CKD

ok so just home from the vets, it all went really positively which is good. Of course I'm gutted that Tempest now has the early stages of CKD but like everything else you just have to get on with it! Now I need to find a low carb food that she will eat that's also good for her kidney issues.. *pulls out hair* any suggestions gratefully received.
As requested on the dental thread, here's Tempests blood test results.

 

Sorry. At least you have a great attitude about it. Here is an article about diet for cats with kidney disease. Sounds like high protein, low phosphorous and moisture, moisture, moisture. There are a few other points in the article, and it directs you to Dr. Lisa's chart.

 

She's really not too bad yet. Stage 2. Sub q's will delay the progression and make her feel better.

 

Are you on Facebook? If so join Cats with Chronic Renal Failure fb group.

 

Thanks, there's nothing I wouldn't do, I conquered my needle phobia with the insulin (well I faced it) so I can do this. I'm in the UK so unfortunately Dr Lisa's list isn't of use to me

That's good to know, I wasn't sure what stage this would be considered.

I am and will do thank you! (Sent a request)

 

Here is a list of foods that work for both FD and CKD. I don't know at this point how up-to-date the list is, but it might at least give you a place to start. Primal Raw Turkey is also good for both.

 

I don't see the list? Is the primal one available in the uk? My kitty will not eat any pate type foods it needs to be in jelly and small pieces. Thank you

 

Oh gosh! I'm sorry!

https://docs.google.com/spreadsheets/d/112NvvzgxEBOtkb42rA0XR8GeShw9xXs9kccf9-olK7I/pubhtml

I was taking my kitty in for extractions this morning and between that and his crying for food, I was a bit of a wreck this morning!

 

Primal comes in a big chunk (~2cm x 5cm). One of my cats will just take bites off the chunk as it thaws. The other one will only eat it if I cut it into bite sized pieces for him. He would never survive in the wild.

 

Tara, I'll tag @Elizabeth and Bertie to see if she knows of any foods in the UK for diabetes and CKD

 

Tanya's site is the CKD bible. Like FD, it's information overload at the beginning. http://www.felinecrf.org

Tempest's phosphorus is well within normal range at the moment. You've got time to figure out food and such. Breathe.

Tagging @Marje and Gracie to take a look at the labs.

 

Haha I know the feeling! Thank you

 

I was following your Dental thread last week. It gave me some comfort knowing that so many folks on here were facing this same thing. I hope your kitty's numbers improve so you can go through with your dental soon!

 

Thank you Djamila, I appreciate your support. Am looking into diets at the moment and reading everything I can.

Looking at raw food diets right now. Any thoughts from folks as to whether this might work?

 

Dear Tara!
Urine testing will give you more answers.
As I said Rocky had quite bad test results pointing in the direction of CKD but after he recovered from UTI his numbers went back to normal. This is not to say that he hasn't got CKD but it is still in very early stages.
Before you get CKD diagnosis your vet will test urine (put it straight in the fridge after you collect it and deliver on ice to the vet's if you can, it's vital that urine is fresh), they should have checked BP as well to get the diagnosis. If they did not do it they should be doing it on the next visit.
It looks that Tempest potassium level is OK so no need for supplementation as yet and phosphorus is fine to so no need to do anything about this too.
Please do not worry, this is such a common problem in kitties and they can live almost normal life for a long time specially when they have such dedicated moms taking care of them.
Sending love and hugs
Marlena and Rocky
Ps. Tanya's site is all you need now to learn about CKD.

 

I'll be happy to look at his labs but we are on our way out for the day. I hope it's ok if I look at them tonight for you.

 

Thank you Marlena, funny I was just thinking the other evening I was glad I didn't have to deal with this.. then wham! Maybe the universe was trying to tell me something.

I've to bring a urine sample up tomorrow so we will see what that tells us. Thank goodness for cling film!

I must be honest. The panic I expected isn't happening, I just need to get my plan of action sorted. The video Janet shared made me feel a whole lot better if I've to give fluids and the de-sensitisation I had handling the insulin needles helped.
Now I need to find food, (that princess fussy nose will eat) and work out when to start fluids, now or in 2 months, how to give them and keep Tempest happy while that's going on. That video will be referenced a lot I think lol as will Tanya's site. I've read a lot of it tonight but my brain is scrambling so taking a break.

