Diet for elderly cat with early kidney disease

waddle

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I have a 17 yo female tabby with early kidney disease. I recently took her in for an emergency visit for a UTI and we will be seeing her regular vet next week.

Her SDMA was 21, up from 13 about 6 mos ago. I got some cans of hills and royal canin Rx kidney food and thankfully she will eat them.

I still have some of the northwest naturals freeze dried raw; she lost interest in this a while ago but her appetite seems better now and she will eat it again, especially if mixed with the canned food (I always rehydrate the freeze dried raw.) I know they recommend lower protein diets for kidney disease so I’m not sure if this is a good food to give her now? I’ve attached the ingredients/nutritional breakdown of the flavors I’ve been feeding her. She wouldn’t eat any other raw food in the past; at first she ate some of the frozen from NW Naturals and the Stella medallions but then wouldn’t touch it.

She also has IBD or IBS and has been on prednisolone (2.5 mg/day) for many years. When we’ve tried to reduce the dose she loses weight quickly.
 

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misty8723

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Here's a good web site with info on kidney disease: Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Everything You Need to Know to Help Your Cat There's probably some info there on raw diets and foods you can feed instead of the junky prescription stuff. I know there are phosphorus binders that can be given so you might be able to continue to feed the Northwest Naturals raw.
Thank you for providing this link. My cat Cricket has been diagnosed with early stages kidney disease. My vet has told me not to do anything different yet, but she will be checking her numbers in October and we will go from there.
 

FeebysOwner

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Lower protein is no longer thought to be beneficial in CKD cats, or any older cats, as they are losing muscle mass just by virtue of the natural aging process. You will find that out when you start to read through Tanya's web site, via the link provided above. I wouldn't avoid the freeze-dried food you are feeding her because of that - but the phosphorus could be considered a little high.

I would also have the SDMA retested just to see if the elevation is a 'one-off' thing. SDMA can be impacted by other factors, including the UTI I believe. I say this because her creatinine is at this point is very, very good!!

Personally, speaking I wouldn't bother with the renal foods, let her have the freeze dried raw, and look for other foods that are lower in phosphorus - there is a section in the web site noted above that lists lower phosphorus foods. A lot of cats who do start out eating the renal food do tend to tire of them pretty easily. Some, like my cat Feeby, won't even consider eating them to begin with!!

Re: the UTI. What does the vet think is behind it? Crystals/stones/urine PH, or mostly due to bacteria? You might consider adding pure D-Mannose to your cat's diet. It helps to flush out bacteria from the bladder, thereby reducing the chances for a UTI. Members on this site also use it for general bladder health in their cats. It is a powder that I add 1/4 tsp. daily to Feeby's food, and it has helped reduce bacterial build up in her urine which was giving her routine UTIs. This is the one I use:
Amazon.com: UTI Pets Pure D-Mannose Non GMO Organic Source Powder 65gram jar : Pet Supplies

And, lastly, you might have her B-12 level checked. A lot of cats with IBD/S don't have great nutritional absorption, and the B-12 helps with that aspect.
 
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furmonster mom

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As has been mentioned, the “low protein“ diet for kidney kitties is outdated.
The thing you really need to lower is phosphorus. This can be achieved with phosphorus binders and low phos foods. You can also “dilute” the phosphorus level of a food by adding cooked egg whites. Egg whites are an excellent simple protein without phos, so you can maintain that protein level.

Kidneys and liver are commonly the first organs to be compromised as cats age. I’ve dealt with both in almost all of mine over the years.
The liver and kidneys work as a team, with the liver as first defender, so you may want to consider giving the liver a bit of support with adenosyl or milk thistle (silymarin). You might not need a lot in first stages, but adjust as needed in accordance to ALT levels from blood tests.
 

FeebysOwner

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The liver and kidneys work as a team, with the liver as first defender, so you may want to consider giving the liver a bit of support with adenosyl or milk thistle (silymarin). You might not need a lot in first stages, but adjust as needed in accordance to ALT levels from blood tests.
waddle waddle - Feeby who has CKD does not have any issues with her liver/ALT level (so far, knock on wood), so don't automatically assume this will be the case with your cat. But it is definitely a thing to keep your eye on!!!
 
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waddle

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She didn’t say anything about crystals. I’ve attached more of the blood work; not sure if one of those would indicate crystals? The culture grew e. Coli.

She does have a couple teeth giving her trouble and will probably have those pulled so that may be affecting things too. I hate the idea of putting her under anesthesia at this age; will see if my regular vet agrees they need to be removed. She is probably in pain because of them. :-(

Her ALT was very good. Vet recommended doing blood work again in three months. Might have to do it again sooner before they’ll do the teeth

I will pick up some of the lower phosphorus foods and see if she will eat them. In the past fancy feast was the only thing she would eat but her appetite seems a lot better now so hopefully she’ll go for something else.
 

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The results don't show bacterial count, nor does it mention (not that I can tell from that report) anything to do with sediment or crystals. The 'BLD' I assume to mean blood, but that can happen with a UTI. Since there was a urine culture done, may there are additional pages related to the urinalysis that you didn't get?

Good news on one level - pure D-Mannose is excellent for keeping e-coli levels down in the bladder. That is what had me start giving Feeby D-Mannose in the first place, she kept getting UTIs related to e-coli.

Sorry to hear about her teeth. Feeby (18+ yo) has some tartar and gingivitis, but it seems not enough to warrant putting her through anesthesia, thankfully. So, I truly feel for you on that one!
 

mrsgreenjeens

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Just want to mention that one of my raw fed cats had both creatinine and SDMA raised due to a UTI a couple of years ago. Once the UTI was gone, both those figures went back into normal ranges. Looking at the bloodwork posted, I think your cat may get the same good results by just getting the UTI under control. If not, since all other kidney values look good, I wouldn't switch to a low protein diet yet. I fed my last kidney cat (not the one mentioned above with the UTI) a raw diet until she started completely refusing it. At that point she was probably in stage 3 kidney disease and we simply fed her anything she would eat because her appetite was getting pretty low.
 

Furballsmom

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There's a lighter anesthesia ( if that's the correct way to put it?) that can be used for older kitties, you might ask about that :)
 
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