A limited number of centres also offer a
method called continous renal replacement therapy (CRRT).
Haemodialysis
This is the type
of dialysis which people usually think of when they hear the word
"dialysis". It is available for cats at a limited number of
facilities, and, as in human patients, the process lasts several
hours and has to be performed several times a week. It can only be given in
hospital and is extremely expensive, with the Animal Medical Center in New
York estimating the cost at US$20-25,000 for the first
2-3 weeks.
One member of
Tanya's CKD Support Group had haemodialysis performed on her cat in February
and March 2017, prior to a kidney transplant. Her cat had the dialysis
catheter implanted under anaesthesia and his dialysis sessions lasted around
six hours. The goal is apparently to halve the kidney values each time; they
will then increase again between sessions but hopefully will remain lower overall
than at the beginning.
The cat required some blood transfusions (not every cat on dialysis will
need these), and medication for low blood pressure, which can be a side
effect of dialysis. He
received dialysis five times over a period of two weeks, but was able to
maintain without further dialysis for a couple of weeks until he received
his transplant.
If your cat does for whatever reason require ongoing dialysis, you will need
very deep pockets. In September 2022 a member of Tanya's CKD Support Group
called a number of facilities offering feline dialysis and was quoted a
price of US$1000-2000 per treatment.
Nephrology Knowledge
is owned by Dr Cathy Langston, a veterinary dialysis expert. She
explains more about how haemodialyis is performed.
Intermittent hemodialysis for small animals
(2011) Bloom CA & Labato MA Veterinary Clinics of America Small
Animal Practice 41(1) pp115-133 discusses the use of
haemodialysis.
Long-term outcome of cats and dogs with acute kidney
injury treated with intermittent haemodialysis: 135 cats (1997-2010)
(2012) Eatroff AE, Langston CE, Chalhoub S, Poeppel K & Mitelberg E
Journal of the American Veterinary Medical Association 241(11)
pp1471-8
discusses the benefits of dialysis. It concludes "Although there was a high
mortality rate prior to hospital discharge, those patients that survived to
discharge had a high probability of long-term survival."
Veterinary Partner has some information
about haemodialysis for pets.
Availability
Ohio State University College of Veterinary Medicine
mentions that "Only 22 veterinary hospitals in the U.S. and 40
worldwide offer dialysis services."
American
Society of Veterinary Nephrology and Urology
has a list of hospitals throughout the world where haemodialysis is
available.
Intermittent hemodialysis for small animals
(2011) Bloom CA & Labato MA Veterinary Clinics of America Small
Animal Practice 41(1) pp115-133 has a list (current in 2011) of
haemodialysis facilities worldwide.
University of California at Davis School of Veterinary
Medicine explains more about haemodialysis,
which it can provide.
University of Pennsylania School of Veterinary
Medicine offers information
and provides haemodialysis.
Ohio State University College of Veterinary Medicine
reports on the successful treatment of a cat given haemodialysis in
2016 at Ohio State.
The Royal Veterinary College
in the UK offers haemodialysis.
Peritoneal Dialysis
This entails using the peritoneal cavity as a means of
dialysis. The peritoneum is semi-permeable, so urea/BUN, creatinine and
phosphorus can pass through it. In peritoneal dialysis, a sterile dialysis
solution is introduced into the peritoneal cavity, and this solution then
collects waste products and excess electrolytes by means of diffusion.
However, it is very hard to maintain sterility and avoid infection using
this method, so it is highly unlikely that you will come across this form of
treatment in practice; it tends to be reserved for cases of
acute kidney injury.
Peritoneal dialysis in cats with acute kidney injury:
22 cases (2001-2006) (2011) Cooper
RL & Labato MA Journal of Veterinary Internal Medicine 25(1)
examines the use of peritoneal dialysis in cats with
acute kidney injury.
Management of acute renal failure in cats using
peritoneal dialysis: a retrospective study of six cases (2003-2007)
(2009) Dorval P & Boysen SR Journal of Feline Medicine & Surgery 11(2)
pp107-115, found that peritoneal dialysis greatly helped five of the six
cats with acute kidney injury.
Peritoneal dialysis in dogs and cats: 27 cases
(1976-87) (1989) Crisp MS, Chew DJ, DiBartola SP & Birchard SJ
Journal of the American Veterinary Medical Association 195(9) pp
1262-6 reports on the success rates of peritoneal dialysis in dogs and cats.
Availability
American
Society of Veterinary Nephrology and Urology
has a list of hospitals throughout the world where peritoneal
dialysis is available.
Continuous Renal Replacement
Therapy (CRRT)
Continous renal replacement therapy is used for acute situations when a cat is
critically ill. It provides continous treatment and is usually only provided
until the cat is stable once again, at which point the cat would often
switch to haemodialysis.
Acute kidney injury in cats: part three - management
(2014) Finch N Veterinary Times haas a photo (page 10) of a
cat undergoing CRRT and intermittent haemodialysis.
Management of acute kidney injury with continuous venovenous
haemodiafiltration in a cat 2015)
Stanzani G, Jepson RE & Chan DL Journal of Feline Medicine and Surgery
17(6) pp551-556 reports on a cat who received CRRT in the UK.
Continous renal replacement therapy in dogs and cats
(2011) Acierno MJ Veterinary Clinics of North America Small Animal
Practice 41(1) pp135-146 discusses the use of CRRT.
Availability
American
Society of Veterinary Nephrology and Urology
has a list of hospitals throughout the world where CRRT is available.
Ontario Veterinary College
offers CRRT in Canada.
The Royal Veterinary College offers CRRT in
the UK.
