Riley has diabetes, IBD, hyperthyroidism now kidney disease

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dana moore

dana moore

Member Since 2015
Hi ladies, I know its been awhile since I've posted, I had a lot going on with Riley. He's recently been diagnosed with hyperthyroidism I have his diabetes under control through soft food but now I find out his kidneys are disease and I'm supposed to limit the intake of protein and sodium.

So here's my question, what kind of food should I give him that's low in sodium and protein? I also have been giving him the Fortiflora which I now have to stop because it's got salt in it. God I hope I didn't cause this kidney disease from that.

I'm planning on doing an iodine radiation treatment, which is 1000.00 on his thyroid so hopefully that will slow down the progression of his kidney disease, irritable bowel disease and diabetes. Too much going on with this little guy.
 
Because hyperthyroidism speeds up body metabolism treating it will raise the indications (make it worse) of kidney insufficiency. RadioCat requires trial on oral hyperthyroid meds to check kidney function before the radioactive iodine treatment.
How bad are the kidney values (Creatitine, phosphorous and urine specific gravity) now?
I myself really only control phosphorous in food. It is not that clear that low protein is really necessary. Just note that in regular food high protein food are also high in phosphorous so they do go hand in had but you can get special diets that have reduced phosphorous. I have also used a phosphorous binder (aluminium hydroxide powder) mixed with food to bind some phosphorous in the GI tract so it does not enter the body.
 
Larry and Kitties said:
Because hyperthyroidism speeds up body metabolism treating it will raise the indications (make it worse) of kidney insufficiency. RadioCat requires trial on oral hyperthyroid meds to check kidney function before the radioactive iodine treatment.
How bad are the kidney values (Creatitine, phosphorous and urine specific gravity) now?
I myself really only control phosphorous in food. It is not that clear that low protein is really necessary. Just note that in regular food high protein food are also high in phosphorous so they do go hand in had but you can get special diets that have reduced phosphorous. I have also used a phosphorous binder (aluminium hydroxide powder) mixed with food to bind some phosphorous in the GI tract so it does not enter the body.
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thanks Larry for the reply the doctor says that his kidneys are not that bad yet and that he thinks that he would benefit from the iodine treatments because a hyper thyroid is hard on the kidneys and heart he thinks that this may help with everything else he's been going through. I do have to say ever since he's been on the hyper thyroid medication oral that his blood sugar levels have been lower he's been in remission for a while now but his numbers were always close to 100 now there more towards the 80's. I don't know any of the values but I will check into that powder that you recommended.
 
dana moore said:
thanks Larry for the reply the doctor says that his kidneys are not that bad yet and that he thinks that he would benefit from the iodine treatments because a hyper thyroid is hard on the kidneys and heart he thinks that this may help with everything else he's been going through. I do have to say ever since he's been on the hyper thyroid medication oral that his blood sugar levels have been lower he's been in remission for a while now but his numbers were always close to 100 now there more towards the 80's. I don't know any of the values but I will check into that powder that you recommended.
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I do have another cat on the urinary s/o so I ordered a case of the pate he already kind of eats the hard food as a snack and that doesn't raises blood sugar so I'm hoping that the soft food I can use for both of them
 
Larry and Kitties said:
I myself really only control phosphorous in food. It is not that clear that low protein is really necessary. Just note that in regular food high protein food are also high in phosphorous so they do go hand in had but you can get special diets that have reduced phosphorous. I have also used a phosphorous binder (aluminium hydroxide powder) mixed with food to bind some phosphorous in the GI tract so it does not enter the body.
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That's what I do too. Especially in early stage CKD, there's no real evidence that reducing the protein helps, and low protein for a cat can cause muscle wasting. There are a few foods that are both diabetic and CKD friendly - i.e. high protein, low carb and phosphorus under 1% (not as low as the prescription kidney diets, but you can always add a phosphorus binder if you need it).

dana moore said:
I do have another cat on the urinary s/o so I ordered a case of the pate he already kind of eats the hard food as a snack and that doesn't raises blood sugar so I'm hoping that the soft food I can use for both of them
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You are extremely lucky if our cat can eat dry urinary s/o without raising his BG levels - it was that exact food that Rosa had been on for several years when she was diagnosed diabetic, and I'm 100% certain that the food contributed as it's really dreadfully high in carbs. However, the s/o isn't the best food for a kidney kitty because it causes the cat to urinate more - in a cat that already has a tendency to lose too much fluid that way from CKD and/or diabetes, that isn't an ideal situation.

If your vet recommends a phosphorus binder, you can order it as Phos-Bind online. I would avoid the liquid preparation that vets sell - it's basically the same thing and it works just fine but it's mint flavored...I had an awful job trying to get Rosa to take that until I figured out why and switched to the flavorless powder.
 
manxcat419 said:
You are extremely lucky if our cat can eat dry urinary s/o without raising his BG levels - it was that exact food that Rosa had been on for several years when she was diagnosed diabetic, and I'm 100% certain that the food contributed as it's really dreadfully high in carbs.
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Same here. Saoirse started piling on weight when she was prescribed it after having oxalate uroliths removed. She also started overgrooming her tummy. The vet at the time put the overgrooming down to "boredom and stress" but I now know it was down to the s/o irritating her GI tract due to an allergic reaction (all the fur on her tummy started to grow back immediately I dropped the dry prescription foods and switched her to a species-appropriate diet).


Mogs
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Saoirse's background is just so similar to Rosa's - the oxalate uroliths, the prescription diet and then the diabetes. Rosa didn't ever have an over-grooming problem, but Regan did...and they were both on the same diet. For Regan the vet thought it would be a good preventative in case there was a genetic predisposition to oxalates. I honestly wish I'd never started either of them on it, but of course hindsight is a wonderful thing!
 
W
manxcat419 said:
That's what I do too. Especially in early stage CKD, there's no real evidence that reducing the protein helps, and low protein for a cat can cause muscle wasting. There are a few foods that are both diabetic and CKD friendly - i.e. high protein, low carb and phosphorus under 1% (not as low as the prescription kidney diets, but you can always add a phosphorus binder if you need it).


You are extremely lucky if our cat can eat dry urinary s/o without raising his BG levels - it was that exact food that Rosa had been on for several years when she was diagnosed diabetic, and I'm 100% certain that the food contributed as it's really dreadfully high in carbs. However, the s/o isn't the best food for a kidney kitty because it causes the cat to urinate more - in a cat that already has a tendency to lose too much fluid that way from CKD and/or diabetes, that isn't an ideal situation.

If your vet recommends a phosphorus binder, you can order it as Phos-Bind online. I would avoid the liquid preparation that vets sell - it's basically the same thing and it works just fine but it's mint flavored...I had an awful job trying to get Rosa to take that until I figured out why and switched to the flavorless powder.
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What food would you recommend?
 
from my understanding it is about the quality of protein -- many people feed raw with CKD

I have 1 whom I have been giving SQ fluids for almost 6 years and he is doing great… he has not needed a phos binder but many do.

I am going to tag @Wendy&Neko as she has tons of knowledge on this and I think she makes her own food.
Mine is very finicky and as long as he eats a majority of wet food I am pleased… I prefer he eat the better quality like weruva/tiki etc… but fancy feast is better than kibble. At almost 17 years old I pick and choose my battle with my Rico :cat:
 
dana moore said:
What food would you recommend?
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I feed Wellness Core Beef Venison and Lamb (that's a real favorite here at the moment), Weruva Paw Lickin' Chicken, Wellness Grain Free Turkey, Max Cat Chicken Supreme, Max Cat Savory Duck, Max Cat Turkey and Chicken Liver, BFF Tuna and Chicken Chuckles, Avoderm Chicken, Evo 95% Chicken and Turkey (the canned, not the dry), Hi-Tor Neo when I can get them to eat it (which isn't often), Pinnacle Chicken and Ocean White Fish and an occasional can of 9 Lives Tuna & Egg for very picky days. There are other weruva flavors that work too, but I've only just added that one to the mix as I found it on special offer at Chewy.com and decided to let them try it. There's actually no need for a prescription diet for oxalates - what's needed is the species appropriate diet, which pretty much is the high protein low carb that we prefer for diabetics. I don't do raw food because our picky little horrors just won't eat it so I just have to do the best I can within the confines of what they're prepared to eat. I add new flavors as I find them and take out ones they're not too keen on but always working on under 10% calories from carbs and under 1% phosphorus as dry matter.

dana moore said:
How do I know when he needs a aluminum binder?
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It's all down to his phosphorus level. Generally with CKD cats, they like to keep it at around 4 so a lot of cats need a binder at some point.
 
