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Management Strategies for Chronic Kidney Disease (CKD) in Cats

Posted by THEPOGG on Jun 08, 2020

Given that we are a site that focuses on casino reviews, an article on kidney disease in cats seems an odd topic for us to write about. So why this article? Over the last 8 years we – the owners of ThePOGG.com – have been lucky enough to share our lives with 8 amazing cats. Two of those cats have now passed away, the most recent only a few days ago, both from kidney disease. Over that time we’ve learned a lot about managing this condition. A lot that would have really helped us to know when our first cat was diagnosed. It is our hope that some of what we’ve learned can help other cat owners in the same position.

A 1992 study carried out by Lulich et al has shown that in senior cats – those aged 12 and over – around 30% of the cohort suffered from CKD. More recently, O’Neill et al in 2015 carried out a study that highlighted CKD as the second most common cause of mortality in cats aged 5 and over (after traffic accidents). These figures are concerning and that is why we feel the need to write a practical article on the subject. In all likelihood, if the Lulich study is accurate, of our 6 remaining cats, 2 more will be diagnosed with CKD at some point in the future.

While there is a wealth of information available online about the various symptoms and treatments for this condition, over the years that we have lived with and treated cats with renal failure, we have had to learn to manage some of the challenges that come with this disease. We would like to share some practical advice that we hope other kidney cat owners may find helpful should they receive this unwelcome (but not hopeless!) diagnosis.

We do need to stress from the outset that we are NOT vets and our experience is over a very small sample size. Nothing discussed here is scientifically proven and you should always listen to the advice of your veterinarian first and foremost. But as with anything, the more you deal with a problem the better you get at managing it, and we do believe that we have found some strategies that other cat owners might find helpful. We are lucky to have had the support of a very knowledgeable veterinary surgeon throughout our time as kidney cat owners and though we have probably asked many silly questions, we have never been made to feel that they were. We do not want this guide to become a heavy read and so we have kept statistical and medical references to a minimum but it is important that you realise there are research papers out there that you can refer to if you wish to know more – our veterinary surgeon is excellent as pointing us towards such sources if we want to learn more and yours will be too so do not be afraid to ask.

Outdoors no More!

We would strongly recommend that if your cat has been diagnosed with kidney disease, you seriously consider keeping them indoors from that point on.

All cats naturally look to eat grass. They do this to irritate their stomach and help them bring up hairballs. One of the symptoms of kidney disease is that many cats experience stomach discomfort. Our experience of this has been that due to this discomfort they will look to eat grass or other irritants even when they do not have a hairball to bring up. This leads to a vicious cycle where the cat has a sore stomach, so eats grass and vomits. Their stomach discomfort them increases due to vomiting too often and they repeat this process. The end result is that your cat will stop eating, which for a kidney cat can be extremely detrimental. By keeping your cat indoors you limit their access to irritants like grass and stop this cycle from occurring.

It should also be noted that if you do decide to limit your cat to the indoors, you will need to be careful as to what you leave around the house. Without access to grass, houseplants, cut flowers, dried flowers, elastic bands, cellophane wrappers, netting or organza like fabrics can become tempting alternatives for your cat (undermining the benefits of keeping them in) and some flowers and plants are poisonous to cats. Even the humble and common carnation is a feline toxin, but lilies are especially dangerous whether your cat is inclined to eat them or not – even a small quantity of lily pollen ingested, for instance after the cat has brushed past the lily and then grooms itself, can be fatal. It is important to keep an eye out for anything your cat might be chewing on and remove it! And never keep lilies in your home or garden!

On occasion, a particularly sunny day for example, we have accompanied our kidney cats outside to allow them some basking time, but never unsupervised. Not all cats will accept this, but harnesses can help manage how far your cat roams. And always keep an eye on them. If they start chewing on grass or other plants it’s time to go back inside.

Food

One of the most harmful habits that your kidney cat can engage in is stopping eating. The nature of the disease is that protein – as found in all meats and regular cat foods – exacerbates the problems with the cat’s kidneys. However, as our vet explained, when your cat stops eating, they start burning their own muscle mass as an energy source, one of the purest forms of protein they can process. As such when your kidney cat refuses to eat not only are they starving themselves, they are accelerating the degeneration of their kidneys. Losing muscle mass comes with its own issues – cats can become somewhat shaky and unstable on their feet for one thing – so it is very important to do what you can to keep your kidney cat eating.

