If your cat's blood phosphorus level is over
6
mg/dl (USA) or over 1.9 mmol/L (international),
it is too high and you need to get it under control.
Keeping phosphorus levels under control can help slow the progression of the CKD,
reduce the risk of serious problems
and make your cat feel better.
Feeding a food low in phosphorus is the first and best step.
Ideally you want a food with a level below 0.5% phosphorus on a dry matter
analysis basis. Therapeutic kidney diet foods are the only complete foods which
meet this criterion.
If your cat will not eat the therapeutic kidney diet, feeding
a food as low in phosphorus as possible and adding
a phosphorus binder to the food when appropriate can help control your cat's phosphorus
levels.
Phosphorus is a mineral essential for good health which
is contained in many foods. The body is very good at regulating its
phosphorus levels by removing excess phosphorus via the kidneys. However,
the kidneys of a CKD cat can no longer
efficiently excrete excess phosphorus, so the vast
majority of CKD cats will develop
levels of phosphorus in their blood that are too high:
this is known as
hyperphosphataemia.
In contrast to the
protein debate, there is no
dispute about the importance of treating
hyperphosphataemia because of the problems it causes. Indeed, an update on
the
Western Veterinary Conference 2017
reports that "phosphorus restriction may be the "single most
powerful treatment," according to Dr. Chew."
High phosphorus
levels may:
Make the Cat
Feel Unwell
High phosphorus levels can cause a variety of unpleasant
symptoms and generally make a CKD cat feel quite unwell. There is a list
of possible symptoms
below.
Cause CKD
Progression
High phosphorus levels can make
CKD progress more quickly. A human study,
Serum
phosphate and mortality in patients with chronic kidney disease (2010) Eddington
H, Hoefield R, Sinha S, Chrysochou C, Lane B, Foley RN, Hegarty J, New
J, O'Donoghue DJ, Middleton RJ & Kalra PA Clinical Journal of the
American Society of Nephrology5(12) pp2251-2257, found that the
risk of dying for patients in stages 3 and 4 was higher if they had higher phosphorus levels, even if the phosphorus was
technically within normal
range. A study of cats,
Survival in cats with naturally occurring chronic
kidney disease (2000-2002) (2008) Boyd LM, Langston C, Thompson
K, Zivin K & Imanishi M Journal of Veterinary Internal Medicine
22(5) pp1111-7, found that there was an 11.8% increase in the risk
of death for every one mg/dl increase in
phosphorus in the cat's blood.
The role of
phosphorus in the pathophysiology of chronic kidney disease (2013)
Geddes RF, Finch NC, Syme HM, Elliott J
Journal of Veterinary Emergency & Critical Care (San
Antonio) 23 pp122-133
reports that a phosphatonin called fibroblast growth factor 23
(FGF-23)
"is now considered to be a key regulator of plasma phosphorus
concentration in people" and states that the role of FGF-23 in companion
animals with CKD is also being investigated.
Early
Detection discusses the role FGF-23 may play in the early detection of
CKD.
Elevated phosphorus levels can adversely affect calcium levels
and
eventually can
trigger problems with a hormone called parathyroid hormone (PTH), causing a serious condition called
Chronic kidney disease (CKD) in dogs and cats
— staging and management strategies
(2015) Chew D
Presentation to the Virginia Veterinary Medical Association 2015
Virginia Veterinary Conference states that it is possible for a CKD
cat to develop secondary hyperparathyroidism even if phosphorus levels
and ionised calcium levels are normal. He explains "In the early stages
of chronic kidney disease increased levels of parathyroid hormone (PTH)
keep serum phosphorous within the normal range by increasing phosphate
excretion into urine. This allows for normalization of serum phosphorous
at the expense of hyperparathyroidism." Therefore, even a cat with
normal phosphorus levels but with elevated PTH levels would benefit from
phosphorus restriction.
High phosphorus levels may reduce the cat's response to
Erythropoiesis stimulating
agents (ESAs), a treatment
used for severe anaemia, which is relatively common in CKD cats.
Symptoms of Hyperphosphataemia
There are a number of different symptoms of high
phosphorus levels. You may not see all of these symptoms, and some of them
may have other causes as outlined under each symptom. However, if you see any
of the symptoms described below, please ensure that your cat's phosphorus
level is checked (via bloodtests) and is no higher than 6 mg/dl (US) or 1.9 mmol/L
(international).
