What You Need to Know
What Happens in
Causes of CKD
How Bad is It?
Is There Any
Appetite Loss and Excess Stomach Acid
The Importance of
All About Constipation
Coping with CKD
Tanya's Support Group
Alphabetical List of Symptoms and Treatments
and Urinary Imbalances (Dehydration, Overhydration and Urinary
Waste Product Regulation Imbalances (Vomiting, Appetite Loss, Excess
Stomach Acid, Gastro-intestinal Problems, Mouth Ulcers Etc.)
Phosphorus and Calcium Imbalances
(Pain, Hiding Etc.)
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)
Tests to Have and Frequency of Testing
Factors that Affect Test Results
International and US Measuring Systems
Which Treatments are Essential
Fluid and Urinary Issues (Fluid Retention, Infections, Incontinence,
Waste Product Regulation
(Mouth Ulcers, GI Bleeding,
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,
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
What to Feed (and What to Avoid)
Persuading Your Cat to Eat
Food Data Tables
Canned Food Data
Dry Food Data
Cat Food Manufacturers
Canned Food Data
Dry Food Data
UK Cat Food Manufacturers
2007 Food Recall USA
Tips on Giving
to Give Subcutaneous Fluids with a Giving Set
to Give Subcutaneous Fluids with a Syringe
Subcutaneous Fluids - Winning Your Vet's Support
Polycystic Kidney Disease (PKD)
OBTAINING SUPPLIES CHEAPLY
Coping with Your Loss
Other People's Losses
Other Illnesses (Cancer, Liver) and
Diese Webseite auf Deutsch
Three CKD Cats: Tanya, Thomas and Ollie
My Multi Ailment Cat,
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Because CKD cats have damaged kidneys which can no longer concentrate
urine, they are at risk of dehydration.
In early stage CKD, the cat can usually drink enough to maintain
hydration but eventually most CKD cats will need some form of fluid
This page explains more about the goals of fluid therapy and discusses
Other pages in this section of the site explain in more detail about the
main types of fluid therapy used for CKD cats.
Purposes of Fluid Therapy
Colorado State University College of Veterinary Medicine,
fluid therapy is given for three purposes. As a person with a CKD cat, you
will usually only be concerned with the first two stages:
replacement phase: the goal is to correct dehydration, which may be
very severe in some cases.
(IV fluids) are commonly used for this purpose. A CKD cat who has
usually given IV fluids;
maintenance phase: the goal is to keep the cat hydrated, so s/he does
not revert to the replacement phase.
fluids (sub-Qs or sub-cuts) are commonly used for this purpose, which
you can usually do yourself at home.
emergency phase: the goal is usually to stabilise a critically ill
animal who has lost a life-threatening amount of body fluids, e.g. because
of a road accident.
are commonly used for this purpose.
Types of Fluid Therapy
a number of different types of fluid therapy. Your vet will decide which
is the best method for your cat.
The most natural way for cats to take in fluids is of course orally, both
from the food they eat and the water they drink. Canned food is a good
choice for a CKD cat because it contains about 80% water. If your cat is
able to maintain hydration through oral fluid intake, that is fine.
though CKD cats do usually drink a lot, eventually they will not be able
to drink enough to maintain hydration, at which point they will probably
need sub-Qs. But for early stage
CKD, encouraging your cat to drink more
(e.g. with water fountains, or by placing several water bowls around your
home), and increasing oral fluid intake e.g. by adding water to food,
should be sufficient. One teaspoon of water is 5 ml, so if you can add 1o
tsp a day to your cat's food, you are increasing fluid intake nicely.
If your cat is in mid-stage CKD and needs help with hydration but your vet refuses to allow you to give
sub-Qs, you could consider syringing water into your cat's mouth instead.
Discuss this possibility with your vet. You have to be careful because cats can
only swallow a tiny amount at a time, and you should always syringe from
the side of the mouth, never from the front - see
syringe feeding for more information. Don't give too much because if
you do, your cat may feel full and then not eat enough.
You should never syringe the bags of fluid used for sub-Qs into your cat's
mouth - these fluids are for injection only, not for oral use. Similarly you
cannot inject ordinary liquid into your cat, you should only use fluids
approved for this purpose and prescribed by your vet.
Oral Rehydration Sachets
If a cat is clinically dehydrated, perhaps from vomiting or diarrhoea, you need electrolytes
(body salts) in addition to water. In such cases your vet may recommend oral rehydration sachets
- my vet gave me some of these for use when my cat was recovering from
brand used in the USA is Pedialyte, which is designed to rehydrate
children with vomiting or diarrhoea. In the UK there is Dioralyte. Only
use the unflavoured variety of these products. Do not use without checking
with your vet first, and be guided by him/her re dosage.
Veterinary Rehydration Products
Royal Canin sells a product called
Lectade is a veterinary oral rehydration product
available in the UK. However, this does contain glucose, so is not suitable for
diabetics. It is also quite expensive. It is not really intended for ongoing use,
the manufacturer advises that you can give your cat 100ml of the mixture
each day for up to 36 days, but if your vet
refuses to allow you to give sub-Qs, s/he may perhaps agree to using
These sachets contain citrate, which should not be mixed with phosphorus
hydroxide because citrate can increase aluminium absorption.
Pet Meds sells Lectade in the UK.
Vet UK sells Lectade in the UK.
Vet UK sells a similar product called
Glutalyte which can be used for up to seven days.
Subcutaneous Fluids (Sub-Qs or
Go to page
Subcutaneous fluids are injected under the skin with a small needle. They are normally used when
the cat can no longer drink enough to remain hydrated, which in practice
tends to be once creatinine levels are
consistently over 300-350 (US: 3.5-4). This equates to high Stage 3
of the IRIS staging system. Sub-Qs are much
easier to give than IV fluids and most people are able to learn how to
give them at
explains more about when to start sub-Qs, how much to give and how often,
and how to cope with giving them.
Go to page
This page discusses the pros and cons of the different
fluid types (Lactated Ringers, Normosol etc.). It also gives
helpful tips on how to make things go as easily and smoothly as possible
for you and your cat.
How to Give Subcutaneous Fluids with an IV
Go to page
This page is
a photographic guide to giving
fluids with an IV administration set (also known as a venoset or a giving set).
This method is commonly used in the USA.
How to Give Subcutaneous Fluids with a
is a photographic guide to giving
fluids with a syringe. If you are allowed to do sub-Qs in the UK, you
will probably be offered this method.
Winning Your Vet's Support
Go to page
Many people outside the USA and Canada will find that their vet is reluctant to
allow them to give sub-Qs at home. This page gives suggestions on how to
ask your vet to permit you to try sub-Qs if they are appropriate for
Intravenous Fluids (IV Fluids)
are fluids given into a vein ("on a drip").
This treatment is normally only used for cats who are hospitalised, so it
tends to be reserved for cats who are in crisis (which is sometimes
referred to as "crashing").
Go to page
Dialysis is only
available at a limited number of veterinary centres in the USA and is
incredibly expensive (it costs literally thousands of dollars). Unlike
human CKD patients, who tend to have dialysis regularly on an ongoing basis,
cats normally only have dialysis as a short term treatment (e.g. to tide a cat over who is awaiting a
This page last updated: 20 September 2013
Links on this page last checked: 15 December 2011