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Managing chronic kidney disease (CKD)

I am writing this blog to help owners and highlight the importance of understanding kidney disease, as CKD involves a long term relationship with the pet owner and the veterinary team. Good understanding means good compliance which equals the best outcome for the animal.

In most cases of chronic renal failure, treatment is symptomatic and supportive as unfortunately CKD is not reversible.  Patients sometimes require intravenous fluid therapy (a drip) to help correct dehydration and possible electrolyte imbalances initially.  Once they are stable the main concern is to support the kidneys there after and there are a number of ways that the vets and the owners can do to this by working together to optimise the animals quality of life and increase life expectancy.

What is checked at the vets and why?

Blood tests are taken initially if there is suspicion of kidney issues. This is to check kidney biomarkers such as; Urea, Creatinine and SDMA levels. The results of these levels can establish how advance the kidney disease is.  It is a fact that kidney issues do not become obvious until 75% of the kidney is damaged – up until this point the kidneys are able to compensate.

The vet may also want to check urine as this establishes how well the kidneys are dealing with concentrating the urine in order to excrete toxins from the body.

Blood pressure can also be checked as the kidneys are really important in maintaining and regulating blood pressure. Too high or too low pressure can lead on to further problems.

We do these tests at regular intervals to monitor the kidneys which enable the vets to decide on the course of treatment, depending on how the kidney disease has progressed. Some treatment plans involve more than one medication and diet change.

 

 

 

Diet and management

Dietary management is crucial in managing chronic kidney disease, there are three main areas involved in this.

Protein content

Protein content in food should be restricted and of high biological value, meaning the kidneys do not have to work as hard breaking down protein.  Toxins from protein breakdown accumulate in the blood during CKD, so by reducing this will put less stress on the kidneys and help improve quality of life.

Water intake

Animals with kidney disease should have plenty access to water as they are much more likely to become dehydrated as their kidneys are not able to conserve water as effectively. Cats get most of their water intake from food so it is always recommended they are fed a wet diet.

Low phosphate content

Reducing phosphorus intake appears to be beneficial in protecting the kidneys from further damage during CKD. Again, this is something that can be done with a special kidney diet. There are also phosphate binders which you can put on to the food which can help reduce the amount of phosphate being absorbed however these are not always successful as cats may not eat the food.

 

 

How can owners help?

  • Feed a vet recommended kidney diet* these will be special formulated diets with modified protein, restricted phosphorus, essential fatty acids and antioxidants.
  • Give your pet plenty of access to water
  • Feed a wet diet such a sachets or tinned food – you can also add a little water to these. You can also warm them slightly which can help increase palatability.
  • Bring your pet for regular and recommended check-ups and blood test as advised by your veterinary team
  • Monitor your pet for any changes in behaviour and speak to your vet if you have any concerns

*Slow introduction of a new diet – especially for cats is essential for them to accept new food. Ask your vet or veterinary nurse on how to do this.

 

Nutrition is a really important factor in chronic kidney disease management can often be overlooked, especially for elderly cats. Sometimes these cats can actually have a slightly increased metabolism but they do have reduced ability to digest proteins and fats and unfortunately their bodies start to use muscle for energy instead of fat. Keeping body condition is really essential to managing kidney disease.

If you are worried that your animal is not eating then they must see a vet. Depending on the circumstances we may be able to offer medications to stimulate their appetite or to help them feel less nauseous as these signs can be caused by kidney disease.

Written by Laura Powell – Registered Veterinary Nurse

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