Hi Dana,

With regard to the phosphorus binders, etc., I suggest you visit Tanya's Site: it is the go-to site for feline CKD. If you look at the topics on the left hand side you will find links to the basic treatments, including phosphorus control. Helen (the site author) has given very comprehensive information on different binder types and guidelines as to dosing depending on the cat's lab values/CKD stage. It's a good idea to join their support group, too. There are a number of very experienced members there and they will happily review labwork for you and make suggestions about how best to proceed.

On food, Saoirse eats a low carb wet food (UK - Sheba Fine Flakes in Jelly Poultry Selection). It's too high in phosphorus but it's all she can eat without upsetting her pancreas more so I have to give her aluminium hydroxide as a binder. The only ingredients are meat products (poultry), vitamins and minerals plus a little fibre. I also add a little pumpkin to her meals and I give her Piriton twice a day (antihistamine). She also gets anti-nausea meds twice a day (she has chronic pancreatitis). I give her a herbal supplement (Nutramed) to help with GI issues, too.

I wrote the following post at the weekend covering the basic things to look at when starting to treat for CKD. It might give you a bit of a boost up the CKD learning curve.

http://www.felinediabetes.com/FDMB/threads/civie-question-vet-visit.151766/#post-1590952


Mogs
.
 
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dana moore said:
How do I know when he needs a aluminum binder? Or phosphorous binder?
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One of the issues with HyperT is that it can mask the kidney disease and there is a chance that you may find the kidney disease is more advanced after getting the HyperT under control. An ultrasound of the heart and kidneys will be done prior to an I131 treatment to determine extent of any damage present.

Now to answer your question about binder, the target level of blood serum phosphorus for a cat 2-12 years old is 4.5-5.5 mg/dL (in US test results). Phosphorus in cats with CKD is especially important as the higher the blood serum phosphorus the more quickly the kidneys decline.

This website can help to answer your questions about CKD and help guide you in what to expect as well as treatments. http://www.felinecrf.org/index.htm

There is also an excellent support group like FDMB but for cats with kidney disease. https://groups.yahoo.com/neo/groups/Feline-CRF-Support/info
 
Critter Mom said:
With regard to the phosphorus binders, etc., I suggest you visit Tanya's Site.
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Seconded. There is just so much information there about every aspect of CKD. It's well worth taking the time to read thoroughly. I learned a lot in a very short space of time there in the second half of last year.
 
Critter Mom said:
Hi Dana,

With regard to the phosphorus binders, etc., I suggest you visit Tanya's Site. If you look at the topics on the left hand side you will find links to the basic treatments, including phosphorus control. Helen (the site author) has guidelines on different binder types and guidelines as to dosing depending on the cat's lab values/CKD stage. It's a good idea to join their support group, too. There are a number of very experienced members there and they will happily review labwork for you and make suggestions about how best to proceed.

On food, Saoirse eats a low carb wet food (UK - Sheba Fine Flakes in Jelly Poultry Selection). It's too high in phosphorus but it's all she can eat without upsetting her pancreas more so I use aluminium hydroxide as a binder. The only ingredients are meat products (poultry), vitamins and minerals plus a little fibre. I also add a little pumpkin to her meals and I give her Piriton twice a day (antihistamine). She also gets anti-nausea meds twice a day (she has chronic pancreatitis). I give her a herbal supplement (Nutramed) to help with GI issues, too. (Nutramed

I wrote the following post at the weekend covering the basic things to look at when starting to treat for CKD. It might give you a bit of a boost up the learning curve.

http://www.felinediabetes.com/FDMB/threads/civie-question-vet-visit.151766/#post-1590952


