Canned food: grain-free or with some carbs?

wasabipea

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Hi again Dr. Kris:

I'm likely adopting a 7 year old shelter cat that was raised by a family her whole life, then for some reason dumped at a shelter.

As of now she has good blood work numbers - I will see them tomorrow when I meet her, but I believe currently her kidney values are fine. I want to keep them that way. Should the adoption go thru, I plan to hit the ground running to prevent future problems.

I'll feed her a good quality canned (provided she is agreeable) - I've heard from vets that high protein, low grain diets are taxing on the kidneys - but cats are carnivores! Do you recommend grain free, or food that contains small amounts of rice, potato, etc as the most kidney friendly way to keep the kidneys friendly?

I know nothing about the care she received with her prior family, but f they dumped her at a shelter at 7 yrs old - I can't imagine she received the gold standard.

Thanks again, I'll try to make this my last question. Appreciate your time - again!

Wendy.
 

lisahe

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Hi, Dr. Kris!

I have a question about diet and prevention of kidney disease, too. Do you have any recommendations about phosphorus levels in food for young healthy cats? Do habitually high phosphorus levels in a cat's diet seem to "wear down" the kidneys faster than moderate levels? If so, what would you consider moderate or high levels, in dry matter terms? I realize this is a complex issue that touches on lots of factors, including genetics, but am wondering if you have any general guidelines.

Just as background: I ask because I have two Siamese mix cats who are about a year and a half old and get a diet of low-carb canned and commercial raw foods. The foods I've/they've settled on seem to work well for them: they do seem to have some sensitivities with potato and some fish. I wonder, though, about phosphorus, in part because they love Stella & Chewy's foods, which are very high in phosphorus! Right now I just them feed small amounts as occasional treats. I definitely want to talk with their regular vet about phosphorus in food when we get them their baseline blood panels this summer.

Like Wasabipea, I had a very senior cat who had all sorts of illnesses -- IBD, kidney disease, thyroid troubles, and a crazy arrhythmia -- so learned a lot about feline nutrition when she was sick. I wish I'd known all that earlier but am glad I can use it for the new cats!

Thank you very much! I'm very much enjoying reading your posts. Thank you for doing this!

Lisa
 
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wasabipea

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Hm, expanding on Lisa's question... she is much more versed in food ingredients and their effect on cats overall health than I am, I'm still in the middle of the learning curve.

I think I recall reading that phosphorus is to be avoided in kidney cats(?) - what does it do and why is it to be avoided? Should it be avoided in the average cats' diets in general, or only in cats with specific maladies?

Sorry... don't want to appear to be "ganging up" on you! Lol.

Thank you :)
 

oneandahalfcats

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I am also interested in phosphorus (and sodium) levels in foods and how this can impact cats over time. I have read that in healthy cats with no renal insufficiency, the kidneys are good at balancing phosphorus levels and will excrete any excess phosphorus. Is there a need to be concerned in your opinion about limiting phosphorus, and also salt in the diet, or is it a matter of ensuring that there is balance as in ratio of phosphorus to calcium for instance? I would expect that with high quality commercial products that these are balanced to feature appropriate amounts of these minerals, but is it possible that some meat protein foods require more phosphorus than others due to containing less naturally occurring amounts, as is the case for other minerals such as methionine for instance?

What do you consider to be an optimal phosphorus and calcium level in cats when doing a wellness blood draw? I have an appointment very soon to have Max done and this would be really awesome information to have.

Thank you very much! ...
 

dr kris

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Wasabipea, that is awesome you are adopting that older kitty! Lisa & 1.5cats I’ll answer your questions too in this post!

In the vet industry, food manufactures have done an incredible job marketing their perspectives. Any industry producing food products are absolute experts at marketing. It will be very common to hear “protein is taxing on the kidneys”. The information from a few key studies are marketed to us this way. You will hear this as often as “metacam is bad for cats”. It's not that people are being disingenuous, but to get to the truth of the matter we got to go deeper and question these blanket statements.  

So let’s start with the mouse. Or rats.

What a cat might naturally hunt and consume is at least 50 % protein, followed by fats. There absolutely is complex carbohydrates and fibre in the rodent carcass as well. So we know they both consume and utilize complex carbohydrates, and have been doing so for thousands of years. They are designed to do this. They can survive on a basic level without any carbohydrates because of their carnivore adaptions, but they will quickly suffer without the right sources of protein. Carb’s do provide some energy though, so they are not without value.  

