Tanya's Comprehensive Guide to Feline Chronic Kidney Disease

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 Search function (top left).

Home

Page	Contents	Last Updated
Just Diagnosed? 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.	25 Aug 2020

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.	30 Jun 2020
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.	13 Nov 2020
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.	04 Mar 2023
Is There Any Hope?	Discusses the various scenarios you might be facing, including what to do if your cat worsens suddenly.	25 Jun 2020
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).	05 Mar 2023

Key Issues: Helping Your Cat Live Longer

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 chances of survival. The other pages in this chapter go into more detail about these issues.	24 Aug 2020
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.	18 Mar 2023
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 is easily treated. This page covers possible symptoms and explains which is the best treatment.	31 Mar 2023
Proteinuria	Proteinuria means excess levels of protein in the urine. This can make the CKD progress faster. It can be difficult to treat, but possible treatment options include ACE inhibitors or ARBs (e.g. Fortekor)	13 Sep 2020
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.	14 May 2023
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.	24 Jun 2021
Pyelonephritis (Kidney Infections) and Urinary Tract Infections	Kidney and urinary tract infections are common in CKD cats, but not always easy to detect. This page discusses symptoms, diagnosis and treatments.	13 Nov 2020
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.	11 Aug 2020
Kidney Stones	Some cats develop kidney stones, which may cause or worsen CKD. This page discusses the various treatment options.	12 Nov 2020

Key Issues: Helping Your Cat Feel Better

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. The other pages in this chapter go into more detail about these issues.	24 Aug 2020
Appetite Loss, Nausea and Vomiting	Most CKD cats have problems with vomiting, nausea and appetite loss. This page describes the possible symptoms and various treatments available for these problems.	26 Nov 2024
Maintaining Hydration	This is eventually a problem for most CKD cats. This section discusses the various types of fluid therapy available.	30 Jun 2020
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.	13 Sep 2020
Constipation	Constipation is quite common in CKD cats and can make a cat feel very uncomfortable. This page describes symptoms and treatments.	27 May 2022

Cat Food Data

Ways of Assessing Food Content, Including What is Dry Matter Analysis	If your cat refuses to eat therapeutic kidney 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.	12 Jun 2020
How to Use the Food Data Tables	This page explains how to use the food data tables contained in this chapter.	12 Jun 2020
USA Canned Food Data	Analysis of the phosphorus, protein, sodium, fat and carbohydrate content of a number of canned and pouch foods in the USA, many of which are also available in Canada. This is purely a list in order of phosphorus content, not a recommendation of any of these foods.	27 Sep 2022
USA Dry Food Data	Analysis of the phosphorus, protein, sodium, fat and carbohydrate content of a number of dry foods in the USA, many of which are also available in Canada. This is purely a list in order of phosphorus content, not a recommendation of any of these foods.	15 Nov 2020
USA Cat Food Brands: Helpfulness Ratings	How helpful I have found the various US cat food brands to be when I have tried to obtain information about their cats foods for my food data tables. This does not rate the food in any way. NOTE: currently not available.	18 Apr 2017
USA Cat Food Brands: Contact Details	Contact details for the main cat food manufacturers in the USA.	09 Jan 2017

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.	11 Nov 2020
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.	13 Sep 2020
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.	26 Jun 2014

Symptoms

Symptoms	A brief overview of this chapter, but also contains important information on what crashing means and the meatloaf position (including photos).	21 May 2020
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.	21 Jul 2020
Fluid and Urinary Imbalances	Fluid and urinary imbalances are common in CKD. This page describes symptoms of dehydration, symptoms of overhydration, and urinary issues, such as blood in the urine.	06 Sep 2021
Waste Product Regulation Imbalances	This page describes the symptoms you might see relating to problems with waste product regulation, such as vomiting, gastrointestinal problems, mouth ulcers etc.	12 Sep 2020
Phosphorus and Calcium Imbalances	These are frequent problems in CKD cats. This page discusses possible symptoms, such as twitching or seizures.	04 Apr 2023
Miscellaneous Symptoms	Discusses symptoms such as pain, hiding and changes in the coat or skin.	16 Sep 2022

Diagnosis

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.	04 Mar 2023
Blood Chemistry: Kidney Function, Potassium and Various Other Tests	Explains the meaning of these tests, such as BUN, creatinine, azotaemia, potassium, magnesium etc.	04 Mar 2023
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.	03 Apr 2023
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.	13 Sep 2020
Urinalysis (Urine Tests)	This page explains more about obtaining urine samples and what these indicate, including urine specific gravity (USG) and blood in the urine.	13 Nov 2020
Other Tests	Discusses other tests which are sometimes used, such as ultrasound, x-rays, biopsy, intravenous pyelogram etc.	13 Sep 2020
Renomegaly (Enlarged Kidneys)	Explains the possible causes of this problem.	22 Jun 2020
Which Tests to Have and Frequency of Testing	Discusses which tests are the most useful, and how often to test.	22 Jun 2021
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.	22 Jun 2020
Normal Ranges	A rough guide to normal ranges for the various tests in the USA and the rest of the world.	13 Sep 2020
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.	22 Jun 2020

