My cat has CKD. Do they need Sub Q fluids or just more water?

This isn't really something we monitor to be honest, so I don't have a good number for you. If he's not drinking much water or eating very wet food, he likely is getting slowly dehydrated if he's getting 200ml water subcutaneous and urinating that 200ml out, since he will lose water through his feces, breathing, skin, etc. I'd recommend letting his vet know what you're seeing, checking in on his kidney values, and consider increasing his fluid levels slightly. However, I wouldn't do this without guidance from his vet, because there are other issues he could have at the same time that would require taking a more moderated approach to the fluid amounts.

SQ fluids must be given with a needle under the skin and although it might look brutal to you it is actually much easier on the cat than try to force her this quantity of water orally, which is virtually impossible.

If she has kidney disease and needs extra fluids than the best way is to give her subcutaenous fluids. Your vet should be able to teach you how to give SQ fluids at home. If she is drinking than you could add some pedialyte to her water in equal parts.

Thank you for using Petco Pet Education Center, formerly Petcoach! Your vet is correct in saying that the subcutaneous fluids given to animals are the same as those given to humans. However, due to their pH, certain fluids can burn while being given subcutaneously as they react with the normal fluids in the body. I recommend asking your vet what type of fluids they recommend, what amount your cat needs, and to show you how to administer them. I sometimes recommend a numbing cream to facilitate the administration, only if there are no underlying medical conditions. If your cat has liver issues, fluids may help correct some of the symptoms, but other issues such as adequate nutrition need to be taken into account as well. I am happy to answer any other questions you may have!

0.9% sodium chloride can be given IV. I am wondering if you mean that you are giving the fluids subcutaneously since this is a procedure that is often performed at home. I would recommend contacting your veterinarian before giving any fluids - there are some blood chemistry changes that might make a veterinarian choose one fluid over another so while sodium chloride can technically be given subcutaneously or intravenously it might not be ideal for Symba.

No, i don't think fluid therapy is necessary at the moment but if he isn't on wet prescription food for kidney disease already then i would definitely recommend trying to switch him to such a diet, he can definitely benefit from that.

Cats tend not to drink much water naturally, because their bodies are adapted to conserve water. Naturally, they get much of their water from the animals they eat. It is definitely good to encourage water intake, because this can help keep the kidneys healthy. The easiest way to do this is to feed wet food or add water to the food. Slipping water into tasty food is going to be your easiest and best option. It's possible that later on he will start drinking water more, so definitely always keep fresh clean water available. I hope that helps.