General information on feline chronic kidney disease (also known as chronic renal failure)

Tanya’s Comprehensive Guide to Feline Chronic Kidney Disease, by Helen Fitzsimmons
The Tanya website is basically the bible of CKD management, and you will want to give yourself ample time to explore the wealth of information it contains. It includes everything from the basics of understanding what a CKD diagnosis even means to detailed discussions, with links to scientific studies, of various drugs commonly used to manage CKD symptoms and secondary illnesses. It also has extensive sections on diet and subcutaneous fluids, among other crucial topics. The online forum related to the website is also an invaluable resource for shared knowledge and general support.

International Renal Interest Society
The IRIS website has detailed information about kidney disease in cats and dogs, and its system of staging the progression of the disease is a common reference point. The website also includes recommended treatment protocol, a useful resource if you need to advocate for your cat with a reluctant vet.

“Top Five Cat Toxins,” by Dr. Justine Lee
Did you know lilies are lethally poisonous to cats? Here is a short list of common cat toxins, some of which, like lilies and NSAIDs, can cause acute kidney failure.

Finding a specialist vet

American College of Veterinary Internal Medicine
Locate a board-certified IM specialist in your area. Note: if you are in a small town or rural area, it is recommended that you search by state, since the search engine will not give you vets in nearby environs.

American Veterinary Dental College
Locate an AVDC board-certified veterinary dentist in your area.

Royal College for Veterinary Surgeons (UK)
Locate an RCVS-accredited specialist in your area.


Plumb’s Veterinary Drugs
The authoritative professional reference guide for drug dosing, side effects, and interactions, available both online and in print.

Diamondback Drugs
A reputable compounding pharmacy with an easy-to-navigate website. You will need a veterinarian’s prescription to order from Diamondback.

Thriving Pets
An online veterinary supplies store that sells commonly used nonprescription items such as ALOH phosphorus binder and Terumo needles as well as prescription items such as subcutaneous fluids.

Torpac Pro Funnel
If you give your cat multiple medicines, you may find it easiest to combine them into one gelcap. This funnel is a bit of an investment ($75, plus shipping, at time of writing), but is very useful for combining the slivers of various cut tablets into one gelcap. You order the funnel to match the size gelcap you use, with #3 or the slightly smaller #4 being the most common sizes for cats. The funnel comes with a bag of 1000 gelcaps.

Food, Eating, and Assisted Feeding

Food data tables (US and UK foods), Tanya’s Comprehensive Guide to Feline CKD
These tables from the Tanya site can help you find a low phosphorus food, and also include other dietary information important for managing CKD, namely percentage of protein, sodium, fat, carbohydrates, and calories. All information is based on a dry matter analysis.

Dry matter analysis calculator
In the US, pet foods give guaranteed analysis values, but it is the dry matter analysis that gives a clearer and comparable measurement of phosphorus, protein, and the like. If the food you want to feed isn’t listed in the above tables, you can calculate the dry matter analysis with this online tool.

“Not Eating Can Be Deadly,” by Dr. Michael Stone
On hepatic lipidosis, also known as fatty liver disease, which can be triggered when a cat goes even a short time without sufficient caloric intake.

“Persuading Your Cat to Eat,” Tanya’s Comprehensive Guide to Feline CKD
Tips on encouraging your cat to eat (“sleep eating” works great on Mama), plus useful information about high-calorie nourishment during crises, appetite stimulants, and assisted feeding.

“Nausea, Vomiting, Loss of Appetite and Excess Stomach Acid,”
Tanya’s Comprehensive Guide to Feline CKD
This is the page I share the most from the Tanya site, as it covers the ins and outs of the various treatments available for nausea and stomach acid—two of the most common, but often unrecognized, symptoms of CKD. If you want your cat to eat regularly and sufficiently, you will need to make sure that stomach acid and nausea are under control, so this page is essential reading.

“Transitioning Feline Dry Food Addicts to Canned Food,” Dr. Lisa A. Pierson
While Dr. Pierson’s condemnation of dry food represents an extreme position not shared by all, if you are looking to make the transition to wet food, you will find many good tips here. Please keep in mind that above all, the most important thing is that your cat is eating sufficiently.

Silicone-tipped syringes
If you are oral assist feeding and find your cat likes to bite at the tip of the syringe, these silicone-tipped syringes from Innovet could be quite useful.

“Pina and the E-tube,” I Will Help Your Cat
A great post by Dr. Kristopher Chandroo on the role of esophageal tubes in realizing your cat’s true health potential.

Esophagostomy feeding tubes (medical supplies)
Most likely your vet will already have e-tubes on hand, but in the event you need to order one or you have your choice of tubes, we really liked the clear tube with the Y-port (the “length adjustable” model). The Y-port allows use of both catheter-style and luer-lock syringes.

Kitty Kollar
If your cat is getting an e-tube, you’ll want to have at least two of these festive protective collars on hand (two so that you can rotate and clean). Our vets sent Mama home wearing one, but some vets will use bandage wrap.

Subcutaneous Fluids

“Sophia Gets Her Subcutaneous (sub-Q) Fluids,” Weird Stuff We Make
This detailed step-by-step description, with pictures, of Sophia getting her subQ fluids is full of excellent tips and is all-around a confidence-boosting narrative. We basically follow this method, with the main difference being that we use a portable IV pole to hang the fluids and, since we give 60ml/session, use a hanging digital scale to measure how much fluid we’ve dispensed.

“SQ Fluids by the Numbers,” I Will Help Your Cat
A beautiful data visualizer that lets you in on how Dr. Kristopher Chandroo calculates recommended amounts of subQ fluids, with commentary explaining the thinking behind the various steps in his method of assessment.

E-Z IV harness for cats
Many folks have found this device helpful when giving subQ fluids, since it allows the cat to walk around while receiving fluids. (And yes, it is for subQs even though it is called an IV harness.)


“Understanding Bloodwork: The Complete Blood Count (CBC),” Dr. Dawn Ruben
A basic guide to what all those abbreviations mean and measure.

“Understanding Bloodwork: The Biochemical Profile for Cats,” Dr. Dawn Ruben
A guide to the 20 most commonly tested biochemicals.

“What Do Your Dog and Cat’s Lab, Urine and Blood Work Results Mean?,” Dr. Ron Hines, 2nd Chance
An extensive list of values tested in labwork, with links to detailed descriptions of each value, including related values/tests.


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