Kidney disease & diabetes

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mislissa777

Member Since 2010
Hello,
I've been doing hours of reading about kidney disease & am very confused & overwhelmed. My Trina has been diabetic for 9 years & is very well regulated. We had bloodwork done today & my vet said her BUN is 40 & CRE is 3. Trina eats Nutro Natural Choice soft loaf canned food only. This is the info. I received from Nutro about the food.
Soft Loaf Turkey
Carbs = 0%
Approx. 1.12% Dry Matter Phosphorous
Approx. 3.20g/1000kcal (0.32g/100kcal) of Phosphorous
111 kcals/100g (1.11 kcals/g) of Product
My vet wants me to transition to a prescription diet. I looked at food charts & they are very high in carbs, 35%. She is eating 0% carbs now. I'm confused on what exactly in a prescription food is supposed to lower the CRE & BUN. Is it the low phosphorus levels? If so, I think the Nutro food she is eating now is low phos. Isn't the dry matter supposed to be under 2%? I could be totally wrong. I'm reading so much that I can't really take in anything else right now & I'm getting confused. I just don't understand what I'm suppose to do. I'd like to switch her to another food ASAP if it will bring those numbers down but I don't know which food. I was also wondering if the Friskies special diet that says it's low phos. would make a difference. But if the food I'm feeding her now is low phos. then would a food change even make a difference? Or maybe the Nutro I'm feeding her now is not low phos. I don't know!!! Please give any guidance & suggestions. I'm so upset about this. I work so hard to get her glucose regulated & I'm scared to death to make a food change. I'm also researching the CRF groups, Tanya's & yahoo & I'll post there as well. But I was wondering what some of you may be feeding your CRF & diabetes babies.
Thank you,
Missy
 
High phosphorus, in food or level in the blood, accelerates the damage to the kidneys. Yes the phosphorus in the Nutro is higher than what kidney cats should eat unless you are using a binder, we typically like to keep the phosphorus under 1% if at all possible. Most cats don't like the renal foods so the general rule to follow is: what ever the cat will eat.

Now with that said, please do join us on yahoo: https://groups.yahoo.com/neo/groups/Feline-CRF-Support/info
And bookmark Tanya's site; it is invaluable.

As for food, you can continue to feed the Nutro or checkout the food list: http://www.felinecrf.org/canned_food_usa.htm. food tip-------the lower the phosphorus the higher the carbs. It is very important to know what the serum phosphorus level is to determine if you need to add phosphorus binder to the food.

One thing before you post to any of the renal groups, get a copy of all labs. In addition to BUN and Creatinine, there are a lot of other blood values that we watch to monitor the over all condition of the cat. Things like White and red blood cells to monitor for anemia, Potassium levels, phosphorus levels, calcium, and blood pressure is another test you need to add to your list as well as periodic urinalysis and cultures as kidney cats can suffer from frequent infections.

Your cat, based on the Creatinine of 3, appears to be in stage 3. Did your vet say anything about dehydration? A cat in Stage 3 is typically on at home sub-q fluids.

I will look forward to your post in the renal group and would really like to see the lab results.
 
Thanks Anita! I won't get a copy of the labs until next week but I don't think a full panel was done to include all of those things. The vet did not mention fluids at home. Trina's appetite has decreased some. I give her a thyroid & allergy pill daily & today was the first time she didn't gobble them in her treats. The past few days she has ate less than usual. I'm so confused as to what to do because if I continue with Nutro her kidney levels are not going to lower. My vet want me back in 3 weeks & expects her to be on prescription only food then. This is terrible when you 2nd guess what your vet is telling you to do but I'm hesitant to switch to prescription. I cannot imagine what that will do to her glucose.
 
mislissa777 said:
Thanks Anita! I won't get a copy of the labs until next week but I don't think a full panel was done to include all of those things. The vet did not mention fluids at home. Trina's appetite has decreased some. I give her a thyroid & allergy pill daily & today was the first time she didn't gobble them in her treats. The past few days she has ate less than usual. I'm so confused as to what to do because if I continue with Nutro her kidney levels are not going to lower. My vet want me back in 3 weeks & expects her to be on prescription only food then. This is terrible when you 2nd guess what your vet is telling you to do but I'm hesitant to switch to prescription. I cannot imagine what that will do to her glucose.
Click to expand...

Squeaker is Stage 4 CRF and a diet controlled diabetic (initially was on 3 units Lantus BID) the Nutro, in and of itself will not increase kidney values-----again the issue is phosphorus. You can feed any food as long as you control the amount of phosphorus absorbed by the system. It is more important to keep the diabetes managed so that appropriate treatment to "manage" the kidney disease can be implemented as it cannot be cured, you can slow the progression through proper management. I personally would not use Rx food, it is lower protein and can lead to loss of muscle mass which complicates everything.

