Stage 2 CKD Care

Approximately 33–66% of kidney function remains.
Stage 2 requires supplement supports, dietary management, and hydration.

Supplements

In Stage 2, A multi-supplement approach is more effective.

✔ If creatinine is below 2.5
(Early Stage 2 / appetite and energy are stable)

  • Dr. Toru Protocol – AIM-based supplement

✔ If creatinine is 2.5 or higher
(decreased energy or noticeable increase in values) A three-supplement protocol is recommended:

  • Dr. Toru Protocol – AIM-based, supports kidney waste clearance
  • Intensive Protocol – cellular energy, AMPK activation, antioxidant support
  • Probiotics Protocol – uremic toxin reduction, gut health support
    + Omega-3 (EPA/DHA) – anti-inflammatory, improves renal blood flow (approx. 100mg/day recommended)

Diet

This is the stage to transition to a renal prescription diet.

Until Stage 1, senior formulas were suitable, but now a renal diet with controlled phosphorus, sodium, and protein is needed.

  • Recommended brands: Royal Canin, Hill’s, etc.
  • Feeding tip: Gradually mix the renal diet with your cat’s current food to prevent food refusal.
  • Eventually, make sure your cat transitions to 100% renal food.

Hydration

Active hydration support is essential.
From Stage 2, dehydration worsens, and voluntary drinking may not be sufficient.

✔ Daily target: At least 40 ml(1.35 fl oz) per 1 kg(2.2 lb) of body weight

  • Example: 4 kg cat → minimum 160 ml/day (9 lb cat → minimum ~5.4 oz/day)

✔ Hydration strategies:

  • Mix wet food with water at a 1:1 or 2:1 ratio
  • Combine 5 ml of lickable treat with 30 ml of water and offer multiple times daily
  • If needed, administer daily subcutaneous fluids as directed by your veterinarian

Kidney Checkpoints

Regular check-ups at home and at the clinic are essential.

✔ At-Home Tracking

  • Check appetite and energy levels daily → sudden decline may be a warning sign
  • Monitor water intake → sudden increase may indicate a problem
  • Weigh your cat weekly (at the same time and under the same conditions)

✔ Veterinary Check-ups (every 1–6 months):

  • Blood tests — Creatinine, BUN, phosphorus, electrolytes
  • X-ray & ultrasound — assess kidney size, stones, and structural changes

Emergency Symptom Checklist

If your cat shows any of the following signs, visit a veterinary clinic immediately:

  • Complete loss of appetite
  • Vomiting more than 3 times a day
  • Severe lethargy or unsteady walking
  • Open-mouth breathing or labored breathing
  • No bowel movement for over 48 hours
  • Frequent straining to urinate or defecate every 5 minutes

Summary – Stage 2 Care

✔ Supplements

  • AIM + AMPK + Probiotics + Omega-3

✔ Diet

  • Gradual transition to a renal prescription diet

✔ Hydration

  • Encourage fluid intake with food + subcutaneous fluids if needed

Complete Your Cat Care Routine

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Before & After on the Greycoat Program

These are real cases where the Greycoat Program was applied—especially in Stage 2 and 3 cats, when guardians were searching for a better way forward.
Take a look and see what parts of their journey might help shape your own routine.

See More Greycoat Case Stories →
  • [Stage 2] Ellie – CREA 2.01 → 1.37

    [Stage 2] Ellie – CREA 2.01 → 1.37

    All of Ellie's kidney levels improved considerably. Her creatinine fell from 2.01 to 1.37, her BUN from 35.7 to 30, and her SDMA from 26.9 to 13, indicating that she...

    [Stage 2] Ellie – CREA 2.01 → 1.37

    All of Ellie's kidney levels improved considerably. Her creatinine fell from 2.01 to 1.37, her BUN from 35.7 to 30, and her SDMA from 26.9 to 13, indicating that she...

  • [Stage 3] Napoleon - BUN 43 → 35

    [Stage 3] Napoleon - BUN 43 → 35

    Napoleon, a 14-year-old cat with Stage 3 CKD, showed significant improvement in creatinine and BUN levels after 5 months on the Greycoat Full Spectrum Care Set.His weight remained stable, appetite...

    [Stage 3] Napoleon - BUN 43 → 35

    Napoleon, a 14-year-old cat with Stage 3 CKD, showed significant improvement in creatinine and BUN levels after 5 months on the Greycoat Full Spectrum Care Set.His weight remained stable, appetite...

  • [Stage 2] Naro - CREA 2.3 → 1.9

    [Stage 2] Naro - CREA 2.3 → 1.9

    Despite his age and multiple chronic conditions, Naro’s health has noticeably stabilized since starting the Dr. Toru Protocol.His kidney values have remained steady for over a year—which, for us, is...

    [Stage 2] Naro - CREA 2.3 → 1.9

    Despite his age and multiple chronic conditions, Naro’s health has noticeably stabilized since starting the Dr. Toru Protocol.His kidney values have remained steady for over a year—which, for us, is...

  • [Stage 2] Rocky - BUN 30 → 23

    [Stage 2] Rocky - BUN 30 → 23

    NAME: Rocky Roo HOME: Idaho, USA DATE of Birth: April.1.2016 (9 years old) Condition: Stage 2  Today, we received some heartwarming news from peaceful Idaho, USA. Most cats with stage 2...

    [Stage 2] Rocky - BUN 30 → 23

    NAME: Rocky Roo HOME: Idaho, USA DATE of Birth: April.1.2016 (9 years old) Condition: Stage 2  Today, we received some heartwarming news from peaceful Idaho, USA. Most cats with stage 2...

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