Cats who do
not eat are at risk of developing a potentially life-threatening condition
known as hepatic lipidosis;
Mar Vista Vet
has more information about this.
Therefore, it is important to try to find the cause and treat it as
quickly as possible.
Itching
Itching is fairly common in cats with
high phosphorus levels, particularly if the high phosphorus levels go
untreated, resulting in
secondary
hyperparathyroidism.
Lack of Co-ordination in the Limbs/Back
Leg Weakness
This can be
due to high phosphorus levels interfering with
the nerve messages that control the limbs, a condition known as
neuropathy. Some of the symptoms include "forgetting" where the hind legs
are (getting up and leaving without them, for instance, or leaving them in
the air after licking them), or stumbling and feet
crossing over when walking.
Plantigrade Posture
You may
also see a plantigrade posture (as demonstrated by
Ollie to the left), where the cat walks on his/her hocks
instead of his/her feet: this is most common in diabetic cats, but may
sometimes be seen in cats with high phosphorus levels,
or with neurological problems from other causes.
Ollie did this because of
low
potassium levels.
Long Beach Animal Hospital has a
photograph of a cat with diabetic neuropathy doing this (click on
Symptoms).
Newman Veterinary
has a good before and after photo of a diabetic cat with this
problem, scroll down a little to Other Common Consequences, then click on
Plantigrade Stance (in red font).
If your
cat's high phosphorus levels go untreated, your cat may eventually develop
a condition called
secondary
hyperparathyroidism. One symptom of secondary
hyperparathyroidism is
"rubber jaw", which may present as teeth grinding.
discuss the various courses of teeth grinding in cats.
Youtube has a video of a cat grinding his/her teeth.
Knuckling
"Knuckling"
may also be seen, where the cat walks on the top of the foot with the toes
tucked underneath, appearing almost to be dragging the toes behind. I
haven't been able to find a photo of a cat with high phosphorus levels
doing this, but there is a video on
youtube
of a dog with a similar problem (but with a
different cause).
Weakness
Weakness
and muscle wastingmay be seen, especially in the back legs. This
can be caused by high
phosphorus levels leading to
secondary
hyperparathyroidism.
Weakness in
the back legs is often caused by
low
potassium levels
or occasionally by
low magnesium or
low calcium levels; while
muscle wasting may be caused by
metabolic acidosis.
General weakness may be caused by
anaemia. If your cat no
longer jumps, this may be thought to be weakness when in fact it is an
unwillingness to jump because of blindness caused by
hypertension. An inability
to jump or climb may also be caused by
arthritis.
If your cat suddenly cannot walk properly on one
leg, particularly a back leg, and the leg feels cold to the touch, this
may indicate a heart-related problem known as an
arterial thromboembolism. This is a medical emergency, and you need to contact
your vet as soon as possible.
Your vet can determine if your cat's phosphorus levels
are too high by checking your cat's bloodwork for phos, P or Pi (these are
all abbreviations for phosphorus). Most vets do this routinely, but if
yours does not, ask for it to be done.
A typical laboratory range for phosphorus levels in cats is 2.5 - 7.5
mg/dl (USA) or 0.81 - 1.61 mmol/L (international).
Unfortunately, many vets see that a CKD cat's phosphorus
level falls within the normal range for their laboratory and are
satisfied, forgetting that the higher part of the
rangeonly applies to healthy
growing kittens.
Even a healthy older cat should have phosphorus levels in
the bottom half of most laboratory ranges.
The role of phosphorus in feline chronic renal
disease (2010) Chew D
& Kidder AC CVC in
San Diego Proceedingsstates "Levels of serum phosphate are often
higher in young growing animals than in adults...The normal range for many
laboratories unfortunately includes that of adult and growing animals,
making it difficult or impossible to detect early rises in serum
phosphorus above normal. Serum phosphate concentration is less
than 5.5 mg/dl in most healthy adults."
If a healthy adult cat needs phosphorus to be in the lower part of most
laboratories' reference ranges, it is even more important for a CKD cat.
