food for a cat with issues - constipation, urinary crystals, food sensitivites, asthma

Hello,

I've read many, many posts on this site and appreciate everyone generously sharing what they've learned regarding their cats. I have a young male cat (Tim) with many issues (and I wonder if they're all connected):

- constipation

- has had struvite crystals

- mild asthma

- possibly food sensitivities

He also has early HCM (hypertrophic cardiomyopathy).

Tim has been grain-free since he was a young cat. I don't remember when we went grain-free, but it was in the first year of his life. Tim will be 5 in July. Last June, due to a second bout of severe constipation that required several enemas to clear, we transitioned Tim and his sister Abby to a grain-free wet diet. Tim also started on 5mg of Cisapride once per day. His diet consisted of Wellness grain-free canned two times per day, with a supplemental treat of Tiki Cat or Weruva Cats in the Kitchen canned once per day.

Because struvite crystals recently appeared in his urine, we eliminated Wellness turkey/salmon and chicken/herring, along with Tiki Cat chicken/salmon and Weruva lamb (contains tuna). So his diet was Wellness chicken and turkey, along with Tiki Cat chicken and Weruva Cats in the Kitchen canned chicken. Thinking that increased moisture would also help, I started shifting both cats to more Tiki Cat and Weruva and less Wellness.

Then Tim started vomiting. At first we (and the vet) thought it was due to the antibiotic he was on in case of a urinary tract infection. We stopped that medication, but the vomiting resumed a week later and got much worse. Poor Tim has been poked and prodded by three different veterinarians - two at our regular place and one emergency vet - and he's been x-rayed and had multiple blood and urine tests. None of the tests show anything wrong.

I began to suspect a food sensitivity to chicken. Tim had had a minor bout of vomiting about a year ago, and the vet had mentioned that as a possibility with the suggestion that we try a "bland" diet. With that in mind, in preparation for Tim's return home from the vet, I purchased one can each of Natural Balance LID and Nature's Variety Instinct LID. Tim did well on each of these foods, though he did not care for them all. The one time I fed him a full meal of chicken, he vomited. I've not fed him chicken since, and he's not vomited since. So we are now on an elimination diet, with the knowledge of our vet, to remove all chicken and fish from his diet. I am also trying to remove carrageenan.

I am at my wit's end! In order to avoid chicken, fish, and carrageenan, both cats are now eating only Nature's Variety Instinct LID turkey and duck. They both really like and it, importantly, Tim keeps it down so far. But here is my concern: This is a higher-fiber food than Wellness (2% compared to 1% as fed) and also includes montmorillonite clay, which is generally thought to be good for IBS in cats, but can cause constipation in some. I've been monitoring the box, of course, and was lucky enough to catch both cats pass bowel movements this morning. Both were rather small and dry. I am not sure if this is because they're eating an even better-quality diet and have less waste (there is no odor!!), or if they're on the verge of constipation.

I am therefore concerned that Nature's Variety Instinct LID, which great for Tim's sensitive stomach, is going to cause his constipation to return. These are both very serious problems and I'm not sure what to do:

1) Keep them on this food, but add even more water to the food in an effort to get the cats to increase their intake? We are already adding a teaspoon per serving and stirring the food into a very thick soup.

2) Change food? Trying to find a canned cat food without chicken and/or fish is really difficult. My preference is to limit the protein to a single source and the carbohydrate, if any, to a single source to aid digestion. And to avoid foods with carrageenan.

3) Continue with this food and rotate with another brand? Is anyone familiar with Wild Calling? I was considering alternating Nature's Variety Instinct LID with just a few flavors of the Wild Calling in order to reduce the overall fiber/carbohydrate load, as well as reduce the amount of montmorillonite clay without eliminating it altogether unless we must.

Is anyone aware of any other limited ingredient or single protein canned foods for cats? At this point, I would even consider a food with two protein sources, as long as they're not chicken or fish, especially if low fiber/carb. Please don't recommend raw, as I'm not ready to go there yet. I want to make sure Tim's insides are healed before I consider that.

Thank you!

So sorry you and Tim are going through this. I don't have a lot of advice but I do feed my cat the Wild Calling Turkey and she does well on it. She won't eat any of the other flavors in fact she will only eat Turkey in any brand of canned food.

I have to make my cats canned food into a soupy mess because she suffers from constipation. I also add Miralax to her food twice a day. I don't know much about the different foods but if he is doing well on the ones he's eating maybe you could try adding Miralax and a little more water. I didn't have good luck with the Tiki cat food either, my cat threw up the 2 times I tried feeding it to her a few years ago. I also know how hard it is to find canned food without chicken and fish. My cat does not like chicken and is allergic to fish. She can't even have food that has fish oils in it. Right now she is only eating Wild Calling Turkey, Blue Wilderness Turkey and sometimes I can get her to eat the Wellness Turkey.

Sorry I am not much help.

I really think Tim would be an ideal candidate for raw. Why don't you think it would be a good option for him?

Is home-cooked an option?

Thank you all for your quick replies!

Snugglecat: Glad to hear your cat is doing well on Wild Calling turkey! It could be that mixing up brands but feeding the same protein at a given meal will help. I fed a little Wild Calling duck to Tim tonight before his Nature's Variety Instinct duck. He cautiously approached the bowl then ate it all. I also added a bit more water to the NVI, and both cats still gobbled it. Abby had a very nice bowel movement this evening - a definite "2".

Sugarcatmom: I am a little worried about raw right now due to the ground-up bones and Tim's problem with constipation. I am also a little worried about slightly higher bacterial risk associated with raw, especially as I don't know what is causing Tim's problems. I'm trying diet before more invasive tests and such, but I haven't ruled out the possibility that he has a more serious problem and his immune system is weakened. If I was more certain it was truly just a food sensitivity, I'd do it. But I don't want to risk it yet.

Peaches08: Homemade has crossed my mind, both cooked and raw. Truthfully, though, I'm scared to try that right now. Part of my fear may be fatigue with all the food trials and noting, realistically, that I have a hard enough time preparing food for myself and my husband. But that is something I have definitely considered and may have to go that route.

As I mentioned to Snugglecat, my female Abby had a perfect bowl movement this evening. Of course, she's not the one I'm worried about. I recognize that part of the issue with the smaller, drier poops (between "1" and "2") may be simply a change in diet (it's been less than 2 weeks since this rather abrupt change) and maybe I just need to monitor the box very closely and make sure to add plenty of water for another week or so before making any other changes. I plan to do this elimination diet for 7-8 weeks, then hope I can successfully add chicken back, which has many more options.

I'm not trying to bully you into raw or home-cooked, but I do want to mention a few things. We have members here that dealt with immune issues such as FIV, chemotherapy, and etc that fed raw with no problems. Also, premixes or commercial raw might be a thought. Some are even treated for bacteria.

I hope you find some answers.

peaches08 said:

I'm not trying to bully you into raw or home-cooked, but I do want to mention a few things. We have members here that dealt with immune issues such as FIV, chemotherapy, and etc that fed raw with no problems. Also, premixes or commercial raw might be a thought. Some are even treated for bacteria.

I hope you find some answers.

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 I don’t know if this will help, but I just wanted to say that Kimmi had IBD and severe constipation as well as struvite crystals, and homemade raw food was a lifesaving miracle. I still feed her raw today and she has not had any immune health issues since.

I completely understand why you may not want to try it out. Transitioning to raw is a big plunge, and you may have to try many different combinations and recipes before you find the perfect fit.

Best wishes for you and your kitty and I’m sorry you’re going through all this.    

Thank you, Peaches08. I know you're not trying to bully. And that's why I presented Tim's problem here - I know I haven't possibly considered every angle of his complicated situation and am hoping someone can share what worked (and didn't work) for them. Truthfully, I am going back and forth on raw - my husband thinks I'm crazy because one day I want to try raw, then the next I don't.  Between researching food and analyzing poop, he thinks I'm obsessed. I am continuing to read of others' experiences, including in the raw and home cooked forum, and hope to find something new to consider.

Thank you, Kimmi's mom. This is really good to hear - thanks for sharing!

I ran across a raw food called Rad Cat. This food is formulated with egg shells instead of bone, which may be more suitable for kitties prone to constipation such as Tim. A store not too farm from my home carries it, so I may try some this coming weekend (I want to be home to see how he does). I'm considering small containers of both the turkey and lamb. Once we get through this elimination diet, I'll try rotating chicken on occasion and see how he does.

I also ordered a bunch of single cans from a holistic pet store based out of Minnesota. It seemed like a better deal to pay the $7 shipping instead of drive all over Southern California to a bunch of stores. We're trying Hounds & Gatos varieties without chicken or fish, Pure Vita varieties without chicken, and Nature's Logic rabbit. I also purchased one each of Weruva Cats in the Kitchen canned turkey/chicken and beef/chicken to try when our elimination diet is done - I haven't been able to find those flavors locally.

Tim had a very nice bowel movement this morning - a "2". He is going every 24-36 hours and some are smaller than others; yesterday's was small, but Saturday and today were perfect. Maybe I'm worrying too much. I am going to stick with the Nature's Variety Instinct LID for now, while adding other brands of the same protein at a given meal. Today I am simmering a half turkey breast on the bone in filtered water (and nothing else) to make a yummy broth to mix in with the food - I think the bone broth will be helpful.

Thank you all for your input, you've given me much to consider and I am happy with my tentative plan.

I am dealing with a cat with Mega Colon so she suffers from chronic constipation.  I have her on 1/4 teaspoon Miralax, had her on a low fiber diet (under 1.5%) prior to making the switch to raw, she has been on raw for a little over a week, and is having regular BM's that are healthy.  I have a dog who suffered from chronic cystitis and crystals in her urine she was switched to a raw diet 3 & 1/2 years ago and no more crystals in her urine, it was honestly the best thing I have ever done for her.

Hi AbbyNTim

Just wanted to give you encouragement.  It's certainly a long, difficult and tiring road - I've dealt with food sensitivities in cats and humans, in fact, last year I was making four different meals for the four residents of this house (2 humans, 2 cats!)

Keep going.  There will always be more options to try, I promise.

You're also very fortunate to be in the US, as you have the choice of many commercial foods.  One thing to file away in the memory to consider if you need to (who knows, this formula you're on might be the winner?!), is that the food sensitivity may not be a meat protein.  It could be an additive.  I don't know American laws, but here there is no law requiring EVERY ingredient to be listed in pet food.  So if that is a suspicion, then changing cans til you exhaust every one is one route (hit and miss), or homemade is the other route (you will know exactly).  For this reason, I went raw - it allowed me to build a number of different proteins into the diet, plus it provided the healing time needed for my Ava's gut; she can now tolerate a little of the canned food that formerly made her ill...so now they get a small ration of canned as well (because they love it!)  I guess I just wanted to say, that if you do get to the point of needing to do raw, don't worry that it won't be 'healing' - it is the very opposite.  (And if you do go home-made, then there are recipes that allow you to do egg-shell as the calcium source instead of bone)

My best wishes!  I hope this current 'formula' you are on is the winner!!  Sending you lots of energy and patience.

Quick update on Tim. First and foremost, he's had a bowel movement every day. Most days, they're moist and smooth. On occasion, kinda small. But I am chalking that up to variety (see paragraph #3). I've seen him in the box most days and I feel confident he is not currently constipated or on his way. Second, no barf in over two weeks. This is a new record. Third, no coughing. Finally, decent size urine balls in the box. So all is going well.

We are feeding mostly Nature's Variety Instinct LID turkey and duck. Thank goodness he is tolerating other poultry! I am going to add the lamb to his rotation, as well. I am blending homemade bone broth into the food to increase the moisture level. I also pick out the whole peas before I serve the food to lower the fiber and carbohydrate load.

