Nephrectomy in Cats

Nephrectomy is a surgical procedure used to treat irreversible conditions of the kidney and ureter that involves the removal of the affected kidney and ureter. Nephrectomy is not commonly performed on cats, but may be used to treat cancer, ureteral abnormalities, and persistent infection. Depending on the condition, nephrectomy can be also be used as primary intervention in cases such as kidney cancer that has not spread. Your veterinarian will diagnose the condition, determine if nephrectomy is warranted, and either perform the procedure or refer you to a specialist or surgeon.

Prior to the nephrectomy procedure, the health of the remaining kidney should be assessed to ensure it can maintain the health of the cat in its own. If cancer is suspected, a full staging should be provided to determine the extent the cancer has spread throughout the body. Any hydration or electrolyte abnormalities should be corrected prior to the procedure as well.

General anesthesia is required for the procedure, as it is an invasive surgery. Most anesthesia protocols are safe for this procedure, though care should be taken to choose drugs that are minimally toxic to the kidneys.

For the procedure, the cat is placed on its back under general anesthesia. An incision is made on the abdomen from just under the sternum to the pubic bone. The kidney is visualized after the rest of the abdomen is explored for any abnormalities. The kidney is removed from its parenchyma (a thin tissue that separates the kidney from the rest of the abdomen) and the renal artery and vein identified. The renal artery and vein are each tied off and cut and then the ureter associated with the kidney is tied off and cut. The kidney and ureter are then removed. After checking for signs of bleeding, the patient is closed and recovery can begin.

Nephrectomy is an effective treatment in the goal of alleviating irreversible kidney and ureter conditions in cats. The effects of nephrectomy are permanent and irreversible. In some cases, partial nephrectomy may be performed to spare some kidney function and spare the other kidney the strain of providing all the renal function for the cat. However, partial nephrectomy carries an increased risk of persistent bleeding after surgery and may be riskier than removing the entire kidney.

After surgery, your cat will be prescribed pain medication to alleviate postoperative pain for the first few days after surgery. A follow-up visit to the vet will be needed within two weeks for suture removal and examination. Prior to this visit, it is important to monitor the incision site for signs of infection such as swelling, redness and discharge. All nephrectomy patients must be evaluated for kidney function and signs of postoperative complications. The most common postoperative complications of nephrectomy are bleeding and urine leaking into the abdomen. These complications can typically be identified through physical exam and bloodwork.

If cancer was the reason for the nephrectomy, follow-up appointments and treatments may  include chemotherapy and monitoring for the spread of disease, including imaging of the chest and abdomen using ultrasound and x-ray.

The cost of nephrectomy in cats can range from $700-$1,200. The cost of the procedure and related treatment varies, depending on the clinic and severity of the condition being treated. Requirements for medication, hospitalization, preoperative testing, postoperative monitoring, and other services may influence the cost of treatment.

Nephrectomy can alleviate symptoms associated with damage to the kidney and ureter and extend lifespan when used to remove a cancerous kidney. The primary risks associated with nephrectomy are bleeding and leakage of urine into the abdomen. Long term, it is important to ensure that the remaining kidney stay healthy for as long as possible.

It may not be possible to prevent some conditions that lead to nephrectomy, such as cancer and trauma. In general, it is important to ensure that the kidneys are as healthy as possible so if nephrectomy becomes necessary, the remaining kidney able to assume all renal function. Steps to take to ensure your cat’s kidneys stay healthy include:

• Providing ample water: Hydration is key to preventing kidney disease
• Balanced diet: A special urinary diet is not needed

For pets that have persistent kidney stones that may lead to infection and eventual nephrectomy, additional steps can be taken, such as:

• Feeding a kidney stone diet
• Medical management
•  Monitoring your cat for signs of urinary tract infection and providing prompt treatment.