1/28 Monty CKD diagnosis

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Tom & Monty

Tom & Monty

Member Since 2020
Heya. Monty has been in diabetic remission for over a year now and we just got a possible CKD diagnosis. We're taking him back in 4 weeks for the second test to confirm. He also has high blood pressure we're going to be treating with Semintra following another blood pressure test next week.

CKD is diet managed right? I can reduce protein and increase fat in his diet.

Symptoms were increased drinking and lethargy. Blood glucose normal.
 
CKD is managed with a low phosphorus diet, yes. Also with fluids and some supplements. After stage 2 you can also use a phosphorus binder. There was a thread the other day about it. I’ll tag you on it. In the meantime, I believe @Diane Tyler's Mom has a list of low phosphorus low cats foods she can share
 
He's currently eating a mixture of Thrive and Lily's Kitchen. Seems like of the thrive cans the fish varieties are low phosphorus so I can stop giving him chicken thrive.

Lilly's kitchen didn't have data for phosphorus, I'll email them.

What's considered "low" phosphorus?
 
Seems like options are low in the UK for low phosphorous foods. I've contacted Lily's Kitchen and asked them to share their phosphorous content of their food.

My vet is recommending a low protein diet but reading through Tanya's CKD guide it seems it's more complicated than that. To be honest my vet was pretty unhelpful when my cat needed insulin and it was only by the advice of this forum that I got him to remission so hesitant to trust my vet for diet advice.

What are people's thoughts on binders? https://www.vetrxdirect.com/product/view/phos-bind-aluminum-hydroxide-for-cats-and-dogs-otc - Perhaps I can get a low-ish phosporous food and get it a bit lower with a binder.
 
Do you have recent blood work so we can see what all his kidney levels were?
What stage did they say Month's in
Ask Lily's Kitchen to give you the dry matter %
 
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Caveat for the above results - he was nil by mouth since 10am previous night because he was due for an x-ray (they cancelled the xray because of high blood pressure).
 
So he has just been diagnosed with hypertension too. My vet's current strategy is: treat the hypertension with Semintra for 4 weeks, measure bloods and symptoms and see what other changes we need to make for the CKD once hypertension is controlled.
 
When I tap on the link for the blood work it says webpage is not available
I assume the SDMA results are on the labs also
Maybe take a pic of them and paste them here

When you have them I can tag @Suzanne & Darcy to take a look at them for you

Can you add to your signature hypertension and the med he is taking
 
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I'll hold off for now on the hypertension in signature. He had high blood pressure on Friday at the clinic. My vet wants him back in 5 days to confirm diagnosis after another measure.

If it's confirmed then he'll be taking Semintra (his identical twin sister has hypertension and she responded very well to this medicine).
 
I can reduce his pretein pretty easily. Currently he eats two cans of Thrive Chicken (70% protein) and two trays of Lily's Kitchen Pate (40% protein). I can chang that ratio to 1:3 thrive:lily or I could cut thrive entirely.
 
SDMA pointed to CKD. Vet called me at a bad time and the line was poor quality so I'll call back Monday. What I managed to catch was:

1. SDMA points to CKD.
2. Blood pressure points to hypertension, bring him back for blood pressure check in 5 days
3. Repeat SDMA check in (few weeks? Didn't quite catch it)
4. If hypertension, treat it and see how much of his blood numbers are due to hypertension so we can see what we're dealing with for CKD before we change anything drastic.
 
Tom & Monty said:
SDMA pointed to CKD. Vet called me at a bad time and the line was poor quality so I'll call back Monday. What I managed to catch was:

1. SDMA points to CKD.
2. Blood pressure points to hypertension, bring him back for blood pressure check in 5 days
3. Repeat SDMA check in (few weeks? Didn't quite catch it)
4. If hypertension, treat it and see how much of his blood numbers are due to hypertension so we can see what we're dealing with for CKD before we change anything drastic.
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I really so think this is a reasonable plan. CKD will need to be managed, at first, with low phosphorus food without worrying about the protein so much. There is no proof documented in the literature that protein damages kidneys. However, there is ample evidence that high phosphorus does damage kidneys. I will say, though, that I have also fed my cats a special prescription kidney food when they reached a later stage of kidney disease. High blood pressure also can damage nephrons. I hope that you will be able to confirm and treat, or rule that out soon. I see you are connected with the felinecrf.org. That is the absolute best site for information and support. I’m happy you are reading that.
 
