The Diagnosis Changed Everything About Her Care
Dr. Patel laid out the treatment plan at our follow-up visit. Prescription kidney diet. Subcutaneous fluids at home, probably every other day. Blood pressure monitoring. Bloodwork every three months to track her kidney values.
She was calm about it, which helped. She said cats can live years with managed kidney disease if you catch it early. But the word "managed" is doing a lot of heavy lifting in that sentence.
The First Month's Bills Were a Wake-Up Call
The initial workup cost $420. Full blood panel, urinalysis, blood pressure check, ultrasound of her kidneys. Dr. Patel wanted a complete picture before starting treatment.
Then came the supplies. Prescription kidney food runs about $55 for a case that lasts roughly three weeks. Subcutaneous fluid bags, $18 each, and we go through about four a month. Needle and line sets, $30 for a box. Phosphorus binder to mix into her food, $25 a bottle.
That first month I spent over $700 between the diagnostic workup and getting everything set up at home. My wife looked at the credit card statement and just said "oh." Not angry, just... absorbing it.
The Ongoing Monthly Reality
Three months in, the costs settled into a predictable rhythm. About $180-$220 per month for food, fluids, and supplies. Then $280 every three months for bloodwork and a vet visit to check her progress.
Some months are worse. In November she got dehydrated despite the fluids and needed two days of IV treatment at the clinic. That was $650 we hadn't budgeted for.
Over the first year after diagnosis, we spent roughly $3,800 on Biscuit's kidney disease care. That's on top of normal cat expenses like litter and her annual vaccines.
What Our Insurance Actually Covered
We'd had Biscuit on a pet insurance policy since she was 3. Honestly, we almost canceled it a few times during the years when she was perfectly healthy. Paying $38 a month for a cat who never got sick felt like throwing money away.
I'm so glad we didn't cancel.
The Diagnosis and Initial Workup
The entire diagnostic workup was covered under our illness benefit. After our $200 annual deductible (which we'd already partially met from a dental cleaning earlier that year), insurance reimbursed 80% of the remaining costs. We got back about $280 of that initial $420.
The ultrasound was the big ticket item. $185 just for that. Without insurance it would have stung a lot more.
Prescription Food and Medication
Our policy covers prescription food when a vet documents it as medically necessary. Dr. Patel wrote a letter and submitted a treatment plan, and insurance approved it.
They reimburse 80% of the food cost after deductible. That works out to saving us around $40-$45 a month on food alone. The phosphorus binder is covered as a prescription medication at the same rate.
Not all policies cover prescription food. I checked a few other companies out of curiosity, and some only cover it if you add a wellness rider. Others exclude it entirely. If your cat has any chance of developing a condition requiring special diet, check this before you buy a policy. It matters more than you'd think.
Fluids and Supplies Were a Gray Area
This is where things got complicated. The subcutaneous fluids themselves are covered as a prescription treatment. The fluid bags, the needles, the IV lines. All reimbursable.
But the company initially denied coverage for the fluids we administered at home. They said home-administered treatments needed a separate authorization. Nobody told us that when Dr. Patel prescribed them.
We appealed. Submitted Dr. Patel's treatment plan showing that home fluid therapy was the standard of care for stage 2 CKD in cats. It took about three weeks, but they reversed the denial.
If a claim gets denied, always appeal. Especially when the treatment was prescribed by your vet. The AVMA recognizes subcutaneous fluid therapy as standard care for feline CKD. That kind of backing helps when you're arguing with an insurance company.
What They Wouldn't Cover
The quarterly bloodwork visits were covered, but they capped reimbursement at $150 per visit. Our actual cost is $280. So we eat about $130 each time after reimbursement. Over four visits a year, that gap adds up to $520 out of pocket just for monitoring.
They also wouldn't cover a water fountain we bought to encourage Biscuit to drink more. Fair enough, I guess. It's a consumer product, not a medical device. But Dr. Patel specifically recommended it as part of her hydration strategy, so it felt like it should count.
The November emergency IV treatment was covered in full, minus our normal reimbursement split. That was a relief. I was worried they'd argue it was related to the chronic condition and apply some kind of sub-limit. They didn't.
What We'd Do Differently
Looking back, there are a few things that would have made this whole experience less stressful.
We Should Have Read the Policy Before We Needed It
I signed up for Biscuit's policy six years before her diagnosis. I picked a plan, set up autopay, and never looked at the terms again. When she got sick, I had to scramble to figure out what was covered, what needed pre-authorization, and how to file claims properly.
Spend 20 minutes reading your policy's section on chronic conditions and prescription coverage. Know where the limits are before you're stressed about a sick pet and a growing stack of vet bills.
Get Insurance Early and Don't Cancel During Healthy Years
We almost dropped Biscuit's coverage twice. Once when she was 5 and once around age 7. Both times, it felt pointless because she'd never been sick.
The NAPHIA 2023 State of the Industry report found that only about 4.8% of pets in North America have insurance. Most people wait until something goes wrong, and by then it's too late for that condition to be covered.
If we'd canceled at 7 and tried to re-enroll after her diagnosis at 9, kidney disease would have been excluded as pre-existing. We'd be paying that full $3,800 a year ourselves with zero help.
Pet insurance is boring when your cat is healthy. It becomes the best money you ever spent the day your vet calls with bad news.
Never Switch Insurers After a Chronic Diagnosis
A coworker told me about a cheaper policy after Biscuit's diagnosis. The premium was $12 less per month. For about half a second I considered switching.
Then I realized: any new insurer would classify kidney disease as pre-existing and exclude it from coverage. Everything related to her kidneys, the food, the fluids, the bloodwork, the emergency visits, none of it would be covered under a new policy.
Once your pet has a chronic condition, you're locked into your current insurer for that condition. Switching saves you a little on premium and costs you thousands in lost coverage. The math is not even close.
Tips for Anyone in This Situation
If your cat just got diagnosed with something chronic, take a breath. It's manageable. Here's what actually helps.
Document Everything From Day One
Keep every receipt, every vet note, every lab result. I started a folder on my computer called "Biscuit Medical" the week of her diagnosis. Scanned receipts go in there the same day. Vet notes get uploaded after every appointment.
When insurance questions a claim, having organized records makes the process faster. When they denied our home fluid therapy, I was able to pull up Dr. Patel's original treatment plan within minutes and attach it to the appeal. That would have been a nightmare if I'd been digging through a drawer of crumpled receipts.
Ask Your Vet to Write Detailed Notes
Insurance companies approve claims based on documentation. "Cat needs fluids" isn't as convincing as "Patient presents with Stage 2 CKD (IRIS classification), creatinine 3.2, BUN 58. Subcutaneous fluid therapy 100ml every 48 hours prescribed per ISFM guidelines for management of feline chronic kidney disease."
Your vet knows how to write these notes. Just ask them to be specific. Most vets deal with pet insurance claims regularly and understand what the companies need to see.
Budget for the Gap Between Cost and Coverage
Even with good insurance, you'll have out-of-pocket expenses. The deductible, the 20% you pay after reimbursement, any costs that hit sub-limits or exclusions.
For Biscuit, insurance covers roughly 60-65% of her total kidney-related costs. We pay the other 35-40%. That's still about $1,300-$1,500 a year out of pocket. We set up a separate savings transfer of $125 a month specifically for her medical expenses. Knowing the money is already set aside takes some of the stress out of vet visits.