Managing hydration is a critical component of caring for cats with chronic kidney disease (CKD). CKD is a progressive illness that impairs kidney function and causes cats to lose their ability to conserve water effectively, which can lead to chronic dehydration. Proper hydration management can significantly improve a cat's quality of life and potentially slow the progression of the disease.
Why Hydration is Important in CKD
Cats with CKD experience excessive water loss through their urine, which can lead to dehydration, especially as the disease progresses into stages 3 and 4. Hydration is essential for maintaining proper kidney function, promoting circulation, and diluting toxins in the blood. Without adequate hydration, the kidneys may further deteriorate, leading to more severe symptoms like nausea, vomiting, and lethargy.
Correcting Dehydration
In cases where dehydration is already present, rehydration is typically achieved with fluid therapy.
If the cat is unstable or in a decompensated state, intravenous (IV) fluid administration in hospital is often required. The amount of fluid required to correct dehydration is calculated based on the cat's body weight, percentage of dehydration, and maintenance needs. This rehydration process generally takes 24–48 hours, but some cats may need slower rehydration to avoid fluid overload
Once the initial dehydration is corrected, ongoing fluid management becomes the focus. Fluid therapy may be tapered over several days to ensure that the cat maintains hydration once discharged from the clinic. Regular monitoring during this period is important to avoid overhydration, which can lead to complications such as fluid buildup in the lungs.
Long-term Hydration Management
Encouraging Water Intake:
Cats with CKD should have access to fresh water at all times. Offering a variety of water sources, including pet fountains, can encourage more frequent drinking. Some cats may prefer flavored water or moving water. Feeding a wet food diet can significantly increase water intake compared to dry food, and additional water can be added directly to the cat's meals to ensure they consume more fluids. Purina has a new product called "Hydracare" that can be used to encourage oral fluid intake.
Subcutaneous Fluid Therapy:
Administering fluids under the skin (subcutaneous) is another common option for home hydration management. We can teach you to give your cat 75–150 ml of fluid every 1–3 days, depending on the severity of the CKD and the cat’s tolerance. Hartmann's solution is often used, though in some cases, a more diluted solution (such as 0.45% saline) with added potassium may be necessary to avoid sodium overload.
Use of Feeding Tubes:
For cats that have trouble maintaining hydration orally, feeding tubes can be an alternative. Through an oesophagostomy tube water, food and medications can be delivered directly into the stomach. This method is preferable to subcutaneous fluids in some cases, as it provides a potentially less stressful route of hydration and ensures the cat receives proper nutrition and medications at the same time.
Fluid Type and Electrolyte Balance
Careful selection of fluid type is essential in CKD management. Balanced electrolyte solutions like Hartmann’s or regular saline are commonly used. In advanced cases, where sodium load needs to be minimized, half-strength saline solutions may be preferable. Electrolyte imbalances, such as hypokalaemia (low potassium), should also be corrected during fluid therapy, as potassium plays an important role in maintaining muscle function and overall health.
Monitoring and Adjusting Treatment
While maintaining hydration is crucial, it's equally important to regularly monitor the cat's condition to avoid complications like fluid overload, which can stress the heart and lungs. Cats receiving long-term hydration support should have their electrolytes, blood pressure, and overall hydration status checked frequently. Adjustments to fluid administration may be needed based on these regular evaluations.
Take a moment to read our other blog posts about important management aspects of CKD: