed out in urine. Weight loss is just around the corner. Patients start producing lots of very dilute urine as the failing kidneys become unable to conserve water. Levels of toxic wastes called urea and creatinine begin to rise and cause a reduction in appetite and well-being. Severe irreversible symptoms are now not far away. Death, inevitably, will follow after a while.

But don’t despair. Diagnosed early enough, loss of kidney function can be slowed. A relatively new drug, benazepril, can increase the survival time of affected cats by a factor of three. Specially formulated diets can reduce weight loss and the build-up of toxic waste products. Anabolic steroids will slow muscle loss and Vitamin B12 can prevent the anaemia that often occurs.

Your vet is better too. They should all be able to test urine samples to determine its concentration. Most can run blood tests in-house that will diagnose the disease before severe symptoms are seen. Many will be able to test blood pressure to allow diagnosis and monitoring.

But none of this will be any use if you just sit idly by, watching your cat drinking a little more every day.

Neil McIntosh BVM&S MRCVS

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