Kidney Disease Diagnosis for my Cat...what should I feed her on?

[PrincipessaP]

Hi I have just come back from the vets with my 13 year old cat (see previous 'strange behaviour..' post') The vet ran tests and it seems that her kidney function is only 50% ... I was in shock so can't remember much of what he said - I'm not even sure if it is acute or chronic.....he told me to feed her on quality protein ...but a low protein diet - he also recommended a Hills renal prescription dry diet which I bought ...but having got home, and done a bit of research, it seems that general census is that a dry diet isn't good ...so I am confused!!! She is drinking and still eating - so what kind of stuff should I really feed her ...is it ok to buy frozen chicken fillets and cook them...but will they contain additives that could harm her? Is tinned tuna okay? Can she eat raw chicken or should it be cooked? Is processed chicken ok??? I'm really not sure what to do.
If you have any advice, I would be so grateful.
Thank you
Paula x

[meriad]

Firstly - I know it's easier said than done - don't panic.... many cats do have kidney issues, in fact most cats as they age will have that as their kidneys naturally shrink as part of the ageing process. I lost my Molly when she was 21 and she had kidney issues for quite a few years, treated with a daily dose of Fortekor.

First thing for now is grab your cat, give her a cuddle and then get yourself a cuppa and take a deep breath. Then call the vet again to have a calmer chat about the diagnoses, and have pen and paper to hand and make notes.

there is a fantastic website Tanya's that I'm struggling to access so hopefully someone will soon post the link for you because I'm not sure I have the right one, but it's A LOT of information and quite mind boggling when you read it, but most of it will soon make sense

as for food - the best food is the food your cat will eat. Wet is better than dry because of the higher moisture content. You get special renal foods but I don't know of many cats that will actually eat the stuff so you may need to speak to your vet about binders to add to regular food (Ipakatine and Renalzine I think are two of them) When feeding add a bit of water to the wet food, again to get more liquid into them.

I would steer clear of tinned tuna or only give as a very occasional treat, and then only if it's in natural spring water - too much salt otherwise. Plain chicken whilst nice won't have the right nutrients / minerals if that's all you're feeding.

As for the dry food - it's a bug bear of mine.... quite a few vets will push you to buy the prescription foods because they in turn often get a financial kick back from the sales rep of that product. It probably won't harm, but I know that I'd be more inclined to go the wet food route vs dry food.

But as said, get yourself a cuppa, mull things over and then give your vet a call again to go through everything.

And we're here with you!

Fusses to your girl

[lilynmitz]

Good advice from Ria, especially the bit about taking a deep breath, giving your cat a good cuddle, and having a calm cup of tea. My tiny scrap of a cat Lily was diagnosed with renal problems, among many other conditions, but we kept her going for years after diagnosis. As Ria says, the best food is what she will eat, but do try her on the renal food. My vet said any food at all is better than none. If she won't eat renal food, then Senior food is better than normal adult food - lower protein, and about one third the way towards being renal food. So with Lily, what worked for her was a combination of the following:

Royal Canin Renal dried food,
Royal Canin renal pouches, if I could persuade her to eat it (she wasn't keen)
Felix AGAIL senior food, but later on.....
...One of the expensive pate type foods, with water added so it was more like a mousse than a pate, which was great for hiding her pills in
Making sure there was always fresh water for her to drink (I put loads around the house and kept them refreshed daily, as she seemed to prefer to drink from multiple places)

She was also on Fortekor, which I used to crush between two teaspoons and add to her food, atlhough tbh I dropped one once and she just picked it up and ate it!

Later she was also on Ipakitine, again sprinkled into her pate food.

Basically she had lots of water, the pate food with meds added, and the renal dried food to snack on between meals. She thrived on this for years, until heart failure took her in the end, almost a year ago.

[PrincipessaP]

Thank you so much for your responses Meriad and Lilynmitz - it is encouraging to know you were able to keep your kitties going despite their ailing kidneys. I am definitely a bit panicky...I think I am still shocked with the diagnosis! At the moment Kimi is all snuggled up on my bed, she looks so peaceful, I could munch her !!! At least she is drinking and she hasn't seem to have lost her appetite so that's good. She is currently eating Purina One (which I will stop now) and Gourmet Gold pate which she loves....I was thinking of maybe mixing the Hills dried food in with a bit of the pate at first to see if she liked it and then go from there....? I will go and look for senior food tomorrow and I will avoid tuna as you suggested....

The vet has given her Fortekor and we have to give her one a day - I am nervous about administering the pill so it is good to know we can crush it up in her food...that might be easier and less distressing for us both!!!

I have to go back in a week so I will update you....thank you again....I'm off to give my kitty another munch....and put the kettle on!!!!

[lilynmitz]

Change her food gradually, or your may end up with a tummy upset to deal with. Lily was on Gourmet pates, so don't ditch them. If Kimi won't eat the renal food, use the Gourmet pate to get the pills inside her. I used to give Lily half a tin, morning and evening, plus the dried food (although she was tiny, so Kimi might need a bit more than that). I'm not sure I'd mix the wet and dried food - it will probably make both of them even more unappetising! The renal dried food seems to go down ok with most cats (Mitz used to pinch Lily's quite happily, despite health kidneys!), it's the wet food they tend not to like so much.

[meriad]

Whilst you're out shopping get some treat sticks if Kimi eat them (love the name!). I find the Sainsbury own brand are the best as they usually are perfect softness for pilling. Break the stick into small pieces, prise one of those pieces apart so it's split and then put the fortekor in there and squish the treat around the pill. Give Kimi two pieces without the pill, then the one with the pill and then the rest

Or do as Anna suggested, crush it between two spoons and put it in her food or another form of treat (lick-e-lix)

Thankfully my Molly was easy enough to pill and fortekor is really small but if Kimi is difficult then the treat idea may work


Re the dry food, try mixing the Hills with the Purina dry and see if she'll eat that or even just give her the Hills directly and see if she eats it. If she does eat the mix then over the course of a few days reduce the purina and increase the Hills until you're at 100% Hills only - that way you won't have to mix it with the pate which I find usually makes the dry food mushy and then the cat won't touch it at all

Enjoy that cuppa!

Ria

[meriad]

Snap Anna

[PrincipessaP]

Thank you so much Ria and Anna - I really appreciate your advice...I will do as you say and keep the Hills separate from the wet Gourmet pate- and perhaps only feed her the pate in the morning so I know she is hungry and then she will probably lap up the pill ok if it's in the food. The treat idea is good too - I'll have to see which one is successful - I really didn't relish the idea of shoving a tablet down her throat! Ugh!!! Poor little thing! She is still snoozing on the bed so it will be interesting to see if she will eat some of the Hills when she gets up and about...bless her - she's had an eventful day!
Thank you again - I am sooo grateful! I will keep you updated.
Hugs
Paula & Kimi

P.s The cuppa was perfect! I am starting to feel much better xx

[PrincipessaP]

Just another stupid question but did your Vets say it was okay to crush Fortekor to put in food..I only ask as I know some pills are designed to be slow releasing and if you crush them they enter into the body too quickly? I was just thinking if I put the tablet in whole in the pate, knowing Kimi she will just lick round it and it will stay in the bowl! xx

[lilynmitz]

No, Fortekor is fine to crush. I used to mix it in the top of the food near the middle of the bowl, with just a light covering of food over it. That way it was more likely that she'd eat most of it. I think it's quite palatable, ie not as bitter/odd tasting as most.

Actually, Ria's reminded me, I used to do that trick with the meaty sticks as well. I tended to use Webbox, which also worked ok. I found cutting the pill in half and using two bits of webbox worked a bit better, as the full size pill used to drop out sometimes. Sometimes I got away with stuffing the whole pill in it in one go, but usually I did it in two. I stopped doing this with the fortekor after a while as I also had to give Lily little pills for her hyperthyroidism, which could NOT be crushed, so I used the webbox for that instead, and I was pushing my luck trying to get three pilled bits of webbox inside her!

[PrincipessaP]

No, Fortekor is fine to crush. I used to mix it in the top of the food near the middle of the bowl, with just a light covering of food over it. That way it was more likely that she'd eat most of it. I think it's quite palatable, ie not as bitter/odd tasting as most.

