Kidney failure is very common in older cats. In fact, it is one of the top causes of death in domestic cats. Read our complete guide on chronic kidney disease in cats to learn more about the disease, its symptoms and treatments, including a thoroughly researched dietary guide.

DISCLAIMER: This post may contain affiliate links. If you click one of these links and decide to make a purchase, I may receive a small commission. This comes at no extra cost to you and helps me to keep the site alive and up to date. If you want more information, please review our Privacy Policy. Thank you for your support!

What Is Chronic Kidney Disease

Kidney disease in cats is a severe and often incurable deterioration of the kidneys’ ability to filter out waste products from the blood. Usually, this deterioration happens over a longer period of time due to aging and general wear and tear. That is why we speak of chronic kidney disease (CKD) or chronic renal failure (CRF). Since the disease takes such a long time to develop, it is most commonly seen in older cats past the age of 7.

The Four Stages Of Chronic Kidney Disease In Cats

  • Stage 1: Around 40% of the kidney function is damaged. SDMA levels are raised, but blood urea nitrogen and creatinine levels are within range. This is the ideal time to start treatment, which underlines the need for early detection. If your cat is getting older, take her to the vet at least once a year for a full check-up.
  • Stage 2: At this stage, around 65% of the kidney function is lost. This means the kidneys are no longer able to maintain the required levels of vitamins and minerals in the blood. As a result, your cat will start to feel dehydrated and drink more and more water.
  • Stage 3: When the kidneys lose more than 75% of their function, your cat enters stage 3 of the disease. Toxins will start to build up in your cat’s bloodstream and outward symptoms will become more obvious.
  • Stage 4: In stage 4 your cat is in acute renal failure. She won’t be able to drink enough to keep up with her failing kidneys, nor can her kidneys keep up with filtering out the toxins. Needless to say, this is a time for immediate action.

If stage 4 kidney disease occurs without a history of chronic kidney disease, it is called acute kidney failure. As the name implies, acute kidney failure is a sudden onset disease, often caused by poisoning. It can occur at any age. If you suddenly see any of the symptoms described in this article in your cat, please take her to the vet or an animal emergency service immediately. If left untreated, acute kidney disease is either fatal or leads to chronic kidney disease.

Symptoms Of Chronic Kidney Disease In Cats

If caught early, there is a lot you can do to slow the progression of kidney disease and lengthen your cat’s life. Your vet can do blood and urine tests to see if your cat’s kidneys are damaged and, if so, how bad the damage is. In the meantime, we list the main symptoms of feline kidney disease to help you judge whether your cat has kidney problems and how far along it has progressed.

Excessive Thirst And Urination

The first obvious sign that your cat could be suffering from kidney disease is an increased thirst. And with that, increased urination. If you notice that your cat starts to spend more time around her drinking bowl or suddenly leaves bigger puddles in the litter box, it is a good idea to take her for a check-up. Excessive urination can also be a symptom of diabetes, another disease that is best caught early.

Loss Of Appetite

A build-up of phosphorus in the blood leads to kidney-impaired cats being notoriously picky eaters. They tend to have trouble finishing their portions and will often snub their noses completely at the food you so carefully picked out for them. Don’t take it personally, and don’t force them to eat it. If you really can’t find anything she will consistently, and happily, eat, then consult with your vet about switching to a low phosphorus cat food for kidney disease.

Digestive Problems

In its advanced stages, kidney disease may co-occur with a host of gastrointestinal issues. The lack of minerals absorbed from food will cause disruptions in your cat’s digestive tract, which leads to vomiting and diarrhea. The inability to retain fluids further impairs the metabolic processes and increases the risk of constipation.

Cat sitting on a desk

Urinary Crystals

It is not uncommon for cats with kidney disease to develop urinary crystals or bladder stones. In fact, there is evidence suggesting that cats who suffer from urinary crystals at younger ages are more prone to developing chronic kidney disease later in life. If your cat has urinary crystals, she will show signs of pain while urinating. The urine may also contain traces of blood.

Kidney And Bladder Infections

The physical deterioration of the kidneys and decreased filtering of toxins can cause recurring infections to the bladder and the kidneys themselves. Your vet will perform regular analyses of your cat’s urine and subscribe antibiotics to treat the infections. You yourself can use nutritional supplements mixed in with your cat’s food to limit the chance of infections occurring.

