Tails of Truth: The Truth about Veterinary Medicine

Kidney Disease in Cats, Part 2: What to Feed, How to Treat & When to Let Go

• Dr. Angie Krause, DVM CVA CCRT • Episode 10

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Summary 

In this follow-up episode of Tails of Truth, Dr. Angie Krause and JoJo continue their deep dive into kidney disease in cats, focusing on what comes next after a diagnosis. They explore the nuanced world of kidney diets, share when (and why) they recommend subcutaneous fluids, discuss phosphorus binders, and get real about quality of life and end-of-life decisions.

Dr. Angie shares her holistic perspective on diet timing, how to navigate treatment options that fit both your cat and your lifestyle, and why being gentle with yourself is part of the process. This is a grounded, compassionate guide for anyone walking the kidney disease journey with their cat.

🛒 Mentioned in this episode:

 🎓 Free Kidney Disease Course with code TRUTHTAILS
📞 Schedule a video consultation with Dr. Angie

Key Takeaways

  • Prescription kidney diets are often recommended too early—it's okay to question this.
  • Cats are obligate carnivores; prolonged protein restriction can cause muscle loss.
  • Start phosphorus and protein restriction around Stage 3, not earlier.
  • Calories and hydration are more important than strict diets in late stages.
  • Subcutaneous fluids can greatly improve how your cat feels—start gradually.
  • Phosphorus binders are useful when dietary changes aren’t enough or aren’t tolerated.
  • End-of-life planning is emotionally hard but offers space for peace and intention.
  • Quality of life is often about eating, grooming, and being mobile.
  • A CKD diagnosis is not the end—it often means years of life left with the right care.

Sound Bites 

“Do I really have to feed this food?”

“Feeding cats is like parenting—what control do you really have?”

“I’m not against anything that helps a cat feel better.”

“Hydration is king, but calories are too.”

Please subscribe and review! xoxo Dr. Angie & JoJo


Dr. Angie Krause (00:00.918)
Welcome back to Tails of Truth podcast where we tell the truth about veterinary medicine. I'm Dr. Angie and this is my co-host JoJo veterinary nurse extraordinaire. And today we are doing our part two of kidney disease in cats.

JoJo (00:17.47)
Yes, couldn't cover it all in one episode. So if you haven't heard the first episode, go back and listen to that one first.

Dr. Angie Krause (00:20.312)
We couldn't.

Dr. Angie Krause (00:25.24)
Yes, Fiona terrorizes the beginning a little bit. And it turns out we recorded the whole thing without the right microphone. It's going to be okay. But if the sound quality is different, we can thank Fiona for that. there was so much that we, Fiona's the cat. She's behind me. If you're listening to us, you can't see her, but her picture's behind me. If you're watching it's this she's mischievous, just like she looks in this photo.

JoJo (00:34.41)
Ha

JoJo (00:38.624)
Fiona the cat, Fiona's the cat. Yeah.

Dr. Angie Krause (00:53.408)
So there were so many things we could not cover. We did cover a lot, like how to get your cat diagnosed, how often to do blood work. We talked about hypertension a lot. I feel like we talked about hypertension so much we don't need to talk about it again. Don't you think?

JoJo (01:07.076)
yeah, I think we covered it in length all the way down to our favorite doppler. Our favorite technique.

Dr. Angie Krause (01:12.854)
Yes, you'll now understand how we prefer to take, to collect blood pressures from gas and exactly how we do it. So what are we going to talk about today? Food, like food, right? Diet.

JoJo (01:19.079)
Yeah

JoJo (01:25.894)
Yeah, we're gonna talk about diet, we're gonna talk about treatments. You had some notes about anemia and phosphorus, so I'm gonna put that on your, yeah, I thought you might.

Dr. Angie Krause (01:33.773)
yeah, I forgot about that.

I know. So JoJo and I do this unscripted, but today, because we are doing an episode with all the medical things and we want you to have like a complete kind of guide, we took notes of like, okay, we can't forget to mention this. So. No script.

JoJo (01:52.928)
And by notes, have bullet points, but not a script. And Fiona last episode is just so much evidence of how unscripted this is. But it's still, I mean, the important piece, important information is getting out. So we have diet, treatments, anemia, phosphorus. We have hypertension on the list, but we're, we're, go back to episode one.

Dr. Angie Krause (02:01.129)
It's also unscripted.

Dr. Angie Krause (02:16.811)
Go back to episode one, everything you need to know about hypertension is there even how to treat it. But what I really want to talk about is food because this is what happens. People take their kitty to the vet. do some blood work, which is great. And their veterinarian finds increased BU and in creatinine or just increased creatinine and says, Hey, your cat has kidney disease. Here is this prescription diet.

JoJo (02:21.258)
Yep.

Dr. Angie Krause (02:44.149)
And I can't tell you how many emails calls we get of like, do I really have to feed this food? And the short answer is no, but it might be beneficial in certain situations and certain stages of kidney disease. And I'm going to share my opinion, which is not an opinion shared by all veterinarians.

And so if your veterinarians has something different than what I'm going to tell you, it's not that they're wrong. And I just want to add this, they are actually not making any money on any kidney diets. Most clinics don't carry prescription diets, but even if they were, I promise the markup on pet food is awful. They are only doing it to make your life easier. But for the most part, veterinarians don't carry food.

JoJo (03:23.52)
Hmm.

Dr. Angie Krause (03:41.181)
And I promise there's not really skin in the game for them to recommend. okay.

JoJo (03:45.28)
I'm going to challenge a piece of that. Is it true that there I believe all of that I believe that there's you know, not a big financial markup like it's not to they're not getting kickbacks and commissions on prescription foods. But do you think or my question is could it be more that it's the easy answer or what they they know to be true and so diet is such a

Dr. Angie Krause (03:49.887)
Yeah.

JoJo (04:12.552)
ginormous umbrella of opportunity that sometimes maybe prescription diet is easier.

Dr. Angie Krause (04:22.101)
Yes. Well, it's my opinion. This is going to sound so snotty and I don't want it to, but I'm just going to say it. Maybe that softened it a little bit. I think some veterinarians prescribe kidney diets in what I consider to be an inappropriate time due to a lack of critical thinking. And it doesn't mean that they're not critical thinkers, but I disagree about how they're approaching

nutrition and kidney disease. So I'm just going to come right out and say that. And I don't think they're bad veterinarians because I think it's most veterinarians, but I think we're missing some nuance that is not being missed. Like if you go to an internal medicine conference, they are not missing this nuance. This is being discussed. But I think sometimes when you boil it down to a general practitioner, which I am one of those, it's easy to just be like, okay, cats and kidney disease, feed kidney diet.

JoJo (04:55.486)
Okay.

JoJo (05:07.85)
Hmm.

JoJo (05:20.064)
Mm-hmm.

Dr. Angie Krause (05:20.845)
move on to the next thing. Cause we have a million things we're thinking about. we're also thinking about your cat's oral health. We're thinking about your cat's weight. We're thinking about your cat's heart murmur. And so sometimes I think it just gets too distilled down.

JoJo (05:32.648)
Right.

JoJo (05:36.372)
Well, yeah, I feel it's just one of those line items in which there's just not enough time in a general practice to dive deeper. And so the easier thing is to write a prescription for the food. Yeah.

Dr. Angie Krause (05:42.785)
Yes.

Dr. Angie Krause (05:46.519)
Yes.

Dr. Angie Krause (05:50.168)
for the food. Yes, because what we know is that your cat's kidneys in kidney disease benefit from having protein and phosphorus restriction. So we know that cats feel better and live longer when we restrict those nutrients. The problem is that cats are obligate carnivores.

