Veterinarian holding a clipboard with "Chronic Kidney Disease" diagnosis, highlighting medical testing for feline CKD.

A Holistic Approach to Feline Chronic Kidney Disease [Mini-Series]

The Story of Joey: The Cat Who Changed Everything

If you’ve found this blog post, I know exactly how you're feeling—overwhelmed, scared, helpless, and struggling to find ways to support your CKD cat. I was in your shoes not too long ago, and I want to share the story of Joey (aka Jo Monster, Monster, and Jo Jo), my fearless, sometimes wreckless, 4-year-old cat. Joey came into my life as a foster fail, and from the very beginning, he had a rough start. He and his littermates were found in a plastic bag on the side of the road, and to make things even worse, Joey had been used as a baseball by an unstable man who threw him up in the air and down on the ground. By the time a kind soul traded Joey to the stranger for a beer and brought him to the cat sanctuary, his little body was already so fragile and traumatized.

The famous Jo-Monster as a baby. Fluffy, adorable, and 100% irresistible from the get go. No wonder he was a foster fail. Lots of pictures of the cutest kitten on the planet (and probably the naughtiest!)

He was severely dehydrated, infested with worms, and spent the first 10 days of his new life with me at the vet, being pumped full of meds and fluids. I promised him I’d give him the best life possible, but it seemed like no matter how hard I tried, Joey’s health struggles never ended. From emergency vet visits, to a severe dog attack that required surgery and months of physical therapy, Joey always managed to pull through—fearless, adventurous, and determined to live his life without limitations. But beneath all that bravery, Joey's health continued to deteriorate in ways I couldn't understand.

In 2022, Joey’s bloodwork showed signs of Chronic Kidney Disease (CKD)—a diagnosis that felt like a crushing blow. Numerous conventional vets recommended prescription kidney diets, and I spent a fortune on both the dry and wet food options, hoping they'd make a difference. But Joey only got worse. I was told to "wait for his symptoms to get worse"—that’s what I was supposed to do while my vibrant, naughty, amazing little booger only got sicker and weaker.

I couldn’t sit by and just watch. There had to be another way.

On a desperate whim, I reached out to the most amazing, craziest cat mom I knew—Kristin, a colleague from my days at another pet startup. I was at my wit’s end and didn’t know where else to turn. I asked if she had any advice, suggestions, or resources that could help. Kristin, you changed my life and saved my Joey. Without hesitation, she recommended that I join The Natural Pet Doctor's 'Healthy Holistic Pet For Life Blueprint' program by holistic veterinarian Dr. Katie Woodley. That same day, I applied to join, clinging to the hope that there were other ways I could support Joey instead just waiting around.

From there, everything changed.

Joey’s health completely changed due to changes to a holistic, natural lifestyle. Pictures of a healthy, vibrant fluffy Joey cat.

I dove headfirst into research—joining holistic pet health communities, attending weekly virtual Q&A sessions, reading scientific studies, and exploring every alternative healing modality I could find. I spent a full year learning everything possible about natural and holistic approaches to feline health, including managing CKD, desperate to give Joey the support he truly needed. And then, with the guidance of Dr. Katie, I completely transformed Joey’s care.

I switched his diet to raw, incorporated probiotics, herbs, and supplements, and systematically removed every toxic chemical I could think of from our home. We started using energy work, acupressure, and other holistic treatments—and though it’s been a challenging journey, Joey is still here with me, thriving, getting into SO much trouble! (He’s now showing his new baby sister how to be naughty has heck…)

I’m not going to sugarcoat it—there are still days when I feel like the worst cat mom in the world, like I’m failing him. But I also know, deep down, that I’m doing everything in my power to give Joey the best chance at a long, healthy, happy life. The road with CKD is long and emotional, but it’s one you don’t have to walk alone.

That’s why I’m sharing Joey’s story. I’ve put together this guide for cat parents like you who are searching for answers, for hope, and for a path forward that feels right. The learning never ends, and neither does the love we have for our kitties.

With that in mind, this guide will offer a starting point—a place to begin understanding Chronic Kidney Disease—what it is, why it happens, and how it progresses. But most importantly, it focuses on the things we can change from a holistic standpoint, like diet, supplementation, and creating a supportive environment. You'll find practical, actionable steps to help manage the disease and improve your cat's quality of life. It’s my collection of the best resources I’ve found throughout my journey, so you don’t have to start from scratch.

Whether you're new to the diagnosis or looking for alternative ways to care for your cat, this blog is designed to empower you to better care for your CKD kitty with practical solutions.

What is Chronic Kidney Disease (CKD) in Cats?

Let’s start with the basics. CKD is when your cat’s kidneys start to lose their ability to do what they do best—filter out toxins and keep your kitty hydrated. When that system starts to fail, toxins build up in the blood, and things start to go haywire throughout the body. Think of it like a slow oil leak in your car’s engine: at first, it’s no big deal, but over time, it can cause serious damage if left unchecked.

CKD is sadly very common, especially in senior cats. Nearly half of cats over 10 years old are affected by it. One of the big reasons? Chronic dehydration. Cats, in the wild, get most of their moisture from prey (picture the juicy insides of a mouse—yum, right?). But in our homes, they’re often eating dry kibble, which doesn’t offer nearly enough water. Over time, this lack of hydration puts enormous strain on their kidneys—kind of like running your car without enough oil, if we’re keeping with the car analogy.

The Vital Role of Kidneys in Your Cat’s Health

Your cat’s kidneys are like the body’s personal filtration system, working non-stop to remove waste and keep everything balanced. Every time your cat eats, proteins break down into by-products like urea nitrogen and creatinine, which need to be flushed out. The kidneys handle all of that, while also keeping hydration and blood pressure in check. Pretty impressive, right?

But when CKD sets in, that filtration system breaks down. Toxins build up, dehydration kicks in, and your cat’s overall health starts to slide. All of your cat’s organs—like the heart, liver, and pancreas—are affected when the kidneys aren’t working properly. You might notice symptoms like weight loss, lethargy, and loss of appetite as the disease progresses. It’s a slow process, and the longer it goes untreated, the harder it becomes to manage.

The good news? There ARE things you can do at home—small changes in their diet and lifestyle—that can make a world of difference. Trust me, I’ve been there, and even the smallest steps can have a big impact on your kitty’s quality of life.

Understanding the Progression of Chronic Kidney Disease in Cats

As kidney function declines, the effects of CKD become more apparent and progressively harder to manage. Understanding how the disease advances over time can help you recognize warning signs early and take proactive steps to support your cat's health. In this next section, we’ll discuss its different stages and what to expect as the disease worsens.

The Stages of CKD

CKD is a progressive disease, which means it worsens over time if left untreated. The stages of CKD are categorized from 1 to 4, with Stage 1 being the earliest (and the easiest to manage) and Stage 4 being the most advanced, where the kidneys lose most of their ability to filter out toxins. Here’s what you can expect at each stage in the disease…

 

Chart showing stages of Feline Chronic Kidney Disease (CKD) with creatinine, SDMA, and blood pressure ranges for cats.

Source: IRIS CKD staging guidelines

Stage 1: Early CKD (Mild Kidney Dysfunction)

  • What It Means: Stage 1 CKD is often asymptomatic and difficult to detect because your cat’s kidneys are still able to function relatively well. This stage is typically diagnosed through routine bloodwork or urinalysis, where elevated SDMA levels are the first red flag.
  • What to Expect: Most cats at this stage will not show any noticeable symptoms. However, subtle changes in energy levels or appetite might appear, though they’re easy to overlook. Early diagnosis is key here—routine check-ups are your best defense.
  • Symptoms: None or very mild. Your cat may show slight lethargy or reduced appetite, but these signs are often dismissed as normal aging.
  • Diagnosis: Blood tests will show elevated SDMA (<18 µg/dL) and mild creatinine levels. Urine may become more dilute, a sign that the kidneys are losing their ability to concentrate urine.
  • Action to Take: At this stage, the focus is on early intervention, including switching to a moisture-rich diet, adding supplements, and monitoring kidney health regularly.

Stage 2: Mild to Moderate CKD

  • What It Means: As kidney function continues to decline, your cat moves into Stage 2. While kidney damage is more apparent, there is still a lot that can be done to slow the progression of the disease. This stage often lasts for a significant period with proper care.
  • What to Expect: Your cat may start showing mild symptoms, such as drinking more water and urinating more frequently. This is because the kidneys are struggling to concentrate urine, leading to increased thirst to maintain hydration.
  • Symptoms: Increased thirst and urination are the primary signs, though you might also notice your kitty getting a bit more sluggish or eating less than normal. Some cats may start losing weight or vomiting occasionally.
  • Diagnosis: Bloodwork will show higher creatinine levels (1.6–2.8 mg/dL) and continued SDMA elevation (18-25 µg/dL). Urinalysis will likely show reduced urine concentration (low urine specific gravity), indicating that the kidneys are not filtering waste efficiently.
  • Action to Take: Dietary changes are absolutely critical at this stage—switching to low-phosphorus, high-moisture, and high-quality protein diets can reduce the kidneys' workload. Regular vet visits (typically every 3-6 months), early use of supplements, and possibly introducing phosphorus binders are crucial.
Visual representation of kidney disease progression in cats, showing the stages from normal kidney function to advanced chronic kidney disease (CKD).

