Feline Chronic Interstitial Nephritis
By: Dwayne Hubbard, V.N.D.
Kidney disease is a common problem of feline old age and is often cited as the second leading cause of deaths in cats. Chronic interstitial nephritis, a progressive destruction of the tiny blood filtering units of the kidneys, is encountered in cats of all species and is somewhat insidious in nature. It often remains undetected because of the tremendous capacity of the cat’s kidneys to compensate for loss of tissue until deterioration is well advanced. As long as one third of the kidney is still functional, there are usually no obvious signs of sickness. Beyond this point, illness will develop with symptoms of excessive thirst, frequent urination and loss of weight becoming evident. By the time kidney deterioration is diagnosed by clinical test, function is severely limited and the disease is usually well advanced and progressing to eventual failure, with only 25 – 30% of the kidney still functional. Treatment at this stage must be radical and is sometimes time-consuming, especially initially. Having said this, there is still hope for renal failure cases, so don’t give up on your feline until you have read all the facts and options. Elderly cats with kidney failure can be brought from a state of debilitating illness to one of relative normality if appropriate treatment is administered. Although this normality is delicate and treatment may need to be continued for the remainder of the cat’s life, this small 5% improvement can make all the difference. To understand how natural care can both treat and prevent renal failure, it may be useful to take a look at the role of the kidneys in the cat’s body and the causes of renal deterioration. Kidney Function Physiologically, the kidneys are primarily involved in maintaining a constant and healthy internal environment in the body. The kidney is the organ of homeostasis or balance. It serves many functions in your cat’s body. One important kidney function is the regulation of the body’s water content. Its role, above excreting excess fluid, is one of conservation (of water) as much of the fluid that passes through the kidney is reabsorbed. The kidneys are also responsible for separating wastes and poisons in the blood from useful substances. Your feline’s kidneys filter hundreds of liters of blood on a daily basis. The electrolyte balance of the body is also regulated by the kidneys which excrete excess amounts. Another important role is maintaining the acid/alkaline balance of the blood. Finally, the kidneys assist in the production of the hormone rennin which is involved in the regulation of blood pressure. At a holistic level, we see the role of the kidneys as one of regulating and transmuting the both physical and nonphysical energies flowing through the body, removing impurities and recycling only that which is harmonious. We recognize the tremendous amount of work our cats’ kidneys are called upon to perform on a daily basis, in response to both the internal and external environment. The Cause of Feline Kidney Disease There is no single explanation for renal disease. However the majority of nephritic problems are now understood to be autoimmune disorders, which means that the destructive process in the kidney is taking place due to circulating antigens and antibodies. These are thought to develop in response to an external or internal factor affecting the cat’s body. Destruction of the nephron is always preceded by acute inflammation. The trigger that causes the destructive antibody/antigen process could be any one of a number of factors. Low-grade infection, dietary deficiency / excess, environmental or ingested toxins, heredity or nervous stress may be involved. Whatever the cause, with natural medicine, we know that this destructive process can be slowed, halted or even reversed in some cases. We can also prevent the onset of this disease through correct natural care and therapy. Common Early Warning Signs In the early stages of renal disease, there may also be occasional periods of low energy, depression, lack of appetite and nausea or vomiting that lasts a few days at a time. Greasy fur and dandruff are sometimes present. Diarrhea, constipation, dehydration, bad breath, inflammation of the mouth or mouth ulcers may also occur. Later, increased thirst, frequent urination of large quantities of pale or colorless urine and weight loss may be evident. These symptoms can also be associated with other diseases so it is important to seek a full diagnosis from your veterinarian. Further signs which may indicate renal deterioration include your feline drinking water on a daily basis (if not on a dry food diet) and repeated attacks of bladder inflammation. Skin eruptions often precede kidney failure. It is important to note these early signs and to take appropriate therapeutic and preventative action.
Sadly, antibiotics, corticosteroids and pH controlled diets do not slow down kidney disease. They only mask the symptoms.