They absolutely must be eating meat, which is high protein. And so when we use kidney diets that are phosphorus and protein restricted, we are not feeding them a balanced diet. And so when we start, when your cat is in stage one or two, iris staging, we talk about that in the first episode, we will likely be feeding this diet for years and years and years.

And I don't like that because I don't want my obligate carnivore patient eating a low protein diet for all of those years. So I take a more moderate approach and I start protein and phosphorus restricting their food in stage three. So that I'm still getting some of that benefit.

JoJo (06:55.36)
Mm-hmm.

Dr. Angie Krause (07:12.247)
but all of their other organ systems and musculature had the benefit for all those years. So it's like, kind of like, I just kind of meet in the middle. And for some cats, they don't want to eat a kidney diet. And I don't ever make them because I think food and quality of life go together. I think you should like what you eat.

JoJo (07:30.889)
Right.

JoJo (07:36.51)
right. Well, in a majority of those prescription diets, are the renal diets canned food or they kibble?

Dr. Angie Krause (07:44.513)
They're canned and kibble.

JoJo (07:46.642)
Okay, I just wonder how they're justifying the kibble in a disease that requires so much hydration

Dr. Angie Krause (07:53.804)
I don't know how we're justifying kibble for cats at all. But well, so and I guess I'll just say this. We need a whole episode on kibble for cats. I, Texas A trained 20, over 20 years ago now. We were taught that, just traditionally, like allopathically. not any, this was not an alternative thought. But we were taught that cats should not.

JoJo (07:57.22)
Okay, I was trying to still stay. Yeah.

Dr. Angie Krause (08:21.549)
be eating kibble. And I don't know if we had more of a nutrition focused education because Texas A &M is home of one of the best GI labs for cats and dogs. Like that's where a lot of the innovation was happening. But when I got out into the world and moved to Colorado, and of course, like everyone here is a CSU grad, everyone was feeding kibble. And I'm like, what is happening? And so it's

For me, it doesn't even like, I don't even know that my aversion to kibble has anything to do with my alternative holistic integrative leaning. Yeah. Yeah. Like it's just, that's what we were taught, but we should have a whole episode on that. So, but if you have a cat with kidney disease, that means your cat's likely older. If your cat does not want to eat wet food and is eating kibble, it's probably not the time.

JoJo (08:58.976)
Hmm, interesting, or rather than your education.

JoJo (09:05.824)
Mm.

Dr. Angie Krause (09:20.621)
to fight with them and have them do something new. And so some cats will only eat kibble and calories are king. And so whatever your cat wants to eat, that's what I want your cat to be eating too. If, you know, I know we're not starving cats out. It's just not gonna happen. They're gonna win. They're going to starve themselves to the point where they get like fatty liver disease and have to be hospitalized. So we're not doing that.

JoJo (09:38.048)
All

Dr. Angie Krause (09:47.477)
So I don't want you to feel like, you know, if you have a 17 year old cat that's in kidney failure and you feed them a kibble, it's totally fine.

It's totally fine. Yes.

JoJo (09:58.344)
heard you totally fine. Yeah, it's a fine line to have a strong opinion and not shame, right? It's okay. That I'm just I've just surprised that the prescription formulation for a kidney diet, specifically kidney disease is kibble. So that that was one of questions. So diet diet is so nuanced because when you have the you have a lot of players in the mix, right? You've got what your desire is, you have what your cat's desire is, you know,

Dr. Angie Krause (10:04.828)
Yes.

Dr. Angie Krause (10:14.208)
Yeah.

JoJo (10:27.06)
financial resources, like diet is palatability. Like there's just so much. And the good news is we have so many options, but what I hear specifically for kidney diet from you is you pause on restricting the protein and the phosphorus because if you're, if you're, if you are restricting that too early on, are you causing other potential issues for your cat?

Dr. Angie Krause (10:34.093)
There's so much.

Dr. Angie Krause (10:54.559)
Yeah. Yeah. Like muscle loss. So we have already seen your kitties most likely that are struggling with their muscle loss. They're having some arthritis and I feel like, no, I don't, I don't want them to have more muscle loss and get around, you know, have more pain because their joints are less supported by muscle. So we know they're having more pain and it's just, so I, I choose to not do that, which is controversial.

in this was a long time ago, because it's 2025. But in 2016, I attended the Internal Medicine Veterinary Conference when it came to Denver. And I think there were two or three discussions about when we should be restricting protein in cats with kidney disease. And it was a panel discussion. It was so interesting. And there I think there were five different internists and everyone had their own take.

No one, there was no consensus of this is when, and so it gave me permission to not feel guilty. I'm not recommending kidney diets for cats with a creatinine of two. It's not going to do it. And now someone can present me with evidence that tells me that that's the wrong thing to do. I am so open, but a lot of these papers,

JoJo (12:04.245)
Yeah.

Dr. Angie Krause (12:17.087)
are not looking at just that. And then what happens when we feed these protein restricted diets for years and what other kind of like comorbidities are happening and all those things are so hard to control for. Like you said earlier, it's complicated.

JoJo (12:32.928)
Is there more that you wanna say on diet and kidney disease? mean, because I feel like that in itself is a whole topic. But it's nuanced and it's not only, I don't think there's a one size fit all answer for this.

Dr. Angie Krause (12:38.017)
course. I know maybe we should make a whole episode.

Dr. Angie Krause (12:47.165)
No, because then you have cats with IBD and kidney disease, and then you have cats with urinary tract issues that are on a special, you know, diet to prevent crystals. And then they have kidney disease and the prescription food companies are doing their best to be like, we made a formula to try to accommodate both, but at some point you can't accommodate everything. And I think that's okay. And so I want to just give everyone a

JoJo (12:53.552)
Often.

JoJo (12:58.4)
Mm-hmm.

JoJo (13:13.492)
Hmm.

Dr. Angie Krause (13:16.501)
like the permission to not feed a renal diet if it doesn't make sense. It's okay. It's not, it's not a big deal. Feed your cat a wet food if you can, but it's, it's not the end of the world. Like I'm going to give you permission. And if, if your cat doesn't eat the renal diet, cause it doesn't taste as good. And some cats are like, I'm not eating this. No, thank you.

JoJo (13:22.08)
Mm-hmm.

JoJo (13:38.164)
Yeah, doesn't smell as good. I don't know. Like when you open that bag, yeah, it's not fantastic. And there are some cats who love it.

Dr. Angie Krause (13:41.309)
No, cause protein tastes good. Yeah.

It's not as good. Some cats love it. And when cats love it, I'm like, go you. You're making that choice.

JoJo (13:52.608)
Yeah, I know I feel like it always comes back to that like you as a guardian really don't have any say in this you get to present options a buffet of choices, but ultimately the Fiona's and the fritz's of the world get to make the final decision It's told it's still like parenting like what control do you really have?

Dr. Angie Krause (13:59.742)
No, it doesn't.

Dr. Angie Krause (14:12.631)
they're making the final choice. so.

Dr. Angie Krause (14:18.221)
my gosh, that's true. Feeding cats is like parenting. I think that's the new quote. What control do you really have?

JoJo (14:23.808)
None, it's all perceived and they just laugh in your face. Okay, so diet. Do you feel complete on the diet topic? I know.

Dr. Angie Krause (14:29.997)
Totally.

Dr. Angie Krause (14:35.149)
I mean, never, but if you want to talk about your cat's diet, then go to our website, boulderholisticvet.com and go to the consultations and book a time with me. And we can go over your cat's diet and go through everything because it is so nuanced that I feel like I can make some generalizations, but it's helpful to know more about your kitty.

