cats, kidney disease, and diet (kinda long)

[Becky]

I know we have a bunch of cat people here, and I'm in need of some cat wisdom.

The short version is that our 12-year old male cat was just diagnosed with kidney disease (failure? insufficiency? What the heck do you call this anyway?) following routine bloodwork and verified with urinalysis. DH and I always thought that, with his fireball personality, he'd be the kitty to expire in a blaze of glory, not some slow chronic decline. So we're still adapting to this new idea. Right now, the vet (whom we love) thinks we can manage this with prescription food and routine labwork to monitor his condition.

This brings me to my first question: We've been feeding a re-hydrated raw food (Prowl), made with extra water, up until now. We like it because it's raw, grain-free, a good source of hydration, and convenient. The cats love it. Now the vet wants us to switch Auric to Hills K/D, whose label makes me cringe compared to the Prowl label. From what little I've read, low-protein doesn't necessarily spare the kidneys and it's more an issue of a) high-quality, low-waste protein and b) nitrogen, potassium, and phosporus reduction as a result of high-nutrition food. The idea of feeding a obligate carnivore a low-protein diet doesn't feel right to me. But I want to do what's right for him. If I'm off-base and K/D is the best thing, say so. If you can help me have an intelligent, fact-based conversation with my vet about not feeding K/D, please do!

Question #2: For those of you who have been down this path, what practical advice do you have for me and DH? It can be anything from "here's what we fed" to "here's what we had to do while on travel" to "here's how we knew it was time for euthanasia". Right now, we're just a little overwhelmed with this new reality.

Thanks for listening.

[Koronin]

I know absolutely nothing about kidney disease. However, we have a cat that we had to go with a prescription diet for because of bladder stones. That vet's office sold Science Diet. However after looking at it and Royal Canin we choose to go with Royal Canin. (Not nearly as good as the raw or higher brand foods, but definitely better than Science Diet). My old vet had no problem ordering it for us. My new vet, after we moved across the state actually stocks Royal Canin and doesn't like Science Diet. She also has non prescription Innova. Unfortunately with her it's either deal with the bladder stores or deal with little red bumps she gets from her allergies to corn (which unfortunately is in Royal Canin although not as much as is in Science Diet). If you do need to go with the prescription food I'd definitely suggest looking at the Royal Canin.

[Eden]

I've also only had experience with a kitty with bladder stones - but after learning more about what cats should eat and how incredibly *bad* prescription diets are (and the Hills stuff was included in the cat food gluten recall... which is what I think *started* my kitty's problems...) I switched him to Ziwi Peak and have never looked back....

One thing I heard is that those companies Hills, Royal Canin, etc pour a lot of $$$$ into veterinary schools and gain loyalty that way.... I have a hard time trusting vets that push the stuff these days... I'd see if you can get a second opinion from a vet who doesn't have one of those brands prominently featured in their lobby....

[Kiwi Stoker]

One thing I heard is that those companies Hills, Royal Canin, etc pour a lot of $$$$ into veterinary schools and gain loyalty that way.... I have a hard time trusting vets that push the stuff these days... I'd see if you can get a second opinion from a vet who doesn't have one of those brands prominently featured in their lobby....[/QUOTE]

I don't have a cat (sorry) but have to agree with this. I once did publicity for an Australian author and vet who advocates a raw food diet for cats and dogs. It was amazing what the pet food industry was trying to do to stop his message. Most vets are "sponsored" by pet food companies and recieve perks and the pet food companies had enough grunt to get this author barred for the Australian Vet Society. It was great fun watching them squirm whne we did a really good media tour, with high profile interviews on TV etc. They never saw it coming and were on the back foot.

If you are interested google "Raw Meaty Bones".

[indysteel]

Becky, I'm so sorry about Auric. I lost my first cat to kidney disease. For better or for worse, she went rather quickly, so we were never in a management phase, but I've struggled since then with what to feed my cats, including a geriatric male who has refused to eat better quality wet food, making me resort to cheap canned food--which is still arguably better than dry.

I, too, have read the mixed verdicts when it comes to protein for cats with kidney disease. I tend to think that they continue to need protein, as they are carnivores. The most important thing is phosphorous reduction. Have you compared the phosphorous content of the Prowl with the prescription Hills? Like the others who have responded, I am leary of these brands when it comes to pet nutrition and it frustrates me that vets continue to push certain brands without a good understanding of pet nutrition. Just yesterday, I read a FB post from a vet who misstated, IMO, the role that a protein based diet plays in the development of kidney disease. But, there is a place for certain of Hill's products when it comes to kidney disease--if phosphorous regulation is your paramount concern. So, I wouldn't yet rule it out. Remember, too, that right food to feed Auric is one that he'll readily eat--so there's that consideration, too.

The best and most comprehensive information I've found on kidney disease in cats is this website. If you're not familiar with it, take some time to read the various topics. Perhaps it will help you in your dialogue with your vet and in managing Auric's illness.

Good luck; let us know what you decide.

[smilingcat]

I stay away from Science Diet even though my vet suggest it from time to time in a very low key lukewarm manner. She knows that I'm not going to put up with that stuff. We feed Evangers, Wellness, Earthborn, Prowl.

Personally, reading the ingredient list of Science Diet makes me cringe. Many of our cats have medical issues yet we manage just fine with the brands I've listed. One is a 14 yo. His number is still okay but always a concern. Next one is a 10 yo who is starting to have arthritis and is now on glucosomine supplement. three others has auto-immune and another has urinary tract problems often and gets blocked from time to time. All were recommended to be on special diet of one sort or another but all are doing quite fine with the premium food.

[Becky]

Indy: thanks for your kind words and for the link. I stumbled across that website in my searching, and I'm glad to hear that my initial favoraable impression of it was reasonably accurate. According to the food chart there, Prowl is low-ish in phosphorus (<1%), but not as low as something like KD (<0.5%).

It sounds like I need to get copies of his labwork and talk more with my vet to determine what the driving factor is right now. Fortunately, he will eat anything that's not nailed down so, for the time being, changing foods and keeping weight on are not issues.

[gnat23]

Sorry to hear about kitty.

One thing is that vet may prescribe subcutaneous hydration if things continue to get worse, and while it's SUPER EMOTIONAL to get the hang of (but I don't WANT to stab my cat!), it's honestly not that bad once you get used to it. Basically it's putting a slug of saline under the kitty's skin to help with hydration every few days.

Once I got confident with the injection (fwew), kitty and I used it as a time to snuggle and bond, so it eventually became a special time (and she got a treat after, so she started looking forward to it). It messed up some travel plans (can't just leave a big bowl of food and water out anymore, more difficult to find sitters), but it was worth it for me. In the end, it was her heart starting to go that I had to put her down for, not the kidneys; so just know that this diagnosis is unsettling, but it's NOT a death sentence, ok? *hug*

-- gnat!

[indysteel]

Indy: thanks for your kind words and for the link. I stumbled across that website in my searching, and I'm glad to hear that my initial favoraable impression of it was reasonably accurate. According to the food chart there, Prowl is low-ish in phosphorus (<1%), but not as low as something like KD (<0.5%).

It sounds like I need to get copies of his labwork and talk more with my vet to determine what the driving factor is right now. Fortunately, he will eat anything that's not nailed down so, for the time being, changing foods and keeping weight on are not issues.

Has your vet checked Auric's phosphorous levels? That would be super helpful information. How is he feeling these days? Is he vomiting a lot or suffer from any of the symptoms of excessive phosphorous?

