How to Treat Chronic Renal Failure in Cats

By Jennifer Coates, DVM on Feb. 12, 2016

Chronic kidney failure is a progressive disease, but it can often be treated with some success,

If your cat has been diagnosed with chronic renal failure, this is what you can expect to happen next:

Medication: Medications and supplements that lower blood pressure, raise potassium levels, lower phosphorous levels, promote kidney function, treat anemia, treat gastrointestinal ulcers, and reduce vomiting may all be a part of therapy.
Diet: Special diets that promote kidney function and reduce the biochemical abnormalities in the body that result from renal failure are often prescribed. Canned food is usually best due to its high water content. Supplemental fluids may also be given under the skin.
Surgery: In rare cases, a kidney transplant may be considered.

What to Expect at the Vet’s Office

If your veterinarian needs to confirm your cat’s diagnosis of chronic kidney failure, he or she may need to order a blood chemistry panel, complete blood cell count, a urinalysis, and blood pressure testing.

Findings typically include some combination of:

dilute urine
elevated blood urea nitrogen (BUN)
increased levels of creatinine in the blood
anemia (low red blood cell count)
high levels of phosphorous in the blood
low levels of potassium in the blood
high blood pressure

After a definitive diagnosis of chronic renal failure, your veterinarian will determine whether your cat needs to be hospitalized. Severely affected cats may need to stay at the veterinary clinic to receive intravenous fluids and begin treatment for any other symptoms they might have (see below).

Once cats with chronic renal failure are stable enough to continue their treatment at home, they can be discharged from the hospital.

What to Expect at Home

Appropriate treatment for chronic kidney failure depends on the specific symptoms and biochemical abnormalities a cat has. Many patients require fluid therapy to combat dehydration. This can be achieved by increasing the water content of a pet’s diet (e.g., feeding canned food only) and through intermittent subcutaneous fluid treatment (giving boluses of sterile fluid under the skin).

Your veterinarian may also prescribe a special diet to help promote kidney function and counteract biochemical abnormalities that commonly occur in the body.

Additional recommendations are based on a pet’s individual needs and may include:

Medications to lower blood pressure (e.g., propranolol, atenolol, or enalapril)
Nutritional supplements that reduce BUN (Azodyl) and phosphorus levels (Epakitin)
Omega 3 fatty acids to protect the kidneys
Medications to treat or prevent stomach ulcers (e.g., ranitidine, famotidine, omeprazole, sucralfate)
Potassium supplements
Medications decrease blood phosphorous levels (e.g., calcium carbonate)
Calcitriol to slow the progression of chronic renal failure
Medications to treat anemia (e.g., erythropoietin or darbepoetin)
Anti-nausea medications (e.g., maropitant or ondansetron)

Kidney transplants may be an option for cats who meet specific criteria.

Questions to Ask Your Vet

Ask your veterinarian what the possible side effects are of the medications your cat is taking. Find out when he or she next wants to see your cat for a progress check and whom you should call if an emergency arises outside of your veterinarian’s normal business hours.

Possible Complications to Watch For

Chronic kidney failure is a progressive disease, but the speed of the decline can vary greatly between individuals. Some cats enjoy good quality of life for many months, or even years, while others have to be euthanized soon after diagnosis.

Talk to your veterinarian if you have any questions or concerns about your cat’s condition, particularly if you notice a worsening of: