Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Symptoms, Diagnosis, Treatments and How to Cope With It

This site is dedicated to my three CKD cats:

Tanya	Thomas	Ollie

HOME

Site Overview

What You Need to Know First

Alphabetical Index

Glossary

Research Participation Opportunities

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Tanya's CRF Support Group Today

WHAT IS CKD?

KEY ISSUES

Nausea, Vomiting, Appetite Loss and Excess Stomach Acid

Maintaining Hydration

The Importance of Phosphorus Control

All About Hypertension

All About Anaemia

All About Constipation

SUPPORT

Tanya's Support Group

Success Stories

SYMPTOMS

Alphabetical List of Symptoms and Treatments

Fluid and Urinary Imbalances (Dehydration, Overhydration and Urinary Issues)

Waste Product Regulation Imbalances (Vomiting, Appetite Loss, Excess Stomach Acid, Gastro-intestinal Problems, Mouth Ulcers Etc.)

Phosphorus and Calcium Imbalances

Miscellaneous Symptoms (Pain, Hiding Etc.)

DIAGNOSIS: WHAT DO ALL THE TEST RESULTS MEAN?

Blood Chemistry: Kidney Function, Potassium, Other Tests (ALT, Amylase, (Cholesterol, Etc.)

Complete Blood Count (CBC): Red and White Blood Cells: Anaemia and Infection

Urinalysis (Urine Tests)

Other Tests: Ultrasound, Biopsy, X-rays etc.

Renomegaly (Enlarged Kidneys)

Which Tests to Have and Frequency of Testing

Factors that Affect Test Results

Normal Ranges

International and US Measuring Systems

TREATMENTS

Which Treatments are Essential

Finding a Good Vet and Record Keeping

Fluid and Urinary Issues (Fluid Retention, Infections, Incontinence, Proteinuria)

Waste Product Regulation (Mouth Ulcers, GI Bleeding, Antioxidants, Adsorbents, Azodyl, Astro's CRF Oil)

Phosphorus, Calcium and PTH (Calcitriol)

Miscellaneous Treatments: Stem Cell Transplants, ACE Inhibitors - Fortekor, Steroids, Kidney Transplants)

Antibiotics and Painkillers

Holistic Treatments (Including Slippery Elm Bark)

ESAs (Aranesp, Epogen etc.) for Severe Anaemia

General Health Issues in a CKD Cat: Fleas, Arthritis, Dementia, Vaccinations

Tips on Medicating Your Cat

Obtaining Supplies Cheaply in the UK, USA and Canada

Working with Your Vet

DIET & NUTRITION

Nutritional Requirements of CKD Cats

The B Vitamins (Including Methylcobalamin)

What to Feed (and What to Avoid)

Persuading Your Cat to Eat

Food Data Tables

USA Canned Food Data

USA Dry Food Data

USA Cat Food Manufacturers

UK Canned Food Data

UK Dry Food Data

UK Cat Food Manufacturers

2007 Food Recall USA

FLUID THERAPY

Intravenous Fluids

Subcutaneous Fluids

Tips on Giving Subcutaneous Fluids

How to Give Subcutaneous Fluids with a Giving Set

How to Give Subcutaneous Fluids with a Syringe

Subcutaneous Fluids - Winning Your Vet's Support

Polycystic Kidney Disease (PKD)

Pancreatitis

Dental Problems

Anaesthesia

OBTAINING SUPPLIES CHEAPLY

SAYING GOODBYE

Coping with Your Loss

Other People's Losses

MISCELLANEOUS

Prevention

Research

Canine Renal Failure

Other Illnesses (Cancer, Liver) and Behavioural Problems

Diese Webseite auf Deutsch

SITEOWNER (HELEN)

My Three CKD Cats: Tanya, Thomas and Ollie

My Multi Ailment Cat, Harpsie

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Introduction

Hello, and welcome to my new look website, though I am sorry you need to be here.

My name is Helen. I have had three cats with CKD, Tanya, Thomas and Ollie (their photos are above). I created this website because I know first hand the shock and fear of the diagnosis, and how helpless it can make you feel, and I wanted to give people the detailed, practical information which would have helped me the first time I received the CKD diagnosis.

If your cat has also just been diagnosed with CKD, you are probably feeling shell-shocked and frightened. Your cat may be in the midst of a crisis, perhaps on intravenous fluids (IV, or a drip, or a flush) at the vet's. If your cat has high bloodwork values, you may not even have been offered any treatment, but instead told that there is no hope and you should just put your cat to sleep. Perhaps your cat has had CKD for a while, but you are now realising that you need to become more proactive if you want him or her to remain well. Or maybe you've caught things early, but are anxious to find out all you can about this disease so you can do all you can to keep your cat stable. Whatever your situation, please take a deep breath and don't give up hope, because it may well be possible to help your cat.

What is Kidney Disease?

There are two main kinds of kidney disease, Chronic Kidney Disease, abbreviated as CKD, and Acute Renal Failure, abbreviated as ARF.

Kidney disease used to be known as kidney failure, and you may therefore see references in some of my links to Chronic Renal Failure or CRF. I used to use these expressions myself, but these days the academic literature prefers the less scary and more accurate expression, kidney disease, so that is what I use throughout the site.

ARF is a serious condition which usually comes on suddenly and which is often triggered by a particular event or "insult", such as your cat eating something poisonous. Lilies and antifreeze are both extremely toxic to cats and may cause ARF. ARF is usually treated with intravenous fluids (IV fluids, also known as a drip) and other medications at the vet's and, although it is hard to treat, if the cat survives the initial crisis, he/she can often regain much or sometimes all of his/her normal kidney function.

CKD may also manifest itself very suddenly and require IV treatment at the vet's, but in contrast to ARF it is an ongoing disease in which it is not possible to regain lost kidney function; so the goal is to keep the remaining function for as long as possible.

This site is primarily designed for people with a cat with the chronic form of the disease (CKD), but may be of some use to those with a cat with ARF. Please visit the Acute Renal Failure page for more information.

Aims of the Site

This site shares all the information and tips I know, in great detail, in order to help your cat feel better and hopefully extend his/her life. I am not a vet, just an ordinary person who has educated herself about CKD in cats, so wherever possible I do try to offer veterinary information to support what I say. I am English, but I lived in the USA from 2004-2008. I therefore have firsthand experience of feline veterinary care on both sides of the Atlantic. I do still spell the English way, so Americans should be aware that, for example, I write 'anaemia' rather than 'anemia'.

I try to share the information I have using layman's language. My goals are to:

describe the symptoms which you may be seeing now or which you may see in the future;
explain what these symptoms and your cat's test results may mean;
discuss treatments which can often help, many of which are not very expensive (the most commonly used treatments can usually be obtained for around US$5 a week in total);
cover the emotional aspects of living with CKD and help you to cope with it, including at the end of your CKD journey.

The site provides information on an international basis, aiming to help you wherever you happen to live, although in practice much of the information relates to the USA and Europe since these are the areas where the most information and treatments are available.

Since I've recently revamped the site, I will no doubt have forgotten to update some of the links so they will be broken. Apologies, and please check the sidebar on the left to find the link you need. I hope to have the revamp complete and all links checked by the end of January 2012.

Where to Start

This site is extremely comprehensive, as you can see from the number of links in the sidebar on the left. But don't panic, you won't need to learn about every single aspect.

Most people who arrive here for the first time have two overwhelming concerns:

they want to know how severe their cat's case is.

they want to know how best to help their cat, and quickly.

I therefore recommend that you read these pages first:

How Bad Is It? - discusses the various stages of CKD in cats.
Is There Any Hope?: discusses the various scenarios you may face.
Key Issues - the crucial issues to focus on in order to best help your cat. Don't worry, it is highly unlikely that you will need to deal with all of them at once.

These pages will get you started quickly so you can hit the ground running. Then, later on, you can gradually get up to speed on CKD in more detail. The Site Overview - Finding What You Need page provides a brief summary of the contents of each page, so if you're not sure where to find something, check here, or just check the sidebar on the left.

If Your Vet Has Recommended Immediate Euthanasia

Please read the Just Diagnosed? What You Need to Know First page urgently. Unfortunately, some vets are not overly familiar with the latest treatments for CKD, and may recommend euthanasia prematurely. You need to educate yourself and work out how severe your cat's case is before you make this irrevocable decision.

My Three CKD Cats

This website is named in honour of Tanya, who was my first CKD cat. Unfortunately Tanya did not receive as much proactive care as Thomas and Ollie, because at the time that she was diagnosed (1998), I did not know about the treatment options described on this website. I tried desperately to find information to help her but I was not online, so my options were limited. Once I got online, I vowed that nobody else should have to go through that, so I created this website.

Thomas, in contrast, had much more severe CKD yet survived longer than Tanya because he received more proactive treatment.

Ollie was a somewhat different case: he came to me a week before his sixteenth birthday with relatively mild CKD but with a host of other health problems which ultimately took him from me.

You can read more about all of them here. You can also read some Success Stories here, some of whom have survived for years with CKD. I can't promise the same success for your cat, but in most cases it's certainly worth a try.

Other Urinary Tract Problems

I sometimes hear from people whose cats have lower urinary tract problems rather than kidney problems. Lower urinary tract problems are relatively common in cats, but do not automatically lead to kidney problems. So please be sure your cat has kidney issues before deciding this is the website to help your cat, because treating for the wrong condition is at best pointless and at worst dangerous.

If you are not sure, ask your vet if your cat has CKD or another condition that would fall into the category of Feline Lower Urinary Tract Disease (FLUTD). You can read about our experiences with FLUTD, including a lifethreatening urinary tract blockage caused by struvite crystals, with one of our other cats, Harpsie.

Is Chronic Renal Failure Terminal?

Sadly, yes, CKD is terminal. BUT that does not necessarily mean death is imminent: it is often possible to buy the cat months or even years of quality life. In fact, with appropriate treatment, quite a few CKD cats not only live for a long time, they eventually die of other causes, with the CKD firmly under control at the time of death.

An analogy used by my vet is that a CKD cat is approaching the edge of a precipice: the cat may approach the precipice very slowly, taking years to reach it; the cat may approach quite quickly; whichever way the cat approaches the precipice, it may be possible to grab the cat and pull him/her back even after he/ she has started to fall over the edge, and this could be done several times if you move quickly enough.

The good news is there are almost certainly a few things you can do to help your cat. This site is geared towards slowing the progression towards the precipice, and may also be able to help pull your cat back if he/she has started to fall over the edge, while simultaneously trying to make the cat's remaining time more comfortable. CKD cats can look very ill at diagnosis, but improve dramatically with treatment, so I strongly recommend trying treatments for a few weeks before considering euthanasia.

Good luck on your CKD journey.

Helen

Need help and support? Available online now through

Tanya's CRF Support Group

where you will meet others fighting this disease

who can offer help and support as you make your CKD journey.

If you would like more information about how the group works

before joining, visit

Tanya's Support Group Page.

If you want to sign up immediately, just click on the button below to join, it's completely free.

If you prefer to join via e-mail, simply enter your e-mail in the box below, and click on the button.

NOTE: If you ask to join, in an effort to protect existing listmembers from spammers we will send you a short (three questions), non-intrusive questionnaire - you have to respond to the three questions before your membership will be approved. Only the two Annes (who help me run the group) and I can see your responses to these questions. Once you answer the questions, we will normally approve your membership very quickly.

DONATIONS

I have no financial interest in any products or services mentioned here, nor do I accept advertisements. I neither solicit nor accept donations for maintaining this site, because I can afford the less than US$60 a year it costs me, and my time comes free.

If you would like to thank me in some way, please pay me the compliment of telling your vet about this site, so that other cats may benefit. If you can afford it, you might also wish to make a small donation to your local branch of Cats Protection (UK) or your local shelter in memory of Tanya, Thomas and Ollie. If you would prefer to make a donation to fund CKD research, please click here. But if funds are tight right now and you need them to pay for your cat's care, please just go and hug your cat (-:

REVIEWS AND AWARDS

"You might be interested to know that I refer veterinarians to the information on your site quite often.

It came up recently regarding one of the experimental therapies and

I just linked to your site and said the folks that run that site are knowledgeable and responsible

and if they say it there, it's been researched and is up-to-date.

I consider what you do in trying to help cat owners to be the work of "angels"."

Dr Katherine James, DVM, PhD

Urology and Nephrology Specialist at the Veterinary Information Network

March 2007

*****

Recommended by Catwatch,

the newsletter of Cornell University College of Veterinary Medicine