Mogs
.
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Thank you so much
 
manxcat419 said:
I feed Wellness Core Beef Venison and Lamb (that's a real favorite here at the moment), Weruva Paw Lickin' Chicken, Wellness Grain Free Turkey, Max Cat Chicken Supreme, Max Cat Savory Duck, Max Cat Turkey and Chicken Liver, BFF Tuna and Chicken Chuckles, Avoderm Chicken, Evo 95% Chicken and Turkey (the canned, not the dry), Hi-Tor Neo when I can get them to eat it (which isn't often), Pinnacle Chicken and Ocean White Fish and an occasional can of 9 Lives Tuna & Egg for very picky days. There are other weruva flavors that work too, but I've only just added that one to the mix as I found it on special offer at Chewy.com and decided to let them try it. There's actually no need for a prescription diet for oxalates - what's needed is the species appropriate diet, which pretty much is the high protein low carb that we prefer for diabetics. I don't do raw food because our picky little horrors just won't eat it so I just have to do the best I can within the confines of what they're prepared to eat. I add new flavors as I find them and take out ones they're not too keen on but always working on under 10% calories from carbs and under 1% phosphorus as dry matter.


It's all down to his phosphorus level. Generally with CKD cats, they like to keep it at around 4 so a lot of cats need a binder at some point.
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Thank you I'll be going to pet store tomorrow
 
dana moore said:
Thank you I'll be going to pet store tomorrow
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That's pretty much what I did - bought just one or two cans of a variety of foods, dropped the ones they didn't like and then ordered the ones they did by the case as that works out cheaper as long as they'll eat the food. I do have a list written down somewhere that would have some other possibilities for you to try - once I can find it I'll add a few more options for you. :)
 
manxcat419 said:
I feed Wellness Core Beef Venison and Lamb (that's a real favorite here at the moment), Weruva Paw Lickin' Chicken, Wellness Grain Free Turkey, Max Cat Chicken Supreme, Max Cat Savory Duck, Max Cat Turkey and Chicken Liver, BFF Tuna and Chicken Chuckles, Avoderm Chicken, Evo 95% Chicken and Turkey (the canned, not the dry), Hi-Tor Neo when I can get them to eat it (which isn't often), Pinnacle Chicken and Ocean White Fish and an occasional can of 9 Lives Tuna & Egg for very picky days. There are other weruva flavors that work too, but I've only just added that one to the mix as I found it on special offer at Chewy.com and decided to let them try it. There's actually no need for a prescription diet for oxalates - what's needed is the species appropriate diet, which pretty much is the high protein low carb that we prefer for diabetics. I don't do raw food because our picky little horrors just won't eat it so I just have to do the best I can within the confines of what they're prepared to eat. I add new flavors as I find them and take out ones they're not too keen on but always working on under 10% calories from carbs and under 1% phosphorus as dry matter.


It's all down to his phosphorus level. Generally with CKD cats, they like to keep it at around 4 so a lot of cats need a binder at some point.
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Great info
 
manxcat419 said:
That's pretty much what I did - bought just one or two cans of a variety of foods, dropped the ones they didn't like and then ordered the ones they did by the case as that works out cheaper as long as they'll eat the food. I do have a list written down somewhere that would have some other possibilities for you to try - once I can find it I'll add a few more options for you. :)
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Thank u
 
Oh, I did better than I thought - I saved it to Google Drive! I must have been feeling very organized that day!! ;) So...here you go... https://docs.google.com/spreadsheets/d/1E_HZnTcJdsr20Gpivo2ID1KQ9wlZAe1Xy3LDTDVRofU/edit?usp=sharing

There are a few things on there I haven't tried yet - some of them I have to find on special offer to try them because with 5 cats in the house, it can get really incredibly expensive to feed the highest priced foods - I tend to try and introduce a new food when I can find it on offer and take it from there...I spend quite a bit of time trawling the internet for the best deals on anything they really love.
 
manxcat419 said:
Oh, I did better than I thought - I saved it to Google Drive! I must have been feeling very organized that day!! ;) So...here you go... https://docs.google.com/spreadsheets/d/1E_HZnTcJdsr20Gpivo2ID1KQ9wlZAe1Xy3LDTDVRofU/edit?usp=sharing

