This page is
about how to cope with living with CKD on a daily basis, both from an
emotional and a practical perspective.
The fact that
CKD is ultimately terminal can be very hard to deal with. You may also be
worried about how much to put your cat through, bearing in mind your cat's
personality and the costs involved.
people and cats do usually learn to cope, and in most cases seeing how
your cat improves and then stabilises makes it well worth it.
Take a Deep Breath
If you've just received the diagnosis, you're no doubt feeling scared and
frightened, and may well be worried that you can't do this. The good news
is, I think you can.
It is true that your life and that of your cat have now
changed. This is upsetting, I know, but you have to face up to it and
try to approach it positively. Your cat has not changed, but you now know
there is a health problem, and knowing about it increases your chances of
helping your cat cope with the disease.
Focus on finding your "new normal" — what works for both of you now in
light of the diagnosis and all that comes with it. Your new normal may
change again over the months and years, but that is OK, you will adapt to
that new normal too. You are flexible.
If you're not sure how much you and your cat can cope with, I would
suggest that you opt for a trial period of, say, one month, during which
you treat your cat to the best of your ability, and according to your
financial limitations, and then review the situation. With luck your cat
will be stable and happy and you will both be getting into a routine that
works for you both. If your cat is critically ill, I would still give
yourselves a minimum of two weeks of treating proactively before making
any irrevocable decisions.
Try not to panic if your cat has a bad day. It does not necessarily mean
the end is nigh, there will be good days and bad days, hopefully far more
of the former, especially once things have stabilised
The Emotional Rollercoaster
rollercoaster refers to the mixed emotions you will feel as you care for
your CKD cat. When your cat is doing well, you will feel good but
will probably also be wondering how long it will last; and when your cat is
poorly, you will feel emotionally drained and very frightened.
These ups and downs are referred to on
Tanya's CKD Support Group as the emotional rollercoaster.
This page talks about how to cope with the rollercoaster ride.
These days there are also the additional stresses brought by trying to
help a CKD cat in the time of Covid-19.
One of my support group members, Stephanie, wrote "We cannot control
whether they will die, because they will, as all living things do, but oh
boy, can we control the way in which they live."
Although this is good news, it is also a big responsibility, and
occasionally things will get on top of you, particularly if you have
little or no support at home. Some people cope better than others,
depending upon their own personality or how well their cat is doing; but
everybody living with CKD needs some level of support at some stage of the
You have to accept that you are going to have days when you feel
overwhelmed, when you really do not think you can cope anymore, or when
you feel you don't want to live this way anymore. You know what? — it is
perfectly fine to feel that way. You are caring for a chronically ill
family member, and facing the eventual loss of a treasured friend, a major
emotional trauma. Accept that you may sometimes feel this way, and that it is fine
to do so; and just get through the bad days as best you can.
Be kind to yourself
and accept that something's probably got to give. Yes, your home may in
part resemble a pet food or hospital supply
store, but as long as it's hygienic, who cares. Focus on the important
things: make sure you get enough sleep, eat properly (important note: a CKD carer's
diet requires large quantities of chocolate), keep things clean,
hang on to your job if you have one and care for your family. Anything else is a bonus.
On the other hand, try to keep some degree of normality in your life. If
you love, say, ice-skating, try to continue to fit it into your life.
Sitting at home all day constantly monitoring your cat can be unhealthy
for you and irritating for your cat.
Your cat may not act exactly the same, which you may find scary at first,
fearing a crash. We all want things to be the way they were before, but
life is all about change, and we must go with the flow. Don't focus on the
numbers or hope for your cat to get better — instead, focus on trying to
make your cat as comfortable and happy as possible, and savour your time
together. Eventually you will both learn to accept this new
Try to get into a routine, but don't sweat it if things slip sometimes.
Consistency is the goal, not perfection. Cats are very forgiving. If
you're having a really bad day, or if sub-Qs don't go too well one day,
take a day off. I would always give blood pressure or heart medications
and make sure your cat eats, but otherwise the occasional day off should
not be a problem for either of you.
It is crucial that you also look after yourself. The line about putting on your
own oxygen mask before helping others fit theirs applies here.
If you are feeling stressed, take a hot bath, buy yourself a book (if you
like thrillers (here is a blatant plug for
books — he's really
good, and I'm not remotely biased) or a bunch of flowers, and most importantly,
give your cat a big hug and tell yourself that having to live with CKD is
much, much superior to the alternative. Consider using Bach
Flower Remedies (see Holistic
Treatments) for yourself on days like this.
Don't forget, your cat can pick up on your mood, so try also to
focus on the fact that you do still have your cat with you, and try to
enjoy his or her presence. Don't only interact with your cat by medicating
and giving fluids. Stroke your cat, talk to them, tell them how you are
trying to help.