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.	20 Jul 2020
Fluid and Urinary Issues	Covers fluid retention and overhydration, incontinence and inappropriate elimination.	06 Jul 2020
Waste Product Regulation	Treatments for problems such as mouth ulcers, gastrointestinal bleeding and diarrhoea. Discusses methods of reducing CKD toxins, including antioxidants, adsorbents, probiotics, prebiotics, Azodyl or Renadyl, and Astro's CRF Oil or Nitrogen Scrub.	07 Oct 2021
Phosphorus Binders	Covers the various phosphorus binders that may be used in CKD cats.	17 Mar 2023
Phosphorus, Calcium and Secondary Hyperparathyroidism	Explains more about how to manage these problems, including high calcium levels. Discusses the use of calcitriol.	07 Mar 2023
Steroids, Stem Cell Transplants and kidney Transplants	Discusses steroids (both anabolic and corticosteroids), stem cell transplants, and kidney transplants.	10 Jul 2020
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.	31 Oct 2020
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.	08 Jun 2022
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.	17 Jun 2021
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 cognitive dysfunction (feline dementia or kitty Alzheimers).	07 Jun 2022
Tips on Medicating Your Cat	Tips on how to medicate your cat with minimal stress for both of you.	07 Sep 2020
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.	29 Aug 2020

Obtaining Supplies Cheaply

UK	Where to obtain fluid supplies, medications and therapeutic kidney food at reasonable prices in the UK.	04 Sep 2020
USA	Where to obtain fluid supplies, medications and therapeutic kidney food at reasonable prices in the USA.	06 Sep 2020
USA Local Fluids	Where to obtain fluid supplies at local pharmacies in the USA.	06 Sep 2020
Canada	Where to obtain fluid supplies, medications and therapeutic kidney food at reasonable prices in Canada.	31 Oct 2020

Diet and Nutrition

Nutritional Requirements of CKD Cats	Discusses the dietary and nutritional needs of CKD cats. Includes a discussion of the reduced protein debate, and explains why reduced protein is not necessarily a good idea for cats in the early stages of CKD.	26 Nov 2020
Which Foods to Feed and Which to Avoid	Tips on how to introduce a therapeutic kidney 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.	27 Sep 2022
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.	08 Oct 2021
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.	27 May 2020

Fluid Therapy

Oral Fluids	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.	12 Nov 2020
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.	27 Mar 2023
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 mg/dl (US) or 300 µmol/l (international).	22 Jun 2021
Tips on Giving Subcutaneous Fluids	This page gives an overview of the various sorts of fluids (lactated ringers solution, 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.	22 Jun 2021
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.	01 Jul 2020
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!	01 Jul 2020
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.	01 Jul 2020
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.	05 Mar 2023

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.	12 Nov 2020
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.	08 Jun 2022
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.	12 Nov 2020
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.	06 May 2020
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.	08 Jun 2022
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.	11 Nov 2020
Anaesthesia	Information on anaesthesia and the precautions that should be followed for CKD cats having surgery performed under general anaesthesia.	11 Nov 2020

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.	11 Nov 2020
Coping with Your Loss	This page contains information on how to cope with your grief after you say goodbye, and where to find support.	02 Sep 2020
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.	02 Jan 2012

Miscellaneous

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.	29 Apr 2020
Feline CKD Research, Including 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.	15 May 2020
CKD Research In Other Species	This page discusses ongoing research into CKD and AKI in other species.	15 May 2020
Canine Kidney Disease	I have no personal experience of canine CKD but this page provides links to information.	13 Jul 2020
Other Illnesses (Cancer, Liver) and Behavioural Problems	Links to information about general feline health issues, cancer, liver disease and behavioural problems.	13 Sep 2020
CKD Flier	A notice for your vet's bulletin board or your local pet shop to let other people with CKD cats know about Tanya's website.	12 Nov 20
Diese Webseite auf Deutsch	This site is also available in German. Wo Sie diese Webseite auf Deutsch finden können.	12 May 2020

Siteowner — Helen

My Three CKD Cats: Tanya, Thomas and Ollie	Tells the contrasting stories of my three CKD cats.	29 Jul 2020
Contact Me	How to get in touch with me.	27 Nov 2024

Back to Page Index

This page last updated: 27 November 2024

Links on this page last checked: 04 March 2020

*****

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.