Prevention 1) Be observant – detect warning signs early and seek professional diagnosis and treatment of the underlying cause. Annual veterinary check-ups are important. 2) Pay attention to your feline’s diet. Avoid feeding dry foods (which contain only 20 – 30% moisture) and foods containing harmful chemical additives and preservatives. These foods increase the work your cat’s kidneys must perform. 3) Feed a pure, natural, raw, whole food diet for your feline at an early age. If your cat is accustomed to eating vegetables and grains when young, it will be much easier to reduce the protein content of the diet as they get older. 4) Create a non-toxic and stress-free environment for your feline friends. Cats are greatly affected by chemicals in the environment such as household sprays, cleaners, pesticides, cigarette smoke etc and absorb these into their bodies through the skin, lungs and paw pads. 5) Ensure that your feline’s friend’s environment is filled with tranquility, harmony and happiness. Felines are also extremely sensitive to environmental and psychic stresses such as noise, chaos, moving house, bullying by other animals, family arguments and other non-supportive emotions. The kidney reflex centre of your feline’s body is the apprehension/anxiety centre of the mind. This centre is associated with the will to live, the fight or flight response and the ability to cope with various life stresses, biochemical, nervous and environmental. Like children, felines easily absorb an atmosphere of anxiety, anger, confusion and depressed feelings and over a long period of time, this can be draining on their health. Always provide your feline friends with their own ‘peaceful haven’ or special part of the house where they can rest, undisturbed and renew their inner strength and vitality. 6) Prepare your felines well in advance for any events which are going to be stressful for them. Communicating with your cat, using flower essences and extra vitamins B and C can help minimize such stressful events as moving house, going to the vet, cattery etc. Treatment The aim of natural medicine in chronic interstitial nephritis is to reduce the load on the kidneys and to strengthen and optimize remaining function through diet, herbal and homoeopathic medicine, nutrients, hydration and mental/emotional healing. In addition to home treatment, I suggest you follow the advice of your veterinarian and holistic animal practitioner. While each feline must be treated as an individual, the following is a précis of natural care. Diet: In renal disease, the diet must be low in protein, phosphorus and sodium, yet the protein must be of high quality. A low residual diet is mandatory (i.e. one which produces as little waste, metabolic and toxic, as possible). Avoid the overuse of beef and organ meats, chemicals and preservatives and replace the diet with lacto-proteins such as eggs, ricotta cheese, chicken, turkey, fish, rabbit and a little lean heart. A suitable diet is low in ash, containing only 24% high quality protein with an abundance of raw, *pureed vegetables and well-cooked pureed grain. enriched white rice, pureed barley flakes (cooked).
NOTE: The Cat’s Meow does not recommend the use of grains and/or vegetables in a carnivores diet. However, if you are going to use them, cooking and/or pureeing does help break down the cellulose and enzymes so they are a little easier for your cat to digest.