Stage 3: Moderate CKD

  • What It Means: In Stage 3, the kidneys have lost a significant portion of their ability to function, and more noticeable symptoms start to develop. The body is struggling to maintain normal hydration and remove toxins, leading to more severe health issues.
  • What to Expect: Cats in Stage 3 CKD are likely to show more obvious signs of illness. You might notice your kitty is sleepier than usual, not eating well, and possibly even losing a good chunk of weight. Since the body can’t remove toxins, you’ll see symptoms like nausea, vomiting, and bad breath (uremic breath).
  • Symptoms: In addition to increased thirst and urination, cats in Stage 3 often suffer from:
    • Persistent vomiting
    • Bad breath due to toxin buildup
    • Loss of appetite
    • Weight loss
    • Dehydration
    • Poor coat condition
  • Diagnosis: Creatinine levels between 2.9–5.0 mg/dL are common in Stage 3, along with elevated SDMA (26-38 µg/dL) and blood urea nitrogen (BUN) levels. Phosphorus levels might also rise, indicating the need for phosphorus binders. Blood pressure may increase, which can damage the kidneys further.
  • Action to Take: In addition to dietary adjustments, phosphorus binders are often prescribed at this stage to help manage elevated phosphorus levels. Subcutaneous fluids may also be necessary to keep your cat hydrated. More frequent vet visits are needed to monitor electrolyte balance and overall kidney function.

Stage 4: Advanced CKD (Severe Kidney Failure)

  • What It Means: By Stage 4, the kidneys have lost most of their function (about 90%), and the disease is considered advanced. Toxins build up rapidly in the bloodstream, severely affecting your cat’s overall health. At this point, the goal is to maintain quality of life for as long as possible.
  • What to Expect: Cats in Stage 4 CKD are often very ill. You’ll notice significant weight loss, vomiting, loss of appetite, and extreme lethargy. They may be severely dehydrated, and toxins in the bloodstream can cause mouth ulcers, bad breath, and even neurological symptoms.
  • Symptoms:
    • Severe weight loss
    • Persistent vomiting and diarrhea
    • Loss of appetite or refusal to eat
    • Severe dehydration
    • Mouth ulcers and foul breath (uremic breath)
    • Difficulty moving or noticeable weakness
  • Diagnosis: Creatinine levels are above 5.0 mg/dL, and SDMA levels are significantly elevated (>38 µg/dL). Blood pressure may be dangerously high, and severe imbalances in phosphorus, calcium, and potassium levels are likely.
  • Action to Take: The goal at this stage is palliative care—managing pain, discomfort, and symptoms to ensure your cat’s remaining time is as comfortable as possible. Regular administration of fluids, anti-nausea medications, and careful monitoring of diet and supplements are crucial.

Wrap It Up

Caring for a cat with CKD can feel overwhelming, but understanding how the disease progresses is the first step in offering them the best support. You’ve learned to spot the signs early, understand what each stage means for your cat’s health, and why taking action as soon as possible can make a world of difference. From diet changes to hydration tips, you've now got a solid foundation for helping your kitty live a happier, healthier life—even with CKD.

I know this journey can be exhausting at times, but remember—you’re not in this alone. Armed with this knowledge, you’re already making positive changes that count. Every small step, whether it’s a new food or making sure they’re getting enough water, adds up!

In the next post, you’ll learn the common causes of Feline Chronic Kidney Disease (CKD), the importance of early detection, and essential diagnostic tests to help your cat live a longer, healthier life!

Additional Resources

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Understanding Lab Results

FAQs

1. What are the early signs of chronic kidney disease (CKD) in cats?

Early signs of CKD in cats can be subtle, including increased thirst, more frequent urination, and slight lethargy. You may also notice a decreased appetite or slight weight loss. Regular vet checkups, including bloodwork and urinalysis, can help detect CKD before symptoms become severe.

2. Can diet changes help slow the progression of CKD in cats?

Yes, switching to a low-phosphorus, moisture-rich diet can significantly reduce the strain on your cat’s kidneys and help slow the progression of CKD. High-quality, easily digestible proteins are essential, and many holistic vets recommend raw or wet food diets for CKD cats. Always consult your vet before making any dietary changes.

3. How often should I take my cat with CKD to the vet for checkups?

Cats with CKD should see the vet every 3-6 months for routine checkups. These visits typically include bloodwork, urinalysis, and blood pressure monitoring to track the progression of the disease and make any necessary adjustments to their care plan.

    Disclaimer

    The information provided in this blog post is for educational purposes only and should not be considered medical advice. It is not intended to replace consultation with a qualified holistic veterinarian or professional feline specialist. Every cat is unique, and individual circumstances may vary. We recommend consulting with a licensed veterinarian before making any changes to your cat's diet, lifestyle, or healthcare regimen. Additionally, we encourage readers to conduct their own research and consider multiple sources of information before making any decisions regarding their cat's health.

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