Chronic kidney disease (CKD) in dogs and cats
— staging and management strategies (2015)
Chew D Presentation to the Virginia Veterinary Medical Association 2015
Virginia Veterinary Conference states "
Control
of total body phosphate burden is an overarching goal in the management of
CKD. Increasing phosphate retention during CKD occurs even as serum
phosphorus values remain within the reference range."
Phosphorus control is also important in CKD because if the cat's phosphorus multiplied by calcium is higher than 70
(US) or 5 (international), the cat is at risk of tissue calcification (see
secondary
hyperparathyroidism).
So if your vet tells you that your cat's phosphorus level is
fine, don't just take that at face value, ask for the exact level. Chances
are it is too high for a CKD cat.
Goal for Phosphorus Level in
CKD Cats
So how low do you want your cat's phosphorus level to
be?
I used to recommend (as did many CKD specialists) that
you try to get the level down to 4.0 mg/dl (US) or 1.3 mmol/L
(international).
Chronic kidney disease (CKD) in dogs and cats
— staging and management strategies (2015)
Chew D A Presentation to the
Virginia Veterinary Medical Association 2015 Virginia Veterinary
Conference gives a slightly less ambitious target: "A targeted serum phosphate
of less than 4.5 mg/dl [1.45 mmol/L] is recommended for CKD patients to ensure less
phosphate burden in the bodies of these dogs and cats."
There is nothing wrong with these goals per se, and if
you can get your cat's phosphorus level down to 4-4.5 mg/dl or 1.30-1.45
µmol/L, that is great; but as the CKD progresses, achieving such levels
can become more challenging.
Treatment recommendations for CKD in cats
(2023) International Renal Interest Society
therefore recommend a staged approach to phosphorus control, as shown in
the table below.
These values apply to adult cats. If your cat is very young (6-12 months old), then a higher
phosphorus target is appropriate, because kittens
need phosphorus for their bones to grow properly. Check out the table
above and discuss with your vet
what would be an acceptable level.
Don't forget, these stages apply to stable cats; if
your cat is dehydrated, for example, the bloodwork will not be accurate.
Phosphorus Goal: US Values
Stage of CKD
Creatinine Level in mg/dl
Phosphorus Goal
IRIS Stage 2
Between
1.6 and 2.8
2.7 - 4.59 mg/dl
IRIS Stage 3
Between 2.9
and 5.0
Below 5.0 mg/dl
IRIS Stage 4
Over 5.0
Below 6.0 mg/dl
Phosphorus Goal: International Values
Stage of CKD
Creatinine Level in mmol/L
Phosphorus Goal
IRIS Stage 2
Between
140 and 249
0.9 - 1.49 mmol/L
IRIS Stage 3
Between 250 and 439
Below 1.60 mmol/L
IRIS Stage 4
Over 440
Below 1.90 mmol/L
When to Act to Reduce Phosphorus
Levels
You must definitely take action if your cat's blood phosphorus
level is above 6 mg/dl (US) or 1.9 mmol/L (international). This
applies whatever stage of CKD your cat is in.
In addition, the International Renal Interest Society issued new
guidelines in 2023 following the introduction of a new test for a renal
biomarker called
fibroblast growth factor 23 (FGF-23)
in 2022.
Treatment recommendations for CKD in cats
(2023) International Renal Interest Society
states that for cats in CKD Stages 1 or 2, where phosphorus levels may
appear normal, "Measurement of FGF23 may help to identify cats which
would benefit from dietary phosphate restriction where plasma phosphate is
in the target range. FGF23 >400 pg/ml in the absence of hypercalcaemia,
anemia or marked inflammatory disease is an indication to start dietary
phosphate restriction. Monitor serum calcium and if total calcium exceeds
12 mg/dl (3 mmol/l) switch the cat to a less phosphate restricted diet.".
What this is saying is that if your cat is in early stage CKD, with
phosphorus level apparently in the normal range, but your cat's FGF-23
level is above
400 pg/ml, you need to take steps to control your cat's phosphorus levels.
Ideally you want your cat's phosphorus level to be no
more than 4.0 mg/dl (US) or 1.3 mmol/L (international), though this is
harder to achieve as the CKD progresses..
So what should you do if your cat has a blood
phosphorus level somewhere between these values, i.e. between 4.0 and 6.0
mg/dl (US) or 1.3 and 1.9 mmol/L (international)?
It may help to take another look at the recommended levels for cats in
different stages of CKD mentioned above.
