Early Signs of Chronic Kidney Disease in Cats: What to Watch For

Quick answer

Learn the subtle, early warning signs of chronic kidney disease (CKD) in cats. D

Chronic kidney disease (CKD) in cats is a progressive condition, but catching it early in IRIS Stage 1 or 2 can dramatically extend your cat's life. The earliest signs are incredibly subtle: a slight increase in thirst, more frequent urination, mild weight loss, or a coat that looks just a bit unkempt. By monitoring these minor shifts and scheduling routine senior bloodwork, you can protect your cat's kidney function before they feel sick.

Why it matters

The kidneys are the unsung heroes of your cat's body. They filter waste products from the bloodstream, regulate blood pressure, balance essential electrolytes, conserve water, and even produce a hormone (erythropoietin) that tells the bone marrow to make red blood cells.

When a cat develops [chronic-kidney-disease], their kidney tissue slowly and irreversibly degrades over time. Because kidneys have a massive reserve capacity, a cat can lose up to 75% of their functional kidney cells (nephrons) before standard blood tests show any abnormalities. This is why understanding the early stages is so critical.

Veterinarians use the International Renal Interest Society (IRIS) guidelines to stage CKD from 1 to 4:

• Stage 1 (Early/Pre-clinical): Kidney function is mildly compromised, but blood creatinine levels are normal. There are usually no outward symptoms, though urine concentration may begin to drop.
• Stage 2 (Mild): Blood creatinine is slightly elevated, and the kidneys are losing their ability to concentrate urine. Symptoms are incredibly subtle and easily missed.
• Stage 3 (Moderate): Waste products build up in the blood, and the cat begins to show obvious signs of illness, such as vomiting, weight loss, and dehydration.
• Stage 4 (Severe/End-stage): The kidneys can no longer sustain life without intensive medical intervention. The cat feels very ill due to the buildup of toxins.

If you catch [chronic-kidney-disease] in Stage 1 or 2, you have a golden window of opportunity. With targeted dietary adjustments, hydration strategies, and close veterinary monitoring, you can slow the progression of the disease, keeping your cat comfortable, active, and by your side for years.

:::key-facts

• Catching CKD in Stage 1 or 2 can add years of high-quality life to your cat.
• Kidneys cannot regenerate; early treatment focuses on preserving remaining healthy tissue.
• Subtle changes in drinking and urination are the very first clues.
• Standard blood tests may miss early-stage decline, making specialized tests essential.
  :::

What good looks like

A cat with healthy, fully functioning kidneys maintains a delicate internal balance. Visually and behaviorally, a healthy senior cat will display:

• Consistent Hydration Habits: They drink moderate amounts of water. They do not linger at the water bowl or obsessively seek out dripping faucets.
• Normal Litter Box Output: Their urine clumps in clay litter are modest in size (roughly the size of a tennis ball or smaller, depending on the cat's size) and consistent in number (usually 2 to 3 times a day).
• Stable Weight and Muscle Mass: Their spine and hips are well-covered with muscle, and their weight remains steady month after month.
• A Glossy, Groomed Coat: Their fur is clean, soft, and free of mats or excessive dander, indicating they have the energy and flexibility to groom themselves.
• Bright Eyes and Good Energy: They are alert, interested in their surroundings, and have a healthy appetite.

Monitoring the size of your cat's urine clumps is a simple way to track changes in kidney function at home.

Step-by-step

To catch [chronic-kidney-disease] in its absolute infancy, you must become an active observer. Do not wait for your cat to act sick. Follow this step-by-step monitoring routine:

Step 1: Monitor water intake

Keep a close eye on how much your cat drinks. If you use a water fountain, note how often you have to refill it. If you use traditional bowls, fill them to the exact same level every day so you can visually track the volume consumed. A sudden or gradual increase in water consumption is often the very first sign of kidney decline.

Step 2: Inspect the litter box daily

When scooping the litter box, pay attention to the size and weight of the urine clumps. If the clumps are suddenly twice as large as they used to be, or if the litter is saturated much faster than usual, your cat's kidneys may be losing their ability to concentrate urine, forcing them to produce larger volumes of diluted urine.

Step 3: Perform weekly weigh-ins

Weight loss is a classic, early indicator of CKD that often goes unnoticed because it happens so gradually. Buy a digital baby scale and weigh your cat once a week at the same time. Record the numbers in a journal. For a 4kg (9 lb) cat, losing just 200 grams (7 ounces) is a significant 5% weight loss that warrants a veterinary visit.

:::pro-tip
To get an accurate weight at home, weigh yourself on a digital scale while holding your cat, then weigh yourself alone. Subtract your weight from the combined weight to find your cat's weight.
:::

Step 4: Assess body condition and coat

Run your hands along your cat's spine, ribs, and hips. You should feel a healthy layer of muscle. If the spine feels increasingly bony or "spiky," or if their hindquarters look sunken, they may be experiencing muscle wasting, a common side effect of early kidney decline. Also, look for a dry, flaky, or unkempt coat.

Step 5: Schedule routine senior wellness screenings

Once your cat reaches 7 years of age, transition them to bi-annual veterinary exams. Request a comprehensive senior panel that includes a urinalysis and an SDMA blood test, which can detect kidney decline much earlier than traditional tests.

:::ask-boo
How much water should a 4kg cat drink daily if they eat wet food versus dry food?
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Signs something's wrong

Because cats are masters at hiding discomfort, the signs of early kidney disease are easy to mistake for "just getting older." However, aging is not a disease, and these subtle shifts should never be ignored.