Renal Diets – As any vet will tell you, the best thing you can do for your cat when they are diagnosed with kidney disease is move them over to a low protein diet. Fortunately, there is an increasingly large selection of these on the market in both wet and dry forms. Unfortunately, as cats are naturally driven to eat protein, these diets are often less appetising than regular cat foods and given kidney cats inclination towards inappetence, this can be problematic.

There is an important balance to be struck here. While it is very beneficial to get your kidney cat on to a diet specially created for cats with this condition, if your cat will not eat, or will not eat enough, of these foods and starts losing weight (something that can happen rapidly), they are doing far more harm to themselves than eating a regular diet would.

It can be challenging to get your kidney cat to engage with renal foods, but one strategy we have found effective is variety. You may well find that there is significant difference in how your cat responds to different brands of renal specific foods and indeed wet and dry foods. It may take time and trying several different brands before you find one your cat likes. Below you can find a list of the manufacturers we are aware of who produce Renal diets:

Royal Canin
Hills
Purina
Beaphar
Kattovit
Integra
Concept for Life
Smilla

Our first kidney cat was an extremely fussy eater, even before his diagnosis. The simple truth is we never managed to get him to eat any of the kidney diets with any regularity. Often our house resembled some sort of cat restaurant with bowls of food he had rejected in one sitting all over the place. We would literally do anything to get him to eat. For him any missed meal could lead to days of anorexic behaviour and stress. While it was at times challenging, even getting him to eat just a few mouthfuls of something in a meal proved more successful in keeping him in an eating pattern than just accepting that he wasn’t going to eat anything that meal which invariably led to more missed meals. He was so fussy that even getting him to eat the most expensive and attractive of regular diets was challenging never mind the renal diets. We went to extraordinary lengths with him, even following some of the advice we had found online from other kidney cat owners and letting him lie on one of our tummies while eating just to get him to eat a few mouthfuls! Often it was exhausting – for us and the cat – but persistence is the key.

Our second kidney cat we had to try several different brands initially before he eventually settled on the Hills dry food which he ate consistently and largely enthusiastically right up until to a few months before the end of his life. Even in the final few weeks he still ate some of this food without too much urging but he was a far more emotionally level cat than our first boy who stressed about everything all the time.

We never had great success with the wet renal foods with either of our kidney boys. The Kattovit and Royal Canin brands were better received than the others but only if used on rotation with other foods. Every kidney cat is unique and if you read the reviews that accompany these brands on any of the supplier sites you will see that this seems very much to be the case.

Novelty – When your kidney cat is going through a bad patch where they are not keen to eat – we’ve found this to be a cycle where they take a dip and you have to work to get them eating again – our experience has been that one of the most effective strategies you can employ is novelty. Go down to your local supermarket or pet store and get one of everything you can find! When your cat is at the low point of the cycle getting them to eat a lot of anything is very difficult. They tend to eat a few mouthfuls of anything you put down then stop. But if you can get them to eat a little bit of a lot of things it soon adds up and their general appetite starts to improve again. So keep trying them with different things. Their natural curiosity will often result in them trying a few mouthfuls of each variety you put down.

Symptoms of renal diseases in humans include a decrease in olfactory senses and an impairment of the taste sensation – in our experience the same seems to be true in cats – both of our kidney cats have responded best to foods with stronger smells – we cannot comment on flavour – we haven’t gone that far. Yet! We found that a strongly smelling food often got their interest and started the process of eating again. At his lowest ebb our second kidney cat responded well to the Lily’s Kitchen Fabulous Fish dry cat food. It had noticeably smaller biscuits and a much stronger smell than any other biscuit brand and this seemed a good combination for him. He also really enjoyed the chicken, liver and liver and cat grass Lick-e-lix treats produced by Webbox – definitely not kidney foods but in the final few weeks it is about giving the cat the best quality of life you can for the time they have left – not evading the inevitable.

It’s also worth trying things like cooked chicken, fish, crab – even lobster roe was a favourite treat of our first kidney cat if he was refusing everything else! Obviously we wouldn’t recommend trying to switch you cat’s diet over the long term to non-cat specific foods, but short bursts of these tasty treats can really help when kitty is refusing everything else.

