Kitty and I need Food HelP!

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kse

kse

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My Kitty has had a tough road lately. She was dx diabetic last Feb, and we struggled for months before finally getting her regulated. For the last 6 months, until the last few weeks, her preshots have been in the 200s and she had nadired into the 80s to 100s. She is dosed Prozinc tid.

Two weeks ago, she was dx with chronic renal failure--CRT 3.7 BUN 102. This was really sudden, as 6 weeks prior her kidney blood work had been stable for the last yr. CRT. 2.3 BUN 54-- though elevated, very stable and she is 16.5 years old. After treating the CRF for a week, I noticed she was getting considerably worse and we ended up at the University Vet hospital, where she was dx with heart failure. She responded very nicely to the treatment and after 2 days in ICU is now home. Her CRT is now 2.5 and BUN is 68. The vet insisted she needed to be on a kidney diet--Purina NF (24 percent Carbs) and that the diabetes was not as important as the kidneys and that I needed to quit concentrating on managing the diabetes. I know her diabetes cannot tolerate 24 percent carbs-- I just checked her at +8 and she was Hi--So, discouraging.

So, my question to you-- would you stick with the high carb food? I can't imagine that is what I should be doing. OR, would you take Janet and Binky's and get as close as you can and lower the carbs. There are actually some Royal Canine renal diets that only have 8 percent carbs. I would appreciate some thoughts. I can't imagine just letting the diabetes run wild.

She is also on a blood thinner and when I tested her today--- I didn't think she would ever stop bleeding. Any thoughts on that? IF I keep feeding the high carb, I want have to worry about testing!!! She will never be low!
 
That was a bind that I found when Scruffy got CRF - he'd gone back on insulin (after almost four years) during his initial hospitalization because they treated him with steroids. And almost all of the recommended non-veterinary diet (NF, KD, etc) foods had gravy and high carbs. There is a very good list of low phosphorus "normal" foods on the Yahoo CRD/F groups website. http://www.felinecrf.org/which_foods.htm Scruffy - after almost 8 years of gravy-deprivation - only wanted pate foods; one that he liked that was almost as low in phosphorus as NF was by Solid Gold - their "Chicken, Turkey, Whitefish and Liver Formula."

You are so lucky that treatment of the CRF is working! And, to my mind, it is the disease that has to receive the most attention, because it has the most potential to be deadly. Diabetes is unlikely to kill her. And, since it seems that the CRF is under some control, you might be able to use more diabetic friendly foods if you put aluminum hydroxide (phosphorus binder) in them. You can order a can of it from http://www.thrivingpets.com for about $50. (In your last post, I mentioned that I have some azodyl capsules that you might be able to use - I didn't see if you responded, by the way.) And, if you have to increase the insulin dosage, that's not the end of the world, right?

Scruffy's circumstances were different because he also had lymphoma and chemotherapy, but I found that after the initial couple of weeks of being back on insulin, his levels kind of settled down in the area of 120 or so on a very, very tiny amount of insulin - too low to risk shooting, and not high enough to worry about. His kidney function deteriorated very quickly, so he didn't even have glucose spilling into his urine. Diabetes just got to be a non-issue for him.

The blood-thinner/ear-poking problem is another story - I have no idea what you should do about that. But I'm sure that other people here have experience.
 
Wow - this is a tough spot to be in. I personally don't agree with the vets statement that the kidney disease is more important to deal with then the diabetes. I think high blood sugar/ketones will kill a cat a lot faster then CRF. If it was me I think I'd go see a internal medicine vet for a 2nd opinion. There is a renal canned food that is under the 10% carb count and low phosphorus - its called Hi Tor Neo. You might have to order it online because I don't think its carried in many stores. I have a cat with both diabetes and CRF - I manage her food on the diabetes first, crf second consideration. There is also a probiotic called Azodyl that helps slow the progress of CRF. Since using it my cats creatnine has gone from 4.4 to 2.8 and she has been stable for a year. It is a bit spendy and has to be kept refrigerated but so does insulin. Hoping your kitty feels better soon. Jan
 
I am sure lynda did a lot of research on foods. but a lot of us also use friskies special diet. there are 4 flavors and they are low in carbs also. i have 2 definite renal kitties, 1 borderline and would be very surprised if wheezer was not borderline also... SQ fluids also for renal kitties to help flush out toxins lactated ringers. yo might not be able to do this cause of heart problems though

I also give binders to the one. we have not had any recent BW done. just DX a few months ago and binders started beginning of month
 
Yeah, Dian - Scruffy's story is different because his kidneys gave up so fast; if he'd had more time, the food issue might not have been so agonizing. I didn't have any negative feelings about Friskies Special Diet; he just didn't have the time to try it on any regular basis. :(

There were people on the Tanya site I linked to above who had had cats in CRD for nine years! If your Kitty looks like hers is going to be manageable, then maybe you can put more emphasis on the diabetes. I guess it depends on which disease seems most threatening at the moment......
 
Thanks to all of you for the responses.

Right now I am having a hard time getting her to eat anything. I am not sure if it is the heart or kidneys that are influencing her appetite. She will eat the Friskies Turkey and Gilbets Special diet, at least some, and I have binders. I actually got a prescription and bought the Royal Canine Modified Renal food yesterday-- the carbs are only 8 according to J&B. I was so desperate to get her to eat last night that I broke the FF out. I know, bad, but she must eat.

Her BG was down last night and this morning, back to more normal numbers--but, I assume that is due to eating less.

If I can get her stabilized and eating, I am certain I will be back with more questions.

Once again---thanks!
 
if you look at this link, scroll down about 1/2 way to the links to foods for various special diet needs. i don't have experience with this, but perhaps one of those food lists will be helpful. i think both marjorie/gracie and ann/tess on the Lantus TR forum have experience with kitties with kidney failure and diabetes - i'll track them down and ask them if they can give you any help. hopefully we can dig up something that will help Kitty!

btw, i saw your response to lu-an - that was very kind of you. thank you!

:lol: eta: maybe it would be helpful if i actually posted the link! must be too early in the morning! LOL http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=18139
 
I had a CKD kitty, and unless you're in the end stages it's really not good to feed the prescription diets. The low protein causes muscle wasting if fed long term. And the diabetes is the more pressing concern right now, so you need to feed a low carb food.

The good news is that there are commercial foods that are good to feed for both conditions. You simply need a low carb, low phosphorus canned food, preferably without byproducts (higher quality protein sources are easier on the kidneys). Keeping your cat as hydrated as possible is key to managing the disease, along with low phosphorus foods, so you'll definitely need to ditch the dry food completely. Mixing water in with the canned food is one good way to help with hydration. Many people also find that cat drinking fountains also encourage cats to drink more. Anything you can do to get moisture in your cat is important.

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 and less than 250 mg/kcal of phosphorus. 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, and Blue Wilderness Duck.

If those are out of your price range (although I would strongly urge a food without byproducts, keep in mind that it's still cheaper than the prescription food), the next best thing to feed are the low carb Friskie's Special Diet flavors. These are Turkey & Giblets and Salmon Dinner--make sure they are the ones that say "special diet" on the can, though. PetSmart carries them, and some grocery stores. Here is an updated list of just the phosphorus values for many commercial foods. They can be cross referenced with Binky's chart for carb values if there's something on there that you want to feed. On this chart, you're looking for something that is less than 1% phosphorus (these values are on a dry matter basis, not mg/kcal): http://www.felinecrf.org/canned_food_usa.htm

Do NOT use Binky's list for phosphorus values--the carb values are still ok to use but the phosphorus values are really out of date, and some things that were low on that list are now ridiculously high in phosphorus. You can cross reference the carb content from foods on Binky's list with the phosphorus values on Tanya's canned food list, however.
 
Julie asked me to pop over from Lantus Land to help. Actually, my diabetic cat is very young and is not my CKD cat who is 16. So...I don't have to worry about carbs so much with my CKD cat but do have to worry about phosphorus. Even still, I don't want him on really high carb food.

Julia listed the foods I would also recommend and that I use for my CKD kitty; the only one I would add to the list is Wellness Chicken. It's a tiny bit higher in phosphorus than the WN turkey but not much. It's still a great choice. Since my CKD kitty has to be monitored closely for his phosphorus level, I do use binders. I get them from thrivingpets.com but I buy them a couple oz at a time as it is cheaper that way and lasts a very long time.

Are you giving her subq fluids at home? I'd be sure and discuss this with my vet....it will help her BUT you must really balance the fluids with the heart condition and that's a tightrope. I'd follow whatever their recommendation is on that.