JoJo (14:58.24)
All right, and for those that are raw food feeders, there's a prescription raw food for kidneys now, right? Am I right? And I bet a lot of veterinarians have not heard of this.

Dr. Angie Krause (15:04.235)
Yes! It's called Medicus. It's super cool. No, nor would they support it because it's raw food.

JoJo (15:14.188)
Right, but I know but that's where you have to come in and like this is what we hope our episodes help you as a listener to do is have the information so that you can advocate for what aligns with your values. So there is one out there.

Dr. Angie Krause (15:30.807)
Yes.

There is, it's in its protein and phosphorus restricted. And it's a freeze dried raw diet.

JoJo (15:40.436)
Have you tried cats on it?

Dr. Angie Krause (15:43.114)
I think I've tried three cats on it and one liked it and the other two wouldn't eat any of the kidney diets. But like historically lifelong picky eater, this kitty wouldn't eat anything other than what she wanted to. And that's what she ate.

JoJo (15:51.308)
JoJo (15:56.756)
Yeah.

Okay. Yeah. Just there's so many options, just so many options. No. So just because someone says prescription diet doesn't mean there aren't. and I think Google has got to be a scary hole of options. And if you have a panel at an internal medicine place at all with different opinions, I can imagine what Google

Dr. Angie Krause (16:05.153)
Yes. Yes.

Dr. Angie Krause (16:16.769)
Yeah.

JoJo (16:25.17)
presents as somebody who's trying to figure this out for themselves. Don't do this alone. That's what I'm trying to say.

Dr. Angie Krause (16:25.293)
my gosh.

Well, you could, we're here to help you because you can find stuff on the information to tell you you're terrible and stuff to tell you that everything you think is right.

JoJo (16:40.606)
Yeah, it's endless. That is endless. so but what we said in episode one or what you said, is, know, calories are king, but hydration is also king. what about treat a very common treatment is subcu fluids or subcutaneous fluids. And when do you start that?

Dr. Angie Krause (16:53.079)
Yes.

Dr. Angie Krause (17:00.673)
Yes, this is so important. I usually start subcutaneous fluids when either my phosphorus creeps up out of the normal limits, because again, like we talked about in the first episode, the kidneys are filtering out the blood and you should be peeing out that phosphorus, but you're not. And so it's building up in the blood and that makes kitties feel poorly. And so if the phosphorus is increased or if my creatinine is in the threes and maybe my patient's starting to not feel good,

I will have my clients give their kitties fluids at home. And for the most part, would say most cats do really well. Once everyone figures out the routine, it's a little rough in the beginning because you're learning how to poke your cat with a needle and fill the space in between their shoulder blades with fluid, but it helps so much. And I'll usually start out like two times a week.

and then we'll go to every other day. And in end-stage kidney disease, usually we're doing fluids every day, but man, it can make such a difference.

JoJo (18:07.84)
But it is so intimidating for somebody who is not in the medical field. It's a fairly large needle. Even you and I have had I use a larger needle than you do. And yeah, but it's a really inexpensive way to to help your kitty and

Dr. Angie Krause (18:17.185)
Yes.

I know.

Dr. Angie Krause (18:27.499)
Yes.

JoJo (18:32.106)
There are in-home nurses or even your vet team who can come in. Sometimes a tech from a clinic will come in and show you how to do that at home. And once you do it a couple times, I promise it gets so much easier.

Dr. Angie Krause (18:45.757)
Yeah, it's just fumbly. It's fumbly for your cat because they're like, wait, what's going on? But once your cat figures it out, usually they kind of settle into it. It's fumbly for you because suddenly you're doing what we're doing in a clinic. You're dealing with a needle. You have this bag of fluids with this line with all these like levers everywhere. It's, it's kind of got an intense curve, but once you do it, I don't know, what do you think? Two to three times. Then you're like, okay. I've got this.