Having other cats when you have a kidney cat is a real boon in terms of food waste as you can redistribute the discarded food from your kidney cat to your other cats, but do not try introducing a new cat into the household for this purpose! New cats coming into the house is one of the most stressful experiences you can ask any cat to deal with. For a kidney cat this is likely to exacerbate any inappetence problems.

Gravy – I do want to stress again at this juncture that we’re basing our conclusions on our experiences with only two kidney cats, so we could easily be encountering coincidences that we’re misinterpreting as patterns. We did see one distinct similarity between both our cats: they both loved gravy. NOT the gravy that you put on your Sunday roast. Cat foods containing gravy – in fact both of our boys would not even look at a food in jelly. In the latter stages of the disease both cats were inclined towards lapping the gravy out of any bowl we put down to them while leaving any meat or chunks. This became so distinct in the months before the end that we actually took to squeezing the gravy out of the pouch while trying to leave the meat behind. In this manner the cat could more easily access the food that they wanted, and we saw an improved consumption level. The two best foods we found on the market for this were Purina Gourmet mon Petit and Pets At Home’s own brand Rich Recipes. The cat soups now readily available were a particular favourite of our first kidney cat but not so well received by the second. In short – kidney cats do not enjoy having to put much effort into eating. If chunks are too large, they will not even try to eat them. Often our first kidney cat would start out eating with gusto but as soon as a larger chunk of meat made its appearance he would just stop eating. Gravy makes eating easier even if it is far from an ideal diet.
Down the same line of thinking we also found in the last 2 weeks of our second kidney cat’s life that kitten food was more manageable for him because the pieces are made smaller.

Please note – even if this gravy preference we have noted is more than a coincidence and common amongst kidney cats, this is not a strategy that we would recommend pursuing unless you are absolutely desperate. Remember, you want your cat to eat a renal specific diet if at all possible. As soon as your cat is showing signs of what is a “normal” appetite for him/her then it is very important to try to switch them back to the renal diet as soon as is possible.

Stress

A great many people have a fundamental misconception about cats – that they are low tariff or ‘take care of themselves’. Having looked after a reasonable number of feline friends, we can state with confidence that this simply is not true.

Far from being robust and self-sustaining, cats are in fact neurotic and very easily upset. While they tend to be good at masking their anxieties, small changes – for instance a night where you are out very late – will upset your feline companion more than you may be aware of. Cats thrive on routine and when life is not as they expect they become insecure very quickly.

This goes double for cats with kidney disease. Both cats we have had with kidney disease have been very highly strung and anxious creatures. Unfortunately, this has married with the symptoms of the disease in a rather unfortunate manner. The stressed cat will stop eating which is dangerous for the reasons discussed above. There are a number of strategies that we would recommend to manage this dynamic which we will discuss below:

Routine – One of the most important things you can do for your cat is try and maintain as structured a routine as possible. Keep consistent feeding time and bedtimes (the latter of our kidney cats was quite the disciplinarian when it came to bed time – he would come and get us to go to bed so he could have his bedtime cuddle). As much as this may not be what you want to hear, it makes a big difference to the overall wellbeing of your cat if you can minimise periods where you are absent (i.e. holidays and business trips). There’s no doubt that reducing holidays etc is a big ask, but our experience has been that there are few bigger triggers for a period of anorexia than absence of one or more of their humans for any extended period of time. Your cat will thank you by being with you longer. Spending time in a cattery is not something a kidney cat can really cope with in our experience. If you do have to go away it is far better for you to arrange for a human the cat is familiar with to care for it in its own home.

Sleeping – In our experience it is beneficial to let your kidney cat sleep in your bedroom with you. Many cats if given the choice will choose to sleep on the bed with their owners. Cats are very vulnerable and seek safety and security when they sleep. Having you close by gives psychological reassurance. You also make a great hot water bottle for the cat and kitty will love the comfort of sleeping on the duvet.

There are disadvantages to this – you do have to ensure that your cat has access to a litter tray, water and food and it does leave a little less space on the bed for you, but it certainly makes for a happier cat and where kidney disease is concerned happier cats are healthier cats.

