Chronic renal insufficiency - Prevention?

Without a single major cause for renal disease, it is difficult to make any effective recommendations for prevention. Thus far there are no magic diets, no medications, and no supplements that will prevent it that we know of. Not all cats will get chronic renal insufficiency. Recommendations for prevention are based on what we theorize may contribute to development of this disease.

Diet

Acidified diets are commonly fed to cats with lower urinary tract disease. The theory (again, not proven fact) is that they may reduce the absorption of potassium, contributing to low blood potassium levels. Feed newer "restricted pH" diets without acidifiers. These will still prevent crystal formation. Examples of this include Royal Canin Urinary and Medi-Cal Preventive.

Cats should be fed CANNED or fresh food whenever possible, not just after they have been diagnosed with renal insufficiency. Canned foods provide more available water, dilute the urine so that there are fewer opportunities for crystals to precipitate in the bladder, and stops the dehydration-rehydration cycles that occurs in cats fed dry foods. (See "Diet, water, supplements")

Potassium

See "Other treatments"

Teeth

If there is inflammation in the mouth, the door is open for bacteria to enter the bloodstream. Gingivitis, accumulations of tartar, periodontal disease, root abscesses, and fractured teeth can all be points of invasion. If the teeth are in need of cleaning, extractions, or other dental work care must be taken to prevent further infection. By the time problems are noticed in the mouth there may be established kidney infection.

Hypertension

The kidneys help to regulate blood pressure as well as being susceptible to damage cause by high blood pressure. In some ways, high blood pressure is a benefit to CRI cats because it forces more blood through the nephrons and increases filtration. This can actually "hide" the disease for a while. However, the increased pressure damages the nephrons so the benefit of hypertension tends to be short lived, and it eventually causes more rapid deterioration of the kidneys as a unit. Treatment of hypertension is important in decreasing renal damage.

Vaccination

Cats should be vaccinated as little as possible while maintaining adequate immunity for their situation. There will be a great deal of difference in the vaccination recommendations between a completely outdoor cat who is always in fights and a totally indoor cat. Given the theoretical link between vaccination and renal disease, it makes sense to minimize the number of vaccines. Remember, this link is not certain. There is no scientific, published information yet about whether decreasing the number of vaccines does anything to decrease the incidence of renal disease later in life, nor is there proof that vaccination is the cause of renal disease.