In the human realm, grains are important in that they allowed for a storable, transportable sources of energy. This equals survival. Many people are of the opinion that there is a difference between “surviving” because of one’s diet, and “thriving” because of ones diet.

All of this to say that protein restriction must happen on a case by case basis. Even with renal disease. There is justification for it, but not in healthy normal cats in the prime of their lives, and not even in the first few stages of stable CKD.

So for your new kitty that has been evaluated as healthy by your vet, you can comfortably feed the higher protein, lower carbohydrate diets. As long as the carbs are complex, they can effectively process those. My own guy gets a smaller proportion of potato in his diet. I want to reduce his weight loss as much as possible, and I see the fat and carb content as important there.  

Even if we assume that protein has some sort of taxing effect on the normal kidney, this argument could be made: We all get taxed in life. We all have stresses. What’s worse - the stress of asking the kidneys to do their job within the body of a pet that is supported with a diet they have been designed to eat, or the documented effects of straying to far from what we are actually designed to consume. I know what side I tend to fall on!

For phosphorous: with higher protein diets, you can expect there to be more phosphorous. Or the phosphorus shows up in the vitamin mineral premix. We have no evidence to say that the normal cat kidney is harmed by this at all.

There is evidence that limiting phosphorous is more important than limiting protein for some CKD cats. Typically, you are waiting until they actually show too much phosphorous in the blood (hyperphosphatemia). I tend to be proactive with it. With my cat, who is stable stage II CKD + normal calcium and phosphourous levels in the blood, I do not protein restrict him, but I do try to bind some phosphorous in the diet with calcium carbonate and chitosan (a bit of aventi KP mixed in). Thats a personal choice i've made for him after evaluating all the research that i think applies to his situation.

Hope that helps!

k
 

dr kris

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I am also interested in phosphorus (and sodium) levels in foods and how this can impact cats over time. I have read that in healthy cats with no renal insufficiency, the kidneys are good at balancing phosphorus levels and will excrete any excess phosphorus. Is there a need to be concerned in your opinion about limiting phosphorus, and also salt in the diet, or is it a matter of ensuring that there is balance as in ratio of phosphorus to calcium for instance? I would expect that with high quality commercial products that these are balanced to feature appropriate amounts of these minerals, but is it possible that some meat protein foods require more phosphorus than others due to containing less naturally occurring amounts, as is the case for other minerals such as methionine for instance?

What do you consider to be an optimal phosphorus and calcium level in cats when doing a wellness blood draw? I have an appointment very soon to have Max done and this would be really awesome information to have.

Thank you very much! ...
Yes - balance is key. If they are getting SQ fluids, there is merit to watching the sodium content in those fluids as well.

Calcium should be in normal range - even if high normal, I am ok with that. For phosphorous on bloodwork, i interpret it in context with urea, creatinine, blood pressure and any evidence of proteinuria. That is too say, if the rest of the blood work is ok, and the phosphorous is on the high side of normal (your lab will supply their normal values), im feeling good about those numbers. If anything else is pointing to those kidneys (or calcium issues), then im looking at phosphorous a bit more critically.

Cheers and good job getting that very important wellness test done!

k
 

oneandahalfcats

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Yes - balance is key. If they are getting SQ fluids, there is merit to watching the sodium content in those fluids as well.

Calcium should be in normal range - even if high normal, I am ok with that. For phosphorous on bloodwork, i interpret it in context with urea, creatinine, blood pressure and any evidence of proteinuria. That is too say, if the rest of the blood work is ok, and the phosphorous is on the high side of normal (your lab will supply their normal values), im feeling good about those numbers. If anything else is pointing to those kidneys (or calcium issues), then im looking at phosphorous a bit more critically.

Cheers and good job getting that very important wellness test done!

k
I think I will look to doing a urinalysis as well so I can have the benefit of checking protein in the urine for a broader picture. Max is due for this as well but hasn't had any problems to-date, so we've let things slide a little in this respect.

Many thanks! ...
 

dr kris

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I think I will look to doing a urinalysis as well so I can have the benefit of checking protein in the urine for a broader picture. Max is due for this as well but hasn't had any problems to-date, so we've let things slide a little in this respect.

Many thanks! ...
Yes, I really like that idea. I do that all the time - the more things like this you do, the better able you are to interpret the blood work and your cats inner workings. Reading their secret diaries!
 
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wasabipea

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Wasabipea, that is awesome you are adopting that older kitty! Lisa & 1.5cats I’ll answer your questions too in this post!