JoJo (19:11.986)
Yeah, I think that's, I mean, cause at first it can feel like, my gosh, this needle, and you have to find a funny place to hang the bag at home, you know, like on a shower rod or somewhere higher than you. And I mean, it can feel scary that there's this big old lump of fluid that migrates, you know, so sometimes it might have started out between the shoulder blades and ends up in the armpit and sometimes leaks.

Dr. Angie Krause (19:21.154)
Yeah.

Dr. Angie Krause (19:32.553)
It does migrate.

Dr. Angie Krause (19:40.077)
Sometimes it leaks. Yeah, it can come right out where you put it in, but not very much, like not all of it. And then it's going to go down your cat's arm in a strange way. Now they don't care about it, but it looks funny sometimes.

JoJo (19:40.937)
Yeah.

JoJo (19:47.786)
heart.

JoJo (19:53.48)
Yeah, and we project all over that it must be uncomfortable or, you know, I remember I tried to get my bag temperature to just the right temperature, like cold fluids probably don't feel good. And I still believe that actually. I think a warm bag is probably nicer. Just in a bowl of water. Just like a bait exactly like that. I don't know, it seems like it would be a little less shocking.

Dr. Angie Krause (19:58.153)
Yeah, it's true.

Dr. Angie Krause (20:05.825)
That's it.

How do you warm your back up?

that's a idea. Like a baby's bottle.

Okay. See, I would be paranoid that I make it too hot.

JoJo (20:22.469)
no, you can test it on yourself.

Dr. Angie Krause (20:24.813)
You can just test it. Like that kicks off my anxiety. Don't. Yeah. Yes. Don't.

JoJo (20:26.24)
Just like a baby bottle. Yeah. Don't boil the water and then put it in your cat. And then say that JoJo said. Don't microwave it. Just room temperature is perfectly fine.

Dr. Angie Krause (20:41.207)
Don't microwave it. Yeah. Yes, totally.

JoJo (20:45.876)
No, okay, fluids. What other kind of treatments are there for kidney disease?

Dr. Angie Krause (20:50.839)
So you can do phosphorus binders where you give your cat a supplement and it binds the phosphorus in the intestines so before they can absorb it. And I think those can be quite helpful if your kitty will eat them. And there are several different types of phosphorus binders. You should try them all, but I think that they can be quite helpful.

JoJo (21:13.984)
Do you advise that that be done under the care of a veterinarian? Okay.

Dr. Angie Krause (21:19.137)
Totally. Yeah. They'll help you like figure out dose. Although rarely do I have a cat that does their full dose of phosphorus binder, because it's a powder. They're usually pretty powdery. And so, but not all, I don't think all of them are powders, but I think that your veterinary team is going to tell you based off of how, on how high the phosphorus is, how much you should be giving.

JoJo (21:24.052)
Mm-hmm.

JoJo (21:43.838)
Right, they might have to recheck before that six month period if you're using phosphorus on a regular basis. So would you do that though if you were not restricting phosphorus and protein in diet? Is that a good time to start or is it later?

Dr. Angie Krause (21:47.307)
Yes. Yeah.

Dr. Angie Krause (21:59.212)
I mean, if we have high phosphorus at that point, we're really trying to restrict in diet. But if the cats aren't gonna let us, if your kitty personally is like, I'm not eating a kidney diet, then we do phosphorus binders. But we can also do phosphorus binders on top of low phosphorus diets, depending on. Yes, the high phosphorus feels bad. So we wanna make them feel better. That's why I'm not against a lot of,

JoJo (22:07.797)
Mm-hmm.

JoJo (22:17.76)
And is a kitty feeling bad when they have a high phosphorus?

Okay.

Dr. Angie Krause (22:28.553)
Integrative vets are like, I'm against kidney diets. And I'm like, I'm not against anything that's going to help my patient feel better. Yeah. Yes.

JoJo (22:34.688)
That makes sense. Okay, so we have phosphorus binders fluid therapy. We talked about amyloidopine in the first episode, which if your cat becomes hypertensive, we can treat that hypertensive meaning high blood pressure. Okay, what do we mean?

