TANYA'S

COMPREHENSIVE GUIDE TO

FELINE CHRONIC KIDNEY DISEASE

      

 
 

SITE OVERVIEW

 

HOME


Site Overview


What You Need to Know First


Alphabetical Index


Glossary


Research Participation Opportunities


 

Join

Tanya's CKD Support Group Today

 

WHAT IS CKD?


What Happens in CKD?


Causes of CKD


How Bad is It?


Is There Any Hope?


Acute Kidney Injury


 

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.)


Calcium, Phosphorus, Parathyroid Hormone (PTH) and Secondary Hyperparathyroidism


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 Secondary Hyperparathyroidism (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 and Recordkeeping


 

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


The Final Hours


Other People's Losses


Coping with Your Loss


 

MISCELLANEOUS


Early Detection


Prevention


Research


Canine Kidney Disease


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 > Site Overview


Finding What You Need


 

This site has a pretty simple structure, but it does contain a lot of information. This page is therefore a brief overview of the various categories in the lefthand sidebar, telling you what each page contains. If you're trying to find something and you're still stuck, try the Alphabetical Index.

 


Home


 

What You Need To Know First

An overview of what the bloodtests mean, which symptoms you may see, and which treatments you may be offered. This page is designed to be a starting point for those new to CKD, especially if you are feeling overwhelmed by the CKD diagnosis, though it could also be a handy refresher later on.

Alphabetical Index

An alphabetical index of the site, so if, for example, you don't know what Baytril is so you don't know where to look for it, this page should help.

Glossary

A glossary of technical terms, such as azotaemia.
Research Participation Opportunities

Describes various research studies in which it is possible to participate. You have to attend the research location for some but not all of the studies.

 


What is CKD?


 

What Happens in CKD

 

A simple explanation of the kidney's functions, and what happens to them in CKD. This page also briefly discusses how much function is required, and why cats are often not diagnosed until over two thirds of kidney function have already been lost.

Causes of CKD

Information about the causes of CKD, both proven and suspected. Once CKD is present, it is treated in the same way whatever the cause (except for glomerulonephritis, when additional treatments may be appropriate); so if you're tight for time, skip this page. Also skip this page if you're on a guilt trip: you did not cause your cat's CKD through e.g. your food choices.

How Bad Is It?

Information on how severe your cat's case might be, and a brief discussion about the concept of end stage renal failure.

Is There Any Hope?

Discusses the various scenarios you might be facing, including what to do if your cat worsens suddenly.

Acute Kidney Injury

Acute kidney injury (acute renal failure) is a kind of kidney problem that comes on suddenly, usually because of an "insult" to the kidneys. It is difficult to treat, but some cats do make a complete recovery, though others will be left with residual damage (CKD).

 


Key Issues


 

Key Issues Overview

If you're feeling overwhelmed, this is probably the best page to start with. This page gives an overview of the main issues of concern for CKD cats. If you focus on any of these issues that are present, you greatly increase your cat's comfort level and chances of survival. The other pages in this chapter go into more detail about these issues.

Nausea, Vomiting, Appetite Loss and Excess Stomach Acid

Most CKD cats have problems with vomiting, nausea and appetite loss, and often the cause is excess stomach acid. This page describes the possible symptoms and various treatments available for these problems.

Maintaining Hydration

This is eventually a problem for most CKD cats. This section discusses the various types of fluid therapy available.

All About Phosphorus Control

High phosphorus levels in bloodtest results can make a CKD cat feel ill and may make the CKD progress faster. Even if the level is within normal range, this may not be enough. This page discusses the symptoms of high phosphorus levels and the possible treatments.

All About Hypertension (High Blood Pressure)

66% of CKD cats develop hypertension. It can make a cat feel rough, and in the worst case, the cat may go blind or have a stroke. Fortunately it's easily treated. This page covers possible symptoms and explains which is the best treatment.

All About Anaemia 

Anaemia may develop for various reasons. Fortunately it is usually easy to control. This page discusses why CKD cats can become anaemic and describes commonly used treatments.

All About Constipation

Constipation is quite common in CKD cats and can make a cat feel very uncomfortable. This page describes symptoms and treatments.

All About Potassium

CKD cats often have an imbalance in their potassium levels. Most of them have levels which are too low, which can cause a number of problems, especially back leg weakness. This page discusses symptoms of a potassium imbalance and how to treat low or high potassium levels.

