Julia & Bandit said:
I've read that low protein diets have only shown to be beneficial in end stage renal failure, and should not be fed long term because they can cause muscle wasting in cats.
And herein lies the conundrum: Advanced CKD cats have a low appetite. Feeding low protein diets to hyporexic cats defies the second grade math discussed in my previous post.
This is what I am fighting among my colleagues. Julia - you are absolutely quoting correctly that the Rx renal diets are being pushed on advanced CKD cats but that is what I am strongly challenging.
There needs to be a serious paradigm shift in this way of thinking otherwise, we will just keep watching our advanced (and even earlier) CKD cats waste away and die.
On a very good note, I am heartened to read threads on the FDMB showing that YOU GUYS GET IT!! More than the mainstream vets....
As for phosphorus binders, it's been my experience (but I've only observed perhaps 4 or 5 cats progress through CKD so I don't have the same amount of experience as a vet) that they tend to be needed once the disease has progressed to the end stages, which is usually when the cat begins to refuse food.
This is not exactly how I would word it.
Some people are under the mistaken impression that PBs can chase down phos that is already in the blood. It does not work that way. That is like closing the barn door after the horse is gone. PBs work by binding the phos in the food and are worthless otherwise. I had to remind a colleague of this when he was having his client use oral PBs (ALOH) on an anorexic cat. He thought that it would help lower the serum phos....completely misunderstanding how PBs work.
Kidneys in early stage kidney disease will likely still excrete phosphorus and a binder will not be needed, while cats in later stages will have higher levels because the damaged kidneys cannot excrete phosphorus from the body as well.
All very true but my point is that sometimes people wait too long before using binders and also don't understand how they work. For instance, they try to cram a bunch of binders (the daily amount) into a small amount of food...that this advanced, hyperphosphatemic CKD is barely eating....completely missing the point of how they work. ie...the less food a cat is eating, the lower amount of binders are needed.
Since the original poster does not seem to even have a diagnosis of renal disease and does not mention an elevated phosphorus level, I'm assuming the phosphorus levels are not so high as to necessitate a binder and a low phosphorus diet alone is appropriate.
I agree. That is why nobody can comment on the OP's specific question without more information.
Also, given that aluminum is toxic, I do try to hold off on ALOH as long as possible but when to start is dictated by the serum phosphorus, not necessarily the diet. (Of course, it obviously makes sense to start by putting as little phos into the body as possible by feeding low phos diets.)
My gripe is that I can formulate homemade diets that are very healthy (using MEAT, not grains) and are low in phos..... so I know that Hill's, etc. could do the same thing if they just were not so focused on the bottom line profit margin...and were not so focused on protein starving many of the cats eating these diets.
