Kidney disease diet

njg55

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My 10-year-old cat was diagnosed with kidney disease a couple of months ago, I guess you'd call it mid-stage. I started with Science Diet kidney diet canned and dry foods, which she was fairly tolerant of until recently. Then she stopped eating and the vet had my try some Royal Canin. She mostly likes that, but it seems like when I get more than about halfway through those large cans she doesn't want it anymore. I'd been working through a can for the past couple of days, and this morning she vomitted after breakfast, again after a small serving around mid-day, and possibly later. I left her dishes unattended a third time, so another cat probably ate the food! I tried switching to one of the SD varieties in the evening, but she wouldn't even touch it. In desperation, I let her have an Inaba Churu (a pureed treat) that I'm sure isn't approved for her diet. I should probably call the vet if she keeps vomiting. I've seen the information from the woman called Tanya who has a site about cats with kidney disease and need to study if further, but based on that I know there are other foods I could try. Does anything come in the smaller cans? I feel like a waste a lot of food when I use the larger ones, especially if she doesn't like it from the beginning and I end up tossing the entire can.
 

Mamanyt1953

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Tanya's site is excellent, so do some exploring there. You may find exactly what you need. I do not have experience with kidney disease (or not yet...my girl is getting up there, it may come), but I've heard wonderful things about Tanya's site on here.
 

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I highly recommend reading Tanya's site in it's entirety. It truly is the "bible" of information of CKD and the care of cats who have it.

Cats with kidney disease are sometimes chronically nauseous. There are medications which can help control this which will usually lead to eating better. I suspect this is the reason she's not as enthused about her meals now.

Educating yourself is imperative with this disease since it is progressive but many people are able to keep their cats with good quality of life a long time after diagnosis. Our boy maintained a good quality of life for several years between SubQ fluids and other supportive care. Do not wait to visit the vet either.

FYI plenty of foods come in smaller cans. And you don't necessarily need to use a prescription diet either. As long as the phosphorus content is low, it's appropriate to feed a cat with kidney problems.

There are several Facebook groups you can join which will be helpful in this journey and have a lot of available information on decent food choices. I personally hate Facebook, but have joined a group because our older girl was recently diagnosed early Stage 2 and there is so much good info available there. Plenty of people on this site have also dealt with this disease and will have good advice for you also.
 

stephanietx

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Kidney kitties need a low phosphorus diet. Here's a link to some comprehensive food lists. Feline CKD Food Lists - Google Drive

If you wanted to try a raw diet, Darwin's Natural Pet Products has a kidney kitty food called Intelligent Design. Intelligent Design™ Veterinary Meals For Cats | Darwin's Pet Food

For my girl, I put her on a grain-free food and added plain canned pumpkin and water to make it like partially thin oatmeal. (Not too thick, but not too runny either) This kept her hydrated and gave her some fiber to keep her poops moving. One thing that happens with kidney kitties is that they get constipated or their bowels slow down due to not enough moisture in their bodies to keep things going smoothly. When this happens, they can develop indigestion and nausea. The symptoms I see most often are lip smacking and increased water intake. You can talk to the vet about adding in Pepcid, which does help keep the tummy issues in check. The vomiting could be because of a tummy/GI issue or she could be intolerant of one of the ingredients in her food.

Regarding food freshness, I take the can and divide into half or fourths and put in a ziptop bag and freeze. This way it stays fresher in portion sizes that is better for us. When I run out of one bag, I just pull one from the freezer at the last feeding of the day, place in the fridge, and it's defrosted by the morning.
 
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njg55

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I definitely need help. Every time I think Luna's OK—she actually eats what I give her and doesn't vomit—that lasts for all of a day or two before she either loses interest in food or can't keep it down. I guess step one is to educate myself further and step two is to call the vet and see what other foods they can recommend: things that are in stock, things they could order for me, things I could buy without a prescription, potentially the use of medication to help with nausea, if that's part of why she doesn't eat. I don't want to go down the slippery slope of fedeing her the food I have for my two other cats just to get something down her. Once in a while, sure, but if I do that too often her condition will get worse, and she's not at any kind of critical stage where it would be more humane to let her have what she wants. I feel so much at a loss about what to do for her. And then this morning, not only did she promptly lose her breakfast, but her mom, who was in the same room, threw up as well, and she's not on a special diet! Can't win some days. Then there's the cat with lymphoma, who isn't on a special diet but half the time rejects whatever I feed him. Aargh.
 

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Struggling with feeding is probably the worst thing to me in dealing with this disease. Since we all know how important it is to get a cat to eat and the risk associated when they don't, it's a real emotional rollercoaster sometimes.

My personal feeling is give the cat what it will eat. Most will not eat prescription diets and you wind up tossing money out the door. With our previous CKD kitty we let him continue to have what we knew he enjoyed but tried to find the lowest phosphorus content possible. I just could not bear to see him pushing food aside. If worst comes to worst you can get phosphorus binders to be added to the food which will negate what's in it.

Adding in Pepcid and/or Cerenia will make a big difference. It should reduce he naseau and throwing up quite a bit. You don't give Cerenia all month; typically it's about 3-5 days of 1/4 pill (so very tiny and easy to hide in a special treat) and then stop until it seems they need it again. Pepcid can be given daily and is dosed by weight I believe.

Adding in small amounts of water to all meals is a good idea - a tablespoon or so should do it.

SubQ fluids will make them feel much better also. We did this 2x a week as that was all the vet felt comfortable with since our boy had a heart murmur. We actually went to the vet to do this, since he traveled well and we just didn't feel very well equipped to emotionally do this for him (we did manage during an episode of him being diabetic to administer insulin for months).

Our current CKD cat is in very early stages and she is also still on her regular food - she's extremely picky and I already know she won't take well to a prescription diet. We are supplementing her with Renadyl which is similar to Azodyl but able to be put into food which a benefit. Both of those are used to help flush the system - they work sort of like having dialysis. Most people use Azodyl if able to pill their cats but we find the human version (which is approved for use in pets) to be a better option for us.
 
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njg55

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Struggling with feeding is probably the worst thing to me in dealing with this disease. Since we all know how important it is to get a cat to eat and the risk associated when they don't, it's a real emotional rollercoaster sometimes.

My personal feeling is give the cat what it will eat. Most will not eat prescription diets and you wind up tossing money out the door. With our previous CKD kitty we let him continue to have what we knew he enjoyed but tried to find the lowest phosphorus content possible. I just could not bear to see him pushing food aside. If worst comes to worst you can get phosphorus binders to be added to the food which will negate what's in it.

Adding in Pepcid and/or Cerenia will make a big difference. It should reduce he naseau and throwing up quite a bit. You don't give Cerenia all month; typically it's about 3-5 days of 1/4 pill (so very tiny and easy to hide in a special treat) and then stop until it seems they need it again. Pepcid can be given daily and is dosed by weight I believe.

Adding in small amounts of water to all meals is a good idea - a tablespoon or so should do it.

SubQ fluids will make them feel much better also. We did this 2x a week as that was all the vet felt comfortable with since our boy had a heart murmur. We actually went to the vet to do this, since he traveled well and we just didn't feel very well equipped to emotionally do this for him (we did manage during an episode of him being diabetic to administer insulin for months).

Our current CKD cat is in very early stages and she is also still on her regular food - she's extremely picky and I already know she won't take well to a prescription diet. We are supplementing her with Renadyl which is similar to Azodyl but able to be put into food which a benefit. Both of those are used to help flush the system - they work sort of like having dialysis. Most people use Azodyl if ablee to pill their cats but we find the human version (which is approved for use in pets) to be a better option for us.
I made an appointment with the vet to learn about giving Luna fluids. My husband and I have done it before, either with Luna or another cat (Luna had stomatitis that ultimately required a full mouth extraction, but we had to wait months for her appointment and do a lot of work at home with special foods, meds, and probably fluids to keep her in good condition while we waited), but it's been a couple of years and we could use a refresher course. The vet tech said the doctor also would have a prescription for Luna that would help with the vomiting, so maybe we'll make some progress. I'll also be able to ask about food options while we're there. It will be easier since in this case we'll be allowed into the building and can have a face to face conversation (masked, of course!) rather than just a phone exchange.
 
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njg55

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Does anyone know if it's OK to occasionally give a Kidney Cat an Inaba Churu? These are pureed food meant as a treat, not a meal serving. My two girls love them; my practice had been to give each of them a tube (single serving) every once in a while, whenever I remembered, not part of their regular diet. I haven't wanted to give them any since one of the cats was diagnosed a few months ago, but when she has a really bad day and either won't eat anything or vomits everything (that would be today!), I give her one of these, just to get something in her. I have no idea where they would fit on the scale of appropriate ingredients, but then I'm not giving these to my girl all the time, just once every week or two. Other than this I adhere to the special prescription canned and dry foods from Science Diet and Royal Canin and an authorized dry treat from Science Diet, so hopefully an occasional extra tidbit won't do too much harm.
 

sivyaleah

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Does anyone know if it's OK to occasionally give a Kidney Cat an Inaba Churu? These are pureed food meant as a treat, not a meal serving. My two girls love them; my practice had been to give each of them a tube (single serving) every once in a while, whenever I remembered, not part of their regular diet. I haven't wanted to give them any since one of the cats was diagnosed a few months ago, but when she has a really bad day and either won't eat anything or vomits everything (that would be today!), I give her one of these, just to get something in her. I have no idea where they would fit on the scale of appropriate ingredients, but then I'm not giving these to my girl all the time, just once every week or two. Other than this I adhere to the special prescription canned and dry foods from Science Diet and Royal Canin and an authorized dry treat from Science Diet, so hopefully an occasional extra tidbit won't do too much harm.
Probably not the best but if a cat won't eat anything else, allowing them to eat something is better than nothing. Even with CKD. I wouldn't stress as long as it isn't a daily part of her diet.
 

stephanie42

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My 16.5 year old Piglet has had chronic kidney disease for about 6 years, congestive heart failure for 4. She is my second cat with chronic kidney disease.

Tanya's CKD is the bible for kidney cats. Read as much as you can on her site, it will really help you understand some things. I recommend keeping track of all bloodwork - i always ask for copies. Neither of my kidney cats would eat a renal diet for more than a couple of days. My belief is that cats need high quality protein with minimal fillers when their kidney function starts declining. Many vets will advise to limit protein, which I do not do. There are plenty of canned foods that aren't too bad for kidney cats - someone else shared a link to Feline CKD Food list, which is a great place to start. Personally, I found that some Weruva varieties were good for my cats, and I also would feed Stella & Chewy's poultry varieties. Piglet loved kibble so I would also add in some grain-free kibble. As others have said, it's most important for kidney cats to eat, even if it's not ideal food. And every cat is different.

Churu is a treat, not a complete diet. If you're giving Churu as a snack in addition to well-balanced cat food, it should be fine. Again - it's more important for kidney cats to eat if they're really picky. I am currently using Churu to keep Piglet stationary and distracted while she receives subq fluids. Weruva and TikiCat both have thin pates (TikiCat actually calls theirs a mousse) that seem similar to Churu's consistency - maybe your cat will like those.
 

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My personal feeling is give the cat what it will eat.
I love this advice. When my megacolon girl was nearing her final days and wouldn't eat, the vet literally told me to feed her whatever I could get into her and we could deal with the health ramifications of that later - it was more important that she didn't develop fatty liver on top of everything else - scrambled eggs seemed to do the trick back then.

