Start a Birman screening plan with the kidney, not the heart. Polycystic kidney disease (PKD) is inherited as a dominant trait, it can be imaged from 10 to 12 months, and it is the 1 item where an early answer changes 10 years of monitoring. The other 3 targets follow in a fixed order: heart from 12 months, eye and skin at the first kitten visit, and a urinalysis every 12 months.
4 targets, 4 start ages
Kidney ultrasound at 10 to 12 months, then every 12 months if cysts are present or every 24 months if clear. Cardiac DNA panel once, any time after 3 months. First eye and skin examination at 6 to 8 months, then annually. Echocardiogram at 12 months, then every 12 months. By 8 years a clean cat moves to a 12-month cycle with blood pressure added; the kidney item never drops off the list.
Why the kidney comes first
PKD fills the kidney with fluid pockets that enlarge over years and replace working tissue. The cysts are present early, but at 4 months they can be too small for a standard probe to resolve, which is why the first scan waits for 10 to 12 months. From there, the numbers that matter are kidney length, the number and size of cysts, and 2 blood values: creatinine and SDMA, with SDMA at or below 14 micrograms per deciliter as the usual reference. A cat with a 4.5 cm kidney and multiple cysts larger than 1 cm is on a 6-month imaging cycle and a 3-month blood cycle, not an annual one.
The kidney imaging schedule
| Age | Scans | Kidney length (cm) | Decision |
|---|---|---|---|
| 10 to 12 months | 1 | 3.5 to 4.5 | cysts present means every 12 months |
| 2 to 5 years | 1 per 12 months | compare to baseline | length down 0.3 cm means recheck in 6 months |
| 6 to 8 years | 1 per 12 months | 3.4 to 4.4 | add SDMA and urine protein every 6 months |
| 9 years and up | 1 per 6 months | record both kidneys | stage with IRIS and treat to stage |
| Any age, cyst over 1 cm | 1 per 6 months | measure the cyst | blood pressure and protein at each visit |
Clean scans at 12 and 24 months usually mean every 24 months from then on. The DNA test settles the inheritance question in 1 sample, 10 to 21 days, 80 to 200 dollars.
DNA, ultrasound, radiographs: what each answers
Radiographs. Not annual: 1 chest film when an echo is not available and you need the heart silhouette, 120 to 250 dollars.
The DNA test answers 1 question, whether the cat carries the known PKD variant, and it answers it at any age from a cheek swab, for 80 to 200 dollars. It cannot tell you how large a cyst is or how much kidney is left. The ultrasound answers the size question and shows both kidneys, for 150 to 300 dollars per study, but a negative scan in a 5-month-old kitten means very little. Use both once: the swab at 3 to 6 months to settle breeding decisions, the scan at 10 to 12 months to set the baseline image.
Skin: congenital hypotrichosis is not a cosmetic issue
Some Birmans are born with sparse or missing coat, not a seasonal shed. Thin coat means a thin barrier: the skin loses water faster, sunburn is real on white or pale areas, and small scratches turn into bacterial infections more often. Bathe every 2 to 4 weeks with a mild non-medicated shampoo, never more than once a week, keep the room at 22 to 24 Celsius, and offer a warm bed, since a thin coat loses heat at night. Any area that is red, weeping, or smells for more than 72 hours needs a skin cytology at 60 to 120 dollars, not another shampoo. Prescription topical or oral antibiotics and steroid classes exist for this, by veterinary prescription only.
Eye: a dermoid is a 1-time surgery
A dermoid cyst on the eye is a small island of skin with hair growing on the cornea or conjunctiva, present from birth. Hair rubs the cornea with every blink, so the clock is not cosmetic: a kitten with a dermoid that is already causing discharge or a corneal ulcer needs surgery at 4 to 6 months, and one with no irritation can wait until 6 to 12 months. The operation is microsurgical excision at 400 to 1200 dollars; earlier means less scarring. Between diagnosis and surgery, use a lubricant drop 3 to 4 times a day and watch for squinting, which means an ulcer is forming and the visit moves to the same week.
