Treating Cats with Chronic Renal Insufficiency

CRI (also known as chronic renal failure or CRF) is a common cause of death among older cats, and symptoms often don’t appear until the illness is relatively advanced. With proper treatment and care, many cats will have a number of years ahead of them and good quality of life. Treatment options include dietary changes, hydration, hemodialysis, and kidney transplants.

Diets for Cats with CRI

While dietary changes cannot reverse kidney damage, they can slow the progress of the illness and improve your pet’s quality of life. In some cases a veterinarian may recommend a diet low in salt, protein, and/or phosphorus (though not all veterinarians agree that a low-protein diet is beneficial). Many cat food suppliers offer such diet options, including Eukanuba Veterinary Diet Multi-Stage Renal Formula and Purina NF Kidney Function Brand FORMULA.

However, some cats with CRI refuse food, particularly if a new food is introduced. Switching a cat’s diet should be done a little at a time, mixing ever-increasing amounts of the new food into the old food and decreasing the original food until the cat is eating the new diet. This may take up to a month if you have a very finicky cat. Cats with CRI should be weighed frequently to ensure that they are eating enough.

Appetite Loss

Some cats lose their appetites completely with CRI and require appetite stimulants, or even syringe-feeding by hand or via a tube introduced into the stomach in extreme cases. Ideally, owners are able to coax their cats to eat with favourite foods and treats. CRI Cats should be given healthy treats that are low in sodium, such as Royal Canin’s Veterinary Diet Feline Treats. But in the case of a cat that isn’t eating at all, if “junk food” treats are the only thing she’ll consume, they’re better than nothing.

Heating food slightly and adding water, tuna juice, clam juice, beef broth, or chicken broth can encourage cats to eat. If using broth, make sure it doesn’t contain onions, as they are toxic for cats. Broth should also should be salt-free, and avoid bouillon, which is very salty.

Many cats love “people tuna.” Canned tuna designed for humans is not nutritionally complete for cats, but it’s okay to mix a little in with regular cat food to encourage a sick cat to eat, or give it as a treat from time to time. Some cats respond to a little catnip mixed into their food as well.

Other tricks that are particularly beneficial for older cats include cutting food into smaller pieces, putting it in a mound rather than flat in the dish, and putting the food dish on a stand so that it’s slightly higher. Hand feeding or placing food on the cat’s paws or mouth works with some cats.

Hydration

It’s critical to ensure that cats with CRI drink plenty of water. Bowls of water should be provided at multiple locations around the house to encourage the cat to drink. As most cats prefer free-flowing water, investing in a fountain-type cat water dish is a good idea. With advanced CRI, administering subcutaneous (Sub-Q) fluids can prolong both the quality and quantity of your cat’s life by preventing dehydration.

Hemodialysis

Cats that suffer renal failure may be treated with hemodialysis, which involves inserting a catheter into the cat’s jugular vein, extracting blood to pass it through an artificial kidney that filters waste products, and then returning the blood to the cat. This takes 3-5 hours, and approximately 3 sessions are required per week.

There are not many veterinary facilities equipped to offer hemodialysis for cats at this time. For more information on hemodialysis and a list of facilities that offer it for pets, see veterinarian Wendy Brooks’ Kidney Dialysis, Is It For Your Pet?

Kidney Transplants

A kidney transplant can add 2-6 years to a CRI cat’s life, though this will vary depending on the age of the cat at the time of the transplant. One cat has survived for 10 years after a transplant.

As with any surgery, there are a number of risks, both during the operation and afterward, but feline kidney transplants have advanced to the point where 80-90% are successful. However, at this time there are not many facilities that offer the procedure.

There are ethical issues surrounding feline kidney donation. Generally, donors are shelter cats, and the shelter will only allow the donation to proceed if owners of the recipient cat plan to adopt and care for the donor cat. Ideally, the sick cat gets a life-saving donation, while the shelter cat receives a loving home for life.

Cats undergoing kidney transplants require 1-3 weeks of intensive in-hospital care after surgery. When the cat is able to come home from the hospital, close monitoring, follow-up veterinary care, and medication are required. Cost ranges from $4,500-$8,000.

Other Issues

Some CRI cats with low potassium levels experience muscle weakness that can make climbing and jumping difficult or painful. If your cat appears to be having trouble, adding ramps or stepping stools so that she can reach her favourite perches can be helpful.

Cats with CRI usually need to have their litter boxes changed more often as they urinate more frequently. If you have a CRI cat, you may find that you go through kitty litter more than twice as fast.

CRI cats should have up-to-date ID tags and a microchip implant if possible, as they need a higher level of care than healthy cats. If lost, a CRI cat could become very ill or even die quickly without proper nutrition and hydration support.

Further Reading

Information for this article was derived from the Feline CRF Information Center, an excellent resource that provides comprehensive information on CRF causes, symptoms, treatments, and care, as well as information regarding kidney transplants. For a brief overview of CRI causes and symptoms, see Symptoms of CRI in Cats.

Cat with CRI

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