Early CKD - Which is worse - fish or phosphorus?

[mysterylover]

Hi!

I have a kitty who was diagnosed with early CKD last year. She is 13 years old.She has dental extractions due to resorptive disease last December. Other than the dental situation and the early CKD, she is otherwise doing good health wise.

She was picky about her food before surgery, presumably because of the pain from the disease. At that time, she would even go and hide if I offered her shredded foods or something that did not smell nice enough for her to bother trying to eat. Then, after surgery, she continued to be picky and want only smooth textures and foods with strong, good odor. I tried so many foods, and I was determined to find her a food or foods that did not have fish and was relatively low in phosphorus with a texture and smell she enjoyed. During the food trials, she had severe constipation with so many foods with low phosphorus- guessing due to her being 13 and less active or due to many of those foods not having even one vegetable as a source of fiber and using gums or a combination of gums as fiber instead. Adding water to the foods does not seem to help that constipation. Adding enough pumpkin to some changed the flavor in her eyes.

I finally found a food that, with adding just a tad of pumkin, she is not constipated, dependably eats several flavors in rotation, and her tummy seems happy (no puking or reflux like some other foods). The phosphorus is not as low as I would like, but most are under 1. She is eating B.F.F. OMG, several flavors of the Land & Sea (Caio Baby, Shazaam, etc.), but of course, they all have not only fish but the fish is TUNA. I swore I would never feed my cats fish and definitly not tuna, but here I am.

I don't dread feeding time now and do not miss praying at feeding time like before that she won't sniff and go hide or making sure I have several other options to offer if she walks away. I don't miss having to watch her struggle to use the litter box from constipation and then give her a food to help her go which leads to diarrhea and cramping even in small amounts. I tell myself that she should be able to enjoy eating (that I would not want to hate my food or be afraid the texture would be uncomfortable), and I know that she needs to eat to live - and that her kidneys need fluid, which this food has more of. However, I still feel guilty about feeding this pretty much every meal, and I find myself worried about her getting hyperthyroid from the tuna.

At the end of the day, there are quite a few foods with tuna in them out there that have lower phosphorus. In early CKD, is it better to choose a food that is higher in phosphorus but with no fish (if i find one that she would like) or one that is lower in phosphorus but has some fish (though I am at least avoiding any foods where fish is the first ingredient, at least, though that does not make me feel better really)? Everyone here is so great! I appreciate your comments.

 

[Furballsmom]

Hi!
Your question might be better addressed by a veterinary nutritionist, I think, but I am wondering if she'd be willing to eat any of the other varieties of Weruva since she's already eating the B.F.F.? For low phos and also low iodine, Weruva is good. A food you might consider for later down the line is their WX variety which doesn't require a prescription and is extremely low in phos. (The AAFCO required them to put the statement on their cans that the food isn't nutritionally complete but other than the phosphorus, all the other ingredients meet AAFCO's guidelines.)
Weruva | A Family Owned Company
Additionally, in case you aren't already familiar with it, this website has a lot of nutritional information, and there is a support group associated with them too.
Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Diet and Nutrition Overview
Towards the bottom of this page, the website author discusses feeding tuna, including commercial foods;
Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Which Foods to Feed, and Which to Avoid

 

[white shadow]

Hi M mysterylover

Just a few quick points/thoughts for you.......

About "texture": If smooth is her preferred type, well, any food can be turned into a smooth (or very near, probably near enough to match her standard) soft-serve/mousse texture by blending it to maximum. I used a 'hand blender' with a coffee mug to excellent effect. Time and patience are the other key 'ingredients'. I frequently added shredded rotisserie chicken into the mix.

The trick to having a cat accept pumpkin is to start off with a very tiny amount and, over time, increase that amount by the tiniest of incremental amounts....until you've achieved the desired result. There are alternatives to pumpkin.....there's an excellent piece on fibers/fibres here - *DON'T skip the intro there, you'll need to know the different types of fibres and which types are best suited - and then go on to the particular varieties.

Of course, your overriding concern is whether/not to use fish.......if your cat were here/my cat, that wouldn't be a prominent concern of mine. Realistically, at 13 she is in the later stages of her life and, imo, unlikely to have enough time to accumulate enough of the ''nasties' from fish to cause thyroid damage........and, all of that is dependent on the veracity of the theory that those 'nasties' cause hyperthyroidism (still unproven). Now, that said, I wouldn't be buying 'tuna' by the case.

Something else to consider/explore further (likely, because most folks, most vets included, are unaware) is that "normal" blood lab results for thyroid evaluation do not apply to cats over age 10. That's the magic age after which a closer look needs to be taken at those numbers - and, with different tests (and, most especially if there's even a hint of a clinical sign/symptom). There's a thorough, reliable coverage of thyroid testing here (pay particular attention to the section "T4-Grey Zone).

OK, out of 'thoughts'!

