19 Cats And Counting

BIO:

Dr. Kelly Cairns graduated veterinary school from CSU in 2004, completed a small animal rotating internship at Cornell in 2005 and completed a small animal internal medicine residency at OSU in 2008, at which time she obtained Diplomate status. She enjoyed a rewarding clinical practice as an internist and medical director of a multi-specialty/ER hospital until joining Pathway Vet Alliance (now Thrive Pet Healthcare) in January of 2018. Dr. Cairns currently serves as Vice President of Medical Excellence and Education for over 400 hospitals in the Thrive Pet Healthcare family. She is also on the dvm360 editorial board and on the Chicago Veterinary Medical Association Board of Directors. She lectures nationally on profession-related wellness coaching topics as well as internal medicine.

Dr. Cairns provides coaching and resources to support the medical excellence, professional development and sustained happiness of veterinary healthcare team members. She is passionate about supporting the people in the veterinary profession on the front line who positively impact the lives of their patients and pet parents every day.
In her personal time Dr. Cairns is an avid runner and enjoys family life with her husband, two daughters, son, two cats and very sweet but poorly mannered lab mix.

Transcript:

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Announcer: This is Pet Life Radio.

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Announcer: Let's talk pets.

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Linda Hall: Hello, my cat-loving friends.

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Linda Hall: We have Dr.

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Linda Hall: Kelly Cairns back with us, our monthly vet visit.

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Linda Hall: Dr.

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Linda Hall: Kelly Cairns, D-V-M-M-S-D-A-C-V-I-M.

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Linda Hall: She's smart, okay?

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Linda Hall: She is the vice president of Medical Excellence and Education for over 400 hospitals in the Thrive Pet Healthcare family.

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Linda Hall: So yeah, she's smart.

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Linda Hall: So it is the mealment of truth.

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Linda Hall: We're going to talk about chronic kidney disease.

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Linda Hall: I think everybody with a cat needs this information, so we'll be right back.

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Announcer: Pet Greens is proud to support 19 Cats and Counting on Pet Life Radio.

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Announcer: We're partnering with pioneer cat behavior expert and best-selling author, Pam Johnson Bennett, to help indoor cats live their best lives with indoor enrichment tips for their parents.

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Pam Johnson Bennett: I'm very careful about the products that I choose because I have built a reputation over four decades where cat parents trust me and they know that when I recommend a brand or talk about a particular product, they know it came from my heart and I really believe it.

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Pam Johnson Bennett: I've done my research with Pet Greens.

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Pam Johnson Bennett: I love the products.

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Pam Johnson Bennett: I love the quality.

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Pam Johnson Bennett: And one of the things that I feel just stands out is the education that Pet Greens provides.

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Pam Johnson Bennett: They guide you every step of the way.

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Pam Johnson Bennett: It's a relationship.

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Pam Johnson Bennett: I know how much they love cats and how much they love cat welfare and cat health, and that's their motivation.

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Announcer: For more information on the benefits of cat grass and catnip for your cat's indoor enrichment, visit petgreens.com.

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Announcer: Let's Talk Pets on petliferadio.com.

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Linda Hall: Welcome back to 19 Cats and Counting.

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Linda Hall: I am your co-host, Linda Hall.

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Linda Hall: Happy to be here with my blonde BFF, Rita Reimers.

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Rita Reimers: How is it June already?

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Rita Reimers: Of course, it'll be later when people hear this, but wow.

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Linda Hall: This year has just disappeared.

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Rita Reimers: I know.

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Linda Hall: But I know you've dealt with kidney disease in cats, and I kind of always, like, I know.

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Rita Reimers: It seems to me like the kidney disease comes up, and you go, yeah, but, you know, you pretty much expect it's going to be kidney or thyroid.

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Rita Reimers: You're old.

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Rita Reimers: But does it have to be this way?

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Rita Reimers: That's what I want to know from Dr.

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Rita Reimers: Kelly.

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Linda Hall: Let's find out.

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Linda Hall: Let's find out.

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Linda Hall: Dr.

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Linda Hall: Kelly, thank you for joining us again.

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Linda Hall: We love you and we look forward to this so much.

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Dr. Kelly Cairns: Ladies, happy Fry Cat Day.

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Linda Hall: Yes, I like that.

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Linda Hall: Fry Cat Day.

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Dr. Kelly Cairns: It is my favorite day of the month to get this time with you and educate our kitty-loving friend.

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Dr. Kelly Cairns: So thanks for having me.

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Linda Hall: Thanks for coming.

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Linda Hall: You have no idea how much the knowledge that you have given us has not only helped us with our own cats, but with our clients.

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Linda Hall: When they bring something up, it's like, we sent the Pandora Syndrome clip over to so many people.

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Rita Reimers: We talk about that so much.

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Linda Hall: So much.

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Linda Hall: And it's all education we got from you.

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Linda Hall: So we are very grateful.

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Linda Hall: It's like going to class.

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Linda Hall: We're getting schooled.

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Linda Hall: So kidney disease.

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Linda Hall: Like Rita said, we just kind of have started to expect that after age 15 or so, this cat's gonna get kidney disease.

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Linda Hall: So first, what is it?

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Dr. Kelly Cairns: Kidney disease.

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Dr. Kelly Cairns: So as a board certified small animal, internal medicine specialist, I have had the pleasure of helping cats with chronic disease live a really long time and feel good while doing so.

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Dr. Kelly Cairns: It is a very common condition.

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Dr. Kelly Cairns: About one in three senior cats will develop chronic kidney disease.

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Dr. Kelly Cairns: So it's typically an age-related condition.

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Dr. Kelly Cairns: And what it is, it's where the kidney degrades to where the kidney is not working normally, and it gets to the point where only a small percentage of the kidney is working, which then leads to a buildup of toxin in the bloodstream and the kidney doesn't feel well.

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Dr. Kelly Cairns: So it's basically chronic kidney disease is the most common cause of eventually kidney failure in the cat.

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Dr. Kelly Cairns: It's the functional unit of the kidney is not working well.