I tried feeding both cats Wild Calling duck. Abby sniffed and walked away. Tim ate it under protest (he does not like to miss a meal). The next day, both refused. Last week I ran across a canned brand called Party Animal. The ingredients look pretty good, appears to be single protein and a good variety of flavors, and no carrageenan. I started mixing the PA duck with the NVI LID duck, and the PA turkey with the NVI LID turkey. Both cats started pooping more. And Tim started acting "needy" the yesterday.  So I'm taking Tim off the PA for now. I wonder if the mix of fruits and veggies in that food is just too much for him right now.

The other foods I ordered are due for delivery Monday. We'll see what happens. Additionally, I purchased Rad Cat raw turkey and lamb today. It is going to take longer to thaw than I thought, so we'll try raw next weekend, perhaps. I want to be around for their first experience with raw (I don't know why I'm so nervous; we feed Tim raw beef scraps every time we make beef stew and he never has a problem).

Thanks for your advice and support!

It it isn't one thing with Tim, it's another.

First, he is doing very well with the issues I described in this original post. He is having very nice bowel movements approximately every 24 hours. They are well-formed and not too large. He's urinating several times a day, golf-ball size clumps. He has not vomited. We have not heard him sneeze or cough. He was belching when I was mixing brands of food, but that stopped once I stopped mixing brands.

After a few rough starts with mixing other brands of foods, and a particularly bad experience with H&G lamb, I decided to stick with a single brand for now. Once Tim has gone for a longer period of time with no issues, I'll try mixing brands again. Right now, he's eating Nature's Variety Instinct LID canned food. He eats turkey each morning, to which I add homemade turkey bone broth and top with some shredded turkey meat. At dinner, he had been eating duck with a little water mixed in. This week, we added lamb to the rotation for dinner only. So turkey for breakfast, alternating duck and lamb for dinner.

Sometime this week, I thought his lower lip looked a little odd. Upon closer inspection today, both my husband and I agree his lower lip/chin area is swollen. Great. I looked and cannot see any obvious problems, though I did notice two small bumps about 5mm apart. His appetite is good, his behavior seems normal, and he plays and romps around the house. So right now I am suspecting a swat from Abby (the female, they play rough at times), a bug bite (we have bugs all year), or maybe even "feline acne". If the swelling doesn't go down in a day or so, or if he loses his appetite or has any other behavioral oddities, back to the vet we go.

I am disappointed because otherwise he is doing so well! Hopefully this is something minor and will clear on its own.

AbbyNTim said:

 
It it isn't one thing with Tim, it's another.

First, he is doing very well with the issues I described in this original post. He is having very nice bowel movements approximately every 24 hours. They are well-formed and not too large. He's urinating several times a day, golf-ball size clumps. He has not vomited. We have not heard him sneeze or cough. He was belching when I was mixing brands of food, but that stopped once I stopped mixing brands.

After a few rough starts with mixing other brands of foods, and a particularly bad experience with H&G lamb, I decided to stick with a single brand for now. Once Tim has gone for a longer period of time with no issues, I'll try mixing brands again. Right now, he's eating Nature's Variety Instinct LID canned food. He eats turkey each morning, to which I add homemade turkey bone broth and top with some shredded turkey meat. At dinner, he had been eating duck with a little water mixed in. This week, we added lamb to the rotation for dinner only. So turkey for breakfast, alternating duck and lamb for dinner.

Sometime this week, I thought his lower lip looked a little odd. Upon closer inspection today, both my husband and I agree his lower lip/chin area is swollen. Great. I looked and cannot see any obvious problems, though I did notice two small bumps about 5mm apart. His appetite is good, his behavior seems normal, and he plays and romps around the house. So right now I am suspecting a swat from Abby (the female, they play rough at times), a bug bite (we have bugs all year), or maybe even "feline acne". If the swelling doesn't go down in a day or so, or if he loses his appetite or has any other behavioral oddities, back to the vet we go.

I am disappointed because otherwise he is doing so well! Hopefully this is something minor and will clear on its own.