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An increase in the frequency or duration of drinking is one of the earliest signs of kidney decline.
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Early Warning Signs (IRIS Stage 1 & 2)

• Increased Thirst (Polydipsia): Your cat spends more time at the water bowl, drinks from unusual places (like the toilet or sink), or finishes their water faster than usual.
• Increased Urination (Polyuria): You notice larger, heavier urine clumps in the litter box, or your cat is visiting the box more frequently.
• Subtle Weight Loss: Your cat looks slightly thinner, even though their appetite seems unchanged.
• Slightly Decreased or Picky Appetite: They may sniff their food and walk away, or suddenly refuse a brand of food they have loved for years.
• Mild Lethargy: They sleep a bit more, play a bit less, or hesitate before jumping onto high surfaces.
• Poor Coat Quality: The fur looks dull, dry, or parted, and you may notice more dander along their back.

Late-Stage Signs (IRIS Stage 3 & 4)

If the disease progresses without intervention, toxins build up in the bloodstream (uremia), leading to more severe symptoms:

• Frequent Vomiting: Often clear fluid or foam, caused by uremic toxins irritating the stomach lining.
• Complete Loss of Appetite (Anorexia): The cat refuses to eat due to nausea or painful mouth ulcers.
• Severe Dehydration: The skin loses its elasticity. If you gently pinch the skin over their shoulders, it stays tented instead of snapping back quickly.
• Uremic Halitosis: Their breath has a distinct, unpleasant smell, sometimes resembling ammonia or urine.
• Extreme Weakness and Muscle Wasting: The cat may struggle to walk, stand, or lift their head (often due to low potassium levels).
• Sudden Blindness: Caused by high blood pressure (hypertension), which is a frequent complication of advanced kidney disease.

:::warning
If your cat is vomiting continuously, completely refuses to eat for more than 24 hours, appears extremely weak, or suddenly loses their vision, this is a medical emergency. Go to an emergency vet clinic immediately.
:::

When to call your vet

If you notice any of the early warning signs—even if they seem minor—schedule a veterinary appointment. Do not wait for your cat to start vomiting or losing significant weight.

Routine blood pressure checks are vital, as hypertension is a common and treatable complication of kidney disease.

To diagnose early-stage [chronic-kidney-disease], your veterinarian will recommend a combination of tests:

1. Urinalysis: This is the most critical test for early detection. The vet will check the Urine Specific Gravity (USG) to see how well the kidneys concentrate urine. A healthy cat should have a USG above 1.035. If it is consistently lower, it suggests the kidneys are struggling. The vet will also check for protein in the urine (proteinuria), which can indicate kidney damage.
2. SDMA Blood Test: Symmetric Dimethylarginine (SDMA) is a biomarker that rises when kidney function declines by as little as 25% to 40%. This test can detect kidney disease months or even years earlier than traditional blood tests.
3. Blood Creatinine and BUN: These waste products are filtered by the kidneys. While they traditionally only rise after 75% of kidney function is lost, tracking their trends over time (even within the "normal" reference range) can reveal early decline.
4. Blood Pressure Measurement: Kidneys help regulate blood pressure, and kidney disease often causes hypertension. Checking blood pressure early allows your vet to prescribe medications to protect the kidneys and eyes from further damage.

:::ask-boo
My vet said my cat's SDMA is slightly elevated but creatinine is normal. What does this mean?
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Common mistakes

When managing a senior cat's health, it is easy to fall into common traps. Avoiding these mistakes can make a massive difference in your cat's prognosis:

• Mistaking increased thirst for a "good habit": Many owners are pleased to see their cat drinking more water, assuming it is a healthy choice. In cats, a sudden increase in drinking is almost always a compensatory mechanism for failing kidneys.
• Relying solely on standard blood tests: If your vet runs a basic blood panel without a urinalysis or an SDMA test, early-stage kidney disease can easily be missed. Always request a complete urinalysis.
• Switching to a low-protein diet too early without guidance: While phosphorus restriction is vital for managing kidney disease, severely restricting protein in the very early stages (especially if the cat is losing muscle) can do more harm than good. Always consult your vet before changing diets.
• Neglecting hydration support: Cats are designed to get most of their moisture from their food. Feeding an all-dry diet puts extra strain on compromised kidneys. Transitioning to high-quality wet food, adding water to meals, and using water fountains are crucial steps.

Adding extra water or low-sodium broth to wet food is an excellent way to support kidney health and boost hydration.

:::ask-boo
How can I transition my stubborn senior cat from dry kibble to wet food?
:::

Quick FAQs

Can chronic kidney disease in cats be cured?
No, damage to the kidney nephrons is irreversible. However, while CKD cannot be cured, it can be highly managed. Cats diagnosed in the early stages can live comfortable, happy lives for several years with the right diet, hydration, and medical support.

What is the life expectancy of a cat with Stage 1 or 2 CKD?
With proactive management, cats diagnosed in Stage 1 or 2 often live for 2 to 5 years, and sometimes even longer. The key to longevity is early intervention to slow the progression of the disease.

Does dry food cause kidney disease in cats?
Dry food does not directly cause kidney disease, but because cats have a low thirst drive, those on exclusive dry food diets live in a state of mild, chronic dehydration. This puts a higher workload on the kidneys over time. Incorporating wet food is highly beneficial for kidney health.

How often should a senior cat have their kidneys checked?
Cats over the age of 7 should have a veterinary exam and blood/urine screenings at least once a year. For cats over 11, or those already diagnosed with early-stage kidney disease, screenings should be done every 6 months.