? Help Please! CKD Diabetic Kitty Not Regulated - Looking for info/suggestions Phosphorous Binders

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jacereske

jacereske

Member Since 2014
Keno is a 16 year old diabetic kitty we adopted 3 months ago. She also has stage 2 kidney disease. We could not get her regulated on the kidney food (35 carbs) her internist prescribed and I'm not confident the diabetic food (17% carbs) will be any better.

It is near impossible to find a low carb/low phos food, so I'm planning to switch to low carb (probably FF pates) with a phosphorous binder. I have absolutely no experience with phos binders.

Any info/suggestions appreciated.

Thank you.
Jeanette
 
Aluminum hydroxide is by far the most effective binder for pulling phosphorus levels down. I have used it and it does work. Epakitin is also used sometimes, but can't be used in a cat with a high calcium level and tends to be less effective. You can actually use the two at the same time if you find Aluminum hydroxide on its own isn't bringing the level down far enough - I was just about to start doing that with Rosa to help resolve the raised level from an acute on chronic episode before she passed...the Epakitin showed up the day after she was PTS. At some point, I need to make a list of the meds that I have left over for the Supply Closet - I've been putting off doing it because it seems so final and I'm just not quite ready to do that yet. But when I do, I may have some stuff that will help you.

And for food - I have a list here that I was using https://docs.google.com/spreadsheets/d/1E_HZnTcJdsr20Gpivo2ID1KQ9wlZAe1Xy3LDTDVRofU/edit?usp=sharing They're all low carb for diabetes and fairly low in phosphorus as well.
 
I have two cats that are diabetic and CKD. One is early stage, one is late stage CKD. I do not believe it is good to give the kidney diet whether they are diabetic or not, simply because they are too low in protein, which is not great for cats imo. It is controversial, but many contend, and I agree, it is NOT the protein that is the problem, but the phosphorus. Still, I have not needed to use phosphorus binders until now because they did not develop phosphorus issues on the better diets. I was using the FF pates, but they started refusing it, and I later learned the phosphorus can be high in those and they were also developing chronic pancreatitis. I have just started using Epakitin because it helps not just with phos, but with ureamic toxins as well. Here's the problem: they seem to refuse the food when I put it in there! So I'm thinking of getting the aluminum hydroxide, which is tasteless.

I'm still treading water here. I don't have a reliable diet or a great protocol. Right now, I've got them on Stella and Chewys and Ziwipeak. They are also on an occasional can of one of several high quality choices like Fussie Cat, Felidae, or what ever is looks like it's worth a try. Plus, as a safety net, I put out Young Again Zero Mature. They don't gorge on this stuff and it's a pretty good quality food for both diabetic cats and CKD cats, but I don't feed it exclusively because it's a kibble.

Anyway, I don't have a great diet to suggest yet, but wanted you to know you're not alone.
 
I also have a bowl of YAZM out pretty much all the time for the cats here. We did wet food only for a long time, but eventually Rosa started getting picky with the wet food, so I bought a bag so she could have a little variety. None of them overate on it after the first day. And wouldn't you know it, Rosa finished up switching herself back to wet food only after a few weeks. But I still have a fair amount of the big bag of YA here, so I still put it out. It does get eaten, but not immediately - only if they finish up all their wet food and need a little top up.
 
manxcat419 said:
I also have a bowl of YAZM out pretty much all the time for the cats here. We did wet food only for a long time, but eventually Rosa started getting picky with the wet food, so I bought a bag so she could have a little variety. None of them overate on it after the first day. And wouldn't you know it, Rosa finished up switching herself back to wet food only after a few weeks. But I still have a fair amount of the big bag of YA here, so I still put it out. It does get eaten, but not immediately - only if they finish up all their wet food and need a little top up.
Click to expand...

Thank you and I'm sorry your Rosa is no longer with us. I tried the YAZM and did not have a good experience - Keno has a pretty sensitive tummy when it comes to food changes.
 