Treatment recommendations for CKD in cats
(2023) International Renal Interest Society
state that you should try to control high
phosphorus levels depending upon the CKD stage, as follows:
Stage 2: phosphorus should be no
higher than 4.6 mg/dl or 1.5 mmol/L
Stage 3: phosphorus should be no
higher than 5.0 mg/dl, or 1.6 mmol/L
Stage 4: phosphorus should be no
higher than 6.0 mg/dl, or 1.9 mmol/L
So if, for example, your cat is in Stage 2 with a phosphorus level of 5.5
mg/dl, you should definitely be treating it.
For cats in Stage 4 CKD,
Treatment recommendations for CKD in cats
(2023) International Renal Interest Society states
"FGF23 may assist in determining whether further phosphate restriction
would be beneficial to the cat. If FGF23 is >700 pg/ml, further phosphate
restriction should be applied (e.g. by increasing the dose of phosphate
binder) provided there is no evidence of hypercalcaemia, marked anemia or
severe inflammatory disease (all of which can increase FGF23 independently
of mineral bone disturbance)."
Even for cats with lower phosphorus levels, if phosphorus multiplied by total calcium is higher than 70in US
values or 5 in international values, the cat is at risk of tissue
calcification (see
secondary
hyperparathyroidism), so action is necessary.
Veterinary References for
Phosphorus Goals
If your vet refuses to accept that a phosphorus level
above 6
mg/dl (US) or 1.9 mmol/L
(international) is too high for your cat, print out and show him/her some
of these references:
Proteinuria and renal disease: a round table
discussion (2005) - on page 14
Professor J Elliott
of the Royal Veterinary College states that "the goal
should be to keep the serum phosphorus concentration at the lower end of
the reference range."
Phosphatemia management in the treatment of chronic
renal disease: a round table discussion
(2006) Elliott J, Brown SA, Cowgill LD, Grauer GF, Polzin DJ,
Fernandez del Palacio MJ & Lefebvre H states
"practitioners need to realise that a phosphate in the normal range could
still be abnormal in renal patients." Page 6
provides detailed recommendations on phosphorus control.
Monitoring Phosphorus Levels
If your cat is
eating a therapeutic kidney diet, it may take up to a month for you to
see a difference in your cat's blood phosphorus levels.
If you are using phosphorus binders, you should start to see a difference
in blood phosphorus levels around 7-10 days after starting binders.
Treatment recommendations for CKD in cats
(2023) International Renal Interest Society
recommend checking phosphorus and calcium levels every 4-6 weeks to
start with, reducing to every 12 weeks once your cat is stable. Dr Chew
makes similar recommendations.
Since in my experience most people will be
visiting the vet fairly frequently in the first month after diagnosis, I
suggest checking your cat's blood phosphorus level
every two weeks until the level is acceptable, then checking it every 2-3
months to see if any adjustments to your treatment plan are necessary.
This is worth doing because Dr Chew mentions that "Serum
phosphorus concentration may increase in CKD cats that increase their food
intake following other supportive CKD treatments." This ties in with
IRIS
Summary of Phosphorus Goals
USA
You must definitely take action as soon asyour
cat's phosphorus level goes above6 mg/dl, though in some cases you should take
action sooner (see above).
You must also take action if your cat is in CKD Stage 1
or 2 with normal phosphorus levels, but with a fibroblast
growth factor 23 (FGF-23)
level above 400 pg/ml.
If your cat's level is below 6 mg/dl,
but multiplying it by your cat's calcium level gives you a reading of
60-70 or over, take action now.
Your aim is to reduce your cat's phosphorus to a
level of below
4.6 mg/dl. You may not
be able to get it this low if your cat is in
IRIS
Stage 3 or 4, but aim never to let it go above 6 mg/dl.
You can read
below
about ways to reduce the level. At first check phosphorus levels every 2-4
weeks to see
if any adjustments to your treatment plan are necessary.
If your cat is very young (6-12 months old), then a higher
phosphorus level is appropriate, because kittens
need phosphorus for their bones to grow properly. Check out the table
above and discuss with your vet
what would be an acceptable level.
Low phosphorus levels (below
4
mg/dl) are extremely rare in CKD
cats, but are generally not considered to be a problem as long as they do
not fall below 2.7 mg/dl. I would try not to go below 3 mg/dl.
