Goof and CKD, food advice?

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Mogmom and Goofus

Member Since 2014
Goof is quite the mess these days. His numbers are hitting the mid 400's and he's just RAVENOUSLY HUNGRY all the time. Had a full blood work-up and unrinalysis done, no infection, his teeth are good. The vet is thinking that he could be developing insulin resistance, I'm about ready to tear my hair out!
 
Goof is quite the mess these days. His numbers are hitting the mid 400's and he's just RAVENOUSLY HUNGRY all the time. Had a full blood work-up and unrinalysis done, no infection, his teeth are good. The vet is thinking that he could be developing insulin resistance, I'm about ready to tear my hair out!
I so hope that Goof is not developing insulin resistance!
 
How long has the insulin vial been punctured?
Taking a BG at +1 is not really of much benefit as yo are seeing since, as yu are seeing, it is not unusual to a BG higher than preshot since the food increase BG faster than the insulin takes effect
 
The vial is only 7 weeks old, I've used a vial for 4 months with no problems. The vet says the insulin should be fine. We're talking about changing insulin, probably Lantus.

I bought a case of k/d, they gave me a 70 cent break per can if I buy a case, so....
But even at that, he'll eat a can and a half per day, I'm not going to be able to afford that. Does anyone know of an acceptable over the counter food?
 
The k/d might not be doing his numbers any good to be honest. I've got a list of foods that I use here https://docs.google.com/spreadsheets/d/1E_HZnTcJdsr20Gpivo2ID1KQ9wlZAe1Xy3LDTDVRofU/edit?usp=sharing all are low carb and fairly low in phosphorus.


Doc said that the carb count won't help the high bg's, but his kidney numbers say he needs a lower protein food. She said we can use the insulin for the high BG, but his kidneys aren't working very well right now and she felt that was the biggest thing right now.

Thanks for that food list! I REALLY wish we could have a "food forum" some day.....
 
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How bad are his kidney numbers at the moment? It's taking a while for vets to come around to the new way of thinking, but low protein is often not recommended now unless a cat is in late-stage CKD with very high numbers. Rosa is Stage 3 and I've just been told to increase the protein in her diet by my vet (and she's been on a diabetic diet all the way through so her protein intake is already fairly high)!
 
How bad are his kidney numbers at the moment? It's taking a while for vets to come around to the new way of thinking, but low protein is often not recommended now unless a cat is in late-stage CKD with very high numbers. Rosa is Stage 3 and I've just been told to increase the protein in her diet by my vet (and she's been on a diabetic diet all the way through so her protein intake is already fairly high)!

Currently these are the numbers:
BUN 43
CREA 2.4
CA 11.9
TP 9.2
ALB 4.0
GLOB 5.2
ALT 129
CHOL 240
LIPA 1513

The rest of the numbers are either normal or just below the "high" reading. The CREA and ALT are both just one point away from reading in the high range.

We also had a full urinalysis done, these were the findings:
Color: Pale yellow
Appearance: Hazy
Glucose: 2000
BIli: Neg
Ketone: Neg
Specific GRA: 1.020
Blood: Neg
PH: 6.5
Protien: 1+
Crystals: None Seen
Bacteria: Present +1
 
Those really aren't bad numbers overall. They put him in an early stage at this point - I wouldn't go to low protein with his numbers where they are. All a low protein diet will do in early stage is cause him to lose muscle mass. I think she may be looking at the proteinuria and telling you to reduce his protein intake. Rosa also has proteinuria, but my vet agrees that the diet she is on is still the best one for her overall. Has he been diagnosed with a UTI at all - he has bacteria present in his urine as well as protein? If there is no UTI, then benazepril can reduce proteinuria rather than having to give him the higher carb, lower protein food.
 
i dont know what to suggest. You're in a tight spot trying to treat both without irritating both conditions! Long acting insulin like the lantus might be a better option? Its the only one we've tried so i have nothing to compare it to.

I hope your kitty feels better soon. I know how it feels to be so frustrated seeing them unwell!!
 
