Pros and Cons of Participation

USA

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• There used to be very little research into feline CKD but fortunately that is changing.

• It is sometimes possible to participate in research studies, both to help your cat and to help other CKD cats who should benefit from the research findings.

• With some studies, you will need to attend the research facility, normally one of the main US vet schools. However, distance participation is possible with some of the studies.

Pros and Cons of Participating in Research Studies

There are often some advantages to participating in research studies. Your cat will usually receive a number of tests, such as bloodwork or ultrasound, for free. Sometimes you receive other types of payment, such as cash or free food. And of course your cat will receive whatever treatment is being tested for free. This may even be a treatment that is not yet commercially available. Plus participating in research can help develop treatments that help other cats in the future.

On the downside, you will usually have to find the time to go for regular check ups, which are sometimes as often as weekly, and for some studies your cat will need to be hospitalised. You also  need to be aware that your cat may receive a placebo, i.e. a dummy treatment that does not contain the active ingredient. If, for example, you are participating in a trial of a treatment for nausea, 50% of the cats participating will usually receive the treatment, but the other 50% will be receiving a placebo. You will not normally know which group your cat is in, so your cat might be suffering from nausea and receiving nothing to help.

University of Missouri Veterinary Health Center explains more about how clinical trials work and the implications of taking part in them.

Studies in the USA

There are thirty accredited vet schools in the USA, but not all of them conduct studies into feline health. I check them all at intervals to see what research they are conducting. Below I list the current trials I am aware of that may be of use to CKD cats.

American Veterinary Medical Association

maintains a database of trials across the USA and Canada.

Current Studies in the USA

• Anaemia gene:

  • Animal Medical Center, NYC

  • NCState University

• Feline erythropoietin for anaemia:

  • University of Georgia

  • University of California at Davis

  • University of Minnesota

• Antibiotic (enrofloxacin) and CKD: University of California at Davis

• Omeprazole and CKD: NC State University

• Variations in bloodwork: University of Oregon

• Aluminium concentrations: Ohio State University

• Aluminium food cans: Ohio State University

• Amyloidosis: University of Missouri

CKD cats are prone to developing anaemia because the kidneys produce a hormone (erythropoietin) which stimulates the bone marrow to make red blood cells, but damaged kidneys find it hard to do this, so anaemia results. There are treatments currently available, including the use of human erythropoietin, but they have potential downsides, so there is interest in finding safer alternatives.

ScoutBio is running a trial for a gene treatment for CKD-related anaemia at a number of locations throughout the USA. The study requires one injection, which it is hoped will enable the cat's body to start producing erythropoietin again so the anaemia resolves permanently. The cat will be monitored for 70 days following the injection.

A much earlier trial, Expression of erythropoietin in cats treated with a recombinant adeno-associated viral vector (2005) Walker MC, Mandell TC, Crawford PC, Simon Gg, Cahill KS, Fernandes PJ, MacLeod JN, Byrne BJ & Levy JK American Journal of Veterinary Research 66(3) pp450-456, gave "intramuscular injections of of a recombinant adeno-associated virus serotype 2 (rAAV2) vector containing feline erythropoietin cDNA" into ten healthy seven week old kittens (poor babies). One of the kittens developed PRCA, a potential problem with erythropoietin too; kittens receiving lower doses had no response; whereas some of the kittens developed HCT levels (a measure of anaemia) that were too high, and removing the part of the muscle where the injection was given did not resolve the problem in every case. I presume this new trial is not anticipating such problems but you might wish to talk to the relevant parties before pursuing this option.

Pilot study to assess the safety and effectivenees of a novel injectable gene therapy (SB-001) for cats with chronic kidney disease-associated anemia that replaces the function of feline erythropoietin

NC State University College of Veterinary Medicine

This study is looking at a form of feline erythropoietin, unlike the studies above which are implanting a gene.

Your cat will receive an injection of feline erythropoietin every week for the first four weeks, then rechecks and further injections as appropriate every two weeks for the next eight weeks. If your cat achieves a PCV of 35%, the frequency of the injections may be reduced. For the next three months your cat will be checked monthly. All costs and blood tests associated with the trial are covered, and if your cat completes the full 24 weeks of the trial, you will receive US$500.

The study is running at three universities but they have slightly different participation criteria.

Dose-ranging efficacy study in cats with non-regenerative anemia due to chronic kidney disease (IRIS stages 2 and 3)

New treatment for anemia associated with chronic kidney disease in cats

This study appears to be largely the same as the feline erythropoietin trial at the Universities of Georgia and Minnesota. One potential stumbling block is that cats receiving daily fluid therapy are not eligible.

Feline free study

This study appears to be largely the same as the feline erythropoietin trial at the Universities of Georgia and California at Davis. Cats receiving daily fluid therapy are not eligible.

Omeprazole at NC State University

Evaluation of the effect of omeprazole on clinical signs in cats with chronic kidney disease

Omeprazole is a proton pump inhibitor which may be used in cats with appetite loss, nausea and vomiting. The study aims to assess the effectiveness of omeprazole in CKD cats for reducing these symptoms.

There is more information about omeprazole here.

Enrolment ends on 31 July 2020.

Antibiotic (enrofloxacin or Baytril) and CKD: University of California at Davis

Antibiotics and kidney disease in cats

This study is looking at whether cats with CKD eliminate enrofloxacin (Baytril) more slowly than healthy cats. The cat will receive one injection of enrofloxacin and will have to stay overnight for testing purposes.

Variation in serum chemistry analytes in cats with chronic kidney disease

This study is looking at how routine bloodwork varies in CKD cats. Your cat would receive weekly blood tests for six weeks.

Aluminium Concentrations: Ohio State University

Aluminum concentrations in cats with kidney disease

Since phosphorus levels often rise in CKD cats, treatments called phosphorus binders are often necessary, and one commonly used phosphorus binder is aluminium hydroxide. There is some concern about the possible risk of aluminium toxicity in cats using aluminium hydroxide based binders, but it is not known what is a normal aluminium level in cats. This study aims to ascertain normal blood aluminium levels in healthy cats and CKD cats, and check the effect of aluminium hydroxide binders on blood aluminium levels.

Enrolment ends on 01 February 2021

Aluminium Food Cans: Ohio State University

Since phosphorus levels often rise in CKD cats, treatments called phosphorus binders are often necessary, and one commonly used phosphorus binder is aluminium hydroxide. There is some concern about the possible risk of aluminium toxicity in cats using aluminium hydroxide based binders. This study aims to determine blood aluminium levels in CKD cats to see if diet influences them.

Enrolment ends on 01 February 2021.

Studies in Countries Other Than the USA

Please see below for information about studies at the Royal Veterinary College in the UK.