Cats with failing kidneys tend to develop inflamed stomach linings, which causes heartburn and, in some cases, gastric ulcers. To provide some relief and encourage your cat’s appetite, your veterinarian may recommend antacids. The typical prescription is omeprazole, a proton pump inhibitor that is extremely effective at reducing gastric acid secretion. Smaller cats usually get 1 mg/kg by mouth once a day; larger cats usually take half a 10 mg tablet once a day.


If you do not have a prescription for omeprazole, you can also try famotidine, which is sold over the counter as Pepcid. Pepcid blocks histamine-induced gastric acid production. Unfortunately, dosing can be difficult. Larger cats typically need a quarter of a 20 mg tablet, but smaller cats usually need an eighth of a tablet, which can be impractical.
 B vitamins are important for digestive health and a good appetite. This group of vitamins is water soluble, so your cat’s increased thirst may wash them away too quickly into the urine. Your veterinarian may therefore recommend a course of injections – usually one injection a week for four weeks – to keep sufficient B vitamins in your cat’s blood.
 If your cat has no appetite – even if you’ve given antacids and made sure there’s no problem with dehydration – you may need to provide an appetite stimulant. Ask your veterinarian about a low dose of intravenous diazepam, which sometimes gets cats to eat. Another possibility is Periactin, an antihistamine that has appetite-stimulating side effects. The usual dose is 0/1-0.5 mg/kg twice per day. Larger cats may require half a tablet, twice a day.
 When given in the early stages of kidney disease, angiotensin-converting enzyme inhibitors (ACE inhibitors) can prolong the life of the kidney. These drugs change the blood flow through the kidney and lower the pressure gradient so that less damage is inflicted on the micro circulation within the kidney. A common prescription is a 2.5 mg tablet of Fortekor once daily. Talk to your veterinarian about the best option for your cat.


Note that ACE inhibitors will not cure kidney disease; they will simply protect your cat’s kidney from some wear and tear. These drugs are not effective in advanced kidney disease.
Give your cat antacid medications.
Supplement with B vitamins.
Consider stimulating your cat’s appetite with medication.
Medicate with ACE inhibitors.
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