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Sounds like Tim is doing very well especially in the BM department! ... Yes, I think it is good to try and stick to one brand (especially) at a time as I have found that there can be significant changes and quantities in the ingredients and supplement content from brand to brand that can be upsetting in itself, so I tend to stick to one (or two) brands if I know that the ingredients and makeup are similar.

The Nature's Variety turkey with extra turkey meat and broth sounds yummy, and the rotation of the duck and lamb is very sensible.

The swollen lower lip could be from a scratch, but also sounds like it might be a reaction to something in the food OR environment. Max gets these from to time, even though I use zero plastic and use fresh plates for every meal. Besides the need to not use plastic, newer studies suggest that bacterial buildup on food (including dry food) and water dishes can pose a problem. Hope this clears up soon. I'd be interested to learn what transpires here.

EDIT: You mentioned in your first post that Tim has mild asthma. Has this been confirmed and is he still having incidents? I ask as I thought Max might be developing this but have since determined that it is more likely that he has a sensitivity to hair. He has never thrown a hairball to my knowledge, and certainly not in my presence, and has never experienced a blockage as the result, but he will hack now and then which looks a lot like asthma, but not produce anything that would confirm hairball.

oneandahalfcats said:

 
Sounds like Tim is doing very well especially in the BM department!

... Yes, I think it is good to try and stick to one brand (especially) at a time as I have found that there can be significant changes and quantities in the ingredients and supplement content from brand to brand that can be upsetting in itself, so I tend to stick to one (or two) brands if I know that the ingredients and makeup are similar.

The Nature's Variety turkey with extra turkey meat and broth sounds yummy, and the rotation of the duck and lamb is very sensible.

The swollen lower lip could be from a scratch, but also sounds like it might be a reaction to something in the food OR environment. Max gets these from to time, even though I use zero plastic and use fresh plates for every meal. Besides the need to not use plastic, newer studies suggest that bacterial buildup on food (including dry food) and water dishes can pose a problem. Hope this clears up soon. I'd be interested to learn what transpires here.

EDIT: You mentioned in your first post that Tim has mild asthma. Has this been confirmed and is he still having incidents? I ask as I thought Max might be developing this but have since determined that it is more likely that he has a sensitivity to hair. He has never thrown a hairball to my knowledge, and certainly not in my presence, and has never experienced a blockage as the result, but he will hack now and then which looks a lot like asthma, but not produce anything that would confirm hairball.

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Tim's chin looks a little less swollen and bulbous this morning, though his lower lip is still swollen. We put a warm compress on it last night and will do so again this morning when he settles down. I don't know if it helped and don't think it will hurt. I really don't want to pack him off to the vet again if I don't have to, so I hope it's something fairly simple like a scratch or bug bite. His appetite is good and he's been romping around the house and "hunting" through the windows.

Allergy and/or environmental irritant has crossed my mind. Abby and Tim have been eating out of wide, shallow ceramic bowls. I recently purchased stainless steel in preparation for introducing raw and fed out of those last night. They seldom drink water, as they are 100% canned, but they have a stainless steel water bowl and two plastic water fountains (when one dies, will replace with stainless steel; maybe sooner). We recently raised their food bowls off the floor using upside-down plastic dog bowls, but the cats don't have any significant contact with these bowls, they are just platforms for the cat bowls. Our house is a little dustier and dirtier than usual due to being very busy with work and dealing with Tim's issues; we need to clean. It also occurs to me that it could be the lamb food, as I just introduced lamb this week and the swelling occurred this week. We are going to temporarily stop the lamb until his lip is back to normal, then re-introduce and see what happens.

