What to feed cat with early kidney disease?

GracieAllen

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Our 14-year-old cat has been diagnosed with early kidney disease. Or vet recommended we try one of the kidney support foods like the Hill’s k/d or Royal Canin Renal support (D, E, T), Purina ProPlan NF.

Turns out she eats them both like crazy. Didn’t like the Purina version at all, but eats the k/d and all 3 of the Royal Canin wet foods (D, E, T).

BUT, WHAT is it that makes kidney support food DIFFERENT?

When I looked for this information it said “low” protein, low phosphorus (between .3 and .6%) and lower sodium. And that phosphorous is the WORST part ‘cause the kidneys won’t filter it out and remove it from the cat’s body.

Then I find articles that say LOW PROTEIN is now BAD and causes loss of muscle mass, which the vet just said she has. And ANOTHER article that says the whole thing is garbage and there’s virtually NO DIFFERENCE between “normal” cat food and the renal support stuff…

THEN, our ”regular” vet told us “yes, if she’ll eat the renal food, good, BUT just feed the cat food she likes”……

As much as I could find, I looked at the nutrition information for Hill’s k/d and Royal Canin Feline Renal Support (D, E and T)

All values percentE pateT slice in gravyD morsel in gravy
Protein Min6.15.16.5
Protein Max9.68.610
Fat54.56.5
Fiber1.71.71.7
Water808179
Phosphorus??.14
I could only find the guaranteed analysis for "D", but they're all the same for everything else, so I presume phosphorus is about the same too.

Hill’s k/d does their nutrition with the moisture REMOVED… I don’t know if this changes the percentages.

NutrientDry Matter %
Protein30 %
Fat23 %
Carbohydrate / NFE38.7 %
Crude Fiber2.4 %
Calcium0.85 %
Phosphorus0.49 %
Potassium1.11 %
Sodium0.24 %
Magnesium0.055 %
Taurine0.45 %

If the Royal Canin is “low” protein at 6 – 9% and the Hill’s k/d is THIRTY percent, isn't that 'HIGH' protein? Who’s right? And if Royal Canin says phosphorus is .14% and the Hill’s is .49%, which one is better – does the fact the Hill’s does their analysis on the dry food after the moisture is removed make a difference…

THEN, just for giggles I looked at Sheba perfect portions pate, which is what we feed the cat, especially when we travel, because she likes it and eats it better than anything else we’ve used, including the Blue Wilderness cat food.

Sheba perfect portions pate:
Crude Protein (min.)9.0%
Crude Fat (min.)5.0%
Crude Fiber (max.)1.5%
Moisture (max.)80.0%
Ash (max.)3.0%
Phosphorus.35%
Taurine (min.)0.06%

Which is essentially the same as the Royal Canin except Sheba shows “ash” and Royal Canin doesn’t. When I specifically queried phosphorus, it said the Sheba has .35%, which is lower than Hills and right at the bottom of the recommended range for renal support at .3-.6%....

SO, WHO’S RIGHT? And what do we feed the 14-year-old cat?
 

FeebysOwner

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Hi. The old school of thought was that protein needed to be reduced in order to cause less work on the kidneys - and, the food manufacturers haven't entirely moved away from this thought process. Newer findings say that lower protein is not as beneficial as once thought, and that older cats need lots of protein because of natural muscle mass loss that goes hand in hand with aging. If she likes these foods, feed them to her because lower phosphorus is a good thing to help with kidney disease. However, you might consider seeing if she likes cooked egg whites and add that to her diet, as they are high in protein.

Always use the dry matter basis for comparison, it is generally considered the most accurate measurement for comparison purposes. A lot of companies don't offer those numbers, but will provide them to you if you ask for them. I think that those numbers for Sheba are guaranteed analysis - not dry matter - so contact them and ask for them. You cannot compare dry matter against guaranteed analysis (apples to oranges).

Have you checked out this web site - Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Everything You Need to Know to Help Your Cat (felinecrf.org)? It is loaded with all kinds of information and, while it is a lot to digest, it is worth reading (and re-reading).
There is a section on Nutrition (under 'Diet'), so maybe you want to start there, but I encourage to read all the sections as you can. The diet section discusses protein, phosphorus, among a whole host of other related nutritional information.
 
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GracieAllen

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I have not read that comprehensive guide, but I will...

I'll have to see if I can get dry matter information on the Royal Canin, OR if I can find out how the do the measurement - it may be easy to convert one to the other.
 

FeebysOwner

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I'll have to see if I can get dry matter information on the Royal Canin, OR if I can find out how the do the measurement - it may be easy to convert one to the other.
Uh - DUH, on my part. I actually have the dry matter numbers from Royal Canin. I don't know why I didn't remember it when I responded before.

Feline Renal Support Dry Matter AnalysisA DryF DryS DryD WetE WetT Wet
Protein24.1527.1425.7836.1835.8233.71
Calcium.87.67.75.69.76.82
Phosphorus.46.46.44.43.46.51
Sodium.37.42.44.43.46.51
 

lisahe

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I agree with FeebysOwner FeebysOwner about sticking to the dry matter figures for comparisons. I think Tanya's site explains how to calculate dry matter but all the better if you can find the figures on that site's charts! I used those charts extensively when we had a kidney cat. She also had a mildish/early case, though was sicker with IBD/lymphoma. We decided to avoid the prescription food for her (though the vet had recommended it) and fed her a lot of Weruva during her last couple months. Lots of their foods are relatively low in phosphorus. And, even more important, she liked them. I'd seen Weruva recommended on a vet site or blog as a brand that tended to work well for kidney cats.

I focused on foods with low phosphorus and quality meat protein, following what Dr. Pierson writes on her site: Feeding Your Cat: Know the Basics of Feline Nutrition – Common Sense. Healthy Cats.
Although Brooksie, who was elderly and frail, didn't live long after her kidney disease diagnosis, her kidney numbers did improve in those last months (much to the vet's surprise but not mine!) before the IBD/lymphoma got her instead.

On another note: Dr. Pierson's site also has a list of canned foods. It's probably more outdated now that the Tanya's site charts. Dr. Pierson cites phosphorus differently, as the amount of phosphorus in 100 calories of food.
 
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GracieAllen

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Thanks for the reply... It looks like all the Royal Canin we'd be using are in the range for phosphorus... Which is good. I'll have to see if I can find "dry" analysis numbers for the Sheba. Or the Blue Wilderness.

We just picked up another half dozen of the tiny cans of each to get us through the weekend while we continue testing. Which sounds silly, but there's a reason - apologies in advance for the long story:

The cat did SOMETHING last Friday and suddenly was walking very poorly. She was fine at dinner, and having problems 3 hours later. Her back end and front end were not in sync, she was having trouble laying down and getting up, controlling her back feet, and so on. In short, she looked and walked like I do when I'm having trouble with my back!

We, of course, panicked and called the on-call vet at 10:30 at night, who recommended confining the cat with food, water, litterbox, bed, nightlight (don't ask) so she wouldn't do any jumping, and bring her in Saturday, which we did. The poked and prodded and did x-rays and kidney work and other stuff, and told us there were no broken bones, no spinal problems, no arthritis, BUT she was tender and guarding the muscles on both sides of the spine. And she had "lower than expected" muscle mass in her rear legs. This wasn't our normal vet, and her legs don't seem any different than 5 years ago, but I'm not sure if she's supposed to be able to leap tall buildings in a single bound or just jump onto the bed...

Anyhow, they gave us gabapentin to give her for the next 2 weeks. She was listless and draggy Saturday, very quiet (she's normally got many loud opinions about everything) and gradually improved, and today she's walking normally, appears to be doing better, and seems more comfortable. And is back to letting us know we're he worst staff EVER!
BUT, I give her the dose first thing in the morning, along with breakfast. She's a nibbler - eat a little, rest 20 minutes, eat some more, pretty much all day. So she'd eat a little breakfast, then crash from the gabapentin for half the day and not eat any more of the breakfast. Then gets up early afternoon, gets new food, gobbles half, nibbles, gets dinner, eats, gets her over night food, and in the morning the plate is empty.

Thus still testing before we start buying cases of whatever.
 

maggie101

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My cat also has early kidney disease though she is only 8. Also struitive crystals. Besides her prescription food I mix in weruva trulex steak frites for extra moisture and protein. Also Churu,tiki,or nutro has tubes of 90%water I mix in and crush Orijin freeze dried treats from a small pet store. It's a compromise since kidney disease is still being studied. There is no for sure answer, yet. Go with the most recent answer. Check out the date of when the article was written
 

maggie101

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Steak Frites is one of Weruva's very lowest in phosphorus. Brooksie ate a lot of it!
It was recommended as the best canned food for cats with ckd. Weruvaa chicken Frick a zee for cats with struitive crystals. I am trying to find out the phosphorus for that.
 

maggie101

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Thanks for the reply... It looks like all the Royal Canin we'd be using are in the range for phosphorus... Which is good. I'll have to see if I can find "dry" analysis numbers for the Sheba. Or the Blue Wilderness.

We just picked up another half dozen of the tiny cans of each to get us through the weekend while we continue testing. Which sounds silly, but there's a reason - apologies in advance for the long story:

The cat did SOMETHING last Friday and suddenly was walking very poorly. She was fine at dinner, and having problems 3 hours later. Her back end and front end were not in sync, she was having trouble laying down and getting up, controlling her back feet, and so on. In short, she looked and walked like I do when I'm having trouble with my back!

