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Tanya's Comprehensive Guide to
Feline Chronic Kidney Disease
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Tanya
Thomas
Ollie
         
         
Introduction
         
                   
Hello, and welcome to my website, though I am sorry you need to be here.
              
My name is Helen, and I have been running this website for twenty years (where does the time go?). I have had three cats with CKD, Tanya, Thomas and Ollie (their photos are above). I created this website because I know first hand the shock and fear of the diagnosis, and how helpless it can make you feel, and I wanted to give people the detailed, practical information which would have helped me the first time I received the CKD diagnosis.
                           
People arriving here usually fall into one of two camps. If your cat has just been diagnosed with CKD, you are probably feeling shell-shocked and frightened. Your cat may be in the midst of a crisis, perhaps on intravenous fluids (IV, or a drip, or a flush) at the vet's. If your cat has high bloodwork values, you may not even have been offered any treatment, but instead told that there is no hope and you should just put your cat to sleep.
              
Or maybe you've caught things early, but are anxious to find out all you can about this disease so you can do all you can to keep your cat stable. Alternatively, perhaps your cat has had CKD for a while, but you are now realising that you need to become more proactive if you want him or her to remain   well.  
              
Whatever your situation, please take a deep breath and don't give up hope, because it may well be possible to help your cat.

This website is extremely comprehensive, which is both a blessing and a curse. On the one hand it will answer 99% of your questions about kidney disease in cats, but on the other hand it may seem a bit overwhelming to start with. Try not to worry, just read the Key Issues section and dip into the other sections that interest you. it will eventually start to make sense. And above all, get food into your cat
Aims of the Site
This site shares all the information and tips I know, in great detail, in order to help your cat feel better and hopefully extend his/her life. I am not a vet myself, just an ordinary person who has educated herself about CKD in cats.

If you are a vet visiting this site because your client has mentioned it to you, I can imagine your heart is sinking about now. It may reassure you to know that, wherever possible, I do try to offer veterinary information to support what I say. Many vets do recommend the site, including a number of vet schools and veterinary specialists (see the reviews below).

I try to share the information I have using layman's language. My goals are to:

  • describe the symptoms which you may be seeing now or which you may see in the future;
  • explain what these symptoms and your cat's test results may mean;
  • discuss treatments which can often help, many of which are not very expensive (the most commonly used treatments can usually be obtained for around US$5-10 a week in total);
  • cover the emotional aspects of living with CKD and help you to cope with it, including at the end of your CKD journey.

The site provides information on an international basis, aiming to help you wherever you happen to live, although in practice much of the information relates to the USA and Europe since these are the areas where the most information and treatments are available.
What is Kidney Disease?
This site shares all the information and tips I know, in great detail, in order to help your cat feel better and hopefully extend his/her life. I am not a vet myself, just an ordinary person who has educated herself about CKD in cats.

If you are a vet visiting this site because your client has mentioned it to you, I can imagine your heart is sinking about now. It may reassure you to know that, wherever possible, I do try to offer veterinary information to support what I say. Many vets do recommend the site, including a number of vet schools and veterinary specialists (see the reviews below).

I try to share the information I have using layman's language. My goals are to:
describe the symptoms which you may be seeing now or which you may see in the future;
explain what these symptoms and your cat's test results may mean;
discuss treatments which can often help, many of which are not very expensive (the most commonly used treatments can usually be obtained for around US$5-10 a week in total);
cover the emotional aspects of living with CKD and help you to cope with it, including at the end of your CKD journey.
The site provides information on an international basis, aiming to help you wherever you happen to live, although in practice much of the information relates to the USA and Europe since these are the areas where the most information and treatments are available.


There are two main kinds of kidney disease:

  • Chronic Kidney Disease, abbreviated as CKD; and
  • Acute Kidney Injury, abbreviated as AKI.

Kidney disease used to be known as kidney failure, and you may therefore see references in some of my links to Chronic Renal Failure (CRF), or Acute Renal Failure (ARF). I used to use these expressions myself, but these days the academic literature prefers the less scary and more accurate expression, kidney disease, so that is what I use throughout the site.

AKI is a serious condition which usually comes on suddenly and which is often triggered by a particular event or "insult", such as your cat eating something poisonous. Lilies and antifreeze are both extremely toxic to cats and may cause AKI. Cats with AKI are normally hospitalized for treatment, which usually includes intravenous fluids (IV fluids, also known as a drip); depending on the cause of the AKI, other treatments may also be offered. AKI is hard to treat, but if the cat survives the initial crisis, he/she can often regain much or sometimes all of his or her normal kidney function.

CKD may also manifest itself very suddenly and require IV treatment at the vet's, but in contrast to AKI it is an ongoing disease in which it is not possible to regain lost kidney function; so the goal is to keep the remaining function for as long as possible.

This site is primarily designed for people with a cat with the chronic form of the disease (CKD), but may be of some use to those with a cat with AKI. Please visit the Acute Kidney Injury page for more information.
Where to Start
This site is extremely comprehensive, as you can see from the number of links in the sidebar on the left. But don't panic, you won't need to learn about every single aspect.

Most people who arrive here for the first time have three overwhelming concerns:

  • they want to know how severe their cat's case is
  • they want to know how best to help their cat, and quickly
  • in particular they want to know how to get their cat to eat

I therefore recommend that you read these pages first:

  • How Bad Is It? - discusses the various stages of CKD in cats.
  • Is There Any Hope?: discusses the various scenarios you may face.
  • Key Issues To Help Your Cat Feel Better and Prolong Life - the crucial issues to focus on in order to best help your cat. Don't worry, it is highly unlikely that you will need to deal with all of them at once.

The main reason why CKD cats won't eat is uraemia (a build up of toxins which make the cat feel poorly and inappetant). Please read Appetite Loss, Nausea and Vomiting and Persuading Your Cat to Eat for tips on how to help your cat.  

These pages will get you started quickly so you can hit the ground running. Then, later on, you can gradually get up to speed on CKD in more detail. The Site Overview - Finding What You Need page provides a brief summary of the contents of each page, so if you're not sure where to find something, check here, or just check the sidebar on the left.
If Your Vet Has Recommended Immediate Euthanasia
Please read the Just Diagnosed? What You Need to Know First page urgently. Unfortunately, some vets are not overly familiar with the latest treatments for CKD, and may recommend euthanasia prematurely. You need to educate yourself and work out how severe your cat's case is before you make this irrevocable decision.

Oh, and do not panic if your vet says your cat has lost 70% of kidney function - it's actually normal for CKD not to be diagnosed until this much function has been lost. What matters is how well your cat can manage with the function that is left, and a lot of cats do well.
My Three CKD Cats
This website is named in honour of Tanya, who was my first CKD cat. Unfortunately Tanya did not receive as much proactive care as Thomas and Ollie, because at the time that she was diagnosed (1998), I did not know about the treatment options described on this website (and of course many of them were not available back then). I tried desperately to find information to help her but I was not online, so my options were limited. Once I got online, I vowed that nobody else should have to go through that, so I created this website.

Thomas, in contrast, had much more severe CKD yet survived longer than Tanya because he received more proactive treatment.

Ollie was a somewhat different case: he came to me a week before his sixteenth birthday with relatively mild CKD but with a host of other health problems which ultimately took him from me.

You can read more about all of them here. You can also read some Success Stories here, some of whom survived for years with CKD. I can't promise the same success for your cat, but in most cases it's certainly worth a try.
Other Urinary Tract Problems
I sometimes hear from people whose cats have lower urinary tract problems rather than kidney problems. Lower urinary tract problems are relatively common in cats, but do not automatically lead to kidney problems. So please be sure your cat has kidney issues before deciding this is the website to help your cat, because treating for the wrong condition is at best pointless and at worst dangerous.

If you are not sure, ask your vet if your cat has CKD or another condition that would fall into the category of Feline Lower Urinary Tract Disease (FLUTD).

Is Chronic Kidney Disease Terminal?
Sadly, yes, CKD is terminal. BUT that does not necessarily mean death is imminent: it is often possible to buy the cat months or even years of quality life. In fact, with appropriate treatment, quite a few CKD cats not only live for a long time, they eventually die of other causes, with the CKD firmly under control at the time of death.

An analogy used by my vet is that a CKD cat is approaching the edge of a precipice: the cat may approach the precipice very slowly, taking years to reach it; the cat may approach quite quickly; whichever way the cat approaches the precipice, it may be possible to grab the cat and pull him/her back even after he/ she has started to fall over the edge, and this could be done several times if you move quickly enough.

The good news is there are almost certainly a few things you can do to help your cat. This site is geared towards slowing the progression towards the precipice, and may also be able to help pull your cat back if he/she has started to fall over the edge, while simultaneously trying to make the cat's remaining time more comfortable. CKD cats can look very ill at diagnosis, but improve dramatically with treatment, so I strongly recommend trying treatments for a few weeks before considering euthanasia.

Good luck on your CKD journey.

Helen
          
*****

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.

*****
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