Protecting Your Cat's Kidneys

ARF (Acute Renal Failure) and CRF (Cronic Renal Failure) 

Feline Kidney Disease

In January 2012 we learned that an acute kidney event led to the damage of JaBelle's kidneys and her eventual death. 
Belle made me realize how important it was to add this page to our website


On 2/14/2012 I ran a kidney panel on Keva, she is JaBelle's full sister from the same litter. Her results came back normal. 

Belle also lived with a sister from the same litter and her kidney panel came back normal also.

Many small animal vets and people use CRF as a catchall term when they see a cats kidneys failing to function properly. They look at a symptomatic purebred cat without complete test results and have already decided its CRF and genetic. Many purebred pet owners also make this assumption after their cat has died of kidney failure. 
The only known genetic kidney disease in cats is polycystic kidney disease which can be confirmed by tests your vet can perform. The cysts present with the disease can be seen on an untrasound of the kidney. There is also a DNA test to determine if breeding cats are carriers. The Siamese breed is not one of the breeds associated with PKD. UCDavis genetic lab info:
In 1990, 5 cats in every 100 cats at teaching Vet hospitals were admitted with diagnosed CRF. In 2000 that number had increased by 100% to 10 out of every 100; this is in all cats regardless of pure or mixed heritage.  I have not been able to find statistics from the past 12 years to know if this number has continued to rise, it makes me wonder if the increasing use of chemicals in our homes is having a devastating accumulative effect on our cats. Apartment and Condo dwellers might be at higher risk with the regular use of pest control due to close high density living.
That figure from 2000 is one out of ten house pet cats; if an average litter is five, you can expect to see one cat out of every two litters develop chronic kidney disease. (This figure does not include acute kidney disease, or ARF.) Vets don’t usually start checking kidney panels on cats until they are older than 10 years, for 95% of cats with CRF are elderly, as it is a disease of the elderly cat. CRF in a cat less than 10 years is uncommon, and in a cat 3 or less, exceptionally uncommon. If a cat is less than 10 yrs. I would question the CRF diagnosis and have an ultra sound of the kidneys done.  

It should be noted an inciting ARF event can damage any cat’s kidneys to the point that it becomes a CRF cat.

There are many, many websites with CRF information. These are just a couple to start with if your cat has been diagnosed with CRF. 

Lysol, Pinesol and many cleaning products are toxic to cats. Yes, you may use them and not notice any illness in your cat and think they are okay but the effect is an accumulative one. Start thinking about what you bring into your cats environment.

 There is very little information on ARF and some of it is misleading. This may be why cats with ARF are diagnosed as CRF cats and aggressive treatment options are lost. Some Vets will tell owners to immediately euthanize a cat with poor kidney panel results. If you feel your vet is not with you on doing everything to help your cat, or is not as informed as they should be, seek out information to help develop a more effective discussion. We all love and cherish our pet cats they are our constant companions and for many they are like children.

I want to provide you with some information as well as personal experiences so you can act proactively to stop an inciting event that produces kidney damage before it’s too late.

  A sudden crash of your cat's kidneys is not CRF. CRF is a long term progressive disease that causes irreversible scaring. It can be managed, slowed down with the right food and supplements, to prolong your pets life for years.  There are owners of CRF diagnosed cats on internet cat care forums that have managed to prolong their cats life for many years.

An elevated kidney panel doesn’t always equal CRF

    Dr. Plotnick’s (Manhattan cat specialist) blog : A case of CRF Misdiognosis:


  The Case of Sasha 

Sasha is a Siamese from our cattery. Her owner contacted me after their Vet had diagnosed 2 year old Sasha with CRF. 
Tuesday 9/28/2010. We were informed of Sasha illness. 
Reported symptoms: “The past week she had started peeing in inappropriate places (the leather couch, the chair, the other couch) and her appetite seemed off plus she was drinking loads more than usual. She is definitely not herself—her appetite is off and I’ve been trying to coax her to eat. She’s completely stopped eating kibble since Fri and only has eaten small amounts of wet food—mostly licking up all the gravy.” They had a kidney panel (blood test) and urine culture done. Her vet concluded CRF based solely on the blood work. There is no blood test to tell the difference between acute renal failure vs chronic renal disease. An ultrasound is very diagnostic. How do you diagnose it as chronic renal failure in an acute case without all the test results in and its a sudden event?

