Back from the vet: Kidney Diet questions

Hi everyone,

My 22 month old cat Echo had some kidney problems earlier this week. We just got back from the vet. She responded to the treatment at the vet, and I'm with her now. She got her weight back up. We're putting her on a kidney diet. She also needs potassium intravenously given.

1) How quickly can I start feeding her the kidney diet food? Can I mix it with other food?

2) Are regular foods/treats/broth okay to give her? I want to see her eating again.

Lots of prayers, positive vibes, and hope if you guys can spare any. I'm confused about this diet,but I'm hopeful too.

From my experience with ckd cats you should just open a can of the renal diet and give it to them. If your cat has a history of stomach troubles mix the food together and gradually increase the new food and decrease the old over the course of a week or so.

With kidney cats you want to get them to eat and drink as much as possible. If you need to entice her to eat open a can of tuna or salmon and drain the juices onto the food.

As for the IV you might need two people especially if you are squeamish around needles or if your cat is fussy. One person can restrain the cat and the other manage the drip. Make sure to give her praise and a super special treat afterwards.

Thank you so much Indy. I'm going to try to do that now.The vet said to try and mix it with her traditional food, but I honestly don't know when to start.

I'm worried, but getting feedback like yours is a big help. Thanks again.

Thanks, my dad is going to help with the IV, but the vet just administered it, so I'm not going to do that tonight. Thanks for responding.

My Charlie is on kidney diet. For a smooth transition, it's best to introduce the new food slowly (over 2wks) by progressively mixing more and more of the new food in with her old food. Go ahead and start with the introduction now, there's no need to wait. Also, regular treats once in a while are fine, kidney specific diet treats are better, but there's no harm in feeding her a few regular treats a day. I agree with IndyJones's post about draining tuna or salmon juices on to the food. It'll give her extra fluid and make the food more appetizing.

Start half and half then decrease the old food over a week while increasing the new so if you give half new and half old today and she tolerates it then tomorrow try more new and less old.

This article might help

http://m.drsfostersmith.com/pic/article.cfm?aid=100

Abyeb, thanks. I'll have to keep a lookout for kidney-specific treats. I don't have any tuna in the house tonight, but she did eat a little of the kidney food. Should I run out and get some cans or do you think it can wait until the morning?

Indy, thanks for the article. I just put the food down and she did eat a little (and she peed for the first time since coming back from the vet a couple of hours ago).

Maybe I'm just being paranoid. I don't know. I just want her to have a great return. We really got scared for a while this week. I can't say I've been eating a lot myself.

Thanks for the help.

Im not a fan of kidney diet foods at all. For the most part unless your cat is at end stage kidney disease you can do better by either feeding one of the better quality low phos non-rx foods, like Weruva, which has a ton, or using a binder. Kidney diet foods are really terrible quality. Low protein, high carbs, and super over-priced. For a young cat, I think it's a bad choice for food. They really need high protein, you just need to control the phos levels. Here's a good list of phos levels in foods, so if you're interested you can pick out the ones that are low phos and try them out.

http://www.felinecrf.org/canned_food_usa.htm

The best treats for any cat, kidney or not, are 100% freeze dried meat only treats. Fresh is Best, Bravo, Orijen, Whole Life, Pure Bites, all make good ones without bone, so phos levels are fairly low. Remember, meat naturally contains phos, and cats as obligate carnivores need meat, so not all phos is bad, you just want to feed as much wet food as possible to maintain hydration, and try and control the phos levels with low phos foods or a binder. 

Missmimz, while you raise a good point about the low protein content in kidney diets, as Charlie's vet says, that is kind of the point of kidney diets. The kidneys process proteins, so the more proteins, the harder the kidneys have to work. For cats with kidney disease or compromised kidneys (my Charlie was born with only one functioning kidney), kidney diets can improve the length/ quality of life dramatically. So, TheBlackSwapper, basically, I'd follow what your vet reccommends.

Abyeb said:

Missmimz, while you raise a good point about the low protein content in kidney diets, as Charlie's vet says, that is kind of the point of kidney diets. The kidneys process proteins, so the more proteins, the harder the kidneys have to work. For cats with kidney disease or compromised kidneys (my Charlie was born with only one functioning kidney), kidney diets can improve the length/ quality of life dramatically. So, TheBlackSwapper, basically, I'd follow what your vet reccommends.

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Cats biologically require high protein, there is essentially no such thing as good low protein for cats. The goal with kidney cats is to control the phos, not to feed low protein, in fact feeding "low protein" to CKD cats is an outdated theory that more well educated vets on cat nutrition are moving away from. As i mentioned above, you can achieve nearly the same thing kidney diets do by feeding low phos foods or using a binder without compromising protein content, which is vital for both young cats with CKD as well as old cats. 

missmimz said:

Cats biologically require high protein, there is essentially no such thing as good low protein for cats. The goal with kidney cats is to control the phos, not to feed low protein, in fact feeding "low protein" to CKD cats is an outdated theory that more well educated vets on cat nutrition are moving away from. As i mentioned above, you can achieve nearly the same thing kidney diets do by feeding low phos foods or using a binder without compromising protein content, which is vital for both young cats with CKD as well as old cats. 