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Dr. Kelly Cairns: But what I'm so excited to chat with you guys about today and educate our kitty loving friends on, is that this disease does not happen right at one time.

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Dr. Kelly Cairns: The cat doesn't have it, now today the cat has it.

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Dr. Kelly Cairns: It is a slow continuum.

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Dr. Kelly Cairns: And what we're going to talk about is knowledge, which is in power, knowledge is power.

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Rita Reimers: Amen.

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Dr. Kelly Cairns: Of how you can work with your veterinarian to identify when your kitty has very, very early, mild decline in kidney function, early chronic kidney disease and how you can identify that as soon as possible using available testing.

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Dr. Kelly Cairns: because the earlier we know it's there, the more we can do to slow progression and minimize conflict patients.

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Dr. Kelly Cairns: We don't want to find it when it's very, very end stage.

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Rita Reimers: When I take my cats in for their senior panel or to get screened for something, he shows me the blood test results, and it shows the different levels of what's in the blood.

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Rita Reimers: He's usually looking at something called the bun, if I remember right, for kidney.

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Rita Reimers: Is that correct?

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Dr. Kelly Cairns: B-U-N is correct, the bun.

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Dr. Kelly Cairns: And this is not a delightful sesame bun.

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Dr. Kelly Cairns: This is the blood urea nitrogen bun.

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Dr. Kelly Cairns: And so what this is is how the body processes nitrogen.

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Dr. Kelly Cairns: Nitrogen comes from a lot of things, and it comes most notably from the protein in our food.

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Dr. Kelly Cairns: So when you take all of that protein and you do the things you need to do with it for energy, you have this nitrogen, and you have to get rid of it somehow.

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Dr. Kelly Cairns: And so it gets turned into this bun, and then it gets excreted or urinated out through the kidney.

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Dr. Kelly Cairns: When the kidney can't do that, the bun builds up in the bloodstream, along with some other things the kidney's meant to filter out that your body does not want inside of it, like creatinine and phosphorus.

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Dr. Kelly Cairns: And so as those values go up in the bloodstream, it tells us that kidney is not filtering well, the kidney is not working well.

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Dr. Kelly Cairns: So that's what the bun is.

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Rita Reimers: Okay, that makes a lot of sense, because I just thought it goes, okay, if you say so.

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Dr. Kelly Cairns: I know.

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Linda Hall: Exactly, we trust you.

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Linda Hall: Are there any early warning signs that we might see that we should be watching for?

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Dr. Kelly Cairns: Such a great question.

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Dr. Kelly Cairns: So let me chat with y'all about the symptoms of kidney disease.

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Dr. Kelly Cairns: And then I'm going to share with you what we should do before we even see those symptoms, to be even more proactive with our wellness care.

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Dr. Kelly Cairns: So the symptoms of chronic kidney disease are most commonly increased thirst and urination as the first thing we see.

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Dr. Kelly Cairns: Now, when it gets very advanced and the kitty is in severe kidney failure and those toxins, the bad bun, and the creatinine build up in the bloodstream, a kitty can be lethargic, depressed, inappetent, anorexia, vomiting.

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Dr. Kelly Cairns: But even way before that, we will see increased thirst and urination.

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Dr. Kelly Cairns: There's very few things that cause that in the cat.

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Dr. Kelly Cairns: So if you notice increased thirst or urination, all of a sudden those clumps of litter are really gigantic in the litter box, get to your veterinarian.

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Dr. Kelly Cairns: They'll do some simple blood and urine tests because there's a few things we're going to want to rule out, including kidney disease, diabetes, or problems regulating blood sugar, and high-functioning thyroid gland as probably the big three.

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Dr. Kelly Cairns: There are some other, okay?

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Dr. Kelly Cairns: So that's the most common symptom.

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Dr. Kelly Cairns: What we can do though, even before we see that, is make sure you're getting your kitty who's over the age of 10, two-year veterinarian, twice a year, for proactive wellness, examination, and laboratory testing.

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Dr. Kelly Cairns: because six months for an older kitty is like a good five to seven years for you and I.

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Dr. Kelly Cairns: So that's a significant length of time for your cat.

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Rita Reimers: That's an interesting way to think of it.

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Rita Reimers: I don't think many people do relate that six months for them is a much longer lifetime span for us.

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Dr. Kelly Cairns: It's four or five years for your cat.

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Dr. Kelly Cairns: So think about how me at a certain age, I'm delighted to share that I'm hit my fifties and feel better than ever.

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Linda Hall: Welcome.

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Dr. Kelly Cairns: I'm going to go to my doctor to have some screenings.

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Dr. Kelly Cairns: So a cat that's 10, it's kind of like a person who's 50.

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Dr. Kelly Cairns: Let's get them in twice a year.

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Dr. Kelly Cairns: Your vet's going to be doing a good exam, feeling the size and shape of those kidneys, because sometimes they can get a little small and we can feel that on exam.

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Dr. Kelly Cairns: Your vet's going to be doing some very simple blood and urine tests to assess the function of the kidneys.

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Dr. Kelly Cairns: The blood and the urine together are critical to make that assessment, because what's really important for everyone to understand is that bad bun we talked about, that creatinine, those blood tests, they don't elevate until 75% of the kidney is not working.

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Dr. Kelly Cairns: So they're extensive markers.

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Dr. Kelly Cairns: We can see other changes in the blood elevate sooner.

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Dr. Kelly Cairns: Your vet will be doing a test called SDMA.

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Dr. Kelly Cairns: It's a simple blood test that will elevate when about 40% of the kidney is not working.

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Dr. Kelly Cairns: And your vet will take that result in combination with your analysis or urine test bindings to be able to say to you, I think that your cat might have what's called stage one or early chronic kidney disease.

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Dr. Kelly Cairns: There's some great resources online for Kitty Love and friends to read about, the International Renal Interest Society.

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Dr. Kelly Cairns: There is folks, material is on there, designed for pet parents.

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Dr. Kelly Cairns: In very simple, easy to understand wording, so you can see the staging of kidney disease.

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Dr. Kelly Cairns: There's four stages.

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Dr. Kelly Cairns: Your veterinarian wants to partner with you to identify stage one.