My questions for the owner:

  Did they start treatment for a kidney infection?

Bacteria from the bladder can travel up to the kidneys and cause problems with function until the infection is treated and resolved.  Experts at Tufts told us kidney infections are very difficult to get out of the kidneys.  They have too many nooks and crannies. Starting an antibiotic asap will not hurt your cat and is very low cost. We also have personal experience with cultures coming back negative when infection is present. Our vet has had a positive test in house sent out for a specific culture growth and had it come back negative. We know the infection was present these tests are not the final word. Remember this.

  Does her scruff "tent"?

What this means is when you lift up the scruff of the neck and let go does it snap right back or stay up sort of like a tent. Tenting of the scruff indicates dehydration. Did they recommended or give subcutaneous fluids? If the kidney blood work shows creatine values are elevated the sub-q fluid would help.  Phosphate binders are used to lower high phosphorous levels. B vitamins in the fluid will help her feel better too. If the values are really high she needs to go on IV fluids to help her kidneys recover.  

She responded no. Her biggest concern was that Sasha was not eating and had lost a lot of weight.  

Not eating in a cat can lead to unrelated complications with the liver. It’s really important to get them to eat anything you can. When a cat won’t eat I find “Fancy Feast Elegant Medleys - Shredded White Meat Chicken Fare in a savory broth  with garden greens" works like a charm. “Fast food” is better than no food. There is an appetite stimulant medication that works well if needed to prevent fatty liver syndrome.

  Who is your Vet and may we have copies of the test results for our Vet to review?  

My doctor knows my cats and lines. My owners can tell their Vet I’m the cats breeder and I look into health issues that come up in the lines I breed. They shouldn't feel offended. I'm willing to provide my kitten owners with a second veterinary opinion.

  Have you had any plants or flowers in the house?

Lilies are particularly toxic to cats. Even a bit of pollen from brushing against them or on your fingers when licked can be toxic. There are many other flowers and plants on the toxic lists. Your cat may only spit up a little after chewing on one.

Would you allow your cat to nibble these house plants?

yellow flowered

white flowered

Pink flowered

white flowered

 These "Shamrock" plants from the grocery or home stores are all Oxalis, a bulb that looks like a clover leaf. It is toxic.  Oxalic acid in the plant combines in the kidneys with calcium to form calcium oxalate crystals. This is the same crystal damage anti-freeze does. ASPCA toxic plant list - Cornell's toxic plant list - CFA's toxic plant list You may notice that some of the plants on these lists are not on all three. If you have any plants or flowers in the house make sure they are safe from more then one source.

Cats lick, chew on, and eat all kinds of things that get processed through the kidneys.
Other common toxins in the home: 

Anti-freeze –snow melt and broken snow globes can contain antifreeze. A small amount will kill a cat if not treated immediately. You may have heard we now have laws that anti-freeze must have bitter taste added to it. This only applies to packed goods for consumers in many states. If you have your car serviced professionally they are not required to have the bitter additive. Keep your cat out of the garage and be careful what you step in. 

Household products and cleaning products are full of chemicals and we use so many of them everyday. What do you mop your floors with, clean sinks with, scrub tubs and showers with? Is there laundry product residue around your washer? Do you use hand sanitizers? Kitty licks your hand and ingests the residue. Do you use a cleaning or antibacterial spray on your kitchen counters? Window cleaner on mirrors and windows? Medications too, even over the counter. Have you ever accidentally dropped a pill that went unfound? Most human medications are not harmless to cats.