Remember, you are not doing things to your cat, you are doing them for
your cat. It may sound strange, but many people find that if they
take the time to explain to their cat what they are doing and why, the
whole process goes much more smoothly. This is particularly the case as
your cat starts to realise that what you are doing helps him/her feel
better. Many people find the bond with their cat is deepened as they
progress along the CKD journey together, and find that they develop as a
person whilst learning how to care for their beloved cat.
Dear Mom is an article from a feline
diabetes website which will
probably also resonate with people with a CKD cat.
Caregiver Burden has a series of articles about the stresses of
caring for a chronically sick cat.
Letting Go Of The
Many people seem to feel guilty for not having noticed sooner that their
cat was sick. Remember, it Is not actually possible to notice CKD until at
least 40-66% of kidney function has already gone — that's the nature of the
disease, so you have nothing to feel guilty about.
Even if you still think you have something to feel guilty about (food
choices are a major source of guilt, even though food does not cause CKD),
ditch it anyway, because it uses up valuable energy which you need for the
journey ahead. And your cat loves you, whatever you did or didn't do.
Ultimately, all any of us can do is our best. If you do your best as often
as you can, using the information and tools you have at your disposal to
the best of your ability, and accepting that your best on some days will
be a different best to that on other days, then you have no reason to feel
bad or guilty or to reproach yourself in any way.
If Others Do Not Understand
Sadly this is a
common problem. Many people around you will not understand why you are so
upset about your cat's illness. I only had one friend who really
understood how I felt when Tanya was sick.
You will probably also lose count, as I did, of the number of people who
tell you that you are foolish to spend your money treating your cat; yet
what could be a more important way of spending money than on extending the
life of a loved one?
If you wish, you can try to explain to those
around you why it matters to you that your cat is terminally ill;
but it might be better just to save your energy and try not to take it too
personally. Really, these people are to be pitied because they
have clearly never experienced the special bond that you have with your cat. If
all else fails, tell them you need to feel you have done your absolute
best to help your cat in order to minimise any guilt you might feel later
on; many people will be able to understand if you phrase it that way.
Even if you have a good relationship with your friends and family, having
a sick pet can be difficult for people who love you to handle. My Mum
finds it very hard when my cats are sick because she can't bear to see me
unhappy and wants to wave a magic wand and make things better again; but
In many cases, it may be easier to seek support from people who are less
emotionally involved with you, such as on
Tanya's CKD Support Group
Tanya's CKD Support Group
If you're feeling alone, come and join
Tanya's CKD Support Group,
where you will find other people prepared to rejoice along with you on
your up days and to support you on the down days.
Many people find it really comforting to learn they are not alone as they
ride the CKD rollercoaster, and it really can make all the difference to
how you cope on a daily basis.
As an added bonus, you can obtain practical suggestions for problems that arise
from people who have already experienced the same problems and who know
what works in handling them.
It is a busy group, but you don't have to receive all the messages, you
can just dip in as and when you wish. You can read more about how the
group works here.
Working With Your Vet
and your vet have a good rapport and are able to work as a team, it can
make a world of difference to how you cope with CKD. Conversely, if your
vet is not prepared to work with you at giving your cat a chance, it is an
extra burden you could do without.
It may be that you
and your vet are never going to see eye to eye, in which case you
need to find another vet; but it might equally
well be a simple misunderstanding. British vets in particular are very conscious of the
quality of life issue, and may misinterpret your attempts to give your cat
a chance and to make him/her more comfortable as you being incapable of
letting go, no matter how ill your cat is.
Do be prepared to listen to
your vet's opinions and medical knowledge, they have an important
role to play in helping you to make decisions about your cat's wellbeing.
At the same time, your vet must understand and respect that this is your
cat and your opinions are valid too. Try to make
it very clear to your vet that you have your cat's interests at heart, not
your own, that you will let go when the time comes (if indeed you will),
but that you feel that time is not yet here.
Essentially you have to learn how to be your cat's
Your Vet page has more information on how to work
in partnership with your vet.
Anticipatory Grief (Worrying About the Future)
means that you worry about and
grieve over losing someone you love before they have actually gone.
you are caring for a terminally ill cat it is
common to panic if your cat is having an off day, even though ups and
downs are very common in CKD. However, sometimes it's even worse than that, and you find
yourself worrying even on good days. You worry so much about what is
around the corner, and how you will cope, that you forget to enjoy the
time you have together right now. You may begin to focus more on your cat's
illness than on your cat, forgetting that this is still the cat you know
and love, even though his or her behaviour may be a little different.
I did this all the time with Tanya (though I was a little better with
Thomas). I spent much of my time sobbing, as I envisaged life without
her, and I forgot to focus on the fact that right at that moment we were
still together. Yet all that worrying and sobbing did not change the
course of her disease, or postpone her death. When I look back now, I wish
I had spent less time fearing the future and more time living in the
present, stroking and holding my lovely girl.