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Dr. Kelly Cairns: Definitely.

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Dr. Kelly Cairns: because as soon as we know, we're gonna talk to you about what we're gonna do to slow progression, to keep the rest of that kidney functioning well for as long as possible, as well as to make sure there's no complications that could make things worse.

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Linda Hall: Yeah.

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Linda Hall: So we understand now that this is going to be something definitely to watch out for senior, you know, the parts are wearing out as they do on all of us as we age.

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Linda Hall: Is it only seniors though?

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Linda Hall: Can my four-year-old cat crop up with kidney disease or do I not need to be watching?

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Dr. Kelly Cairns: So cats of any age can develop kidney disease because there's many causes.

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Dr. Kelly Cairns: When a cat is younger than 8 to 10 years of age, chronic kidney disease or age-related degenerative kidney disease is less likely to occur below the age of 8 to 10.

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Dr. Kelly Cairns: But absolutely, we could have a kitty that has other kidney problems younger in age.

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Dr. Kelly Cairns: We could see a kidney infection lead to scar tissue, which then could predispose a cat to have significant problems as they get older.

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Dr. Kelly Cairns: Sometimes it can be a little complicated, and there's multiple pieces of the puzzle that go together.

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Dr. Kelly Cairns: But what we call traditional chronic kidney disease that we see in older cats is more typically related to aging.

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Linda Hall: Now, everybody know what she said about it being complicated in the parts, and this is why we do not try to be our own veterinarians.

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Linda Hall: I just throw that in there.

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Linda Hall: Sometimes when people have had, and I'm guilty of this with my human kids, I've seen strep throat so many times, I can diagnose it.

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Linda Hall: I really can.

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Linda Hall: I always know.

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Linda Hall: I've just seen it so much.

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Linda Hall: And I think sometimes we get, oh, I had a cat that was diabetic, it was regular, this cat must be diabetic, right?

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Linda Hall: Like, you know, we tend to be our own vets, and it's a little more complicated than that.

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Linda Hall: We really need some professional help, right?

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Rita Reimers: Well, it's okay to suspect some things, but that's when you run to your vet and go, you know, I think it might be blah, blah.

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Rita Reimers: And your vet will tell you for sure what it is or isn't.

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Dr. Kelly Cairns: Yes, absolutely.

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Dr. Kelly Cairns: And it's a partnership because you know your kitty better than anybody.

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Dr. Kelly Cairns: So when we partner with pet parents, we take that into account.

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Dr. Kelly Cairns: And it is a robust partnership where the information that you give and what I call your gut is super critical as we partner with you to bring our expertise to the table to get the best outcome for your kitty.

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Linda Hall: Okay.

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Linda Hall: I love you.

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Linda Hall: I love you.

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Linda Hall: I love you.

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Linda Hall: I love you.

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Linda Hall: I love you.

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Linda Hall: because I told people this is a lesson I learned with human children.

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Linda Hall: We had a pediatrician who if he didn't feel it, it wasn't happening.

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Linda Hall: And sometimes you're just like, something's wrong.

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Linda Hall: I don't know what's wrong.

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Linda Hall: I don't know, you know, or well, she's sleeping.

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Linda Hall: Oh, kids that age, dude.

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Linda Hall: No, no, no, not my kid, you know, and I feel it.

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Linda Hall: So I really learned that with medical doctors for human beings.

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Linda Hall: And we told clients many times, if you don't like what they say and you just feel it's wrong, get a second opinion.

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Linda Hall: Like this doesn't hurt your feelings, right?

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Linda Hall: Like I think sometimes they're afraid to check off their bat and come back and say, well, I went to Dr.

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Linda Hall: Smith.

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Dr. Kelly Cairns: You need to be your cat's advocate.

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Dr. Kelly Cairns: And you need to have a partnership with a health care provider for your cat.

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Dr. Kelly Cairns: That is the style of the human being that you want that meets your needs.

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Dr. Kelly Cairns: So 100% and no veterinarian is ever going to feel at all upset if you go to get a second opinion.

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Dr. Kelly Cairns: As a matter of fact, just like when you go to a human physician or your pediatrician, they might refer you to see a specialist that partners with them.

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Dr. Kelly Cairns: Your general practitioner, your primary care veterinarian may send you to someone like me, a board certified small animal internal medicine specialist who's completed an additional four years of internship and residency to only focus on those chronic diseases of internal body systems like chronic kidney disease.

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Dr. Kelly Cairns: I partner very well with general practitioners.

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Dr. Kelly Cairns: So absolutely be your cat's advocate, talk to your veterinarian, and make sure you have someone that's a right fit for you.

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Rita Reimers: Yes.

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Rita Reimers: Let's say your vet has told you your kidney has stage one, is in stage one kidney failure.

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Rita Reimers: Now what?

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Rita Reimers: What do we do for that?

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Rita Reimers: Do we prevent it from growing?

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Rita Reimers: Do we just slow it down?

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Rita Reimers: We can't cure it, right?

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Rita Reimers: Yeah.

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Dr. Kelly Cairns: So once we identify kidney disease and it's staged, and hopefully we catch it at stage one, but there's still a lot we can do, even if it's a stage two, three or four, then we are going to be talking to you about a few additional simple tests.

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Dr. Kelly Cairns: These are simple blood and urine tests, nothing invasive, as well as a blood pressure.

00:15:32.437 --> 00:15:42.237
Dr. Kelly Cairns: because we want to do what's called fully stage that kidney disease and make sure there's nothing going on that is going to change what we recommend.

00:15:42.757 --> 00:15:50.137
Dr. Kelly Cairns: So there's certain things we always recommend, and we could talk more about those in a little bit, like diet and some other treatments.

00:15:50.137 --> 00:15:53.617
Dr. Kelly Cairns: And then there's other things we only recommend if they're indicated.

00:15:53.617 --> 00:16:06.937
Dr. Kelly Cairns: For example, cats with chronic kidney disease have a very high frequency of urinary tract infections, protein in the urine, which can be damaging, and high blood pressure and some other hormone changes.

