Early kidney issues - home made food?

FeebysOwner

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I read the response you got from EZC and am not sure what you find confusing. Based on my previous dialog with this company, they do know what they are talking about. If Know Better Pet Food cannot explain to you about the dry matter percentage of the phosphorus content in their pre-mix, then go back and ask EZC how they arrived at that percentage they quoted you. I am pretty sure they will tell you. In all sincerity, KBPF should be able to explain it to you as well.

The CKD forum can be pretty intense. I am not entirely sure, but I don't think they are complaining about the use of homemade food pre-mixes, so much as they are saying a lot of these supplement companies might not be all that educated in terms of CKD. As far as the commercial CKD foods, their issue is the reduction in protein in order to reduce phosphorus, particularly with CKD cats at the earlier stages.

Speaking of which, what exactly is your cat's phosphorus level?

I would use Tanya's web site - over the CKD forum, to determine if your cat even needs to have a significantly reduced phosphorus intake. Simply put, a cat with Stage 2 CKD, which is the IRIS' base of a creatinine level between 1.6 and 2.8 mg/dl should have a goal of 2.7 - 4.59 mg/dl for the phosphorus level. As the stages raise, so does the level of phosphorus because there is only so much that can be done as kidney function decreases.
Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - The Importance of Phosphorus Control (felinecrf.org)

Your zeal to help your cat is wonderful - just don't overdo it in your attempts to reduce her phosphorus level. And don't forget about phosphorus binders to aide in this process when they are deemed appropriate and necessary.
 

Furballsmom

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I'm not sure what the legal, liability, and/or regulatory issues that are involved in marketing a "kidney" pre-mix that is "imbalanced" due to lowered phosphorus levels, but I'm not aware of any on the market, and I imagine it would be legally complicated.
Just to mention, I assume the company would have to do the same as Weruva does with its new varieties Weruva WX which are lower in phosphorus than AAFCO guidelines while still providing full quantities of the other feline nutritional requirements including protein, and state that the product isn't a complete and balanced formula.
 

Box of Rain

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Just to mention, I assume the company would have to do the same as Weruva does with its new varieties Weruva WX which are lower in phosphorus than AAFCO guidelines while still providing full quantities of the other feline nutritional requirements including protein, and state that the product isn't a complete and balanced formula.
I'm sure, at the least.

I really am ignorant about the regulation of "prescription" cat food and whether that is something required by statute, or done to mitigate legal liabilities, or if it is simply an arrangement that provides mutual benefit to companies like Hills and veterinary practitioners?

Bill
 
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terestrife

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ya's web site - over the CKD forum, to determine if your cat even needs to have a significantly reduced phosphorus intake. Simply put, a cat with Stage 2 CKD, which is the IRIS' base of a creatinine level between 1.6 and 2.8 mg/dl should have a goal of 2.7 - 4.59 m
My vet didnt mention a stage yet. Said we caught it early. Her creatine is 3.0. Her phosphorous levels are normal still. I will reach out again to KBPF.

Edit: What confuses me is because I was told the phosphorous in their diet is too high at the tanyackd group and now this other company says the level used by KBPF is better than theirs. Everyone keeps giving me different info.
 

FeebysOwner

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If KBPF pre-mix composition is in fact 0.5% DM, then they meet the minimum phosphorus level required by AAFCO. What I am curious about is the very few prescription foods that are under that threshold. The very first one listed on Tanya's web site under therapeutic CKD foods (My Perfect Pet Low Phosphorus Chicken Carnivore Grain-Free Blend at 0.35%DM phosphorus) does in fact state on their product that it does NOT meet the AAFCO guidelines.

Now, I am trying to look a couple more, but I found some interesting information regarding two processes that both meet AAFCO requirements, per this linked document. You can find what I am referring to under the Nutritional Adequacy Statement section. Perhaps, Hill's and RC have the latter requirement noted on their products. I will see if I can find out.
Pet Food Labels - General | FDA


Her creatine is 3.0. Her phosphorous levels are normal still.
So, you don't actually know your cat's phosphorus level? The typical phosphorus range for most US labs is 2.5 - 7.5, however, the range includes what is normal for growing kittens which is higher than what even healthy adult cats should be. My cat has a phosphorus level of 5.9 - which falls into that range but is really a bit too high. You really should know what your cat's phosphorus level is. Creatinine is not the only number that 'counts', especially when you are considering using phosphorus restricted foods.

A cat with a creatinine level of 3 but a phosphorus level of let's say 4.0 is really not in need of a severely low phosphorus food as my cat should have at 5.9. You also need to know the phosphorus level, because once you restrict it, the level should be monitored - if for no other reason than what the EZC company mentioned to you. Tanya's web site also discusses the possible ramifications of lowering the phos level too much.
 
