How to Care for a Cat With Chronic Kidney Disease


Last updated January 19, 2018

Chronic Kidney Disease, also known as Chronic Renal Failure (CRF) is a common condition in aging cats. It is the result of a gradual decrease in kidney function.

The Function of Healthy Kidneys

Healthy kidneys act like a filter to remove waste products from the body. They regulate electrolytes such as potassium and phosphorous, and they produce erythropoietin which stimulates red blood cell production. Kidneys also produce rennin, which contributes toward regulating blood pressure. Kidneys also play a major role in turning vitamin D into its active form, which controls calcium balance in the body.

Signs of Chronic Kidney Disease

Signs of CRF can be subtle at first, and include increased thirst and urination, vomiting or other signs of nausea, lethargy or depression, poor hair coat, loss of appetite, lingering over the water bowl, eating cat litter, constipation, a strong ammonia-like odor to the breath, and changes in vision and hearing.

Chronic Kidney Disease is Irreversible

There is no cure for kidney disease, but it can be managed with supportive care. Early diagnosis improves the prognosis for longterm survival with good quality of life.

The goals of therapy for chronic renal failure are to increase hydration, decrease the buildup of toxins in the blood, treat any possible underlying reversible disease (infection, hyperthyroidism), maintain good blood flow to the kidneys, and minimize any further damage.

Dietary Modification

Cats with kidney disease need moisture in their diet, so dry food is contraindicated. There is some controversy around protein restriction for cats with kidney disease. While many veterinarians still recommend so-called prescription kidney diets, there is no solid evidence that protein restriction prevents further damage to the kidneys, especially not in early stages of the disease. In fact, protein restriction may do more harm than good. Additionally, these “kidney diets” are generally not very palatable, and many cat won’t eat them.

There is, however, strong evidence that restriction of phosphorus benefits cats with kidney disease. Phosphate binders such as Calcitriol are generally well tolerated by most cats.

All veterinarians will agree that it is more important that a cat will eat than what he eats.

For more information, read The Right Diet for Cats With Kidney Disease

Fluid Therapy

Cats with chronic kidney disease pass large amounts of urine and become easily dehydrated. Dehydration can be prevented by feeding canned or raw food, and by encouraging cats to drink. However, frequently, these cats don’t feel well enough to eat or drink enough to combat dehydration, and your veterinarian may prescribe fluid therapy. Fluid therapy also aids in flushing waste products through the kidneys.

Cats will need to be hospitalized for intravenous fluid therapy, but fluid therapy can be also performed by the cat’s guardian at home by giving the fluids subcutaneously. Depending on the stage of kidney failure, cats may benefit from fluid therapy ranging from once a week to every day.


Holistic supplements to strengthen renal function may be beneficial and are available in the form of herbal, homeopathic or nutraceutical form. Always discuss supplements with your cat’s veterinarian prior to administering.

Getting Cats to Cooperate with Treatment

One of the most frustrating aspects of treating cats with chronic kidney disease is getting cats to cooperate with the various treatments. Frequently, multiple pills and supplements a day, combined with fluid therapy, can interfere with the bond between cat and human. The goal of therapy needs to be to choose the most effective treatment with the least amount of stress for the cat, and the human.

This article was previously published on and is republished with permission.

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