Hugs and love always appreciated

 

Thank you, whenever it suits of course! I would just be grateful to get a wee bit of insight.

 

Thanks...I will be more than happy to do that for you!

 

Hi Tara!
So sorry to hear about Tempest's kidney dx. (((Hugs))) But it sounds like it's early stage, and maybe the disease will only progress slowly.

Bertie is also early CKD, but his blood phos is within normal range at the moment.
At this point - and this is purely my choice - I feed low carb foods that have no more than 1.2 % dry matter phosphorous. (Well, or maybe a smidgette more on occasion....) .
If his blood phos gets higher than normal range I'll add a phosphorous binder (probably aluminium hydroxide) to reduce phos absorption. And concentrate on even lower phos foods.
As Red and Rover said above, the Tanya site IS the CKD 'bible'. So much brilliant information. There is also a book (based on the site content) that is absolutely fab (and absolutely huge....) ...I love the book because I can curl up in bed with it and scribble in it and make notes in the margins.... (Yeah, I know, I should 'get out more'.... )

We don't have phos levels for all UK foods on our list, but we do have phos levels for some. You'll find the current food list in my signature. And then, in the blue column, you'll find phos levels if we have the data to calculate them.

Hugs to you, Tara. And chin scritches to Tempest!

Eliz

 

Thanks so much! And I am sorry to hear about Bertie! Much love and cuddles for him from me.

I'm still feeding the low carb food tonight, I've nothing else to give her, but I added water to it and made the jelly into a thin watery gravy. Lol
Most of the foods seem to be 1.2 or so. I was told to stay under .80 or .70 if possible.

I'm looking towards raw, or even making my own if someone can recommend some good recipes but then how do I know what the phos is?

My vet did say she doesn't need a binder yet - I did mention that.

I have read some of Tanya's site but my head is now overloaded so leaving that tonight until tomorrow, a book! Oh my! lol I may look into that! (Who needs to get out when there's a warm cuddly purry kitty to cuddle up with! )

Thank you for the hugs. Tempest is enjoying the scritches - she's cuddled up beside me.

 

CKD is scary, especially when it's on top of diabetes (or in my case, diabetic remission).
The single most important thing is that Tempest eats. What she eats is secondary. Eating better food may slow the progression, but not eating at all is worse.

I tried 9 different varieties of low phosphorus food for Shenandoah. Yes, nine. She won't eat them. So we are back on FFC, with a touch (30g max) of lower phosphorus (not prescription) dry food to help keep her weight up, and then I just monitor her BG to make sure it's not going up.

I had a thorough discussion with my vet about the pros and cons of trying to force a lower phosphorus wet diet, increasing the dry, adding a phosphorus binder to what she's getting now, or just keeping our current plan. In the end we ended up decided to go with the current plan for the moment, and we'll re-evaluate next time we do bloodwork.

If you trust your vet, I suggest having a similar discussion. Tempest's numbers and clinical signs, along with your vet's past experiences, should give you a good approach for now. As long as she continues to eat, and doesn't seem to be feeling poorly, you are doing well for her.

 

With the tests you have, it does look like Stage 2 CKD. But there can be other reasons why the creatinine is increased such as a cat with a lot of muscle, a cat with pancreatitis, a cat that has had DKA, etc.

I agree with testing urine but it needs to be the very first sample of the day so you can see see whether she "can" concentrate her urine. As the day progresses, urine becomes more dilute especially if she's drinking.

Ask your vet if their lab is associated with IDEXX. IDEXX runs an SDMA test and if the SDMA and the creatinine are elevated, it's a good indicator of CKD.

IF she does have CKD, a few points:

• I absolutely would not start subq fluids now. Subq fluids shouldn't be started until creatinine gets to 300-350 and into Stage best for her to get as much fluid as possible by drinking it or by you adding it to her food.
• Phosphorus, potassium, calcium, and sodium look great. A CBC is needed to see whether she is anemic or not.
• I would try to feed as low P foods as you can find and she does not need a binder at this time.
• I would be sure you have her blood pressure checked every time you go to the vet.

