pet connection

I was fresh out of vet school when I met Ruth. It wasn’t under the best of circumstances; she was elderly and all alone in the world except for her very senior cat Puff, and Puff wasn’t doing very well. In fact, despite three days of everything the medicine of those days could do for him, he was slipping away.

I told my wife Teresa that I dreaded breaking the news to his owner, knowing he was all she had left to live for.

If you’ve read Chicken Soup for the Cat Lover’s Soul, you know how it ended: I asked the people at my church to pray for Puff and for Ruth, and the next morning he began to recover. In fact, he made it to the ripe old age of 22.

Not every cat has an entire prayer circle pulling for him, so it’s fortunate that our ability to diagnose and treat kidney failure in cats has gotten better in recent years.

But few of these interventions make much difference if the cat’s kidneys have progressed too far into failure. As a veterinarian I can tell you that the earlier we can detect a kidney problem, the better chance we have of successfully treating or controlling it.

In order to get a jump start on kidney failure and other diseases, I’ve long recommended that owners have their cats age 6 and older undergo a battery of tests including a complete blood count, serum biochemistry panel and a urinalysis to determine if the kidneys and other body systems are functioning properly.

That early detection is critical as it allows us a period of grace before something becomes more difficult or impossible to treat, cure or control. It also prevents unnecessary pain, risk or worse. And, harkening back to a commercial of my childhood talking about routine oil changes, “You can pay me now or pay me later.” In other words, prevention and early detection can save money in the long run.

There are several tests available to get an idea of how the kidneys are functioning. Blood tests and urinalyses are familiar to most pet owners, although they typically don’t detect kidney problems until they’re quite advanced — kidneys will have lost around 66 percent of their function by the time it shows up in the urine, and around 75 percent by the time it can be detected in a blood chemistry profile.

Two other less well-known tests can detect loss of kidney function at an earlier stage. One of these is the glomerular filtration rate/Iohexol clearance test, which your veterinarian can have done through the Michigan State University.

To understand how this test works, you have to understand what it means for a kidney to “fail.” Kidneys are made of cells called “nephrons,” which filter the blood and remove wastes so they can be flushed out in the urine.

The rate at which the nephrons can flush out waste is known as the “glomerular filtration rate,” or GFR. The less efficient the nephrons are at removing waste, the more severe the kidney failure.

Iohexol is a substance used as a contrast medium for radiographic tests, and it’s excreted by the kidneys. By measuring how long it takes the cat’s kidneys to process a dose of iohexol, the lab can calculate the GFR, and get a strong indication of how well the nephrons are doing their job.

Another test is the E.R.D. Healthscreen from Heska Corporation, which looks for microscopic amounts of albumin in dog and cat urine, an indication that the kidneys are beginning to fail. This test is done in the veterinarian’s office, and is a quick and easy urine test.

It would be nice if you could walk into the veterinarian’s office with your pet, take one of these tests, and walk out with a definitive answer as to how well your pet’s kidneys are working. Unfortunately, that’s not how it works.

There are a number of causes of abnormal kidney function, including simple, treatable problems like an infection. That’s why it’s critical for older cats and dogs to have kidney function tests at regular intervals, to provide their veterinarians with a picture of how that function is changing over time.

A single test might not tell you anything, but a series of changes in kidney values are much more clinically significant. Talk with your pet’s veterinarian about which tests are most appropriate for that dog or cat, and how frequently they should be given. That’s your best bet for catching renal failure early.

This information is very important for all dog and cat owners, because kidney failure is on the rise; it’s the number two cause of death in cats.

That increase may be because our pets are living longer, and kidney failure is associated with aging. It may also be due to stresses of modern life such as toxic exposures and infectious disease. And let’s not forget the dogs and cats exposed to melamine in the 2007 pet food recall; many of those pets’ kidneys have been compromised, and their owners will need to be particularly vigilant as those animals grow older.

Kidney failure is also irreversible. Short of a kidney transplant, which costs north of $20,000, you can’t restore kidney function once it’s been destroyed. By catching kidney damage early on, by treating the underlying causes if possible and by instituting certain preventive measures such as special diets, supplements or medication, you not only will save money in the long run but much more importantly, give your pets a happier, healthier, fuller life.

Time to talk to your veterinarian!

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