Diabetes/Acromegaly and Kidney Function

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Hope Y.

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Your forum has been very helpful to me in the past, but now I'm kind of mentally stuck. Our 13-year-old cat Smokey has been diabetic for about 1 1/2 years. Shortly after that diagnosis he was found to have acromegaly. He's now on daily Bexacat and Cabergoline every other day. His ketones are excellent, but the last blood panel showed that his kidney function is down (stage 2). The vet has recommended prescription kidney care cat food, which we've started (Royal Canin). It seems to me that the kidney issue has to do with the huge amounts of water he drinks (and excretes), which has to be hard on his system. How would renal-care cat food help with what I think is the basic problem? Also, it seems that renal-care cat food isn't low-carb enough for a diabetic cat.
Maybe off topic--but can anyone guess why several times a day he yowls loudly? He doesn't seem to be in pain, and it passes quickly. Could he be getting dementia too?
I've had cats all my life, but these issues are new to me. I'd appreciate any help!
Thanks, Hope
 
The biggest issue is that the prescription kidney food tends to be rather high in carbohydrates which is the last thing you want to be feeding Smokey. We consider low carb as under 10% as you probably know. If you've not found Tanya's website, it's the equivalent of FDMB for cat's with kidney issues. I have a cat that has been in Stage 2 kidney disease for years and I do not feed him a prescription diet. You may want to switch to a low carb, low phosphorus diet. This food chart may be helpful. For cat's with kidney issues, low phosphorus is important.

Actually, keeping a cat hydrated is good for their kidneys. However, if your cat is drinking tons of water, it likely means that Smokey's diabetes is not well controlled. Drinking and urinating in large amounts are symptoms of uncontrolled diabetes.

I have a kitty who likes to hear himself yell. He's done it for years. I was convinced he likes the echo. I don't know if he's trying to get my other cat's attention.
 
This list of CKD foods has a entry specifically for CKD and diabetes.

Have you seen this post: New Treatments for Feline Diabetes
Bexacat is not a good option for a cat with CKD. Another quote from the above paper:
  • Approximately 20 – 30% of cats have persistent excessive urination and/or water intake due to Bexacat-induced osmotic diuresis. This can be a risk factor for dehydration-induced DKA.
Click to expand...
and this quote:
  • Cats should be evaluated for concurrent disease including pancreatitis, infectious disease, urinary tract infection, neoplasia, and hypersomatotropism (acromegaly) before initiating and while receiving either Bexacat or Senvelgo.
Click to expand...
I don't think Bexacat is a good solution for an acrokitty, especially not one with kidney issues.
 
A big thanks to everyone who has responded, and I'll continue to check. Your combined expertise (and experience) is very valuable. Smokey (I've been trying to get his photo on the site with no luck) has a vet appt. in 2 weeks, so I'll be sure to bring up some of these issues; specifically whether we should switch from Bexacat to something else (back to insulin?), go with a wet food that's both low in carbs and low in phosphorus (until two weeks ago he was on a low-carb diet), make sure his blood pressure has been checked, etc. I'll of course investigate those links you all have sent.
----Smokey's Mom
 
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