Actually, Ria's reminded me, I used to do that trick with the meaty sticks as well. I tended to use Webbox, which also worked ok. I found cutting the pill in half and using two bits of webbox worked a bit better, as the full size pill used to drop out sometimes. Sometimes I got away with stuffing the whole pill in it in one go, but usually I did it in two. I stopped doing this with the fortekor after a while as I also had to give Lily little pills for her hyperthyroidism, which could NOT be crushed, so I used the webbox for that instead, and I was pushing my luck trying to get three pilled bits of webbox inside her!

Aww thanks for that - I'll pop it in her food tomorrow and hopefully she will eat it ok. On a positive note, she got up and came downstairs, went straight to her litter box and did a piddle - she then proceeded to eat all of the Hills dried food that I had put in her bowl and left the Purina!! So it seems she quite likes it...for now! She is quite finicky so if she doesn't like it I will know by tomorrow! Thanks again x x x

[bobbys girl]

Glad you have got to the bottom of the problem. I can't really add much to the excellent advice you have already heard, except to say that ALL our cats seemed to like the Hills food. I got chicken fillets from Iceland - on my shopping list it was called 'Tommy chicken'. He had a meal of that most days, half a fillet for him and the rest for the others.

Also he preferred pond or puddle water to our tap water (which is pretty awful). I always had a bowl of water from the pond in the hall for him (sounds like the pond is in the hall? ) he would often come in with a very wet chin where he had been guzzling water outside, almost as if he wanted us to know he WAS drinking.

Big fusses to Kimi.

[MarkB]

There is a bit of controversy over renal food. For many years, the thinking was to reduce protein and renal wet has reduced protein - however, in recent years, the experts have been saying that good quality (ie from eggs and meat) protein is fine ( although renal food is still the same)

I had have had 4 cats of the years with CRD and none of them would touch wet renal. It is expensive and I would have fed it if they ate it, but it always ended up in the bin, I compromised by feeding renal dry (happy cat kidney was the favourite, although there are plenty of others) alongside foods like Felix senior, with added binders. Our Clapton loved his chicken and I allowed him some every day, dusted in Ipakitine powder. He mainly ate Felix senior and Tesco own fish pouches with binder in. He managed well for 5 years.

I agree that Fortekor (there are cheaper generic versions available now with the active ingredient, benazedril hydrochloride in) crumbled into food is fine for cats that will eat all of their food. I used to either hide in a treat or 'down the hatch' to make sure they got the full dose. For the record, I chewed one years ago to see if it was bitter, The nearest thing I could compare it with was a Horlicks tablet! (although I wouldn't make a habit of it)

There is a newer drug called Semintra, that lots of vets are giving instead of Fortekor, but it is only suitable for cats that are losing protein in their urine. I don't claim to be an expert on any of this, but dealt with it for years.

Regarding any chicken or fish I fed, I would always check as some of them have added phosphates, which is something you want to avoid with any cat, especially cats with kidney problems. I started buying Co-op ready-cooked whole chickens. Not the cheapest, but the only additive is a bit of dextrose. We justified it by helping the cats to eat it - usually with the cats getting the meat and me making a soup with the carcass! - I still buy them now.

One other thing I would look into is supplementing B vitamins, especially B12 -the reason being that B vits are water soluble and CRD cats pee them out.

I give one of mine (not for CRD, but something else) B12 most days mixed into vitamin paste or fur ball paste.

Keeping them hydrated is another must - I found a water fountain the best thing. I have tried various ones, but this one is the easiest to keep clean and maintain. http://www.amazon.co.uk/Pet-Mate-06039- ... r+fountain I don't bother with filters. I just wash out and change the water every day or so.

Sorry if all this sounds dry and matter of fact, but was just trying to get the important stuff in. There is a lot of stuff to take in.

[meriad]

Paula, this is the link I was referring to in one of my first replies: http://www.felinecrf.org/ it is a lot of information to take it and it can be quite overwhelming. Don't try and absorb it all in one go, but it is quite handy information

Ria x

[PrincipessaP]

Glad you have got to the bottom of the problem. I can't really add much to the excellent advice you have already heard, except to say that ALL our cats seemed to like the Hills food. I got chicken fillets from Iceland - on my shopping list it was called 'Tommy chicken'. He had a meal of that most days, half a fillet for him and the rest for the others.

Also he preferred pond or puddle water to our tap water (which is pretty awful). I always had a bowl of water from the pond in the hall for him (sounds like the pond is in the hall? ) he would often come in with a very wet chin where he had been guzzling water outside, almost as if he wanted us to know he WAS drinking.