Garden and lawn treatments / fertilizers can be toxic. Pest control products are poison. This includes rodenticides and well as pesticides, Ever put out one of the nice little ant baits to keep those tiny pests out of your kitchen? Ants carry the poison around with them and leave traces of it. Sweet poison syrups that ants carry back to the nest leave tracks on your homes surfaces. Even if you never use these a neighbor may. A mouse can chow down at the neighbors and run next door to your home where your cat catches it entering your home. Ants too can travel far with a bit of poison food they have found. Apartment and condo dwellers may be at higher risk because of the close proximity of neighbors.

Not everything you eat is good for pets either. Products with sweeteners are deadly. Onions and garlic cause Heinz Body Anemia in cats. Some baby food meats have onion and garlic powder in them. There are more human foods that will make cats sick but that's a whole different subject.

Then there is the pet food controversy, do we really know what is in our commercial pet foods? We were only told about the 2007 melamine after hundreds of pets died. How may ingredient mistakes go unreported? If your cat(s) throws up after you open a new bag of food, no hairball, set it aside and feed something else. Buying a premium cat food from a pet store is very important. Grocery and discount store brands, even with well known names, are not the same as their premium versions. This is the FDA petfood recall list. Click on the brand you feed and bookmark the page for ease in checking for any new recalls.

 A tiny bit of any of the above toxins can damage the kidneys and you may not notice. Over time the damage builds, its accumulative, and function decreases. A cat will lose 70% of its kidney function before it becomes symptomatic. 

There is a new concern being discussed on the web that vaccinations may play a part in some cats developing CRF. While there are no definitive completed studies ongoing research does suggest that there may be a correlation between the FVRCP vaccine and chronic renal failure in cats and  distemper vaccines in dogs. Dr. Jean Hofve, DVM states " The common feline distemper (panleukopenia) virus is grown in a culture of feline kidney cells. Recent work at Colorado State University showed that most kittens developed autoantibodies to their own kidney tissues after being vaccinated for distemper. When autoantibodies react with body tissue, the result is inflammation. Each booster vaccine creates even more antibodies—and more inflammation. Chronic low-grade inflammation is the primary cause of CRF" read more on this subject at 

Information on Dr. Lappin’sresearch on the effect on feline kidneys of vaccines developed using kidney cells.

Wednesday 9/29/2010, Sasha's test results were faxed to my vet. The owner's vet also asked for Sasha to come in to begin sub-q fluids. Her owner came home with a sub-q set up to give fluids at home and an appetite stimulant. She was also told to give half a Pepcid for stomach acid. Her owner reported that as soon as they were home from the Vet Sasha had perked up, was more active, eating, and using the litter box. Her Vet said that the urine culture was not growing anything so it looked like there was no bacterial cause. 

Monday 10/4/2010, the ultrasound showed normal kidneys and no congenital abnormalities. Her vet said Sasha's kidneys did not look like a cat that had CRF. They were now thinking maybe it was an infection that didn't show up in the bladder. They started Clavamox antibiotics. This is seven days after we asked if their vet put her on an antibiotic.

Friday 10/8/2010, Sasha's owner had to convince her vet to test kidney levels again. He really wanted to push off retesting levels for another week or two. They will finish up sub-q fluids in the next few days. 10/9 the kidney panel was NORMAL, liver levels not elevated. She will finish the first round of antibiotics and do a second round  of antibiotics to be sure the bacteria is gone. They will  retest kidney levels in 2 weeks. Their Vet was surprised at the results. He really didn’t believe there would be any improvement.

Tuesday 10/26/2010, Sasha’s follow up Vet visit and kidney panel are still normal. Sasha's owner said basically their Vet is scratching his head in disbelief at her recovery.

Sasha’s owner told me she was afraid to contact me initially. Thank goodness she did.  If you own one of our kittens, Please don’t be afraid to ask for advice or help. Working in conjunction with my Vet we were able to offer some treatment suggestions and family support that saved Sasha life.  Despite her vet’s disbelief Sasha’s owner pushed for what was needed and they worked together to help Sasha fight her kidney crisis. Sasha is a happy healthy cat because she got the treatment she needed in time.