Tom & Monty said:
I have purchased a binder: https://www.viovet.co.uk/Ipakitine-phosphate-binder-for-Dogs-Cats/c455/

I've shared this with the vet to check it's not going to interfere with hypertension meds.
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I've used that binder myself in some cats where the phosphorus wasn't too terrible high. It's weaker than using an aluminum hydroxide powder binder and, as long as Monty's calcium isn't high, should be okay (since it's a calcium based binder.) I'm really happy that you are on top of the high blood pressure!
 
Well low phosphorus is the most important factor in CKD, I would not go with low protein because you will have muscle wasting if you go too low. So that leaves you with fat since you only have three components to adjust: protein, fat, and carbohydrates. Obviously you want to avoid too many carbs at this stage. You don’t want to risk pushing him out of remission with too many carbs.
 
Lily's Kitchen have responded with the dry matter phosphorous in the food monty eats:

Hi Tom,
No problem, here is the information for you, let me know if I've missed any:
Organic Beef Paté - 1.17%
Organic Fish Paté - 1.6%
Organic Turkey Paté - 1.84%
Organic Chicken Paté - 1.69%
Chicken Paté - 1.34%
Lamb Paté - 1.1%
Chicken & Game Paté - 2%
I hope this helps
​
Who maintains the UK food spreadsheet? We could get these added to that sheet. Seems like I should start adding a phosphate binder to his food for these patés.
 
I've been reading through felinecrf and looking at Monty's numbers from his blood work. I'd already purchased Ipaktine (calcium based binder) but I can see from his bloods that his calcium is on the upper end of healthy so it might be a bad idea to use a calcium based binder for him. The aluminium based binder I'm looking at (aluminium hydroxide) seems more appropriate but I'll need to buy it from the US.

I'm taking Monty to the vet on Friday to confirm the diagnosis of hypetension, I'll ask her when I'm there about binders. But if she's in agreement I intend to use the calcium binder until the alumium based one arrives and I'll switch to that.
 
Bron and Sheba (GA) said:
I don’t think I would change to a lower protein diet Tom. That is old thinking. It risks muscle mass loss.
What are your thoughts @Suzanne & Darcy
I’ll tag @Teetee (UK) as he had a great food chart and may be able to help you.
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Hi @Bron and Sheba (GA) @Tom & Monty
I have this food list but unfortunately it only contains carbs and calories but no phos content.
Hi @Suzanne & Darcy
The UK food list i use is this one as posted above by @Diane Tyler's Mom
https://docs.google.com/spreadsheets/d/1J5JpMe6TDXrHq_aTl9hUtHy6Gs9oRBqlz4nPGKxtySA/pubhtml#
When we had our old cat who we lost through kidney disease we used Tanya's CKD site for food choices but unfortunately the site owner Helen removed the UK food list a few years ago, a shame really as it was a great help.
There is also the Tanya's Feline Chronic Kidney Disease Support Group
that has British members on there that might be able to help regarding food.
https://tanyackd.groups.io/g/support
 

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Tom & Monty said:
Lily's Kitchen have responded with the dry matter phosphorous in the food monty eats:

Hi Tom,
No problem, here is the information for you, let me know if I've missed any:
Organic Beef Paté - 1.17%
Organic Fish Paté - 1.6%
Organic Turkey Paté - 1.84%
Organic Chicken Paté - 1.69%
Chicken Paté - 1.34%
Lamb Paté - 1.1%
Chicken & Game Paté - 2%
I hope this helps
​
Who maintains the UK food spreadsheet? We could get these added to that sheet. Seems like I should start adding a phosphate binder to his food for these patés.
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Hi Tom,
I can add those phos values to the UK list (some of those are pretty high though, sadly...) ...I'm doing the main annual update on the list at the mo. So I can do the Lily's Kitchen foods next.

Eliz
 
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