Big fusses to Kimi.

Hi Bobby's girl - thank you for your reply - I may go and check the iceland counter and have a look at the chicken fillets and try her with one to see if she likes it (she can be quite finicky, even with chicken!) It's funny how cats will refuse a bowl of clean fresh water and yet drink out of a dirty puddle! Lol! Fortunately Kimi loves drinking from the tap and she always bolts upstairs to the bathroom and waits for us to turn it on! I don't mind as I want her to keep drinking. She went missing for 6 weeks about 3 months ago so I wonder whether the kidney problems stem from that - either she ate something toxic or it's due to dehydration....fortunately for her..and me..a man saw my poster on the lamppost and realised it was the cat that had appeared in his garden so he contacted me...she was just skin and bones bless her! xx

[PrincipessaP]

There is a bit of controversy over renal food. For many years, the thinking was to reduce protein and renal wet has reduced protein - however, in recent years, the experts have been saying that good quality (ie from eggs and meat) protein is fine ( although renal food is still the same)

I had have had 4 cats of the years with CRD and none of them would touch wet renal. It is expensive and I would have fed it if they ate it, but it always ended up in the bin, I compromised by feeding renal dry (happy cat kidney was the favourite, although there are plenty of others) alongside foods like Felix senior, with added binders. Our Clapton loved his chicken and I allowed him some every day, dusted in Ipakitine powder. He mainly ate Felix senior and Tesco own fish pouches with binder in. He managed well for 5 years.

I agree that Fortekor (there are cheaper generic versions available now with the active ingredient, benazedril hydrochloride in) crumbled into food is fine for cats that will eat all of their food. I used to either hide in a treat or 'down the hatch' to make sure they got the full dose. For the record, I chewed one years ago to see if it was bitter, The nearest thing I could compare it with was a Horlicks tablet! (although I wouldn't make a habit of it)

There is a newer drug called Semintra, that lots of vets are giving instead of Fortekor, but it is only suitable for cats that are losing protein in their urine. I don't claim to be an expert on any of this, but dealt with it for years.

Regarding any chicken or fish I fed, I would always check as some of them have added phosphates, which is something you want to avoid with any cat, especially cats with kidney problems. I started buying Co-op ready-cooked whole chickens. Not the cheapest, but the only additive is a bit of dextrose. We justified it by helping the cats to eat it - usually with the cats getting the meat and me making a soup with the carcass! - I still buy them now.

One other thing I would look into is supplementing B vitamins, especially B12 -the reason being that B vits are water soluble and CRD cats pee them out.

I give one of mine (not for CRD, but something else) B12 most days mixed into vitamin paste or fur ball paste.

Keeping them hydrated is another must - I found a water fountain the best thing. I have tried various ones, but this one is the easiest to keep clean and maintain. http://www.amazon.co.uk/Pet-Mate-06039- ... r+fountain I don't bother with filters. I just wash out and change the water every day or so.

Sorry if all this sounds dry and matter of fact, but was just trying to get the important stuff in. There is a lot of stuff to take in.

Hi Mark
Thank you so much for your reply - I tried her with the Fortekor this morning and she took it no problem popped in a bit of Gourmet Gold...her favorite! She also seems to like the Hills dry so I gave her some of that this morning. You made me laugh when you said you had chewed the tablet to see what it tasted like!!! Hopefully I won't need to do that! Lol!

I have never heard of Ipakitine powder - is that what you mean when you say you add a 'binder' to the food? Is that something I can get from the vets or online? What does it do?

I might pop to Morrison's later to see if I can get some Senior food for her - she's not keen on anything in gravy or jelly - she tends to lick off the juices and leave the meat! She only eats the pate so I hope I can find something that she likes.

The vitamin B supps you mentioned - are they for humans or can you get pet versions?

