Treatment of Acute Kidney Injuries

Cooper RL, Labato MA: Peritoneal dialysis in cats with acute kidney injury: 22 cases (2001–2006), J Vet Intern Med 25:14, 2011.

Peritoneal Dialysis (PD) is a process used in managing acute kidney injury that is refractory to fluid therapy. PD utilizes the peritoneum as a semipermeable membrane in order to move solutes and water between blood in the peritoneal capillaries and fluid (dialysate) instilled in the peritoneal cavity. This study of the medical records of 22 cats with acute kidney injury examined the indications, effectiveness, outcomes, and complications associated with use of PD in the affected cats. Indications for peritoneal dialysis include acute-on-chronic- kidney injury, acute kidney injury caused by toxins, bilateral ureteroliths, bilateral ureteral ligation as a complication of ovariohysterectomy, and unknown causes. For all cats on PD, the median survival time was 4 days, though the median survival time for cats discharged from the hospital was 774 days. Dialysate retention and sequestration of dialysate under the skin were the most common complications noted. Results found a significant decrease between the pre-and post-dialysis results for blood urea nitrogen, creatinine, potassium, phosphorus, total protein, and albumin concentrations. PD could be used as an effective option for treatment in cats with acute kidney injury that is refractory to fluid therapy.  [VT]

Related articles:
Cooper RL, Labato MA: Peritoneal dialysis in veterinary medicine, Vet Clin North Am Small Anim Pract 41:91, 2011.

More on cat health: Winn Feline Foundation Library
Join us on Facebook
Follow us on Twitter

Cooper RL, Labato MA: Peritoneal dialysis in cats with acute kidney injury: 22 cases (2001–2006), J Vet Intern Med 25:14, 2011.

Peritoneal Dialysis (PD) is a process used in managing acute kidney injury that is refractory to fluid therapy. PD utilizes the peritoneum as a semipermeable membrane in order to move solutes and water between blood in the peritoneal capillaries and fluid (dialysate) instilled in the peritoneal cavity. This study of the medical records of 22 cats with acute kidney injury examined the indications, effectiveness, outcomes, and complications associated with use of PD in the affected cats. Indications for peritoneal dialysis include acute-on-chronic- kidney injury, acute kidney injury caused by toxins, bilateral ureteroliths, bilateral ureteral ligation as a complication of ovariohysterectomy, and unknown causes. For all cats on PD, the median survival time was 4 days, though the median survival time for cats discharged from the hospital was 774 days. Dialysate retention and sequestration of dialysate under the skin were the most common complications noted. Results found a significant decrease between the pre-and post-dialysis results for blood urea nitrogen, creatinine, potassium, phosphorus, total protein, and albumin concentrations. PD could be used as an effective option for treatment in cats with acute kidney injury that is refractory to fluid therapy.  [VT]

Related articles:
Cooper RL, Labato MA: Peritoneal dialysis in veterinary medicine, Vet Clin North Am Small Anim Pract 41:91, 2011.

More on cat health: Winn Feline Foundation Library
Join us on Facebook
Follow us on Twitter

Read More

Diagnosis of Hyperthyroidism in Cats with Kidney Disease

Wakeling, J., K. Moore, et al. (2008). "Diagnosis of hyperthyroidism in cats with mild chronic kidney disease." Journal of Small Animal Practice 49(6): 287-294.


It is a well known phenomenon that hyperthyroid cats with concurrent non-thyroidal illness, such as chronic kidney disease (CKD), may have total thyroxine concentrations within the normal reference range. This causes a diagnostic dilemma. The objective of this study was to determine total thyroxine, free thyroxine and/or thyroid-stimulating hormone concentrations in cats with mild CKD. Three groups of cats were included: 16 cats with CKD and clinical signs compatible with hyperthyroidism but total thyroxine within the reference range (these cats were confirmed with hyperthyroidism at a later date); 20 cats with CKD and no signs of hyperthyroidism; 20 clinically healthy senior cats (over 8 years of age). Four of the 20 cats with CKD had free thyroxine concentrations that were borderline or high. Of the 16 cats with hyperthyroidism and CKD, free thyroxine was high in 15/16 cats and thyroid-stimulating hormone was low in all cats. The researchers conclude that the combined measurement of free thyroxine with total thyroxine or thyroid-stimulating hormone may be of merit in the diagnosis of hyperthyroidism in cats with chronic kidney disease.
>> PubMed abstract


Related articles:
Langston, C. E. and N. J. Reine (2006). "Hyperthyroidism and the kidney." Clin Tech Small Anim Pract 21(1): 17-21.
>> PubMed abstract


More on cat health: Winn Feline Foundation Library

Wakeling, J., K. Moore, et al. (2008). "Diagnosis of hyperthyroidism in cats with mild chronic kidney disease." Journal of Small Animal Practice 49(6): 287-294.