There are a few things on there I haven't tried yet - some of them I have to find on special offer to try them because with 5 cats in the house, it can get really incredibly expensive to feed the highest priced foods - I tend to try and introduce a new food when I can find it on offer and take it from there...I spend quite a bit of time trawling the internet for the best deals on anything they really love.
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Your awesome thank you so much I have 7 cats myself
 
dana moore said:
Your awesome thank you so much I have 7 cats myself
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You're very, very welcome. If it saves you some time figuring out what to try, that's great. :) We did have 6 cats, but we lost the oldest one at New Year. We have to try and find things they can all eat, based on the needs of any of them with special requirements - I've tried separating them, but the 2 that are officially mine are litter-mates and won't eat if I split them up. Finding things they all like can be a challenge - I'd say the one I've had most consistent success with is the Wellness Core Beef Venison and Lamb. I buy more of that one any time I see it on offer anywhere as it's one of the more expensive options at full price. Hopefully you'll be able to find something off the list that will please all of your babies. :)
 
Now I,m freaken out about the Urinary SO I give my other cat. She recently had a very large kidney stone removed so I guess that's totally different then Kidney disease. I hope its okay for her issues. UGH.
 
dana moore said:
Now I,m freaken out about the Urinary SO I give my other cat. She recently had a very large kidney stone removed so I guess that's totally different then Kidney disease. I hope its okay for her issues. UGH.
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Try not to worry about what she's eaten so far - you can only work with the information you have at the time. That said, if you can get her onto the same food as Riley, that would be better for her long-term.
 
For more reading on what to feed our older kitties, including those with CKD and hyperthyroidism, check out this blog: http://www.endocrinevet.info/2011/09/best-diet-to-feed-hyperthyroid-cats.html
Dr. Mark Petersen is a well known vet endocrinologist who posts many excellent blog articles.

My kitty has acromegaly (causing diabetes), CKD, and possibly early stage hypothyroidism. She gets raw food, made with low phosphorus, high quality protein. She gets a rotation of proteins, some of which are made with a raw premix that is specifically made for CKD cats.

Great job April @manxcat419 on the canned food list!
 
dana moore said:
Where do I find 9 Lives Tuna and egg? I found tuna and cheese in sauce but it's in sauce. Hmmmm
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Our local Walmart stocks the Tuna and Egg but not the Tuna and Cheese. Amazon usually has both as does Petfooddirect.com. They are in 'sauce' but when you open the can, it's obviously not a gravy-type thing...it's more like a very wet cat food so isn't the carb-loaded sauce we're used to seeing on a lot of the in-sauce or in-gravy canned foods.
 
manxcat419 said:
You're very, very welcome. If it saves you some time figuring out what to try, that's great. :) We did have 6 cats, but we lost the oldest one at New Year. We have to try and find things they can all eat, based on the needs of any of them with special requirements - I've tried separating them, but the 2 that are officially mine are litter-mates and won't eat if I split them up. Finding things they all like can be a challenge - I'd say the one I've had most consistent success with is the Wellness Core Beef Venison and Lamb. I buy more of that one any time I see it on offer anywhere as it's one of the more expensive options at full price. Hopefully you'll be able to find something off the list that will please all of your babies. :)
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Someone on here told me nature's variety wasn't low in phosphorus. I just bought a case and it's on the list you sent me. They were talking about RAW which is different, what do you think? They said they've changed the recipe?
 
The ones I've got on my list are the raw foods - I'll have to check their website if the formula has changed and re-calc the phosphorus percentages...so difficult to keep up with all of these things when the manufacturers keep changing them. Though if you've bought canned, it's possible that one might be OK too - again, I'd have to check the website...if they've changed one thing who's to say they didn't change up a load of their stuff.
 
manxcat419 said:
The ones I've got on my list are the raw foods - I'll have to check their website if the formula has changed and re-calc the phosphorus percentages...so difficult to keep up with all of these things when the manufacturers keep changing them. Though if you've bought canned, it's possible that one might be OK too - again, I'd have to check the website...if they've changed one thing who's to say they didn't change up a load of their stuff.
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True. Thanks for quick reply
 
OK, not the very best info but based on the Guaranteed Analysis on their site, a lot of the canned foods do come in under 1% phosphorus. The Instinct originals look to be all under (about 0.9%), the limited ingredient ones are OK apart from the Rabbit and Pork flavors. I only looked at a couple of the Pride ones, but they look to be over. I'll have to contact them during the week to confirm that those Guaranteeds are close to the As Fed values, but it does look as though they've changed the formula on the canned as well as the raw.
 
Got this from Natures Variety today
image.jpg
 
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