I deal with diabetes, euthyroid sickness, CRF, and RCM daily so I can say I have a pretty good understanding of juggling multiple conditions.

As for appetite, here are a few tricks I use for Squeaker. I just run down the list till something works.

Liquefy the food in a blender with added water (for a 5 oz can I add 2 oz water---great way to get extra fluid for the kidneys)
Chill the food
Warm the food
Add tuna water
Sprinkle with a little grated parmesan cheese
If none of that works, add chicken baby food (I use Beech Nut Stage 1 Chicken-no carbs, low phosphorus) or you can feed just the baby food meat to spark the appetite.

Weruva brand foods are also good. They are low carb and four varieties are fairly low in phosphorus-Steak Frites, On The Cat Wok, Paw Lickin Chicken, and Peking Ducken. You can widen your food options a little but it takes a lot of work.
 
You might use distilled water, which has no dissolved minerals in it the way tap and spring water do. Just one less thing for the kidneys to filter.
 
Anitafrnhamer said:
Squeaker is Stage 4 CRF and a diet controlled diabetic (initially was on 3 units Lantus BID) the Nutro, in and of itself will not increase kidney values-----again the issue is phosphorus. You can feed any food as long as you control the amount of phosphorus absorbed by the system. It is more important to keep the diabetes managed so that appropriate treatment to "manage" the kidney disease can be implemented as it cannot be cured, you can slow the progression through proper management. I personally would not use Rx food, it is lower protein and can lead to loss of muscle mass which complicates everything.

I deal with diabetes, euthyroid sickness, CRF, and RCM daily so I can say I have a pretty good understanding of juggling multiple conditions.

As for appetite, here are a few tricks I use for Squeaker. I just run down the list till something works.

Liquefy the food in a blender with added water (for a 5 oz can I add 2 oz water---great way to get extra fluid for the kidneys)
Chill the food
Warm the food
Add tuna water
Sprinkle with a little grated parmesan cheese
If none of that works, add chicken baby food (I use Beech Nut Stage 1 Chicken-no carbs, low phosphorus) or you can feed just the baby food meat to spark the appetite.

Weruva brand foods are also good. They are low carb and four varieties are fairly low in phosphorus-Steak Frites, On The Cat Wok, Paw Lickin Chicken, and Peking Ducken. You can widen your food options a little but it takes a lot of work.
Click to expand...

Anita, Thank you so much for all of this info.!!!! Just want to be sure I understand correctly. I do want to stop feeding the Nutro though, right? What do you mean by I can feed any food but need to control the amount of phosphorus? Would that entail using a binder? (I don't even understand what that is yet but I've read it in a few posts.) I wonder why my vet wouldn't suggest using a binder if that's what your referring to. I actually went to Petco & Petsmart today looking for Weruva & they don't carry it. I was desperate this morning to increase her appetite so I opened a can of Hills K/D & mixed some with Nutro & she loved it. But I really don't want to keep using that since it's so high in carbs. I'm so anxious to get the phosphorus lowered. At least I'm assuming that it's high, is that the only reason the Creat. would rise? I'm sure my vet will not be happy if I don't follow her recommendation & switch to Rx diet. As much as I do not want to use it I'm wondering if I should try it for 3 weeks & then retest blood which is what she wants to do. And then tell her that I'd like to try Weruva and/or phos. binder. Or just ignore her & start Weruva now. Or maybe ask her on Monday about a phos. binder & keep her on Nutro. Oh my gosh Im so confused!!!! Thanks again for all of your help!
 
Anitafrnhamer said:
Squeaker is Stage 4 CRF and a diet controlled diabetic (initially was on 3 units Lantus BID) the Nutro, in and of itself will not increase kidney values-----again the issue is phosphorus. You can feed any food as long as you control the amount of phosphorus absorbed by the system. It is more important to keep the diabetes managed so that appropriate treatment to "manage" the kidney disease can be implemented as it cannot be cured, you can slow the progression through proper management. I personally would not use Rx food, it is lower protein and can lead to loss of muscle mass which complicates everything.

I deal with diabetes, euthyroid sickness, CRF, and RCM daily so I can say I have a pretty good understanding of juggling multiple conditions.

As for appetite, here are a few tricks I use for Squeaker. I just run down the list till something works.

Liquefy the food in a blender with added water (for a 5 oz can I add 2 oz water---great way to get extra fluid for the kidneys)
Chill the food
Warm the food
Add tuna water
Sprinkle with a little grated parmesan cheese
If none of that works, add chicken baby food (I use Beech Nut Stage 1 Chicken-no carbs, low phosphorus) or you can feed just the baby food meat to spark the appetite.

Weruva brand foods are also good. They are low carb and four varieties are fairly low in phosphorus-Steak Frites, On The Cat Wok, Paw Lickin Chicken, and Peking Ducken. You can widen your food options a little but it takes a lot of work.
Click to expand...