Progressive vets will not agree to use a low protein diet .... the quality of the protein is important but even if Goof won't eat raw of other "excellent" sources of protein most moist foods low carb would be a better choice for a CKD cat especially because the high numbers will cause more internal harm to the organs.
My Rico does not have FD but he has ben CKD and on SQ fluids for 6 years. He is 17 and going strong.
Staying ahead of the disease will make a huge difference and SQ is a large component in that.
Ricos numbers were about the same or a little worse than Goof when we stated SQ which has slowed the disease. When he has BW done now his kidney values are normal due to the SQ.

Remember the kidneys are the 1 organ that you cannot "heal" but you can slow it down and have lots more quality time:cat:
 
I went with slightly different B-vitamin formulations (the Jarrows apparently has some sugar in it so may not be suitable for a diabetic). But I agree that B-complex and methyl B-12 are useful. The ones I have are these:-
http://www.amazon.com/Integrative-T...olate/dp/B00CFD0TC4?tag=felinediabetesfdmb-20
http://www.amazon.com/Pure-Encapsul...sules/dp/B0017L9N4A?tag=felinediabetesfdmb-20
Hopefully those links work - I had to grab them from my Amazon orders page to make sure I got the right ones (there was 2 hours of research into finding those particular formulations).
 
Absolutly everything I've read online says that for CKD a low protein diet is the way to go. Goof's kidney numbers aren't terrible yet, but he's also anemic, not bad, but it's there. Every site, every doctor, every vet teaching college says low protein for Goof's numbers to help hold the disease back. I may not be phrasing eveything exactly as I read, but you get the gist, I hope.

The thing is, Goof HATES the k/d food and the carbs have pushed him from 221 to 570 in one day, so the Hill's k/d is going back tomorrow. Even the other kitties won't eat it. Goof ate it the first day, but wouldn't touch it today but is yowling for food. I'm just not going to make him even more miserable than he already is. So he got Friskies tonite.

So, now, back to my original question, is there a LOWER protein yet LOWER carb food?
 
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I just did a little food research and found that Evo 95% chicken canned food is 25% protein with only 2 carbs, thats only slightly higher protein than the k/d. That's what he was getting when he went into remission, looks like I'll be ordering some tomorrow.
 
Tammy, there is plenty of evidence that CKD cats don't actually need low protein diets and that, particularly in the early stages of CKD, a low protein diet is not going to help any cat because they will suffer from muscle wasting much more than they otherwise would do. The thinking that low protein is the way to go is actually being challenged by a number of vets now too. If you haven't already, please join the forum at Tanya's site - again, everyone there will tell you that sticking with the diabetic-friendly diet is much, much better for cats, especially cats with both conditions. Here are a few links that I hope will help to explain why this thinking is changing
http://allthebestpetcare.com/kidney-failure-in-cats/
http://consciouscat.net/2011/10/17/kidney-failure-and-diet-in-cats/
http://healthypets.mercola.com/sites/healthypets/archive/2012/08/06/kidney-disease-in-cats.aspx
http://www.naturalcatcareblog.com/2014/05/dr-hofve-on-what-feed-a-cat-with-kidney-disease/

The issue that we've been fighting is that the old guidelines for CKD cats were based on research done in other animals - including humans. Research done on non-obligate carnivores that was then translated for cats as though cats are mini humans, or mini dogs...which they're not. So many of the problems that our cats face are caused by a history of non-species appropriate nutrition and yet we have historically aimed to fix these problems by feeding a non-species appropriate diet - when you think of it like that, doesn't it sound completely crazy to you? The new guidelines state that we should be feeding a diet with a species-appropriate percentage of high quality protein...exactly what a cat is evolved to eat to stay healthy.

Anemia, unfortunately, comes with the territory. If you're not already giving Goof B-complex and B-12, those can certainly help. I give Rosa injectable B-12 in her sub-q fluids plus oral B-complex every day and oral methyl B-12 on the days she doesn't get the injectable. For a number of cats, the anemia does progress to the point where an ESA (Epogen or Aranesp) is needed - there is little that can be done to avoid that because the mechanism that stimulates new red blood cells to be produced becomes damaged as a result of the kidney issues and that can't generally be reversed.

