Dietary modification is an important and proven aspect of CKD treatment. Studies suggest that therapeutic diets that are restricted in protein, phosphorus and sodium content and high in water-soluble vitamins, fiber, and antioxidant concentrations may prolong life and improve quality of life in cats with CKD.
Is phosphate retention a risk factor for chronic kidney disease in cats?
Treatment options for hyperphosphatemia in feline CKD: what's out there? J Feline Med Surg. 2009 Nov;11(11):913-24. doi: 10.1016/j.jfms.2009.09.012. Authors Aimee C Kidder 1 , Dennis Chew. Affiliation 1 Department of Veterinary Clinical ...
How can hyperphosphatemia be managed in CKD patients?
Nov 01, 2009 · Phosphorus restriction in CKD patients with phosphate retention is initiated by feeding a low phosphorus, low protein diet. Compared with an average Western diet, cats consume six times, and dogs five times, as much phosphate on a mg/100 kcal basis when eating grocery store pet foods (Fig 3).
What are the causes of hyperphosphatemia in cats?
Nov 01, 2009 · Clinical significance With careful monitoring of serum phosphate and parathyroid hormone, and implementation of phosphate-restricted dietary management and intestinal phosphate binders, progression of CKD and the degree …
Is there a cure for chronic kidney disease in cats?
There is evidence in cats suggesting that the use of a phosphate-restricted diet in IRIS stage 2–3 disease has a beneficial effect on clinical outcome. However, despite the fact that intestinal phosphate binders are commonly used in veterinary practice for patients with CKD, there have been few published reports focusing on the safety and efficacy of these products in veterinary …
How is hyperphosphatemia in CKD treated?
There are three main strategies for correcting hyperphosphatemia:I. Diet: restricting dietary phosphate intake.II. Enhancing elimination: removing phosphate with adequate dialysis.III. Minimising phosphate absorption: reducing intestinal absorption using phosphate binders.
Does CKD cause hyperphosphatemia?
When bone resorption exceeds bone formation rates in CKD, phosphorus and calcium release contribute to hyperphosphatemia and hypercalcemia.Apr 30, 2008
How is hyperphosphatemia Aki treated?
The strategy for treatment of hyperphosphatemia in patients with normal renal function is to enhance renal excretion. This can be accomplished most effectively by volume repletion with saline coupled with forced diuresis with a loop diuretic such as furosemide or bumetanide.Dec 2, 2020
What is a good phosphorus level for cats with kidney disease?
The recommended phosphorus range on a dry matter basis for cats with CKD is 0.3-0.6%. Since phosphorus content is related to protein content, it is impossible to achieve these lower levels of phosphorus without limiting protein content.
How do you fix hyperphosphatemia?
How is it treated?reduce the amount of phosphate in your diet.remove extra phosphate with dialysis.lower the amount of phosphate your intestines absorb using medication.
What is the nursing intervention for hyperphosphatemia?
Nursing interventions for hyperphosphatemia include the following: monitor renal function (blood urea nitrogen and serum creatinine levels) monitor for signs and symptoms of hypocalcemia.
What are binders in kidney disease?
Abstract. Background: Phosphate binders are used to reduce positive phosphate balance and to lower serum phosphate levels for people with chronic kidney disease (CKD) with the aim to prevent progression of chronic kidney disease-mineral and bone disorder (CKD-MBD).Aug 22, 2018
How do you treat Hypophosphatemia?
Treatment of hypophosphatemia is twofold: (1) correct any precipitating causes of hypophosphatemia, and (2) replace total body phosphates. Depending on the clinical situation, replacement options include dietary phosphate, oral phosphate preparations, and IV phosphate.Dec 10, 2021
What is a binder medication?
Phosphate binders are medications used to reduce the absorption of dietary phosphate; they are taken along with meals and snacks. They are frequently used in people with chronic kidney failure (CKF), who are less able to excrete phosphate, resulting in an elevated serum phosphate.
Is tuna high in phosphorus for cats?
Tuna is high in phosphorus and while a healthy cat may cope with this, it won't be good for cats with kidney disease. Raw fish can contain thiaminase which is an enzyme that destroys thiamine, or vitamin B1. Too much raw fish in a cat's diet can, therefore, lead to thiamine deficiency.Jan 21, 2022
What do you feed a cat with chronic kidney disease?
There are three pet food lines that have products that are very effective for CKD management: Hill's Prescription Diet is the best, and Purina Veterinary Diets and Royal Canin are decent alternatives.
What can you not feed a cat with kidney disease?
High salt (sodium) diets may increase blood pressure and may worsen kidney damage, so diets designed for pets with kidney disease are low in sodium. You should also avoid feeding high salt treats such as cheese, bread, deli meat, and many commercial dog and cat treats.May 3, 2016
Can cats eat phosphate?
