In: Bistner SJ, Ford RB, and Raffe MR philadelphia, PA: W.B. Saunders Company; 2000

Caney Smidlothian: Cat Professional Publication; 2008

Carney HC, Little S, Brownlee-Tomasso D, Harvey AM, Mattox E, Robertson S AAFP and ISFM feline-friendly nursing care guidelines. J Feline Med Surg. 2012; 14:(5)337-49

Cooper E Hospital Leads Breakthrough in Dialysis for Cats and Dogs. VN Times. 2013;

DiBartola SP, 3rd edn. St. Louis: Saunders Elsevier; 2006

Diehl SH, Seshadri R Use of continuous renal replacement therapy for treatment of dogs and cats with acute or acute-on-chronic renal failure: 33 cases (2002-2006). J Vet Emerg Crit Care. 2008; 18:(4)370-82

BSAVA Manual of Small Animal Cardiorespiratory Medicine and Surgery. In: Fuentes VL, Swift S UK: British Small Animal Veterinary Association; 1998

Jack CM, Watson PMIowa: Blackwell Publishing; 2008

Lee Y-J, Chan JPW, Hsu W-L, Lin K-W, Chang C-C Prognostic factors and a prognostic index for cats with acute kidney injury. J Vet Intern Med. 2012; 26:(3)500-5

Mazzaferro ELondon: Manson Publishing; 2013

Michell AR, Bywater RJ, Clarke KW, Hall LW, Waterman AEOxford: Blackwell Scientific Publications; 1989

Monaghan K, Nolan B, Labato M Feline acute kidney injury: 2. Approach to diagnosis, treatment and prognosis. J Feline Med Surg. 2012; 14:(11)785-93

Pittari J, RodaN I, Beekman G American Association of Feline Practitioners: Senior Care Guidelines. J Feline Med Surg. 2009; 11:763-78

Schaer M Clinical Medicine of the Cat and Dog.London: Manson Publishing; 2003

Understanding and nursing acute kidney injury: a patient care report

02 May 2014
12 mins read
Volume 5 · Issue 4


An otherwise healthy cat suddenly presents with renal failure. Based on clinical examination and biochemistry/haematology results, a diagnosis of acute renal injury is reached. A discussion of this condition and its treatment follows, with a focus on nursing considerations.

An unvaccinated, indoor-outdoor, 9-year-old male neutered Oriental cat presented with a 2 day history of lethargy, anorexia and vomiting. On examination the normally bright and vocal cat was dull and unresponsive. Body condition score was normal at 6/9. Mucous membranes were tacky, and oral lesions were observed in addition to halitosis. On auscultation the patient was bradycardic with a heart rate of 128 beats per minute (bmp) (normal range 110–220, Jack and Watson, 2008), but pulses were matching. Systolic blood pressure was recorded initially by indirect Doppler measurement (CAT Doppler, Thanes Medical) and found to be 130 mmHg (reference range: 120–170 mmHg, Jack and Watson, 2008). On abdominal palpation the anterior abdomen was tender and his bladder empty. Rectal temperature was slightly low at 37.0°C (normal range 38.0–39.0, Jack and Watson, 2008). Blood tests were collected for full haemotology and biochemistry with electrolytes and a 24G intravenous (IV) canula was placed in the cephalic vein immediately. IV fluid therapy (Hartmanns, Aqupharm, animalcare) was started at twice maintenance. In-house blood results indicated severe hyperkalaemia and azotaemia (Table 1), as well as a stress leucogram (neutrophilia with lymphopenia); IV fluid therapy was changed to 0.9% saline. The owner knew of no possible toxin exposure and did not report any other significant events such as trauma or recent illness. The patient had last been seen at the hospital 2 years previously for pre-anaesthetic blood tests (all normal) and dental treatment including extractions. The blood results along with clinical signs and history suggested acute kidney injury (AKI), although other possible differential diagnoses included acute decompensation of pre-existing kidney disease (acute-on-chronic), ruptured bladder or (very rarely in cats) hypoadrenocorticism (DiBartola, 2006). To rule out Addison's disease an adrenocorticotropic hormone (ACTH) test was performed once the patient was stable; the results subsequently came back normal.

Register now to continue reading

Thank you for visiting The Veterinary Nurse and reading some of our peer-reviewed content for veterinary professionals. To continue reading this article, please register today.