Stages of Feline Chronic Kidney Disease

Chronic kidney disease is staged depending on the severity. This is estimated based on the level of waste products in the blood and abnormalities in the urine.

The International Renal Interest Society (IRIS) developed a method to gauge the severity of the disease in four stages. Stage 1 is the least severe and Stage 4 is the most severe. Staging the disease is useful for treatment, monitoring and management of the disease.

Early stage kidney insufficiency

As you might guess, once a cat is in stage I of chronic kidney disease (CKD), kidney function is no longer at 100%. It might still be at 99%, but it can drop to as low as 33% (in other words 67% loss of kidney function).

Although there’s a lot you can do for your cat if he or she is in stage I of CKD, you probably won’t even realize that you should because seeing the signs during this time is rare. Tests are usually required to diagnose CKD this early, but testing cats that look healthy is not common practice.

late stage kidney insufficiency

At stage II, cats have about 25% to 32% of kidney function left (in other words up to 75% of kidney function could have been lost already). The kidneys are still able to perform their roles, but the performance is not optimal. They specifically struggle to conserve water and electrolytes such as sodium, potassium and chloride.

Cats in stage II of CKD will typically experience increased thirst and therefore need to drink more water. They will also produce more urine and urinate more frequently. They may even urinate in inappropriate places. A reduction in appetite, weight and energy levels may become apparent in this stage or otherwise in stage III. Once you’ve told your veterinarian about the symptoms, he or she can test creatinine and electrolyte levels as well as blood pressure to confirm or rule out CKD.

Early kidney failure

During stage III, cats can lose up to 85% of kidney function. Now, the dangers are very real and without proper treatment the inevitable will happen much sooner. The same tests that can help diagnose CKD in stage II can be used once more and by now the creatinine and electrolyte levels will be even more alarming.

The same signs that may have already surfaced in stage II may become more severe, but other things can start to happen as well. In stage III, a cat’s coat may seem worse for wear. Bladder infections, nausea and vomiting are also not uncommon.

If a treatment plan has not already been designed and implemented, it should be prioritized immediately.

end stage kidney failure

The amount of protein passed in urine and the presence of elevated blood pressure are also factored into the staging process. 

Symptoms in a cat with stage IV CKD cannot be missed. More than 85% of kidney function has been lost and the irreversible damage is at its peak. Cats that have reached stage IV don’t have much longer to live, perhaps not even a year.

By now, additional symptoms can include dark urine, diarrhea, bloating, lethargy, mouth sores, bad breath and anemia. Quality of life has greatly declined in stage IV.

Managing the disease may not be as effective anymore and supportive treatment may not be enough. You need to make a decision about your cat’s condition and how long he or she can endure it.

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