Chronic Renal Failure in Cats
Chronic Renal Failure (CRF) is a disease of the kidneys. It is ultimately terminal, however with prompt and proper treatment, most cats with CRF can do very well for a long time, even many years.
The most telling, initial signs of Chronic Renal Failure are increased thirst (polydipsia) and excessive urination (polyuria). You might notice larger than usual urine clumps in the litter box, if you use clumping litter. You may see your cat lifting his rear while urinating, overshooting the sides of the litter box. The cat will do that to keep the urine from pooling around his feet as he is urinating an overly large amount at one time.
As the condition progresses, the cat may experience nausea, loss of appetite, vomiting, weight loss, poor hair coat and emaciation. It can be hard to tell a cat is emaciated just by looking at it, particulary a longer haired, fluffy cat. But if you feel the cats body under the fur you can tell the cat is emaciated when all you feel is skin and bones!
Since only 30% of kidney capacity is needed for normal functioning, no symptoms will be seen until approximately 70% of renal function is lost. It is important to begin treatment as soon as the first symptoms appear, since by then, the cat has no reserves left and will die soon without treatment.
Creatinine and BUN are the two most important elements of the blood test for cats with CRF. When these are elevated and the urine is dilute, the cat is most probably in chronic renal failure.
Normal ranges may vary somewhat depending upon the lab. In general:
Normal BUN in cats: 16.0 - 36.0 mg/dl Normal Creatinine: 0.8-2.4
Read the diary of Galen's diagnoses of CRF and treatment at Galen. He went from a near death, emaciated cat to a cat that seems totally healthy, after getting proper treatment.
Links with detailed, important information:
Feline Kidney Disease by Dr. Derek Duval, VMD http://www.netpets.com/cats/reference/info/catkidney.html
http://www.manhattancats.com/Articles/CRF.html An excerpt: "Fluid therapy remains an important part of the treatment for renal failure. In an attempt to rid their bodies of toxins, cats with CRF will urinate more often, and they need to take in more water in order to maintain hydration. Dehydration reduces the blood volume and consequently, the blood flow to the kidneys becomes reduced, further impairing kidney function. Some cats require hospitalization and intravenous fluid therapy. While there are ways to encourage additional water intake (feeding canned food rather than dry food, adding water or broth to the food), a few cats may require additional therapy in the form of subcutaneous (under the skin) fluids administered .."Tanya's Feline Chronic Renal Failure Information Center http://www.felinecrf.org/
*Nadia's CRF Homepage (This is an excellent, extremely helpful site, a must see if you have a cat with CRF.) http://www.geocities.com/nadiacrfsite/
Giving Sub-q Fluids:
http://www.weirdstuffwemake.com/weird/stuff/pets/cats/sophia/catjuice.htmlA great personal site by a person who did sub-q fluids at home, with photographs of all the steps and photographs of all the needed supplies and how to set everything up.
Interpreting blood tests and normal ranges: http://www.felinecrf.com/tests0.htm
Definitions of hematology blood test results in cats: http://felidaeworld.com/hematology.html
Why Terumo needles are the best and better to use:
Terumo needles have thinner walls that those of other brand needles. This allows for a faster flow of fluids in corresponding sized needle of other brands. Also, Terumo needles seem sharper, and do go in the cat's skin easier. Read more details in the article below:
Online veterinary supply stores to order Sub-q supplies (cheaper than what most vets charge):
Lambriar Vet Supply. Their site is a little hard to navigate, see particular links below:
For Terumo needles (some states require a prescription, but not all do.) Terumo needles are the best to use.
The venoset (tubing connecting fluids to needle- no prescription needed in some states)
Fabulous syringes for dispensing liquid medicines or paste like supplements such as Nutrical- has a silicone O-Ring seal that slides much easier than those with the rubber tip. These really are better: O-Ring syringes
Brico Medical Supplies http://www.bricomedicalsupplies.com/CRFpage.html (they require a prescription for needles, venosets and fluids.)
Listings of other places to get supplies:
This comprehensive resource brings together cutting edge information about fluid, electrolyte, and acid-base physiology and fluid therapy as they apply to small animal practice. It also offers complete coverage of relevant physiology and pathophysiology, as well as important information for interpreting and analyzing biochemical test results.
Phosphorus levels in food have been found to be of greater importance than the protein levels, though protein levels are also an important consideration. If a cat has borderline kidney problems and is not at the point of needing a prescription diet for managing Chronic Renal Failure, one might try serving a commercial cat food with the lowest phosphorous percentages than other commercial cat foods. (Most cat food lables do not give the phosphorus information, so contacting the manufacturer is necessary to find that information.) Then, have blood work done again after a few months to see if there was a positive effect.
Lists of cat foods giving protein, phosphorous and other nutrient percentages:
- Dry food: http://webpages.charter.net/katkarma/dry.htm
- Canned food: http://webpages.charter.net/katkarma/canned.htm