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terestrife

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If KBPF pre-mix composition is in fact 0.5% DM, then they meet the minimum phosphorus level required by AAFCO. What I am curious about is the very few prescription foods that are under that threshold. The very first one listed on Tanya's web site under therapeutic CKD foods (My Perfect Pet Low Phosphorus Chicken Carnivore Grain-Free Blend at 0.35%DM phosphorus) does in fact state on their product that it does NOT meet the AAFCO guidelines.

Now, I am trying to look a couple more, but I found some interesting information regarding two processes that both meet AAFCO requirements, per this linked document. You can find what I am referring to under the Nutritional Adequacy Statement section. Perhaps, Hill's and RC have the latter requirement noted on their products. I will see if I can find out.
Pet Food Labels - General | FDA



So, you don't actually know your cat's phosphorus level? The typical phosphorus range for most US labs is 2.5 - 7.5, however, the range includes what is normal for growing kittens which is higher than what even healthy adult cats should be. My cat has a phosphorus level of 5.9 - which falls into that range but is really a bit too high. You really should know what your cat's phosphorus level is. Creatinine is not the only number that 'counts', especially when you are considering using phosphorus restricted foods.

A cat with a creatinine level of 3 but a phosphorus level of let's say 4.0 is really not in need of a severely low phosphorus food as my cat should have at 5.9. You also need to know the phosphorus level, because once you restrict it, the level should be monitored - if for no other reason than what the EZC company mentioned to you. Tanya's web site also discusses the possible ramifications of lowering the phos level too much.
Sorry about that. I didnt realize you wanted the exact number. Her phosphorous level is currently 4.4. I do have a checkup with the vet in november. So I am considering keeping things as is for now.

I attached her results just incase.
 

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FeebysOwner

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Her phosphorous level is currently 4.4. I do have a checkup with the vet in november. So I am considering keeping things as is for now.
It seems like her phosphorus level has been fairly consistent dating back to 2017. So, it might be a good idea to not change things for now and see what happens in November if she is getting blood work done again.

I've lost track, but has she been on a homemade/raw diet for a while? That can elevate creatinine levels, without it pointing specifically to CKD. It can also affect the SDMA results as well.
 
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terestrife

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It seems like her phosphorus level has been fairly consistent dating back to 2017. So, it might be a good idea to not change things for now and see what happens in November if she is getting blood work done again.

I've lost track, but has she been on a homemade/raw diet for a while? That can elevate creatinine levels, without it pointing specifically to CKD. It can also affect the SDMA results as well.
She only ate regular wet food her first few years. I would guesstimate that shes been on homemade food for about 8 years or so. I brought that up with my vet and he claims that he has a lot of patients on homemade food and has never seen them with high creatinine. I am not sure if I believe that. I keep getting different info from different sources.

But I can keep her diet the same until November and just focus on giving her supplements and more water.
 

Box of Rain

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It seems like her phosphorus level has been fairly consistent dating back to 2017. So, it might be a good idea to not change things for now and see what happens in November if she is getting blood work done again.

I've lost track, but has she been on a homemade/raw diet for a while? That can elevate creatinine levels, without it pointing specifically to CKD. It can also affect the SDMA results as well.
Again, not my area of expertise, but over the years I've seen so many reports of slightly elevated creatinine levels (and often BUN) in raw fed dogs (who are healthy and not showing any signs of kidney disease) that it seems like a normal expectation on blood work.

I'm still learning when it comes to raw-fed cats, but as you suggest the slightly elevated numbers on blood work seems very similar. This is a widely reported phenomenon anecdotally and a search will reveal similar reports on raw-feeding websites.

The suggestion is that this is a normal deviation that comes from a high-protein diet, rather than a diet inclusive of significant calories from carbohydrates. A raw-fed cohort will have a different range of "normal" than cats fed a high-carb diet and the slightly elevated numbers not necessarily a sign of kidney disease, according to what I've read.

I don't have the expertise to make judgements, but many healthy raw-fed cats (and dogs) do seem to have similar bloodwork.

I'd work with my vet to monitor. In this case, the vet did suggest not making dietary changes at this point.

Bill
 

lisahe

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I've lost track, but has she been on a homemade/raw diet for a while? That can elevate creatinine levels, without it pointing specifically to CKD. It can also affect the SDMA results as well.
Yes, this has happened with our cats when they've had blood work before dental cleanings/extractions: the creatinine looked high but then the vet ran other tests. Everything was fine. (She knows the cats eat a very protein-rich diet!)
 
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