I adopted Carlos after finding him in the middle of a busy road. I quickly discovered he wasn't able to hear my horn because he was deaf. Shortly after, he rapidly started to lose weight and was diagnosed with diabetes. For eight years, I kept up with daily insulin treatment. At the age of 16, he was diagnosed with kidney disease. We began daily sub-q fluids at home. Unfortunately, this complicated his blood sugar. For the last two years of his life, we were monitoring his gluclose at home every few hours, administering daily fluids, and twice daily insulin. He was a trooper until the end. He finally crossed rainbow bridge at the age of 18, ten years after his original diabetes diagnosis. Three years later, there still isn't a day that I don't miss him. Pet Parent- Jonathan
From our friends at Kidney-Chek, here is some great information about Feline Chronic Kidney Disease
General CKD facts and info: What is CKD?
● Chronic Kidney Disease (CKD) is a common illness in cats and dogs.
■ 1 in 3 cats will be affected in their lifetime
■ 1 in 10 dogs will be affected in their lifetime
○ CKD is caused when nephrons, tiny structures in the kidney responsible for filtering waste products out of the blood, are damaged. This damage can be irreversible and progressively gets worse over time, especially if CKD is left untreated.
○ If caught very early, treatment and preventing further damage can help the nephrons recover and sometimes kidney function can improve!
○ Diagnosing CKD in the later stages of disease means that there may be too much damage to the nephrons, so treatment options are based on helping the pet feel better and trying to prevent more damage to the remaining nephrons.
○ Unfortunately, the early signs of CKD can be subtle and many pets are not diagnosed until they are clearly ill, at which point up to 75% of their kidney function could be permanently lost.
Risk Factors
● It’s often too hard to pinpoint what caused CKD in an individual pet, because by the time they get diagnosed there is too much damage to determine why and where it started.
● There are many factors that can increase the risk of CKD, but unfortunately it's difficult to know which pets will be affected! Some risk factors include the dog or cat's breed (genetics), age, diet, exposure to drugs or toxins, or if other illnesses are also present.
● Inflammation from various infections and abnormal blood pressure (too high or too low) can also damage the kidneys.
● Here is a more complete list of risk factors from the IRIS website:
○ http://www.iris-kidney.com/education/education/risk_factors.html
What is Urea
● All bodies need protein from our diets in order to function properly. When we eat protein, it has to be broken down into smaller parts that our body can use. Our liver is responsible for a large proportion of this process, called protein metabolism. Urea is a nitrogen based compound that is created as a by-product of protein metabolism and it is carried by the bloodstream to the kidneys, where it is filtered out into the urine.
● If the kidneys are not working properly, urea can start to build up in the bloodstream. This can be found with bloodwork, which shows elevated blood urea nitrogen (BUN). When urea is elevated, it spills out from the blood into the saliva, which is where Kidney-ChekTM can detect it!
○ This is one of the reasons why it’s recommended that pets with CKD are switched to a lower protein diet. Less protein means less urea from protein metabolism.
What pet parents can watch for at home:
Cats and dogs can’t use words to tell us how they are feeling, so it’s important to watch your pet for any signs of changes to their health. Here are some common symptoms of Chronic Kidney Disease (CKD) you can look out for, with some tips to help you monitor your pet at home:
● Drinking more water (polydipsia). Pets with CKD will start drinking more water to try to replace what they are losing due to poor kidney function.
○ Try to refill your pet’s water bowl at the same time every day, so you can see how much they drink in between refills.
● Urinating more (polyuria). Pets with CKD will start urinating more often, and larger amounts of dilute urine because their kidneys are not concentrating their urine properly.
○ This can lead to chronic dehydration, and also problems with constipation
○ Clean your cat’s litterbox at least once a day and try to notice how many clumps there are, and how big each clump is. This way you can tell right away if there are any changes. If you have to clean the litterbox more frequently because it’s excessively full, or if your cat is urinating outside of the box or crying when they are in the litterbox, your cat should be seen by a veterinarian.
