I’ve had several cats over my adult years that were diagnosed with Chronic Kidney Disease (CKD). When deciding on a treatment plan with their veterinarian I had to consider multiple factors. Was I able to administer the necessary medications and treatments? Would the cat be accepting of those? Could I feed the appropriate foods to the cat, and would they eat that food? How would the required diet and treatment affect my lifestyle and the lives of all of the cats living in my home?
My most recent cat that I lost to CKD was Savannah. She had been left behind when someone in the neighborhood moved. She showed up on my doorstep begging for food and shelter. I had many wonderful years with her. She had a sweet temperament, got along well with my other cats, and at the time she joined our household she looked out for a cat that was geriatric and going through CKD. Years later when Savannah was diagnosed, I wanted to do the best I could for her. Having health insurance for her gave me options I would not have otherwise had.
SDMA (Symmetric dimethylarginine) testing was relatively new and gave Savannah an earlier diagnosis than any of my previous cats had gotten. While the news is always heart wrenching, I was aware of new foods and treatments for different IRIS levels, along with more knowledge available to her veterinarian.
During the earlier stages of CKD, diet was the most important thing for her. There were several good choices, and she was happy with a couple of the available foods. Because of my multi-cat household, I had to make sure everyone was fed using an electronic feeder. I used microchip reading feeders for the canned foods and RFID collar chips for the kibble. This kept Savannah on her prescription diet, and my younger cats were on a food appropriate for their life stages.
Savannah had regular visits to the vet for bloodwork and physical exams. Keeping a close eye on her health measurements allowed her veterinary care team to watch her IRIS staging and make adjustments as Savannah needed. As the CKD progressed, Savannah needed more supportive care to keep her comfortable.
One of the challenges with treating CKD is balancing other health issues. Savannah had arthritis and was taking gabapentin for pain. As her kidneys declined, she could not clear the gabapentin from her system at the same rate. Her dose of gabapentin had to be adjusted so that she would not have too much in her system. It also made her sleepier than previously. We made the choice to let her sleep that extra hour per day so that
she was more comfortable during the hours she was awake.
Savannah also lost weight during this time. I got her a heated bed specifically for pets. She spent many hours, even during the summer months, enjoying the extra warmth. I kept the bed in a central location in the house so that she was able to keep track of where everyone was without leaving the warmth of that bed.
Access to resources had to be adjusted as her health declined. She was kept comfortable, but I determined that food, water and a litter box all had to be in the room with her. I wanted her to have easy access. While the living room was not my first choice, especially for the litter box, it was more important for Savannah to be able to get to these resources easily when awake from a nap.
Steps became another necessary household item. I had bed or pet steps up to both my bed and the spare bed, as well as the sofas in the living room. Savannah’s arthritis made jumping up onto furniture difficult to impossible depending on the height of a particular piece of furniture. The steps gave her access to the pieces she used most.
I kept her medications on a strict schedule. This allowed me to keep better track of what she needed and allowed Savannah to anticipate when they would be given. The rest of the day she could relax without wondering if I was coming with something she didn’t want to take.
As the disease progresses, cats will flush water from their body faster than they can take it in. Even with fresh water and a canned food diet they will still dehydrate. Subcutaneous (SubQ) fluids become critical in keeping them hydrated. Without fluids, they will experience symptoms including nausea, vomiting, and inappetence. Being able to give fluids at home makes life much easier for both the cat and the owner. Savannah and I got into a routine for this also. I installed a hook on the catio and in good weather we sat out there while I administered her fluids.
Savannah also had complications that made treatment challenging at times. With her veterinary care team tracking her health and her treatment plan we were able to navigate some of the more difficult challenges. She spent a night in the emergency clinic for a transfusion. She also had a recurring respiratory infection that required treatment each time she relapsed.
It was heartbreaking when the time came to have to say goodbye. I knew that I had done my best and kept her comfortable during the time we had. Savannah was ready when I let her go.
Ellen Vogel is an outreach and education volunteer with EveryCat Health Foundation. Ellen lives in Durham, North Carolina with her four Maine coon cats, Maggy, Vivo, Turbo, and Rainbow. After trying a few other careers, she is now her happiest as the owner of Trilling Cat Inn & Spa, a cat exclusive grooming and boarding business. As a Certified Feline Master Groomer (CFMG), Ellen enjoys making cats look and feel beautiful. She has trained several of her Maine Coon Cats as Pet Partners registered therapy pets, and also speaks on cat care and the basics every cat owner should know. Ellen is a Cat Friendly Veterinary Professional (CFVP) and an Elite Fear Free Certified Professional (Elite FFCP).