There is evidence in cats suggesting that the use of a phosphate-restricted diet in IRIS stage 2–3 disease has a beneficial effect on clinical outcome. However, despite the fact that intestinal phosphate binders are commonly used in veterinary practice for patients with CKD, there have been few published reports focusing on the safety and efficacy of these products in veterinary medicine. No phosphorus binders are licensed as medications for dogs or cats. This article draws on data from clinical trials in humans and studies in cats to discuss treatment goals and options for phosphate retention and hyperphosphatemia in feline CKD.
Does phosphate reduce CKD in cats?
With careful monitoring of serum phosphate and parathyroid hormone, and implementation of phosphate-restricted dietary management and intestinal phosphate binders, progression of CKD and the degree of hyperparathyroidism in cats may be reduced.
Is phosphate retention a risk factor for CKD?
Most agree that phosphate retention is a major contributor to the progression of CKD in many species and it is well known that hyperphosphatemia is associated with a significant mortality risk in humans with end-stage renal disease.
Is phosphate retention a risk factor for CKD?
Most agree that phosphate retention is a major contributor to the progression of CKD in many species and it is well known that hyperphosphatemia is associated with a significant mortality risk in humans with end-stage renal disease.
Can cats eat phosphate binders?
There is evidence in cats suggesting that the use of a phosphate-restricted diet in IRIS stage 2–3 disease has a beneficial effect on clinical outcome. However, despite the fact that intestinal phosphate binders are commonly used in veterinary practice for patients with CKD, there have been few published reports focusing on the safety and efficacy of these products in veterinary medicine. No phosphorus binders are licensed as medications for dogs or cats. This article draws on data from clinical trials in humans and studies in cats to discuss treatment goals and options for phosphate retention and hyperphosphatemia in feline CKD.
Does phosphate reduce CKD in cats?
With careful monitoring of serum phosphate and parathyroid hormone, and implementation of phosphate-restricted dietary management and intestinal phosphate binders, progression of CKD and the degree of hyperparathyroidism in cats may be reduced.
What are the risk factors for CKD in cats?
An age-matched case-control study was initiated to determine the major risk factors associated with CKD in cats and dogs and to determine what clinical signs cat and dog owners observed before their veterinarian diagnosed their pet with CKD. When compared to controls, the feline cases were more likely to have had polydipsia and polyuria in the year before the owners' cats were diagnosed with CKD. In the dogs, increased water intake, increased urination, small size and a recent history of weight loss and bad breath were noticed by the dog owners before veterinary CKD diagnosis. Dog owners recognized abnormal drinking and urination behavior over half a year before their pet's veterinary diagnosis with CKD, and they recognized weight loss almost 4 months before CKD diagnosis. Bad breath was noticed 1.2 years before recognition of CKD by a veterinarian. Given that earlier CKD diagnosis should have been possible in most cases, clinical trials should proceed to measure the efficacy of early interventions.
What is kidney failure in cats?
The kidneys fail to maintain metabolism and fluid and electrolyte balance, causing uremia. This disease is a common problem in old cats and dogs that not detected by the owners up to 75 % of kidney function is damaged. Clinical signs vary as polyuria, polidipsi, anorexia, vomiting, weight loss, pale mucous membranes, mouth ulceration, halitosis and acute blindness. Chronic renal failure is not curable so that the necessary medication management and proper diet in orderto improve the quality of life and prolong the life of the animal.
What is CKD in cats?
Practical relevance: Chronic kidney disease (CKD) is one of the most frequently encountered disorders in cats , having increased in prevalence in recent decades. Although the underlying cause is rarely identified, the common final outcome of feline CKD is tubulointerstitial fibrosis. Knowledge of CKD pathophysiology is necessary for optimal individualised patient management, especially with regard to diagnosis and treatment of extrarenal complications. Patient group: CKD is most common in senior and geriatric cats, but should be considered in any feline patient with ureterolithiasis, hyperthyroidism, retrovirus infection, systemic hypertension, cardiovascular disease or urinary tract infection. Evidence base: Most of our knowledge of the pathogenesis of CKD is extrapolated from human nephrology and experimental animal studies. There is, therefore, a need for further studies in cats. The prevalence of clinical signs in feline CKD is well documented. Several concurrent diseases associated with CKD have also been reported in cats, especially in the geriatric population, but there is no or only limited published evidence demonstrating a cause-and-effect relationship between most of these conditions and CKD. Studies performed over the past 15 years have nevertheless allowed identification of major risk factors (proteinuria, plasma phosphate and plasma creatinine) influencing the progression of feline CKD. Clinical challenges: Clinical signs occur in the late stages of renal disease, so populations at higher risk of CKD should be screened routinely. CKD-associated complications (systemic hypertension, secondary renal hyperparathyroidism, hypokalaemia, anaemia, metabolic acidosis) must not be overlooked as they may affect the progression of disease. Disease progression is itself unpredictable and renal function may remain stable for extended periods. Most cats with early CKD do not progress to end-stage CKD before they die. Audience: General practitioners play a major role in screening feline patients at risk of development or progression of CKD.
