Mild Renal Insufficiency - food suggestions?

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arozeboom

arozeboom

Member Since 2011
Ruby went in for a check up on Thursday night and we got her tests back today.
Everything came up in normal range other than her USG came back as 1.028. The doc described this as "mild renal insufficiency".

Is there a list of diabetic friendly, low phosphorus food?

And what does this really mean?

Thanks
Amy & Ruby
 
Re: Mild Renal Insufficiency

BUN - 33
Creatinine - 2.1

The creatinine is the only thing that is flagged as out of normal range. The vet also said her USG is 1.028, if that means anything.
 
Re: Mild Renal Insufficiency

She currently eats Fancy Feast. Usually the "Beef & Chicken", occasionally "beef & liver", "Chopped Grill" or "Turkey & Giblets".

Do those fall into the low phosphorus category?
 
All the fancy feast are pretty high in phosphorus--none are great for a CKD cat.

There are several commercial foods that are good for both CKD 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.

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.

Here is a fantastic website with a lot of information about CKD: http://www.felinecrf.org/
 
Hobbs is CKD. Right now he's on Royal Canin Renal, canned (the larger can w/o gravy) however he refuses to eat it, so I mix that with Merrick Cowboy Cookout & Surf & Turf. I had him on EVO 95% as Julia suggested, but it became too rich for him.
 
Thank you, Julia!

The Before Grain varities are the ones I was planning on trying. I'm going to pick some up tonight. At this point I'm more concerned about quality (and if she'll eat it) than price. Is there any issue with feeding Midgie, my civvie, the same thing? Right now they both eat the same.

This is interesting...I just got the lab results from December, when she was diagnosed with FD. Her creatinine is the same that it was then, 2.1. Her BUN was 29, slightly lower than it is now (33). The creatinine is flagged as high in December but they never said anything about it. Granted her glucose was at 442, she had a urinary tract infection and was dehydrated so there were other things going on, but I'm curious as to why it wasn't mentioned. The BUN at 33 is still within their reference range (14.0 - 36.0). Her phosphorus is lower now than it was.
 
Fishy foods tend to be higher in phosphorus, and the only non-fishy food I can see that they make has brown rice in it, so it's probably too high in carbs. I would not feed any of that brand without the as-fed values so you could figure out both the carb and phos content.

One thing that's important to remember about CKD is that your cat's symptoms and behavior is more indicative of the progression of the disease than the numbers--the numbers are just indications that something is up and how bad it *might* be, not exact measurements of how things are progressing. There are other things that can cause slightly elevated BUN and Creatinine, including dehydration and a high protein diet: http://www.felinecrf.org/diagnosis_blood_chemistry.htm#bun.
 
The Solid Gold Chicken is what was suggested to me. They said its low in carbs & phos.

I have a couple of hesitations on it because 1) I don't think I've seen in on any of "our" food lists here and 2) the company did a voluntary recall during the big Diamond recall awhile back. It was the dry dog food, but still....

We finally get both Ruby and her FD and Midgie and her lung surgery somewhat under control and now Ru throws kidneys at me. :roll:
 
Another question...Dr K mentioned we could put Ruby on benazepril, if I wanted.

Any opinions on that? When I have the choice of medicating or not, I would rather go with not unless there is pretty strong evidence to the contrary.
 
I read somewhere that benazapril can raise the creatinine(at first). I used a phosphorus binder (ipakatin) years ago that seemed ok. I do make sure my crf cat gets filtered water and water down her wet some as well.
 
Wow...the Merrick Before Grain Beef did NOT go over well. They both practically ran from the bowls after 1 sniff. Ruby went back and tried to bury it.

The turkey got a slightly better reception. Last night they seemed to really like it. They didn't come close to cleaning either bowl over night and are a bit suspicious of it this morning. Midgie seems to like it a bit more than Ru.

I picked up the Beef and the Turkey BG, some Wellness Turkey, Wilderness Duck and some Merrick Cowboy Cookout. Hopefully at least one of these will be acceptable. :smile:
 
I would also get some fortiflora! Not only will it help the cats adjust to the different taste of the food (the flavoring is similar to what they use in Fancy Feast), it will also help with any temporary gastro issues that might pop up because of the food change. You can get it from your vet but it's cheaper to buy it on Amazon. Some vets will sell it by the packet rather than by the box, though if you don't want to buy a whole box. Another thing that helps is mixing the food half and half with the FF while you're transitioning to get them used to the flavor.

And sometimes it takes some trial and error to find the right food, because CKD cats are notoriously picky. Gabby hated anything EVO or Merricks BG, but she absolutely loved the Merricks 5 star entrees (Cowboy Cookout, Surf and Turf, Grammy's Pot Pie). She liked the Wellness Turkey enough to eat it, but sometimes I had to mix a little Fortiflora in every now and then. The big thing was variety with her--I had to find a few different foods she liked and switch them up, or she would get sick of the tastes stop eating them completely. Fortunately, most of the low phos foods I was buying were also low carb, so my kitty garbage disposal Bandit would take care of the cans she refused. :smile:
 
I have some FortiFlora. I'll try that. Ru liked it the couple of times I used it. Midgie is my super picky girl and wanted nothing to do with it. That was really early on though. Maybe it will be more appealing now. If I can find 2 or 3 kinds that they will eat, it would be great. I do try to rotate flavors because Midgie gets bored pretty quickly

This morning was so funny with the BG Beef. They were both completely offended by it. :lol:

Thanks for all of your advice. I really do appreciate it.
 
Wow...its like I've raised children who will only eat mac-n-cheese and chicken fingers...

Merrick Before Grain Turkey - nope ohmygod_smile
Merrick Before Grain Beef - nope ohmygod_smile
Merrick Cowboy Cookout - nope ohmygod_smile
Friskies Special Diet Turkey & Giblets - NOPE! ohmygod_smile

I caved and fed them FF tonight because they've barely eaten since yesterday morning.
 
I kept my Fred on Wellness, Merrick, Evo canned for the 6 years of his CRF...it didn't progtress much. I refused to put him on renal food. The last year I added phosphorus binder to the food. I never gave him seafood flavors.

Some of the blood value levels can vary depending on things like hydration.

Start putting little bowls of water everywhere, by the bed, by the TV, etc. so it's easy for your kitty to drink a little more.
 
She did seem to like the Wilderness Duck with Fortiflora mixed in. She doesn't drink a whole lot of water at this point. Less than 4 oz. a day (I measure what I put in the bowl and again when I change the water). Our house is so small she's never very far from the bowl.

Midgie had blood work done about 6 weeks or so ago. I'm going to have them fax the lab report to me tomorrow. I'm curious to see how they compare to Ruby's. The girls are about a year apart and were raised on the same diet. Ru has always been a bit of a bruiser and Midgie has always been skinny as all get out.
 
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