00:16:06.937 --> 00:16:17.897
Dr. Kelly Cairns: So these very easy tests your vet will do will allow them to say to you, here's the specific customized plan for your cat.

00:16:17.897 --> 00:16:23.057
Dr. Kelly Cairns: And those things will slow progression as best as we can.

00:16:23.057 --> 00:16:26.257
Linda Hall: I know Rita's going to take us into a break in a minute, but when we come back...

00:16:26.257 --> 00:16:28.157
Rita Reimers: We've got about three or four minutes before we have to.

00:16:28.417 --> 00:16:28.897
Linda Hall: All right.

00:16:28.897 --> 00:16:32.197
Linda Hall: Well, I just wanted to ask about life expectancy.

00:16:32.197 --> 00:16:36.057
Linda Hall: Let's say I've been told my cat's at stage one versus stage four.

00:16:36.677 --> 00:16:37.637
Linda Hall: What can I expect?

00:16:37.637 --> 00:16:39.757
Linda Hall: How much longer am I going to get to keep my cat?

00:16:39.757 --> 00:16:44.617
Dr. Kelly Cairns: So we talk about statistics, and then we always talk about individuals.

00:16:44.617 --> 00:16:46.777
Dr. Kelly Cairns: So statistics are just the objective.

00:16:46.777 --> 00:16:48.097
Dr. Kelly Cairns: Here's the average.

00:16:48.097 --> 00:16:53.697
Dr. Kelly Cairns: And then we're not going to be doom and gloom about those numbers, because we're also going to look at the individual.

00:16:53.697 --> 00:17:00.197
Dr. Kelly Cairns: So in the same way that a person's say that might have been given a cancer diagnosis, there's statistics associated with that tumor.

00:17:00.197 --> 00:17:06.997
Dr. Kelly Cairns: So statistically speaking, a cat will live, assuming nothing else goes on, and we're only dealing with kidney disease.

00:17:06.997 --> 00:17:15.897
Dr. Kelly Cairns: A cat will live the longest and feel the best while living the longest, certainly the earlier stage that they are versus the later stage.

00:17:15.897 --> 00:17:32.837
Dr. Kelly Cairns: By the time you have a cat that is in what we call stage four advanced kidney failure, where that bun and that creatinine are very high in the bloodstream, statistically speaking, they would be not likely to have a good quality of life and live more than a year or so.

00:17:32.837 --> 00:17:33.557
Dr. Kelly Cairns: Could it be longer?

00:17:34.277 --> 00:17:35.557
Dr. Kelly Cairns: Could it be shorter?

00:17:35.557 --> 00:17:36.617
Dr. Kelly Cairns: Yes.

00:17:36.617 --> 00:17:38.617
Dr. Kelly Cairns: But that's what I would say if it's very advanced.

00:17:38.617 --> 00:17:49.037
Dr. Kelly Cairns: Now on the other side of the coin, I've diagnosed many cats in stage one, early kidney disease, where we don't even have an elevation in the bun and creatinine.

00:17:49.037 --> 00:17:51.357
Dr. Kelly Cairns: We've caught it before that happens.

00:17:51.357 --> 00:17:58.057
Dr. Kelly Cairns: And I've had cats that, including some of my own cats, who have lived many years after that diagnosis.

00:17:58.057 --> 00:18:01.677
Dr. Kelly Cairns: So this is not a death sentence at all.

00:18:02.337 --> 00:18:03.057
Linda Hall: Okay.

00:18:03.057 --> 00:18:04.737
Rita Reimers: Let's go ahead and take a quick break.

00:18:04.957 --> 00:18:08.877
Rita Reimers: And we'll be back to talk more about kidney disease in kitties.

00:18:08.877 --> 00:18:10.057
Rita Reimers: Is it inevitable?

00:18:10.057 --> 00:18:12.157
Rita Reimers: Perhaps, perhaps not.

00:18:14.757 --> 00:18:17.957
Linda Hall: Hey, it's Linda Hall from 19 Cats and Counting.

00:18:17.957 --> 00:18:21.197
Rita Reimers: And I'm Rita Reimers from 19 Cats and Counting.

00:18:21.197 --> 00:18:24.197
Rita Reimers: You know the expression that cats have nine lives?

00:18:24.197 --> 00:18:26.357
Rita Reimers: Well, what if you can give them one more?

00:18:26.357 --> 00:18:30.677
Rita Reimers: The Give Them 10 movement is on a mission to help give cats an extra life.

00:18:31.237 --> 00:18:31.977
Rita Reimers: How?

00:18:31.977 --> 00:18:33.777
Linda Hall: With spay and neuter.

00:18:33.777 --> 00:18:37.317
Linda Hall: Spaying or neutering your cat helps them live a longer, healthier life.

00:18:37.317 --> 00:18:40.677
Linda Hall: And it helps control the free roaming cat populations too.

00:18:40.677 --> 00:18:47.957
Linda Hall: You can learn more about the benefits of spay and neuter and meet Scooter, the neutered cat, at givethem10.org.

00:18:47.957 --> 00:18:49.297
Rita Reimers: That's givethem10.org.

00:18:52.777 --> 00:18:55.777
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00:18:55.777 --> 00:19:02.537
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00:19:02.537 --> 00:19:11.097
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00:19:11.097 --> 00:19:21.717
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00:19:21.717 --> 00:19:26.277
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00:19:26.517 --> 00:19:35.037
Announcer: Marvel at 1,000 non-pedigree and pedigree cats, adoptable felines, and explore over 100 cat-themed vendors.

00:19:35.037 --> 00:19:39.997
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00:19:39.997 --> 00:19:43.057
Announcer: And guess what feline influencers are coming to meet and greet?

00:19:43.397 --> 00:19:52.377
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00:19:52.377 --> 00:19:57.157
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00:19:57.157 --> 00:20:01.837
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00:20:01.837 --> 00:20:06.597
Announcer: Get your tickets at cfacatexpo.com, that's cfacatexpo.com.

00:20:10.157 --> 00:20:11.257
Announcer: Let's talk pets.