We tried Shadow on K/D for a while. We also tried NF, and the other main prescription kidney food (I forget the name of the third one). Not one of the 6 cats in the house would take even one bite of any of those foods. That, alone, tells me that it is not a good food for cats.

The Evo - I did have that on my list of 'approved' foods for Rosa, but I had to take it off again after they reformulated. I think the issue was that it's now much higher in phosphorus - and phosphorus control is MUCH more important than protein control for a CKD cat.

When you increase the carbs in a diabetic cat's diet, the likelihood is that you will lose control of the diabetes - as you've already seen with Goof. Uncontrolled or poorly controlled diabetes makes the kidney damage progress faster - this is why so many people will tell you that keeping control of the diabetes is vitally important in a cat with both conditions.

As to your questions about a lower protein food - Rosa's kidney values are significantly worse than Goof's. And I feed foods off the list that I linked for you earlier. I don't know of anything lower protein - they are out there, but to reduce the protein, you're increasing the carbs and risking loss of diabetic control (if you reduce the protein, the rest of the calories have to be made up somewhere else). And I won't risk that, nor can I in all conscience suggest to you that you risk that for Goof. My vet, after looking into the issues and reading the research at my request, agrees that Rosa should not be switched away from her diabetic-friendly diet. In fact, she's just asked me to INCREASE the amount of protein Rosa gets above the levels in the foods I'm giving her - I've just ordered some egg white powder to do exactly that without increasing the phosphorus. That request was based on blood work done on Wednesday afternoon.
 
@manxcat419
I was wondering about the b12 in the sq
Can you send me the link of the one you use?
Do you just infuse it into the fluid port?
Rico gets sq 4/5 times a week, is OK to do b12 that often in fluids ?

Do you give the b12 oral as well?
I just ordered the stuff Marje mentioned in my previous reply. Rico is not diabetic.
Sorry so many questions.
We are just staring the b12 stuff. Rico has become more mellow so I can do more now to help him.
Thank you sooooo much :bighug::bighug:
 
The one I use as an injectable is this https://www.vetdepot.com/vitamin-b12-1000-mcg-100-ml.html though I bought Rosa's from our vet (it was about $18 from the vet). Rosa gets 0.25 cc 3 times a week, but that is a fairly high dose - she started on 0.25 cc once a week. I just drop it into the port on the fluids line after I've run the line to flush it and before I start actually giving the fluids - you can inject it direct, but I figured if Rosa's getting the fluids anyway it's as easy to drop it into those. I imagine you could give a smaller dose 5 times a week - my vet only ever prescribed it as a once per week thing, but I increased it to help counter Rosa's anemia. You can't really overdose B-vitamins of course because they're water soluble, so the cat just pees out what it doesn't need. On the days in between she gets 500 mcg of methyl B12 orally - I bought the pure encapsulations to avoid any sugar, so I have to give half a one but you should just be able to give one capsule of the Vitacost. It's meant to be flavorless, so you could add it to Rico's food if you prefer - it won't harm a healthy cat if they do get some of it.

The B-complex I have is a little different as the standard human dose is 2 capsules instead of 1 so I only need to divide each capsule's contents into 5. Unfortunately, with the Jarrows, you have to give 1/10th of the human dose which is a little tricky, but apparently can be done. Once or twice, I've found myself explaining to people what I'm doing with Rosa's meds - if anyone has to come to the house for appliance repair etc, it must look really odd that I have all these random bottles and capsules of powder that I carefully measure and divide! But if it keeps her healthy for longer, it's worth the explanations! :)
 
Absolutly everything I've read online says that for CKD a low protein diet is the way to go.
Hi Tammy,

Have you looked at Tanya's Site for dietary stuff? Their overall leaning is toward the suggestions that April made above (i.e. low protein diets are not really helpful in early stages). Might also be worth joining the Yahoo CRF group if you've not already done so:

https://groups.yahoo.com/neo/groups/Feline-CRF-Support/info

How are you doing yourself, Tammy?

:bighug:


Mogs
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The B-complex I have is a little different as the standard human dose is 2 capsules instead of 1 so I only need to divide each capsule's contents into 5. Unfortunately, with the Jarrows, you have to give 1/10th of the human dose which is a little tricky, but apparently can be done.
Thanks for the recommendation for the alternative B-complex, April. I was giving Saoirse Provet B-complex (specially for cats - has sugar but it doesn't impact Saoirse's numbers adversely when it's split over 6 meals a day). However I think they changed the formulation and I became wary of giving it to her. I switched to the Jarrow B-complex but, as you correctly note, it is a real sprag to measure the doses. I actually discard half the contents of each capsule and then loosen the remainder to make it easier to gauge the amount I give her.

I've just checked on Amazon UK and your B-complex is available here. I'm going to order some for Saoirse. :)


Mogs
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Glad to be of assistance, Mogs! :) I will admit, the thought of splitting a capsule into 10 doses was daunting so I was happy to find one that's half the dose per capsule - it's still a lot of splitting meds, but easier at least. I did think that the sugar in the Jarrows would probably not be enough to do anything to Rosa's BG, but if I can find something where the probably doesn't apply, I tend to go with that option instead - she can be a tricky customer...she can eat foods that are 11% carbs with no problem, but just 2 doses of Pet-tinic spiked her levels for 3 or 4 days. :eek:
 
Hi Tammy,

Have you looked at Tanya's Site for dietary stuff? Their overall leaning is toward the suggestions that April made above (i.e. low protein diets are not really helpful in early stages). Might also be worth joining the Yahoo CRF group if you've not already done so:

https://groups.yahoo.com/neo/groups/Feline-CRF-Support/info

How are you doing yourself, Tammy?

:bighug:


Mogs
.


I have looked at Tanya's site, and every other site I could find, my eyes feel like they're about to BLEED from so much reading. :nailbiting: My brain feels like it's tied up in a huge knot from reading so much CONTRADICTING info. :banghead: Having never been one to conform willingly until I can wrap my brain around something and feel 100% comfortable with my choice, these are my thoughts:

1. Goofs CRF numbers aren't high enough to switch to a very low protein diet if it means sending his sugar through the roof. That's just going to create another issue.
2. Read everything you find so that you can make an informed decision, as the truth usually lies somewhere between the lines, and then go with that.
3. I believe the old sayings "everything in moderation" and " nip it in the bud", so I'm not going to wait until until the numbers require immediate and drastic action.

This is my plan, I'm going to return the k/d food, Goof went from 221 to 570 in 12 hours,:mad: not going to happen again if I have anything to say about it. But, I'm also not going to wait until the numbers call for drastic action, I'm going to begin a LOWER protein, yet LOWER carb diet and see how it goes. I feel comfortable with this, so that's my story and I'm sticking to it. :cat:

As for myself, and thank you for asking, it appears that I'm facing a major surgery on my neck that carries a high risk of a stroke and could leave me virtually "stiff-necked". My stroke risk is even higher because I had a slight one 3 years ago. The specialist I saw 3 weeks ago won't touch me, he's sending me to a specialist-specialist :rolleyes: that I'll see on Thursday.
 
I have looked at Tanya's site, and every other site I could find, my eyes feel like they're about to BLEED from so much reading. :nailbiting: My brain feels like it's tied up in a huge knot from reading so much CONTRADICTING info. :banghead: Having never been one to conform willingly until I can wrap my brain around something and feel 100% comfortable with my choice,
I empathise with this - completely! I'm exactly the same way. Indeed, even with treatments Saoirse has received before that worked OK, if anything changes I sometimes withhold them and revisit their benefits and risks over and over and over again. (And when I do reintroduce things with no ill effects I then feel like carp for the time when she wasn't getting them when she might have been getting benefit from them were it not for my paranoia. :( )

At the end of the day, our little ones rely on us to make the best choices of which we are capable in order to make them as well and happy as possible. Your comment about how much of a head wreck the conflicting information available can be really resonated with me. As the ultimate arbiters of which treatment modalities to embrace or reject, we have to be able to live with the consequences of our choices. I wish that our endeavours to make well-informed choices was more straightforward because the stakes are so high.

