Stage 3 CKD Care

Daily subcutaneous fluid administration is required under veterinary supervision.

※ Caution is needed if the cat has heart or lung conditions.

✔ Dosage guideline:

• 40–50 ml(1.35–1.7 fl oz) per 1 kg(2.2 lb) of body weight per day
• Example: 4 kg (9 lb) cat → 160–200 ml/day (5.4–6.8 fl oz/day)

✔ Commonly used fluids:

• Hartmann’s Solution
• Normal Saline (NaCl 0.9%)
• Plasma-Lyte

In Stage 3, blood tests should monitor and manage the following:
Phosphorus (P), Potassium (K⁺), Calcium (Ca²⁺), Bicarbonate (HCO₃⁻), Sodium (Na⁺)

✔ Elevated P – Hyperphosphatemia

• Common in Stage 3 CKD.
• Administer phosphate binders with food.
  → e.g., Sevelamer, Lanthanum

✔ Low HCO₃⁻ – Metabolic Acidosis

• Blood pH becomes acidic, disrupting electrolyte balance.
• Supplement with Sodium Bicarbonate
  → Helps alkalize blood and stabilize electrolytes

✔ Elevated K⁺ or Ca²⁺ – Hyperkalemia / Hypercalcemia

• Often occurs with persistent low HCO₃⁻ and acidosis.
  → Correct with Sodium Bicarbonate supplementation

✔ Low K⁺ – Hypokalemia

• Caused by excessive urinary potassium loss.
• Supplement with potassium products
  → e.g., Potassium Gluconate, Potassium Citrate

✔ High Na⁺ – Hypernatremia

• Adjust by switching to low-sodium fluids.
  → Replace NaCl 0.9% with Hartmann’s Solution (Lactated Ringer’s)