 

[white shadow]

.........oooooops, one more

By coincidence, I came across two videos today that cover off thorough thyroid testing in older cats. The transcripts are attached and those are what I'm basing this post on. While the link I provided above is reliable, thorough, AND in plain-language, it IS science, and science melts MY brain. If you're like me, I think you'll find this alternative coverage more 'digestible'. It's in two parts, one and two.

That's it!

 

[FeebysOwner]

Hi. I doubt that a daily diet of fish is good - for any cat, healthy or otherwise. But when cats start to age and begin to have health problems, getting them to eat, whatever they will eat, is the best choice. The type of choices that you are trying to make seems reasonable enough to me. And you can always look through all of the food suggestions above to find additional foods that might appeal to her. But bottom line, getting her to eat, and enjoy it, beats out the worries about fish, IMO.

I also have a cat that was diagnosed with hyperthyroidism, via just the standard T4 test, and has pretty much never eaten fish cat foods - she just doesn't like them. So, it can happen regardless. The more elaborate thyroid testing is usually only needed when the T4 results show 'borderline' numbers, as some cats can have hyperthyroidism without their T4 being much above normal readings.

Feeby also has CKD but I was never able to get her to eat most of the low phosphorus foods I tried with her. So, I resorted to a phosphorus binder. I decided to do that over fighting with her to try to eat foods she is not fond of. Phosphorus binders can attribute to constipation, but most CKD are given Miralax if that happens to them. Phos binders are not generally used unless the phos level in a cat's blood work is denoted as too high. This is a debatable point, as cats with phos levels above 6 mg/dL should be considered candidates for lower phos or phos binders, even though most lab test don't indicate high numbers until past 8. And the higher the CKD stage the lower the phos level should be kept.

Although Feeby is an avid water drinker, I still have multiple water dishes around the house. I have found she stops by most of them in her house travels, just because they are 'there'. And, I even add a bit of water to her food for extra moisture.

 

[mrsgreenjeens]

With our CKD cats, our Vet always told us it's better for them to eat than to try to get them to eat low phos foods. So, personally, I'd stick with whatever makes her little heart happy. If that's fish, and it happens to be low in phos, it seems to be me you have a win/win situation. I believe there are many cats around who won't eat anything but fish. Since some of the foods you feed (if I am understanding you correctly), also include another protein, I think you're fine.

 

[stephanietx]

I have had 2 CKD kitties. The first one was on RX food, but we chose not to change the food for our 2nd CKD kitty. She continued to eat her regular food until she passed. We gave her a potassium supplement and a feline renal supplement from Standard Process. That combination worked well and her kidneys were very good when the vet ran her panel before her passing. (She passed from lymphoma)

 

[mysterylover]

Thank you all for all of this information and encouragement. We inherited my mother-in-law's cat after she died and ultimately lost that cat to CKD and hyperthyroidism, so that is why I am stressing, I guess.

When I found out Junie had early CKD, I was at least glad it was early. Food for her is a balance of ingredients she can tolerate without having liquid diarrhea or likes and managing constipation- putting 1/16 of a teaspoon of MiraLAX in 2 cups of water and using a dropper to add 2 drops to her food gave her liquid stool with multiple trips to the litter box with cramps. Adding 1/4 teaspoon of Applaws Chicken with pumpkin to her food has worked well, and she is willing to eat the tiny shreds - something in that supplemental food smells good to her and worth the one bite.

I did think that I might try adding 1/2 or 1/2 teaspoon of something like the lowest phosphorus pate in the BFF Play line to one of the chicken based ones that have no fish to see if she would eat it. At least, that way, I am controlling the fish content or might get her to eat some variety if she acts bored. I find that, if a food has too much fish or tuna, she gets diarrhea. For instance, she LOVES the Weruva pates like Jolly Good Fares or Meows 'N Holler Purramid, but they gave her diarrhea as a stand-alone meal. She loved Press Your Dinner for a while but had severe constipation and tired of it when she realized something else I offered had seafood (green mussels).I am wondering if she would maybe even do okay with 1/4 teaspoon of Jolly Good Fares mixed into a bit of Press Your Lunch (which did not smell strong enough for her) or Press Your Dinner and not have diarrhea. Honestly, back then, I maybe did not feel good about her having fish at every meal, even in small amounts - but I think that ship has sailed LOL! We got here when she was walking away from multiple foods (even blended with the hand mixer) in a meal, and I finally said, "Fish it is!" because we both needed sleep. I kept foods with some fish in it because that was what kept her eating in the days after her dental surgery - and her brother chipped a tooth and had dental surgery about 6 months after hers. Brother, fortunately,is back to eating a wide variety of non-fish foods, but his surgery actually was not as extensive.

