Part 3 in our series on senior pets, "Senior Moments" focuses on a disease we commonly see in aging cats and was written by Dr. Amanda Stephenson. Chronic Kidney Disease, or CKD, is estimated to affect 30% of cats over the age of 12 years. 

​How do you know if your cat has kidney disease? Cats are notorious for being able to hide their illnesses.  Often, changes in their normal behaviour are the only clues that they leave for their owner.  For example, suddenly your cat is hiding and is less sociable then normal. Of course, the opposite may be true and a cat who does not normally like to have a lot of physical contact suddenly is vying for your attention.  The abnormal behaviour may be a way that your cat is trying to communicate that they are not well or may even be trying to hide it. Sometimes these changes are very subtle so don't feel bad if you miss them.  Often owners don’t realize that their pet was "off" until they think back on it later. There are more "obvious signs" signs of illness though and hopefully you will be able to pick up on these more readily.

​This is one of the most common symptoms owners report when they come to the vet clinic with their kitty. They will often complain of "accidents" on the floor and full litter boxes as the volume of urine excreted increases.

5. Bad breath and/or a sore mouth-sometimes when owners bring their cats in for an exam they are prepared for the possibility of dental disease but are surprised to hear that kidney disease can share these symptoms as well.  As kidney disease progresses the kidneys begin to struggle to get rid of the toxins in the bloodstream. They build up in the smallest vessels first causing inflammation. Some of the smallest vessels externally are located in the mouth-the gingiva leading to gingivitis which can cause bad breath and dental disease (secondary to the original problem of kidney disease). Another problem often found in the mouth are "sores" or ulcers because of this same situation and they can make it hard for a cat to eat dry food so owners will often report that they will only eat canned food.

​Severe dehydration can also lead to weakness and an owner is often shocked to hear this because their cat is drinking so much.  Unfortunately, the kidneys are not able to "hold on to the water" and they are urinating it out as fast as they are drinking it, resulting in dehydration and dry stool causing constipation as mentioned previously. 

​After reading about all the "obvious" signs of kidney disease I hope that you will tell anyone who feels badly for missing them that they shouldn't. Most of our feline friends are so good at hiding any illness that it is more common to miss the signs then to pick up on them.  It is likely that 75% of kidney function is lost before we can detect it even if a cat is brought to their vet clinic "early". The good news is that we have better medications, diets, and even supplements which can help support the kidneys. Often an animal being treated will have a much better quality of life and for a longer period of time then if they had been left untreated. 

​High blood pressure
Infection-bacterial, viral
Cancer
Ingestion of a toxin
Obstruction caused by a kidney stone
Kidney blockage-urethral obstruction
Hereditary

 The main difference between the two classifications of kidney disease is the timeline in which it occurs...ACUTE cases can be measured in days or weeks while CHRONIC cases are measured usually by months. It is important to a veterinarian because the clues to the cause of the disease can often be found in the duration. For example, infections and toxin exposure usually are cases where a cat is suddenly, violently ill are acute cases. Acute cases of kidney disease have a higher rate of reversal than chronic cases. 

Part 2 in our series on senior pets focuses on Canine Cognitive Disorder, a frustrating and sometimes devastating affliction of our older dogs. 

​She is stiff getting out of bed and stumbles down the hall to grab a drink of water. She’s not quite sure why she got out of bed when it’s still dark out but goes to pee anyway.  Forgets where she is for a moment and cries out " Hey, anyone there?!". She hears John's voice saying "Come back to bed!", then realizes where she is and goes back to bed. Is this John's wife who has dementia or his dog Lucy who has Canine Cognitive Disorder? It could be either!

​When a dog has CCD, they exhibit changes in the brain both structurally and behaviorally. A protein in the brain called beta-amyloid accumulates and causes plaques to form; a process very similar to human dementia and Alzheimer's disease. When these plaques form, they cause cells in the brain to die. This can result in “empty” spaces in the brain which fill with cerebral spinal fluid. So, what does this mean for a dog's behaviour? Symptoms can include loss of memory and some motor function. Often, they will forget training that occurred earlier in life such as house training. It can be comparable to living with a young puppy again. Some dogs will develop incontinence with urine or bowel movements as well. 

​Think of these old dogs as reverting to the puppy stage again. If we change our expectations of them, it can improve life with our senior companions. Be patient with possible “accidents” on the floor and be prepared for getting up in the middle of the night again just like when Rover was a puppy. Also be aware that your senior dog may start to roam if they get disorientated so having Rover close by you is also important. The senses like vision and hearing also may be deteriorating so your doggo may need help getting around, especially at night, and just having someone closer by in general sometimes for reassurance. She may also need you to be next to her when using the stairs.

​ A predictable routine, proper exercise and cognitive stimulation can also help slow the progression of CCD. Exposing dogs to new smells is an excellent way to stimulate their brain as it can allow them to learn more effectively. 

​Dogs with CCD can get disoriented and wander off, eliminate on the floor, and vocalize like puppies would. If we can start to see dogs with CCD as puppies again, I think we would have more patience and understanding as we do with puppies.
So, Lucy's owner John treats her with the understanding he does his wife who has a similar set of behaviours. With knowledge comes understanding and patience which is exactly what Lucy needs right now.