keeping kidney cats eating

momto3cats

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Do you have any tips for getting enough food into a cat with kidney disease? My cat is 16 and has stage 3 CRF, and her appetite is increasingly capricious. I give her a variety of wet foods to try and keep her interested (she won't touch k/d anymore). 
 

mrsgreenjeens

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Do you have any tips for getting enough food into a cat with kidney disease? My cat is 16 and has stage 3 CRF, and her appetite is increasingly capricious. I give her a variety of wet foods to try and keep her interested (she won't touch k/d anymore). 
Boy, join the club
.  My 14 year old kidney cat gives me fits daily with her food.  Some days she eats as little as 1.5 oz, and other days as much as 5 oz (still not nearly enough
.  She is half the size she was in her prime


I keep a tube of Nutrical on my nightstand, and if she wakes me anytime during the night, I squeeze out a little on my finger, and she will lick just a little off my finger.  I will offer her some all during the day too.  As far as food goes, I offer freeze dried 100% whole meats like Wholelife or Purebites or Stella and Chewy's as treats because these are caloric.  And for wet food,  I use this chart:  http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf. and using the Dry Matter % column, just look for foods trying to keep the Phos under 1%.   But you know what, even our Vet said it's better to have her eat ANYTHING than nothing, so when push comes to shove, I'll even feed her Fancy Feast Classics, which are really high in Phos
.   Lately, though, she's really liking Fancy Feast Gravy Lovers Turkey (which isn't even on this list, but is pretty low in Phos but high in carbs (darn it), and Nutro Natural Choice Chunky Loafs in various flavors, all of which, so far, are under 1% phos. 

Additionally, you can try adding cooked eggwhites to her food, as they are good protein and practically zero phos
.   Don't add the yolks though, as they are really high in phos. 

Another thing you can try are toppers like tuna juice, crushed treats, parmesan cheese (but sparingly because it's salty -not good for kidney cats) bonita flakes, Fortiflora. 

Have you talked to your Vet about an appetite stimulant, or are you using anything for her nausea, if she has it?   Sometimes they won't eat because they are nauseated.  Are you familiar with this site:  http://www.felinecrf.org/index.htm        This is my "bible" for anything kidney related.
 
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dr kris

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I hear you.

We have to beg Zack to eat sometimes. You’ve usually got several issues affecting appetite to contend with for a 16 year old with CKD - any they can change over time! The first things I would think about are:

1) gastritis and metabolic acidosis
2) uremia, dehydration and nausea.

CKD cats might have extra gastrin hanging around as their kidneys lose function (a hormone involved in the production of stomach acid). This happens so frequently that using antacids for stage III cats can be considered standard, baseline therapy. My cat is stage II, yet a simply trial with famotidine (an antacid) quickly increased his appetite.

Fluid therapy (aka SQ fluids) and eliminate or modify the effects of metabolic acidosis, uremia and dehydration. Sometimes they need medications to get rid of nausea (e.g. cerenia). I’ve had to use those on my own cat as well. I worry about them by the time they need those measures (i.e. what else is going on so that i might find a way to decrease the nausea at the source).

So while antacids, fluids or antinausea techniques are not pure appetite stimulants, you are in fact eliminating things that suppress appetite.

The second set of factors are less obvious and less talked about i think. They come down to the sense organs of your cat at that age. Their ability to taste and process food. Cognitive dysfunction (i.e. they get senile!). Concurrent unaddressed issues (dental, hypertension, pancreatitis etc). It’s super easy to miss pancreatitis in a CKD cat, because the symptoms are very similar. Arthritic cats - when it hurts to hold that posture while eating, they are going to eat less. Real easy to miss arthritis as well.

At 19, I recently did a dentistry for Zack. To eliminate inflammation in his mouth - and to give him the best chance and keeping his appetite and weight.

So many factors and I havent touched on all of them. So what do you do?

Eliminate things that suppress appetite first. Dont overwhelm yourself. Test things one at a time. If your vet agrees, start with the antacid. From there, I try and eliminate any acidosis, dehydration and the feeling of uremia (i.e. via sq fluids). I’ll know if these things work in days to a week. Past that, Im going on a food rotation (like mrsgreenjeens has brilliantly illustrated), assembling trials of different diets. Further than that, im eliminating those factors i listed above. It can sound daunting, but it’s not as hard as you would think once you get going.

While micro/macronutrients are important, I really really really want the body weight to stay as steady as possible. That is my main goal. Like I said in another thread, If Zack wanted nothing but cupcakes and beer tomorrow, that’s what I’d be feeding him.

And we both would be getting happy and fat together.

Best of luck!

kris
 

betsygee

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Boy, join the club
.  My 14 year old kidney cat gives me fits daily with her food.  Some days she eats as little as 1.5 oz, and other days as much as 5 oz (still not nearly enough
.  She is half the size she was in her prime


 Lately, though, she's really liking Fancy Feast Gravy Lovers Turkey (which isn't even on this list, but is pretty low in Phos but high in carbs (darn it), and Nutro Natural Choice Chunky Loafs in various flavors, all of which, so far, are under 1% phos. 
That's exactly the combo that keeps my 18+ year old Travis going--Fancy Feast Classic or Gravy Lovers chicken and turkey, and the Natural Choice Chunky Loaf.   He's on subq fluids every third day.  So far, so good.
 

betsygee

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That is my main goal. Like I said in another thread, If Zack wanted nothing but cupcakes and beer tomorrow, that’s what I’d be feeding him.
Haha, that's great.  That's what I say about Travis, whatever he wants to eat, that's what he's getting.
 
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momto3cats

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Thank you for the replies! And I agree, whatever she wants to eat, I'm happy to give her.

I'll ask our vet about trying an antacid next.
 
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