Pet Connection

Catch It Early

Kidney disease is common in aging cats, but earlier detection and management may help to increase lifespan and quality of life

By Kim Campbell Thornton

Old cats get kidney disease, and it typically isn't diagnosed until it is far advanced. But presentations last month by Dr. Jane Robertson, Dr. Dru Forrester and Dr. Margie Scherk at the annual meeting of the American Association of Feline Practitioners offered new research findings on early diagnosis and tips on nutritional management of the disease.

Typically, cats don't show symptoms in the early stages of chronic kidney disease. Concentrations of kidney waste products such as blood urea nitrogen (BUN) and creatinine may still be at normal levels. It's not until the disease progresses significantly that cats begin to develop physical signs, such as weight loss, decreased appetite, dehydration and excessive water consumption and urination.

But a new kidney function test called SDMA, introduced last summer, can identify chronic kidney disease an average of 17 months sooner in cats, according to a study published last year in the Journal of Veterinary Internal Medicine. Symmetrical dimethyl arginine -- you can see why it's called SDMA -- is a form of arginine, an essential amino acid for cats. If you remember your grade-school science class, you know that amino acids are building blocks of protein. As protein breaks down, it releases SDMA into the blood; it's then excreted by the kidneys. Rising levels of SDMA in the blood are noticeable when only 40 percent of kidney function has been lost, as opposed to higher levels of BUN and creatinine, which may not become evident until 75 percent of kidney function is gone.

Does that mean your cat should get the test? Not necessarily, Dr. Scherk said in an email interview. Factors that are known to affect progression and survival, such as proteinuria (protein in the urine), hypertension and anemia, are not detected with SDMA. She adds that dehydration, which is common in cats, may cause artificial elevations of SDMA.

Among the cats who may benefit from the test are thin, older cats with muscle wasting, Dr. Scherk says. That's because those cats may have artificially low levels of creatinine caused by muscle wasting, but SDMA levels aren't affected by muscle. The test could also be useful for cats with heart disease who may also have early kidney disease that could be worsened by treating the heart disease.

Veterinarians can also make better use of old tools by routinely screening creatinine and urine-specific gravity and looking for trends over time. For instance, if creatinine levels have increased only a tiny amount and are still in the normal range, that may signal the possible presence of CKD.

"Very small changes can be extremely important to pay attention to," Dr. Forrester said.

Cats with CKD may also have hypertension, or high blood pressure, as well as proteinuria. Both of these conditions can be treated or managed more effectively when diagnosed in early stages.

Even if your aging cat hasn't been diagnosed with CKD, you can watch for early physical signs such as weight loss and muscle loss. Check your cat's body condition score monthly to pick up changes early. Ideally, you should be able to feel his ribs beneath a slight covering of fat. Take him to the veterinarian if you notice that he seems thinner than normal.

Kidney disease can't be cured, but earlier recognition and management may help to slow the rate of progression and increase lifespan. Veterinarians can seek an underlying cause before CKD becomes too advanced and treat it if possible. Early diagnosis also allows them to help avoid further damage to the kidneys by taking precautions when anesthetizing cats and prescribing drugs. If appropriate, they can prescribe a special diet to support kidney function.

"Hydration, nutrition, analgesia and meeting environmental and emotional needs are the four key things to focus on," Dr. Scherk says.

Q&A

Help pup develop

coping skills

Q: I have a 2-year-old Shih Tzu we got as a puppy. He is very spoiled, fearful of noises and sticks to me like glue. We have to leave him for a week. I'm so concerned about his well-being. Any thoughts? Thanks. -- via email

A: If your trip is coming up quickly, the best thing you can do for now is to make sure his environment stays as normal as possible. You may want to hire a pet sitter who stays in your home with him rather than put him in a boarding kennel.

For the future, it's important to start working on his confidence and ability to stay home alone and entertain himself when necessary. These are things that every dog of any size or breed should learn as a puppy. An experienced trainer or behaviorist can help you teach him these skills and work with the two of you on his noise phobia.

If your dog is anxious when you leave him alone, here are some things you can try to help him be more comfortable. Don't make a big deal about it when you leave the house or when you come back. Calmly give him a treat when you leave and tell him in a normal tone of voice that you'll be back. You may want to start by leaving for only a minute or two, then gradually extending the amount of time you're gone. When you return, greet him calmly instead of making a big fuss over him.

You can also leave the radio on so he has some background noise. Choose a station with soothing jazz or classical music, or put on some calming harp music. A white noise machine can help block out sounds that may be disturbing him. Give him a puzzle toy filled with treats to keep his brain occupied. Filming him while you're away can help a veterinary behaviorist or veterinarian working with a reward-based trainer to see what triggers his anxiety and how it escalates when you're away. -- Mikkel Becker and Kim Campbell Thornton

Do you have a pet question? Send it to askpetconnection@gmail.com or visit Facebook.com/DrMartyBecker.

THE BUZZ

Yoga, tea, movies

stoke cat adoptions

-- Love cats, tea and yoga? If you're in the city by the bay (San Francisco, natch), all your interests converge at KitTea, the city's first cat cafe, located at 96 Gough St. in Hayes Valley. The relaxing space is dedicated to enriching the interactions between humans and adoptable felines from Wonder Cat Rescue. Enjoy Friday "mewvie" nights featuring flicks such as "Bell, Book and Candle" with mind-reading cat Pyewacket, unlimited tea and a dessert; or practice yoga with cats on Monday and Thursday evenings, with a 90-minute flow and restorative class followed by 30 minutes of tea and cat time. Meowvelous!

-- The pharaoh hound may have an exotic, regal appearance befitting a breed named for the ancient rulers of Egypt, but beneath that chiseled exterior lies a hound with a sense of humor who is prone to stealing doughnuts, chasing squirrels and generally keeping his people entertained. Despite their name, the dogs are actually from Malta, where they are still prized as rabbit hunters. The sleek sighthounds have a rich tan or chestnut coat with white markings; an intelligent, playful, loving temperament; and the unique characteristic of blushing bright pink when they are happy or excited.

-- Employee benefits network BenefitsPRO lists five good reasons companies should consider making offices pet-friendly: they relieve stress (who doesn't relax when giving a dog a belly rub or petting a cat?); they boost employee relationships; they reduce absenteeism from pet-owning employees; they can drive creativity; and they create a welcoming atmosphere for people visiting the premises. To help things go smoothly, lay down guidelines to ensure that pets who come into the office are friendly, well-trained and get along with other animals and let visitors know about the policy in advance in case they have allergies. -- Kim Campbell Thornton

ABOUT PET CONNECTION

Pet Connection is produced by a team of pet-care experts headed by "The Dr. Oz Show" veterinarian Dr. Marty Becker and award-winning journalist Kim Campbell Thornton. They are affiliated with Vetstreet.com and are the authors of many best-selling pet-care books. Joining them is dog trainer and behavior consultant Mikkel Becker. Dr. Becker can be found at Facebook.com/DrMartyBecker or on Twitter at DrMartyBecker. Kim Campbell Thornton is at Facebook.com/KimCampbellThornton and on Twitter at kkcthornton. Mikkel Becker is at Facebook.com/MikkelBecker and on Twitter at MikkelBecker.

CAPTIONS AND CREDITS

Caption 01: Chronic kidney disease in cats can be managed with nutrition and treatment of related conditions. Position: Main Story

Caption 02: Pharaoh hounds are independent thinkers who like to lounge on the sofa when they're not running, stealing food or chasing squirrels. Position: Pet Buzz/Item 2

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