00:20:12.157 --> 00:20:13.177
Announcer: On Pet Life Radio.

00:20:13.177 --> 00:20:14.497
Pam Johnson Bennett: Pet Life Radio.

00:20:14.497 --> 00:20:16.697
Announcer: petliferadio.com.

00:20:26.392 --> 00:20:32.952
Rita Reimers: And we're back with 19 Cats and Counting, the awesome Linda Hall, and our favorite veterinarian, Dr.

00:20:32.952 --> 00:20:35.852
Rita Reimers: Kelly Cairns of Thrive.

00:20:35.852 --> 00:20:42.552
Rita Reimers: She has too many credentials to even relist here, but I'd like to get back to talking more about the kidney disease.

00:20:42.552 --> 00:20:47.732
Rita Reimers: So what are the treatments like for kidney disease, and are they different at each stage?

00:20:47.732 --> 00:20:51.872
Dr. Kelly Cairns: So the treatments for kidney disease fall into a couple big buckets.

00:20:52.672 --> 00:20:56.772
Dr. Kelly Cairns: One is diet, the other are certain medications.

00:20:56.772 --> 00:21:01.712
Dr. Kelly Cairns: And what we do is based upon what that specific cat needs.

00:21:01.712 --> 00:21:08.372
Dr. Kelly Cairns: The most important thing that every cat needs is a diet change.

00:21:08.372 --> 00:21:15.272
Dr. Kelly Cairns: Cats with kidney disease at all stages can very much benefit from what we call a kidney diet.

00:21:15.792 --> 00:21:18.112
Dr. Kelly Cairns: These are commercial diets.

00:21:18.112 --> 00:21:20.692
Dr. Kelly Cairns: They are often prescription diets.

00:21:20.692 --> 00:21:24.852
Dr. Kelly Cairns: Many great reputable manufacturers make these diets.

00:21:24.852 --> 00:21:29.232
Dr. Kelly Cairns: And there's different types of kidney diets related to the stage of kidney disease.

00:21:29.232 --> 00:21:38.352
Dr. Kelly Cairns: For example, there's a slightly different diet we might do for a stage one versus a stage four based upon what needs to be in the diet for that stage of disease.

00:21:38.352 --> 00:21:52.052
Dr. Kelly Cairns: All of these kidney diets are lower in protein and phosphorus and those two things, lowering those things, it does confer a protective benefit to the kidney over time.

00:21:52.052 --> 00:22:06.872
Dr. Kelly Cairns: We have some great actual data, evidence-based studies that show us that cats with kidney disease who eat a kidney diet, in quotes, that their veterinarian has prescribed and recommended, they do live longer and feel better than cats who don't.

00:22:06.872 --> 00:22:09.092
Dr. Kelly Cairns: And that's because of what is in the diet.

00:22:09.092 --> 00:22:11.172
Dr. Kelly Cairns: There's a bunch of other great things in that diet.

00:22:41.972 --> 00:22:47.232
Dr. Kelly Cairns: But it's not just a low-calorie, high-quality protein.

00:22:47.232 --> 00:22:48.312
Linda Hall: Okay, okay.

00:22:48.312 --> 00:22:49.852
Linda Hall: That makes sense.

00:22:49.852 --> 00:23:02.312
Linda Hall: So if I've got a stage 4, 20-year-old cat who is old and has lived his life, are the treatments worth it by stage 4, or is it okay?

00:23:02.312 --> 00:23:03.832
Rita Reimers: By then you just feed him whatever you want.

00:23:03.832 --> 00:23:08.652
Linda Hall: Let's just realize that this cat is like 100 years old and let it go.

00:23:08.652 --> 00:23:14.612
Dr. Kelly Cairns: That's a very individualized question that you'll want to talk to your veterinarian about because there's so many variables.

00:23:14.612 --> 00:23:28.032
Dr. Kelly Cairns: There's definitely things that still can be done to help a kitty symptomatically feel well and even slow progression to keep those remaining kidney cells working, and then you have to balance, can the cat, will the cat take the medication?

00:23:28.032 --> 00:23:29.212
Dr. Kelly Cairns: Is the cat fighting?

00:23:29.212 --> 00:23:32.152
Dr. Kelly Cairns: Does that become a quality of life limiting thing?

00:23:32.232 --> 00:23:43.872
Dr. Kelly Cairns: With diet too, the most important thing for any cat is always that the cat eats, otherwise we get weak, we get malnourished, we can get dehydrated.

00:23:43.872 --> 00:23:47.132
Dr. Kelly Cairns: Dehydration is the enemy of kidney disease.

00:23:47.132 --> 00:23:49.172
Dr. Kelly Cairns: We need lots of water.

00:23:49.172 --> 00:23:54.672
Dr. Kelly Cairns: We cannot let these kitties get dehydrated, and so that's a combination of lots of water sources.

00:23:54.672 --> 00:24:02.572
Dr. Kelly Cairns: If your cat likes fresh water fountains, if your cat likes to drink out of your cup instead of their bowl, so you trick your cat, I do that all the time at home.

00:24:03.592 --> 00:24:16.932
Dr. Kelly Cairns: And then with diet, if the kitty is intermittently inappetant or nauseous or not wanting to eat, then we have to be pragmatic in terms of whatever the cat will eat.

00:24:16.932 --> 00:24:34.112
Dr. Kelly Cairns: And then there might be some what we call symptomatic or palliative medications we can give that will help a kitty decrease nausea, increase appetite, so they feel good, even if we're not treating any longer directly the kidney disease.

00:24:34.112 --> 00:24:36.352
Dr. Kelly Cairns: And this is where your veterinarian is your advocate.

00:24:36.352 --> 00:24:40.752
Dr. Kelly Cairns: You have that conversation and you find a plan that's going to work for everybody.

00:24:40.752 --> 00:24:41.932
Rita Reimers: That was my big issue.

00:24:41.932 --> 00:24:44.552
Rita Reimers: The cats would get to a point where they wouldn't eat.

00:24:44.552 --> 00:24:46.512
Rita Reimers: Remember, I was going so crazy with Missy, Linda.