Lethargy And Depression

Cats tend to hide it when they are in discomfort or pain. So you can imagine how bad your cat must be feeling when she actually starts to show it. It costs a lot of energy to keep going with damaged kidneys and as a result, your cat will become lethargic. On top of that, the chronic pain from her bladder and kidneys may even make her depressed. Not surprisingly, cats with kidney disease love to sleep the day away somewhere safe and comfortable.

Skin And Coat Problems

As the disease progresses, your cat will become more and more dehydrated. Toxins will start to build up in the bloodstream and get distributed throughout your cat’s system. This can lead to problems with her skin and coat, varying from dry skin and matte looking fur to rashes and hair loss.

Weight Loss

In the final stages of kidney disease, your cat won’t be able to absorb enough nutrients from her food to maintain her body mass. You will see a rapid loss of muscle and weight as your cat deteriorates. Consult with your vet about a change in diet and monitor her weight daily.

Treatments For Cats With Kidney Disease

Fluid Therapy

When your cat is first diagnosed with kidney disease, your vet will likely suggest that she undergo fluid therapy to flush out her renal system. A large quantity of fluids is administered to your cat either intravenously (into a vein) or subcutaneously (under the skin). For more serious or progressed cases, this process can be repeated several times over a period of days and at regular intervals throughout your cat’s future.

If your kidney diseased cat does require periodic fluid therapy and you want to save her the stress of the repeated vet visits, ask your vet about the possibility to administer the subcutaneous injections yourself at home. It may sound scary, but there really isn’t much to it once you know what you are doing and use the proper equipment.

Monitor Blood Pressure

Your cat’s blood pressure is an important gauge of her wellbeing and the progression of her kidney disease. As the toxins in her bloodstream go up and the nutrients go down, your cat’s heart will have to work harder and harder to keep up with the needs of her body. This will cause her blood pressure to rise. Monitoring the changes in your feline’s blood pressure over time can give a good indication of how well she is holding up.

Nutritional Supplements And Treats

Depending on the results of your cat’s blood work, you may want to consider adding specific nutritional supplements or a dietary treat to her food. Cats with kidney disease can often use some extra potassium, vitamin B and fatty acids (omega-3 and omega-6). If your cat suffers from loss of appetite, consider adding a phosphate binder to lower the levels of phosphorus in her blood. You might even consider giving your cat CBD oil or CBD treats especially designed for cats to boost their appetite and keep up their overall health.

Related Post: Is CBD Oil Good For Cats With Kidney Disease?

Is CBD oil good for cats with kidney disease? How does it affect them? This guide will answer all your questions.

Medication

Cats with kidney disease are unfortunately prone to developing kidney and bladder infections, as well as gastrointestinal complications such as a sensitive stomach or even hyperthyroidism. Your vet may prescribe some anti-inflammatory medication or antibiotics to help control these conditions. Of course, medication does put a strain on the renal system, so definitely use all of our other tips to prevent this from happening as much as possible.

Stress Management

Being ill in general is quite a load to bear for your poor feline. But stress and depression are especially detrimental to a cat with chronic kidney disease. A distressed cat may deprive herself of food or water just when she needs it the most, which can have devastating effects on her already compromised kidney function. An increased level of stress hormones also increases the risk of complications whenever your cat has to undergo more invasive treatments involving surgery and/or temporary hospitalization.

Find ways to reduce your cat’s stress levels, both in daily life and surrounding vet visits. In general, I would advise you to be extra attentive to your cat’s needs. A bit of spoiling and play goes a long way in building a cat’s self esteem. There are also a host of more controlled solutions available, ranging from calming sprays and powders to CBD-oil and hemp supplements. Consult with your vet and other pet owners about their experiences, so that you can make a well-informed decision about what is best for you and your cat.

Weight Management

When kidney disease gets really severe, your cat will start to lose weight quickly. To avoid you overlooking this suddenly appearing symptom, you should weigh your cat at least once a week. Write down her weight and the date, so that you have a clear log of her progression. In the meantime, manage her other symptoms and her calorie intake as best you can to help her maintain, or even gain, weight.

Proper Diet

Last, but most definitely not least, you should get your kidney disease cat on a healthy diet tailored to her exact needs. Now, as with all things related to feline nutrition, opinions on what exactly is a healthy kidney diet vary. The debate mainly surrounds the question of how much protein a cat with CKD needs.