I know people who have struggled with anticipatory grief whose cats lived
for four years or more! In retrospect, they realise they wasted a lot of
energy on something that was a long way off.
Sometimes anticipatory grief may lead you to try to distance yourself
emotionally from your cat, in a sub-conscious effort to spare yourself
pain when s/he
dies. But it doesn't work, you are going to feel pain at that time anyway, so you
may as well try to enjoy your time together now, in fact try to savour
every moment, enjoying your cat's uniqueness.
Try to take it a day at a time rather than thinking too far ahead. When you get up
each day, if your cat seems
relatively stable, give thanks and resolve to enjoy the day. If worrying thoughts enter your mind, send
them away, telling yourself "yes, s/he will die, but not today."
Remember, your cat does not worry about the future, but lives entirely in
the present. We could learn a thing or two from them here.
When my Harpsie
was diagnosed with terminal cancer, and the vet said he might only have a
week or two to live, I made a conscious decision that I was going to do my
best not to do anticipatory grieving. I figured if we didn't have much
time left, I was going to savour and cherish every moment, and anyway,
there would be plenty of time for tears later. So each day I would get up,
and be glad Harpsie was still there, and if he would eat breakfast (I was very
lucky that he did keep eating) and his breathing was no worse (he had
secondary lung cancer), and he seemed reasonably comfortable, I'd say to
myself "I don't think today is the day", and then I'd focus on enjoying
Of course I would get bad moments if he became subdued later in the day or
something like that, and sometimes I'd get upset anyway, because the
thought of losing him was so horrible. But I did largely avoid
anticipatory grief, and I'm so very glad I did. I now have memories of our
last two weeks together of him eating as I held the plate for him, of
little chats where I told him how much I love him, rather than of me
sobbing into his fur all the time (though I did this sometimes, of
course). So do try if at all possible to just live in the moment and not
worry too much about tomorrow. But of course there's nothing wrong with
expressing your sorrow and fear sometimes too, bottling it up is not good
Anticipatory grief often includes bargaining. When Harpsie was diagnosed
with terminal cancer, my bargain was "OK, I accept I have to lose him, but
I would at least like to be allowed to keep him until June please". In
fact, we had to have Harpsie put to sleep on 23rd May because of breathing
difficulties. My bargain was not a bargain
at all, because the situation was completely beyond my control — Harpsie's
cancer progressed at a rate that had nothing to do with me or my efforts
to help him. The Pet loss
link below does have some information on the types of bargains which are
more likely to be helpful to you.
I know all this is easier said than done, but this quotation might help
you to live in the moment:
"There are persons who shape their lives by the fear of death,
and persons who shape their lives by the joy of life.
The former live dying; the latter die living."
Doug and the B Brothers
has an excellent article about how to cope with the fear that
typically accompanies caring for a cat with CKD.
Pet Loss has a helpful article
about what it calls "pre-bereavement", or coming to terms with the fact
that your cat has a terminal illness.
has some helpful tips on mindfulness and staying in the moment despite
There are also practical issues which can cause stress when you are living
with CKD. One very important thing you can do to help you to help your cat
is to find a good vet. See
Working With Your Vet for tips on how to do this.
Here are some tips to help you deal with your cat's CKD from a practical
One important step I recommend is to get into a routine as soon as you
can. This may be hard initially when you don't know whether you are coming or
going, but it will help you and your cat cope better (cats love routine)
and will ensure you don't forget to give a medication.
records of your cat's situation so you have less to
remember. This will also help you whenever you go to the vet's, or if you
have to go to the ER or visit a specialist.
If you are prone to forgetting whether or not you have given a
My Med Schedule
allows you to create a free medicine schedule and to receive
reminders via text or e-mail.
Also try to make things easier for both of you. For example, if your cat
adopts a bed a long way from the kitchen, place food and water bowls and a
litter tray nearby so your cat does not have to walk too far.
Some people get depressed because their cats start to
hide from them. It is common for cats to hide at the beginning of the CKD
journey when they do not feel well, see
This should improve as your cat starts to feel better.
Medications are often an important part of your cat's treatment plan.
If you think your cat is starting to fear you because s/he does not like
being pilled, see Medicating
Your Cat for tips on how to make medicating less stressful for both
It is important not only to interact with your cat when
giving treatment — don't forget cuddles. It can help if you use a special
word before medicating your cat — this helps your cat know when
medications are coming, and means s/he should not be wary of you when you
approach at other times.
It is always hard at the beginning, especially if your cat is in crisis at
diagnosis, but hang in there. Once you have your routine going (e.g.
you've managed to find a food your cat likes, and s/he enjoys it and keeps
it down), and you can see how it is helping your cat, the thrill and
relief will be indescribable.