00:24:46.512 --> 00:24:47.232
Linda Hall: Oh, I remember.

00:24:47.232 --> 00:24:49.672
Rita Reimers: Well, I actually talked with you about her, Kelly.

00:24:49.672 --> 00:24:51.052
Linda Hall: Yeah, she was in hell.

00:24:51.052 --> 00:24:51.992
Linda Hall: Yeah, literally.

00:24:51.992 --> 00:24:52.992
Linda Hall: It was bad.

00:24:53.612 --> 00:24:54.792
Rita Reimers: So were the cats.

00:24:54.792 --> 00:24:57.472
Rita Reimers: I mean, if Kelly became a parent, it was time to let her go.

00:24:57.472 --> 00:25:00.152
Rita Reimers: But for a while, she wasn't ready.

00:25:00.152 --> 00:25:06.252
Rita Reimers: It was just a matter of trial and error, getting her to eat something, and she would not eat anything on the kidney diet.

00:25:06.872 --> 00:25:14.792
Rita Reimers: So she was 20, so she had a good life, and I just pretty much let her eat whatever she would eat, so that she wouldn't die.

00:25:14.792 --> 00:25:16.292
Linda Hall: Put her on hospice, yes.

00:25:16.292 --> 00:25:18.312
Linda Hall: I didn't want her to starve to death.

00:25:18.312 --> 00:25:19.412
Linda Hall: Exactly.

00:25:19.412 --> 00:25:29.792
Linda Hall: So is there something I can do for my younger cats now to make it less likely that they'll have kidney disease in the future?

00:25:29.792 --> 00:25:37.092
Dr. Kelly Cairns: At this point in time, there's nothing really out there that's a magic bullet to prevent a cat getting chronic kidney disease.

00:25:37.092 --> 00:25:56.972
Dr. Kelly Cairns: But being able to do those blood and urine tests frequently for the duration of the kitty's life is gonna allow you to identify, like we talked about, as early as possible, so that we can use all the things in our toolkit to help you and kitty so you can have a great life together for, like I said, a really long time.

00:25:56.972 --> 00:25:58.692
Dr. Kelly Cairns: Very, very manageable.

00:25:58.692 --> 00:26:05.972
Dr. Kelly Cairns: Now, I am excited to talk to you, though, about where we might go in the future in terms of future state.

00:26:05.972 --> 00:26:21.872
Dr. Kelly Cairns: So there's, I've been delighted to see the energy globally in the veterinary community, research community surrounding, identifying targeted therapeutics or treatments for cats, for cat-specific things, y'all.

00:26:21.872 --> 00:26:24.172
Dr. Kelly Cairns: Cats are not small dogs.

00:26:24.172 --> 00:26:36.692
Dr. Kelly Cairns: And we see the fruit of that labor, and we see the fruit of that passion and energy to help our cats in a lot of great products that have come out that are FDA approved for cats, which is a big deal.

00:26:36.692 --> 00:26:38.172
Dr. Kelly Cairns: We've talked about this recently.

00:26:38.172 --> 00:26:42.312
Dr. Kelly Cairns: Everybody should go on your website and check out the podcast we did on diabetes in cats.

00:26:42.892 --> 00:26:44.232
Dr. Kelly Cairns: We have a new treatment.

00:26:44.232 --> 00:26:54.292
Dr. Kelly Cairns: It's a novel mechanism of action, meaning a new class of drugs that previously had only been for people, and now we have an FDA approved drug for cats.

00:26:54.292 --> 00:27:03.552
Dr. Kelly Cairns: In that same spirit, there's been a lot of energy in the veterinary community across the globe for the last 10 or 15 years surrounding.

00:27:03.552 --> 00:27:09.692
Dr. Kelly Cairns: Why do older senior cats seem to get chronic kidney disease with so much more frequency than dogs?

00:27:10.032 --> 00:27:17.132
Dr. Kelly Cairns: We know about one in three cats will develop chronic kidney disease by the age of 10 or older, and it's really only one in 10 dogs.

00:27:17.132 --> 00:27:24.052
Dr. Kelly Cairns: So I don't know that we have all the answers, but we're getting closer to the why or potentially the whys.

00:27:24.052 --> 00:27:26.092
Dr. Kelly Cairns: It may be more than one reason.

00:27:26.092 --> 00:27:33.232
Dr. Kelly Cairns: And there's been some great work coming out of some very innovative researchers in Japan.

00:27:33.232 --> 00:27:47.392
Dr. Kelly Cairns: And there was some news articles actually published this spring that they've been doing research and they've identified a possible target for potential therapy or treatment in a forward state.

00:27:47.412 --> 00:27:58.832
Dr. Kelly Cairns: So there's no drug yet, but there might be with a little bit of funding, additional time and a little bit of luck, a little bit of magic fairy dust, we are cautiously optimistic.

00:27:58.832 --> 00:28:05.352
Dr. Kelly Cairns: We might have a medication in a clinical trial setting, maybe even as soon as 2025.

00:28:06.072 --> 00:28:23.472
Dr. Kelly Cairns: because if this drug does or this target does what we think by the initial studies, it might, then it could be that we could actually not have chronic kidney disease be such a big thing for cats so early on.

00:28:23.472 --> 00:28:24.012
Rita Reimers: That would be awesome.

00:28:24.012 --> 00:28:32.292
Dr. Kelly Cairns: And the initial data suggests maybe even as long as nothing else happens to that kitty, maybe even the kitty's lifespan could go up to be 20 to 30.

00:28:32.292 --> 00:28:38.672
Dr. Kelly Cairns: So again, way too premature to have that crystal ball, but I am so excited by this.

00:28:38.672 --> 00:28:50.372
Dr. Kelly Cairns: And I'm so grateful for the energy that the global community is putting behind this, because we really are passionate as a profession about doing more to help cats and the people who love them.

00:28:50.372 --> 00:28:50.852
Rita Reimers: Wow.

00:28:50.852 --> 00:28:53.332
Rita Reimers: Could you imagine some of our younger cats that we have?

00:28:53.332 --> 00:28:57.052
Linda Hall: I actually almost, I actually almost teared up.

