Kidney Disease in Cats
Kidney disease is complicated and has several stages as the disease progresses. Our goal is to cut through all the hype you might encounter on the web and lay out some simple guidelines to help you focus on what is truly important to help your kitty.
There are three basic rules you must follow.
First, your cat must eat. With chronic kidney disease (CKD) (CRD) cats often have a suppressed appetite, especially in the later stages of the disease. If they refuse to eat their normal food, then try anything to get them eating again. Once they are eating, you can go back to their normal food. Your vet has medications that can help stimulate their appetite.
Second, the food you feed must be low in phosphorus; less than 0.55% phosphorus on a dry matter basis (no moisture in the food). The food you feed may be dry or wet or you may feed a combination of both. Current research has found that restricting phosphorus is the best and only way to slow the progression of CKD. Many Vets monitor the blood phosphorus level and prescribe a phosphorus binder that can be added to food to help maintain blood levels in the lower third of normal phospherous range. Lower blood levels of phosphorus help kidneys function longer. Most non-prescription dry and wet foods contain high levels of phosphorus. If you don’t know the phosphorus level in your cat’s food, call the company to find the actual level based on a dry matter analysis.
Third, current research states that high levels of protein do not cause CKD to progress faster. There are still recommendations made for low protein diets based on assumptions made decades ago. Current research has found that the protein source should be highly digestible. Animal protein is more digestible than plant protein and hydrolyzed animal protein is more digestible than animal protein. With hydrolyzed protein, the protein chain molecules have been reduced from several hundred thousand chain links to less than ten thousand links. This makes the protein easier for your cat to digest and process. Hydrolyzed proteins are also great for IBD, IBS and cats with allergies to protein sources.
Choosing the right food for a CKD cat.
You may feed dry or wet food to a CKD cat. Some people recommend only wet food because they feel the cat will be better hydrated. This is a nice idea, but generally does not help to better hydrate your cat. In the later stages of kidney disease, your cat is already drinking copious amounts of water and is still not able to stay adequately hydrated. As long as the dry food contains less than 1% carbs/starch your cat will remain just as hydrated as feeding any canned food containing less than 1% starch/carbs. Research shows that the higher the carbs/starch content of a food the less overall water the cat will consume. Wet food does have one advantage; you can easily mix in medications. Feeding a small amount of wet food (a tablespoon twice a day) will allow you to easily add medications, like the phosphorus binder, that your cat may need. It is also an excellent way to make sure your cat is still eating.
The right dry food is an excellent way to feed a CKD cat. Many cats prefer dry food over wet so you are more likely to keep your cat eating. The food must be low in Phosphorus and contain minimal carbs/starch, less than 1% is best. The protein to fat ratio should be at a minimum 2 parts protein to 1 part fat. It is actually better if the fat is slightly higher than the one part. For example, the diet Young Again recommends is the LID Zero Mature Health. The LID uses only hydrolyzed animal protein. The phosphorus level is 0.52%, ash is less than 5%, protein averages 59% and fat averages 27%. Having a little more fat helps the cat with their energy balance. The dry food should be available at all times and you need to monitor their daily food intake. If they stop eating, take action before they get in trouble.
The problem with carbs.
There are kidney disease diets low in protein and low in phosphorus, but high in carbs. These diets state that a ten-pound cat will consume 65 grams of their food a day. That same cat will only consume about 35 grams of the LID Zero Mature Health a day. Both diets contain similar amounts of phosphorus, however, the high carbs often cause cats to consume higher levels of food. The more food the cat consumes the more phosphorus they consume. Another problem with feeding cats a low protein food, skinny old cat syndrome. As your cat ages they process protein less efficiently and they can slowly loose muscle mass. Older cats actually require higher levels of protein in order to maintain their muscle mass.
Hydration is a serious problem with later stage CKD cats. It is important to learn how to tell if your cat is becoming dehydrated and how to administer Sub Q fluids. Most people find this easy to do after 15 minutes of training from their Vet. Providing these fluids can make a huge difference in how your cat feels and will often encourage their appetite.
Helping your CKD cat to feel better does not have to be hard, please feel free to call us for more information.
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