  The Case of Tiggy 

Berry is one of our kittens she lives with a dear friend of mine. Tiggy is her domestic shorthair companion that was born of a feral mom in their garage. Tiggy went through something very similar to what Sasha went through with the exception that her owner was well informed and so was her vet. Her owner is a former Vet Tech and show dog breeder. She grew up helping her uncle who was a country vet. When she noticed Tiggy was not feeling well she got her right in to see the vet.  This is her telling of the events. 

Sept. 21st 2011,  Tiggy had been sick to her stomach /vomiting since the 20th. (yes only a day, but she looked unwell to me).  I had Keith take her to the vet on the 21st and at that time he gave her an injection of antibiotics plus he sent home with Baytril tablets [antibiotic]. He also gave her a dose of Drontal [de-wormer].  She was NOT running a fever. Temp was normal at this time. Told us to see how it went and if not better, bring her back up and we would start blood work and dig a little further.

The next 2 days she went downhill. Lethargic, listless, not eating and not drinking much. I called and took her back up. 

Sept 23rd 2011, We took her up and he ran blood work. At this time she was running a fever. He said he was almost happy to see that...meant her body was fighting. He did a feline leukemia test and FIV lab VS Comprehensive Chem/CBC. She was absolutely a limp kitty. No fight in her at all. The blood work showed that her kidney functions were off, the rest of the blood work was ok. Seems like the glucose was a little bit elevated also. He said he still felt it was a kidney infection and was good with the meds he had put her on. He said he was going to confer with the other vet and get his opinion and call me the next day. Which he did...the other vet thought kidney function was the problem and My Doc continued to go with his belief that it was kidney infection and would clear. 

Sept 24th 2011, At that time he asked me if I had been able to get her to eat or drink. Nothing to eat and not drinking much. He asked me if I wanted to IV her and I said YES! quickly. She laid there and let him IV her and he told me that he would rather she come home with us and stay with us than to put her in the hospital. We brought her home and she went right from the cat carrier to going to the dish for food!  I was in shock...I had been trying EVERY thing to get her tempted to eat. She didn't eat a lot but wow, that was wonderful! She just gradually improved and got stronger and better.  

I took her back on Sept 26th, 2011 for a recheck and he gave me another round of Baytril tablets and was amazed at how well she looked. She even tried to run from him when he went to check her temp :)  We all laughed...he said she is a good kitty and THAT is more what I expect to see! Then he told us how worried he had been about her and really wasn't sure if she would make it or not, she had been so sick.

She has been fine since.....

Tiggy's owner really believed Tiggy would not make it through her ARF kidney crisis but they helped her fight.  They didn’t wait for test results they started her on an antibiotic immediately. She was given intravenous fluids.  The kidney panel numbers were bad but  Tiggy held on and she improved. Because she was given prompt aggressive treatment she is a normal happy cat today. She was not a CRF cat despite those elevated numbers in her kidney panel. Her follow up kidney panel shows her kidneys are functioning normally.

Both of Sasha’s and Tiggy’s cases show that bacteria can get into the kidney and not show up on tests or cultures.

With infection or toxins if treatment begins immediately there is a reasonable chance a cat can recover. However, the more time that passes before treatment starts, the less likely it is a cat will escape permanent kidney damage or complete kidney failure.

If your cats become symptomatic of reduced kidney function, you can help. One of the best quotes I read on the felinecrf website was “Treat the cat, not the blood work”
     • At the very least support their body systems with sub-q fluids, or iv fluids if the cat is critical
     • Give antibiotics. 
     • If necessary discuss the use of an appetite stimulant. 
The items above are low cost treatments well worth the time they will buy your cat while testing is done. 
     • Urine tests – culture and sensitivity, specific gravity, protein creatinine levels, to see how well the kidneys are functioning
     • Blood work - Kidney panel and if the levels are elevated...
     • Ultrasound of the kidneys is very diagnostic – until recently this was the only reliable way to determine PKD in cats. UCDavis genetic lab can now identify the mutated gene that causes PKD.
Quick treatment may even prevent permanent kidney damage. Kidney disease is not painful for your cat, cats feel much like people who are on kidney dialysis feel. There is no reason to rush to euthanasia unless it has been proven they have been poisoned and are in pain because of the effect of the poison.