It is a well known phenomenon that hyperthyroid cats with concurrent non-thyroidal illness, such as chronic kidney disease (CKD), may have total thyroxine concentrations within the normal reference range. This causes a diagnostic dilemma. The objective of this study was to determine total thyroxine, free thyroxine and/or thyroid-stimulating hormone concentrations in cats with mild CKD. Three groups of cats were included: 16 cats with CKD and clinical signs compatible with hyperthyroidism but total thyroxine within the reference range (these cats were confirmed with hyperthyroidism at a later date); 20 cats with CKD and no signs of hyperthyroidism; 20 clinically healthy senior cats (over 8 years of age). Four of the 20 cats with CKD had free thyroxine concentrations that were borderline or high. Of the 16 cats with hyperthyroidism and CKD, free thyroxine was high in 15/16 cats and thyroid-stimulating hormone was low in all cats. The researchers conclude that the combined measurement of free thyroxine with total thyroxine or thyroid-stimulating hormone may be of merit in the diagnosis of hyperthyroidism in cats with chronic kidney disease.
>> PubMed abstract


Related articles:
Langston, C. E. and N. J. Reine (2006). "Hyperthyroidism and the kidney." Clin Tech Small Anim Pract 21(1): 17-21.
>> PubMed abstract


More on cat health: Winn Feline Foundation Library

Read More

Kidney Insufficiency After Treatment for Feline Hyperthyroidism

Riensche, M. R., T. K. Graves, et al. (2008). "An investigation of predictors of renal insufficiency following treatment of hyperthyroidism in cats." J Feline Med Surg 10(2): 160-6.

Renal insufficiency is a common finding in older cats, affecting about 30% of cats over age 15. Hyperthyroidism is the most common endocrine disorder in cats, and it appears to be increasing in incidence over time. Hyperthyroidism can mask underlying renal disease by causing an increase in the glomerular filtration rate (GFR). Treatment of hyperthyroidism leads to a decrease in GFR and an increase in blood urea nitrogen (BUN). Different treatments exist for hyperthyroidism in cats, including reversible (methimazole) and irreversible (thyroidectomy, radioiodine) options. The ability to predict which cats will develop renal insufficiency after treatment for hyperthyroidism would help guide treatment decisions. The purpose of this retrospective study was to determine if routine pre-treatment clinical data can be used to predict the development of overt renal insufficiency following treatment of feline hyperthyroidism. Medical records were reviewed for 39 nonazotemic cats undergoing treatment for hyperthyroidism at the College of Veterinary Medicine, University of Illinois. The records were reviewed for for signalment, clinical signs, and serum biochemical, hematologic and urinalysis findings before and after treatment for hyperthyroidism. Cats that developed renal insufficiency within 6 months after treatment (n=20) were compared to cats that did not (n=19). No significant differences could be detected between the groups with respect to the parameters measured. The study suggests that the results of routine pre-treatment clinical data cannot be used to predict renal function after treatment for hyperthyroidism, and that a trial of methimazole therapy is indicated before choosing irreversible treatment such as radioiodine.
>> PubMed abstract

Related articles:
Boag, A. K., R. Neiger, et al. (2007). "Changes in the glomerular filtration rate of 27 cats with hyperthyroidism after treatment with radioactive iodine." Vet Rec 161(21): 711-5.
>> PubMed abstract

More on cat health: Winn Feline Foundation Library

Riensche, M. R., T. K. Graves, et al. (2008). "An investigation of predictors of renal insufficiency following treatment of hyperthyroidism in cats." J Feline Med Surg 10(2): 160-6.

Renal insufficiency is a common finding in older cats, affecting about 30% of cats over age 15. Hyperthyroidism is the most common endocrine disorder in cats, and it appears to be increasing in incidence over time. Hyperthyroidism can mask underlying renal disease by causing an increase in the glomerular filtration rate (GFR). Treatment of hyperthyroidism leads to a decrease in GFR and an increase in blood urea nitrogen (BUN). Different treatments exist for hyperthyroidism in cats, including reversible (methimazole) and irreversible (thyroidectomy, radioiodine) options. The ability to predict which cats will develop renal insufficiency after treatment for hyperthyroidism would help guide treatment decisions. The purpose of this retrospective study was to determine if routine pre-treatment clinical data can be used to predict the development of overt renal insufficiency following treatment of feline hyperthyroidism. Medical records were reviewed for 39 nonazotemic cats undergoing treatment for hyperthyroidism at the College of Veterinary Medicine, University of Illinois. The records were reviewed for for signalment, clinical signs, and serum biochemical, hematologic and urinalysis findings before and after treatment for hyperthyroidism. Cats that developed renal insufficiency within 6 months after treatment (n=20) were compared to cats that did not (n=19). No significant differences could be detected between the groups with respect to the parameters measured. The study suggests that the results of routine pre-treatment clinical data cannot be used to predict renal function after treatment for hyperthyroidism, and that a trial of methimazole therapy is indicated before choosing irreversible treatment such as radioiodine.
>> PubMed abstract