Regarding asthma, this is something the vet mentioned in passing when Tim was having barfing problems. She mentioned his x-rays showed very minor constriction in the airways and thought that perhaps some rogue cells had gotten into his stomach and caused the irritation. Tim is a cat who used to toss hairballs pretty frequently (he hasn't had one in several weeks now). He also used to cough fairly regularly like he had a hairball, but nothing came out. The vet indicated this behavior is consistent with mild asthma and she prescribed a low dose of medication for Tim. Tim reacted very badly to the medication and, because his asthma is so mild, we took him off. Interestingly, he's not coughed or sneezed since we changed his food. Makes me think all this stuff is related and an inflammatory response (to what, I am trying to figure out). The next time Tim goes to the vet, which I am hoping will be in June for his yearly exam, we will do another x-ray to see if the asthma is still there.

If Max were my cat, I would keep an eye on him and monitor the coughing. If the coughing continues, might want to get an x-ray just to see. Tim was coughing when he was so terribly constipated; he was so impacted that it was putting pressure on other organs and caused fluid in his lungs. Also, coughing can be a sign of heart problems, so it's not something to take lightly (in fact, when Tim had his last terrible constipation episode, the emergency vet thought he was in heart failure due to the fluid in his lungs; thankfully, after an enema and supportive treatment, the fluid cleared). But hopefully it's just due to hair sensitivity or some mild environmental irritant.

AbbyNTim said:

 
Tim's chin looks a little less swollen and bulbous this morning, though his lower lip is still swollen. We put a warm compress on it last night and will do so again this morning when he settles down. I don't know if it helped and don't think it will hurt. I really don't want to pack him off to the vet again if I don't have to, so I hope it's something fairly simple like a scratch or bug bite. His appetite is good and he's been romping around the house and "hunting" through the windows.

Allergy and/or environmental irritant has crossed my mind. Abby and Tim have been eating out of wide, shallow ceramic bowls. I recently purchased stainless steel in preparation for introducing raw and fed out of those last night. They seldom drink water, as they are 100% canned, but they have a stainless steel water bowl and two plastic water fountains (when one dies, will replace with stainless steel; maybe sooner). We recently raised their food bowls off the floor using upside-down plastic dog bowls, but the cats don't have any significant contact with these bowls, they are just platforms for the cat bowls. Our house is a little dustier and dirtier than usual due to being very busy with work and dealing with Tim's issues; we need to clean. It also occurs to me that it could be the lamb food, as I just introduced lamb this week and the swelling occurred this week. We are going to temporarily stop the lamb until his lip is back to normal, then re-introduce and see what happens.

Regarding asthma, this is something the vet mentioned in passing when Tim was having barfing problems. She mentioned his x-rays showed very minor constriction in the airways and thought that perhaps some rogue cells had gotten into his stomach and caused the irritation. Tim is a cat who used to toss hairballs pretty frequently (he hasn't had one in several weeks now). He also used to cough fairly regularly like he had a hairball, but nothing came out. The vet indicated this behavior is consistent with mild asthma and she prescribed a low dose of medication for Tim. Tim reacted very badly to the medication and, because his asthma is so mild, we took him off. Interestingly, he's not coughed or sneezed since we changed his food. Makes me think all this stuff is related and an inflammatory response (to what, I am trying to figure out). The next time Tim goes to the vet, which I am hoping will be in June for his yearly exam, we will do another x-ray to see if the asthma is still there.

If Max were my cat, I would keep an eye on him and monitor the coughing. If the coughing continues, might want to get an x-ray just to see. Tim was coughing when he was so terribly constipated; he was so impacted that it was putting pressure on other organs and caused fluid in his lungs. Also, coughing can be a sign of heart problems, so it's not something to take lightly (in fact, when Tim had his last terrible constipation episode, the emergency vet thought he was in heart failure due to the fluid in his lungs; thankfully, after an enema and supportive treatment, the fluid cleared). But hopefully it's just due to hair sensitivity or some mild environmental irritant.

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Good! Warm compresses are what I do as well in response to inflammation caused by reactions, bites, etc. A little salt in the water doesn't hurt either. I had read something about stainless being a potential issue if the cat gets a shot from stainless bowls? Other than this, stainless is good as a food/water bowl. I purchased a fountain around Xmas and all cats are using it.

