Over 30% of cats over 15 years have CKD. IRIS (International Renal Interest Society) staging guides treatment and prognosis. SDMA rises earlier than creatinine, enabling earlier detection. Use the Feline Medicine Specialist and Bloodwork OCR for workup.
| Stage | Creatinine (mg/dL) | SDMA (mcg/dL) | Focus |
|---|---|---|---|
| 1 | <1.6 | 18-25 | Early detection, reduce risk factors |
| 2 | 1.6-2.8 | 26-38 | Renal diet, BP control, phosphorus |
| 3 | 2.9-5.0 | 39-50 | + Calcitriol, potassium, anti-nausea |
| 4 | >5.0 | >50 | + Fluid therapy, anemia management |
Staging requires stable, fasted creatinine (two samples 2 weeks apart). Sub-staging by proteinuria and blood pressure refines prognosis.
Renal diet: restricted phosphorus, high-quality protein, omega-3 fatty acids. Start in Stage 2. Phosphorus binders (aluminum hydroxide, calcium acetate) if hyperphosphatemia persists.
Blood pressure control: amlodipine. Proteinuria: ACE inhibitors or ARBs (use cautiously with monitoring). Potassium supplementation if hypokalemic. Anti-nausea (maropitant, ondansetron), appetite stimulants (mirtazapine). Calcitriol for secondary hyperparathyroidism in Stage 3-4.
Subcutaneous fluids at home can improve quality of life in Stage 3-4. Many owners learn to administer 50-100 mL every 1-3 days. Reduces dehydration and uremia.
Warning: Avoid NSAIDs in CKD patients—they reduce renal perfusion. Use alternative analgesics. Ensure adequate hydration before anesthesia.
- CKD common in senior cats; IRIS staging guides treatment.
- SDMA enables earlier detection than creatinine alone.
- Renal diet from Stage 2; phosphorus binders if needed.
- BP control, potassium, anti-nausea, fluids as disease progresses.
- Avoid NSAIDs; ensure hydration before procedures.