Sorry for all the questions but you have all been so helpful - I really appreciate all your advice - it has really helped xx

[PrincipessaP]

Paula, this is the link I was referring to in one of my first replies: http://www.felinecrf.org/ it is a lot of information to take it and it can be quite overwhelming. Don't try and absorb it all in one go, but it is quite handy information

Ria x

Thank you for the link Ria - I will check it out later xx

[meriad]

Paula, from what I understand the binders bind the phosphates in the food so they pass through the gut and not as much is absorbed by the body

Cheapest place usually is online and I gather it doesn't need a prescription but am not 100% sure on that.
https://www.viovet.co.uk/Ipakitine_phos ... oC_2Xw_wcB

but whatever you do, don't start giving Kimi anything without checking with your vet first

[PrincipessaP]

Paula, from what I understand the binders bind the phosphates in the food so they pass through the gut and not as much is absorbed by the body

Cheapest place usually is online and I gather it doesn't need a prescription but am not 100% sure on that.
https://www.viovet.co.uk/Ipakitine_phos ... oC_2Xw_wcB

but whatever you do, don't start giving Kimi anything without checking with your vet first

Thank you for confirming that Ria - I am taking Kimi back to vets next week so I will ask about the binders xx

[booktigger]

There are a few options for senior pate, do you have a pets at home nearby?

I've just remembered that Zia, who preferred dry to wet before diagnosis, ate renal dry with a small amount of adult wet and her kidney values went back within normal limits

[MarkB]

You can get pet versions of B vitamins, but I think they are hard to find and quite expensive. I'm not sure about B-complex, as I didn't do it when by CRD cats were around. It was only recently that I looked into B12 and the 'doctor's best' brand was recommended (may have been on Tanya's site) they are a fracton of the price of the ones made for cats, but still pure B12 - one thing you have to be careful of is additives etc. Even Doctor's Best do two types. One is a melt (for human to put under their tongue) but it contains a sweetener than is toxic to cats - so it must ne the capsules that are used for cats. They are the smallest capsules I have ever seen. I just empty one onto a bit of fur ball paste or vitamin paste and she happily eats it

These are the ones I use http://www.ebay.co.uk/itm/252168361193? ... EBIDX%3AIT

[Lilith]

Hey Mark (and everyone else) have you ever tried Kitzyme? These have been around for decades and are sold as a 'conditioning' tablet but they contain B complex - and cats have been known to eat them like sweets though I expect most cats would have to take them crushed up in food. I'm not an expert on all this stuff - this thread is being an education for me, and I haven't found an exact analysis of the Kitzyme, but they're widely available and cheap

[Jan]

My heart goes out to you PrincipessaP....not least because Blackie (13) was diagnosed with CKD almost a year ago, and even though told it was Stage I, I cried my heart out when I got home thinking he would be dead within a few months. I was in a stressed state for quite a while as I tried to find out as much about the disease as I could.

After telling the vet that Blackie was refusing to eat the RC renal food, she told me to add Ipakitine to his usual wet food as well as warmed water to keep his kidneys flushed through (I was already doing this due to Blackie's stress related cystitis). I queried about lowering his protein levels but she was undecided - she felt the most important thing was for Blackie at the moment was to eat what he enjoyed.

However, Blackie latest blood results showed improvements in some areas to what they'd been 6 months before and his latest urine tests also showed nothing negative. The vet said based on these results, giving the cat his usual wet food with added Ipakitine plus 60-100ml warmed water per day is working and has even reversed some of the results.

So please don't lose hope ... btw Ipakitine doesn't need a prescription. I buy mine from Viovet - a lot cheaper than buying it from the vet! Best of all ... Blackie eats it mixed in with his food with no trouble at all!

[MarkB]

I haven't tried Kitzyme on Kylie, but she needs a really high dose of B12 due to malapsorption. Thanks, I will find out what is in them I know they are 'as old as the hills' we used to give them to our cat Tinker when I was little - I am talking about 1969/1970! - the used to come in a little tin. I remember them smelling like yeast tablets.

PS - re Ipakitine. I think the reason cats don't mind it is because it is quite natural - a mix of groundmollusc shells and calcium. One of the ingredients binds the phosphorus so it is expelled via the gut, rather than being used by the body - the other ingredient helps the gut to expel toxins - creatinine I think.

Edit: I Igoogled to check ingredients of Kitzyme. They are pretty vague. It just says 'b complex' nut no quantities of which of them are in it.

[PrincipessaP]

There are a few options for senior pate, do you have a pets at home nearby?

