Investigating the efficacy of intestinal phosphate binders and subcutaneous fluid therapy in the management of feline chronic kidney disease

Chronic kidney disease (CKD) is a very common disease in cats and is a prevalent cause of morbidity and mortality in this species. Consensus guidelines exist for the management of this progressive disease but there are few to no clinical studies providing supportive evidence for the use of several of these recommendations. Examples include the management of elevated phosphorus (hyperphosphatemia) with medications that bind phosphorus in the gastrointestional tract (intestinal phosphate binders) and the management of dehydration with subcutaneous fluid (SCF) therapy (fluid given under the skin). Hyperphosphatemia in CKD cats has been shown to be associated with progression of CKD and can lead to negative effects such as abnormalities of calcium and phosphorus balance. This imbalance can cause nausea, vomiting, anemia, and lethargy. No studies have investigated the efficacy of aluminum hydroxide, a commonly used intestinal phosphate binder, in naturally occurring CKD in cats.

Cats with CKD can suffer from dehydration which can result in decreased appetite, decreased activity, constipation, and worsening kidney values. Maintaining appropriate hydration is extremely important, particularly in cats suffering from CKD. Intermittent or daily SCF therapy has been recommended to help maintain hydration in cats with CKD, however, no prospective clinical studies have been performed to evaluate their efficacy in CKD management. The purpose of this six-month study is to evaluate how intestinal phosphate binders and subcutaneous fluid therapy help CKD cats over time.