CKD, SQ Fluids, and the Art of Holding Steady
Q:
I am going through your STS course. My 5 badass Bengal, Emerald, has stage 4 CKD. I’ve been giving her SQ fluids, every other day, since July. It’s like walking on a tightrope. I’ve been experimenting with different size needles, syringe method, etc. Wondering if there is a SAFE and EFFECTIVE calming medication or supplement I could give my cat who prior to SQ fluids? I know someone who uses Gabapentin, but I’m reluctant to go there. Would CBD help? Feliway? Magnesium?
A:
Great question, and first, a moment of respect for you and for Emerald the badass Bengal. Equally as badass is Stage 4 CKD plus regular SQ fluids. It can really be a tightrope, and the fact that you are still showing up every other day to do this tells me a lot about the kind of caregiver you are.
For those who don’t know Chronic Kidney Disease (CKD) is something I’ll see in about 50% of cats. No joke. It’s why I wrote Nine Lives, One Mission: Vet-Approved Home Treatments for Cats with Chronic Kidney Disease (CKD)
Short answer first, yes, there are safe and effective ways to reduce a cat’s anxiety or aversion around SQ fluids. The best choice depends on the cat, the kidneys, and how much calming effect you actually need.
I’ll talk about each one you’ve asked about.
Gabapentin
Gabapentin is the most commonly used option in cats for procedure related anxiety. It is not a sedative in the classic sense, it is more of a nervous system volume knob. It can lessen the feeling of a needle poke. For many cats it takes the edge off fear without knocking them out, depending on the dose you use. In CKD cats it can still be used, but dosing and timing matter more, which is why I talk about it carefully in the CKD Master Guide with a 45 minute Dr. Kris consult.
Your reluctance is understandable. When used thoughtfully it can be a kindness rather than a crutch. Tip - you want to test it first and the dose must be reduced depending on what the creatinine level is in the bloodwork. There is also a bonus effect for older cat’s that can actually help their kidneys!
CBD
When used properly, high quality, pet specific CBD, with no THC at all, can be a calming tool for CKD cats. I do discuss it’s use. CBD works differently than other medications, often taking the edge off anxiety without disconnecting the cat or causing the “drugged” feeling that we sometimes worry about.
Because quality, dosing, and kidney considerations matter, this is something I guide privately one on one, which is exactly why I built this into the CKD Master Guide plus the 45 minute Dr. Kris consult. That private setting allows us to evaluate a product, and educate about the right suggested dose based on experience and the scientific literature.
Feliway
Feliway is safe and useful. Think of it as support, not the main solution. It helps lower the overall stress in the environment, which makes everything else work better, including CBD or medication.
Magnesium
Magnesium is often suggested as a gentle calming supplement when combined with a few other ingredients. In my experience many cats who truly need help relaxing will simply overpower the effect of magnesium. It is usually too subtle for the level of anxiety that comes with anticipation of a needle. On top of that, in stage 4 CKD, electrolytes are already walking their own tightrope.
SQ fluid sparing alternatives
This is also where the bigger CKD picture matters. SQ fluids are a tool, to achieve a goal. Sometimes there are alternatives, that lesson the amount, or even change how ofter you are giving SQ fluids, which I discuss as part the BITE strategy in my CKD Master Guide (just released this week BTW).
Bottom line, when you are already steady and attentive, as you are, you’ve got options. A layered approach, smart technique (also see my thunder shirt technique in STS), supportive medications when needed, all shaped by CKD, gives you room to adapt as Emerald does.
