covers miscellaneous symptoms which you may see in a CKD cat.
complete list of CKD symptoms, or to look up a symptom which is bothering
you, please see the
and Treatments, where all the symptom are listed alphabetically,
with quick links to each individual symptom and appropriate treatment
I am often
asked if CKD cats are in pain. No, it is thought that the typical CKD cat is not in pain.
Some of the symptoms of CKD can be uncomfortable (e.g. dehydration is
often described as feeling like a hangover), and pain may arise if your
cat experiences certain complications, such as
calcification, but CKD generally is not painful.
most CKD cats are older, so they may be experiencing pain for other
reasons, e.g. from
dental problems. Other possible causes of
pain include kidney infections or
kidney stones, or if
the cat is having trouble breathing. Again, most
painful conditions can be managed.
Immediately below I discuss some possible symptoms of pain in more detail, but these
are not the only ones.
WSAVA guidelines for recognition, assessment and
treatment of pain (2014) Mathews K, Kronen PW, Lascelles D,
Nolan A, Robertson S, Steagall PVM, Wright B & Yamashita K Journal of
Small Animal Practice55(6) ppE10–E68 discusses how to
recognise pain, whether acute and chronic. It states that changes in any
of the following categories should be considered:
General mobility, e.g.
reluctance to move, jumping less
Problems with the litter
tray, e.g. finding it harder to climb into the tray
Reduced grooming, e.g. can
the cat reach and scratch easily
Relaxing, e.g. does the cat
seem able to lie comfortably, or is s/he sitting hunched up (which
sometimes is a symptom of a
Less sociable, both with
humans and other feline family members, maybe even hiding
e.g. is the cat unhappy or even aggressive when picked up, which was
never previously the case
can be so difficult to detect pain in cats, a
number of pain scoring tools have been developed, including:
2015 AAHA/AAFP pain management guidelines for dogs
and cats (2015) Epstein ME, Rodan I, Griffenhagen G, Kadrlik J,
Petty MC, Robertson SA & Simpson W Journal of Feline Medicine and
Surgery17 pp251–272 discuss the importance of recognising
pain in cats and the various pain scoring systems that are available.
relatively common for CKD cats to hide, perhaps in a cupboard or under a
bed, or somewhere up high. This is because the cat does not feel well — it
is instinctive for cats to hide when they feel ill or stressed so as to
minimise the risk of attacks by predators.
Will a hiding box provide stress reduction for
(2014) Vinke CM, Godijn LM & van der Leij WJR Applied Animal Behaviour
found that cats in a shelter who were given a hiding box appeared to cope
more effectively with the stressors of that environment than cats who had
nowhere to hide.
As your cat
improves with treatment, you should find s/he will hide less, though a CKD
cat may always require more rest and peace than a healthy cat, and may
well choose a place that is less public than was previously the case.
to be aware of is that some cats may take this a step further and go away
from home to hide. Therefore if you usually let your cat go outdoors, I
would be careful or perhaps restrict access until you know your cat is
stable once again, because there is nothing worse than not knowing where
your cat is and being unable to give the medications that are necessary to
keep the cat happy and comfortable.
Seeking You Out
some cats will seek you out, and want to snuggle more. This may even
happen with cats who previously were somewhat stand-offish. This may
simply be because the cat does not feel well and wants you close for
comfort and reassurance. However,
signs of pain in cats: an expert consensus
Merola I & Mills DS PLOS One pp1-15 reports that seeking
contact with a person may be seen in cats with high or low level pain.
knows that cats purr when they are content or happy. However, fewer people
realise that a purr is not automatically a good sign, because it is also
possible that cats may
also purr when they are in discomfort or pain. Some years ago, a cat was
run over by a car in front of my eyes. I ran to the cat and rescued it
from the road but s/he died in my arms within a minute or two - the cat
purred the entire time.
Behavioural signs of pain in cats: an expert
consensus (2016) Merola I & Mills
DS PLOS One pp1-15 reports that purring may be seen in some cats
with high or low level pain, though this is rare.
The precise mechanism of purring is not known, but
it is thought it may produce endorphins or "feel good" hormones in a cat.
Why do cats purr (2003) Lyons L
Scientific American explains more about this. In the case of a cat in pain, this may help the cat cope with the pain, or
comfort the cat in some way. Dr Lyons also mentions that the sound
frequencies used in purring may actually promote healing.
your cat's purr develops a rattle, this can sometimes indicate
So please do not assume that your cat must be well simply because s/he is
dysfunction, which is sometimes referred to as senility or feline Alzheimer's).
