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Feline Chronic Kidney Disease and Hypertension

3/12/2017

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Updated on March 12, 2021.
Zach and Emma, the two sweet kitties mentioned in this post, have both passed away.  They will be missed, and we are thankful to their families for sharing their experiences to raise awareness of blood pressure monitoring.
     Feline Chronic Kidney Disease (Feline CKD) and hypertension very often go hand in hand.  The relationship is a complex one that is not yet fully understood.  One of the studies that we're currently supporting at the Royal Veterinary College, London, "Unravelling the Genetic Basis of Blood Pressure and  Kidney Function in the Cat", has, as it's goal, the determination of whether or not there are genes in cats that are associated with Feline CKD and/or hypertension.  In addition to it's complex relationship with CKD, high blood pressure can also lead to many other health problems in cats, including blindness, brain damage, and other cardiovascular issues. 

     Despite the importance of blood pressure monitoring, pressure checks are still not routine in veterinary practice.  You may be told that it's impossible to get accurate blood pressure measurements in cats, because the test causes stress, which in turn, elevates blood pressure--a phenomenon known as "white coat syndrome".  This may occur; however, individual blood pressure measurements are not valuable just as stand-alone tests.  It's important to get baseline measurements, and then continue checking the pressure at regular intervals to spot trends over time.  Even if the measurements are falsely elevated due to stress, measurements that continue to increase over time could be indicative of developing or progressing hypertension. 

     Although it’s common for cats to experience stress during the test, there are some ways to help reduce the stress your cat experiences.  Here are some tips from one of our supporters, Susan, whose cat Zach had hypertension and CKD, and had his blood pressure checked every three months: 

"Take a towel or blanket to the vet; it smells like home, and cushions the exam table.  Ask that the blood pressure check be done in the exam room, let the cat lie on the blanket/towel, and while the pressure check is being performed, stay close to your cat and gently rub the ears, cheeks, and under the chin." 

Susan reports that Zach actually fell asleep once during a blood pressure check, and that his vet now follows this procedure for pressure checks on all patients. 

And, Carol, who's cat Emma had CKD said: 

"Emma tolerates (blood pressure readings) pretty well.  We go in early so she can get used to the room. She gets treats, scratches and praise, and is getting used to it; I think not giving up is the key."  

     Here are some reliable resources to help you and your vet learn more about Feline Hypertension, and techniques for getting accurate measurements:

"ISFM Consensus Guidelines on the Diagnosis and Management of Feline Hypertension"

ISFM has released excellent new, comprehensive guidelines, aimed primarily at veterinarians, on the diagnosis and treatment of Feline Hypertension.  Dr. Rosanne Jepson,  BVSc, MVetMed, PhD, DipACVIM, DipECVIM, FHEA, MRCVS. a leader in the field, and the Principal Investigator on the study we're currently supporting, is one of the experts who drafted the guidelines.  

"Indirect Blood Pressure Measurement"
 You can learn more about noninvasive methods of obtaining accurate blood pressure readings in companion animals from this article by Clinician's Brief (free subscription required).   

"Which Drugs Can Control Systemic Arterial Hypertension in Dogs and Cats?"
If hypertension is discovered, there are some medications that may be appropriate.  Cats have a unique biochemistry; some drugs can be harmful to cats, and extra care must be taken in cats with Chronic Kidney Disease.  Vets, this article from Clinician's Brief about blood pressure medications includes cautionary notes for treating animals with Chronic Kidney Disease (free subscription required).  

     We hope that by spreading the word, and urging people to ask for the testing as part of their cats' wellness care, it will become more routinely available. Getting accurate blood pressure readings can be challenging, but the results can be invaluable. If you haven't already, please speak with your vet about measuring your cat's blood pressure. 

Vets and cat companions, have you had success measuring cats' blood pressure?  If so, please share.
 
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If you like what we do, please remember that we can't do it without YOU!  Please help give cats  a healthier future by making a donation to support groundbreaking Feline CKD research.  