I've just remembered that Zia, who preferred dry to wet before diagnosis, ate renal dry with a small amount of adult wet and her kidney values went back within normal limits

Hi Booktigger - that's really encouraging! At the moment Kimi is eating the dry Hills renal but she had an upset tummy when I got home from work - I rang the vets and they said I needed to give it her more gradually. (I think I must have got over excited at the fact she seemed not to mind it!!)

[PrincipessaP]

My heart goes out to you PrincipessaP....not least because Blackie (13) was diagnosed with CKD almost a year ago, and even though told it was Stage I, I cried my heart out when I got home thinking he would be dead within a few months. I was in a stressed state for quite a while as I tried to find out as much about the disease as I could.

After telling the vet that Blackie was refusing to eat the RC renal food, she told me to add Ipakitine to his usual wet food as well as warmed water to keep his kidneys flushed through (I was already doing this due to Blackie's stress related cystitis). I queried about lowering his protein levels but she was undecided - she felt the most important thing was for Blackie at the moment was to eat what he enjoyed.

However, Blackie latest blood results showed improvements in some areas to what they'd been 6 months before and his latest urine tests also showed nothing negative. The vet said based on these results, giving the cat his usual wet food with added Ipakitine plus 60-100ml warmed water per day is working and has even reversed some of the results.

So please don't lose hope ... btw Ipakitine doesn't need a prescription. I buy mine from Viovet - a lot cheaper than buying it from the vet! Best of all ... Blackie eats it mixed in with his food with no trouble at all!

Thank you for your encouraging post Jan - I am really happy to hear that Blackie is making good progress I was exactly the same as you - I felt soooo upset and stressed when the Vet said her kidneys were in a bad state ..... I'm not sure if he thought it was CKD or Acute (she was missing for 6 weeks so dehydration could be a factor...) But I feel a lot more positive now!! xx

[Crewella]

I can't add much to the excellent advice that you've been given, but just say that I've had several cats with kidney issues as it's very common in older cats. Do have a read of Tanya's site to get some background info as it really helps if you understand the issues involved, and it will also stop you feeling so worried. You will feel more in control, have a better understanding of what the blood test results are telling your vet and therefore be able to ask more specific questions about treatment. On the right diet cats can still live long and happy lives, and mine made it to 18 or more - several years after diagnosis.

[PrincipessaP]

I can't add much to the excellent advice that you've been given, but just say that I've had several cats with kidney issues as it's very common in older cats. Do have a read of Tanya's site to get some background info as it really helps if you understand the issues involved, and it will also stop you feeling so worried. You will feel more in control, have a better understanding of what the blood test results are telling your vet and therefore be able to ask more specific questions about treatment. On the right diet cats can still live long and happy lives, and mine made it to 18 or more - several years after diagnosis.

Thank you Crewella - really appreciate your message - I have looked at Tanya's page - it is very in-depth but helpful - might take me a while to get my head around it ...I had NO idea about anything like this until Kimi became unwell - for her sake I need to do as much research as I can to make sure she has a few more years of quality and happy life ahead xx

[PrincipessaP]

There are a few options for senior pate, do you have a pets at home nearby?

I've just remembered that Zia, who preferred dry to wet before diagnosis, ate renal dry with a small amount of adult wet and her kidney values went back within normal limits

Thanks Booktigger for the tip about the senior pate being at Pets at Home - I went into my local Morrisons but they didn't sell it - but have just checked Pets at Home and it seems they do the same range she likes in Senior - Phew! It's not that more expensive than the usual stuff so that's good. Guess where I will be tomorrow morning!!!

XX

[PrincipessaP]

Hi all
Just an update on my Kimi-monster! I took her to the vets and he examined her again - he reckons she has about 30% kidney function - but said she seemed stable, her breath smelt ok, her heart was fine and generally she seemed ok. I told him she has a good appetite and that she was taking the Fortekor without too much trouble. So he told me to carry on as I am doing with her, and to come back in 6 weeks - although to be honest, I might leave it longer than that unless I feel she has deteriorated. He told me that Ipakitine was good so I ended up buying some (although I think I can get it cheaper online) and I got another month's supply of Fortekor. I might look into your suggestion Mark B to see if there any other cheaper alternatives to give her rather than Fortikor. Anyway - thank you all for the advice you gave me - I now know that Kimi can have a good quality of life and it doesn't mean the end for her just yet! Really appreciated all your advice x x x x x x