- Rizwan F, Yesmine S, Banu SG, Chowdhury IA, Hasan R, Chatterjee TK. Renoprotective effects of stevia (Stevia rebaudiana Bertoni), amlodipine, valsartan, and losartan in gentamycin-induced nephrotoxicity in the rat model: Biochemical, hematological and histological approaches. Toxicol Rep. 2019 Jul 11;6:683-691. doi: 10.1016/j.toxrep.2019.07.003. PMID: 31372346; PMCID: PMC6656923.
Management of CKD – A multifaceted approach
According to the IRIS guidelines, depending on the stage of the disease and the findings during the diagnostic process, individualised management will be carried out.
It is fundamental to bear in mind that there are main strategies like early intervention, progression monitoring, dietary management, symptomatic relief and client education that can provide comprehensive and individualised care for feline patients at different stages, aiming to optimise their well-being and extend their quality of life.
Phosphate binders: managing hyperphosphatemia
Serum phosphorus levels, when elevated, can contribute to the progression of CKD and the manifestation of associated clinical signs.
Phosphate binders, crucial in managing hyperphosphatemia, operate by binding to dietary phosphorus within the gastrointestinal tract and impeding its absorption. These binders contribute to the overall regulation of mineral balance, addressing a key component of CKD management.
The incorporation of phosphate binders into therapeutic regimens underscores the comprehensive nature of CKD management, aiming not only to address impaired renal function but also to tackle the intricate biochemical imbalances contributing to the disease progression.
Controlling blood pressure
Hypertension management is multifaceted, involving pharmacological interventions tailored to individual patient needs (Acierno et al, 2018) Vigilant and regular blood pressure control contribute to overall kidney health.
The incorporation of antihypertensives (e.g. calcium channel blockers like amlodipine) into the therapeutic arsenal for feline CKD, exemplifies a multifaceted approach. Beyond their primary role in blood pressure management, these medications exhibit renoprotective properties (Rizwan et al, 2019), contributing to an integrated strategy aimed at preserving renal function and improving the overall QoL for feline patients with CKD.
Symptomatic management: Enhancing quality-of-life
CKD in cats is often accompanied by a spectrum of symptoms that can significantly impact their well-being, such as anaemia, constipation, nausea and vomiting, among others. Symptomatic management is a crucial aspect, focusing on targeted interventions to alleviate specific manifestations and enhance the overall QoL for feline patients.
Advanced therapeutic options: Kidney transplants
In advanced cases, kidney transplants emerge as a viable treatment option, which can lead to significant improvement in QoL and an extension of lifespan. Success rates for kidney transplants can vary (Bernsteen et al, 2000 & Viernes et al, 2023) and they are influenced by factors such as donor compatibility and the overall health of the recipient. Veterinary collaboration and informed decision-making are key elements in navigating these advanced treatment avenues for the benefit of our feline companions.
In conclusion, effectively managing CKD in cats necessitates a holistic and proactive approach from veterinarians. Beyond precise diagnostics and tailored therapies, the pillars of feline healthcare lie in routine check-ups for early detection, adherence to IRIS guidelines for accurate staging, and transparent communication with cat owners. By proactively identifying subtle signs, utilising staging guidelines, and involving owners in the process, veterinarians not only enhance the lives of feline patients but also exemplify a commitment to advancing feline healthcare.
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