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What Can I Do To Prevent Kidney Disease in My Cat?

12/28/2016

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(Updated on March 2, 2019)

What Can I Do to Prevent Kidney Disease in My Cat?


Feline Chronic Kidney Disease (Feline CKD) causes tremendous pain and suffering, and claims the lives of approximately one of every three cats.  People frequently ask us, "What can I do to prevent kidney disease in my cat?"  Feline CKD is a progressive disease, and there is currently no known prevention or cure. We're proud to be supporting the research of the best academic veterinarians in the field as they work diligently towards better treatments and, ultimately, a cure(s).  (Feline CKD is a complex disease, and kidney damage may occur via multiple mechanisms.)  In the meantime, you need not feel helpless.  Here’s what you can do to help keep your cat healthy for as long as possible:
 
 I.  See Your Vet Regularly.
Your first line of defense is regular veterinary checkups.  Although CKD in cats is notoriously difficult to detect, (clinical signs usually don’t appear until about 70% of kidney function is lost), regular veterinary care, including blood tests, urinalysis, and blood pressure measurement, will help your vet detect the disease as early possible. Cats are masters at hiding illness and pain, so regular checkups are very important, even if your cat seems well.  According to the American Veterinary Medical Association (AVMA), cats should have yearly veterinary checkups until they reach about 7 years of age, at which time checkups should be increased to every six months.  (Each cat is different and, especially if your cat has a known medical problem, they may need to be seen more frequently.  Speak to your vet about your cat’s particular needs).
 
 Also, be certain that your vet knows about the International Renal Interest Society (IRIS).  Their team of world-renowned veterinary nephrology experts (including Dr. Jonathan Elliott, a giant in the field of Feline CKD research, whose current genetics research we’re very proud to be supporting), promulgates staging and management recommendations that are considered the gold standard for vets. 
 
II.  Know What’s Normal.
Each cat is a unique individual.  Keep close track of what’s “normal” for your cat.  Being attuned to your cat’s typical behavior will help you spot deviations that may be signs of trouble.  If your cat doesn’t seem to be acting quite right, don’t just assume it’s part of the normal aging process.  Here’s an article from ​the American Association of Feline Practitoners (AAFP​) about monitoring your cat​'s behavior.  And this article by Preventive Vet, about how to detect pain in cats, discusses a variety of very subtle behavior changes that can be signs of trouble.
 
III.  Know the Signs of Feline CKD.
Signs can vary, but some of the most common ones are excessive drinking, excessive urination, poor appetite, vomiting, weight loss, lethargy, and neurologic problems including confusion and loss of coordination.  If your feline companion exhibits any of these signs, bring them to the vet without delay. If your cat is diagnosed with CKD, your vet can recommend measures that may help him/her feel better, and slow (although not prevent) progression.  Such measures may include special food, medications, and subcutaneous fluids.  
 
IV.  Practice Good Oral Hygiene.
Early research indicates that advanced dental disease MAY be associated with kidney disease in cats.  This is very early research, and more investigation is needed.  But good dental hygiene is always a ​great ​idea, so have your vet check your cat’s teeth during checkups.  And, if your cat will permit it, brush her/his teeth.  Here’s a video from Cornell University about how to accustom cats to tooth brushing.
 
Finally, please don’t overlook the last very important step that you can take in the battle against Feline Chronic Kidney Disease--become an ally!  We are completely committed to working hard for as long as necessary until a cure is found, but we can’t do it without your help! Please check out our research pages, and please donate so that we can keep supporting the very best, most promising research.  You can help us give cats a healthier future—there is so much to be done!  
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We care passionately about animal welfare issues, and about Feline Chronic Kidney Disease in particular, but please understand that we are not veterinarians, and are not qualified to provide veterinary medical advice.  If you have a companion animal suffering from CKD or other health issues, it is imperative that you consult with a licensed veterinarian, who is qualified to provide you with medical advice and care that meets your animal’s particular health needs. 

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