00:28:57.052 --> 00:28:57.972
Rita Reimers: My sweetie pie.

00:28:57.972 --> 00:29:00.772
Rita Reimers: I told her she has to live to be at least 35.

00:29:00.772 --> 00:29:05.852
Linda Hall: So I told my daughter the other day when Rita loses sweetie, we're leaving the country.

00:29:05.852 --> 00:29:06.932
Linda Hall: I can't.

00:29:06.932 --> 00:29:07.892
Rita Reimers: Yeah, it's going to be bad.

00:29:07.892 --> 00:29:09.752
Linda Hall: I'd be at your house, but it's going to be bad.

00:29:09.752 --> 00:29:10.072
Linda Hall: Yes.

00:29:10.072 --> 00:29:12.212
Linda Hall: But yeah, I literally, my eyes started.

00:29:12.212 --> 00:29:13.112
Rita Reimers: She's only five.

00:29:13.112 --> 00:29:13.712
Rita Reimers: It's all right.

00:29:13.912 --> 00:29:14.712
Linda Hall: I know.

00:29:14.732 --> 00:29:15.432
Linda Hall: I know.

00:29:15.432 --> 00:29:18.132
Linda Hall: And we've got all the knowledge to help her out.

00:29:18.132 --> 00:29:22.672
Linda Hall: I think in general, you know, when well, especially Rita, she's been in this field longer than I have.

00:29:22.672 --> 00:29:28.692
Linda Hall: But even as long ago as when I jumped in, cats seem to have been the forgotten animal.

00:29:28.692 --> 00:29:29.332
Linda Hall: They're like this.

00:29:30.212 --> 00:29:31.712
Rita Reimers: The red-headed stepchildren.

00:29:31.712 --> 00:29:32.252
Linda Hall: Yes.

00:29:32.252 --> 00:29:35.352
Linda Hall: They're like this accessory you have in the farm to eat the mice.

00:29:35.372 --> 00:29:38.092
Linda Hall: And we haven't seen as many products.

00:29:38.092 --> 00:29:45.432
Linda Hall: You know, there's many dog focused products that we've recommended to people like food puzzles and things for cats because there's a lack of them for cats.

00:29:45.432 --> 00:29:53.132
Linda Hall: So I think we're starting to see like you're the one that told us about Salencia that's for the arthritis, the first FDA approved medication for cats.

00:29:54.132 --> 00:29:59.092
Linda Hall: And now this, is this a switch up in everybody's thinking?

00:29:59.092 --> 00:30:06.012
Dr. Kelly Cairns: Well, I will tell you, it's not a switch up in terms of, well, now we're leaving the dogs on Lonely Island.

00:30:06.012 --> 00:30:11.152
Dr. Kelly Cairns: There's a lot of great new work that's coming out and new drugs in the same spirit for dogs.

00:30:11.152 --> 00:30:18.972
Dr. Kelly Cairns: So Salencia is that drug you mentioned for cats to treat pain associated with osteoarthritis or age-related arthritis.

00:30:18.972 --> 00:30:22.612
Dr. Kelly Cairns: And there's also a dog product that does the same thing for dogs called Labrela.

00:30:23.352 --> 00:30:44.752
Dr. Kelly Cairns: So what we're seeing is, again, a deepening in the commitment and investment in the even pharmaceutical space by amazing companies that make drugs for spending the time and the money to fund veterinary researchers to actually get these products to the finish line.

00:30:44.752 --> 00:30:51.832
Dr. Kelly Cairns: And so that is leading to more focus on cats and a deepening of the already the focus that there had been on dogs.

00:30:51.912 --> 00:30:53.712
Dr. Kelly Cairns: So it's an exciting time.

00:30:53.712 --> 00:31:04.752
Dr. Kelly Cairns: And I think what it really reflects is that, and this is so delightful, everybody, is that we've always known how important pets are to people and the importance of the human animal bond.

00:31:04.752 --> 00:31:07.112
Dr. Kelly Cairns: And I don't know, I'm just speculating here.

00:31:07.112 --> 00:31:19.592
Dr. Kelly Cairns: I'm sure it's complicated, but I think one of the silver linings of COVID was a reinvigoration of the recognition of the value of not only human to human relationships, but human and pet relationships.

00:31:20.852 --> 00:31:29.632
Dr. Kelly Cairns: The universe is wanting to do things to invest into things that allow that bond to continue and deep.

00:31:29.632 --> 00:31:33.752
Dr. Kelly Cairns: And to do that, we need to double down on what we're doing to keep those pets feeling good.

00:31:33.752 --> 00:31:34.872
Rita Reimers: Yeah, it's so true.

00:31:35.052 --> 00:31:44.892
Rita Reimers: We just had on the guy that founded the Boss Brands, Boss Dog Food, Boss Cat Food, maybe Boss Parrot Food coming out soon.

00:31:45.772 --> 00:31:54.512
Rita Reimers: But he said he's noticing a shift in the pet food industry, going more towards holistic and wellness for both cats and dogs.

00:31:54.512 --> 00:32:01.192
Rita Reimers: And there's actually a lot more new brands coming out for cats than I've ever seen before in the last few years.

00:32:01.192 --> 00:32:02.172
Dr. Kelly Cairns: That's totally true too.

00:32:02.312 --> 00:32:26.812
Dr. Kelly Cairns: We're seeing in the pet food space, as you mentioned, pet parents have renewed kind of zest for really making sure that their pet is getting great nutrition and looking at all the different ways you can accomplish that, whether it's a traditional store-bought diet or a homemade diet or a store-bought different diet, right?

00:32:26.932 --> 00:32:33.612
Dr. Kelly Cairns: Like one of the, you talk about holistic or natural or even, you know, some of the complimentary diets that are out there.

00:32:33.612 --> 00:32:36.292
Dr. Kelly Cairns: So I think it's a great time overall.

00:32:36.292 --> 00:32:37.512
Linda Hall: It is.

00:32:37.512 --> 00:32:39.552
Rita Reimers: It's very exciting.