Related articles:
Boag, A. K., R. Neiger, et al. (2007). "Changes in the glomerular filtration rate of 27 cats with hyperthyroidism after treatment with radioactive iodine." Vet Rec 161(21): 711-5.
>> PubMed abstract

More on cat health: Winn Feline Foundation Library

Read More

Acute Kidney Failure in Cats

Worwag, S. and C. E. Langston (2008). "Acute intrinsic renal failure in cats: 32 cases (1997-2004)." J Am Vet Med Assoc 232(5): 728-32.

Acute renal failure (ARF) is the sudden onset of impaired renal function with associated inability to regulate fluid, electrolyte and acid-base balance. The prognosis for ARF in dogs and humans is generally poor, with mortality rates of 50-60%. Very limited data has been available on the characteristics of cats with ARF. The purpose of this study was to determine the demographics, clinicopathologic findings and outcome of cats with ARF. In a retrospective case series, the records of 32 cats with ARF were examined. Causes of ARF included nephrotoxins (e.g., drugs, lily toxicity) and ischemia, among others. Increases in serum potassium were associated with decreased chance of survival. Other negative prognostic indicators were low serum albumin or bicarbonate concentration at initial diagnosis. Of the 32 cases, 17 cats (53%) survived but 9 cats had persistent azotemia. The results of this study indicate that survival rates of cats with ARF are similar to rates in dogs and that about half of surviving cats have persistent renal damage.
>> PubMed abstract


Related blog posts:
Lily toxicity in a cat

More on cat health: Winn Feline Foundation Library

Worwag, S. and C. E. Langston (2008). "Acute intrinsic renal failure in cats: 32 cases (1997-2004)." J Am Vet Med Assoc 232(5): 728-32.

Acute renal failure (ARF) is the sudden onset of impaired renal function with associated inability to regulate fluid, electrolyte and acid-base balance. The prognosis for ARF in dogs and humans is generally poor, with mortality rates of 50-60%. Very limited data has been available on the characteristics of cats with ARF. The purpose of this study was to determine the demographics, clinicopathologic findings and outcome of cats with ARF. In a retrospective case series, the records of 32 cats with ARF were examined. Causes of ARF included nephrotoxins (e.g., drugs, lily toxicity) and ischemia, among others. Increases in serum potassium were associated with decreased chance of survival. Other negative prognostic indicators were low serum albumin or bicarbonate concentration at initial diagnosis. Of the 32 cases, 17 cats (53%) survived but 9 cats had persistent azotemia. The results of this study indicate that survival rates of cats with ARF are similar to rates in dogs and that about half of surviving cats have persistent renal damage.
>> PubMed abstract


Related blog posts:
Lily toxicity in a cat

More on cat health: Winn Feline Foundation Library

Read More

Lily Toxicity in a Cat

Berg, R. I., T. Francey, et al. (2007). "Resolution of acute kidney injury in a cat after lily (Lilium lancifolium) intoxication." J Vet Intern Med 21(4): 857-9.

This is a case report of a young male cat that suffered acute kidney failure after ingestion of orange tiger lily flowers (Lilium lancifolium). After 12 days of intensive care, including hemodialysis and an esophageal feeding tube, the cat recovered fully. Easter lily toxicity usually causes death in cats due to severe kidney damage. Common signs of toxicity include vomiting, increased thirst and urination, disorientation, swelling of the face and paws, and seizures.

More from the American Assoc. of Feline Practitioners:
Lily ingestion toxicity in cats

More on cat health: Winn Feline Foundation library

Berg, R. I., T. Francey, et al. (2007). "Resolution of acute kidney injury in a cat after lily (Lilium lancifolium) intoxication." J Vet Intern Med 21(4): 857-9.

This is a case report of a young male cat that suffered acute kidney failure after ingestion of orange tiger lily flowers (Lilium lancifolium). After 12 days of intensive care, including hemodialysis and an esophageal feeding tube, the cat recovered fully. Easter lily toxicity usually causes death in cats due to severe kidney damage. Common signs of toxicity include vomiting, increased thirst and urination, disorientation, swelling of the face and paws, and seizures.

More from the American Assoc. of Feline Practitioners:
Lily ingestion toxicity in cats

More on cat health: Winn Feline Foundation library

Read More