Balancing Other Commitments
Most people have to earn their living
in some way, which will probably limit the amount of time that they can
spend with their CKD cat. This can be particularly distressing if your cat
is having a bad time yet you have to go into work or care for your
children or elderly relatives (or even do all of these).
Try not to feel guilty about the conflicting demands on your time. Take some time off work
if possible, but do not beat yourself up if it is not.
Try to make your cat comfortable and arrange for somebody to
call in and check on your cat's wellbeing if you can — if you are at work
during the day, a phone
call at lunchtime to tell you your cat is bearing up can be enormously
comforting. Alternatively, some people set up webcams to monitor their
cats remotely (see below).
If you need to take time off work because of your cat, I would simply say
a family member is sick. If you say you need time off to care for your
cat, many people will be unsympathetic, but your cat is indeed a family
member, even if it does not occur to them that that is what you mean.
If you work five days a week, spend some time on your free days doing
things that will help you during the busier times, such as cooking and
freezing meals for you to eat during the week, putting a week's worth of
pills into gelatin capsules, placing online orders for supplies etc.
Some people who travel regularly set up a webcam so they can check on their
cat. Actually, some people do this even if they are only going into work
for the day! This is because it can be very reassuring to check on your
cat and see if food is being eaten and the litter tray is being used.
The following models have been used by members of Tanya's CKD Support
Unfortunately veterinary treatment is not cheap. There is no reason why it should it be,
vets have trained for many years and have a lot of overheads; but that
doesn't make it any less stressful for you if money is tight.
Below are some possible ways to ease the financial burden. Please do not
feel guilty if financial constraints limit what you can do for your cat,
it is not your fault.
Obtaining Supplies More
It is possible to buy many of your supplies at much reduced prices if you
know where to look.
Obtaining Supplies Cheaply
has links to suppliers in the USA, UK
Also, if you can afford the upfront outlay, consider buying in bulk. Once
we knew Thomas was stable, we bought his supplies for two months at a time
from our vet and it worked out much cheaper for us.
If you are finding things a struggle, check out the
Treatments page to learn which treatments are crucial and where you
can afford to be a bit more flexible.
If your cat is not insured and you are unable to obtain cheap supplies,
but your cat is doing well on treatments, politely ask your vet if he/she
could possibly give you a reduction for regular tests or treatments, or
perhaps provide some of the supplies you need at cost, either regularly or
Your vet does not have to agree to this but may do so in some cases.
It is also worth contacting local shelters and asking them if they know of
any low cost vets in your area.
The Royal Veterinary College in London
(near Kings Cross) offers free health screening, follow up monitoring and
therapeutic kidney diets for CKD cats. Medications and additional tests
will be charged for. Eligible cats include cats who are aged at least nine
who fall into one of the following categories:
Cats diagnosed with chronic kidney disease who have not yet started
eating a therapeutic kidney diet
Cats diagnosed with an overactive thyroid and not yet on medication
Cats diagnosed with high blood pressure
Cats suspected of having one
of the conditions listed above
Cats with diabetes or other
significant health problems are not eligible.
If your cat is
insured, then obviously the financial burden will be much less and
treatment options might be available to you that you otherwise could not
I do not know of any insurance company that would take on a CKD cat
post-diagnosis, but I would consider insuring your non-CKD cats in
order to remove this strain in the future. You can either obtain
commercial insurance or self-insure (save money every month in a savings
account for a rainy day).
If you do insure your cat, make sure you use a company that provides
cover for life; some companies will only pay for a condition for a maximum
of twelve months, which is of limited use for a cat with a chronic disease
like CKD. Other companies may only insure up to a certain age (as young as
eight in some cases).
I do insure my cats, currently I am using
and have had no problems with them, in fact I have been very pleased with
them, though they are not particularly cheap.
If you need funds urgently, you can try selling your unused stuff on eBay,
hold yard sales or sell baked cookies or lemonade.
You might wish to consider setting up a GoFundMe account or something
There are also the following possible options to obtain financial support
to help with your cat's vet bills.
is a payment scheme accepted by some veterinary clinics in the USA or
This is essentially a credit card for veterinary fees, which offers a
variety of payment options, from interest free periods (usually for six
months, though it depends upon the vet) to extended payment plans. If your
vet offers this card, you can usually apply when you are at the practice
and get a decision very quickly, which can be helpful if your cat needs
urgent, expensive care, such as hospitalisation.
Try to avoid paying interest if you can because, like many cards, the Care
Credit card has a high interest rate once interest kicks in, and it will
be backdated to the date of the transaction. You have to use the account
at least once a year to keep it active.
Of course, if you already have a standard credit card, you might prefer to
Financial Assistance: USA
There are a number of organisations which may be able to assist, though
many of them can only help with emergencies, and fund availability can
vary. Some vet schools, including Cornell, have financial assistance
programmes which can offset a small percentage (usually around 5-10%) of
vet school costs.