All About Metabolic Acidosis

Metabolic acidosis means the cat's body is too acidic (which has nothing to do with stomach acid). It is quite common in CKD cats, usually in those with more advanced CKD, and this page explains more about the problem and how to deal with it.

Kidney Stones

Some cats develop kidney stones, which may cause or worsen CKD. This page discusses the various treatment options.

 


Support


 

Coping with CKD

It can be emotionally draining dealing with CKD, so this page gives tips on how to cope with the ups and downs of the CKD rollercoaster, including worrying about the future, and how to deal with practical issues, including financial concerns.

Tanya's Support Group

I have set up an online support group which is free to join. This page explains how to join and how the group works.

Success Stories

The stories of some CKD cats, all of whom have led high quality and, in most cases, long lives despite having CKD. Includes cases of young cats, cats with kidney stones, cats with acute kidney injury etc.

 


Symptoms


 

Symptoms

A brief overview of this chapter, but also contains important information on what crashing means and the meatloaf position (including photo).
Alphabetical Index of Symptoms and Treatments

There are many possible symptoms of CKD. This page lists the symptoms which you may see in alphabetical order, and provides quick links to more information for each symptom and the relevant treatment. 

Fluid and Urinary Imbalances

Fluid and urinary imbalances are common. This page describes symptoms of dehydration, symptoms of overhydration, and symptoms linked to the urinary tract, such as urinary tract infections.

Waste Product Regulation Imbalances

This page describes the symptoms you might see relating to problems with waste product regulation, such as vomiting, gastro-intestinal problems, mouth ulcers etc.

Phosphorus and Calcium Imbalances

These are frequent problems in CKD cats. This page discusses possible symptoms, such as twitching or seizures.

Miscellaneous Symptoms

Discusses symptoms such as pain, hiding and changes in the coat or skin. 

 


Diagnosis


 

Blood Chemistry: Kidney Function, Potassium and Various Other Tests

Explains the meaning of these tests, such as  BUN, creatinine, azotaemia, potassium, magnesium etc.

Calcium, Phosphorus, Parathyroid Hormone (PTH) and Secondary Hyperparathyroidism

Imbalances in phosphorus and calcium levels are extremely common in CKD cats. This page explains more, and includes a discussion of high calcium levels, ionised calcium and calcification.

Complete Blood Count (CBC): Red and White Blood Cells

Discusses the tests which indicate whether infection or inflammation are present and those which indicate anaemia and its severity.

Urinalysis (Urine Tests)

This page explains more about obtaining urine samples and what these indicate, including urine specific gravity (USG), proteinuria (excess protein in the urine) and the diagnosis of urinary tract infections and kidney infections (pyelonephritis).

Other Tests

Discusses other tests which are sometimes used, such as ultrasound, x-rays, biopsy, intravenous pyelogram etc.

Renomegaly (Enlarged Kidneys)

Explains the possible causes of this problem.

Which Tests to Have and Frequency of Testing

Discusses which tests are the most useful, and how often to test.

Factors that Affect Test Results

Explains more about factors such as fasting before tests, and how the handling of the blood may affect the results.

Normal Ranges

A rough guide to normal ranges for the various tests in the USA and the rest of the world.

International and US Measuring Systems

The USA uses a different measuring system to the rest of the world. This page explains more about this and how to convert values from one system to the other.

 


Treatments


 

Which Treatments are Essential

There are so many treatment options that it can seem overwhelming. This page explains which are the most important treatments, which may be necessary in some circumstances, and which are optional or not recommended.

Fluid and Urinary Issues

Covers fluid retention, urinary tract infections and kidney infections, incontinence, inappropriate elimination and proteinuria.

Waste Product Regulation

Treatments to help with problems such as mouth ulcers and gastro-intestinal bleeding. Includes antioxidants, adsorbents, Azodyl and other probiotics, and Astro's CRF Oil.

Phosphorus, Calcium and Secondary Hyperparathyroidism

Explains more about how to manage these problems, including high calcium levels. Discusses the use of calcitriol.

Miscellaneous Treatments

Includes stem cell transplants, ACE inhibitors, including benazepril (Fortekor), steroids and kidney transplants.

Antibiotics and Painkillers

Discusses commonly used antibiotics (Baytril, Convenia, Clindamycin and Clavamox/Synulox) and painkillers, including meloxicam (Metacam). It includes a treatment protocol should your cat have been given too much meloxicam and developed acute kidney injury.

