Today's Veterinary Practice

SEP-OCT 2018

Today's Veterinary Practice provides comprehensive information to keep every small animal practitioner up to date on companion animal medicine and surgery as well as practice building and management.

Issue link: https://todaysveterinarypractice.epubxp.com/i/1015043

Contents of this Issue

Navigation

Page 10 of 79

todaysveterinarypractice.com SEPTEMBER/OCTOBER 2018 9 ESSENTIALS ESSENTIALS Chronic kidney disease (CKD) is one of the most commonly diagnosed conditions in older cats. A 1992 study of 2228 cats found 31% of cats older than 10 years to be affected 1 ; a smaller and more recent study of a random cohort of cats found incidence to be 50%. 2 New testing options may help you diagnose and intervene earlier in the disease process, but to ensure timely and appropriate intervention, you should base any diagnosis of CKD on a combination of those screening and confirmatory procedures. This article provides an overview of those diagnostic procedures; a follow-up article will focus on the nutritional management of cats with CKD. CKD SCREENING TESTS Because CKD is a common disease for older cats and can progress quietly for years before overt clinical signs are noted, annual screening of healthy cats should begin when they are approximately 5 to 6 years of age. This screening enables you to establish a baseline against which changes can be monitored over time. Components of CKD screening include a physical examination, blood testing, and urinalysis. Physical examination. A physical examination is an essential and cost-effective component of CKD screening and can point to possible kidney impairment. Specific elements of the examination should include ■ Body and muscle condition scoring. It is very important to monitor all aspects of body composition, including body condition score and muscle condition score. (Charts of these scoring systems are available as PDF downloads with the online version of this article.) Gradual, unintentional weight loss and muscle wasting can be signs of early disease. A recent study indicated that weight loss in cats can occur 1 to 3 years before kidney disease is diagnosed. 3 ■ Kidney palpation. Palpation can determine if kidneys are symmetrical and if they are enlarged or smaller than expected. Enlarged kidneys can be caused by ureteral obstruction, cystic changes, or infiltrative disease; abnormally small kidneys can be suggestive of CKD. ■ Fundic exam. Hypertension is commonly associated with CKD in cats, 4 and signs of hypertension may be evident before other signs of CKD are noted. Ocular changes, including retinal edema, intraretinal hemorrhage, tortuous vessels, detached retinas, and dilated pupils that are unresponsive to light, may be signs of hypertension caused by kidney disease. In an ideal world, blood pressure screening would be part of any routine examination; however, detection of ocular changes should prompt the measurement of systolic blood pressure if it was not part of the routine examination. Chronic Kidney Disease Screening and Confirmation Testing in Cats Valerie J. Parker, DVM, DACVIM, DACVN Associate Professor, Dept. of Veterinary Clinical Sciences, The Ohio State University NUTRITION shutterstock.com/Patrick Lienin

Articles in this issue

Links on this page

Archives of this issue

view archives of Today's Veterinary Practice - SEP-OCT 2018