Covid-19 has brought new challenges to us all on many levels. I feel
really sorry for those people experiencing financial difficulties and job
losses, and it must be very hard for people who are struggling
emotionally. My heart goes out to those who have lost loved ones. My
cousin died unexpectedly in March (not of Covid-19) and I was unable to go
to her funeral.
Obtaining Veterinary Care
I hear regularly from people who find it extremely distressing having to
drop their cats off for treatment and then wait outside and talk to the
vet on the phone about their findings. Please try to focus on the fact
that at least now you can obtain veterinary care, which wasn't possible
I can understand people's fears on this, but I think we need to prioritise
here. As a CKD caregiver, you've got enough on your plate without worrying
about things that may never (and most probably never will) happen.
I'm a control freak, but I don't actually worry much about Covid-19 in my
cats, because it's simply beyond my control. Since they never leave home,
they are not being exposed to it unless I bring it in; so I take all the
precautions I can to protect us all and that is all I can do. CKD cats
often have to go to the vet's fairly regularly, but vets are also taking
all the precautions they possibly can, so the risk at the vet's is very
Please let this go. We'll worry about it when and if it happens. Instead,
focus on the things you can control that can help your cat feel better,
such as getting food into him/her. Oh, and focus on things to help you
too. Enjoy a sunset, eat more chocolate (my top tip for life generally; I
wonder why my waistbands are getting tight?). Life is terminal, so we may
as well try to enjoy the ride while we are still on it.
If you do go away, please try to enjoy your break: if you return with
recharged batteries, it can give you the boost you need to carry on and
your cat will benefit.
In the USA and
Canada it is possible to book petsitters who are happy to give your cat
sub-Qs and medications each day. I used to do this in the USA and found it
very useful. The cats certainly preferred staying at home in their
Petsitters are less common in the UK, and petsitters who can give sub-Qs
are an even rarer breed. You might be able to persuade a family member or
a friend to learn how to treat your cat and to step into your shoes while
you are away if your cat is relatively stable. In this case,
feeders may be useful.
You could also ask at your vet's: often one of the vet nurses (vet techs)
will be happy to come in twice a day to check your cat, give sub-Qs and
medications and deal with food and litter trays in order to boost their
income. This is what I do, and when you have a sick cat it is particularly
reassuring to have a veterinary professional caring for your cats. On one
occasion, my wonderful petsitter noticed from some quite subtle signs that my little old lady was not very well so she
took her into work with her and placed her on IV fluids and she and my vet
monitored her all day. On another occasion, when my return home was
delayed because I was travelling with my mother who was hospitalised, my
petsitter was able to carry on petsitting and even offered to do so for
free. Bless you, Emma, you're a sweetheart!
If you do book a catsitter, triple check the timings with the sitter. I
heard a horror story on my support group of a lady who went on a business trip lasting several
days, leaving her cat in the care of a carefully chosen professional
petsitter. Unfortunately the petsitter had written July in her diary
rather than June, and the lady returned to a severely dehydrated and
starving cat who needed hospitalisation to recover.
If you are in
the UK, you probably have a cattery nearby. I used a local cattery for
many years with no problems. Most catteries will not be able to give sub-Q
fluids but will be well used to medicating cats.
Many catteries ask to see
vaccination certificates, but your vet should be able to give you an
exemption letter for your cat if necessary.
Travel: Vet Boarding
You can also consider booking your cat into your vet's. Many cats would
find this stressful, but at least
your cat will get the necessary medications while you are away, and the
staff in most veterinary surgeries will also stroke the cats and play with
them if they are well enough and if time permits.
I think cats are
most happy in their own environment. However, some cats are used to
travelling (e.g. camping trips) from an early age, or you may have no
choice but for your cat to travel e.g. if you are moving home or if you
live in a disaster area.
very least, you will probably have to take your cat to the vet's office,
so getting your cat used to that can reduce stress for both of you.
Travel: General Tips
want to drive or use a taxi, though I have also taken my cats on planes,
trains and the subway.
Get your cat
used to whichever cat carrier you are using by leaving it out in your home with the door open
and a favourite blanket or throw inside. Many cats will choose to go in
and sleep there. This way it will at least smell familiar to them when
they are in the car or the plane.
help with travel — spray it liberally in the carrier and the car if you
are using one.
travelling, it may help to cover the carrier so your cat is less stressed
by everything flashing by.
Ensure on long
journeys that you have your cat's medical records and supplies to hand.
Travelling By Car
This is usually
the best choice for cats because you can control your environment better.
If you have to
make a long journey in the car, do a few shorter trips
first to get your cat more used to it and to see what works and what
doesn't work about your routine.
If you are
travelling by car, get as large a carrier as you can. The Pet Tube Car Kennel is recommended by
some people travelling by car. It is available on
Amazon, but it is very expensive.
which type of carrier you are using, you may be able to put a litter tray
inside it. If not, be sure to put
puppy pads in the carrier on top of a washable blanket or towel. Peel off
and dispose of used puppy pads as soon as you can.
