Supporting quality of life in feline patients with chronic kidney disease
Chronic kidney disease (CKD) is a progressive terminal disease that is commonly seen in cats in small animal veterinary practices. Veterinary nurses will be involved in caring for these patients during the diagnostic and treatment phases including providing end-of-life care when symptoms increase and the patient either dies a natural death or is euthanased. Palliative or hospice care will be provided by owners in the home environment. Veterinary nurses have a role in supporting owners to deliver high quality care to their pet and when making difficult decisions about their pet's death.
Chronic kidney disease (CKD) is defined as a progressive and irreversible loss of renal function over a period of 3 months or longer (Polzin, 2011). Marino et al (2014) established that 50% of 86 randomly selected cats, recruited from a veterinary practice, showed signs of CKD. This is considerably higher than the 30% incidence level previously reported in the literature (Lulich et al, 1992). The difficulty in detecting early stages of kidney disorder may mean that the actual percentage is much higher within the feline population.
CKD may be influenced by genetic, individual and environmental factors (Jepson, 2016). Decline in kidney function is considered normal in ageing animals (Polzin, 2011), however incidences of CKD in much younger patients indicates that age is not the only influencing factor. One suggested theory is that following an initial insult to the kidney, resulting in nephron damage, the kidneys try to compensate for the loss of function, resulting in further damage and nephron loss (Finco et al, 1999).