If your
cat suffers from one particular CKD-related problem, there may be
several symptoms present, some of which you might not necessarily
associate with each other. For example, you may know that weakness is a
common symptom of anaemia, but not many people realise that eating
litter is often a sign of anaemia.
This chapter aims to describe the various symptoms which you may see
and their possible causes.
,
where all the symptom are listed alphabetically, with quick links to each
individual symptom and appropriate treatments.
Although the
number of symptoms may appear overwhelming, you will not necessarily see
all these symptoms, and which ones you see at any one time will depend
upon the severity of your cat's CKD and his/her own particular weaknesses.
Almost all of the symptoms are treatable, so don't give up hope. .
If your cat is showing any of the symptoms listed, make an appointment
with your vet, since some of the symptoms may have more than one cause, so
you need an accurate diagnosis in order to treat properly.
Vet Help Direct allows you to
select your cat's symptoms, answer a number of questions and be given
advice on possible causes of the symptoms.
IMPORTANT:
CRASHING
Crashing
in a medical context means a sudden and severe downturn in the patient's
condition. In a
CKD cat it indicates a crisis usually associated with severe dehydration.
Crashes are rarely treatable at home - in most cases the cat will require hospitalisation. If, after
reading the information below, you think your cat may be
crashing, please seek veterinary advice urgently.
Body Fluid Regulation and Urinary
Issues Go to
page
This page
covers fluid and urinary-related symptoms. It includes the common signs of
increased urination and drinking, proteinuria, dehydration and its
opposite problem, overhydration, constipation and diarrhoea, urinary tract
infections and kidney infections, blood in urine, reduced urination,
incontinence, inappropriate elimination
, weight gain and swelling, coughing
and runny eyes.
Regulation of Waste Products in the Body Go to
page
As the kidneys gradually lose their ability to regulate
and remove waste products effectively, these waste products build up in
the blood; this is called uraemia and can make a cat feel very unwell.
Phosphorus
and calcium are minerals used in the body, but imbalances may arise in CKD
cats and lead to a condition known as
secondary
hyperparathyroidism, which may make the CKD progress faster.
Symptoms include appetite loss, itching, twitching, back leg weakness and unco-ordinated
limbs
Potassium is an
electrolyte essential to the functioning of the
body at cellular level, but with increased urination, imbalances may arise,
and may cause the following symptoms:
Lethargy,
weakness and muscle wasting,
a plantigrade posture, where the cat walks on his/her hocks instead of
his/her feet, stilted gait, stiff neck, hoarseness, trouble breathing,
constipation, increased night time urination, seizures or twitching.
This is quite
common in CKD cats. Symptoms include weight loss, particularly lean muscle
loss and a bony spine, breathlessness, mouth ulcers, vomiting and
twitching.
Nausea, Vomiting, Loss of
Appetite and Excess Stomach AcidGo to page
Many
CKD cats have problems with excess stomach
acid.
Symptoms that may be seen include:
Loss of
appetite, excess stomach acid, vomiting and nausea,vomiting water, playing
with water, hunched over water bowl, liplicking, teeth grinding, yawning,
eating grass, bad breath, mouth ulcers, gastro-intestinal bleeding,
diarrhoea, body odour, itching, twitching, seizures, howling, hoarseness.
This is also very common in CKD cats. Symptoms include vomiting before,
during or immediately after using the litter tray, loss of appetite, pooping next to the litter
tray, dry stools and an ungainly
walk.
The kidneys produce a hormone called erythropoietin, which stimulates the
bone marrow to make blood cells. As the kidneys fail, they cannot produce
enough erythropoietin, and a particular type of anaemia called
non-regenerative anaemia results (other types of anaemia must be excluded,
of course).
Signs of anaemia include
nausea, appetite loss, weakness, feeling cold, liplicking, pale nose, gums
or eyelids, lethargy, back leg weakness, heavy breathing, fast heart rate,
wheezing, eating litter, ice or snow, low temp.
Severe anaemia is life-threatening, so please read up on it.
High blood pressure is common in CKD cats. It is
essential to watch for it and treat it if present because it can cause
some serious problems, such as blindness or a stroke.
