By Dr. Becker
The University of Georgia Veterinary Teaching Hospital is one of just three veterinary hospitals in the US able to perform kidney transplants, and one special cat was a recent recipient of the surgery.
Arthur, a 4-year-old flame point Siamese, had end-stage chronic renal failure, and his owners had been turned down for transplant surgery by veterinary hospitals at the University of Pennsylvania and the University of Wisconsin. (In both cases, the hospital staff was concerned about potential complications.)
One of Arthur’s guardians, Tony Lacaria, told OnlineAthens, “At that point Arthur was very ill. He was dying.” So Lacaria and his partner, Frederick Petrick, jumped in the car and drove 10 hours to the University of Georgia. They had no idea if UGA would also turn Arthur down, but “He only had a few weeks to live,” said Lacaria. So they felt they had to try.
Veterinarians at UGA Take a Novel Approach to Arthur’s Kidney Transplant
Lacaria, Petrick, and little Arthur met with Dr. Chad Schmiedt, a veterinary surgeon who runs UGA’s feline kidney transplant program. A big hurdle for Arthur was that his body didn’t properly absorb cyclosporine, which is an immune suppressant given to transplant patients that reduces the risk of organ rejection.
Dr. Schmiedt suggested an alternative to cyclosporine: feline adult stem cells, called mesenchymal stem cells. Stem cells are found in neonatal tissues, bone marrow, placenta, umbilical cords, and fat tissue. Schmiedt removed some fat from Arthur and left it with UGA’s Regenerative Medicine Service laboratory. Over the next week, the lab grew stem cells from the tissue.
Mesenchymal stem cells have a proven anti-inflammatory effect that reduces immune responses in a number of situations. According to Dr. John Peroni of UGA, whose research focuses on stem cell therapy:
“When you place a new organ into any species, in this case a cat, the immune system is going to think the organ does not belong to the cat and is going to fire off the immune system in an attempt to reject it. There’s evidence in literature that suggests that administering stem cells in conjunction with the transplant will lessen immune response and the rejection effect will decrease.”
On May 15, 2014, Arthur Received a New Kidney
Arthur received his new kidney on May 15th of this year, and once the blood vessels to the organ were in place, he was given a dose of about 4 million stem cells. As Dr. Schmiedt explained, the use of stem cells is a novel approach with the potential to improve outcomes for transplant patients.
Arthur is the second kitty to undergo a successful kidney transplant at UGA using stem cells. The first transplant was done in 2013, and that cat is reported to be doing well a year later.
Considering Arthur’s Siamese breed, relatively young age, and advanced stage of kidney disease, it’s likely he was predisposed to develop the condition and the transplant was the only way to save his life. However, immunosuppressive drug protocols, which most transplant patients must take for the rest of their lives to prevent organ rejection, typically have severe, debilitating and often life-shortening side effects.
Feline Kidney Disease Is Epidemic
While certain cat breeds, including Arthur’s, are predisposed to chronic kidney disease (CKD), studies show that about half of all pet cats over the age of 10 suffer from the condition. Once CKD is full-blown, it is irreversible and can be difficult to manage. Treatment is strictly supportive and typically involves trying to slow the progression of the disease through dietary changes, fluid injections, and other therapies.
To help prevent CKD, I recommend feeding high-quality protein in its natural, unadulterated form as soon as a kitten is weaned. This will provide a moisture-rich diet for the cat’s lifetime, which in turn will take tremendous stress off the kidneys.
In kitties already diagnosed with kidney disease, a diet high in excellent quality protein and lower than normal amounts of sodium and phosphorus is recommended.
If your cat is addicted to a poor-quality food that is difficult to digest and process, I recommend you reduce the amount of toxic protein in the diet. However, if your cat is eating human-grade protein, then protein restriction is often counterproductive and actually exacerbates problems of weight loss and cachexia (muscle wasting) -- two common health issues for cats with failing kidneys.
Cats with renal disease do best eating high-quality, human grade canned food or a fresh, balanced homemade diet. Cats with the disease still eating kibble should be transitioned if at all possible to a diet that provides much more moisture to help nourish the kidneys. But most importantly, cats with kidney disease must continue to eat, and unlimited access to fresh water should always be provided.