In terms of the small can size, the science diet ones we use are pretty small and I know the fancy feast ones come in small cans, but I'm not sure if they're an appropriate long-term diet for a CKD cat.

I'll throw my hat into the ring for Tanya's site, though, as I found it HUGELY helpful when working with my megacolon cat (who likely had CKD as well, but we just never pursued the further testing as by that point, she was too symptomatic to stress out with further vet visits)
 

colby

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From Tanya's site:

...your goals are as follows:
  • phosphorus level under 0.5%. No complete non-therapeutic food can be that low, but you should aim to get as close to that as you can.
  • protein level of 35% or as close to this as you can get.
  • sodium level not much higher than 0.2% but this is much less important than phosphorus and protein levels.

From Inaba's site (Tuna):

GUARANTEED ANALYSIS
Crude Protein (min) 7.00%

Crude Fat (min) 0.20%
Crude Fiber (max) 0.30%
Moisture (max) 91.00%
Vitamin E (min) 310 IU/kg
Taurine (min) 0.025%
Sodium 0.38%
Phosphorous 0.23%
Magnesium 0.01%
Calcium 0.03%
Potassium 0.13%

(Bolding mine)
Seems perfectly fine for a CKD cat to me (ask your vet, of course).
 

SixDegrees

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From Tanya's site:

...your goals are as follows:
  • phosphorus level under 0.5%. No complete non-therapeutic food can be that low, but you should aim to get as close to that as you can.
  • protein level of 35% or as close to this as you can get.
  • sodium level not much higher than 0.2% but this is much less important than phosphorus and protein levels.

From Inaba's site (Tuna):

GUARANTEED ANALYSIS
Crude Protein (min) 7.00%

Crude Fat (min) 0.20%
Crude Fiber (max) 0.30%
Moisture (max) 91.00%
Vitamin E (min) 310 IU/kg
Taurine (min) 0.025%
Sodium 0.38%
Phosphorous 0.23%
Magnesium 0.01%
Calcium 0.03%
Potassium 0.13%

(Bolding mine)
Seems perfectly fine for a CKD cat to me (ask your vet, of course).
I would be cautious interpreting this; these amounts are small, but they are per tube; they aren't like percentages of minimum daily requirements as human nutritional content is often reported. 0.23% may be a lot or a little, depending on how much you give the cat and how much the cat weighs. Agree that your vet should be consulted if possible.
 

pearcat

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From Tanya's site:

...your goals are as follows:
  • phosphorus level under 0.5%. No complete non-therapeutic food can be that low, but you should aim to get as close to that as you can.
  • protein level of 35% or as close to this as you can get.
  • sodium level not much higher than 0.2% but this is much less important than phosphorus and protein levels.

From Inaba's site (Tuna):

GUARANTEED ANALYSIS
Crude Protein (min) 7.00%

Crude Fat (min) 0.20%
Crude Fiber (max) 0.30%
Moisture (max) 91.00%
Vitamin E (min) 310 IU/kg
Taurine (min) 0.025%
Sodium 0.38%
Phosphorous 0.23%
Magnesium 0.01%
Calcium 0.03%
Potassium 0.13%

(Bolding mine)
Seems perfectly fine for a CKD cat to me (ask your vet, of course).
I know this is an older thread, but I thought it was important to point out that the numbers shown here for the Churu treat are the as fed values, not dry matter basis values. The recommendations for phosphorus, sodium, and protein from Tanya's are the dry matter basis values, and the two sets of numbers are not directly comparable. From what I have seen, the dry matter basis phosphorus in the tuna Churu treat is 2.2%. (Please note, I have not done the conversion calculation myself, the 2.2% number is just what I found online and may be more or less accurate). I am not really giving advice as to whether a CKD cat should be given these, only that we need to be careful reading labels, understand the difference between dry matter basis and as fed/guaranteed analysis numbers, and remember that the 0.5% phosphorus recommendation is referencing dry matter basis.

My best wishes to all of you.
 
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