See
Diagnosis for more information.
International
You must definitely take action as soon as
your cat's phosphorus level goes above1.9 mmol/L, though in some cases you should take
action sooner (see above).
You must also take action if your cat is in CKD Stage 1
or 2 with normal phosphorus levels, but with a fibroblast
growth factor 23 (FGF-23)
level above 400 pg/ml.
If your cat's level is below 1.9 mmol/L,
but multiplying it by your cat's calcium level gives you a reading of 5
or over, take action now.
Your
aim is to reduce it to a level ofbelow 1.5 mmol/L. You may not be able to get it
this low if your cat is in
IRIS
Stage 3 or 4, but aim never to let it go above 1.9 mmol/L.
You can read
below
about ways to reduce the level. Check phosphorus levels every month to see
if any adjustments to your treatment plan are necessary.
If your cat is very young (6-12 months old), then a
higher phosphorus level is appropriate, because kittens need phosphorus for their
bones to grow properly. Check out the table
above and discuss with your vet
what would be an acceptable level.
Low phosphorus levels (below
1.3 mmol/L) are not normally present in
CKD cats, but are generally not considered to be a problem as long as they
do not fall below 0.9 mmol/L. I would try not to go below 1 mmol/L. See
Diagnosis for more information.
Ways to Control
High Phosphorus Levels
As discussed
above, focusing on phosphorus control is one of the most
effective ways to help your CKD cat feel better and live longer. The good news is, it is usually not too difficult or
expensive to do this, though it may become
harder to keep your cat's phosphorus levels as low as you would like as the CKD progresses..
There are two main ways to control phosphorus levels,
in order of preference:
How high your
cat's blood phosphorus level should be depends upon the stage of the disease
(see above for more
information) but it should always be below 6 mg/dl
(US) or 1.9 mmol/L (international).
The first line of
phosphorus control is to feed foods low in
phosphorus.
If your cat's phosphorus level is currently below the
level mentioned above, it is still wise to feed a food as low in phosphorus as you can,
because the less phosphorus your cat eats, the less work there is for the
kidneys to do trying to process it. Also, phosphorus levels tend to rise as
the CKD progresses, and usually it is easier to keep them low rather than have
to work on reducing them.
Management of feline chronic failure
(1998) Brown S Waltham Focus8(3) pp27-31
states that ideally you want to
feed a food with a phosphorus level
under 0.5% on a dry matter analysis basis.
Feeding a Therapeutic Kidney
Diet
A therapeutic kidney diet has many characteristics, but one of the most
important is the reduced phosphorus content. Many
therapeutic kidney diets have phosphorus levels below 0.5%.
Most vets do recommend feeding these foods.
Chronic kidney disease (CKD) in dogs and cats
— staging and management strategies
(2015) Chew D
Presentation to the Virginia Veterinary Medical Association 2015 Virginia
Veterinary Conference says "An initial goal is to attempt
to return high serum phosphorus concentrations to within the normal range by
the feeding of a phosphate-restricted renal diet."
Fibroblast growth factor 23 (FGF-23) is important for
the regulation of phosphorus levels in the body. It is possible that
FGF-23 levels may in fact rise before other signs of CKD appear.
The effect of feeding a renal diet on plasma fibroblast
growth factor 23 concentrations in cats with stable azotemic chronic kidney
disease(2013) Geddes RF,
Elliott J & Syme HM Journal of Veterinary Internal Medicine27(6)
pp1354-61 states "Feeding renal diet is associated with reductions in plasma FGF-23
concentrations in hyper- and normophosphatemic cats with stable azotemic
CKD, suggesting that dietary phosphate restriction may enable cats with
CKD to maintain normal plasma phosphate concentrations in association with
lower plasma FGF-23 concentrations."
Survival of cats with naturally occurring chronic
renal failure: effect of dietary management (2000) Elliott J,
Rawlings JM, Markwell PJ, Barber PJ Journal of Small Animal Practice41(6) pp235-242 found that feeding a reduced phosphorus therapeutic
kidney diet provided effective phosphorus control in two thirds of the cats in
Stage 2 and 3 CKD. In addition, the cats eating the therapeutic kidney diet
lived more than twice as long as the cats in the study who ate normal food
with no phosphorus binder.
