CKD/Diabetes Diet AGAIN!!!

Ugh. I am so frustrated. Took Hobbs in for his follow-up yesterday, and his creatine was up to 3.25. His glucose is good, he's been OTJ for 2 months. So now the vet wants to put him back on a Rx kidney diet. Are any low carb? Open to suggestions!

Sorry, on my phone, forgot to add, he's currently eating EVO 95% Chicken & Turkey (canned).

 

I would like to know as well, I'm in the exact same situation

 

I feel like I've beaten this topic to death and here I am back at square one. I thought I had this figured out.

She was recommending the Royal Canin. From what I gather, it's 10.2% carbs but also has by-products and corn flour (?) and vegetable oil (?) in it.

The Purina NF (according to Pet Food Direct) also has by products but it says the carbs are 8.89%.

Can't find Iams on their website. Hills says "dry matter" carbs are 35.4% but I don't know how to convert that to % of cal. They both have liver which I've heard is bad.

I'm concerned about muscle wasting and about his diabetes taking a turn for the worse if I switch him. If I do, I definitely will do canned only.

I'm not sure what to do or what's the best for him.

 

HI Sabrina, here is some info from Tanya's CRF website http://www.felinecrf.org/which_foods.htm (which is just as awesome as this board):
Prescription kidney diets are not only about low protein. I would consider feeding one if my cat would eat it.

What is essential is to feed a food as low in phosphorus as you can. High phosphorus levels will make your cat feel bad and will make the CKD progress faster. Because this is so important, I've created tables of commercial foods in order of phosphorus content for the UK and US markets. Ideally feed a wet food, because this helps with problems such as dehydration. If your cat is a dry food junkie, you may be able to gradually switch him or her over to wet food. If you can't, don't sweat it. It's more important that your cat eats than that s/he eats a wet food.

So - the main goal is to find a food that is lower in carbs and low phosporus content. It is do-able - I've cross checked Tanya's list with Binkys and I found Merricks has both - fortunately Sitka will eat the Cowboy Cookout and Surf/Turf. The other thing would be to ask your vet about subq fluids - this helps flush out the kidneys and can help extend your cats comfort and life. My cat has both CRF & FD so she is in the same arena as Hobbs. I did find a supplement called Azodyl and its helped keep Sitka's CRF stable. Its a bit spendy ($35 a bottle which lasts 30 days) and must be kept refrigerated but her creatnine actually dropped from 4.4 to 2.8 after a month on it.

 

The EVO is a low phosphorous and low carb diet, I guess it isn't low enough. Through that link I found a link to the OSU College of Vet Medicine and they have a diet search there. According to that the Royal Canin is the lowest in carbs. I think. It says "CHO" which I believe is a medical abbreviation for carbohydrates. It says "2g" per 100 kcal. Is that the same as 2%? Anyone know? If so, that's the same at the EVO he's getting now. According to this. I'm OK with calling up Royal Canin and finding out for sure I'm just not sure what to ask or how to compare the numbers. I've never gotten how to figure these numbers out, I'm terrible at math.

As far as "if he'll eat it" Hobbs is pretty much a champ in that department. He's only ever turned his nose up at one food before and it was a diet food. I can't say I blame him on that, mama doesn't like diet food either!! LOL

Thank you. I'm really not the type to freak out about stuff except when it comes to Hobbs' health. He's my little love bug, what would I do with out him?

 

So now I just found on Royal Canin's site http://www.walthamusa.com/Learning%20Ce ... pouch.html that carbs are 4.39g per 100g as fed and 35.12 per 1000 kcal. Can someone help me translate this? Am I over analyzing this too much?

 

I would not change his diet. Here's some info on creatinine for you: http://www.felinecrf.org/diagnosis_blood_chemistry.htm#creatinine. You don't mention BUN, so I'm assuming it's normal? Was there proteinuria in the urine? What is his USG? Creatinine is waste product of the muscles, and a high number with low BUN can be indicative of pancreatitis.

None of the prescription diets are low enough in carbs for a diabetic cat. You really have to feed for both conditions, and he will need insulin if he goes back on the prescription diet. Regardless, low protein diets should not be used until BUN is about 60-80 mg/dl. Here is some more information on protein restriction here and here.

Another option is to switch to a home made diet. Have you been to Dr. Lisa Pierson's site? She does phone/skype consultations and would be able to help you formulate a recipe that is ideal for both his diabetes and his CKD. Here's some info on that: http://catinfo.org/?link=makingcatfood#Note:.

 

His BUN/Creat was 11

I don't see proteinuria or USG

As for the homemade diet, I don't know if I could make it work financially. I don't have the means to freeze enough of a quantity to make it affordable.

 

Has he been tested for pancreatitis? That BUN is actually lower than normal. BUN is more reflective of diet than the creatinine, which suggests diet is not his problem. And that creatinine value is a little high, but nowhere near end stage. I really would not change his diet. If you can't do home made, stick to a commercial food. Try and get as much moisture in him as possible on a daily basis--mix water with his food, and maybe get a pet fountain to encourage drinking.

 

Thanks for posting as I'm in the same boat. Except Skipper's kidney levels are currently normal, and his BG is out of control. I've found two kinds of canned food he'll eat, and thankfully they both meet Tanya's criteria. They are Wellness CORE Salmon, Herring and Whitefish, and Blue Wilderness Salmon. He is allergic to beef, and my other cat is allergic to chicken, and they both throw up duck, venison and rabbit, so that doesn't leave us a lot of options. Someone sent me this link the other day, and it was very helpful:
https://docs.google.com/leaf?id=0B8Uu8g ... ist&num=50.

I'll stay tuned to see what you find out.

 

He hasn't been tested for pancreatitis, but the vet didn't seem to think this was a concern. Or I don't think he has, would it show up on this blood panel? I'm reading that it's diagnosed with a white blood cell count and a Pancreatic Lipase Immunoreactivity test, I'm not seeing either of those on this panel.

There isn't a normal range for BUN on the panel but according to Tanya's site the normal BUN range in the US is 9.8 - 35.0. I don't recall what it was at his last test in December, it's at home and I'm at work.

I'm concerned that if I don't switch him that his kidneys will continue to deteriorate. Also according to Tanya's site a 3.25 Creat level is Stage 3. :sad: However if I do switch him I'm worried that his diabetes will go out of control. AND I'm concerned about the ingredients in the Kidney food. I feel like I can't win.

Millerb, Hobbs was there in December. His kidney numbers were down to normal after being on Hills K/D (dry) for three months but his BG was over 400. He's not allergic to anything in particular but I've always stayed away from fish because it gives him the most gawd awful gas!! :lol:

Oh, also something else I was concerned about, the Royal Canin site says that the Renal wet food is "intended for intermittent or supplemental feeding only" but that it's also a "complete food suitable for adult cats" Um, what? Which is it?

 

To figure out percent carbs, there are 4 calories per gram of carbs. So if Royal Canine pouches have 4.39 grams of carbs per 100g of food, that's 17.56 calories of carbs per 100 grams of food. Royal Canine lists there are 148 calories per 100g, so 17.56/148 = 11.8% carbs. Binky's list has it at 11%, so that works out. Anyone can correct me if I'm wrong.

 

Thank you!!! I did some digging (as much as I can at work) and found Binky's spreadsheet and yes, that looks to be right. 11% carbs which is a bit high :?