Humans with cognitive dysfunction are often confused, though this may
also be a sign of a
tract infection in humans, and possibly in cats.
recommend always having blood pressure checked in a howling cat.
Increased vocalisation in elderly cats
(2015) Gunn-Moore DA European Journal of Companion Animal Practice 25(3)
pp20-29 states "The most common causes of increased vocalisation
are cognitive dysfunction syndrome, hyperthyroidism (with or without
systemic hypertension), systemic hypertension (most commonly associated
with chronic kidney disease, hyperthyroidism or hyperaldosteronism),
deafness, osteoarthritis (or other causes of chronic pain) and brain
Treatments for treatment options for cognitive dysfunction.
Hair and Coat-Related Symptoms
Hair or Fur Loss
Anagem effluvium in chronic renal failure
(2001) Suwanwalaikorn S, Sivayathorn A, Chiba M, Vareesangthip K,
Manonukul J, Tsuboi R & Ogawa H Presentation to the European Hair
Research Society Conference found that the sudden loss
of hair is not unknown in human CKD patients. In all cases, no specific
reason was found but the hair grew back without treatment. The same may
apply to cats, but please also see alopecia below. Sometimes cats will
develop hair loss at the site of subcutaneous fluids; this is not
normally of concern.
food allergies may also lose their hair. One of our cats, Harpsie, had
food allergies, and lost the fur around his neck in a ring, like a collar.
He also lost fur in other areas. Once his allergies were under control,
the fur grew back.
food allergies or other types of allergy.
If allergies are ruled out, this may
be a symptom of
hyperthyroidism. Cats in
pain may pull out their hair.
overgroom so that they suffer fur loss on the rear end and abdomen may
have urinary or anal gland problems.
If your cat is scratching rather than pulling out hair, it might be
because of an uraemic itch, i.e. caused by the levels of toxins in
the blood. Itching is fairly common in cats with
high phosphorus levels, particularly if the high phosphorus levels go
untreated, resulting in
reflects the general loss of condition of a CKD cat, and is also
dehydration. The body is
fighting a tough battle with CKD and concentrates its efforts on its more
critical functions; a glossy coat is not one of them.
If you look at the photograph of Thomas on the homepage, you will notice his
back looks brown rather than black like his head and face. This is partly
because the photograph was taken in the summer, when Thomas loved
sunbathing, which seemed to turn his black coat brown. This is relatively
common in black cats, and is known as "rusting". However, his coat
also changed colour in winter when he was first diagnosed. My vet told me
this often happens to dark-haired cats when they are ill — the body has
more important things to focus on than the cat's coat.
Getting the CKD under control should help with this problem — it did help
Reduced protein diets may also be a factor in coat colour change, because
tyrosine, an amino acid, is important for the production of coat colour,
but reduced protein diets contain less tyrosine than normal diets.
The carnivore connection to nutrition in cats
(2002) Zoran D
Journal of the American Veterinary Medical Association 221
explains more about
this (see page 3). The addition of tyrosine to the diet may help, but this is not essential, and should not be
done without your vet's approval. See also
Dull coat/dandruff/spiky fur.
If your cat has any Siamese genes, the points may darken as a cat ages.
The coat colour of Siamese and Himalayans (colourpoint Persians) is
actually determined by temperature changes. As cats age, their circulation
often worsens, so their extremities become cooler and their points get
darker. However, sick cats with Siamese genes who have a raised
temperature (e.g. because of an infection) may actually develop lighter
colour fur. In either case, it is normally nothing to worry about.
this is incredibly rare in a CKD cat! If you see it, it most likely is
caused by hyperthyroidism.
Some cats with diabetes
may also have an increased appetite. Alternatively, a cat who has had a
will often feel suddenly very hungry afterwards.
is possible to treat all of the above symptoms, in many cases effectively,
and details can be found in the Treatments section.
TREATING YOUR CAT WITHOUT VETERINARY ADVICE CAN BE
tried very hard to ensure that the information provided in this website is
accurate, but I am NOT a vet, just an ordinary person who has lived
through CKD with three cats. This website is for educational purposes
only, and is not intended to be used to diagnose or treat any cat. Before
trying any of the treatments described herein, you MUST consult a
qualified veterinarian and obtain professional advice on the correct
regimen for your cat and his or her particular requirements; and you
should only use any treatments described here with the full knowledge and
approval of your vet. No responsibility can be accepted.
If your cat
appears to be in pain or distress, do not waste time on the internet,
contact your vet immediately.
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