We, of course, panicked and called the on-call vet at 10:30 at night, who recommended confining the cat with food, water, litterbox, bed, nightlight (don't ask) so she wouldn't do any jumping, and bring her in Saturday, which we did. The poked and prodded and did x-rays and kidney work and other stuff, and told us there were no broken bones, no spinal problems, no arthritis, BUT she was tender and guarding the muscles on both sides of the spine. And she had "lower than expected" muscle mass in her rear legs. This wasn't our normal vet, and her legs don't seem any different than 5 years ago, but I'm not sure if she's supposed to be able to leap tall buildings in a single bound or just jump onto the bed...

Anyhow, they gave us gabapentin to give her for the next 2 weeks. She was listless and draggy Saturday, very quiet (she's normally got many loud opinions about everything) and gradually improved, and today she's walking normally, appears to be doing better, and seems more comfortable. And is back to letting us know we're he worst staff EVER!
BUT, I give her the dose first thing in the morning, along with breakfast. She's a nibbler - eat a little, rest 20 minutes, eat some more, pretty much all day. So she'd eat a little breakfast, then crash from the gabapentin for half the day and not eat any more of the breakfast. Then gets up early afternoon, gets new food, gobbles half, nibbles, gets dinner, eats, gets her over night food, and in the morning the plate is empty.

Thus still testing before we start buying cases of whatever.
StackPath
According to this article written 2019, low phosphorus,low sodium or none, and omega 3's are important. protein is OK for a cat in early stages. The weruva has no omega 3 so I will continue mixing it with the prescription food. There is a laxitone with just fish oil so I may buy that
 
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lisahe

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It was recommended as the best canned food for cats with ckd. Weruvaa chicken Frick a zee for cats with struitive crystals. I am trying to find out the phosphorus for that.
Weruva has great charts on their site!

Here's the one with Steak Frites: Truluxe Nutrition Information - Weruva | Because We Luvya
And here's the one the Chicken Frick A Zee: Cats in the Kitchen Nutrition Information - Weruva | Because We Luvya

They're both below 1% dry matter phosphorus.
 

maggie101

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What's confusing is the hills cd disolved her crystals so I fed her weruva and they came back. Coincidence or not? Though that is not the exact same as ckd
. So compromise and feed kidney and commercial
 
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Furballsmom

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Hi
Take a look at Forza10 renal actiwet, and Koha LID chicken pouch variety, and possibly Tiki cat after dark grain free chicken if this one wasn't mentioned already-- these may be useful for you.
 
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GracieAllen

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I've concluded that the cat is insane... The exact same k/d she gobbled like she hadn't eaten in a week, today is poison! And the Royal Canin that was the best thing EVER a couple days ago is now swill! Goofy Cat!
 

FeebysOwner

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I've concluded that the cat is insane... The exact same k/d she gobbled like she hadn't eaten in a week, today is poison! And the Royal Canin that was the best thing EVER a couple days ago is now swill! Goofy Cat!
Sometimes, cats will associate how they feel with their food. Perhaps, she is connecting the grogginess from the Gabapentin with her food? It is also possible that she can pick up on the taste of the Gabapentin too, although I thought I read it really doesn't have much of a taste.

And, a lot of cats don't like the taste of the prescription foods, or grow tired of them very quickly - but I would have thought it would take longer for her to get to that point.
 

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I'll tell you a secret; those big brands like Purina, IAMS, Royal Canin, Hills, etc. bribe the vet industry into selling their junk diets as healthy.

This could be further from the truth. They are knowingly making the situation worse and they are laughing all the way to the bank.

Use common sense and read the ingredients listed.

Hill’s Prescription dry c/d -
Brewers rice, corn gluten meal, chicken by-product meal, pork fat (preserved with mixed tocopherols and citric acid), chicken, chicken liver flavor, fish oil,

Hill’s Prescription r/d-
Brewers Rice, Chicken By-Product Meal, Corn Gluten Meal, Powdered Cellulose, Chicken Liver Flavor, Soybean Oil

Very high carbohydrates, poor quality ingredients, corn [sugar], soy [estrogen].


Two namebrand wet foods that are excellent for your cat, Tiki cat and Weruva. Add more water on the food when feeding.
 

maggie101

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Great article for healthy cats but with ckd I worry more about phosphorus. It is unfortunate that prescription foods have less phosphorus than weruva which is why I mix the 2. My cats were never fed dry since I rescued them as kittens. Also give them churu,tiki, or nulo tubes for 90% Moisture and freeze dried treats for added protein. The tubes are also useful when I give her a pill. Slides down her throat easily and she loves it!
 

Raul-7

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Great article for healthy cats but with ckd I worry more about phosphorus. It is unfortunate that prescription foods have less phosphorus than weruva which is why I mix the 2. My cats were never fed dry since I rescued them as kittens. Also give them churu,tiki, or nulo tubes for 90% Moisture and freeze dried treats for added protein. The tubes are also useful when I give her a pill. Slides down her throat easily and she loves it!
Add CaCO3 to their food; it's a PO4 binder.
 
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