Centre for Evidence-based Veterinary Medicine
   
   
  

Chronic kidney disease in cats

Prioritising treatment uncertainties - chronic kidney disease in owned cats

Picture of a cat

Chronic kidney disease (CKD) is common in older cats and causes weight loss, loss of appetite, vomiting and many other unpleasant clinical signs. We cannot cure CKD, but there are now a number of treatments available that may slow the progression of the disease, reduce the severity of the signs and potentially increase life expectancy.

‘Treatment uncertainties’ occur when questions about treatment cannot be answered by up to date information based on research evidence, so remain unanswered. There still remain many uncertainties about the effects of many of the treatments available for treating cats with CKD.

A recent study that involved a survey of both cat owners and veterinary surgeons was undertaken to identify the questions they have about the treatment of feline CKD. 

The aim of the study was to determine which of the questions regarding CKD are treatment uncertainties e.g. there is not enough or no evidence to answer the question.  We identified 28 unique treatment uncertanties or unanswered questions about feline CKD.  A prioritise list of these questions was then established through a priority setting partnership meeting of both cat owners and vets.  The top 10 most important questions about the treatment of CKD that needs more research are:

    1. What is the single best treatment for cats with Chronic Kidney Disease belonging to clients with a limited budget?
    2. Do the veterinary kidney diets improve the life of cats with Chronic Kidney Disease?
    3. What is the best alternative diet for cats with Chronic Kidney Disease if they won’t eat the veterinary kidney diets?
    4. Do ACE inhibitors (e.g. Fortekor) or angiotensin receptor blockers (e.g. Semintra) improve the life of cats with Chronic Kidney Disease?
    5. Do subcutaneous fluids (fluids under the skin) improve the life of cats with Chronic Kidney Disease?
    6. Do oral phosphate binders (e.g. Renalzin, Epakitin) improve the life of cats with Chronic Kidney Disease?
    7. Are Non-steroidal Anti-inflammatory Drugs (NSAIDs e.g. Metacam) safe to use in cats with Chronic Kidney Disease?
    8. Does vitamin B12 and Anabolic steroids (e.g. Laurabolin) improve the life of cats with Chronic Kidney Disease?
    9. What is the best way of stopping vomiting in cats with Chronic Kidney Disease?
    10. Would stem cell therapy help cats with Chronic Kidney Disease?

This study successfully adapted methodology commonly used in medicine and developed by the James Lind Allianis adapting the methodology commonly used in medicine and developed by the James Lind Alliance (www.lindalliance.org).  The CEVM would like to thank all of the cat owners and vets who participated in this study.

The CEVM in partnership with cat owners and veterinary practitioners are now searching for funding and collaborators to undertake high quality research to answer the prioritised questions and improved the health and welfare of cats with CKD.

Photo of the cat owners and vets who worked together with CEVM to identify research priorities for the treatment of CKD in cats

Team

We would like to acknowledge the support and collaboration of Vet Professionals Ltd and International Cat Care.

For further information, please contact Dr Rachel Dean.

CEVM Newsletter Issue 5, November 2014 pdf file

Centre for Evidence-based Veterinary Medicine

School of Veterinary Medicine and Science
University of Nottingham, Sutton Bonington Campus
Leicestershire, LE12 5RD

Tel: +44 (0) 115 951 6576
Fax: +44 (0) 115 951 6415
Email: CEVM@nottingham.ac.uk