Cures for Cats: New Research Offers Hope for Cats With Kidney Diseas

If there is one thing we know about kidney disease in cats, it is that we need to know much more.

Chronic Kidney Disease (CKD) is extraordinarily common, particularly in older cats. Roughly, at least, 30 to 50 percent of cats over age 10 may be affected, according to estimates cited by NC State College of Veterinary Medicine, and the percentage rises in geriatric cats. Cornell’s Feline Health Center estimates that CKD affects up to 40 percent of cats over age 10 and 80 percent of cats over 15. Yet veterinarians often diagnose it only after substantial, irreversible kidney damage has occurred. We know how to manage some of the consequences of CKD, but we still don’t understand why so many cats develop it—or how to stop the disease before it becomes established.

That is precisely why research matters. EveryCat Health Foundation’s Cures4Cats campaign and Kidney Disease Fund supports research aimed at answering those unanswered questions. The Cures4Cats campaign conceived by feline veterinarian and a past President of EveryCat Dr. Vicki Thayer, this year supports research into kidney disease.

CKD, Progress

And there is encouraging evidence that research is beginning to produce answers.

A particularly intriguing development is research involving AIM—Apoptosis Inhibitor of Macrophages. A new clinical study from Japanese researchers found that cats with advanced CKD receiving recombinant AIM survived significantly longer than untreated cats. About 80 percent of treated cats were alive one year later, compared with about 20 percent of untreated controls. The study was small, involving 35 cats, and the treatment is not yet proven. But it represents something potentially important: an attempt to address an underlying mechanism of kidney disease rather than simply manage its consequences. The recent research and what it could mean for cats offers more detail.

Another advance is the possibility of identifying cats at risk before they become sick. A genetic test developed by researchers at Washington State University looks for a variation associated with the function of AIM and progressive CKD. If further validated, such testing could eventually allow veterinarians to identify cats genetically predisposed to kidney disease years before clinical signs appear. That potential early-warning test illustrates why early detection may ultimately be as important as better treatment.

EveryCat-funded research is also looking for biomarkers that can identify kidney damage earlier—before conventional tests show significant loss of kidney function. Researchers are examining blood and urine for molecular signals that could eventually allow veterinarians to detect CKD sooner, identify its causes and monitor whether treatments are working.

Another current EveryCat project is investigating extracellular vesicles and non-coding RNA, tiny biological packages that may contain clues about the earliest stages of kidney disease. Researchers hope to identify molecular changes that appear as CKD begins.

And researchers are looking in some unexpected places. A preliminary study noted by the Purina Institute found distinct chemical changes in the cat feces with CKD, including an increase in a compound called 2PY that appeared in the earliest stages of disease. The findings add to growing evidence of a “gut-kidney axis”—a relationship between the intestinal microbiome and kidney function. The research is preliminary and has not yet been peer-reviewed, but the study and what researchers found in the litter box point toward another possible avenue for earlier detection and treatment.

Those studies address one of the great challenges of feline nephrology: conventional tests largely tell us how well the kidneys are functioning, not necessarily when the damage began.

We do have better tools than we once did. SDMA (Symmetric Dimethylarginine) in cats is a sensitive blood biomarker used to detect declining kidney function., along with creatinine and urine testing, can help veterinarians identify reduced kidney function earlier and stage the disease more accurately. The International Renal Interest Society (IRIS) continues to update its guidelines for diagnosing and managing CKD.

Treatments Options

There is currently no treatment that reliably reverses established chronic kidney disease in cats. Special renal diets, appropriate hydration, blood-pressure control, management of phosphorus and other therapies can help many cats live longer and feel better. The challenge is determining which interventions are most appropriate for an individual cat and at what stage they should begin.

There is also growing interest in the biology of the kidney itself, including why some cats deteriorate rapidly while others remain stable for years. Researchers are investigating genetic factors, inflammation, oxidative stress, blood flow, nutrition and interactions among different organ systems.

That is the larger story of feline kidney disease: We know a lot about what happens when kidneys fail. We know considerably less about why they fail in the first place. That gap is why funding research is so important.

EveryCat Health Foundation is the only nonprofit foundation focused exclusively on feline health research, and its grants support studies ranging from disease identification and diagnostics to treatment and nutrition. Feline health research remains comparatively underfunded, making private philanthropy particularly important.

The Cures4Cats campaign isn’t simply about helping cats with kidney disease today. It is about funding the science that could change what veterinarians are able to do tomorrow. What we don’t yet know is how to prevent it, detect it at its very beginning, stop its progression—and ultimately cure it.