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Diet and Drug Therapies for Cats with Kidney Disease

Treatment of feline chronic renal (kidney) disease often includes dietary and pharmacological components. This Cat Health Topic reviews some of the more commonly used prescription diets and drugs. For information about fluid therapy in cats with chronic renal disease, please see this Cat Health Topic,

A new book "Caring for a Cat with Kidney Failure" , has been written as an information source and support tool primarily aimed at cat owners whose cats have been diagnosed with kidney failure.
 
Cornell University College of Veterinary Medicine offers this informational video chapter on Drug and Dietary Therapy for cats with chronic renal disease.
 
DIETARY THERAPY
Dietary modification can help slow down the progression of feline chronic renal disease. Many prescription diets have been designed specifically for renal disease. These diets usually contain reduced amounts of protein, which helps decrease the workload on the kidneys and altered amounts of other nutrients, such as reduced phosphorous and sodium and added potassium.
ONLINE RESOURCES

The most commonly prescribed diets for feline chronic renal disease are:
Other diets may be applicable, so check with your veterinarian about the brand in question.

DRUG THERAPY

Drug therapy with pharmaceuticals and/or supplements can treat many of the symptoms of feline chronic renal disease, including two of the most commonly observed symptoms: inappetence (poor appetite) and vomiting caused by increased gastric acidity or even ulceration of the stomach lining. Other symptoms your veterinarian might want to treat include anemia, electrolyte imbalances, vitamin deficiencies, and protein loss.


ONLINE RESOURCES

Veterinary Partner,a website created by veterinarians for companion animal caretakers, has information about
  • Calcitriol, the active form of vitamin D, is sometimes used to prevent signs of hyperparathyroidism such as elevated blood calcium levels, which sometimes occurs secondary to renal disease. Blood phosphorous and calcium levelsmust be closely monitored when cats are on calcitriol.
  • Cyproheptadine, an appetite stimulant thatmight be prescribed in a persistently anorexic cat.
  • Famotidine,an antacid that might be prescribed to reduce stomach acid production and makeyour cat more comfortable.
  • Mirtazapine, a medication used to treat depression in people. Anecdotal evidence suggests it is also an effective appetite stimulant in cats.
  • Sucralfate, adrug used to coat the stomach lining, which might be prescribed if gastric ulcerations are present or suspected.
David Jacobson, a dedicated cat caretaker and proprietor of Scooter's Mail Order Supplies for Chronic Renal Failure, provides detailed information about many of the supplements your veterinarian might recommend, including:
  • B-vitamins, which are water soluble, might be recommended because depletion of water soluble vitamins is a side effect of increased urine production;
  • A phosphorous binding drug might be recommended if phosphorous remains elevated despite feeding a phosphorous-restricted diet; and
  • Supplemental potassium, which might be prescribed if potassium levels are low.
Novartis Animal Healthmakes Fortekor (benazepril), an ACE inhibitor, which issometimes recommended to help reduce protein loss through urine.

Vtoquinol manufactures Azodyl, a new drug that contains special bacteria that reportedly decreases the amount of renal toxins in the GI tract and, subsequently, in the bloodstream. A study is currently underway to verify the drug's effectiveness in treating chronic renal disease.

Arnold Plotnick, MS, DVM, DACVIM, DABVP (Manhattan Cat Specialists, New York, NY), a board certified feline internal medicine specialist and member of the American Association of Feline Practitioners, writes about the risks and benefits of human erythropoietin, a hormone that promotes red blood cell production and is used to treat severe anemia. Cats with chronic renal disease are at risk for developing anemia because erythropoietin is produced by the kidneys. Because of the risks associated with using human erythropoietin in your cat, you should carefully weigh the risks and benefits with your veterinarian before treatment begins.


Amy Lynn, DVM
Michigan Veterinary Specialists
Southfield, MI
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