Heart, on the same invoice as the kidney
Hypertrophic cardiomyopathy (HCM) appears in the breed, and the screening logic is the same as for any cat: 1 echo at 12 months, 1 every 12 months after that, wall thickness under 5 mm normal, 5 to 5.9 mm a gray zone, 6 mm or more diagnostic. Ask for the echo and the abdominal scan in 1 visit; 2 trips cost 2 exam fees.
4 numbers to write down weekly
- Water intake above 60 ml per kg per day, measured by refilling a marked bowl.
- Urine clumps larger than a golf ball, or a litter box that needs changing twice as often.
- Weight down 5 percent in 30 days with a normal appetite.
- New squinting, tearing, or a red patch on the eye that lasts more than 24 hours.
When to stop waiting
| Signal | Window (hours) | Move |
|---|---|---|
| Open-mouth breathing, blue gums, collapse | 0 | Emergency room, no callback wait |
| Male cat straining, no urine for 12 hours | 0 | Emergency, fatal in 24 to 36 |
| Resting rate above 40 per minute | 1 | Call and arrive within the hour |
| No food for 24 hours, or 3 vomits in 12 | 4 | Same-day clinic |
| Sudden cloudy eye with hard squinting | 6 | Ophthalmic exam, ulcer risk |
| Weight down 10 percent in 60 days | 72 | Book a full exam |
What the plan costs per year
Exam 60 to 120, kidney ultrasound 150 to 300, bloodwork with SDMA 80 to 200, urinalysis with protein to creatinine 40 to 90, echo 220 to 450, blood pressure 20 to 60, and the DNA swab once at 80 to 200. A quiet year is 450 to 850 dollars; a year with an echo, a kidney scan, and a 6-month recheck is 700 to 1200. Insurance for a breed with a known kidney item typically quotes 25 to 45 dollars a month, and any cyst found before the policy starts is excluded for life, so order the 10-to-12-month scan before the policy.
5 moves for the next 30 days
- Book the 10-to-12-month kidney scan and ask for both kidneys measured in centimeters.
- Do the PKD swab now if the cat is over 3 months and has never been tested.
- Measure daily water intake for 3 days and write the number on the chart.
- Photograph both eyes at 6 months and compare monthly, so a dermoid is caught early.
- Put the weight on the weight trend chart and the heart protocol next to it.
The cardiac side follows the same wall and ratio numbers used in the Maine Coon heart screen. Before any supplement, human kidney product, or plant goes into the bowl, run it past the toxin list, because lily exposure alone can end a kidney in 72 hours.
Terms mentioned in this article
Frequently asked
When should a Birman have its first kidney ultrasound?
At 10 to 12 months. Cysts are present early but can be too small to resolve on a standard probe at 4 months, so an earlier scan buys false reassurance. From the first scan, a cat with cysts moves to every 12 months, or every 6 months if any cyst is over 1 cm, and the image is compared against the 12-month baseline rather than read in isolation.
Is the PKD DNA test enough on its own?
No. The swab answers whether the cat carries the known dominant variant, and it does that at any age from 3 months for 80 to 200 dollars. It cannot show cyst size, kidney length, or how much function is left, so it does not replace imaging. Most plans use the swab once for breeding or family decisions and the ultrasound at 10 to 12 months to set the imaging baseline, then repeat the scan on schedule.
At what age should an eye dermoid be removed?
Between 4 and 6 months if it is already causing discharge, squinting, or a corneal ulcer, and between 6 and 12 months if it is quiet. The surgery is microsurgical excision at 400 to 1200 dollars. Waiting on an irritated dermoid costs cornea: every blink drags hair across the surface, and scar tissue that forms before surgery is permanent, which is why a new squint means a visit that week, not next month.