If she were mine, the next time I had labs done, I'd ask for a superchem, CBC, and urinalysis. I would probably repeat labs in a couple months.

In the meantime, I'd start to read as much as I could on Tanya's. I think two things are most critical for longevity in CKD: controlling the phosphorus and anemia so that's where I'd focus my first readings.

There are a lot of moving parts with CKD and somthe more you can read while she's stable, the better.

Pls let me know if you have questions.

 

Thank you for your input! It's good to hear from someone in a similar situation, Tempest is also a remission kitty so I really need the best balance for her.

At the moment she's eating (vet says she's the same weight as last year) I had felt she had lost a little so did up her food intake. She is a free feeder so there is always food left out for her, and she eats pretty well. She's still playing, fetching her mouse if I throw it for her and loves her wand, purring pooping and doing everything normal. She did start drinking a little more which I noticed, and I checked her bg more often, but he bg is normal, 4.6 was her last reading.

They have suggested I do change her diet but my mind boggles at all the different foods and I get a brain fart (sorry, bst way to describe it) when I try to work out the balance of carbs and phos. Math was never my strong point. I mentioned a binder but the vet said that a phos binder wasn't an option at this time as her level was still in the normal range.

Bless her, she offered to call the food companies for me and see if they could recommend a food for her. While I appreciated that, I declined, I really do not like those big companies and the fact their foods have sawdust in them doesn't fill me with confidence. I mean what else is in there..

We will do the urine test and then talk about it I guess.

I better start thinking about what questions I need to ask.

 

Thank you for taking the time to decipher that for me!

She's not a muscled kitty so I can rule that out. I have suspected pancreatitis before. So that could be worth looking into and she's always been negative on keytones (so thankful for that!)

I missed her first pee of the day was gutted as was reaching for the cling film and was aiming for her second... I better leave that until tomorrow then.

I will ask them if they can do the SDMA test, if not maybe the hospital can help there. But I think there's only one lab for pets here.
I did ask for everything so I'm surprised they didn't do a CBC..
and I will ask for a BP check too.
And I'm writing down everything else you've suggested for tests. She was due to go back in 2 months but maybe I should do all that sooner rather than wait?

Many thanks Marjie.

 

Tara @TempestsMum , if you're interested in feeding raw do take a look at Bron's thread in the TT forum. She has used crushed egg shell, I think, instead of bone, to keep the phos level down.
Home prepared diet of CRD cats

Also, regarding other UK foods, there may be some on the UK list on the Tanya site that I haven't been able to get the data for; so do look there also.

Eliz

PS. Bertie says 'thanks for the cuddles', and returns them to you across the Irish sea.

 

You're welcome. I think two months is fine.

 

I also use egg shell powder in Rocky's food (make my own) and egg white is also a good source of protein without much of phosphorus. I think the best meat for low phos is turkey but I need to do more research on this.

 

Definitely going to research these diets, however the ultimate judge will be Tempest lol

 

Good luck Tara, I hope Tempest will cooperate!
Sending big hugs

 

Fluids have a lot of sodium so I wouldn't give them until necessary although others may disagree. I'd add water to the canned food and feed as low a phosphorus food as your cat will eat. I know it's hard to find real low phosphor and low carbs so I would look at the food list and buy a few to try. Marje really said it all.

 

Thanks
I already started adding water to her food. I'm cramming on Tanya's site and spoke to the nurse this morning at the vets who has said they would be happy enough when I need to give fluids to allow me to do that.

It's the food issue is the main problem as you said.. looks like there's a gap in the market

 

I had some good news this morning! Tempest is still concentrating her urine - somewhat. The vet said about medium on the scale and I've written to all the companies about the phosphorus levels and Felix just got back to me. 0.22 per 100g as fed, so I can still feed that one.

 

Hi!
That's good news! You don't have to hunt for other food. Could you ask what they mean by as fed and how they calculate that? Then I can ask about my cat food Burp.

 

It's great news! I'm hanging onto every positive I can
I am hopeful that her other food is the same too, because she gets bored quickly lol
As fed means the amount in 100g as it is straight from the pouch/tin.
It really is worth messaging and asking. Although some companies take a long time to get back to you.

 

My cats get bored quickly too! They like burp cos it has a variety of flavours. What about Sheba? Does it have low phosphorus? I saw this brand in the supermarket.
Ya I will call the shop again about the as fed content.

 

I'm still waiting to hear back from Sheba, Lily's Kitchen and Whiskas. I will post as I know

 

Ok great! Thanks! Sheba and whiskas are available here.

 

Burp replied! It's 0.1-0.3% per 85g can. It's as-fed. Should be ok ? 0.1% of 85 is 0.085g. Unless my maths is wrong.

 

Maths isn't my strong point so I'm not much help. Still waiting to hear back from the other companies, didn't help my internet was down for the day.. only got back n today.

 

No worries. I'll ask the experts on Fb group.

 

I think you are correct
Because 10% is calculated as 0.1
So 1% would be 0.01
and 0.1 should go to 0.001

 

Hiya TempestsMom. Have a little experience with CKD from caring for a HyperT baby. I totally agree with joining the Fb CKD group. Nancy Weizner is really helpful. In short, with CKD, unless they are Stage4 the ideal is wet food, High protein, low phosphorus. Sub Cue shouldn't be an issue at the moment. Certainly look to supplement with such things as L-Lysine, VitB and CQ10. Omega Oils can help too. I can highly recommend looking at the ProVet range. The website is a bit of a nightmare, unless they have changed it, but the supplements are formulated to be low phosphorus for kitties.

You can also get phosphorus binders from your vet if needed.

A little tip I picked up was to use nettle tea for the CRE and BUN numbers. It acts as a very gentle diuretic for the kidneys. It will help lower the numbers and help Tempest to feel better. I used to make up a cup of tea - 1 to 2 tsp per cup of dried nettle. I used to give Milo about 20ml a day (ish). If I can remember any more I'll definitely let you know. xx

 

Thanks I will look into the nettle tea for sure! Can probably make it with fresh ones, there's plenty growing wild up at the horses field and 'organic' - I will look into it.

I definitely will check out the supplements you've suggested!

The food seems to be my major hurdle right now. Low carb low phos seems hard to find.

 

Fresh Nettle tea is perfect Good for soup too (human soup! )

At the end of the day, it is more important that Tempest eats. The phosphorus you can deal with through phosphorus binders. Top of my head I cant remember the names of them. There are a few, some more palatable than others. xx

 

Thanks Yong! Seems like burp is suitable for cdk n diabetic cats. But the caloric content is low. They replied that it's 47-52% kcal/100g. So I calculate and looks like jebat needs 5-6 cans a day! No wonder it was hard for him to put on weight. I was just giving him enough to maintain his weight. They also said it's not a suitable food for cdk and diabetic cats. But I thk it was just a disclaimer since it's not recommended by vets.

 

@Waheeda I got replies from Sheba and Whiskas and here they are..

Sheba average 3.04g/1000kcal in Sheba Fine flakes

Whiskas +7 jelly 2.5g/1000kcal average just below this maximum.

Anyone able to work out what that is per 100g yep really am rubbish at maths!

 

Would you happen to know what's the kcal per can?

 

@TempestsMum it should be written on the can. Eg on FF it's indicated 96 kcal/can.

 

Just had a look

Sheba are pouches at 85g
Whiskas are pouches at 100g

 

Did they indicate what's the kcal per pouch or can? Then only I can calculate the amount of phosphorus per pouch/can.

 

Sorry it's been a looong day..
it doesn't say. But I will look again in the morning when I'm less tired maybe I'm just not seeing it.

 

No worries! Rest well.

 

Yay success! found It on the side of the box..

Sheba 62kcal
Whiskas 77kcal

 

So Sheba will contain 62/1000 x 3.04 = 0.188g in the pouch

Whiskas 77/1000 x 2.5 = 0.192g

Is that a safe amount to give?
Who wants to check if my calculation is correct?

 

On the CKD website they say to try for under 80 but I see a lot of people saying under 100 so not sure..

 

What unit is that? 80 of? Where did you see that?

 

Hi @TempestsMum
The person who responded to me on Fb said p level should be no more than 250mg per 100 cal. That means less than 0.25g per 100 cal. So that should be 2.5g per 1000 cal which means only the whiskas is ok.

 

Have you looked at Dr. Lisa's food chart? The Sheba food look higher than what you are getting.

 

Thanks! Just saw this! Dr Lisa's chart doesn't cover the UK unfortunately

 

@Elizabeth and Bertie has put together a food list for UKers. She has marked the phosphorous levels for a number of them Here are the links:


http://www.felinediabetes.com/FDMB/...-including-link-to-low-carb-food-list.137376/


https://docs.google.com/spreadsheets/d/1J5JpMe6TDXrHq_aTl9hUtHy6Gs9oRBqlz4nPGKxtySA/pubhtml

If you need more information she may be able to help you.

 

Thank you Mary Ann. Elizabeth was very kind to give me that one. I'm still dithering though as to what to feed. The Felixagail is low carb low phos. But I'm researching raw at the minute or home made.. gaaah why is nothing simple lol

 

My boy's p number went down from 7 to 6.2 in 3 wks after using the binder. I would think it will lower further in a few weeks. Perhaps u can consider using the binder and stick to the food Tempest likes?

 

Just from reading the forum , I believe less than 250mg is for earlier stages and as CKD progresses, the phosphorus number decreases. I forget which thread though

 

My vet said she's not at a stage where I should use a binder? Wondering if that has something to do with her other values. Her felix food is 0.22 per 100g so is still ok to feed (I think). My vet recommended she lose some weight too. She's crept up a wee bit and the concern is the diabetes.

 

I was told to keep it under .80 or .70 if possible on the Facebook site. I'm still reading through Tanya's site though.

 

Tara, phos has to be calculated on a dry matter basis. In order to calculate that you need the moisture % and the phos %.
Here is a dry matter calculator that's quick and easy to use:
http://fnae.org/dmb.html?inputboxm=77&inputboxi=1.7&button.x=75&button.y=21&button=Click

In terms of UK foods, the lowest (ordinary) foods I found were Terra Faeilis 'chicken and squash' and 'turkey and zucchini' (from Zooplus). But unfortunately my cats didn't like them very much... ...Next lowest were Granapet 'poultry' and 'salmon and seafood', Kattovit 'sensitive', and Feringa 'chicken and squash' from Zooplus; which my oldies will eat in rotation. ...There's also the Granatapet 'symphonie' range from the Happy Kitty co, but I don't know if they ship to Ireland...
.

 

Thanks Elizabeth,
I can order those from Zooplus and Happy Kitty Company does ship here I ordered from there before and Tempest turned her nose up at everything lol I will try the Terra ones, You never know! Maybe if I blend some half and half she won't notice lol

I tried Granatapet ( might try again with mixing it) but not the kattovit we are testing feringa at the moment. But the one I have is lamb and chicken.. oh the joys of a fussy kitty.

 

At least u can get these food!
Well my poor boy now has heart failure. Will be on diuretics and anti coagulant medicine.

 

Oh no Waheeda I'm so so sorry.
If I can be of help let me know, I have kept cavalier King Charles spaniels for 30 years and they suffer from CHF (congestive heart failure) so I know a good lot about it. The good news is that they can live happily with it for many years and heart medication is so much more advanced than it used to be.

 

Thanks Tara. Will ask you if I need help. Can't believe he can be so unlucky.

 

Thanks Tara. Will ask you if I need help. Can't believe he can be so unlucky.

 

Poor boy!
Here's something I hope will help, my dogs brother Romeo was born with a heart problem and given 6momths to live. He's now 12! He's on borrowed time now but the mean age of cavs is 10 so that's pretty dang good for a dog that wasn't expected to make it past puppyhood!

 

Wow! That's awesome. But jebat also has cdk so now his kidney has to work hard as the diuretics will be working to remove the fluid in his lungs. Anyway, I'm glad we sent him in before he has any clots.

 

Be positive for him, many times animals amaze us. Is it frusiomide they put him on?

 

Ya I know we have to be positive! He's named after a warrior so I hope he will fight on. Yes he's on frusiomide and benazepril.
His last blood test he was anaemic but now he's not anymore and his new blood cells number is high. His kidney values have also improved very slightly.

 

Oh come on, Jebat, you can fight this kitty!

 

That's positive. Give him massive cuddles from me.