Re. Max, oh yes I certainly do keep an eye .. In fact we were at the vets just yesterday which is our second hacking-related visit, among others things. His heart, breathing and stomach were all checked. My holistic vet maintains that she thinks its hair, and suggests that for it to be asthma that there would be constant breathing problems, increased breathing rhythm, etc. We were going to do an x-ray but I am going to try a couple of other things first as I dislike putting him through these procedures - he's not fond of being probed or x-rayed.  

As I wrote in response to another poster, I am modifying Tim's diet on my own. My vet knows, but is not providing much guidance or support. They've mentioned "novel protein" foods a few times, but in the context of prescription diet foods, which, considering the ingredients, I would rather stay away from. As such, I feel alone in this effort and am very grateful for the support and guidance I've found here.

Because Tim has so many issues, many of which I believe are connected, I had been wanting to take him to a holistic vet for another opinion. We had our appointment yesterday and I am relieved that she believes we are on the right track. We're going to make some minor changes with a follow-up in six months, unless something comes up. But she thinks Tim looks great considering his history and is generally a healthy cat. Following are our minor tweaks.

1. Upon a thorough physical exam, the vet noticed some white flakes in his fur, which suggest to her that he is not properly absorbing his nutrients. We started Proviable-DC probiotics today to help with his digestion and nutrient absorption.

2. The vet did not notice any abrasions associated with Tim's swollen lip and chin. No dental issues, teeth and gums look good even though he has some plaque. The swelling has gone down considerably since the weekend and the vet is speculating allergy of some kind, possibly food or even environmental. We'll see if it happens again and go from there.

3. We are going to wean him off the Cisapride. He had been taking one 5 mg capsule per day for his constipation. The Proviable-DC should also help with this process. I am a little nervous, but at the same time I think his constipation was due to lack of moisture in his food and not anything physical with him. I'd been wanting to get him off this medication, so it's nice to have support.

4. Because Tim is on a 100% wet food diet, this vet is not terribly concerned with a trace amount of crystals in a single urinalysis. In fact, a subsequent urinalysis showed nothing so I wonder if the one that did was a false positive. I just need to continue to monitor the litter box.

5. For now, we are sticking with the NVI LID duck and turkey, as he's doing well. We are going to stay away from the lamb, it may have been too rich for him. She suggested we try rabbit to add some variety. She agrees it would be good to try some other brands if he can tolerate them, but do it slowly so I can see how he reacts. And give each new food a couple of days. I took all the foods I am considering to our appointment and she reviewed the ingredients and nutritional analyses, advising me to stay away from foods that are more fat than protein and/or high carb.

6. Once Tim is off the Cisapride, then she wants us to add raw to his diet. She thinks he is a perfect candidate and does not see any concerns or downsides. We had a nice conversation about how to transition him and things I need to watch out for at first. I am feeling much more comfortable with the idea of this now. I thought those of you that suggested this (Sugarcatmom, peaches08, KimmisMom, cprcheetah, and tammyp) would appreciate knowing this.

7. Regarding the asthma, we never had a confirmed definite diagnosis. Only suspected due to some minor constriction in his airways in his last x-rays coupled with very frequent coughing. He's not coughed since I changed his diet. We will follow up with more x-rays to see how his airways look. But will combine that with the procedure in the next item to reduce stress on Tim.

8. Regarding his mild HCM, we will do another cardiac ultrasound in June to see how it looks. They saw a very minor thickening of the heart wall last year and we are going to keep an eye on this. Last year, our vet believed it was minor enough that medication was not needed and I hope it continues to be minor.

9. Tim is a little on the heavy side. He's a big boy and close to 15 pounds. The vet would like to see him drop a pound or two, so I'll gradually reduce his food. She believes weight loss will also help him cope better with asthma, if he does indeed have it, and HCM.

Wow, this is longer than I intended. But wanted to provide an update and again thank everyone for guidance and support. I'll continue to update Tim's progress with the added probiotics, getting him off Cisapride, experimenting with canned foods, and adding raw.

Fantastic!!  That's wonderful - what you are doing, and also being able to find such a good holistic vet!