The diet must be supplemented with an adequate supply of nutrients, especially the water-soluble vitamins B and C which are quickly lost through frequent drinking and copious urination. The following recipe meets the above requirements, containing about 25% good quality proteins. It supplies adequate amounts of the water-soluble vitamins B complex and C and supplies also vitamin A which is good for the kidneys. The recipe makes a 5 day supply of meals. Feline Kidney Diet 1½ cups of ground or diced meat (raw or very lightly steamed fish, lamb, chicken, turkey, lean heart etc) 4 cups of cooked white rice, or pureed barley flakes 4 organic raw egg yolks 2 tablespoons Omega Pet (combined oils) or Fish Oils 1 cup of pureed raw vegetable such as carrot, zucchini, alfalfa 5,000 i. u. vitamin A (or 2 tsp. Cod Liver oil) from health shop (not required if using Omega Pet oil) 2 tsp. Animate Supplement powder or 4 crushed Orachel Multi-Vitamin tablets 50 mg. B-complex liquid or tablets crushed from health shop Mix all ingredients together in a bowl, including the ground or powdered supplements. Freeze or refrigerate in portions and thaw as needed. Remember to warm gently before serving. To each meal, add ½ tablet/capsule of mixed digestive enzymes, and if required, flavor with a few drops of tamari soy sauce, preservative-free baby food, chicken broth, a teaspoon of tuna (or any other healthful food your cat finds delicious). Once a week, add a 500 I.U. of vitamin E. In addition to the diet, it is important to provide filtered or spring water at all times. You can also offer your feline friend warm chicken or fish broth once or twice a day. This is particularly useful as ‘crisis therapy’ when your cat friend is refusing to eat. Home Made Broth To make a meat or fish broth, take ½ cup minced meat, chicken, turkey or fish. Add 2 cups of pure water and some flavoring (such as a few drops of tamari sauce) and blend well. Add pureed vegetable and a sprinkle of vitamin/mineral powder. Make sure you arm before serving. Home made broth can be stored in the freezer and thawed as needed. If your feline friend is in an advanced stage of kidney disease and is not eating well, the following hints may prove useful: Warm oatmeal or barley porridge with a little yoghurt can supply energy. Green barley powder in the meal is excellent if your cat friend likes it (just a pinch is sufficient). It is nutritious, cleansing and will generally improve appetite. Bee Pollen or pure honey with a little slippery elm powder supplies all the nutrients required to sustain life if your cat friend is weak and will not eat. Feed three or four small meals daily rather than several large ones. Herbal Medicine The aim of herbal medicine is to produce a tonic, demulcent (soothing), antiinflammatory and gentle diuretic effect on kidney tissue. Corn silk, Marshmallow and Clivers are often used in combination. Barberry, Buchu, Pellitory and Parsley are also sometimes used. Alfalfa herb is a general tonic for the kidneys and will improve digestion. Dandelion leaf and root will improve both liver and kidney function. Burdock Root,a powerful alterative and blood purifier can both tonify kidney tissue and detoxify the body of poisons. Although there are very few herbs which have a regenerating effect on renal tissue, both Astragalus and Indian Kidney tea appear promising. Always consult an experienced animal herbalist/holistic practitioner in kidney disease. Felines can only tolerate minute doses of herbal medicines and some herbs useful for humans will have a different effect in feline medicine. Generally, for cats, I find it safer to prepare the herbs in potency or as a tea rather than in tincture form. Clinical Nutrition: Vitamin and mineral therapy for nephritis is also beneficial. The mineral Zinc improves immune function and accelerates healing. Along with Vitamin E, it is a scar tissue preventative. Vitamin B complex, especially B6, is important for both nerve and renal function. Vitamin C is an all-round healer, providing a buffer for stress, reducing inflammation and boosting immunity.As Vitamin C plays an important role in the formation of collagen, it is important in any rebuilding process. Magnesium (which is plentiful in green vegetables and green powders) and Potassium are important nerve nutrients. A feline kidney patient is often susceptible to low potassium levels in the body, so this mineral is frequently included. Micro doses of colloidal, biochemic or homoeopathic tissue salts may also be appropriate. Sodium Sulphate or Sodium Phosphate, Potassium Chloride and Calcium Phosphate are often prescribed. Homoeopathy An experienced animal homoeopath will select the correct constitutional remedy for your feline. Renal failure relates to the tubercular miasm and hence Calc. Phos. may be appropriate. Natrum Mur can help the cat who appears hot, thirsty and prefers to be alone. Sepia is selected for the cat with nausea, vomiting and poor appetite. Pulsatilla is a constitutional remedy for the mild, gentle cat that shows no signs of thirst. Berberis is often used in renal problems