A side note to this – we have to stress that it is absolutely critical that your kidney cat has access to a litter tray at all times! Kidney cats will need to urinate far more often than other cats. Alongside this, if your cat is older – which many kidney cats are – they may be getting a little stiff. To avoid accidents, it’s worth getting a litter tray with high sides and a dip on one side (so that your cat is not faced with the equally off-putting effort of having to climb over something to get into the litter tray. This made a big difference to one of our kidney cats who had a habit towards the end of standing in the litter tray and peeing on the floor. Puppy training pads also helped.

It is also worth considering buying in a veterinary approved pet heat pad for the bottom of the bed if your cat is older. Cats love heat, especially if they are getting on in years and have a bit of stiffness in their joints or a sore belly. These pads cost pennies a day to run. As we had one of these pads on 24/7 we bought two and switched them over every 24 hours to try and give each pad a rest day (we have previously burned one out by leaving it on all of the time). These pads are very popular with all of our cats! It is not uncommon for us to find 4 of them snuggled up together on our heat pad.

You may find that if you have a regular height bed, again if your cat is older, your cat may have difficulties getting on and off the bed. We found it very beneficial to put in place some makeshift steps to help our old man get back up to his favourite sleeping position in the form of widely available cardboard scratching units – we found one in the shape of a paw which provided the perfect little steps shape for his needs. Not only did this make it easier for him, but it stopped him scratching us during the night when he’d try jumping back up onto the bed and had to cling on and pull himself up because he wasn’t strong enough to make the jump in one go. We also used a chaise longue shaped cardboard scratching unit as a step to help him step down form the high side of the litter tray – he used the cut-away side to walk in – but refused to use it to leave again.

Pharmaceutical relaxants – Before we discuss this particular option it is important to stress again that you should always ask and follow the direction of your vet before administering any medicine to your cat. We did a lot of research online for natural relaxants for our cats – whenever we mentioned one we’d found to our vet – he knew exactly what we were talking about and was able to tell us all about it and whether it was capable of producing the results it claimed to. I would also state that we have had mixed success with these treatments according to the needs and habits of an individual cat. In each of the below cases, one of our kidney cats responded to the treatment whilst the other appeared impervious to it. They are also one of the most significant costs you could end up facing if your cat is diagnosed with kidney disease and you do feel that stress is a factor in its periods of anorexic behaviour.

Zylkene – We would sing the praises of Zylkene pretty highly. For our first kidney cat this drug made a very visible difference. It is a milk protein derivative that our vet advised can be given without fear of overdosing or causing harm (though do please check with your vet) and is available without prescription. It comes in a capsule form. You could try tableting your cat with Zylkene, but the capsules are big and you may find this challenging. Generally we administer Zylkene by breaking open the capsule and sprinkling over food (for some of our other cats), though the kidney cat that Zylkene was effective for would actively refuse to eat any food with Zylkene on it so we had to employ a different strategy that will be discussed below in the Tableting section. We have recommended Zylkene to several friends and they too have reported benefits of using it. A family member also uses Zylkene for his dog. Be aware that the cat and dog varieties are vastly different doses – the cat capsules are 75mg. Zylkene does not turn your cat into a zombie (as one person voiced concerns about to us!), it does not cause sensory dullness or any observable slowness or lack of awareness – it simply soothes frayed nerves and makes life more pleasant for a highly strung cat or dog who is experiencing a period of difficulty.

Feliway – Feliway is a plugin diffuser that uses various odourless pheromones that are soothing to cats. It comes in a Classic and Friends variety. Use Classic if you only have one cat in the household and Friends if you have a multi-cat household. Do be aware that the diffusers need to be periodically replaced – usually every 6-12 months. If not they will ultimately start to give off a hot/burning smell. We use Feliway Classic and Feliway Friends because each targets specific issues of behaviour. We run a Feliway Classic diffuser in the rooms most frequented by our most anxious cats and most rooms we have a Feliway Friends diffuser – this just helps multi-cat households achieve some sort of equilibrium.

Christmas – This is really a subset of the discussion of routine above but one important enough to warrant its own section. Christmas or other big festive celebrations can be a very stressful time for any cat. Changes within the household, broken routines and unfamiliar people all make cats anxious. It is important to take this into consideration during any festive event and minimise that which could be detrimental to your cat.

