Kidney issues diet

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Lisa and Witn (GA)

Lisa and Witn (GA)

Member Since 2009
My cat Simon does not have diabetes but does have IBD. For several months he has been on a homemade diet consisting of a single protein and the EZ Complete supplements for raw food mixed in. I do cook the meat first and then mix it with the supplements and juices from the meat after it has cooled. On this diet he has gained back his weight.

Today he had blood work and his BUN and ALT were a little high. BUN was 49 mg/dL and ALT was 145 U/L. The vet put him back on Denamarin for the liver. He was on this before and it brought his ALT down before they decided to stop it. For the kidneys she wants to start him on Royal Canin Feline Hydrolyzed+ Renal Support. I have two concerns about it. First is his IBD flaring back up with the diet change and the second is it is only available as dry food. Plus it is extremely expensive.

I did ask about other options such as a phosphorus binder, especially since this prescription is supposed to be low in phosphorus. She said since his phosphorus test results were normal, 3.8, she didn't recommend it.

Since we have several members with experience caring for cats with kidney disease, I am hoping you have some suggestions.
 
Is his IBD flaring up? Are there any symptoms? I don't think I would go to a hydrolyzed diet (especially dry) unless I had no other choice. I think it sounds like your homemade diet is working well for him -- and his phos is at an excellent level (close to 4, which is very good indeed) -- that's the EZ Complete which uses the eggshell calcium instead of bone (which I know you know about.) As far as the renal component of that food -- again, it's most likely a lower protein food and a controlled phosphorus food if it's a renal diet combined with hydrolyzed protein. I don't think you want to restrict protein at this stage. You didn't say what his Creatinine was, but I'm assuming it must not be outside of the normal range? Denamarin is very good and I have seen reduced ALT in many of my cats when they take it. I have a cat on it now to protect her liver because she's on a lot of meds (that are metabolized in the liver) for her heart. But an ALT of 145 isn't really all that bad. Vets don't usually get concerned until it's much higher than that (like two or three times the upper limit of the reference range.) But still, I would give the Denamarin because it will support his liver.
 
Oh, what I was going to say is -- IF the IBD is flaring -- why not try some Prednisolone for the IBD? He's not diabetic. Some cats can be controlled via diet alone and maybe your baby can be. Do you get ultrasounds done on him to see how the inflammation is doing? I get them every 6 months or so for my IBD boy -- but he takes EOD pred -- I do this because I'm afraid of it morphing into SCL, which has happened to me before. I don't want to miss anything in case I have to start Leukeran (chlorambucil) -- but that's another story.
 
What kind of meat do you use? Is it ground meat? Do you buy it at your local grocery store or do you order it? How long do you cook it? I'm only asking because I continue to want to do this for my cats, but I continue to delay. Probably because I have a lot of cats and it would be onerous to do this for so many -- but it's expensive to feed Weruva to so many as well.
 
His creatinine was 2.0. He is not having any IBD issues. The only issue he had that led to his IBD diagnosis was weight loss. All of his blood work levels were normal and that is when his vet referred us to an internal med specialist. I don't remember the name of the tests but it was determined that his body wasn't absorbing all of the nutrients from the food. Originally we started on a hydrolyzed diet which did help. However he quickly started not liking the food. Then we decided on trying either a novel or single protein diet. That is when I started making his food. I rotate his proteins and he is fed chicken, pork and rabbit. The meat is cooked in an instant pot with water and after the meat is cooked and shredded, I add the EZ Complete using the cooking water so I am adding back what nutrients that may have been lost during cooking. The rabbit is the only protein that also has bone and organs and I use Alnutrin instead of EZ Complete.

He doesn't take any meds for the IBD. I really would not want to screw up his diet since it is working for the IBD. I am hoping there is a possible way to keep the kidneys healthy as possible at the same time as keeping the IBD under control. It's similar to having a diabetic cat that also has kidney disease. Which disease is more important to keep under control?

He was on Denamarin for a month and they decided his levels were back to normal and took him off of it. Since it works I don't have any concerns about putting him back on it.
 
I just want to caution you about pred or even budesonide. Bobo also has IBD and had CKD and after a month on budesonide he became diabetic. I tampered it down and he’s on remission now, but I took a deep Google dive then and it seems that cats who have a kidney or liver issue and go on steroid are more likely to be some diabetic.
 
Ale & Bobo & Minnie (GA) said:
I just want to caution you about pred or even budesonide. Bobo also has IBD and had CKD and after a month on budesonide he became diabetic. I tampered it down and he’s on remission now, but I took a deep Google dive then and it seems that cats who have a kidney or liver issue and go on steroid are more likely to be some diabetic.
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So far he has not shown a need for any type of steroids. The home made food seems to be working for the IBD. I am hoping someone has suggestions for keeping the kidneys healthy while on a diet that keeps his IBD also under control. I really do not like the option of feeding him dry prescription food. I have had 6 diabetic cats and dry food is not welcome in my house.
 
Bobo won’t eat any of the kidney friendly foods so I had no choice but to keep him in the same FF diets he’s always been on. His levels have stayed pretty much the same for the past 2 years and when it advances, I’m going to add the binder to his food but we’re not there yet. The vets tried to push the prescription kidney friendly foods on us and I did try them but he would rather starve than eat them. Then I tried all the non-prescription CKD friendly food and still no go. That’s where we’re at right now. I’m managing his IBD with ondansetron, metroclopromide and Cerenia.
 
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