Holistic Treatments

Describes some treatments which are not mainstream but which have proven to be effective for many CKD cats, such as slippery elm bark and acupuncture. Also explains which treatments may not be appropriate, such RenAvast.

Erythropoiesis Stimulating Agents (ESAs) for Severe Anaemia

Explains more about using ESAs to treat severe anaemia (PCV or HCT under 20%). Commonly used products are Epogen, Eprex, Aranesp (darbepoetin), Procrit or Neorecormon.

General Health Issues in a CKD Cat:

Covers standard feline health issues as they apply to CKD cats, such as vaccinations and flea treatments. Also discusses arthritis treatments and how to handle feline dementia (kitty Alzheimers).

Tips on Medicating Your Cat

Tips on how to medicate your cat with minimal stress for both of you.

Working with Your Vet

This page has suggestions on how to work with your vet as a team, and how to get a second opinion. It also explains the benefits of keeping your own records.

 


Obtaining Supplies Cheaply


 

UK

Where to obtain fluid supplies, medications and prescription food cheaply in the UK.

USA

Where to obtain fluid supplies, medications and prescription food cheaply in the USA.

Canada

Where to obtain fluid supplies, medications and prescription food cheaply in Canada.

 


Diet and Nutrition


 

Nutritional Requirements of CKD Cats

Discusses the dietary and nutritional needs of CKD cats. Includes a discussion of the low protein debate, and explains why low protein is not necessarily a good idea for cats in the early stages of CKD.

The B Vitamins (Including Methylcobalamin)

CKD cats lose Vitamin B through increased urination. This page explains how supplementation, particularly of Vitamin B12 in the form of methylcobalamin, can help with problems such as anaemia and appetite loss.

Which Foods to Feed and Which to Avoid

Tips on how to introduce a prescription diet, and what your options are if your cat refuses to eat it. Also explains why certain foods, such as tuna or garlic, are not appropriate for cats.

Persuading Your Cat To Eat

This page tackles the common problem of persuading your CKD cat to eat, and how to get additional nourishment into him/her.

Food Data Tables

 

If your cat refuses to eat prescription foods, it can help to know the content, particularly the phosphorus content, of other cat foods. This page explains how and why I analyse the foods using Dry Matter Analysis (DMA), and gives a brief overview of what to consider when choosing a food.

USA Canned Food Data

Analysis of the phosphorus, protein, sodium and fat content of a number of canned cat foods in the USA, many of which are also available in Canada.

USA Dry Food Data

Analysis of the phosphorus, protein, sodium and fat content of a number of dry cat foods in the USA, many of which are also available in Canada.

USA Cat Food Manufacturers

Contact details for the main cat food manufacturers in the USA.

UK Canned Food Data

Analysis of the phosphorus, protein, sodium and fat content of a number of tinned cat foods in the UK, many of which are also available in the rest of Europe.

UK Dry Food Data

Analysis of the phosphorus, protein, sodium and fat content of a number of dry cat foods in the UK, many of which are also available in the rest of Europe.

UK Cat Food Manufacturers

Contact details for the main cat food manufacturers in the UK.

2007 Food Recall USA

In 2007, a number of cats in the USA (and later in some other countries) suddenly began developing kidney failure. Some of them died. Some cats survived but were left with CKD. The problem was eventually traced to cat food ingredients imported from China. This page explains more about the scandal.

 


Fluid Therapy


 

Fluid Therapy

Maintaining hydration is very important for CKD cats. This page gives a brief overview of the different fluid therapies (oral fluids, intravenous fluids and subcutaneous fluids), and explains which is used when.

Intravenous Fluids

Intravenous fluids (IV fluids, or a drip) are given into a vein, and are therefore usually given in hospital. For this reason they are normally reserved for crisis situations, such as when a cat crashes. They are also commonly used before, during and after surgery.

Subcutaneous Fluids

Subcutaneous fluids (sub-Qs or sub-cuts) are given under the skin and can therefore be given at home. They are used to maintain hydration. Generally speaking, CKD cats benefit from subcutaneous fluids once their creatinine is over 3.5 (US) or 300 (international).

Tips on Giving Subcutaneous Fluids

 

This page gives an overview of the various sorts of fluids (Lactated Ringers, saline etc.). It also provides tips on which needles to use, how to keep your cat calm, and generally how to make the process easier for you both.

