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Chances are good you’re here because your cat has just been given a diagnosis of CRF. And if you’re anything like me, you’re numb and in a panic all at the same time. Stay strong, and keep your chin up because your cat needs you. CRF is not a death sentence.
In my experience CRF is one of the most treatable conditions out there and with gentle methods i.e. no or minimal drugs and supportive treatments, a cat can enjoy an excellent quality of life for many years.
The kidneys are an incredibly hard-working set of organs. They contain several thousand microscopic nephrons, which filter and reabsorb fluids in the body. Nephron damage and loss of kidney function can occur due to drugs e.g. Metacam at any time and particularly during surgery, infections, toxins, cardiac output causing decreased blood flow to the kidneys, and possibly as part of the aging process.
Progression of the disease depends on several things, including how much time the kidney has to compensate for nephron damage. Even with 25 percent of its original nephrons remaining i.e. by the time elevated BUN and creatinine (both waste products) are discovered on a blood test, a kidney can continue to function for many years.
Common early symptoms include nausea, poor appetite, dull coat, listlessness, increased thirst, and frequent urination. Sometimes the signs are very subtle and thus easy to miss.
Many of the symptoms of CRF can match those of diabetes and hyperthyroidism. One difference in the case of hyperthyroidism, cats are more likely to have a ravenous appetite, but with no weight gain. A CRF kitty will typically not have a huge or even the same appetite s/he did earlier on in their life.
At a later stage, things to watch out for include bad breath with or without mouth ulcers, hind leg weakness (usually due to potassium depletion/deficiency), high blood pressure (which can cause retinal detachment resulting in blindness), and anemia. In some cases, your vet might be able to feel that the kidneys are small and irregular, though in a smaller % of cases, there might be kidney enlargement.
Prolonged vomiting, and impaired ability of remaining nephrons can lead to metabolic acidosis which can be helped by Slippery Elm, and/or sodium bicarbonate (please be very cautious with this), and Potassium citrate if accompanied by hypokalemia.