Anyway, thank you all for your time and compassion for her. She is so sweet. She is doing really good right now. Her weight is good. I think that whole thing with her teeth just changed the way she approaches food. It has to taste/smell good enough for her to bother or be the "perfect" texture, and some foods I tried to puree were too "sticky" depending on the ingredients - and adding too much water lowered the calories of some per meal a good bit. -- so yep, it is about balance. I don't know how long we will have her here and happy, but I certainly do not want every meal to be a battle. If I had a year or two or three to live, i would not want to dread mealtime. I LOVE food!! Mealtime takes up about a good chunk of her day (and mine LOL), so it matters to her happiness. I'll look at some of these links that were provided as well. Bless all of you who care about kitties and share your time so freely!

 

[Furballsmom]

 

[Caspers Human]

I doubt that a daily diet of fish is good - for any cat, healthy or otherwise.

In my opinion, cats eating fish is a legend just like the legend that cats drink milk.

Yes, cats can drink milk but it's not good for them to have too much. Just a little bit, now and then, won't hurt but, if they have too much, it's not good for them. The same goes for fish.

Consider that your average cat in the wild won't have much opportunity to catch and eat fish. In most cases, the only cats that eat fish on a regular basis are ones that live near bodies of water where fish are plentiful. Even then, it's unlikely that a wild cats diet would be exclusively fish.

When deciding whether to feed your cat any fish, consider that and I think you'll be okay.

[O]ur Vet always told us it's better for them to eat than to try to get them to eat low phos foods. So, personally, I'd stick with whatever makes her little heart happy.

Absolutely agreed!

Any cat, be it elderly or young, needs to eat. Eating something is better than nothing even if it's not the optimal diet. As long as the cat's diet isn't harmful, let them eat what they will accept.

If you have a cat that's a picky eater, you can try weaning them off the food you don't want them to eat by mixing new, good food with the old food, little by little. We did that with our eldest, Casper. When we adopted him, he was hooked on Meow Mix. (Cats ask for it by name because it's junk food for cats. ) It took quite a while to wean him off Meow Mix, onto something better. We did it by mixing the new food with the old.

Our youngster, Elliot, (AKA: "The Little Upstart.") is like a garbage disposal, compared to Casper! He'll eat anything. On the few occasions when I eat a bowl of breakfast cereal (usually a midnight snack) Elliot will be right there by my side, begging for some milk!

Of course, milk isn't very good for cats but a little bit won't hurt. I leave a couple of spoons full of milk in the bottom of the cereal bowl for him to lap up after I'm done.

Our House Rules say that humans eat first. Pets eat second. There's plenty of cat food available at all times. When humans decide to share, we leave a bit on our plate and put it on the floor for the cats to "clean up."

Anyhow, be it milk, fish or anything, most of the time, a little bit won't hurt.

If fish is something your cat likes to eat, there's no reason not to let them. Maybe you could save it as a special treat.

 

[IndyJones]

In my opinion, cats eating fish is a legend just like the legend that cats drink milk.

Yes, cats can drink milk but it's not good for them to have too much. Just a little bit, now and then, won't hurt but, if they have too much, it's not good for them. The same goes for fish.

Consider that your average cat in the wild won't have much opportunity to catch and eat fish. In most cases, the only cats that eat fish on a regular basis are ones that live near bodies of water where fish are plentiful. Even then, it's unlikely that a wild cats diet would be exclusively fish.

When deciding whether to feed your cat any fish, consider that and I think you'll be okay.



Absolutely agreed!

Any cat, be it elderly or young, needs to eat. Eating something is better than nothing even if it's not the optimal diet. As long as the cat's diet isn't harmful, let them eat what they will accept.

If you have a cat that's a picky eater, you can try weaning them off the food you don't want them to eat by mixing new, good food with the old food, little by little. We did that with our eldest, Casper. When we adopted him, he was hooked on Meow Mix. (Cats ask for it by name because it's junk food for cats. ) It took quite a while to wean him off Meow Mix, onto something better. We did it by mixing the new food with the old.

Our youngster, Elliot, (AKA: "The Little Upstart.") is like a garbage disposal, compared to Casper! He'll eat anything. On the few occasions when I eat a bowl of breakfast cereal (usually a midnight snack) Elliot will be right there by my side, begging for some milk!

Of course, milk isn't very good for cats but a little bit won't hurt. I leave a couple of spoons full of milk in the bottom of the cereal bowl for him to lap up after I'm done.

Our House Rules say that humans eat first. Pets eat second. There's plenty of cat food available at all times. When humans decide to share, we leave a bit on our plate and put it on the floor for the cats to "clean up."

Anyhow, be it milk, fish or anything, most of the time, a little bit won't hurt.

If fish is something your cat likes to eat, there's no reason not to let them. Maybe you could save it as a special treat.

Agree with this. My vet even told me, unless there is a medical reason (food intolerance, alergy etc) fish is perfectly fine for cats as long as it is the cat food kind. If metals are a concern look for trout or other freshwater fish. Trout has some of the lowets metal levels of any fish and is packed with omega 3. Salmon is good too.