What are the hematological abnormalities of cats with leishmaniosis?
infantum is not accompanied by hematological abnormalities commonly reported in cats with leishmaniosis, such as anemia, leukocytosis, leukopenia, neutrophilia, neutropenia, lymphopenia, thrombocytopenia and pancytopenia (Pennisi et al., 2004;Rufenacht et al., 2005;Marcos et al., 2009;da Silva et al., 2010;Pennisi et al., 2013) or that these abnormalities occur in a minority of infected cats and are obscured by the hematological abnormalities due to their primary diseases. Increased serum concentrations of inorganic phosphorus and creatinine were observed in none of the 30 non-infected cats and in 3/20 infected cats, including two cats with acute kidney injury due to urethral obstruction and one cat with chronic kidney disease (Tuzio, 2001;Javadi et al., 2005; Kidder and Chew, 2009; Segev et al., 2011). Although this difference was not significant in the final logistic regression model, the increased concentration of inorganic phosphorus was. ...
What is a uremic toxin binder for cats?
Background Intestinal phosphate binders, uremic toxin binders and some other types of supplements are an integral part of the management of chronic kidney disease (CKD) in various species, including cats. This pathology in domestic carnivores requires life-long nutritional and medical management. In this context, the compliance of owners and patients cannot be achieved without an adequate level of palatability for oral medication or supplementation. Knowing that hyporexia and anorexia are among the most commonly seen clinical signs in cats suffering from CKD this is already, in itself, a serious obstacle to acceptable compliance in sick animals. The aim of the present study was to investigate the palatability of four commercially available products designed for cats suffering from CKD: Ipakitine® (Vetoquinol, France), Azodyl® (Vetoquinol, USA), Renalzin® (Bayer, France), Rubenal® (Vetoquinol, France) and an additional recently developed product: Pronefra® (Virbac, France). The study was performed with a group of previously-characterised cats, all living in an enriched and well-being securing environment of an independent centre housing panels of pets expert in palatability measurement. In total 172 monadic testings were performed. The palatability of each product was assessed by measuring their rates of prehension and consumption, and the consumption proportions were also analysed. Results The most palatable presentation (based on useful consumption) was Pronefra®, which was significantly higher than Azodyl® (p = 0.046), Ipakitine® (p < 0.0001), Renalzin® (p < 0.0001) and Rubenal® (p < 0.0001). The product with the highest rate of prehension was also Pronefra®, which was significantly higher than Azodyl® (p = 0.0019), Ipakitine® (p = 0.0023), Renalzin® (p = 0.0008) and Rubenal® (p < 0.0001). Conclusion Pronefra® was the most palatable presentation tested, meaning it may be useful for improving ease of supplementation in CKD cats.
What is the ISFM consensus for cats?
Practical relevance: Chronic kidney disease (CKD) is one of the most commonly diagnosed diseases in older cats. In most cats, CKD is also a progressive disease and can be accompanied by a wide range of clinical and clinicopathological changes. These ISFM Consensus Guidelines have been developed by an independent panel of clinicians and academics to provide practical advice on the diagnosis and management of this complex disease. Clinical challenges: Although CKD is a common clinical problem in cats, the manifestations of disease vary between individuals. Thus there is a need for careful and repeat evaluation of cats with CKD and adjustment of therapy according to individual needs. In addition to addressing problems arising from CKD and improving quality of life (QoL) for the patient, therapy may also target slowing the underlying progression of disease and hence prolonging life. While maintaining QoL is of paramount importance in our patients, this can be challenging when multiple therapies are indicated. In some cases it is necessary to prioritise therapy, given an understanding of what is likely to most benefit the individual patient. Evidence base: In preparing these Guidelines, the Panel has carefully reviewed the existing published literature, and has also graded the quality of evidence for different interventions to help to provide practical recommendations on the therapeutic options for feline CKD. This is a field of veterinary medicine that has benefited from some excellent published clinical research and further research findings will undoubtedly modify the recommendations contained in these Guidelines in the future.
Does phosphorus affect kidney function in cats?
