Kidney disease in cats: what to know

9 November 2023 - 4 min read
cats and kidney disease

Over 30% of cats may develop chronic kidney disease, the most common form of the condition, by the time they are 15 years of age.

While kidney disease is not usually painful, it can make cats feel very, very bad. If you think that your cat might have kidney disease, get them to a veterinarian as quickly as you can.

Here's some more information about the types, stages, and treatment options for chronic and acute kidney disease in cats.

What is kidney disease in cats?

There are many different types of kidney disease in cats, but veterinarians typically put cats into one of two broad categories: acute kidney disease or chronic kidney disease.

Acute kidney disease in cats

Acute kidney disease, also called acute kidney injury, comes on fast, often making a seemingly healthy cat very sick over just a few days.

Chronic kidney disease in cats

Chronic kidney disease, also known as chronic kidney failure, is a slow but progressive disease, meaning that symptoms are mild at first but get worse over time.

Here are some basic differences charted out:

Acute kidney disease in cats Chronic kidney disease in cats
Comes on fast Develops over time
Often caused by sudden damage to kidneys (toxins, trauma, birth defects, etc.) May include chronic infections, medications, or other undetermined causes
Symptoms may include: increased thirst or urination, vomiting, poor appetite, lethargy, bad breath (more listed below) Symptoms are similar, but may develop more slowly
Treatments may include IV fluid therapy, medication, special diets, dialysis, kidney transplant Treatments are similar

What causes kidney disease in cats?

Acute kidney disease is most often caused by things that damage a large portion of the kidneys at once, including

  • exposure to toxins like antifreeze or lilies 

  • infections 

  • congenital anomalies, like birth defects

  • anything that limits the delivery of blood or oxygen to the kidneys, an episode of very low blood pressure caused by severe dehydration or trauma, for example

In contrast, chronic kidney disease develops as a cat slowly but continually loses a small amount of kidney function over a longer period of time.

Often, the specific causes of this gradual loss of kidney function can’t be identified but may include things like chronic infections, medications that damage the kidney, or simply the daily wear and tear that occurs over a long life.

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Signs and symptoms of kidney disease in cats 

Regardless of type, the first signs of kidney disease in cats that pet parents often notice are:

  • an increase in thirst 

  • the production of more urine than normal 

From there, cats may develop additional symptoms like:

The progression of symptoms is quite slow with chronic kidney disease but can be very quick, over just a few hours in some cases, with acute kidney disease.

Stages of kidney disease in cats

All of the symptoms that can be seen when a cat has kidney disease can also be seen with other diseases. That's why it's so important to see your vet.

All of the symptoms that can be seen when a cat has kidney disease can also be seen with other diseases. That's why it's so important to see your vet.

To diagnose kidney disease in cats, veterinarians will perform a physical exam, ask questions about your cat’s lifestyle and health history, and then run some lab work, which often includes:

  • A blood chemistry panel to evaluate kidney function and the levels of electrolytes and other important substances 

  • A complete blood count to look for anaemia, infection, and more 

  • A urinalysis to further evaluate kidney function and look for infection 

  • SDMA (symmetric dimethylarginine) testing to evaluate kidney function 

  • Blood pressure measurement 

Once a diagnosis of kidney disease is made, the veterinarian will then determine whether it is acute or chronic, and if it is chronic, stage the disease according to guidelines (PDF) put in place by the International Renal Interest Society (IRIS). This helps determine what type of treatment will be best for the cat.

Treating kidney disease in cats

Treatment for cats with acute kidney disease focuses on the underlying cause, antibiotics for a kidney infection, for example, while simultaneously doing everything possible to support kidney function.

Treatments for acute kidney disease may include:

  • Intravenous fluid therapy 

  • Monitoring urine production and treating the cat with diuretics if needed 

  • Correcting electrolyte imbalances and acid or base disturbances 

  • Medications to control vomiting and diarrhoea and to prevent or treat ulcers in the gastrointestinal tract 

  • Nutritional support 

  • Dialysis

Treatment for chronic kidney disease is similar and can involve:

  • Subcutaneous fluid therapy, which are fluids given under the skin

  • Medications to lower phosphorus levels, increase potassium levels, improve appetite, treat anaemia, decrease blood pressure, control vomiting, diarrhoea, or constipation, prevent or treat ulcers in the gastrointestinal tract, and reduce protein loss in the urine 

  • Special diets 

If treatment for either acute or chronic kidney disease does not lead to significant improvements in kidney function or quality of life, a cat can be said to have kidney failure, also called renal failure.

For pet parents who are willing and able, kidney transplants are an option for some cats with kidney failure.

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How long can cats live with kidney disease and can it be reversed?

The good news is that with timely treatment, some cases of acute kidney disease can be reversed, and cats will go on to live happy and healthy lives.

The good news is that with timely treatment, some cases of acute kidney disease can be reversed, and cats will go on to live happy and healthy lives.

However, if there has been a severe kidney injury, the cat may not be able to survive without a kidney transplant, which isn’t a realistic option for most pet parents.

The life expectancy for cats with chronic kidney disease varies and depends on many factors, including how advanced the disease is at diagnosis, how rapidly it progresses, and how old the cat is.

One study showed that the median survival for cats with earlier-stage kidney disease was 1,151 days, but that decreased to 778 days for more advanced-stage kidney disease and to 103 days for end-stage kidney disease.

Sadly, treatment for chronic kidney disease becomes less effective as a cat’s condition progresses, and knowing when to euthanise a cat with kidney disease is difficult. Your veterinarian can help you evaluate your cat’s quality of life and determine the best course of action.

How to prevent kidney disease in cats 

With a condition as serious as kidney disease, prevention should always be top of mind.

Keep your cat indoors to reduce their likelihood of being exposed to toxins and infectious diseases and being injured.

Feed a high-quality diet—ideally wet food that promotes good hydration. And don’t delay treatment if you think that your cat is sick or injured.

How pet insurance can help 

Diagnosing, treating, and managing a cat with kidney disease can get expensive, which is where cat insurance can help.

The best time to purchase a policy is when your cat is young. If you wait until your cat develops symptoms of kidney disease, the condition will likely be considered pre-existing and may not be covered.

Add the MoneyBack optional extra for 20% back at the end of the policy year if you don’t need to claim.

Jennifer Coates, DVM
Veterinarian, Veterinary Writer, Editor, and Consultant

Dr. Jennifer Coates is a writer, editor, and consultant with experience in veterinary medicine, science, animal welfare, conservation, and communications. She has written for outlets including petMD, Chewy, and ManyPets.