Most significantly with Christmas, you should be aware that decorations like Christmas trees and tinsel may become tempting targets for your cat to chew on instead of grass. It is really important to either not put up Christmas decorations that your cat can chew on, or to put them up somewhere in your house that you can restrict the cat’s access to. We found that both of our kidney cats quickly recognised our artificial Christmas tree and other similar decorations as potential tummy irritants and this resulted in a lot of unnecessary vomiting and lack of appetence until we realised this. Ultimately, we learned, by the 2nd year of our 2nd kidney cat, that we needed to limit the changes we made to the house around the festive season. We reduced the decorations that were put up and moved to non-traditional decorations to allow us to feel festive, while denying our cat the irritants that they were using to try and bring up hairballs they didn’t have. Instead of the traditional style tree we switched to a large twig tree which had no components that they could chew on (they checked thoroughly!). We also made a wall hung tree from left over beading and micro fairy lights. This does sound like a lot of changes to make to a well-loved routine but when it came to it, for us, our cat’s health was more important than having tinsel and faux pine in December.

Tableting

This section is not really specific to kidney cats, but all cats. We’ve no doubt that a large number of cat owners have watched their vet easily tableting their kitty in the practice without problem, then have gone home with a prescription, only to find that their favourite snuggly cuddle friend turns into a ball of teeth and claws whenever they try to give a tablet. Or you manage to get the tablet into the cat’s mouth and just cannot get the cat to swallow. There is something intensely depressing about the experience of holding on to your cat for 10 minutes, rubbing its throat as you avoid its little claws, then letting go only for the soggy pill to be deposited on the floor magically before your very eyes!

Some of our cats we manage to tablet without issue, but for the others we’ve found two different work-arounds for this problem:

Hide the pill – With an ordinary cat (is there such a thing?), and obviously depending on the size of the pill, it’s often a successful strategy to hide the pill inside a particularly tasty treat. A tiny bit of cheese, some chicken, malleable chew sticks (like those made by Webbox), anything that the cat will enthusiastically engage with and swallow before they realise there is something adulterating their favourite treat.

In our experience, this strategy does not work nearly so well with kidney cats. Their inappetence makes them far more likely to either ignore the treat altogether or locate the pill before they swallow and spit it out. The Webbox sticks were the only treat that worked using this method for our kidney boys and this did not work every time.

Grind and pâté – Before going any further with this, we do need to stress the importance of talking to your vet about any medication you are thinking of trying this with. Some medications can be ground up and sprinkled over food with no risk. Others would be dangerous to do this with as the drug is intended to be released into the system slowly as the pill is digested. Do not risk it, ask before you try.

The first part of this strategy is obvious and simple. If your vet says it is okay to grind up a pill or open a capsule all you need to do is crush the pill with a couple of teaspoons and sprinkle it over food.

Kidney cats never make things simple though. Both of our kidney cats would reject food that had some drugs sprinkled on them. Our first kidney cat would not take any food we had added any medication to at all, including Zylkene which is a highly palatable milk derivative. Our second kidney cat was far more pliant and would take his blood pressure medication or Zylkene without any great fuss but would reject anything else he detected.

We did have some success hiding the ground medication in the middle of the food – putting down a layer of wet food, putting on the ground medication, then covering this up with another layer of wet food. It seems to be the smell of the medication that put our cats off, so by not allowing them to smell it initially they would start eating and not realised when they came to the medication. However, with the often unpredictable appetite of a kidney cat, this strategy risks the cat stopping before or part of the way through the medication, making determining how much of the medication they have actually taken difficult. And as the cat’s appetite dwindles getting them to eat enough of a bowl of food to get to the medication becomes harder and harder.

We needed to develop a new strategy for tableting our kidney cats when they were being difficult. It took a while, but we found a very effective solution. Crush your tablet as normal and place the ground results in a small container. You will need a tin of mouse or pâté style cat food. Use a teaspoon and take just the tip of the teaspoon worth of food. Mix it with the crushed tablet then gather the results up on to the end of your finger. Get your cat, open their mouth and quickly smear the mixture on the roof of their mouth. This strategy works because unlike tablets, the cat will struggle to spit out the mouse. Think of having a mouth full of peanut butter. The natural response is to dislodge it with your tongue and swallow. This technique made tableting our kidney cats far easier, less stressful (for both us and the cat) and more successful. It should be noted that using this strategy results improved with familiarity. For the first while the cat got rather upset about this, but gradually came to understand – though never enjoy – what was happening.