Objectives High phosphorus intake may further impair renal health in cats with chronic kidney disease (CKD). The hypothesis that a high phosphorus (HP) diet might be nephrotoxic for healthy animals was tested in cats, a species with a high incidence of naturally occurring CKD. Methods Thirteen healthy adult cats were fed a phosphorus excess diet (about five times maintenance requirements), and this HP group was compared with cats on a balanced control diet (CON). The trial lasted for 29 days (10 days of faeces and urine collection). Endogenous creatinine clearance was determined towards the end of the trial. Fresh urine was tested for glucose and proteins. Results Glucosuria and microalbuminuria were observed exclusively in the HP group in 9/13 cats. Creatinine clearance was significantly decreased after feeding HP. In the HP group phosphorus was highly available (apparent digestibility around 60%). Renal phosphorus excretion was significantly increased in the HP group (115 mg/kg body weight/d vs 16 mg/kg body weight/d in the CON group). Conclusions and relevance The intake of a diet with an excessive content of highly available phosphorus may have adverse effects on parameters of kidney function in healthy cats.
What is hypokalemia in cats?
Cats with CKD should be routinely screened for hypokalemia. Hypokalemia is a common finding in cats with stage 2 and 3 CKD with approximately 20–30% of cats affected. Mild hypokalemia may not be associated with clinical signs and clinically relevant hypokalemia can often be missed due to the lack of electrolyte readings on in-house chemistry analyzers. Moderate hypokalemia (2.5–3.0 mEq/L) may result in muscle weakness, lethargy, inappetence, and constipation. Severe hypokalemia (<2.5 mEq/L) may result in hypokalemic myopathy including cervical ventroflexion and plantigrade stance.
Which organs are responsible for phosphorus excretion?
The kidneys are the main route of phosphorus excretion and as kidney function declines, hyperphosphatemia develops. Hyperphosphatemia is detrimental because it contributes to renal secondary hyperparathyroidism, tissue mineralization and progression of CKD. Thus, controlling phosphorus intake through diet and phosphate binders is an important part of CKD management.
What is the best treatment for CKD in cats?
Dietary modification is an important and proven aspect of CKD treatment. Studies suggest that therapeutic diets that are restricted in protein, phosphorus and sodium content and high in water-soluble vitamins, fiber, and antioxidant concentrations may prolong life and improve quality of life in cats with CKD.
What is a cat's kidney disease?
Healthy kidneys perform many important functions, most notably filtering the blood and making urine, so problems with kidney function can result in a variety of health problems for a cat.
What is the best way to evaluate kidney function?
To evaluate kidney function, veterinarians will most often turn to blood tests and urine analysis (urinalysis) to evaluate the concentrations of waste products and other components that healthy kidneys normally filter or regulate.
Why do cats have lethargy?
Another cause of lethargy in cats with CKD is the buildup of acids in their blood. The kidneys of cats with CKD may not excrete these compounds appropriately, making affected cats prone to blood acidification, or acidosis, a condition that can significantly affect the function of a variety of organ systems in the body.
What is the most specific indicator of kidney function?
Blood tests can determine the concentration of two important waste products: blood urea nitrogen (BUN) and creatinine, but creatinine is generally recognized as a more specific indicator of kidney function.
Why do cats have pink gums?
CKD may also decrease a cat’s ability to produce red blood cells, which can lead to anemia, a reduced concentration of red blood cells in their blood. This may cause their gums to appear pale pink, or in severe cases, whitish in color, and may make them lethargic. Diagnosis.
How long does it take for a cat to have kidney function?
Ideally, a veterinarian will base his or her interpretation of kidney function on at least two blood samples, obtained within two weeks of one another, from a normally hydrated cat that has fasted for 12-24 hours.
How long can cats live with CKD?
ALIX McBREARTY in the concluding part of this series, discusses the long-term management of CKD patients and explains how affected cats can survive for many years with a good quality of life
How long can a cat live with renal disease?
Although feline chronic renal disease is an incurable and usually progressive condition, medical management combined with regular monitoring and appropriate treatment modification enables cats to survive many years after the initial diagnosis with a good quality of life.
What is the role of a vet nurse in a puppy's development?
Veterinary nurses can play a huge part in the development of puppies and their bonding to the practice by educating and helping not only new puppy owners, but also breeders
How long should I feed my cat?
Diets should be introduced gradually over a period of at least seven days and often 3-4 weeks and it can be helpful to offer both the old and new diets side-by-side. The temperature, texture and formulation of food may all be important and some cats will accept one brand or flavour but not others.
How often should I monitor potassium levels?
Patients on intravenous potassium supplementation should undergo monitoring of their serum electrolytes at least daily. Initially, patients started on oral potassium supplements will need serum potassium measurement every 1-2 weeks, to enable appropriate dose adjustment.
What is the goal of CKD management?
Once any active renal disease has been recognised and treated appropriately, the goals of CKD management are to: prevent and/or treat the complications of decreased kidney function, thereby improving the clinical signs, slow progression of the disease and treat any concomitant unrelated conditions. As CKD is almost invariably a progressive disease, ...
Why is it important to introduce a renal diet?
It is important for owners to understand the significant benefits of renal diets not only to decrease mortality but also to decrease the frequency of uraemic episodes and therefore improve quality of life.