You are your cat's best advocate. You will never truly know how informed your Vet is until you experience a crisis, and at that point you will receive crash course in veterinary diagnostics. It’s not much different than diagnostic medicine on human patients, except that feline patients can’t tell a vet any information about what they licked, ate, or were exposed to. You end up with educated guesses and "lets try this".
Not all cats will display all the same symptoms, many will hide they are sick from their owners until it is too late. As the kidney's function decreases, toxic waste levels in the blood will increase, making a cat feel sick and tired. It may lose interest in its normal activities, like playing. 

They do not have to display all of these symptoms, just one or two can clue you in to a problem before it goes too far to resolve.
Some symptoms of kidney issues are:

  • increased water consumption 
  • increased urination. 
  • going outside their litter box 
  • decreased water consumption 
  • decreased urination.
  • dehydration
  • apathetic behavior
  • lethargy
  • loss of appetite or not eating
  • weight loss 
  • vomiting
  • diarrhea

We lost our Maeve to kidney disease, and her  CRF was not genetic in origin. It was a result of life events, including  two septic infections and the ingestion of toxic, melamine tainted food. Maeve had  multiple kidney ultrasounds, and a necropsy, which included two kidney biopsies.  Details can be found on her necropsy page and in her Fall 2006 litter diary (first systemic infection), and her Pyometra (and kidney infection) page.

We also were informed that Pinky of Maeve’s first litter died of ARF. We were told her vet advised she be euthanized immediately because of the pain she was in.  A sudden crash with pain is indicative of toxic event.

Update: I want to add one more case to this page that we just learned about. Deb's boy is a big Siamese weighing over 11 pounds. He's a bit on the oral side and likes checking things out and playing with things using his mouth, he's a licker. Deb wrote to me Jan. 2013; "He opened the door to the cellar recently, and I naturally thought that he had eaten something that would pass through his system quickly.  He started losing weight rapidly and his skin felt tight-fur didn't look as smooth and shiny as usual, he started vomiting and stopped eating.  I took him in to the hospital, they did blood work and found that he was in renal failure.  His creatine levels were so off of the chart that they were unrecognizable.  He is on 2 different antibiotics, fluids, and an anti-nausea med." She was afraid by assuming what he ate wouldn't hurt him that she allowed this to go untreated too long. She took his sister to see him in the hospital. They ran a kidney panel on her and she is normal.  With each day he improved a little until he was eating again and could go home. His BUN and CREA are still high and his Potassium is low.  He continues to receive sub-q fluids with Potassium at home. She said he passed a large "wad" of red raffia that he must have eaten before Christmas...without her knowing. All the research I have done online says Raffia Palm is not toxic but what else was it treated with? We know it contained red dye. I believe most raffia originates from Africa where it is died in the sun and boiled to artificially color it. We really don't know what caused his kidney damage but ingesting foreign substances is a leading cause. I doubt I would have done anything different in this circumstance.

To my kitten owners,  We can't help you if we're not informed.      



The information on this page is provided to help inform and provide a starting place for discussion between you and your vet. You should trust and follow your licensed veterinarian’s advice.

Please keep in mind this is an opinion piece written by a lifelong cat owner and experienced (~10 yrs) cat breeder, I am not a veterinarian. I have no formal training. I’m merely sharing information that I have learned during my years of dealing with many of cats. While we believe the information contained in this page is reliable, it is possible that some of the information may be out-of-date, incomplete or inaccurate, and therefore we assume no responsibility for results.


All images, text, and all other contents of this site are protected by copyright law.
The contents of this site may not be reproduced, distributed, exhibited, published, or used in any form, in whole or in part, without prior written permission from the copyright holder.

All images, and text copyright © Black&Tan, 2013 | All Rights Reserved