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Chronic kidney disease in cats: complete guide
Early diagnosis (IRIS stage 1-2) can double life expectancy. This guide covers overlooked signs, IRIS stages and the standard management protocol.
🚦 Urgency triage: yellow vs red flag
🟡 Yellow flag — monitor / vet in 24-72h
- drinks more / urinates more / gradual weight loss
🔴 Red flag — emergency NOW
- stopped eating / repeated vomit / extreme apathy
Early signs (easy to miss)
- Drinking much more water (polydipsia)
- Larger urine volumes (polyuria)
- Gradual weight loss (muscle wasting)
- Dull coat
- Occasional vomit
- Bad breath (uremic)
- Variable appetite
IRIS stages
| Stage | Creatinine (mg/dL) | Prognosis | Action |
|---|---|---|---|
| 1 | <1.6 | Excellent | Monitor every 6 months |
| 2 | 1.6-2.8 | Good | Renal diet + hydration |
| 3 | 2.9-5.0 | Guarded | Diet + SC fluids + meds |
| 4 | >5.0 | Severe | Palliative care, hospitalization |
Standard treatment
- Renal therapeutic food (Royal Canin Renal, Hill's k/d, Farmina Vet Life)
- Extra water sources (fountains, multiple bowls, wet food)
- At-home subcutaneous fluid therapy (250-500ml, 2-3× week in stage 3)
- Supplements: phosphate binders, antinauseants, B vitamins
- Quarterly vet visits with blood and urine
Frequently Asked Questions
Is there a cure for CKD?
No. Progressive and irreversible. With proper management, a stage 2 cat lives 3-5 quality years.
Is renal diet enough?
It's the main — reduces phosphorus and bad protein. Combined with plenty of hydration, prevents 50% of decompensations.
Can I do at-home fluid therapy?
Yes, vet teaches technique. Monthly cost: R$ 80-150 (saline + needles) vs. R$ 400-800 in-clinic.
My cat drinks a lot, is it CKD?
Could be CKD, diabetes or hyperthyroidism. Blood and urine tests first — don't assume.
When to stop treatment?
When quality of life declines despite management. Vet helps assess — uncontrolled pain, persistent dehydration, refusal to eat.