● Decreased appetite or weight loss. Pets with CKD can lose weight for a variety of reasons:
○ not eating as much as they should because they don’t feel well
○ they aren’t digesting their food very well (senior pets don’t digest food as well as
young pets)
○ they could be losing protein in their urine so their body compensates by breaking down their muscle mass.
○ Nausea/vomiting
■ CKD can make your pet feel pretty miserable and nauseated partly because of the build up of waste products, like urea, in their body. If they are not eating properly, it can make them feel even worse.
○ Nutrition is a vital part of keeping your pet healthy! Pets with CKD require special diets to help protect their kidneys from further damage.
■ Feeding a phosphorus-restricted renal diet has been shown to improve CKD–mineral and bone disorders, reduce urea in the bloodstream, and increase the pet’s remaining lifespan by up to 3 times.
■ Renal diets will have a balance of omega fatty acids, potassium, fiber, and appropriate amounts of highly-digestible protein, with decreased amounts of phosphorus.
■ Canned diets provide the benefit of improving hydration. If a cat will not eat a commercial renal diet, a home-cooked diet can be formulated with the help of a veterinary nutritionist.
■ Your veterinary team is a great resource to help you figure out exactly how much food to feed your pet based on their current weight, life stage, and health status!
● Bad breath
○ CKD leads to a buildup of waste products like urea in the bloodstream. When the level of urea increases, it starts leaking into the saliva and causes very bad breath and even ulcers!
● Poor hair coat
○ CKD can cause prolonged dehydration and can change the way your pet's body uses and processes protein, which can lead to dull fur and dry skin.
Here are 5 tips to help keep your pet healthy:
1. Hydration is important. Make sure clean water is always available, and it's even better to have multiple water bowls or fountains in multiple rooms so your pet never has to go far to get a drink.
2. Feed a diet that is appropriate for the life stage and health status of your pet. Feeding both canned and dry foods can be beneficial! Ask your veterinary team to check your pet’s food if you have questions about pet food nutrient profiles, how many calories your pet should be eating, or for general nutritional advice.
3. Make sure your pet sees their vet regularly! Veterinarians perform full nose-to-tail exams and make detailed notes so they can tell if there are any changes from previous appointments. Regular laboratory tests, even if your pet appears healthy, are also critical for vets to see if there are any concerning changes. Vets can potentially catch CKD in the earliest stages by noticing trends in lab work, even if everything is still in the normal range.
4. Keep on top of that bad breath! Dental disease is caused by bacteria in the mouth and has been associated with damage to the heart, liver, and kidneys. If your pet already has lots of tartar on their teeth, get a veterinarian to perform a thorough dental cleaning under anesthesia so you can take over the rest of the dental care at home. Feeding special dental food or treats, using water additives, and regular tooth brushing are all good ways to keep those pearly whites healthy!
5. Use Kidney-ChekTM in-between your pet's regular vet appointments to make sure there are no health issues developing! If Kidney-ChekTM alerts you to a problem, it's important to follow up with your veterinarian as soon as possible to figure out the best treatment plan for you and your pet.
● The vet’s focus when examining mature adult and senior cats will be on early detection of disease. Veterinary visits may be more challenging for the senior cat, in part because many cat owners do not seek preventative wellness visits, but only bring in their cats when there is a clear medical problem.
● Routine vet exams contribute to uninterrupted health care and early detection of disease, often resulting in easier disease management and prevention, and may lead to better quality of life; it is less costly and more successful than crisis management.
● The cat’s innate ability to hide ailments makes regular physical examination that much more critical in the elderly cat.
● Diminished GI tract function in seniors may also lead to consumption of smaller volumes of food at each feeding, with cats over 10 years requiring calorie-dense diets with highly digestible proteins offered in smaller, more frequent meals.
● Clinical signs of CKD can be overlooked by cat owners, and may include polyuria, polydipsia, inappetence, nausea, constipation, poor haircoat, weight loss and muscle wasting.
Kidney-Chek is a great product to use to screen your pets kidney health on a regular basis to help catch any potential problems. We are glad this is out in the world to help cat and dog owners screen their furry friends kidney health at home for peace of mind, in between regular veterinarian visits. We wish this was around when our cat Nefi was with us, perhaps it could have caught his kidney issues before it was too late. But now others have a chance to use this product, which we are so happy about!
