diabetic with new diagnosis of kidney disease

[chekoya]

The vet said his kidney readings are not that bad yet, but are higher than is good. I have to do something that will lower the readings. I don't have the results yet on paper, was only notified by phone.

Maxx, 18 yrs old, has been diabetic and doing well with BCP insulin for approx 10 years. I feed him Evo canned food with very little Evo dry food and he gets 1 unit of insulin am and pm. His BG readings are usually around 125 - 175.

The vet says he needs a high fiber and low protein food. Does anyone know of a fiber I could add to his food that is not high in carbs? I know high protein diets cause kidney problems in older cats. I just don't know what exactly I can do that won't cause high BG problems and still not aggravate kidney problems.

I read that beans are lower in carbs and high in fiber. Could I add cooked lentils to his food?

Any other suggestions? Thank you. chekoya@verizon.net

 

[arozeboom]

One thing I noticed you said is that you feed Maxx a little dry food. Everyone here will tell you that its not a good idea, for either diabetics or CRF cats. It will be high in carb and also, don't have the moisture they need.

This post has links to a lot of information.
http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=80048&p=864694#p864694

My Ruby is currently diet controlled (she doesn't get insulin shots). It took a lot of trial and error to find a food that works with both keeping her glucose level low and hopefully not making the kidney issue worse. We've settled on Friskies Special Diet Turkey & Giblets or Beef & Chicken. Its in a good range to keep the carbs in check. The phosphorus could be better, but right now, we're concentrating on keeping her diabetes under control. She does have problems with constipation, so I put a teeny bit of miralax in her food to keep things moving.

The "Ruby's SS" link in my signature takes you to a document with her glucose charts and there is a tab for "Lab Tests" which has all of the bloodwork and other tests she's had that indicate the kidney issues.

 

[SabrinaFaire]

Hobbs is CKD & Diabetic. I feed him a mix of Royal Canin & Merrick, both canned. (Merrick Cowboy Cookout or Surf & Turf) I really don't like the RC stuff but trying to go non-Rx food that was low phos sent his numbers up. But he won't eat the RC food, or will eat very little of it. So I mix it and the vet agrees it's the best to do. He also gets a vitamin that's basically a fish oil supplement for cats.

 

[Lizzysdad]

A couple of places that may have info for you on CRF

1. http://www.felinecrf.com/

2. Yahoo has a couple of very good CRF Groups with very knowledgeable people who are just as good as the people here. They were very helpful for me when I had a CRF cat several years ago.

Andy

 

[Julia & Bandit (GA)]

There are several commercial foods that are good for both CKD (Chronic Kidney Disease, also called CRF or Chronic Renal Failure) and diabetes. To manage diabetes, you want to feed a low carb (less than 10%) canned food, and to manage the kidney disease, you want to feed a high quality, low phosphorus canned food. Many vets simply recommend low protein diets for cats with CKD, because they are by default low in phosphorus. However, it's the quality of protein and phosphorus levels that matter, not the protein values. The low-protein prescription kidney diets have only been shown to be beneficial in end stage renal failure and should not be fed long term. In fact, they cause muscle wasting when fed in early stage CKD and are completely inappropriate for an early stage cat--the muscle wasting is more debilitating than the CKD.

Here's an updated food list with the values for several premium foods: https://docs.google.com/leaf?id=0B8...MzhkYTkxOGM4NThk&sort=name&layout=list&num=50. You're looking for something with less than 10% carbs (for the diabetes) and less than 250 mg/kcal of phosphorus (for the kidneys). The foods I would suggest are Merrick's Before Grain Beef, Merrick's Before Grain Turkey, Merricks' Cowboy Cookout, Merrick's Surf & Turf, Wellness Turkey, EVO 95% Chicken & Turkey, or Blue Wilderness Duck.

If those are out of your price range the next best thing to feed are the low carb Friskie's Special Diet Turkey & Giblets and Salmon flavors. However, I would strongly urge a food without byproducts, and keep in mind that they're still cheaper than the prescription foods and usually about the same as many grocery store brands if bought in large cans or in cases. Studies have shown that the quality of the protein source does make a difference in controlling the disease, and that needs to be considered along side phosphorus content.

Keeping your cat well hydrated is also key in managing CKD, which means NO DRY FOOD. At all. Dry food is moisture depleted and causes chronic dehydration in cats, often the cause of CKD as cats progress in age. Adding a little water with the canned food portions helps, as do pet fountains, since they encourage cats to drink even when they are not thirsty (cats have very low natural thirst drives, so by the time they seek out their water dish they're already dehydrated).

Here is a fantastic website with a lot of information about CKD: http://www.felinecrf.org/, and more information about CKD and diet: http://catinfo.org/#Kidney_Failure.

 

[Julia & Bandit (GA)]

Hobbs is CKD & Diabetic. I feed him a mix of Royal Canin & Merrick, both canned. (Merrick Cowboy Cookout or Surf & Turf) I really don't like the RC stuff but trying to go non-Rx food that was low phos sent his numbers up. But he won't eat the RC food, or will eat very little of it. So I mix it and the vet agrees it's the best to do. He also gets a vitamin that's basically a fish oil supplement for cats.

This doesn't make much sense to me. Why are you mixing a higher carb, low protein prescription renal food with a low carb, high protein commercial food? That means you're feeding a medium amount of protein, when there are low carb, low phosphorus foods that are cheaper, better quality, and give you the exact same protein and phosphorus content that you're feeding now by mixing, WITH lower carbs for the diabetes (see my food recommendations above). By feeding a food that contains brewer's rice and rice flour (ingredients a diabetic should not eat), you're risking knocking Hobb's diabetes out of remission. It sounds to me that you're feeding the the renal diet to placate your vet maybe? Remember that your vet is making money of the prescription diets, so they will nearly always tell you you need it--but you certainly don't. In nearly every case, there is a commercial alternative that is cheaper and much better for the cat.

See this section and this section of Dr. Pierson's page for more info on prescription diets, and why they are not good to feed with CKD.

Just take the renal diet back to the vet and tell them that your cat doesn't like it and won't eat it, even mixed with the Merrick's. Most cats hate the taste of the renal diets. And then just feed a low phos, low carb food. It will be better for your pocketbook and Hobbs.