The Guide for Kidney Care in Cats


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- Updated March 19, 2024

Key Takeaways

  • Understanding Feline Kidney Disease: Feline chronic kidney disease (CKD) is common in older cats and irreversible.
  • Causes and Risk Factors: Various factors contribute to CKD in cats, including viral infections, genetic predisposition, aging, and underlying health conditions like dental disease and hyperthyroidism.
  • Signs and Symptoms: Look out for changes in appetite, gastrointestinal issues, weight loss, increased thirst and urination, and decreased energy levels.
  • Diagnosis and Staging: CKD is diagnosed through urine and blood tests, imaging, and physical examination.
  • Dietary Management: Cats with CKD require a kidney-friendly diet low in protein, phosphorus, and salt.
  • Hydration and Fluid Therapy: Proper hydration is crucial for kidney function.
  • Medication and Supplement Management: Prescription medications and supplements like omega-3 fatty acids and phosphate binders may be necessary to manage CKD symptoms and slow disease progression.
  • Veterinary Intervention and Monitoring: Regular vet check-ups are essential for monitoring kidney function, adjusting treatment plans, and addressing any changes in your cat's condition.
  • Pet Insurance for Kidney Care: Consider pet insurance to alleviate the financial burden of CKD-related medical expenses, including tests, treatments, and medications.
The Guide for Kidney Care in Cats

Overview of Kidney Health in Cats

Most cat owners try to do everything within their power to ensure the health of their furry friends. They purchase high-quality cat food, take their cats for regular vet visits and immunizations, as well as ensure they have plenty of exercise and playtime. One thing that many cat owners fail to consider is their cat's kidney health.

Unfortunately, just like human beings, cats can experience kidney complications, including kidney disease. If you're concerned about your cat's kidney health because he or she has been exhibiting strange symptoms, or you simply want to learn more about kidney care in cats, here is a comprehensive overview that can provide you with some useful information.


Understanding Feline Kidney Disease

Feline kidney disease (CKD) is diagnosed when a cat's kidneys fail to filter toxins from the blood and urine. CKD is quite common in cats as they grow older, and the disease is irreversible. The functioning of the kidneys will slowly diminish over time, and your cat may eventually experience kidney failure.

If your cat is diagnosed with feline chronic kidney disease (CKD), it's important to be proactive in how you care for your kitty. While your cat's veterinarian will very likely prescribe medications and recommend other treatments to manage the disease, there are several changes that you can make that can slow the progression of the disease.

Causes and Risk Factors

There are several causes and risk factors for CKD in cats. Cats that have contracted certain viruses, renal inflammation or lymphoma are more susceptible to developing CKD. Another cause of chronic kidney disease is autosomal dominant polycystic kidney disease, a genetic condition in partial or full Persian breeds. Aging is yet another cause of CKD because as a cat grows older, its kidney function can be impacted by dental disease, hypertension, and hyperthyroidism, which can weaken the kidneys.

Signs and Symptoms

As a cat's CKD progresses, signs and symptoms will begin to emerge that will affect how your cat feels and behaves. Symptoms to look for if you suspect your cat is experiencing worsening kidney disease are:

  • Difference in Appetite - Picky about cuisine, loss of appetite, or complete refusal to eat
  • Gastrointestinal Changes - Vomiting and diarrhea
  • Weight Changes - Weight loss
  • Increased Water Intake - Increased thirst and more frequent urination
  • Decline in Energy Levels - Increased fatigue

Diagnosis and Staging

There are stages of chronic kidney disease, with each stage becoming progressively worse. Each stage signifies a higher level of severity, and they are as follows:

  • Stage 1 CKD - This stage is considered to be mild, and CKD may not be detectable. Creatinine levels may or may not be elevated, and SDMA is typically normal. Around 50% of kidney function has been lost. Diet and treatment can help to delay advancement in the disease.
  • Stage 2 CKD - This stage is considered to be mild/moderate, and toxins may be present in the blood. Creatinine and SDMA are normally slightly elevated, and symptoms may start to become more apparent. Up to 75% of kidney function is lost in this stage.
  • Stage 3 CKD - This stage is considered moderate/severe. Greater amounts of toxins accumulate in the blood, and symptoms become markedly more severe. 75-90% of kidney function is lost, and it can be very challenging to coax your cat to eat due to poor appetite, dehydration, vomiting, and other challenges.
  • Stage 4 CKD - This stage is the highest level of severity. Your cat will struggle to function normally and will likely appear very ill. Your cat will need more intensive care to ensure the kitty is as comfortable as possible. Working closely with the cat's vet during this stage is important for the kitty's quality of life, as well as to prolong life for as long as possible.

To diagnose CKD, veterinarians use various tests, including urine, blood, and more. A vet can palpitate the kidneys to determine kidney size, as smaller than normal size is indicative of CKD. A vet may also use imaging tests like x-rays and ultrasounds, in addition to non-imaging tests like biopsies and urinalysis. Despite testing, it's not always simple to diagnose CKD in its early stages, as chronic kidney disease in cats often doesn't become evident until considerable kidney function has been lost. This is because creatinine, a chemical compound that builds up in the body when kidney function wanes, doesn't show up in blood and urine tests until later stages of the disease.

Dietary Management

Managing your cat's diet is essential to keeping your cat well-nourished, despite a reduced appetite, and a healthy diet can also slow the progression of CKD. Conventional cat food is not recommended, as cats with CKD need to follow a kidney-friendly diet. A kidney-friendly diet consists of lower levels of protein, phosphorus, and salt, all of which are harsh on the kidneys. Some nutrients to add to your cat's diet that can improve kidney function and energy levels are omega-3 fatty acids and antioxidants.

For your convenience, there are commercial renal diet cat food options available. However, many people caring for cats with CKD prefer homemade kidney-friendly foods. Homemade kidney-friendly foods include:

  • Rice
  • Turkey
  • Chicken
  • Sweet potato
  • Liver
  • Egg yolk

The benefits of making homemade renal-friendly meals for your cat are that you know exactly what's in them, and it's a great alternative if your cat refuses to eat commercial kidney-friendly food. However, homemade renal-friendly meals might not contain the proper balance of nutrients that your cat requires, and as a result, your cat's health could decline. Every cat is different, and if your cat refuses to eat commercially prepared renal diet foods, you may need to consult with a pet nutritionist who can assist you with developing a customized nutrition plan.

If your cat tolerates it, a commercial renal diet is recommended. Not only are commercial renal diets nutritionally balanced, but they're safe and advanced, and they may also promote a noticeable difference in your cat's quality of life. Furthermore, it's not necessary to spend hours in the kitchen preparing specialized meals for a cat, as this can be time-consuming and stressful.

Hydration and Fluid Therapy

Proper hydration is another important component when it comes to supporting your cat's CKD, as dehydration impedes kidney function, therefore, worsening the CKD. Ample water is conducive to improved kidney function, and if you're not sure whether your cat is drinking adequate water, you need to monitor Kitty's intake. This can be accomplished by doing one or more of the following:

  • Fill your cat's water bowl each morning and determine how much is consumed by the end of the day. Perform a skin elasticity test by gently pinching the skin on the back of your cat's neck. If the skin fails to retract immediately, your cat may be dehydrated.
  • Keep an eye on your cat's litter box. If the litter box is drier than usual, this could indicate that your cat needs more water.
  • There are methods for promoting hydration in your cat, and the easiest way is to provide multiple bowls of clean, fresh water throughout the day. You could also purchase a cat water fountain or obtain electrolyte drinks for your cat. You might also be able to successfully encourage your cat to drink more water by adding ice cubes to your cat's water bowls.
  • If these methods fail, you should seriously consider subcutaneous fluid therapy. This type of therapy entails supplementing your cat's water intake with fluid administration just below the cat's skin. This can be performed at the vet's office, but if your cat needs this therapy frequently, it can be done at home. You will need a bag of fluid, a needle, and a fluid drip set. Your veterinarian can walk you through the process, and there are also many step-by-step videos available online.