This discussion had made me start thinking again about feeing our geriatric. I know that a lot of damage has likely already been done in that he had a dry food diet for much of his life--before his mother wised up. We really push hydration in our house. There are water dishes everywhere and he drinks more now than he used to. But as I mentioned, he turns his nose up at anything that isn't smelly, cheap canned food. I'd buy some Prowl, but honestly, I don't think he'd touch it. I have bloodwork done every year, and so far so good. But, goodness, I the thought of him with kidney disease. I really feel for anybody going through it with their kitties.

I do want to comment on something gnat said. No, kidney disease isn't necessarily an immediate death sentence, but one should not lose sight of the fact that it is chronic and incurable. I think it's important to keep that in mind when deciding how to treat it with any given cat. Quality of life issues and the stress that change, frequent visits to the vet, and the like can cause a cat should ideally be considered when trying to treat a chronic disease such as CKF. Some cats might handle it better than others, both emotionally and physically. I felt tremendous guilt when it came to my cat's death, but I had to keep in mind that there was only so much that could be done, even under the best of circumstances (which we didn't have).

I'm not trying to be a downer or suggest that Auric isn't long for this world; I'm just trying to encourage you to look at the big picture if and when quality of life issues start to become evident.

[Becky]

Gnat: Thanks for the feedback. I'm slowly reaching the realization that he's still my same cat, just with some added baggage, and I need to enjoy him while he's still with us. I just had to grieve a little and mentally get there. We're working to find a pet sitter since we both travel occasionally for both work and fun, so that will be new, but not insurmountable. We'll deal with the SubQ fluids if we need to...


Indy: I'm not sure about the phosphorous levels. I need to get copies of the labwork. He seems to be feeling like himself, full of p!ss and vinegar and our usual cuddly cat. No vomiting.

DH and I have already started thinking about the end of life issue. We'd both rather think about what defines Auric's quality of life now, while he's healthy, than confront it when he's very ill and it becomes a much more emotional issue for us. We're both planners that way. I realize that we have no way of knowing how long he has or what sort of decline he may have, and this discussion may be moot, but it helps me to feel a little more emotionally in control to plan for contigencies. I appreciate any and all feedback about quality of life issues.

Thanks, everyone, for talking me through this. Helps me process some of it...

[Norse]

My beloved Boo-Boo, black male cat, was diagnosed with kidney disease when he was 14. The vet emphasized at the time that while incurable, he may very well die of old age rather than the kidney disease. The diagnosis occurred long before I researched cat food and switched the cats to a raw food diet, so Boo-Boo never got that. I did put him on the vet-recommended Hills k/d formula, supplemented by occasional bits of tasty chicken and fish - which, of course, he just loved. Towards the end, we did have to start hydrating him with the i/v fluids, but it wasn't bad once we, and he, got used to it and it always perked him for a bit afterwards. When he started having trouble with his balance and walking and was less interested in food, we finally had to make that last, difficult decision - but Boo-Boo was then the ripe, old age of 19 and he lived a long, happy, loving life. Best wishes to you and your feline friend.

[indysteel]

That's a very encouraging story, Norse. Thank you so much for sharing. As someone with a 14-year old cat herself, I keep bracing myself with every round of bloodwork for a CKF diagnosis. It makes me feel better to know that you can potentially prolong a cat's life by years, rather than months, with supportive treatment. My poor Sophie went downhill so fast; I didn't even have time to process it.

[Norse]

Awww... (((Indy))).

[indysteel]

Awww... (((Indy))).

Thanks, Norse. It's been a few years now, so the worst of the pain has passed. I just want to do as right by my current (and future) cats as I can. It's hard to make good nutrition choices for them, especially when some vets are better than others at helping you navigate the options. It doesn't help that cats can be incredibly fickle and picky when it comes to food. For instance, Henry Cat will only eat about a tablespoon or two of wet food at any given time. So, we have to feed him multiple times of day to get enough of it into him. Even then, we have to sometimes bribe him with a treat to whet his appetite. I love him to pieces, but some days I want to scream. Last year, we cared for a stray that would gobble up whatever I put in front of her. Just once, I'd love to see Henry do that.