Dr. Angie Krause (22:48.865)
Yes. And then we talked about our favorite supplements. We went in depth about what supplements I recommend. So go back and listen to that episode.

JoJo (22:59.548)
Mm-hmm. And they all come in a bundle on our website. So you can find them there too.

Dr. Angie Krause (23:03.489)
Yes. You don't even have to remember. Yeah. Go to boulderholisticvet.com and then go to our shop, go to bundles. Although, so we're just, we're going to rebuild our site. It's happening right now. I don't know if the, will the bundle section stay? I don't actually know this. So, but well, the bundle will stay, but right now we have a category called bundle where you can find it, but find it.

JoJo (23:15.122)
It's so exciting.

JoJo (23:20.091)
I don't know.

JoJo (23:27.104)
Hmm.

Dr. Angie Krause (23:28.705)
So if you forget everything we said or you don't want to go back to the other episode, you can go to the, is it called a feline kidney bundle? Just type in kidney bundle to our website. Yeah.

JoJo (23:35.486)
Mm-hmm.

Yeah, you'll find it. Great. Okay. And then the last thing you have on your bullet points today was talk about, well, you had end of life, but I wonder if you want to talk about quality of life before end of life. Yeah. They do go together.

Dr. Angie Krause (23:49.686)
at same time. Yeah, I feel like they go together. They're intertwined and I cats that succumb to their kidney disease often have such a slow decline. It's hard for people to decide that it's time to send them on. And that's assuming that you are going to euthanize your kitty, give them a peaceful death. Some people would rather hospice their kitty and let them die without intervention. And so

Either way, it's important to have your veterinary team, like good communication with your veterinary team, like, hey, I'm not gonna keep doing fluids and I think this is the end and start talking to them about euthanasia, whether it's gonna be in the office, whether it's gonna be at home. I feel like those plans are best made ahead of time if you have the luxury to do that.

JoJo (24:48.958)
Yeah, and what does a quality of life decline look like in a kitty with chronic kidney disease?

Dr. Angie Krause (24:54.621)
Yeah, kitties with end stage kidney disease have a lot of toxins in their blood. So they get nauseous, they vomit. Sometimes they can even get sores in their mouth. They definitely don't want to eat. They don't groom. So they're feeling pretty poorly. For me personally, with my own kitties, when they stop eating, and they're not responding to interventions, like subcutaneous fluids, and there's nothing else I can do.

that's when I call it quits or if I feel like they're suffering before that. If your cat has so many toxins built up in their blood that they're having sores in their mouth or really bad breath, I feel like there's almost no chance to come back from that. And that's also when I say it's time to let them go. I feel like eating, you know, being able to use the litter box. It's really important. Cats don't really want to go outside the litter box. And so

If they've always gone in the litter box and then suddenly they're not, or if they're so wobbly, a lot of kitties just kind of waste away with kidney disease and they just can't even walk in a straight line. feel like those are times where quality of life has declined too far. What do you think?

JoJo (26:10.912)
that? I know I think you nailed it. I think the nice thing about kidney disease is you're seeing that you're seeing that decline happen most likely because it's been happening over years. So I feel like there's more time to be prepared.

Dr. Angie Krause (26:32.215)
There is. Yeah.

JoJo (26:33.438)
So I feel like the gift in that is you have often have the choice to call in an in-home euthanasia. That's the gift, right? Like there's just more choice in that transition period. Yeah, but I'm with you 100 % that kitties don't wanna be urinating outside the box. I mean, it's never.

Dr. Angie Krause (26:50.881)
There is more choice. Yeah.

JoJo (27:00.488)
Intention, I mean at that stage is not intentional. There are times when cats definitely do intentionally. Yeah, but not in this situation. So in the eating piece when they when they don't want their food anymore. I feel like that's a good clue.