Medication and Supplement Management

It's important to take your cat for regular veterinary check-ups to ensure your cat is stable and doesn't need additional medical interventions. Once a cat reaches a certain stage of CKD, prescription medications may become necessary to slow the progression of the disease. The medications that the veterinarian prescribes will depend on the symptoms that your cat is exhibiting, as well as the results of blood, urine, and imaging tests. These medications might include antihypertensives, appetite-stimulating drugs, medications to encourage the expulsion of toxins, among others.

The use of supplements may also benefit your cat's CKD. Omega-3 fatty acids and phosphate binders can work wonders for delaying the progression of your cat's CKD. If you're not sure which brands are the best, your cat's vet can provide you with recommendations.

Environmental Modifications

Your sick cat might become more easily stressed, which is why you must make some environmental modifications that can keep your cat's stress levels to a minimum. Firstly, since water and elimination are necessities, you must create easy access to them. If your cat doesn't have easy access when it's thirsty or needs to eliminate, it could cause unnecessary stress, worsening its CKD in the process.

Minimizing your cat's exposure to toxins is another environmental modification you should consider making to reduce the progression of your cat's CKD. By eliminating air fresheners, pesticides, and other potentially harmful chemicals in your home, you can keep your cat's BUN levels low, therefore, improving kidney function. BUN stands for blood urea nitrogen, and high levels of this compound indicate that your cat's kidney function is declining.

Other ways to reduce stress in the environment are to provide easy hiding places, a cat tree and areas to climb, as well as a comfortable bed area. Clean water and a fresh litter box can also help.

Veterinary Intervention and Monitoring

Again, your cat must be taken to the veterinarian regularly so that proper monitoring can be performed. Your cat's veterinarian will perform an examination and tests to monitor kidney function. The veterinarian will develop an initial treatment plan for your cat that is personalized, but during each visit, you must report how well your cat is responding to the treatment. It might be necessary to adjust the plan based on any changes that arise. Don't be shy about asking as many questions as necessary for you to understand your cat's treatment options and prognosis. The more knowledgeable you are about your cat's condition, the more prepared you can be regarding what to expect, and the more proactive you can be when it comes to caring for your cat.

Pet Insurance for Kidney Care

Just like humans, cats with CKD can quickly rack up medical expenses, especially in the most advanced stages. Blood tests, ultrasounds, and the many possible treatments can be costly, and your cat may need to have these conducted regularly. Medications can also be expensive for cats. For many, this can become a financial burden, which can make a stressful situation even more stressful. However, you should be aware of your options, and one option is to explore the possibility of purchasing a pet insurance policy. Pet insurance can take the burden off you, so you won't be responsible for paying high vet bills out of pocket.

There are many pet insurance providers available, so you will have to take the time to research all the possible providers. Some top pet insurance providers are Healthy Paws, Pumpkin, ASPCA Pet Insurance, and more. Each provider must be researched to determine rates, coverage, waiting periods, deductibles, etc. You can easily check out each provider online and compare the pros and cons of each one before making a choice. It's also important to make certain which illnesses might be covered or excluded. Regardless of the provider you ultimately decide to go with, obtaining pet insurance can save you hundreds, if not thousands of dollars.



A CKD diagnosis in a cat can be scary and overwhelming, but it doesn't have to be. By following a strategic kidney care plan that includes a renal-friendly diet, ensuring adequate hydration, making lifestyle modifications, and working closely with your cat's veterinarian to monitor and manage the disease, you can improve your cat's prognosis and extend his or her life. Starting your cat on a kidney-friendly diet as soon as a CKD diagnosis is made is essential to the successful management of the disease.

Pet insurance is also a recommendation, as vet bills can quickly accumulate because of your cat's increased need to access medical care. As long as you're vigilant and willing to follow all recommendations, your cat can live a relatively happy life despite being diagnosed with CKD.

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