People: Megan Conroy, Ruby Chang, David Brodbelt, Jonathan Elliott

BackgroundCKD is a common problem in cats in the UK, with recent VetCompass studies reporting approx. 3.6% of cats may suffer from it (O'Neill et al 2014) and that renal disorders were the most common cause of mortality in cats over 5 years old (O'Neill et al 2015). However, there is little information available on the epidemiology of this disease specifically, with previous studies limited to small samples and referral clinics. The current project will expand on this previous work, providing a prevalence estimate, investigating potential risk factors for the development of CKD in cats, and providing information on the current treatment practices and the survival of cats with CKD. This work will provide information for clinicians and owners with diagnosis, treatment and management of this disease.

As a second objective, the project will look at hypertension in cats. Hypertension is commonly recognised in older cats, however the prevalence in the UK is currently unknown. One study examining cats 9 years and older reports a prevalence of 12.7% (Jepson et al 2009). Blood pressure has been shown to increase as cats age (Bijismans et al 2015). This study will aid identification of the burden of disease within the UK cat population. 

Aim 1: To estimate the prevalence of chronic kidney disease (CKD) in cats attending VetCompass-participating veterinary practices in the United Kingdom. We also aim to explore the risk factors for developing CKD, and describe the survival of cats suffering from CKD. 

Aim 2: To estimate the prevalence of hypertension in cats in the UK, prevalence of ocular damage, identify risk factors for ocular damage, and describe current practices for measuring blood pressure and treatment for hypertension in cats. 

Dates: September 2015 - 1 year (MRes project)

Funding bodyCeva Animal Health 

  

References

O'Neill D, Church D, McGreevy P, Thompson P, Brodbelt D (2014) Prevalence of disorders recorded in cats attending primary-care veterinary practice in England. The Veterinary Journal 202 pp286 - 291

O'Neill D, Church D, McGreevy P, Thompson P, Brodbelt D (2015) Longevity and Mortality of cats attending primary-care veterinary practice in England. Journal of Feline Medicine and Surgery 17(2) pp125-133

Jepson RE, Brodbelt D, Vallance C, Syme HM, Elliott J (2009) Evaluation of the predictors of azotemia in cats. Journal of Veterinary Internal Medicine 23 pp806-813

Bijsmans ES, Jepson RE, Chang YM, Syme HM, Elliott J (2015) Changes in systolic blood pressure over time in healthy cats and cats with chronic kidney disease. Journal of  Veterinary Internal Medicine 29 pp855 - 861

Abstracts

Chronic Kidney Disease in cats presenting to primary-care practice in the UK.

Chronic kidney disease (CKD) is commonly diagnosed in cats in the UK. Previous studies have estimated a prevalence of 1.7% - 3.6% in the cat population in the UK. Little is known about how CKD is diagnosed and treated in the primary-care setting in the UK. The aims of the present study were to estimate the prevalence and incidence of CKD in the UK and to describe diagnostic procedures and treatments employed.

Cats that presented to 90 veterinary clinics between January 2012 and December 2013 were included in the study. Using the VetCompass database, potential cases were identified by searching the electronic patient record for key terms associated with CKD diagnosis. A random sample of 20% of the potential cases were reviewed in detail to identify cats diagnosed with CKD. Data were extracted from the database for demographics, diagnosis, treatment and comorbidities. Prevalence and incidence were estimated adjusting for the sampling approach.

Of 104977 cats presented, 6691 potential cases were identified. From the potential cases reviewed in detail, 345 new and 199 pre-existing cases were confirmed. Estimated prevalence was 2.6% (95% CI 2.4% - 2.8%) and estimated incidence of new cases was 1.6% (95% CI 1.5% - 1.8%) over the study period. Median age at diagnosis was 15 years (IQR 12.5 – 16.9yr). Most cats (61.1%) were presented because of owner reported clinical signs. The majority of cats (51%) had 2 or more signs at diagnosis with weight loss (44.1%) and polydipsia (32.5%) most commonly reported. Combined biochemistry and urinalysis was the most common method of diagnosis (61.9%). One fifth (20.9%) of cats had a UPC performed. Just under one third (30.4%) of vets recorded IRIS staging with just over half (50.2%) of the staged cats having IRIS CKD stage 2 at diagnosis. One third (33.6%) of cats had at least one blood pressure measurement, with 47.4% of these cats being diagnosed with hypertension. A commercial ‘renal diet’ (65.8%) and Benazepril (32.8%) were the most common treatments prescribed.

One in 40 cats presenting to primary-care practices in the UK were diagnosed with CKD. UPC and blood pressure are performed in a minority of cats, despite the recognised importance of proteinuria and hypertension influencing prognosis and treatment of cats diagnosed with CKD. Improved knowledge of how veterinarians are diagnosing CKD in primary-care practice will allow targeted continuing education of practitioners. This study also highlights the need for better owner education regarding CKD.

This abstract was presented at ECVIM-CA 2016

Vet Compass Project Type: Cat

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