Good luck....I hope she starts eating and feels better.

AND...I agree on not using the renal foods. And also....while Hi Tor Neo is low phosphorus, the ingredients are pretty bad. I'd much rather feed my kitty a high quality diet and add a little binder.
 
Hi, sorry that all this is really dumping on you. I'm lucky in that Tess is just in the early stages of her kidney problems. The foods that have been recommended are all good. You can treat both conditions. There isn't a lot of selection, but there are choices. For Tess we are feeding foods that are less than 200 mg/100kcal (J&B list or the new list you were given the link to) or less than 1% on Tanya's list (you have that link also). Just by concentrating on low phosphorus as well as low carb foods, Tess's renal values improved significant;y in the last 6 months since her dx.

I have gathered most of the low carb/low phos foods in a separate sheet on Tess's SS. Click on the link in our signature and look for the "LC/low phos" tab. There are a few other good foods that haven't been mentioned. i haven't tried them because they aren't available locally and I don't want to order a whole case and find Miss Picky Eater won't touch them. The ByNature Organics canned foods (not the 95% line, that is higher phos) are rated .68% on Tanya's list, it's not on any of the others but someone worked it out to about 2% carbs. I've contacted the company, but haven't heard back yet. Wysong Gourmet Chicken is another lower phos food, but i can't get that either.

If feeding raw food doesn't make you cringe Nature's Variety is a very good choice. Easy to feed w/ 1oz. medallions. Tess loves the Organic Chicken, the Chicken and Turkey and Beef are also low phos on J&B's list (Tanya's list doesn't include raw foods), so I'm not sure how up to date it is. Their website lists the Organic Chicken at 2% carbs and .26% Phosphorus. but I think that is As Fed not Dry Matter (Tanya's list) or Metabolized Energy (J&B list). One really good aspect bout the NV is that it is 65 kcal/oz. Twice the calories of FF, so you only need to feed half as much. Good news for a cat w/ a small appetite. Most cats need 20 to 30 kcal per pound of ideal weight, depending on their activity level.

I also make a customized homemade raw, very low in both carbs and phos. There are several places to get one worked up by analyzing your cats test results. The consultations are not cheap, but the cost of making your own food isn't bad at all.

You might want to look into phosphorus binders too. The newer thinking on CRF is not to restrict protein, (the BUN levels are considered less important than Creatinine) but to lower phosphorus. Dr. Elizabeth M. Hodgkins book Your Cat has a lot of great information on feline diet.

Besides phosphorus binders, using a low phos protein source helps. 100g ofcooked egg whites have 11g of protein, only 15mg of phosphorus and 48 kcal. While 100g of raw chicken breast is 23g of protein and 196mg of phosphorus :shock: and 110 kcal. I cook the egg whites in about a tablespoon of butter which adds 100kcal., no protein and only 3.4 mg of phosphorus. You can add up to 15% of other proteins to the diet w/out effecting the extra minerals needed for a balanced diet.
 
Thanks so much to everyone for your input! I cannot Thank You enough.

I have read all the posts, but I have not had time to look through all the links...tonight, I hope to read all of them.

Today I have had success feeding Friskies Turkey and Giblets Special Diet with a little chicken broth added (I boiled and added no salt), and Phosporus binders. I know this isn't the "perfect" food-- but, last night I would have fed dry if she just would have eaten!! So, how bad is what she is eating today? Do any of you see any major concerns with the meal?

Kitty has always been an eater, so if she gets to feeling better I think I can adjust the food. I have the Wellness Turkey and Chicken flavors and almost every other variety that appeared low in carbs and Phosphorus, but I don't want to change to quickly and she quit eating.

Also, her Potassium is 3.9-- would you give the Tumil K supplement? Tanya's site said to supplement if under 4-- and she is on lasix, so I am certain the potassium will go lower.I was giving it last week-- she hated it. Are there any supplements I could add to the food if necessary?

So, thoughts on the food combination today?

I really do appreciate your help.

Kim
 
Friskies is good for both phos and carbs, most importantly, she's eating it! :-D :-D Not the highest quality ingredients, but the prescription foods aren't any better. :roll: Good idea on making the broth! :-D

Sorry, no info on the potassium. I haven't had to deal w/ that yet.
 
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