Kidney Prescription diets versus Over the counter (OTC) foods with phosphorus binders

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First off, thank you so much, Dr. Rachel Boltz, for writing and posting your Article in the Blog section:"A Scientific Take On Cat Nutrition", here on(TCS), the Cat Site

1.       In CKD cats, have there been any studies done on prescription diets...versus cats eating OTC foods with phosphorus binders?

2.       In early stage CKD, how does a Vet determine which food, prescription or OTC, would be best for the cat?

3.       When would you determine that 'canned kitten food with a phosphorus binder' would be more helpful, in a senior ckd cat? Is it based solely on weight loss, or on blood chemistry numbers?

4.       Do Vets keep a record of what their feline kidney patients eat, or any type of central data base?

That may be too many questions, but I am really interested in #1 and #3.

Thank you.
 

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My pleasure to be here.

In reply:

1) The difference between OTC foods with phos binders and renal diets is essentially the level of protein and fat.  Renal diets are actually calorie boosted and lower in protein than most OTC diets. I am not aware of specific diets that compare OTC diets + phos binders against renal diets.  There are many studies that compare OTC and renal diets, and benefit is often demonstrated to cats in stage 2-4 CRF.  Benefit has been found in body weight maintenance, decrease in renal azotemia or damping progression of azotemia, and phosphorous control.

2) Renal diets in early stage renal failure (IRIS Stage 1-early 2) does not appear to substantially benefit cats.  Cats is Stage late 2-4 appear to constantly benefit from renal diets, especially those with protein in their urine (which is not common).  Companies that make renal diets have spent a lot of time making their food tasty, with a variety of flavors and textures.  Sometimes it is worth considering offering these cats such diets when they are still feeling well.  

3) I consider this feeding method especially for cats with other co-morbidities like hyperthyroidism, diabetes mellitus, IBD, and neoplasia.

4) I certainly do for my patients, but I am not aware of a central database.  
 
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Very interesting info. Thanks again.
 
 
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