MsBliss said:
I have two cats that are diabetic and CKD. One is early stage, one is late stage CKD. I do not believe it is good to give the kidney diet whether they are diabetic or not, simply because they are too low in protein, which is not great for cats imo. It is controversial, but many contend, and I agree, it is NOT the protein that is the problem, but the phosphorus. Still, I have not needed to use phosphorus binders until now because they did not develop phosphorus issues on the better diets. I was using the FF pates, but they started refusing it, and I later learned the phosphorus can be high in those and they were also developing chronic pancreatitis. I have just started using Epakitin because it helps not just with phos, but with ureamic toxins as well. Here's the problem: they seem to refuse the food when I put it in there! So I'm thinking of getting the aluminum hydroxide, which is tasteless.

I'm still treading water here. I don't have a reliable diet or a great protocol. Right now, I've got them on Stella and Chewys and Ziwipeak. They are also on an occasional can of one of several high quality choices like Fussie Cat, Felidae, or what ever is looks like it's worth a try. Plus, as a safety net, I put out Young Again Zero Mature. They don't gorge on this stuff and it's a pretty good quality food for both diabetic cats and CKD cats, but I don't feed it exclusively because it's a kibble.

Anyway, I don't have a great diet to suggest yet, but wanted you to know you're not alone.
Click to expand...

Thank you, the Diabetes/CKD combo takes us on quite the roller coaster ride. I wish I had never gone down the kidney disease food road - I feel it has set us back by several months in getting Keno regulated. I know the FF pates are really high phos, so I haven't been feeding those and I have ordered the aluminum hydroxide. I am also going to give making my own cooked food a try.
 
jacereske said:
Thank you and I'm sorry your Rosa is no longer with us. I tried the YAZM and did not have a good experience - Keno has a pretty sensitive tummy when it comes to food changes.
Click to expand...
Thank you Jeanette. It's been a difficult few weeks - Rosa was only 13, so I was expecting a few more years with her. The YAZM is a very individual thing with cats - some do well on it and some don't, just as with any other food. If it doesn't work for you, then I'm sure you'll find something that does work for Keno instead. And I agree - I avoided the kidney diets completely because Rosa was OTJ and I didn't want the high carbs to put her back on insulin when she had enough to deal with already. If you can get him onto home-prepared food, then that is ideal - you can control exactly what goes into it and change it as his needs change.
 
manxcat419 said:
Thank you Jeanette. It's been a difficult few weeks - Rosa was only 13, so I was expecting a few more years with her. The YAZM is a very individual thing with cats - some do well on it and some don't, just as with any other food. If it doesn't work for you, then I'm sure you'll find something that does work for Keno instead. And I agree - I avoided the kidney diets completely because Rosa was OTJ and I didn't want the high carbs to put her back on insulin when she had enough to deal with already. If you can get him onto home-prepared food, then that is ideal - you can control exactly what goes into it and change it as his needs change.
Click to expand...

I'm so sorry about dear Rosa. Usually kidney disease can be managed for a long period of time. Did something else happen besides the kidney disease? I'm asking because one of my cats has been in kidney disease for many years, and I notice that my vets, NEVER advise me thoroughly so I rely on my fellow cat people and the Tanya website, to help fill the gaps on the best care. You mentioned phosphorus as the issue and I'm wondering if there is something symptomatically I should be looking for. Again, I am so sorry for your loss.
 
MsBliss said:
I'm so sorry about dear Rosa. Usually kidney disease can be managed for a long period of time. Did something else happen besides the kidney disease?
Click to expand...
Yes, unfortunately. A negligent IM specialist happened while she was recovering from surgery to bypass a kidney stone. She didn't directly die from the CKD - she died of heart failure caused by associated anemia that he should have noticed on her blood work...and that he refused to return my calls on when I noticed it myself and asked for treatment for it. The surgery was meant to give her anywhere between 1 and 5 more years...possibly longer...but in the end it only got her 6 weeks.
 
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