Food suggestions for a cat in early stage renal failure

I guess it’s not really early stage because his blood work has reverted back to slightly above what it was when I got him almost 2 years ago, after a significant improvement for an old cat. Vet would like me to try a lower protein/phosphorous diet and see if that helps before we put him on steroids.

Foods he can eat are raw chicken, rabbit, turkey, duck, quail, most of the Weruva flavors and Fancy Feast Appetizers. Anything else gets puked up and then he quits eating or starts a vicious cycle of puking everything. I’m hesitant to change his diet but I’d rather get started now than when it becomes a necessity.

What are the tried and true low protein, low phosphorous foods? Must be canned or raw and I would prefer no grains or excessive fruits and veggies. Vet wasn’t specific but she is supportive of the diet he’s been on and didn’t suggest Science Diet. He will NOT eat the same thing day after day so I need a few options. Doesn’t matter if they are expensive or cheap, so long as he tolerates them.

ETA: I will be looking into the raw meats he eats to see which I should be cutting out.

I feed my early stage renal failure cat Before Grain wet food, and she is also on mirtazipine for appetite. Her values have improved since we have been consistent with the mirtazipine. Has your vet given you target numbers for protein and phosphorus?

Vet hasn’t mentioned target numbers but we are waiting on urine results to see if he has a bladder infection. When that comes back, we’ll devise a plan for his kidneys. I’m trying to be a step ahead in case she wants to do anything radical. :wink:

He can’t tolerate BG. I have cases of it here for fosters and as a back-up to raw for my own dog but all flavors come right back up for him. I believe it’s a texture thing so I could try mixing it with raw, though.

Appetite is not a problem. He eats around 9 ounces a day split into 3 or 4 meals. There is a back story about his hip/spine X-rays but that is not related to the kidneys.

Perhaps some Cerenia would be useful to control the vomiting and allow you to play around a bit with his diet? Even if you don’t go with BG, it sounds like you might be limited by his tender tummy.

Working theory on why we saw better values with consistent mirtazipine use is the kitty would go off food regularly due to her very slightly elevated kidney values. If she’s eating consistently, she’s also very well hydrated, since we serve soup. Better hydration = better values. Can you get more water into your guy by adding more water to his current diet? That alone might give you an improvement in the labs. :slight_smile:

Hydration is not an issue. He eats an all wet diet (has since the day I got him) and drinks loads of water from a fountain. The litter box is flooded and he’s not diabetic or hypo (hyper?) thyroid.

The vet feels his fluid intake is what’s kept the renal failure at bay so far. Now we need to look at tweaking his diet.

Sorry to hear your kitty is having renal issues! I have had several; actually one did very well on CD-I have serious conflicts about Hills but he did very well on that with extra subQ fluids (he drank plenty but not enough). My old girl who just died in January would not touch CD so I let her eat whatever the heck she wanted-she also got Cerenia for the nausea-those toxins build up and they feel awful, and cyroheptadine for an appetite stimulant. She also got daily subQ.

This is a pretty good page on CRF- ideas to run by your vet…

http://www.felinecrf.org/persuading_cat_to_eat.htm

prayers and jingles for your guy!

I got, but yet to install a motion detector auto fountain that you add to your sink, from skooterdiddles. I have steel pipes so am scared to drill a hole into the supply line, it’s easier with a copper input:
http://www.engadget.com/2008/07/12/cat-faucet-solves-elusive-cat-drinking-from-sink-issue-we-sigh/

I’d suggest keeping him on the current diet but perhaps adding either Azodyl or Epakitin to help.

I have had good luck with Purina NF; more palatable than Science Diet KD. I have had to mix it with a little Classic Beef Fancy Feast (he thorws up any of the other flavors) but so far so good. Cats in renal failure get sick to their stomachs very easily AND they get ulcers. I make a soup with NF, a little Beef FF and slippery elm broth.

The slippery elm is a stomach soother and coats the stomach and has healing properties. I make a very slippery/cat food concoction that the cat has to almost drink, he laps it up. He ABSOLUTELY LOVES the stuff; I serve it warm. It gets a lot more fluid into him than he would normally get just drinking water or eating canned food.

Slippery elm also helps with constipation, which many cats with kidney problems have. SE is good fiber and has kind of a sweet taste to it that cats seem to like.

I have had serveral cats with renal failure over the years and this works every time, tweeked a little to personalize it for each cat.

My current cat with renal failure is going on 20 years old and was diagnosed a year and a half ago. Hes doing pretty good so far with this concoction and sub fluids when he needs it, which lately, within the last 4 months, he hasnt needed at all.

I’d read that link before, and it goes along with what my vet is saying, but I just saw the table for phosphorous levels in commercial food. That was really helpful!

It looks like the canned I’m already feeding is “middle of the pack” so I’ll try some of the brands that are lower. I’m torn about keeping him on raw. On the one hand, I truly feel like he’s only gotten this far because of it but switching back to canned will be easier to control. His kidney values were at the very top range of normal when I got him in July of 2010 and went down to middle range that December, which was about a month after I started feeding raw. They have slowly crept up and now he’s just above high end normal.