DryFur Pet Carrier Insert Pads
may be better than puppy pads, since they absorb urine so your cat
Ensure your cat
is wearing a collar
and harness. I would not
allow my cats out at rest stops in a car unless we were staying overnight.
If you need
cat-friendly accommodation en route, some motel chains accept cats, such
though be sure to mention your cat when you make a booking. Ideally you
will not leave your cat unattended in the room, but if you need to do so,
put the Do Not Disturb sign up.
Travelling By Plane
plane is more stressful because there are so many restrictions these days,
but it is doable. I've flown across the Atlantic (in both directions) with
three cats, so I've been there, done that. One of our flights was a
nightmare, but that was to do with the airline in question (Air France)
rather than the flying itself.
You want your
cat to travel in the cabin with you. This is common in the USA, and can
even be done across the Atlantic in most cases. There is a limit on how
many animals are allowed to travel per flight, so be sure to book early.
The first thing
to do is to obtain a suitable soft-sided carrier that is acceptable as
hand luggage. It needs to be lightweight and fit under the seat in front
of you, but be big enough for your cat. I always use
carriers, though I have also heard good things about
You also need to carry your supplies with you as hand luggage. It is probably better to
pack your needles in your checked luggage, but I would take other
medications and food. After you have gone
through security, buy a water bottle for your cat's use.
Do not use
The American Veterinary Medical Association
says "It is recommended that you DO NOT give tranquilizers to your
pet when traveling by air because it can increase the risk of heart and
You will need
to pack a small litter tray and litter in your hand luggage. Bacofoil baking
trays for roasting turkey are a good option, lightweight and disposable,
though PetSmart also sells disposable litter trays. I took my cats into
the disabled toilet before boarding the aircraft but they were too
stressed to use the litter tray.
When you go
through security, you usually have to carry your cat through the metal
detector while the cat carrier goes through the luggage scanner. We had no
problems with this, but it may be wise to have a harness on your cat
(though this may trigger the metal detector). Apparently you can ask the
TSA to allow you to take your cat out of the
carrier in a private room, which would probably be less stressful.
about your cat howling on the plane, it is highly unlikely anybody could
hear over the noise of the aircraft.
in the USA register their cats as emotional-support animals (a psychiatrist will have
to sign off on this), which may give you more flexibility in terms of
taking your cat in the cabin.
probably be very concerned about your cat's quality of life; but please do not
forget your own quality of life in the process. CKD is a very hard disease
to live with, and if you feel you must be a saint in the process it can be
Try not to become too despondent if what you try doesn't immediately help
your cat feel better. Cats are individuals, and what works well for one
cat won't work as well for another. Take a deep breath and keep trying.
Don't feel inadequate if you don't know what all the medications are for.
I know this website is so comprehensive that it can feel overwhelming at
times, especially at the beginning. Don't panic. Keep reading. Keep
breathing. Eventually things will fall into place,
especially if you join the support group where people can make suggestions
tailored to your cat's situation.
If your cat is relatively healthy, you may decide to give up on the site,
thinking you can come back later when you need it. Please don't do that! I
often hear from people who have done that and regret it. If you have a
stable cat in early stage CKD, you have the luxury of time, time to get to
grips with this disease. At the very least, read the
Key Issues page so
you know what to watch for.
You may experience immense frustration e.g. if your cat is urinating
inappropriately (which fortunately is not that common in CKD cats). Whilst
your frustration is probably aimed more at the disease than at your cat,
it is possible that occasionally you will find yourself taking this stress
out on your cat by shouting at him or her. This is obviously not something
to be proud of, and you should try to avoid this kind of behaviour; but it
is at least understandable. Please do try your best not to take your
stress and frustration out on your cat, but if it does happen, try to put
some space between you for a while until you regain some perspective; and
tell yourself that your cat will remember many years of loving care rather
than one moment of weakness.
We all have our own personal limits in other ways too. Just as some people
have more emotional resources than others, so some people have more money
than others. If you can easily find the money to pay for your cat's
treatment, that is one less stress for you; or you may not have too much
money but are happy to go without other things in order to pay for your
cat's treatment. It becomes more complicated though if you have others to
consider apart from your cat; or if you simply do not have much money. It
might theoretically be possible, for example, to take out a loan to pay
for your cat's care; but not everybody can bear the strain of making loan
repayments for months or years to come.
One thing that can be very difficult is if your other half is not
supportive, and/or objects to the cost (financial or your time) of caring
for your cat. Even if your partner does not understand, ask them to at
least tolerate your efforts because it is important to you.
is no shame in acknowledging your own personal limitations in all these
areas, and trying to accept them. This does not mean you love your cat any
less, just that you have other demands on your financial and emotional
resources, and that you must juggle everything as best you can. You are
only human and can only do your own personal best — as long as you do
that, you have nothing to reproach yourself for.
