Acute Kidney Failure in Cats

Acute kidney failure in cats will create a very sudden illness. This is renal failure that has come on very rapidly. As with humans, acute renal failure will create symptoms that look much like the flu or worse. We have seen cases over the years that had a great response to aggressive treatment. The earlier the owner notices the sudden change and the quicker the response the better. The kidneys are very resilient because they are made up of millions of functional units called nephrons. Our hope is to prevent as much permanent damage as possible. Unfortunately, we can not predict which cats will respond. We have a number of great success stories so we feel it is well worth the effort.

The following information on acute kidney failure in cats will allow you to better understand this condition and its treatment.

What is acute renal failure?

Acute renal failure (ARF) or acute kidney failure refers to the sudden failure of the kidneys to perform normal filtration duties. This is not the same as the much more common form of kidney failure, chronic renal failure (CRF). ARF leads to accumulation of toxins and other metabolic wastes in the bloodstream, dehydration, electrolyte imbalances and disturbances in the acid-base balance of the blood. ARF is potentially reversible if diagnosed early and treated aggressively. Older cats are at higher risk for developing ARF.

What are the clinical signs of acute renal failure?

The clinical signs of ARF may include sudden anorexia, listlessness, vomiting (the vomited material may have blood in it), diarrhea that also may contain blood, a strange breath odor, and/or seizures. Some cats will urinate more frequently while others may not be producing any urine at all. There may be a recent history of ingestion of a toxin (especially antifreeze) or of recent trauma, surgery or illness. Many cats are in shock by the time they reach the veterinary hospital. The veterinarian will frequently find enlarged and painful kidneys during the physical examination.

What causes acute renal failure?

There are numerous causes of ARF. Some of the more common causes include:

  • Ureteral or urethral obstruction
  • Antifreeze poisoning (ethylene glycol toxicity)
  • Systemic shock
  • Heart failure
  • Hypotension or low blood pressure
  • Clotting disorders
  • Drugs such as NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) or certain antibiotics
  • Insect or snake venom
  • Heavy metals such as lead, mercury, arsenic or thallium
  • Ingestion of toxic plants, especially lilies
  • Ingestion of rodenticides (rat poison)
  • Pyelonephritis or bacterial infection of the kidney
  • Feline Infectious Peritonitis

How is acute renal failure diagnosed?

Diagnosis is based on medical history, clinical signs, and the results of blood and urine tests. Other diagnostic tests may include abdominal radiographs, abdominal ultrasound, radiographic contrast or dye studies, fine-needle aspiration or surgical biopsy of the kidneys.

What is the treatment for acute renal failure?

Treatment is focused on removing the circulating toxins as quickly as possible and restoring electrolyte balance. This is usually accomplished by administering intravenous fluids for twenty-four to ninety-six hours (1 to 4 days). Peritoneal dialysis and hemodialysis are rarely performed, but may be available in your area. If toxin exposure or a drug reaction is suspected, it is recommended that the stomach be emptied of its contents immediately, followed by administration of activated charcoal to prevent further absorption of toxins.

Nutritional support may be required in cats with persistent or uncontrollable vomiting. Your veterinarian will recommend an aggressive treatment plan to give your cat the best chance of recovering from ARF.

What is the prognosis for a cat diagnosed with acute renal failure?

The initial prognosis is guarded for all cases of ARF. If the cause is an infection, there is a better prognosis than if the cause is a toxic substance. The long-term prognosis for recovery depends on the amount of kidney damage that has occurred. The kidney has very little capacity to regenerate or "heal" itself, justifying the guarded prognosis. Your veterinarian will provide you with a more accurate prognosis based on your cat's clinical signs and individual condition.

If your cat is hospitalized for treatment of acute kidney failure we are happy to let you spend time visiting. We understand the bond you and your kitty share. It is very scary to see your cat go from full health to being very sick. We will do everything in our power to get both of you through it. We will spend as much time talking to you about what to expect as needed. Never be afraid to ask any questions you may have. Give us a call as our AAHA Accredited pet friendly staff would be happy to assist in all your pet health concerns.

Our Pet Health Mission?

Our mission at Newport Harbor Animal Hospital is: "To provide the highest quality veterinary care for our patients and the best service for our clients. Our goal in every case is a healthy pet and a happy client."

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