If your CKD cat suddenly becomes blind, hypertension
is the most likely cause, and can be reversed in some cases if you treat
it quickly enough.
This is such an important topic that it has its own page
here.
This page
includes pain, hiding,
increased appetite, seeking you out, purring, and symptoms relating to the
coat, such as hair or fur loss, pulling
out hair or coat colour change.
Crashing
Crashing
refers to a crisis situation for your cat. It may happen suddenly and be
what finally alerts you to the existence of CKD in your cat; or it may
happen after your cat has been suffering from CKD for some time.
If your cat exhibits some or all of
the following symptoms: is severely dehydrated; has extremely strong bad
breath; has a strong body odour;
is
lying in a "meatloaf" position; eyes are dull; is refusing to eat and possibly also to drink; then
s/he may be crashing.
A cat
who has crashed will often be lying in a "meatloaf" position, which is
very similar to the Sphynx position but with the
head down and the front paws close to the body. I am often asked exactly
what the meatloaf position looks like. Indie to the left is lying in the
Sphynx position, which is not exactly the same but it gives you some idea
of what meatloaf position looks like. Many healthy cats such as Indie assume this pose too, so the
pose itself is not grounds for worry; you need to see the symptoms
described below in addition to the pose. Here Indie (non CKD) is in the
basic meatloaf position, but her head is not down, her eyes are not dull,
and she's making eye contact. The day Tanya died, she lay in this position
too but she refused to raise her head and her eyes were dull. She
also stayed in that position, seemingly unwilling to move.
I find this section of the site can really worry people. Remember, the
meatloaf position is not identical to the photo above, and on its own it
is not a reason to panic. Cats with
excess stomach acid, for
example, may lie in this position. It is when you see the meatloaf position
in conjunction with the other symptoms described in the second paragraph
above that you should contact your vet.
Crashing
usually occurs because your cat has reached a crisis point in terms of
balancing his or her fluid intake and output. The cat has probably been
drinking more to compensate for the increased urination, but can no longer
drink enough. As a consequence most cats who crash are very dehydrated,
and their bloodwork values when tested are very high.
The bad breath smell will be particularly strong, perhaps with mouth
ulcers present, and your cat may also have a generally strong body odour.
The cat will often be unable to get comfortable because of all the toxins in the body
- this may explain the meatloaf position. He/she will have
dull, perhaps sunken eyes and not make eye contact. Your cat will probably
refuse to eat and may also refuse to drink.
Crashing
is a medical emergency. Your cat will usually need rehydration therapy at
the vet's in an attempt to combat the dehydration and reduce the bloodwork
values, and you should contact your vet WITHOUT DELAY. Delaying could
be very serious for your cat, as the toxin levels in the body will
continue to rise if left untreated. When Thomas first crashed, I didn't
realise what it was and I did not call the vet because it was a Sunday and
I didn't like to bother her - she told me off, and said waiting had been
very risky and at the very least had condemned Thomas to another day and
night of feeling awful. If caught early enough, your vet may
be able to save your cat as our vet saved Thomas on two occasions, so
don't take any chances.
During
Thomas's first crash, his BUN was 86 (US: BUN 241), and this value did not
change at all after four solid days and nights of IV. However, with home
treatments, we did gradually reduce his numbers to urea 27 (BUN: 76) and creatinine 316 (US:
3.57), where they stabilised for some months. You can read Thomas's
story in the Tanya, Thomas
and Ollie section.
A cat
who has crashed will often be lying in a "meatloaf" position, which is
very similar to the Sphynx position but with the
head down and the front paws close to the body. I am often asked exactly
what the meatloaf position looks like. Indie to the left is lying in the
Sphynx position, which is not exactly the same but it gives you some idea
of what meatloaf position looks like. Many healthy cats such as Indie assume this pose too, so the
pose itself is not grounds for worry; you need to see the symptoms
described below in addition to the pose. Here Indie (non CKD) is in the
basic meatloaf position, but her head is not down, her eyes are not dull,
and she's making eye contact. The day Tanya died, she lay in this position
too but she refused to raise her head and her eyes were dull. She
also stayed in that position, seemingly unwilling to move.