The Protein Debate: Less Or More?

I have a stake in this debate as far as my cat having been diagnosed with early-stage kidney disease about a year ago. My vet advised me to put her on a low protein diet and offered me some sample packages of, surprisingly, grain-based dry food.

If there is anything I’ve learned about a cat’s nutritional requirements it is that cats need high quantities of quality animal protein. Especially older cats, because of their increased metabolism. So it struck me as counter-intuitive when my vet suggested the exact opposite of that. I decided to do a bit of my own research to find out if my doubts were justified.

The Science

What I’ve found is that the views are indeed split when it comes to the benefits of less versus more protein in kidney diets. The main argument for low protein diets for kidney disease is that they relieve stress on the kidneys by reducing the amount of protein waste products in the blood. In the long term, this is supposed to slow down the progression of the disease by stabilizing, or even lowering, creatinine levels.

This is what veterinarians are taught in school and what most of them believe to be true. However, the science behind the low protein argument is outdated and mostly based on studies done on dogs. I’m sure you’re not surprised when I tell you that cats aren’t dogs.

Recent studies show that the stabilization or lowering of the creatinine levels in low protein diets is actually a result of the cat losing muscle mass. The implication that there is less strain on the kidneys is only a ghost effect created by there being less cat.

On top of that, most kidney diets for cats contain a lot of vegetable protein and carbs. Carbs are converted into fat. Combined with the loss of muscle mass from a lack of animal protein, this sets your cat on the road to diabetes and heart problems.

A high protein diet, on the other hand, helps to support your cat’s weight throughout her life as a kidney patient. This gives her a better ability to maintain her overall health, fight off infections and make it through tougher times. There is absolutely no evidence to show that renal failure cats on a high protein diet progress faster or die sooner. What’s more, they seem to have a better quality of life throughout all stages of the disease.

Related Post: Top 20 Feline Medical Emergencies: When To Take Your Cat To The Vet

We list the top 20 cat medical emergencies that require an immediate visit to the veterinary clinic. Read on to find out when to take your cat to the vet.

My Own Experience

Just to give you my own perspective on the matter: I fed my cat the prescription renal diet for about six months. She liked the kibble, but the wet food was mostly left untouched. During this time she suffered from hairballs and severe constipation. I had to give her malt paste and laxative medications daily, but it didn’t help much. Her coat looked matte and her skin was flaky. And she was very moody from me having to fuss over her all the time.

I finally decided to follow my own instincts and ditch the renal food. I went for a grain, sugar and additive free freeze-dried kibble from Orijen with high levels of locally sourced animal protein. I combined it with wet food from Lily’s Kitchen, which my local supermarket recently added to their stock. This is also grain, sugar and additive free with a single source of animal protein.

You have to understand, my sweet cat never ever got excited about food before. She’s been picky all her life. She almost always left her dry food for her sister, or the trash. And she rarely finished her wet food before deciding she’d had enough.

That has changed completely!

She loves the Orijen kibble! She will come running up excitedly when I fill her bowl. I often hear her chow down on it in the middle of the night, which she has never done before. I really feel like she’s telling me: “You finally got it! This is what I need!” She seems less excited about the wet food, but still eats it most days. That could be because she eats more during day now.

Healthwise, it has also been a game changer. Her coat looks shiny, she isn’t scratching herself anymore and shedding has been reduced to a minimum. As a consequence, the hairballs are gone and so is the constipation. I haven’t had to give her a single laxative since starting this new diet.

I eventually took her back to the vet for another blood panel. The vet didn’t agree with my choice of diet. Luckily, I could prove her wrong with my cat’s results. Both her BUN and her SDMA values had significantly decreased, and her creatinine level had remained stable. It turns out that my cat was misdiagnosed and only has renal insufficiency instead of renal failure. Go kitty!

A cat and a human giving each other a high five

Best Diet For Cats With Kidney Disease

After all my research, I definitely advise going for a diet that supports your cat’s health on as many fronts as possible. Therefore, I cannot in good conscience recommend feeding your cat a low protein diet. Because, let’s face it, what do you think those lost proteins get replaced with? Fairy dust?