which are accompanied by hepatic symptoms. Obviously, in a crisis, you would seek assistance from your veterinarian as soon as possible. However, symptoms of uremia and toxicity may be assisted by a few doses of Carbo Veg and Nux Vomica, until veterinary help is available. Another first aid remedy for uremia, especially where there is restlessness, great distress, thirst or even kidney fits or convulsions is Arsenicum Album. These remedies are all contained in the Natural Animal Help (first aid) Kit. In a crisis situation they may save a life until veterinary help is obtained. Bach Flower Essences Flower essences can relieve distress, release stress, heal emotions and raise the spirits. Select the essences which are appropriate for your individual feline friend. I find that Scleranthus is a good general ‘renal’ tonic. Many cats respond well to Water Violet which releases inner tension. Hornbeam gives strength and Olive is useful where there is exhaustion. Wild Rose can boost immunity and stimulate healing. Gorse will often increase enthusiasm for life and food and ease depression. Aspen helps where there are vague fears Crab Apple will encourage physical and emotional detoxification. An individual flower essence combination can be prepared for your cat by any naturopath or health store. These remedies are totally safe and benevolent with no side-effects. Crisis Care In renal disease, a crisis occurs when the kidney is no longer able to effectively filter the by-products of metabolism and poisons build up in the bloodstream. At this point, your cat will be feeling very sick and will refuse food. There may also be vomiting as your feline’s body tries to eliminate the poisons. An inability to regulate fluids may cause dehydration and constipation. The first aid remedies may be useful in a crisis situation, but at this stage, your cat needs to get to your veterinary hospital promptly. Your vet will use I.V. fluids to hydrate your cat and restore some form of normality. Once your cat returns home, with the danger period over, you can implement the new diet and additional therapy with the assistance of a holistic veterinarian or naturopathic animal practitioner. In addition to flower essences, herbal and homoeopathic care, subcutaneous hydration can be easily learned and safely given at home, to improve your feline’s condition. Your veterinarian can show you how to do this procedure and can also supply the equipment needed. Subcutaneous Hydration Subcutaneous hydration will alleviate the dehydration that occurs in the later stages of renal disease. Basically, it involves the administration of fluids through the skin. Ilearned of subcutaneous hydration several years ago through Anitra Frazier’s wonderful book, The New Natural Cat. Since then, I have found it invaluable advice to pass on to guardians of cats with renal problems. It is a simple home therapy procedure that can, says Anitra, “add weeks, months and often years to a cat’s life. Nothing will so dramatically improve the health, comfort and well-being of a dehydrated cat as subcutaneous hydration.” A subcutaneous fluids set up is similar to i.v. fluid administration except that the (warmed) saline solution is gently dribbled underneath the skin by means of a small needle. Once your veterinarian has shown you how to do it, the process can be safely done at home. It takes about 5 minutes to complete and is as simple as giving an insulin injection. For the hydration you will require a fluid bag with a tube and small needle (size 18 or 20). Once your feline friend is comfortably positioned on a warm, fluffy towel, the needle is gently inserted under his skin and the warm fluid gently dribbles in for a few minutes. Cats happily accept this therapy and feel very much better afterwards! Initially, hydration may need to be carried out on a daily basis but after your cat’s health improves, it can usually be reduced to several times a week only. Anitra, who runs the Feline Health Spa, a haven for sick cats in New York City, cites a beautiful story of one of her patients, a 15 year old cat called Suzie. Suzie arrived at her clinic in the terminal stage of kidney disease and was anorexic, constipated, stiff in the joints, dehydrated and very weak. After putting Suzie on the kidney diet and administering s.c. fluids daily, Suzie perked up and took over as hostess of her place. At the time she wrote the book, Suzie was 19 years old, still on the kidney diet, receiving home fluids weekly and “feeling fine”. Summary Chronic interstitial nephritis is not always a death sentence. With an appropriate diet, supplementation, natural medicines and regular hydration therapy, felines may choose to continue to live a relatively normal life for many years.
Of course, awareness and preventative health care is always the best treatment.
__________________________ Dwayne Hubbard, V.N.D.
Dr. Dwayne Hubbard is a specialist in the field of natural animal health and is available for personal and telephone consultations. His naturopathic modalities encompass both large and small animals. __________________________