Good news, and well done - I know it is a lot of effort, research, concern, hope etc in dealing with food issues.  Best wishes for Tim!

AbbyNTim said:

 
As I wrote in response to another poster, I am modifying Tim's diet on my own. My vet knows, but is not providing much guidance or support. They've mentioned "novel protein" foods a few times, but in the context of prescription diet foods, which, considering the ingredients, I would rather stay away from. As such, I feel alone in this effort and am very grateful for the support and guidance I've found here.

Because Tim has so many issues, many of which I believe are connected, I had been wanting to take him to a holistic vet for another opinion. We had our appointment yesterday and I am relieved that she believes we are on the right track. We're going to make some minor changes with a follow-up in six months, unless something comes up. But she thinks Tim looks great considering his history and is generally a healthy cat. Following are our minor tweaks.

1. Upon a thorough physical exam, the vet noticed some white flakes in his fur, which suggest to her that he is not properly absorbing his nutrients. We started Proviable-DC probiotics today to help with his digestion and nutrient absorption.

2. The vet did not notice any abrasions associated with Tim's swollen lip and chin. No dental issues, teeth and gums look good even though he has some plaque. The swelling has gone down considerably since the weekend and the vet is speculating allergy of some kind, possibly food or even environmental. We'll see if it happens again and go from there.

3. We are going to wean him off the Cisapride. He had been taking one 5 mg capsule per day for his constipation. The Proviable-DC should also help with this process. I am a little nervous, but at the same time I think his constipation was due to lack of moisture in his food and not anything physical with him. I'd been wanting to get him off this medication, so it's nice to have support.

4. Because Tim is on a 100% wet food diet, this vet is not terribly concerned with a trace amount of crystals in a single urinalysis. In fact, a subsequent urinalysis showed nothing so I wonder if the one that did was a false positive. I just need to continue to monitor the litter box.

5. For now, we are sticking with the NVI LID duck and turkey, as he's doing well. We are going to stay away from the lamb, it may have been too rich for him. She suggested we try rabbit to add some variety. She agrees it would be good to try some other brands if he can tolerate them, but do it slowly so I can see how he reacts. And give each new food a couple of days. I took all the foods I am considering to our appointment and she reviewed the ingredients and nutritional analyses, advising me to stay away from foods that are more fat than protein and/or high carb.

6. Once Tim is off the Cisapride, then she wants us to add raw to his diet. She thinks he is a perfect candidate and does not see any concerns or downsides. We had a nice conversation about how to transition him and things I need to watch out for at first. I am feeling much more comfortable with the idea of this now. I thought those of you that suggested this (Sugarcatmom, peaches08, KimmisMom, cprcheetah, and tammyp) would appreciate knowing this.

7. Regarding the asthma, we never had a confirmed definite diagnosis. Only suspected due to some minor constriction in his airways in his last x-rays coupled with very frequent coughing. He's not coughed since I changed his diet. We will follow up with more x-rays to see how his airways look. But will combine that with the procedure in the next item to reduce stress on Tim.

8. Regarding his mild HCM, we will do another cardiac ultrasound in June to see how it looks. They saw a very minor thickening of the heart wall last year and we are going to keep an eye on this. Last year, our vet believed it was minor enough that medication was not needed and I hope it continues to be minor.

9. Tim is a little on the heavy side. He's a big boy and close to 15 pounds. The vet would like to see him drop a pound or two, so I'll gradually reduce his food. She believes weight loss will also help him cope better with asthma, if he does indeed have it, and HCM.

Wow, this is longer than I intended. But wanted to provide an update and again thank everyone for guidance and support. I'll continue to update Tim's progress with the added probiotics, getting him off Cisapride, experimenting with canned foods, and adding raw.

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This is a good update with some positive news. Sounds like you found a good resource in the holistic vet. I am very happy with mine, and particularly that I can speak freely and comfortably about employing natural solutions rather than relying on conventional medicines. Of course, conventional medicine is not off the table, but if we can fix something naturally, its so much better for the system in the long run.