A proper diet for cats consists of around 95% quality animal proteins and fat, and around 5% carbohydrates and fiber from vegetables. Most commercial cat food, and probably also yours, is instead loaded with cheap filler ingredients that have no place in a cat’s diet. Prescription veterinary diets are no exception, unfortunately.

Based on my research and experience, I have assembled the ideal requirements for a healthy diet for cats with kidney disease into an easy to follow list. Please use it as a guide to see if your cat food passes the test for felines in kidney failure, or if you need to supplement/replace it with something else:

  • High Quality Protein: Just like all sensible cat diets, high quality, easily digestible, animal protein should be the main ingredient of a diet for cats with kidney disease. Choose a protein source that is easy to digest and doesn’t contain too much fat. Poultry (chicken, turkey, duck) is an excellent option for kidney disease cats. Salmon is also a great choice, because it contains more omega-3 acids. However, fish can also contain more toxins, so try to balance it out.
  • Low In Carbohydrates: Most commercial cat foods, wet and dry, contain way more carbohydrates than are necessary healthy for your cat. Worst of all, these often come from cheap, difficult to digest sources such as wheat and corn. Eating too much of these filler ingredients can not only contribute to renal failure, but also set your cat on a path towards diabetes and allergies.
  • Low In Phosphorus: Increased phosphate levels are the most common and often earliest cause of appetite loss in cats with kidney disease. It stands to reason that a low phosphorus diet will help your cat to regain her appetite and maintain a healthy weight.
  • High In Potassium: Potassium plays a very important role in maintaining brain and muscle function. However, the increased drinking of a cat in renal failure can cause too much potassium to be removed from the bloodstream. Find a food that has added potassium, or choose a supplement that does.
  • Calcium: Cats with kidney disease often have high levels of calcium (hypercalcaemia), which is associated with a further progression of the disease. In those cases, low calcium foods are recommended. However, there are also cases where calcium levels are actually lowered through kidney disease (hypocalcaemia). In that case the exact opposite applies.
  • Low In Sodium: Your kidney disease cat’s food should be low sodium, as sodium increases the strain on the kidneys and raises her blood pressure.
  • Vitamin B: A disease that commonly occurs together with chronic kidney disease is hyperthyroidism, a gastrointestinal disorder that speeds up your cat’s metabolism. Vitamin B, in all forms, is great for digestive health and helps to combat some of the most debilitating aspects of both diseases.
  • Omega-3 And Omega-6 Fatty Acids: Fatty acids support the damaged kidneys in retaining healthy proteins in the bloodstream. The reduce the risk of inflammation and infection and, as such, can actually help in slowing down your cat’s kidney disease.
  • High In Moisture: Above all, a cat with kidney disease needs lots and lots of moisture. The more the better. Remember that cats aren’t the most avid drinkers and tend to only go for the drinking bowl if they need a little extra. So the fact that your cat in kidney failure is drinking excessively means she needs a lot extra. Help her out with a diet of exclusively wet food.

Read our guide on the Best Wet Food For Cats With Kidney Disease to get some specific product recommendations. Don’t feel discouraged if your cat won’t eat a certain type of food. All of the foods that we recommend are a step up from regular or dietary food. Whichever one your cat settles for, you are already doing her a huge favor.

In case your cat is more into dry food, we also have a guide on the Best Dry Food For Cats With Kidney Disease. Just remember to always provide your feline with unlimited access to fresh water and/or to supplement it with a high quality wet food.

How Long Do Cats With Kidney Disease Live

I’m sure you’ve wondered about this if your cat has chronic kidney disease. I know I have. The truth is, it all depends on the progression of your cat’s renal failure and your proactiveness in treating it. The sooner it is diagnosed, generally, the longer you can stall the deterioration of her kidneys.

That said, even in later stages, progression of the disease is often characterized by longer periods where the symptoms seem to stabilize, followed by periods of sudden and more severe deterioration.

You can give your cat the best chance at a long and healthy life by taking her to the vet regularly. At least once a year. Preferably twice, if you have the resources. This way you can catch any diseases she may develop early and monitor her condition if she is diagnosed with one like chronic kidney disease.

Final Thoughts

Chronic kidney disease is incurable and often fatal, but with early detection and proper care your cat should be able to retain a good quality of life for a long time. A pure and natural diet with the right supplements can help to support her overall health and slow down progression of the disease from months to years.