He ate and kept down some BG Chicken last night. I haven’t tried in over a year but maybe I can start adding it back into his diet. Couldn’t find chicken on the chart but BG Turkey is low phosphorous so that could work, too. I’m not against prescription foods but I know he’s not going to eat anything more than 3 times in a row so I need several options to mix it up.

I will talk to the vet about something for his appetite, or settling his stomach. Thanks for the ideas and stories. He’s one of the best cats I’ve ever had, even though he was a grumpy old man when I got him.

Good luck with your guy! you might also ask your vet (you probably already have!) about whether or not subQ fluids might be helpful. He might not need them yet but they sure helped mine!:slight_smile:

My cat gets Purina n/f (I think that’s what it is) special food. Science Diet also has a special kidney disease food. They are both low phosphorus and low protein.

However, most important thing is that your cat continues to eat. If he pukes up a lot, try adding Pepcid to his diet. Kidney disease often gives them upset tummies.

I dont know why, but the Purina NF seems to be super palatable for cats. Its probably got some grain in it, so that might be against your beliefs, but I have really seen it do wonders in renal cats.

Finally got the results for bladder infection and he is negative.

We’re going to try a lower phosphorous diet and a quarter tablet of Pepcid AC for now to see how that goes. This vet has no experience with slippery elm but has heard good things and she’s willing to try if I am. I’m also going to be giving subQ fluids any time he seems to be having a rough day.

I didn’t mention it before but I starting using this vet because she also offers a home euth service. Grumpy Old Man takes days to recover from a trip to the office because of his arthritis and I didn’t want to keep putting him through that for blood work every few months. She has taken great interest in treating an animal that isn’t on its next to last breath and says I am the least squeamish, most realistic client she’s ever had and will treat at home as much as she is capable of. Then we got on the subject of horses (her daughter used to ride) and realized we knew a few of the same people back in the day. :lol:

I’ll second or third the slippery elm, Pepcid, and subQs. My RIP CRF cat had a course of epogen, as well, which helped. She lived a good quality of life for another 3 years post-diagnosis.

She did pretty good with Weruva and one of the Wellness canned foods (can’t remember which - whatever it was had the lowest phosphorous). Towards the end, I had to bump-start her appetite with whatever would work: sliced turkey, tuna, lunchmeat, fish, bay shrimp, chicken baby food, cheese, steak bits etc etc. Better she should eat something than nothing…

If you do use oral meds in addition to the slippery elm, don’t dose your cat with the meds at the same time as the slippery elm, because the slippery elm can interfere with absorption (so I was told). I syringed about 2 ml slippery elm (gruel consistency) into her daily, with no protest from her. About an hour later, I administered Pepcid. She never puked with that regimen.

Be sure to watch for ulcers in your cat’s mouth too. IIRC they are common in CRF cats and will certainly affect their appetite/ability to eat.

Sounds like you’re managing your old man beautifully, CGPL. He is one lucky Kitty.

Darn it. He started puking up the BG chicken and won’t touch the turkey, or the chicken anymore. He was fine on a meal of the BG every other day but the trouble started when I tried replacing his (raw) breakfast with canned. Now he’s getting 4-6 tiny meals a day until we get over this.

He’s been on the Pepcid for 3 days now and think I see other improvements, though.

My vet says Cerenia is very useful in cats like yours, CGPL. We tried it for Juliet, and we found mirtazipine more effective for her issues, but perhaps it would be worth a try for you? It is only dosed twice a week, so it’s relative easy to deal with, and not very expensive. It is a whole different class of drug than pepcid and works in a very different way to settle the stomach.

Also, the chicken BG is fairly high in Phos at 1.73%. The turkey and the beef are the lowest, at 0.95% and 0.79%, respectively.

Totally recommend talking with your vet about Cerenia-go with the shots rather than oral (which did little) but really really helps with the nausea.
And, as you mentioned, the subQ also helps.
I had great luck with cyroheptadine as an appetite stimulant. The vet said that with the almost chronic nausea, they can associate that nausea with whatever foods they ate, and the stimulant helps.
At some point, not sure where you are, I just let 'em eat what they want as long as they EAT. My old girl would ONLY eat a FRESHLY opened can, and NOT good stuff, she ate some kind of FF.I just let her go with what she wanted.
Someone mentioned epogen as well. Certainly not a cheap option but depending on your kitty, worth talking to your vet about.

Jingles and prayers for your boy.

I’ll ask the vet about Cerenia, Mirtazipine and might get him started on the slippery elm.

He’s always had this pattern of puking up or avoiding things he eats too often. Canned is the worst because it’s more limited than I what I can feed raw, but he also does it with rabbit (his favorite) after 3 meals in a row.

Simkie, he doesn’t tolerate beef and, so far, won’t eat the BG turkey although he eats raw turkey just fine. I already had the chicken so it was just a starting point to see if he’d changed his mind about BG.

Yeah. I almost don’t care what he eats as long as it’s halfway nutricious. He appears to be a food snob, though. :lol: