TANYA'S

COMPREHENSIVE GUIDE TO

FELINE CHRONIC KIDNEY DISEASE

 
 

FLUID THERAPY: SECTION OVERVIEW

 

HOME


Site Overview


What You Need to Know First


Alphabetical Index


Glossary


Research Participation Opportunities


 

WHAT IS CKD?


What Happens in CKD?


Causes of CKD


Early Detection


How Bad is It?


Is There Any Hope?


Acute Renal Failure


 

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


Potassium Imbalances


Metabolic Acidosis


Kidney Stones


 

SUPPORT


Coping with CKD


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


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


Dialysis


 

RELATED DISEASES


Heart Problems


Hyperthyroidism


Diabetes


Polycystic Kidney Disease (PKD)


Pancreatitis


Dental Problems


Anaesthesia


 

OBTAINING SUPPLIES CHEAPLY


UK


USA


Canada


 

SAYING GOODBYE


Saying Goodbye


The Final Hours


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


Find Me on Facebook


Follow Me on Twitter


Contact Me


Home > Fluid Therapy

 


Overview


  • 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 therapy.

  • This page explains more about the goals of fluid therapy and discusses oral fluids.

  • 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


According to 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:

  1. the replacement phase: the goal is to correct dehydration, which may be very severe in some cases. Intravenous fluids (IV fluids) are commonly used for this purpose. A CKD cat who has crashed is usually given IV fluids;

  2. the maintenance phase: the goal is to keep the cat hydrated, so s/he does not revert to the replacement phase. Subcutaneous fluids (sub-Qs or sub-cuts) are commonly used for this purpose, which you can usually do yourself at home. 

  3. the 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. Intravenous fluids are commonly used for this purpose.


Types of Fluid Therapy


 

There are a number of different types of fluid therapy. Your vet will decide which is the best method for your cat.

 


Oral Fluids


 

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.

 

Unfortunately, even 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 dental surgery.

 

One popular 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 Rehydration Support.

 

Lectade


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 Lectade.

 

These sachets contain citrate, which should not be mixed with phosphorus binders containing aluminium 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 Sub-cuts)                                                          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 home.

 

This page explains more about when to start sub-Qs, how much to give and how often, and how to cope with giving them.

 


Subcutaneous Fluids Tips                                                                                            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 Administration Set                        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 Syringe                                                   Go to page


This page 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 your cat.

 


Intravenous Fluids (IV Fluids)                                                                                      Go to page


Intravenous 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").

 


Dialysis                                                                                                                                                             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 kidney transplant).

 

 

 

This page last updated: 20 September 2013

 

Links on this page last checked: 15 December 2011