What do I feed this sugar/kidney cat. Suggestions?

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Robin & Ed

Member Since 2012
I'm pretty new here and still trying to get down all the lingo so please bare with me.

Ed was diagnosed with diabetes 4 years ago. Immediately I switched him to fancy feast after doing my own research and all it took was one shot of insulin and the diet change to control it. Since then things have been good until around February when he started acting strange. He would all of a sudden become wobbly and would fall over and couldn't/wouldn't jump on things.

I took him in for a check up and was told that he was CRF and we switched him to medical LP which Ed really seemed to enjoy and for awhile everything was good. In April I moved to a new city and I noticed he had become quite lethargic and didn't seem his usual self so I started checking his sugar and sure enough it had spiked up to 31 which is higher than it's ever been.

One vet check up later I'm told Ed has to go back on the juice but that all his kidney levels had not changed much since the last check up so I could go back to feeding him a high protein low carb diet.

Here is where I'm getting confused and need some suggestions...

Because he is CRF he cannot have high protein as I'm finding it causes constant constipation even when I add fibre to his food. In theory I guess I should be feeding him the Renal LP food but I find it causes his suger to go up like crazy when I do. So I guess I'm looking for a Low phosphorus, high fibre, quality protein and low carb food. I've looked at all the food charts and it all just leaves my head spinning. Some of the food I can't even find at any of the stores here in Ontario either.

I started thinking maybe I just need to put him on kidney support food and control the diabetes with insulin if his sugar starts going up again? That doesn't make a lot of sense to me though.

So I would just like to know what everyone is feeding their sugar kidney cats because the veterinarians don't seem to be much help. I'm so confused.
 
I wish I had info to give you on this, but have had no experience with CRF. Do you check Ed's blood glucose regularly, and if so, do you have a spreadsheet so the more experienced members here can view it? I am wondering if the 31 is really indicative of anything if it is a one-time reading? Sometimes a cat's BG will spike up if, for example, he has gone too low the night before -- indicating too much insulin rather than too little. But if you have multiple BG home checks for the more experienced members to review, that would help a great deal.
 
I'm having this same problem with Beauregard. :(

Just two weeks ago, he was diagnosed with early-stage kidney disease. His vet recommended starting on kd, but I can't bring myself to start him on that because his diabetes is diet controlled and he's OTJ, so I don't want to increase his carbs. My original plan was to go 50/50 with kd (or other kidney food) and a lower protein/phosphorus than his Fancy Feasts. That's not going to happen though, he's hating every version of the kidney food, even a little spoonful in his fav Cowboy Cookout goes untouched. He's lost a couple of pounds in the past month, so whatever he will eat is what I'm going to feed him.

So, for now we are going with a lower protein, lower phosphorus than what he had been getting (Fancy Feasts, most any of the "Classic" flavors). Thus far, there's been an improvement with the massive pees - there seems to be smaller pee clumps in the box, though no change in the frequency. One step at a time. This might not be the 'best' approach, and is not what seems to be the most common course of action to take, but my little Boo has been through so much in his life, and I don't want to make the end (if we're nearning the end) miserable for him.
 
We fed Blackie Wellness Chicken. Its low carb, but lower in phosphorus than most low carb foods. Its really the phosphorus you need to watch, not the protein. Merrick's Cowboy Cookout is also lower in phosphorus. And if your cat won't eat the lower phosphorus foods, you can always add a phosphorus binder to the food. I know that others here have fed Friskies Special Diet, which is even lower in phosphorus and still low carb.

You can check the food charts on Tanya's site and then check the carbs on FDMB food charts. I don't think there are current charts for both, but maybe I'm wrong.
 
There are several commercial foods that are good for both conditions. Here's a great website that explains the basics of feline nutrition: http://catinfo.org/. 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, and 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 bulk. 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/
 
Hi. I don't know what your cat's creatinine number is, but Tanya's CRF site felinecrf.org, as Julia suggested, is great. The idea that CRF cats need low protein has been in controversy. I don't feed low protein. I think Tanya's site says treat the diabetes first until the CRF creatinine number is at a certain point.

Are you giving subcutaneous fluids? My cat had a terrible time with constipation until I starting giving fluids and getting his blood sugar under control. Now, it's much better. I do not think, in his case, it was the food so much as the dehydration that was causing the constipation.

Here's what I wrote to someone else just yesterday:
Giving subcutaneous fluids can be a detriment at times, as Lisa said. Just like with diabetes, a vet will say, "Give x amount y times a day or z times a week," and send you home. You don't find out until later that the vet was treating the numbers only, not the whole cat, or that the vet has a generic treatment plan for all cats with CRF. Part of it is, of course, that vets don't know if you are the type to take a proactive approach or the type to just wing it. They just have to hope you'll bring the cat back for more tests and they can catch any complications caused by what you have been doing to the cat. I suggest you read Tanya's site, and learn about all the issues so you can be active in the cat's treatment.

BUN can also be elevated by mere dehydration. What happens in CRF is that the kidneys cannot concentrate the urine as well. Instead of peeing only the waste product and a little water, the cat is peeing a lot of water, too, just like with diabetes. You may notice that the pee doesn't smell nearly as bad as it did before, and that there is a lot of it. If the kidneys were working well, a lot of that water would be retained for the cat's body to use again. Cats evolved this way because they were desert animals. The severity of your cat's CRF cannot be assessed until you get the cat hydrated and stabilized. Then, the BUN and creatinine numbers may go down. My cat's numbers did.

[Be] careful to give fluids only when necessary -- not on a set schedule that does not take into account the cat's actual hydration.

So how do you know if the cat is in need of fluids? That's the million dollar question. I'm trying to keep my cat hydrated without over-hydrating him which will tax his kidneys or risk high blood pressure if he has an undiagnosed case of that. I can't pay for a BUN test to be done every week.

Tanya's site shows you how to check hydration by pulling up on the cat's scruff, and I'm sure there are a number of youtube videos that will show you how, too. I am hoping that I will learn over time how much fluid Max needs on a weekly basis by logging hydration checks and all the times I give fluids. Even with diabetes, 100 ml twice a week turned out to be far too much. It's probably because I'm feeding wet food only, and the vet didn't take that into consideration.

[T]here a[re] lot of videos on youtube and a lot of information about how to [give subcutaneous fluids] right on Tanya's site.
Click to expand...

Hope you get the dehydration under control. A caution about Miralax: It's great and it works, but the way it works is by holding water in the cat's gastrointestinal tract to help with the constipation. The rest of the cat continues to get dehydrated if you are not giving fluids often enough or in high enough quantities. If there is not enough liquid in the system, the insulin, as well as everything else the cells need, will not get where it needs to go. It's a balance thing.

Good luck!
 
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