00:32:39.552 --> 00:32:45.852
Rita Reimers: Thank you so much for bringing us all this great information and all these breakthroughs and new things that are coming out.

00:32:45.852 --> 00:32:50.052
Rita Reimers: It's really making me think my cats are going to be outliving me.

00:32:50.052 --> 00:32:51.192
Rita Reimers: Sorry, Linda.

00:32:51.192 --> 00:32:51.612
Linda Hall: Right?

00:32:51.912 --> 00:32:52.472
Linda Hall: Right.

00:32:52.472 --> 00:32:53.872
Rita Reimers: Linda's a little younger than me.

00:32:53.872 --> 00:32:57.292
Rita Reimers: So if I go first, she inherits whoever I have.

00:32:57.292 --> 00:32:59.232
Linda Hall: Kelly, I am the beneficiary.

00:32:59.232 --> 00:33:03.652
Linda Hall: Well, the cat's the beneficiary of life insurance policy, but I'm the guardian of it.

00:33:03.652 --> 00:33:06.332
Linda Hall: If Rita gets hit by a bus tomorrow, I've got 30 cats.

00:33:06.332 --> 00:33:09.012
Linda Hall: So please pray for a very long life for Rita.

00:33:09.012 --> 00:33:09.252
Linda Hall: Please.

00:33:09.252 --> 00:33:10.212
Rita Reimers: Vice versa.

00:33:10.652 --> 00:33:12.232
Rita Reimers: She has 11 of the sanctuary cats.

00:33:12.232 --> 00:33:13.812
Rita Reimers: I end up with all 30 of them here.

00:33:13.812 --> 00:33:15.052
Rita Reimers: So yeah.

00:33:16.392 --> 00:33:17.992
Linda Hall: I'm in trouble if that happens.

00:33:17.992 --> 00:33:18.992
Linda Hall: So yeah.

00:33:18.992 --> 00:33:21.032
Rita Reimers: Any last words of wisdom for us, Dr.

00:33:21.032 --> 00:33:21.332
Rita Reimers: Kelly?

00:33:21.532 --> 00:33:24.692
Rita Reimers: I always love your departing advice.

00:33:24.692 --> 00:33:25.592
Rita Reimers: Now I just put you on the spot.

00:33:25.592 --> 00:33:29.372
Dr. Kelly Cairns: We guys, why don't we give our kitty-loving friends an actionable tool kit.

00:33:29.372 --> 00:33:30.452
Dr. Kelly Cairns: So let's just review.

00:33:30.452 --> 00:33:32.812
Dr. Kelly Cairns: What are some take-home points here that we learned?

00:33:32.812 --> 00:33:39.792
Dr. Kelly Cairns: So I want everyone who has a kitty in their life that they love to remember that chronic kidney disease is common in older cats.

00:33:39.792 --> 00:33:45.972
Dr. Kelly Cairns: And we're not really sure what causes it, but it's just kind of age-related, kind of kidneys don't work as well.

00:33:45.972 --> 00:33:48.352
Dr. Kelly Cairns: It will progress over time.

00:33:48.352 --> 00:34:07.352
Dr. Kelly Cairns: And it is important that you know that you can identify it early, throw active wellness care to have that older cat seen by your veterinarian twice a year for routine examination, conversation, and some simple blood and urine tests so we can identify if your cat has it as early as possible.

00:34:07.352 --> 00:34:29.472
Dr. Kelly Cairns: And then listen to your veterinarian's recommendations with what they feel is best surrounding diet and any medications, because those are going to be the custom package for your cat to slow progression of this chronic disease and to minimize complications, like potentially high blood pressure or a saliciated urinary tract infection.

00:34:30.652 --> 00:34:44.812
Dr. Kelly Cairns: And know that even if your vet says to you, okay, your kitty has stage three or even stage four, where those toxins had built up, there's still a lot of things that can be done to help your kitty feel good for as long as possible.

00:34:44.812 --> 00:34:48.632
Dr. Kelly Cairns: So we are going to be positive and pro act.

00:34:48.632 --> 00:34:49.172
Rita Reimers: Nice.

00:34:49.172 --> 00:34:50.132
Linda Hall: Best advice.

00:34:50.132 --> 00:34:50.712
Linda Hall: Yep.

00:34:50.712 --> 00:34:52.432
Rita Reimers: Yes, that's definitely the best advice.

00:34:52.572 --> 00:34:55.692
Rita Reimers: And kitty parents love hearing that all is not gloom and doom.

00:34:55.692 --> 00:34:59.572
Rita Reimers: It's not, but make sure you have a good relationship with your veterinarian.

00:34:59.572 --> 00:34:59.952
Linda Hall: Yes.

00:34:59.952 --> 00:35:02.452
Rita Reimers: Linda Hall, my best friend, ride or die.

00:35:02.452 --> 00:35:06.672
Rita Reimers: You need to get down here to the Carolinas before I fly up there and bring you down.

00:35:06.992 --> 00:35:07.812
Linda Hall: All right.

00:35:07.812 --> 00:35:08.792
Linda Hall: Come get me.

00:35:08.792 --> 00:35:09.132
Rita Reimers: Dr.

00:35:09.132 --> 00:35:13.992
Rita Reimers: Kelly, as always, we thank you for your wisdom, your advice, your humor and everything.

00:35:13.992 --> 00:35:18.152
Rita Reimers: I can't thank you enough for being a regular part of 19 Cats and Counting.

00:35:18.152 --> 00:35:23.752
Rita Reimers: And of course, Mark Winter, our awesome producer who edits us and makes us sound so good.

00:35:23.752 --> 00:35:26.032
Rita Reimers: Thank you for this spot on Pet Life Radio.

00:35:26.032 --> 00:35:28.072
Rita Reimers: We so appreciate it.

00:35:28.072 --> 00:35:32.872
Rita Reimers: And just remember, every day of your life is Caturday, not just Saturday.

00:35:32.872 --> 00:35:34.152
Rita Reimers: Every day is Caturday.

00:35:34.152 --> 00:35:35.172
Rita Reimers: We'll see you next time.

00:35:35.892 --> 00:35:37.152
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