Common Concurrent Conditions: Renal Failure
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Renal (Kidney) Failure

Whether or not your cat has diabetes, kidney problems are very common.

Types of Renal Failure:

  • Acute (ARF)
  • Chronic CRF)

Acute Renal Failure(ARF)

Acute renal failure means kidney failure that comes on suddenly. This is an emergency and your cat should go to the veterinarian at once if you suspect ARF. It can be reversed if diagnosed quickly and treated aggressively. Otherwise, the prognosis is very poor. If your cat stops peeing or has trouble peeing, go to the vet as soon as possible.

Signs of ARF
  • anorexia (failure to eat)
  • listlessness
  • vomiting
  • diarrhea
  • stumbling or seizures
  • bad breath (ketone smell)
  • changes in urination (no or decreased urine output; sometimes excessive urination)
Of course these can occur with other conditions so it is important to have your veterinarian conduct a physical examination and appropriate laboratory studies.

Useful lab tests
  • Urine specific gravity - measures the concentration of urine.
  • Progressively increased BUN, creatinine, phosphate
  • Other tests to be determined by your vet based on your particular cat's history and examination
  • Inpatient management by your veterinarian

Chronic Renal Failure(CRF)

Chronic renal failure is not a medical emergency but does need regular follow-up and treatment with your veterinarian. Mean age of diagnosis in cats is 9 years and the prevalence of CRF increases with increasing age. About 15% of cats are reported to have CRF by age 15.

CRF is defined as azotemia and urine specific gravity <1.035. Azotemia is the accumulation of urea and creatinine in the blood and can occur for several reasons. It may or may not be associated with changes in your cat's phyical examination. Abyssinian and Persian cats have a genetic predisposition to developing CRF but it can occur in any cat. The cause is generally not known.

Cats with mild CRF may not have any symptoms. An animal with stable CRF can suddenly decompensate ("uremic crisis") and need emergency treatment. See signs of ARF, above.

Signs of CRF
  • excessive drinking and urination (known as PU/PD)
  • anorexia
  • weight loss
  • vomiting
  • constipation
  • acute blindness (due to high blood pressure)
  • seizures and coma (late in the disease)
Laboratory Findings
  • Anemia (low red blood cell count)
  • High BUN, creatinine, and phosphate
  • Urine specific gravity <1.035
  • Mild proteinuria (proteins in the urine)
  • Inpatient treatment for uremic crisis
  • Dietary changes:
    • protein restriction for severe cases, controversial restriction otherwise
    • n-3 fatty acid supplements may be beneficial
    • sodium and phosphorus decreased
    • "Alkalinizing diet"
  • Free access to fresh water at all times

For more information on CHRONIC RENAL FAILURE (CRF), an excellent resource is the Feline CRF Information Center.

Last updated 2/18/05


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