High protein, seniors, kidney disease and CRF

[mschauer]

#1 Protein. A diet of high quality meat protein will have less “residue” due to its high bioavailability for cats. The key here is the quality of the meat, perhaps including the processing that it goes through. Also, in commercial foods, the amount of protein most likely is NOT from only the meat content. It can also include protein amounts in grains, veggies, and fruits. 

Dr. Karen Becker talks about this very issue in another one of her great videos on the topic of pet food: 

The Nutrient Your Pet Needs More Of As They Age

It's curious that Dr. Becker sees that '92 study as definitive proof that even CRF kitties need a high protein diet and yet that doesn't seem to be the consensus of veterinarians. 

She also says:

Since that research was published, veterinary recommendations have changed. What we’re recommending for animals struggling with under-functioning kidneys and livers is that you feed really good quality protein that is highly digestible and assimilable.

We also recommend you restrict phosphorus in the diet, but not necessarily protein.

"Veterinary recommendations" with regards to protein for CRF kitties hasn't changed in general though, right? Isn't one reason we are discussing the issue because vets are still recommending low protein diets for CRF kitties?

 

[ldg]

Well, if anyone has access to a library, we can find out what Finco has to say about his own research: http://www.sciencedirect.com/science/article/pii/S1096286798800066

Interventional nutrition for renal disease
VMD, PhD, Diplomate ACVIM Scott A. Brown, DVM, PhD, Diplomate ACVIM Delmar R. Finco, DVM, PhD, Diplomate ACVIM Joseph W. Bartges, VMD, PhD, Diplomate ACVP Cathy A. Brown, DVM, MS, Diplomate ACVIM Jeanne A. Barsanti

Clinical Techniques in Small Animal Practice Volume 13, Issue 4, November 1998, Pages 217–223

The abstract:

Interventional nutrition plays a central role in the management of renal diseases in veterinary medicine. Most of the clinically observable abnormalities produced by the disruption of renal function are influenced by dietary intake of calories, phosphorus, sodium, potassium, protein, or acid load. Further, the kidney is susceptible to self-perpetuating injury, an inherent property of this organ, and the extent of this injury can be modified by adjustments in dietary intake of phosphorus and polyunsaturated fatty acids. The response of each animal with renal insufficiency to the disease and to nutritional intervention varies dramatically, and individualized therapy is required; the only constant nutritional characteristic of renal insufficiency is inappetance and loss of body weight. Successful interventional nutrition must take all of these principles into account.

Though this is published the same year as the Protein and calorie effects on progression of induced chronic renal failure in cats. ( http://www.ncbi.nlm.nih.gov/pubmed/9582959?dopt=Abstract )

And the 1992 Finco study was a study conducted in dogs only. :dk: http://www.ncbi.nlm.nih.gov/pubmed/1476305

Am J Vet Res. 1992 Dec;53(12):2264-71.
Effects of dietary phosphorus and protein in dogs with chronic renal failure.
Finco DR, Brown SA, Crowell WA, Duncan RJ, Barsanti JA, Bennett SE.

 

[tobytyler]

Ok, this is not about raw feeding but it is about senior cats/kidney disease and what can help in addition to diet.  Subcutaneous fluids (Lactated Ringers Solution with added potassium if needed) administered regularly at home, usually every other day, will help tremendously in taking the strain off the kidneys, make your cat feel much more comfortable, and very well may extend it's life.   Your vet or vet tech can show you how to do it, how much, and how often - it's really very easy.   A tip: warm the bag in a basin of warm water before administering and your kitty will love it! Good luck!

 

[ldg]

Oh what a great idea about warming up the bag! Thanks for sharing. I had to give one of my kitties sub-q fluids. Wish I'd known that!

 

[tobytyler]

Sub-q fluids can work wonders for all sorts of things!  I don't know why the vets don't tell you about doing this simple procedure at home, but I had to ask them.  Recently, my guy was on them for over 3 years and I know it made a huge difference in his longevity and quality of life after being diagnosed with CKD.  He always knew there were treats waiting and he would run to a certain spot to get his treats after his fluids.  He would usually purr as I was giving them to him.  Sadly, he passed away last spring, it was not from kidney disease but I knew he was well hydrated and comfortable.

 

[ldg]

I'm so sorry about your boy. :heart3: But he clearly had a wonderful life with you, so well cared for! :rub:

And yes, having worked with a lot of health compromised kitties, I'm familiar with how important sub-q fluids can be. But you're right - too many vets don't suggest you learn how to do it at home, and it's not hard at all! I'm so glad you brought it up given the topic of the thread. :nod:

 

[daniel625]

Regarding WhollyCat's well-founded rationale against low-protein list, I always felt that my vet was seriously out of touch when dealing with my cat's alleged CKD.  Even if it was CKD that ultimately did it for my cat, I thought it was strange how, when my cat had a good weight (still a bit on the thin side but better than it was before), he told me to give him Hill's K/D (low-protein).  After getting a second opinion from another vet, they said that usually, that is saved for the later stages, as CKD patients need to keep/gain weight, not lose more.  But my vet insisted, saying it was what he needed.  So I reluctantly fed it to my cat, and of course what happened?  He started losing weight and now felt bonier than ever!  I knew exactly what the vet was going to say before I even asked him what the reason for this was, and sure enough it was exactly what I predicted he'd say:

"It is just the disease progressing, because CKD is a degenerative problem and blah blah blah".

B***s***!

It was because my cat was being deprived of the much needed protein to sustain his healthier weight.

This vet treated every case that came before him in such a uniform manner; despite my then 16-year old kitty being as healthy as can be, apart from UTI crystals and stones that needed to be dissolved, he said that my cat needed to undergo a complete lifestyle change, which is what caused him to start slowing down in the first place.  And ironically, it was one of the cans of Hill's C/D, which they probably kept near a radiator in their office, which made my cat violently ill, and nearly killed him right then and there, making him literally lose three pounds by profusely vomiting and pooping on the floor uncontrollably.  My cat lost an incredible amount of water that he would ultimately never regain.  This started what I felt was the REAL problem all along, which was chronic dehydration.  Yet NOBODY believed me when I told them this was why he was this way; they just kept saying "oh he's just getting older, everyone loses weight when they get older".  NOT LIKE THIS THEY DON'T!!!  I'm no doctor, but I could plainly see that this was not a slow and steady decline; this was an all-in-one-shot crisis situation!  People and animals lose weight over a period of months or years, not minutes or seconds!

How is it that everywhere else I have looked and heard from says that high BUN and normal Creatinine and SDMA means dehydration, as opposed to true kidney disease (if this is not the case, please clarify), but this vet still insists that not only did my cat have CKD, but mid-level CKD?  He prescribed a phosphorous binder, despite my cat's phosphorous levels being perfect.  WTH!?

Anyway, rant over.