See
Which
Foods to Feed for more information about therapeutic kidney diets.
Feeding Other Commercial Foods
If your cat won't
eat the therapeutic kidney foods (see Which
Foods to Feedfor tips on this), you still need your cat to eat, so
you will need to look at feeding commercial or homemade foods with a lower phosphorus
content.
In the USA,
the minimum level of phosphorus in a non-therapeutic adult maintenance food
is 0.5%, so you are not going to find a complete commercial
food with phosphorus below this level; however, most
non-therapeutic adult maintenance foods unfortunately contain far more phosphorus than this.
Many people seem to think that a food below 1% phosphorus on a dry
matter analysis (DMA)
basis is low phosphorus but that is not the case; you
want to get as close to a level of below 0.5% on a DMA basis as possible. If you check the
food data tables in the
Diet and Nutrition
section, you can try to find a
food which your cat will eat with the lowest
possible level of
phosphorus.
I sometimes receive
excited e-mails from people who are thrilled because they have apparently
found a food that does not contain any phosphorus at all, because it is not
mentioned on the label. It is virtually impossible to find a cat food
containing little or no phosphorus, especially if the food contains animal-based
protein, as most cat foods do (phosphorus is found in meat,
particularly bones). It is simply because
US law does not require phosphorus to be listed on the label.
Food Choices
Although canned
foods are generally a better choice for CKD cats than dry foods, since
phosphorus control is so important, if I had a cat who was prepared to eat a
dry therapeutic kidney diet, I would feed that rather than feed a
non-therapeutic
commercial canned diet with added binders.
Effect of boiling on dietary phosphate and nitrogen
intake (2006) Cupisti A, Comar
F, Benini 0, Lupetti S, D’Alessandro C, Barsotti G & Gianfaldoni D Journal
of Renal Nutrition16(1) pp36–40 is an interesting study which
assessed the effect of boiling beef and chicken breast for 10, 20 and 30
minutes. The study found that this reduced phosphorus levels, and that soaking
the meat in cold water for an hour before boiling it reduced the phosphorus
content even further. The study concludes "Our results show that consuming
boiled foods can significantly reduce dietary phosphate while preserving
protein intake, namely reducing the effective phosphate intake per gram of
dietary protein. This can represent additional advice to the patient for
limiting the dietary phosphorus load at the same protein intake, leading to a
better control of phosphate balance together with a lower risk of protein
malnutrition." This may be worth bearing in mind if you make your own cat
food. However, you cannot simply boil a chicken breast and give it to your
cat, that would not consitute a balanced meal. See
Which Foods to
Feed for more information on homemade diets.
See above
for information on how to monitor your cat's phosphorus levels.
Controlling Phosphorus Levels with Phosphorus
Binders
If your cat will not eat a therapeutic kidney diet, or if
his/her phosphorus levels are still too high (over6 mg/dl (US) or 1.9 mmol/L
(international)), despite feeding such a diet for a
month, products called phosphorus binders are used.
Unfortunately, even if your cat is eating a low
phosphorus diet, at some point it is quite possible that this will become
insufficient to control your cat's phosphorus levels.
The role of phosphorus in feline chronic renal disease (2010) Chew D
& Kidder AC CVC in
San Diego Proceedings states "Diet
alone is not successful in adequate phosphorus control as chronic renal
disease becomes more advanced. In these instances serum phosphorus
concentration increases above the normal range or stays in the upper half
of the normal range." In this situation,
you will also have to consider the addition of phosphorus binders.
Phosphorus binders are simply added to the cat's food:
they bind with some of the phosphorus in the food in the
intestine, thus preventing it from being absorbed
and thereby
reducing levels of
phosphorus in the cat's body.
Survey of dietary and medication practices of owners
of cats with chronic kidney disease
(2014) Markovich JE, Freeman LM, Labato MA and Heize CR Journal
of Feline Medicine and Surgery22 found that only 22% of the
1080 cats in the survey were receiving phosphorus binders. Not all of the
cats may have required binders at the time of the survey but this is still
a very low percentage considering the consequences of not controlling
phosphorus levels in CKD.
TREATING YOUR CAT WITHOUT VETERINARY ADVICE CAN BE
EXTREMELY DANGEROUS.
I have
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. 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
your link.
You may
also see a plantigrade posture