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Feline Kidney Disease

Pet cats can get sick for many different reasons. One common illness in cats is kidney disease. Healthy kidney function is vital for cats, as kidneys perform blood filtration. The filtering mechanism in the kidneys maintains normal electrolyte balance while filtering out toxins and retaining water and nutrients that the body needs. Therefore it is no surprise that disease or failure of the kidneys can cause life threatening illness.

Kidney disease is categorized as acute or chronic. Acute or chronic kidney failure may occur in different populations of cats, and treatment and prognosis varies significantly. Examination by a veterinarian and diagnostic testing is helpful to determine what is making a cat sick, how sick they are, and what can be done to help them.

Acute Kidney Disease in Cats

Acute kidney disease in cats can cause a decreased appetite, vomiting, increase in thirst and urine output, bad breath, and discomfort around the abdomen and mouth.  Causes include toxin ingestion (such as lilies or antifreeze), sensitivity to some medications like non-steroidal anti inflammatories, infection of the kidneys, generalized organ failure, urinary blockages of the urethra or ureter, and various less common causes.

Determining the cause of symptoms is important to determine prognosis and treatment and starts with establishing a history.  For example, a cat that goes outside will have access to antifreeze that leaks from a car. If an indoor male cat is straining to urinate but not producing much urine which is obvious when monitoring their litter pan, they may have a urinary blockage that needs to be addressed. Bloodwork, urine testing, and ultrasound are usually required to make a diagnosis.

Once a diagnosis is made, proper treatment of acute kidney disease in cats includes hospitalization with intensive care, intravenous fluids with added electrolytes and nutrients, and addressing the cause. Medication to help a cat feel more comfortable may include pain medication to ease discomfort from oral and gastrointestinal ulcers and nutrients or medications such as phosphorus binders to decrease phosphorus levels which can cause an overall feeling of illness.

Prognosis of acute kidney disease depends on the cat’s condition when they get to a veterinarian and subsequent response to treatment.  Additionally, acute kidney disease can have long term implications, even if a cat initially responds to supportive care. Therefore, it’s important to have regular examinations and lab work performed as recommended by the veterinarian.

Chronic Kidney Disease and Failure in Cats

Chronic kidney disease in cats comes on gradually over a period of weeks to months and even years. Symptoms include weight loss, decreased appetite, increases in thirst and urine production, vomiting, dehydration, decreased energy, and bad breath. Chronic kidney disease is more common in older or pure bred cats.

A veterinarian will review the cat’s history, perform an examination, lab work, and sometimes imaging such as X-rays or ultrasound to reach a diagnosis. The prognosis is determined by how advanced the kidney disease is and if the cat has other concurrent health problems.  Treatment depends on the stage of chronic kidney disease.

Treatment for early stage chronic kidney disease in cats can include prescription diet and fluid administration by injection under the skin on a regular basis.  Owners are often intimidated by giving fluid injections to their cats, but they soon realize it is not difficult and most cats tolerate it very well.  Fluid supplementation allows any remaining healthy kidney tissue to stay healthy for as long as possible.  Treatment for late stage chronic kidney failure includes hospitalization for at least 72 hours with intravenous fluids, special diet, and sometimes nutrient and electrolyte administration.  If a cat does well after intensive care, continued treatment at home is possible with regular fluid injections under the skin.


Overall, kidney disease and failure is a very common life threatening disease in cats.  Early detection and treatment by a veterinarian can prolong a good quality of life and lifespan.  Therefore, it’s important to schedule an appointment for pet cats with a veterinarian on a regular basis and follow through with recommended diagnostic testing.