Lucy is a 7 year old British Shorthair cat who came to see Vet Anna in January.
She had a reduced appetite and had been drinking and urinating more than usual. Examination showed she had lost weight and had painful kidneys.
Lucy was admitted for blood test, urine sampling and intravenous fluids. Analysis of her urine showed dilute urine with protein; indicating that her kidneys, which filter and retain water, were not working properly. The blood test showed that her kidney values were elevated. Kidney disease is common in older cats and the majority of cases are idiopathic, which means that there is no identifiable cause. Initial treatment is to support the function of the kidneys with rehydration and prescription diet. This is low in protein which reduces the production of toxic waste products, and low in phosphate, which protects the kidneys from further damage. After a couple of days of supportive treatment Lucy was eating again and went home. Unfortunately, her improved appetite was not sustained so she was re-admitted for further fluids, abdominal ultrasound scan and urine culture and sensitivity, to see if we could find an underlying cause.
The ultrasound scan of her kidneys showed severe polycystic kidney disease. This is an inherited condition where multiple fluid filled cysts form within the kidney. The cysts would have been present from birth but would initially have been small enough not to cause a problem. As Lucy got older, the cysts grew until the surrounding tissue was compromised and chronic kidney disease developed. There is no specific medical or surgical treatment for Polycystic Kidney Disease. We can use supportive therapies to minimise the impact of the kidney disease, but unfortunately it is a progressive condition. Lucy is on a prescription diet to maintain her kidney function, and medication to increase her appetite as needed. It is important that she takes on plenty of fluid, either in wet food, from a water fountain, or by drinking flavoured water. We will monitor her electrolyte levels, as she may need medication to stabilise there. ACE inhibitor medication may be needed to support the blood flow through the kidneys and reduce protein loss.
Lucy is currently at home, eating well, and being regularly monitored.