ArcaMax

Chronic Kidney Disease (CKD) may be the most common illness of aging cats. If cats live long enough, at least one in three will at suffer from CKD. What's more, according the Banfield Pet Hospital State of Pet Health 2012 Report, the disease is on the rise in cats, increasing 15 percent from 2007 to 2011.

"I have no doubt that many cats go undiagnosed, and suffer without their owners having any idea," Dr. Kate Pietsch, of Dartmouth, MA, adds.

Supporting Dr. Pietsch's notion, the same Banfield survey demonstrated that at least three in five cat owners are unaware that diarrhea, vomiting, lethargy and/or weight loss may be associated with the illness.

"By the time I diagnose the disease, the kidneys are seriously compromised," Pietsch notes.

That is, until now,

Kidney disease has traditionally been diagnosed by running blood work and looking for creatinine (when there's kidney damage or kidney disease, and the kidneys are unable to filter waste efficiently, there will likely be a rise in creatinine levels in the blood) and BUN (the blood urea nitrogen level, used to help determine if kidney function is impaired), paired with a urinalysis.

The only problem is that by the time damage is detected, about 75 percent of kidney function is destroyed. The effects are apparent, as the cat is suffering quality of life issues, or will soon be. Making matters worse, these are often elderly cats with other medical issues.

A new sensitive test called Symmetric dimethylarginine or SDMA, now offered with the IDEXX regular blood chemistry panel, determines kidney disease far earlier, while there's only a 40 percent loss of function.

"A cat can live a completely normal life with about 50 percent of kidney function," says Pietsch. "We believe these cats still feel great, while that's not the case for cats diagnosed with a 75 percent loss of function."

Pietsch is among the legion of veterinarians who call the test a "game changer." But now what? That's the big question.

After all, there's still no magic pill -- at least so far -- to stop kidney disease in its tracks. And how do veterinarians treat this early diagnosis? Veterinarians are in the process of figuring that out.

"Still, having this information early is very significant," Pietsch adds.

"Diagnosing CKD earlier allows us to monitor these cats more carefully, and if it's appropriate we can begin to treat them," says Dr. Susan Little, president of the American Association of Feline Practitioners and editor/co-author of "The Cat: Clinical Medicine and Management" (Elsevier/Saunders Publishing, Philadelphia, PA, 2011; $180).

The International Renal Interest Society (IRIS) is incorporating the SDMA test into its staging guidelines and veterinary recommendations. IRIS is led by a board of 15 independent veterinarians from 10 different countries, all with expertise in nephrology. The mission of IRIS is to help veterinary practitioners better diagnose, understand and treat renal disease in cats and dogs.

Little notes that there are various other benefits to early diagnosis. For example, high blood pressure is common among cats with CKD. As in people, high blood is a silent threat, but it takes some effort to read in cats. Knowing a cat has CKD, veterinarians may be more inclined to check the pet's blood pressure.

"Also, hyperthyroid disease and kidney disease tend to go hand-in-hand," says Pietsch. "We have sensitive testing for hyperthyroid disease, but only now for CKD. Noting earlier kidney changes could mean an increased risk of hyperthyroid disease, though we don't know that yet."

When the SDMA test indicates kidney changes, Pietsch suggests "encouraging cats to stay hydrated; encouraging more water can do no harm. Some cats like running water provided by a drinking fountain for cats. Depending on the cat, I may advise a moist food diet (which contains more water than kibble)."

"We're discovering loss of kidney function (determined by SDMA) in lots of middle-aged cats before the cat becomes sick," Pietsch says. "This is extremely important to potentially slow the disease progression and help us monitor kidney loss."

Cats with changes in kidney function or CKD should visit a veterinarian at least twice a year. Without the SDMA test showing kidney changes, most of these cats might not see a vet until they become ill, for whatever the reason. Preventive care matters, and the additional visits not only allow vets to track kidney changes, but also allow veterinarians to find anything from dental disease to a heart murmur.

While dogs don't suffer from CKD as often as cats, the disease is not uncommon in canines. Similarly, the SDMA test offers dogs an earlier diagnosis.

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