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What You Need to Know First

Alphabetical Index


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What Happens in CKD?

Causes of CKD

Early Detection

How Bad is It?

Is There Any Hope?

Acute Renal Failure



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



Coping with CKD

Tanya's Support Group

Success Stories



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.)



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



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



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



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




Heart Problems



Polycystic Kidney Disease (PKD)


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The Final Hours

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Canine Renal Failure

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Home > Fluid Therapy



  • 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 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