As for myself, and thank you for asking, it appears that I'm facing a major surgery on my neck that carries a high risk of a stroke and could leave me virtually "stiff-necked". My stroke risk is even higher because I had a slight one 3 years ago. The specialist I saw 3 weeks ago won't touch me, he's sending me to a specialist-specialist :rolleyes: that I'll see on Thursday.
Oh, Tammy! I'm sorry to hear that you have all of this worry, too. I will keep you in my thoughts and prayers. Drop me a PM to let me know how things go on Thursday.

:bighug::bighug::bighug:


Mogs
.
 
I just did a little food research and found that Evo 95% chicken canned food is 25% protein with only 2 carbs, thats only slightly higher protein than the k/d. That's what he was getting when he went into remission, looks like I'll be ordering some tomorrow.
Make sure you are using the newest values for EVO 95%. I don't remember all of the details but the formula changed when they got bought out by one of the big companies and it isn't as good as it used to be. I think it is too high in phosphorus now?
 
I just went to Evo's site and it looks as though they're no longer making the pate food - just 2 "in gravy" types so I can't get the numbers for the pate style food any more. But I do know that when they changed the formula, I had to take the pate off my list of acceptable foods and I'm 99.9% sure it was because the phosphorus content went from quite low to really quite high.

ETA: The in gravy food is 1.59% phosphorus dry matter - way, way too high for a CKD cat. IIRC, the pate food went to a similar amount when they reformulated.
 
I just went to Evo's site and it looks as though they're no longer making the pate food - just 2 "in gravy" types so I can't get the numbers for the pate style food any more. But I do know that when they changed the formula, I had to take the pate off my list of acceptable foods and I'm 99.9% sure it was because the phosphorus content went from quite low to really quite high.

ETA: The in gravy food is 1.59% phosphorus dry matter - way, way too high for a CKD cat. IIRC, the pate food went to a similar amount when they reformulated.
Thank you for weighing in @manxcat419! I knew something changed but couldn't remember what.
 
I should also add - when I spoke to my vet about protein content, they said that when they're looking at protein % for a CKD cat, they look at the DM value...the Evo, on that basis is not much different from all the other foods - the old formulation of the pate was 40%, it looks like the new formula of the in gravy is 43%. On that basis, and with the phosphorus as high as it is in the new formula, you'd do as well sticking with Friskies!
 
I empathise with this - completely! I'm exactly the same way. Indeed, even with treatments Saoirse has received before that worked OK, if anything changes I sometimes withhold them and revisit their benefits and risks over and over and over again. (And when I do reintroduce things with no ill effects I then feel like carp for the time when she wasn't getting them when she might have been getting benefit from them were it not for my paranoia. :( )

At the end of the day, our little ones rely on us to make the best choices of which we are capable in order to make them as well and happy as possible. Your comment about how much of a head wreck the conflicting information available can be really resonated with me. As the ultimate arbiters of which treatment modalities to embrace or reject, we have to be able to live with the consequences of our choices. I wish that our endeavours to make well-informed choices was more straightforward because the stakes are so high.


Oh, Tammy! I'm sorry to hear that you have all of this worry, too. I will keep you in my thoughts and prayers. Drop me a PM to let me know how things go on Thursday.

:bighug::bighug::bighug:


Mogs
.


Mogs, I wish I could phrase things as beautifully as you! I think I usually come across as being kind of (b)itchy. Lol
 
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How long has the insulin vial been punctured?
Taking a BG at +1 is not really of much benefit as yo are seeing since, as yu are seeing, it is not unusual to a BG higher than preshot since the food increase BG faster than the insulin takes effect

I finally figured out what you meant by +1 readings, actually those numbers were retest numbers. Because I use Freestyle Lite strips in an AlphaTrak meter, if I ever get what I think is a wonky number, I'll retest with an AT strip, just to be sure. Lol

I removed the numbers from the ss because apparently it wasn't a good idea to post them there, I should've written them in the "remarks" section. ;)
 
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