Your cat also has limitations. Some cats cope better with treatments than
Your Cat for tips on making the pilling process easier for both of
Going to the vet's is not exactly top of most cats' wish lists either.
has tips on making the process a little easier. There are global
campaigns to encourage vets to make visiting the vet less stressful for
Friendly Clinic enables you to
search for a cat friendly clinic near you.
Hospitalisation can also be a challenge. Some cats are so timid or frightened at the vet's that they find
being an in-patient highly stressful. Actually, I think most cats find
hospitalisation scary — I wish vets would find ways to make this easier on
them, e.g. by not having dogs in the same room. If your cat is going to be
kept in hospital, have a little chat. Explain that you know it is scary,
but that it is the best way to help them, and it is only for a short
while. Or have your cat kept on intravenous fluids in hospital during the day and bring
him/her home overnight.
Your cat will probably be exhausted when s/he comes out of hospital; this is normal. so don't panic.
Give yourselves a couple of weeks
of treatment to try to get into a routine — see
above. If your cat
is not coping, discuss with your vet which treatments are the most crucial
(I would say food, sub-Q fluids if appropriate, phosphorus binders if required,
medication for hypertension and anaemia if present, and treatments for
nausea and/or constipation if needed — all things that can
help your cat feel better), and give those to your cat, and skip the rest
if necessary. Remember, the goal is to make your cat feel more
comfortable, not to torture you both. Give it a couple of weeks, and with
luck things will look a lot brighter. If, however, you decide your cat
simply cannot cope anymore, then you must do what is best for him or her.
Mary Helen and Snicklefritz
Here is Mary Helen's story of how she decided what was important to her
and her elderly CKD cat, Snicklefritz. This was in response to someone who
asked why people keep cats with CKD alive when there is no cure for the
disease. Your own criteria may be different but I think Mary Helen's words
help us to realise that cats do not worry about their own health the way
we worry for them.
"Snicklefritz wanted to live, and it was my job to support that until she
was ready to leave. Because she could not speak English, it was up to me
to work with the vet to carry out her wishes. Really very simple.
"My father is in kidney failure and he doesn't always feel great, but he is
preparing for dialysis and transplant screening, because he's willing to
endure those "extreme measures" so that he can continue to live. Why
our cats be different?
"Snicklefritz was 22 years old and age had taken its toll, but her will to
live was strong. Her eyesight had dimmed over the years and she no longer
looked out the windows, but just because her world had gotten smaller
didn't mean she didn't treasure her little niche.
"She was arthritic and didn't walk and jump like she had, but that didn't
keep her from enjoying her plush cat bed right in the middle of the living
room, the center of the action, where she could watch and enjoy as family
life with a toddler swirled around her. She happily slept with crayon
drawings, stuffed animals, all kinds of crazy things tucked into her bed
by my daughter, to the point where sometimes her happy purrrring face and
the tip of her tail were all that you could see. She didn't need to walk
much, her loving presence filled our house and people came to her.
"She reigned supreme in her little fiefdom, and she was not about to give
that up until she was ready. I'm not saying she liked the medicines, the
vet trips, the fluids. But even though her life was very limited
physically, she was happy loving us and being loved, and it was enough for
"My mother lives out of state and had heard the saga of Snicklefritz's
decline. She loved Snickle dearly and had gently suggested a couple of
times that perhaps it was time to let her go. Well, my mother came to
visit and watched as my darling 3.5-pound, arthritic old girl carefully
and slowly walked across the room. With tears in her eyes, Mom looked at
me and said it was like watching the walking dead.
"And then, Snickle taught my mom a lesson. In her classic Snickle-way, she
taught my mother an important thing about life. Never cranky, never
scolding, always full of joy and love...
"She went over and somehow managed to hop up to Mom's lap by herself. And
she settled down and began to purrr her HUGE happy purr. And she looked up
at my mother's face and gave her that slow wink of contentment and love.
"Snickle may not have had much of a life, but it was enough. She might have
felt pretty lousy, but it was worth it to be able to be with those that
"She was 22 and wasn't going to be cavorting about like a kitten, CKD or
not. But she was older and wiser and needed different things to make her
happy. A soft bed, a loving family, that was what mattered to her at the
end. She made a tremendous effort to say "goodbye" to us in her final
illness and then she let go and stopped fighting. It was time, and
although I miss her more than I can describe, I know that she was ready to
"I think we can focus too much on what our cats have lost through their
illness and not enough on what remains. Simple things like warm sunshine
and time with our loved ones are the essence of joy...
"My daughter was privileged to know Snicklefritz until she was almost 3.5
years old and was nursed through her second surgery by that old, frail
kitty that loved with a passion and a strength that belied her tiny,
arthritic body. We have greatly mourned the loss of our beloved feline
companion, but we have also learned so much about the strength of love.