In the vet industry, food manufactures have done an incredible job marketing their perspectives. Any industry producing food products are absolute experts at marketing. It will be very common to hear “protein is taxing on the kidneys”. The information from a few key studies are marketed to us this way. You will hear this as often as “metacam is bad for cats”. It's not that people are being disingenuous, but to get to the truth of the matter we got to go deeper and question these blanket statements.  

So let’s start with the mouse. Or rats.

What a cat might naturally hunt and consume is at least 50 % protein, followed by fats. There absolutely is complex carbohydrates and fibre in the rodent carcass as well. So we know they both consume and utilize complex carbohydrates, and have been doing so for thousands of years. They are designed to do this. They can survive on a basic level without any carbohydrates because of their carnivore adaptions, but they will quickly suffer without the right sources of protein. Carb’s do provide some energy though, so they are not without value.  

In the human realm, grains are important in that they allowed for a storable, transportable sources of energy. This equals survival. Many people are of the opinion that there is a difference between “surviving” because of one’s diet, and “thriving” because of ones diet.

All of this to say that protein restriction must happen on a case by case basis. Even with renal disease. There is justification for it, but not in healthy normal cats in the prime of their lives, and not even in the first few stages of stable CKD.

So for your new kitty that has been evaluated as healthy by your vet, you can comfortably feed the higher protein, lower carbohydrate diets. As long as the carbs are complex, they can effectively process those. My own guy gets a smaller proportion of potato in his diet. I want to reduce his weight loss as much as possible, and I see the fat and carb content as important there.  

Even if we assume that protein has some sort of taxing effect on the normal kidney, this argument could be made: We all get taxed in life. We all have stresses. What’s worse - the stress of asking the kidneys to do their job within the body of a pet that is supported with a diet they have been designed to eat, or the documented effects of straying to far from what we are actually designed to consume. I know what side I tend to fall on!

For phosphorous: with higher protein diets, you can expect there to be more phosphorous. Or the phosphorus shows up in the vitamin mineral premix. We have no evidence to say that the normal cat kidney is harmed by this at all.

There is evidence that limiting phosphorous is more important than limiting protein for some CKD cats. Typically, you are waiting until they actually show too much phosphorous in the blood (hyperphosphatemia). I tend to be proactive with it. With my cat, who is stable stage II CKD + normal calcium and phosphourous levels in the blood, I do not protein restrict him, but I do try to bind some phosphorous in the diet with calcium carbonate and chitosan (a bit of aventi KP mixed in). Thats a personal choice i've made for him after evaluating all the research that i think applies to his situation.

Hope that helps!

k
Thank you very much for your detailed reply. I have to admit, I'd love to have you as my regular vet. Back to my current kitty, I'm not sure what I'm treating anymore, since my vet seems to have filed her under the "she's 18, what do you expect?" category and I've been avoiding her since her ambivalence upsets me.

Her last creatinine reading at the end of June was 2.2, and she has been receiving fluids on a regular basis (varying intervals and cc's) - I'm assuming her kidney insufficiency is stable (it spiked at 3.2 late May). I just don't know what I'm treating right now, seems as though I'm trying to keep her alive, and she's not thriving. I'm assuming that she is dying. Now she's on a relatively high protein food at the moment (one that she will eat), its main ingredients are animal proteins, followed up by carrots and potato, and I was surprised to read fats pretty high on the ingredient list right after that.
She's eating it, for now, sounds okay from what you describe. I was wondering why fats would be so high on the list.

I did decide to shelve the adoption (I think) - with the current cat's condition, I don't think it's in her best interests since I think she is still in mourning after two months for her brother, as well as ill on top of that. But I'll be out there when he time is right. Thank you again.
 

dr kris

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Thank you for your kind words!

I always make a problem list. Stuff I can readily identify. When I present it to my clients, I usually concentrate on the first 3 things only. Once they have mastered that, onto the next. For many folks, overwhelming them with 8 things to do all at once is a disservice - it actually makes them feel hopeless and pushes them towards euthanasia.

You are not one of those folks, but i think it still stands. Find those three things we know for sure. That is 3 x more than some people would ever do. Your cat will tell you what to do next.

PS - fat higher up on the ingredience list is ok; the primary wet commercial diet I feed Zack is primarily protein and fat;

k
 

lisahe

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Thank you, Dr. Kris, for addressing the phosphorus question and the question from 1.5 Cats about test results. I appreciate it and I'm sure the cats will be happy to keep eating Stella & Chewy's food!
 
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