Use our affiliate link below to try out Kidney-Chek, we will receive a % of each sale, which will be donated to EveryCat Health Foundation Feline Kidney Disease Fund.
Click here to buy a Kidney-Chek test kit for your cat (and/or dog) 
Resources:
1. Our peer-reviewed study published in the Journal of Veterinary Diagnostic Investigation on Kidney-ChekTM:
a. https://journals.sagepub.com/doi/10.1177/10406387221086917
2. Find our instructional videos on Youtube by clicking here.
3. Many veterinarians use the guidelines from the International Renal Interest Society (IRIS) to diagnose and stage CKD in their patients.
a. Here’s their page for pet owners:
i. http://www.iris-kidney.com/education/education/what_pet_owners_should_kn
ow_ckd.html
b. here’s a quick summary of the IRIS staging guidelines:
i. IRIS pocket guide
4. Catfriendly.com is a website put together by feline-focused vets to help cat parents take the best care of their fur-babies:
a. Here’s the page specifically for CKD:
i. https://catfriendly.com/feline-diseases/chronic-kidney-disease/
b. And the page for general information about senior cat care:
i. https://catfriendly.com/life-stages/senior-care/
5. American Association of Feline Practitioners website (https://catvets.com/) has lots of resources about cat care including:
a. Life Stage Guide and
b. Senior Care Guide
About Feline Diabetes
Diabetes mellitus is a condition in which the body cannot properly produce or respond to the hormone insulin. This results in elevated levels of the sugar glucose in the blood, which is the main source of energy for the body. Like the human body, the cells in a cat’s body need sugar in the form of glucose for energy. However, glucose in the blood requires insulin, a hormone produced by the pancreas, to “unlock” the door to cells. Insulin attaches to cells and signals when the time is right to absorb glucose. By absorbing glucose, cells in fat deposits, the liver, and the muscles get vital fuel while lowering levels of glucose in the blood.
In Type I diabetes, blood glucose concentrations are high because of a decrease in insulin production. In Type II diabetes, glucose levels are high because cells in the body do not respond appropriately to insulin. In both Type I and Type II diabetes, cells cannot access the nutrients they need even though there is plenty of sugar in the blood, because insulin can’t transport the sugar from the bloodstream into the cells that need it.
Cats with diabetes most commonly suffer from the Type II form of the disease. It is estimated that between 0.2 % and 1 % of cats will be diagnosed with diabetes during their lifetime.
* Sourced from the following: https://bit.ly/333yVlp
More Information
Managing Diabetes In Cats
https://www.vetsulin.com/cats/diabetes-managing.aspx
What is Diabetes Mellitus?
https://catfriendly.com/feline-diseases/diabetes/
How environment affects development of diabetes mellitus in cats
https://everycat.org/cat-health/how-environment-affects-development-of-diabetes-mellitus-in-cats/
An ultra-long-acting recombinant insulin for the treatment of diabetes mellitus in cats
https://everycat.org/cat-health/an-ultra-long-acting-recombinant-insulin-for-the-treatment-of-diabetes-mellitus-in-cats/
Inherited Deafness in White Cats
In cats, inherited congenital (present from birth) deafness is seen almost exclusively in white coated individuals. The deafness is caused by degeneration of the auditory apparatus of the inner ear and may affect one ear (unilateral) or both ears (bilateral).
Breeding studies have defined the relationship between deafness in white cats and blue eye colour. The gene responsible is an autosomal dominant gene termed W (for White). This gene appears to be pleiotropic – ie, it has more than one effect, being responsible for the white coat colour and also blue eyes and deafness. However, while the gene has complete penetrance for white coat colour (all cats that carry the gene will have a white coat), it has incomplete penetrance for blue eye colour and for deafness (but these two are strongly linked). Thus deafness is strongly linked to the white coat colour and blue eye colour, but not all white cats or white cats with blue eyes are necessarily deaf. The variable penetrance of deafness and eye colour may be caused by interplay with other genes and/or environmental factors.
* Source: https://icatcare.org/advice/inherited-deafness-in-white-cats/