Please take the above advice with caution. We are very familiar with all of our cats and all of our cats are very used to being handled. Our first kidney cat was prone to lashing out with his claws. We had a good read on his body language and could usually judge how to manage his more assertive tendencies when dealing with medicating him. That did not however mean that there weren’t numerous occasions where he was faster than us and having slashed hands was far from unusual for us. You need to be careful and assess what you feel you can reasonably do to your cat. If your cat is more likely to lash out when they do not want you to do something, trying to force their mouth open and insert a finger may not be a great strategy for your cat. Remember that cat bites and scratches can – in extreme circumstances – lead to nasty infections and potentially other serious illnesses. Do not take unnecessary risks, if you do end up hurt, clean the wound properly as soon as possible and if you have any lingering concerns consult a medical professional.

Subcutaneous Fluids

In some cases, where your kidney cat is becoming dehydrated, your vet may suggest giving the cat subcutaneous (under the skin) fluids. This tends to be done in the latter stages of the disease (Stages 3 and 4) though both of our kidney cats received fluids from around later Stage 2 so it is worth discussing with your vet whether they feel there are any benefits to starting fluids earlier. We are strongly pro-subcutaneous fluids as we feel it made a huge difference to both the quality and length of life our kidney cats experienced, but again this is not a scientific assessment, just our observation of our own experience. There can be downsides to fluids – increased chance of some infections and mineral leaching due to increased urination. This can be harmful if done too early or too intensely, so again it is critical you discuss this strategy with your vet. We were lucky not to experience any of the issues that can arise from giving subcutaneous fluids because our vet was very adept at assessing what our individual cat’s needs were and advised us accordingly.

We were initially recommended to give subcutaneous fluids via injection as many owners giving small quantities of fluids are. You simply tent the cat’s skin (pull the loose skin away from their body using your thumb and forefinger), insert the needle and squeeze in the fluids from the syringe. This works for a great many people. Many sites show videos of owners injecting fluids into their cat as it lies calmly on the sofa next to them. Sadly, for our extremely highly strung first kidney cat this became an absolute nightmare. The first time we tried to give him fluids in this manner we spent 2 hours trying and ended up with a cat that was absolutely demented, close to a pin cushion, and both of us in tears. The problem was that we could get the needle into the cat, but the moment that we pressed down on the plunger the cat would respond to the sensation of the fluids entering by jerking. When you are holding the needle firm and the cat jerks like this it’s only natural to worry that the cat is going to hurt itself on the needle. So you take the pressure off the syringe. Then the cat’s jerking motion causes the needle to exit its skin. Repeat ad infinitum.

The next strategy that we attempted was to have a catheter surgically implanted. This is a plastic port that creates a stable injection site. This was far more successful and did allow us to give the fluids. However, the cat hated it. He was constantly trying to wash at the implant or scratch around it, it occasionally got infected requiring further vets appointments and antibiotics and whenever he managed to escape the house (darting past one of us when the door was open) when he would return the implant would inevitably have been torn out meaning further surgical procedures. For us this really was not a great solution.

And then one of our vets hit upon a different strategy for us. Rather than trying to give the fluids via injection, give them via drip. You set up the bag of fluids with a Giving Set (plastic tube set that transports the fluids between the bag and the animal). You still need to place the needle, but as you don’t need to squeeze the syringe there’s no pressure behind it. Once the needle is placed, open the fluid lock and even if the cat jerks, the needle simply moves with them. We would recommend this strategy to anyone who needs to give their cat fluids. It was so much easier than using a syringe and far better for the cat than a catheter. It becomes an especially useful method as the illness progresses and larger quantities of fluids need to be administered.

Giving fluids is a process that takes time and practice. Early on you will more than likely find that your cat will wriggle and try and get away. The more you repeat this practice (we would have the cat on the drip at full flow for 2 minutes in the morning and evening initially and slowly increase the time as the cat needed more assistance to stay hydrated) the more used to the process the cat gets. Neither of our cats ever “enjoyed” getting fluids but they did come to accept it and were more settled during the process. That said you will still have bad days!

Another tip for giving fluids is that it is best to get the cat when they are warm and sleepy (the heat pads we discussed above are particularly good for this). We’ve found that the cat tends to be less resistant under these circumstances. And having treats available afterwards is also a good motivator for an easier experience while your cat still has a reasonable appetite.