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Oh okay! I didn't know that. I was just quoting my vet on this topic, tbh. I'll check out these low pho foods for my cat. Thanks!!

Abyeb said:

Oh okay! I didn't know that. I was just quoting my vet on this topic, tbh. I'll check out these low pho foods for my cat. Thanks!!

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It's just something worth thinking about. I'm not necessarily saying your vet is wrong, or that anyone's vet is wrong, but it's always worth doing your own research to see if what your vet is recommending is the most up to date nutritional recommendations. My vet, for example, doesn't sell or recommend any RX foods. I am fairly active over in the CKD group on FB and it does seem like the vet's that are more up to date on nutritional guidelines are moving away from the RX foods and towards recommendations for low phos high protein commercial foods and/or using a binder to control phos levels without compromising those protein levels too much. 

I ran into a problem with Hector a few months ago when she was diagnosed with advanced ckd I had her on a special food because she was sensitive to a whole bunch of stuff chicken,corn,pork pretty much everything. She was put on Primal Pheasant which I would order in a case and store in a chest freezer in the shed (Extremely noisy).

So I was told since it was more important for Hector to eat a food she could keep down they kept her on the primal pheasant and gave her a phospherous binder and a medication called Semintra. The Semintra is a fairly new drug that reduces the protein in the urine . She did fairly well on these. Hector died of a heart condition just after new years

missmimz said:

Here's a good list of phos levels in foods, so if you're interested you can pick out the ones that are low phos and try them out.

http://www.felinecrf.org/canned_food_usa.htm

The best treats for any cat, kidney or not, are 100% freeze dried meat only treats. Fresh is Best, Bravo, Orijen, Whole Life, Pure Bites, all make good ones without bone, so phos levels are fairly low. Remember, meat naturally contains phos, and cats as obligate carnivores need meat, so not all phos is bad, you just want to feed as much wet food as possible to maintain hydration, and try and control the phos levels with low phos foods or a binder. 

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Thanks. We're doing okay on the wet food front so far, but this is a big help. I'll look into those treats too.

missmimz said:

It's just something worth thinking about. I'm not necessarily saying your vet is wrong, or that anyone's vet is wrong, but it's always worth doing your own research to see if what your vet is recommending is the most up to date nutritional recommendations. My vet, for example, doesn't sell or recommend any RX foods. I am fairly active over in the CKD group on FB and it does seem like the vet's that are more up to date on nutritional guidelines are moving away from the RX foods and towards recommendations for low phos high protein commercial foods and/or using a binder to control phos levels without compromising those protein levels too much. 

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Can you please explain what a binder is and how it works? I just checked out that chart. It seems very helpful with the low pos/high protein breakdown.

missmimz said:

It's just something worth thinking about. I'm not necessarily saying your vet is wrong, or that anyone's vet is wrong, but it's always worth doing your own research to see if what your vet is recommending is the most up to date nutritional recommendations. My vet, for example, doesn't sell or recommend any RX foods. I am fairly active over in the CKD group on FB and it does seem like the vet's that are more up to date on nutritional guidelines are moving away from the RX foods and towards recommendations for low phos high protein commercial foods and/or using a binder to control phos levels without compromising those protein levels too much. 

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I'm just asking here, but this is the time to start? Right now? This is the first close of the first full day she's been home, and the focus is just on getting her to eat.

Do the standard "segue/transition" rules and timelines apply?

This is a good explanation of phosphorus binders http://www.felinecrf.org/phosphorus_binders.htm   They work by binding to some of the phosphorus in the intestines so it is passed with stool.  The general website with that link is very good and has a lot of good info about kidney disease in cats.

TheBlackSwapper said:

I'm just asking here, but this is the time to start? Right now? This is the first close of the first full day she's been home, and the focus is just on getting her to eat.

Do the standard "segue/transition" rules and timelines apply?

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You might want to join this FB group. They can answer more specific questions about using a binder or whether or not it's necessary. You should also consult with your vet about whether or not a binder would be good for your kitty if you go off the RX food. Cats with early stage disease don't always need a binder they can do well on just low phos foods. Whether you decide to change the food is up to you. If she's doing well on RX food you might want to keep going that route, and if she gets bored or doesn't like the RX food you might want to try some other lower phos foods. 

https://www.facebook.com/groups/felinecrf/

Unfortunately with kidney disease it typically doesn't show up until it has progressed past early stages. They often have little if any signs during early stage which is why it isn't detected. In early stage the kidneys simply increase productivity in one side (the good kidney) to compensate for loss of functionality in the other (the failing kidney).

From what I understand, the kidneys are like a filter on a kitchen faucet, they filter the blood. As the filter becomes blocked by contaminants the kidneys clean themselves by putting the contaminates into the urine which is flushed out during urination.

With kidney disease, the kidneys can no longer flush themselves efficiently and the filter becomes clogged with contamination. By the time the kidneys reach about 70% efficiency we start to see changes in the blood and urine but we don't necessarily see signs.

At stage 4 which is considered fairly serious the kidneys are only operating at about 15%-10% efficiency we see symptoms start to show up and permanent damage has already been done.

This is why it's so difficult to pick up kidney disease early.