How to Give Subcutaneous Fluids with a Giving Set

A photographic demonstration of how to give sub-Qs using a giving set, the method commonly used in the USA.

How to Give Subcutaneous Fluids with a Syringe

A photographic demonstration of how to give sub-Qs using a syringe, the method usually recommended in the UK. It shows how you don't have to stick your cat multiple times!

Winning Your Vet's Support

In the UK in particular, it can be extremely hard to find a vet who permits you to use sub-Qs at home. This page discusses commonly used objections and how you can try to counter these.

Dialysis

Description of peritoneal dialysis, haemodialysis and continuous renal replacement therapy. These treatments cost thousands, so are rarely performed on cats, but the information is provided in case of need.

 


Related Diseases


 

Heart Problems

Heart problems are not unusual in older cats, so you may find yourself dealing with these as well as CKD. This page explains the different types of heart problem, describes the various heart medications that may be used, and discusses how to balance treatment for both CKD and heart problems.

Hyperthyroidism

Hyperthyroidism means that the thyroid is overactive, so the body's metabolic processes are in overdrive, causing a variety of different problems. Treating hyperthyroidism is therefore essential, but must be done cautiously because treating it may unmask existing but hidden CKD. This page explains more about hyperthyroidism and how to juggle both conditions.

Diabetes

Diabetes is relatively common in CKD cats. It is usually manageable. This page discusses the various treatments available and how to balance the dietary needs of a cat with both CKD and diabetes.

Pancreatitis

Pancreatitis is inflammation of the pancreas. It is fairly common in CKD cats, and shares some of the same symptoms. If your cat has relatively low creatinine levels but is acting sicker than you would expect, with vomiting and severe appetite loss, read this page.

Polycystic Kidney Disease

PKD is a genetic disease in which cysts form in the kidneys. It is most commonly found in Persian cats. It can eventually lead to CKD. This page explains more about the condition.

Dental Problems

 

Most cats eventually develop dental problems, and many of them eventually need surgery. This page explains how to reduce the risk of dental problems, and what precautions are necessary in cats who need dental surgery.

Anaesthesia

Information on anaesthesia and the precautions that should be followed for CKD cats having surgery performed under general anaesthesia.

 


Saying Goodbye


 

The Final Hours

Since CKD is ultimately terminal, eventually you will have to say goodbye to your cat. This page contains information on facing up to this painful parting, and explains the symptoms and behaviour which you may see in your cat's last few days or hours. This page also contains a discussion on whether to opt for euthanasia, and a description of what to expect during the procedure if so.

Other People's Losses

This page consists of descriptions from a few brave people of what they and their cat experienced towards the end, and why in most cases they opted for euthanasia. 

Coping with Your Loss

This page contains information on how to cope with your grief after you say goodbye, and where to find support. 

 

Miscellaneous


 

Early Detection

Normally, CKD cannot be detected before 66% of kidney function is already gone. This page discusses possible methods of early detection of CKD.

Prevention

In most cases you cannot prevent CKD. However, there are a few steps you can take to reduce the risks, which this page discusses.

Research

This page discusses ongoing research into CKD and AKI.

Canine Kidney Disease

 

I have no personal experience of canine CKD but this page provides links to information.

Other Illnesses (Cancer, Liver) and Behavioural Problems

Links to information about general feline health issues, cancer, liver disease and behavioural problems.

Diese Webseite auf Deutsch

Wo Sie diese Webseite auch auf Deutsch finden können.

This site is also available in German.

 


Siteowner - Helen


 

My Three CKD Cats: Tanya, Thomas and Ollie

Tells the contrasting stories of my three CKD cats.

My Multi Ailment Cat, Harpsie

Harpsie was my second cat. He was an adorable blond Persian who had a host of ailments but who nevertheless lived to the age of 14. He had PKD, which was diagnosed at the age of 7, but it never developed into CKD.

Find Me on Facebook

This website is on facebook. I have terrible trouble logging into facebook for some reason, so I'm not on there very often. It's far quicker to find me via this site or Tanya's CKD Support Group.

Follow Me on Twitter

The website is also on Twitter. I think I have done about three tweets so far. As you're beginning to guess, I'm not really a social media person but hey, I'm trying.

Contact Me

How to get in touch with me.

 

 

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This page last updated: 09 February 2012

Links on this page last checked: 04 January 2012