Just wondering, what do you feed Squeaker?
 
You can purchase phosphorus binder from a couple of companies. I use ALOH- aluminum hydroxide. You can find sources and dosage here: http://www.felinecrf.org/phosphorus_binders.htm. But first you need to know what the phosphorus level is before you dose.

You vet may not have suggested binder because they may not be overly knowledgeable about CRF. And in reality, the phosphorus level is different for different ages of a cat. Older cats should have lower phosphorus where very young cats have higher phosphorus.

I feed Squeaker Weruva and Little Friskies Classic Pate, they are the foods that he will and can eat (I have to deal with food allergies and sodium restriction as well).

You can read about Creatinine here, sometimes a high protein diet will elevate Creatinine: http://www.felinecrf.org/diagnosis_blood_chemistry.htm#creatinine

I would also suggest that you get a fountain bowl now. As the renal disease advances you will want to make sure your cat is drinking sufficient amounts of water and a fountain bowl works so well to keep them drinking.
 
Ann & Tess has a list of low carb - lower phos foods included in the link to Tess' spreadsheet. Click on the LC/low Phos tab at the top of the spreadsheet. Maybe you'll find some low carb - lower phos foods that Trina may like.
 
I'm glad you asked this question. My sugar cat Kali's litter mate Savvy has stage 3 CKD. He does not like the kidney food and because he also had food allergies, the vet switched him to restricted ingredient special diet which all three of the cats liked at first, but then didn't. I was feeding Weruva and Wellness Blend until Kali was recently diagnosed with diabetes. They all hated the diabetes diet, so we are now on Fancy Feast which they all love, but in the last week I've been noticing that Savvy is not feeling very chipper. He has a few other health issues including arthritis and it may be his back legs are hurting him or it may be the higher protein content of the food, I'm not sure. I feel like the story of the little boy at the dike, not having enough fingers to plug the leaks everywhere with all the special issues each cat has (one is obese, they all have heart murmurs, two with food allergies, one with chronic eye and nose infections and constipation, one with asthma, etc., etc., etc.) all needing contradictory diets. Reading this makes me think that now may be the time to investigate Phos binders for Savvy.

At any rate, thank you for bringing up this topic. I hope the info has helped you. It's given me lots to consider! Good luck with your baby! Nora and Kali
 
Anitafrnhamer said:
You can purchase phosphorus binder from a couple of companies. I use ALOH- aluminum hydroxide. You can find sources and dosage here: http://www.felinecrf.org/phosphorus_binders.htm. But first you need to know what the phosphorus level is before you dose.

You vet may not have suggested binder because they may not be overly knowledgeable about CRF. And in reality, the phosphorus level is different for different ages of a cat. Older cats should have lower phosphorus where very young cats have higher phosphorus.

I feed Squeaker Weruva and Little Friskies Classic Pate, they are the foods that he will and can eat (I have to deal with food allergies and sodium restriction as well).

You can read about Creatinine here, sometimes a high protein diet will elevate Creatinine: http://www.felinecrf.org/diagnosis_blood_chemistry.htm#creatinine

I would also suggest that you get a fountain bowl now. As the renal disease advances you will want to make sure your cat is drinking sufficient amounts of water and a fountain bowl works so well to keep them drinking.
Click to expand...
Thank you for all the info.! And I'm going to look into a fountain bowl too! I'm still very confused as to which route to go. Have more research to do.
 
nora said:
I'm glad you asked this question. My sugar cat Kali's litter mate Savvy has stage 3 CKD. He does not like the kidney food and because he also had food allergies, the vet switched him to restricted ingredient special diet which all three of the cats liked at first, but then didn't. I was feeding Weruva and Wellness Blend until Kali was recently diagnosed with diabetes. They all hated the diabetes diet, so we are now on Fancy Feast which they all love, but in the last week I've been noticing that Savvy is not feeling very chipper. He has a few other health issues including arthritis and it may be his back legs are hurting him or it may be the higher protein content of the food, I'm not sure. I feel like the story of the little boy at the dike, not having enough fingers to plug the leaks everywhere with all the special issues each cat has (one is obese, they all have heart murmurs, two with food allergies, one with chronic eye and nose infections and constipation, one with asthma, etc., etc., etc.) all needing contradictory diets. Reading this makes me think that now may be the time to investigate Phos binders for Savvy.

At any rate, thank you for bringing up this topic. I hope the info has helped you. It's given me lots to consider! Good luck with your baby! Nora and Kali
Click to expand...
Oh my goodness, you do have your hands full with special needs babies. Good luck to you & your babies too!!!!! I hope Savvy feels better soon! I think I read that Fancy Feast is high phosphorus so maybe that is why Savvy doesn't feel well. I'm brand new at this disease & just mentioning something I thought I read so I'm not sure if that is correct about Fancy Feast being high phos. There are different food charts around though to check that on.
 
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