Try to give your cat fluids at the same time of day each time they are administered – we found with both our boys that they knew when to expect their fluids and would become agitated if we left longer than normal between doses – they immediately know they can relax for the rest of the day or night when the process is complete. In fact both our cats would seek to hide around fluid time. We found it very beneficial to minimise any ‘chase’ before fluids. We did this by closing doors and denying the cat access to areas where it was difficult to extract them from before making any move to collect the cat. The more you allow them to ‘run away’ the more agitated they will generally be during the fluid giving process and the less likely you are to come out the other side scratch free.

It’s also a good idea to try and hang the giving set on an internal wall (i.e. not next to a window) as in the winter the fluids can be quite cold – our cats found less pleasant to receive fluids in winter as a result of the cold sensation as they entered their warm bodies.

If you want to find out more about the benefits of subcutaneous fluids you can find it on the IRIS website.

Conclusion

Dealing with kidney disease in your cat is a challenge for any cat owner. There are no end of problems and the end is emotionally difficult. But your cat can have a high quality of life for years after a diagnosis if you are willing to make the changes to support your friend. The above advice comes from our experiences managing the treatment of our own cats and may not work for everyone. But we do hope that you will be able to find something here that makes your experience easier and helps you find a balance that gives your kidney cat the best life possible for the time that remains to them. Find an experienced veterinary practitioner who understands the disease at all its stages and who can explain to you what to look out for. In our experience this support is invaluable especially when the disease is in its later stages and you are confronted with making the inevitable difficult decision. Helping kidney cats to continue to enjoy life is incredibly rewarding despite the challenges. Our first kidney cat survived almost 7 years after his diagnosis – but as our vet kept saying, “Not all kidney cats are Caliban’s.” We do believe that his overall happiness and our efforts to keep his life as stress free as possible helped him achieve this. Our second kidney cat lived 3 years after diagnosis – but he was only a couple of weeks from being 19 years old when he died – so he was fighting natural ageing alongside CKD. We think he did very well!

The Cats

Caliban – we rescued the beautiful black and white Caliban from a local farm. He had lost his home when a relationship broke down and his owner failed to take him with them when they left. He’d been living rough for a number of months – trying to catch bats for food – before we became aware of this and set traps to catch him. We renamed him when he came into our life after the wild man “civilised” by Prospero in Shakespeare’s The Tempest. We wouldn’t normally rename an animal but Caliban really needed a fresh start – though most often – for reasons unknown – he’d be referred to as Beezle. He was approximately 5 years old when we caught him. He was diagnosed with kidney disease shortly afterwards. He was with us for almost 7 years after his diagnosis, though it should be noted that our vet considered him very unusual in how slowly the disease progressed with him.

Caliban was feisty and fiercely loyal to his mummy. He used to run up the side of doors and sit on the top of them. He loved lap cuddles and chin rubs. He wasn’t the dominant cat in the household, but when he was in a mood all the other cats stayed out of his way. He made his presence felt. He was at times insecure but very loving and without question he had his own unique personality.

 

 

 

Houdini – we rehomed the sweet black and white Houdini from the SSPCA in Inverness to West Lothian – a big journey for a man of his age! He was 16 years old and had been left at the centre with his two sisters who were 12 years old. Someone had taken the two girls but left Houdini behind and it broke our hearts to think that he was stuck up there lonely and heartbroken when he could be curled up on our bed with us. We chose not to rename Houdini because he was an old man who had lived his whole life with his name and clearly had been loved by owners who must have been devastated when they had to give him up. We did however tend to call him ‘Hood’ or ‘Hoodle Dood’. Shortly after picking him up we spotted that he was drinking a lot and had him tested for kidney disease (being familiar with the condition from Caliban). Houdini made the transition to living with our 6 other cats effortlessly – he was integrated within a matter of days. He lived to around one month short of 19 years old and every single day we cared for him was a privilege.

Houdini was a gentle old soul who was simply grateful to have a loving home again. He had his own song – “Hoodley-doodley, appley-struddley, hoodley-doodley bop.” He was strict about bedtimes, coming to tell us off if we did not go to bed when he expected us to. He also demanded a cuddle every night before going to sleep, lying on my chest with his paws at the base of my neck and his face right up close to look at me.

They are both very deeply missed.

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