Dr. Angie Krause (27:05.549)
That's a whole nother episode. Yeah.

Dr. Angie Krause (27:15.731)
Yeah, it's hard to come back from that one. It's hard. And you know, we do all these things that we can help control nausea. So we've got syrenia, we have appetite stimulants, and you can do all those. And at some point they stop working. And that's usually when you've run out of treatments, it's time, time to let go, which feels awful. And I just want to say, I know we had a whole episode about end of life care, but it's really hard when it's your own cat.

JoJo (27:20.308)
Mm-hmm.

JoJo (27:30.762)
Mm-hmm.

JoJo (27:35.616)
Yeah.

JoJo (27:45.312)
Mm-hmm.

Dr. Angie Krause (27:45.39)
because you're so close and I really recommend people get outside opinions, whether it's a friend or a neighbor, a veterinarian, just to help them. Because I always know when it's me, I'm just, it's awful. I'm just going up and down and riding the roller coaster. It's now it's later. What do I do? And it feels like such a heavy responsibility. And so I encourage people to get other opinions.

JoJo (28:12.992)
Yeah, I think it can still be challenging to come to terms with the end. Even when you have known the end is coming for years when you've been treating this disease for years. It's, it's still always challenging to

Dr. Angie Krause (28:27.817)
It's sometimes just impossible. then I always tell people this decision makes itself because you think, how am going to know? But you do, you do know it just suddenly happens. And

JoJo (28:29.994)
Mm-hmm.

JoJo (28:34.773)
Mm-hmm.

JoJo (28:38.24)
Yeah, it's more less about knowing and more about accepting. just if I ever become that enlightened, fantastic. It's not gonna happen in this lifetime.

Dr. Angie Krause (28:44.663)
Yeah.

Yeah.

Dr. Angie Krause (28:51.937)
Fantastic. And I'll say if you're listening to this, because you're in the stage where you think it's time to let your kitty go, it is an act of love. Euthanasia is, you know, having a peaceful death is a gift that we can give our kitties.

JoJo (29:02.634)
Mm-hmm.

JoJo (29:08.97)
Mm-hmm.

JoJo (29:13.568)
Yeah. Oh, I feel like we should end there because it just feels heavy. Oh, because it's been a week of loss, right? No.

Dr. Angie Krause (29:17.94)
I know.

Dr. Angie Krause (29:22.165)
Yes, we lost a patient this week to kidney disease that we have been seeing for years and years and years. And so we, we all feel sad and she lived for years with her kidney disease with great quality of life.

JoJo (29:43.712)
Hmm.

Dr. Angie Krause (29:45.291)
So, but I would love to help you with your kitties, kidney disease. And if you go to boulderholisticvet.com and go to courses, you can download my prerecorded class on my holistic approach to kidney disease for free by using, is it truth tales? T R U T H T A I L S. I always have to ask because I can't remember.

JoJo (30:06.365)
It's truth tales.

Dr. Angie Krause (30:12.493)
And we would love to hear from you. So wherever you're listening to this YouTube, Spotify, wherever, please leave us a review. If you have time, that would be so, um, it'd be so great if you could, um, or leave us a comment. We want to know what you think. We want to know about your experience and what you want to hear more about. Anything else, JoJo?

JoJo (30:34.108)
I think that's good. okay, I always say no and then I say one more thing. Okay, my one more thing is, well, it felt like a sad ending. And I just wanna remind people that just because your cat has a kidney disease diagnosis doesn't mean the end of life is here now.

Dr. Angie Krause (30:38.987)
Okay, here's your one more thing.

Dr. Angie Krause (30:51.233)
That is correct. Yes.

JoJo (30:53.002)
there's a lot of years of support that we can offer.

Dr. Angie Krause (30:57.044)
Absolutely. Okay, we'll see you next time. Bye.

JoJo (31:02.09)
Bye.