Murphy - Question on Dx of CRF and Glucose`

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Well, Murphy has CRF. We tested her thyroid and started treatment and she is 2nd stage. We caught this early, but the importance of a renal diet has become ever apparent. Unfortunately, she will not be able to have the higher protein diets, and what I'm finding is that her glucose is somewhat higher. She is more hungry now, evidenced by a 3-meal feeding per day. But, she is not ravenous and drinking and peeing a lot showing symptoms of diabetes. I tested her mid-day last week and on the OTU meter, her BG was 185. I guess my question is -- even though her diabetes was from the iatrogenic Cushing's, is there a possibility that it could come back? I hate to see her so hungry all the time. She has gained almost 1 pound in a month since we started thyroid treatment. I've got her on a very good renal diet, but want to know if anyone has experienced this on the diabetes end and how they are managing with a lower protein diet. What a bummer, but she seems to feel better.

Hope all is well. Lisa and Murphy
 
Love you all so much for caring for my girl. She's a pretty special little baby, and I just cannot believe what we're dealing with now, but I think it's early enough on that her diet can be controlled enough to stave off some of the progression of CRF. She has, however, gained about one pound in about 3 weeks from the lower protein diet.

This is tricky, but she isn't showing symptoms of returning diabetes, which could be due to the fact that the Cushing's was controlled when I lowered the dosage of inhaler for her asthma.
 
HI Lisa, the ravenous appetite plus weight loss could be the hyperthyroid disease - that is one of the hallmark symptoms. My cat had hypert and she would eat her normal food plus a full can of Hills A/D a day (which is very rich) AND still lose weight. So once you get the hypert under control you'll find her appetite goes back to normal and as you've already noticed her weight coming back. As for the CRF that is usually found after the thyroid hormones get controlled - because with the thyroid hormone raging it makes the kidneys work much harder. Tanya's CRF site is terrific and just as informative as this one is for diabetes: http://www.felinecrf.org/. My cat has both CRF and Diabetes and it is possible to work with them both for optimal treatment. Hopefully your kitty will stay OTJ even with a higher carb food. Jan
 
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 cause less protein metabolism residue, which are easier on the kidneys). Keeping your cat as hydrated as possible is key to managing the disease, along with low phosphorus foods, so definitely no dry food at all (if you're feeding any). 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. The low-protein kidney diets have only been shown to be beneficial in end stage renal failure and should not be fed long term. In fact, they can cause muscle wasting when fed in early stage CKD.

Because diabetes is also a concern, you really need a diet that feeds to BOTH conditions. This is an absolute necessity--there's no point trying to manage the CKD if you're then going to have to deal with uncontrolled diabetes. You have to treat both, or you're still going to have a sick kitty.

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.

My Gabby had early stage CKD and she was on a med-high protein, low phosphorus diet for the last 2 years of her life. Her CKD did not progress AT ALL on the low phosphorus/high quality protein diet. She passed away from cancer, unrelated to her CKD.
 
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