Food recs for diet controlled diabetic with kidney issues

[Karen and Flo]

Hello all. Flo is a 19 year old, diet controlled diabetic (eating grain free canned Wellness chicken, turkey, occasional turkey/salmon, and some chicken/turkey EVO, all mixed with water). She's drinking normally (she's always been a good drinker), eating, peeing, pooping, running around like a little 8 pound herd of elephants, and seems totally fine. She's lost a little over a pound in about 7 months, so vet did a blood panel. Don't have numbers in front of me (BUN may have been ~54 and Creatinine ~2.9?), but will get them corrected when I hear back from vet. Vet wants me to put her on a diet that is <10% protein, which, of course, is my nightmare, considering how well she's doing otherwise. Any advice would be greatly appreciated.

 

[weeble]

Generally speaking, it's not the protein, it's the phosphorus. Here's the Binky's chart; look for the low phosphorus foods: http://binkyspage.tripod.com/CanFoodNew.html.

I would also check out this site: http://www.felinecrf.org/. There's some foods listed there as well.

I can't really give personal recommendations because it's a struggle to get my cat to eat any canned at all...

 

[Karen and Flo]

Thanks, Amanda! I'll check out your recs.

 

[Lisa and Merlyn (GA)]

As stated by weeble, its the phosphorus thats the issue. Cats are obligate carnivores, so depriving them of protein makes them catabolize their own muscle mass. Saving the kidneys at the expense of the rest of the cat makes no sense. Newer thinking is to switch to low protein foods at "end stage".

I managed Merlyn with Wellness canned food, calcitriol, and sub qs when his creatinine went over 3.0..some cats might need fluids earlier if they are dehydrating, or later if not. Starting sub qs too early can make the kidneys work harder before they have to.

On janet and Binkys charts, you want to stay around 250.. on these katkarma charts
http://webpages.charter.net/katkarma/canfood.htm
the food is analysed differently so you want to stay around 1% or so.

Talk to your vet about calcitriol.
http://members.verizon.net/~vze2r6qt/calcitriol/

 

[Martica and Fred]

Fred was first diagnosed with CRF 1 year before Dx (so 6 years ago). He had the early stages and for 6 years he has always been on Wellness (and other low carb/no grain). 15 months ago his CRF worsened--forget the figures but to the point where he needed fluids. Vet wanted me to switch to renal food. I refused (and vet got mad at me, his take was just increase the insulin). But I did not and for past 15 months Fred has been fine, progressing slowly but not drastically (and he is 20y and 2m, by the way). I started adding phosphorus binders to his food (a fiber, and I switch between two kinds--epikitan and aluminum hydroxide I think it is) back earlier this year, forgot when...it brought his phos numbers down.

Anyway, I'm not sure if Fred could have done better on renal food, but he is old and his progression was very long and slow--and he has other diseases heart disease and Dx so not sure. But seems like the better nutrition is the better thing--especially for an old cat. I looked for the research but couldn't find any. I have given Fred distilled water almost exclusively for 6 years, and genrally avoided fish flavors, etc. So not sure if those played a role in his slow progression.

Even now he's not in a terrible stage...although he is finally progressing--but he's also been on some heart drugs and even the pepcid that may be affecting the kidneys now...

TWO things, if your vet advises you to give subQ fluids--insist on doing an echocardiogram before you do it. Fred had underlying heart disease and the vet did not check, so 6 months of fluids (or even before) threw Fred into cardiach heart failure. If we had done that test he would not have had that. Also, he had not progressed terribly considering he has been off fluids for 9 months. I water down his food.

Also, give hiim pepcid a/c (1/8 or 1/4 of a 10mg tab once or twice a day, start low) if you notice that he vomits a lot, swallows a lot, and esp vomits while pooping. the kidney disease causes nausea/acid reflux apparently. Giving this to Fred has almost completely stopped vomiting.

 

[Karen and Flo]

Thanks so much for the info. Flo has always been what I've lovingly called "dyspeptic", however she hasn't been vomiting any more than usual (which is only on occasion, but her brother almost never did, and my other boys rarely do either). My tentative plan is to continue with the Wellness (thoughts on chicken/turkey EVO? I need to check the numbers on that one, and get rid of the occasional turkey/salmon I was using). Continue to mix with water, and try the phosphorus binders. From what I've read, eating is the most important issue here, and she eats Wellness just fine. I had been giving her maybe a tablespoon of CORE/EVO grain free kibble about once per week as a treat, but haven't been lately. I figured it wasn't worth the potential BG increase. I'm tempted to start it up again, just to get more calories in her, but am worried about dry food screwing more with her kidneys. I know she loves it.

Flo had an echo a few years ago before her eye surgery, because the folks at Davis heard a heart murmur. I will certainly get another one done if/when it gets to that point.