And I know that my daughter knows that I would care for her with the same
love and patience that I gave Snickle, even when it was not easy, even
when I felt I could barely go on. And I learned that about myself as
people have more than one cat, and sometimes this may make dealing with
CKD even harder. You may find it tricky trying to feed your CKD cat a
different food to the others (see
Which Foods to Feed for more on this). You may feel guilty for giving so much of your time to
the cat who is ill, perhaps feeling you are neglecting your healthy cats.
Your healthy cats will probably sense that something is not right, and may
start to act differently. This is fairly common when the sick cat has been hospitalised and returns home
— the other cats may hiss and spit and not
accept the sick cat. This is usually only because the sick cat smells
differently, and of the hospital to boot. If you can make all the cats
smell alike, perhaps by rubbing each cat with a piece of your clothing or
dabbing them on the nape of their neck with a tiny amount of vanilla, this
behaviour usually disappears.
If you can, try to find a little time each day for your healthy cats
— it can be very comforting spending time with a cat who doesn't need much
care, and of course it is good for your cat too. But if you simply cannot
find the time, do not worry too much, you can always spend time with your
healthy cats later on, but your CKD cat's needs must take priority for
I am sometimes asked whether people should get another cat to keep their
CKD cat company. This question often arises if another family cat dies,
and the CKD cat becomes an only cat. It does partly depend upon the
personality of your CKD cat — some cats are simply more sociable than
others. However, cats are solitary predators, which means they will need
time to adapt to a newcomer; and to expect an elderly sick cat to suddenly
accept another cat in his/her territory can be very stressful. A 16 year
old cat is 80 years old in human terms, so being asked to suddenly share
the home with a baby or teenager (a kitten or young cat) can be really
hard. For this reason I would be particularly reluctant to adopt a kitten
in such circumstances, but if you do decide to do so, please adopt two
kittens so they can play with each other and leave your CKD cat in peace.
can often be very helpful to create memories of your cat, in the form of
photographs, video recordings, collecting locks of hair etc. — whatever
appeals to you. My husband arranged for portraits of Tanya and Harpsie to
be painted for me as a birthday present one month before Tanya was
diagnosed, and I find them enormously comforting now both of them are
also happened to start videoing Tanya a few weeks before
her diagnosis, and I continued to film her even when she was ill. Before
she died, I felt sure I would never be able to watch the videos after she
was gone; but in fact, only a few days after she died, I felt the urge to
watch them, and I sat there, with tears streaming down my face, yet at the
same time finding the images tremendously comforting. I had begun to worry
that I had kept her with me for too long, but watching the video taken
only two weeks before she died, when she actually looked relatively well
and happy despite being very thin, reassured me about her quality of life during those last few
weeks; while seeing her before her diagnosis enabled me to remember her at
her best. I still watch those videos even now, and they never fail to lift
my spirits. Of course, I also have videos of my other cats which are equally
Please try to remember that living with
CKD is not always
doom and gloom. The first few weeks after Thomas crashed when we were
trying to stabilise him were certainly very hard emotionally,
with us wondering every day if he would last another week; but after the
first few weeks it was really quite simple. Giving him his medications
took only 15-20
minutes a day and for the rest of the time he acted like a healthy cat,
eating, sunbathing, grooming himself - and it delighted us to see it.
When you reach some level of stability like this, then it really does make
the emotional rollercoaster worthwhile. In addition, many people on
Tanya's CKD Support Group find
that their bond with their cat is deepened as a result of the joint effort
in fighting CKD. If you'd like some support, come and join the group.
TREATING YOUR CAT WITHOUT VETERINARY ADVICE CAN BE
tried very hard to ensure that the information provided in this website is
accurate, but I am NOT a vet, just an ordinary person who has lived
through CKD with three cats. This website is for educational purposes
only, and is not intended to be used to diagnose or treat any cat. Before
trying any of the treatments described herein, you MUST consult a
qualified veterinarian and obtain professional advice on the correct
regimen for your cat and his or her particular requirements; and you
should only use any treatments described here with the full knowledge and
approval of your vet. No responsibility can be accepted.
If your cat
appears to be in pain or distress, do not waste time on the internet,
contact your vet immediately.
This site was
created using Microsoft software, and therefore it is best viewed in
Internet Explorer. I know it doesn't always display too well in other
browsers, but I'm not an IT expert so I'm afraid I don't know how to
change that. I would love it to display perfectly everywhere, but my focus
is on making the information available. When I get time, I'll try to
improve how it displays in other browsers.
This site is a labour of love, from which I do not make
a penny. Please do not steal from me by taking credit for my work.
If you wish to
link to this site, please feel free to do so. Please make it clear that
this is a link and not your own work. I would appreciate being informed of