Emerald: Food for Cats with Both Kidney and Diabetes Issues

Hello All,

So what are your suggestions for cats who have both kidney and diabetes issues?

Serephina

 

Pick a food both low in carbs (under 10% carb) and low in phosphorus (under 250). If it’s advanced ckd or your cat has very high phosphorus levels you can additionally add a phosphorus binder to the food (aluminum hydroxide).
https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

 

Thanks Janet,

That chart is helpful. However, that chart has a HUGE amount of choices. I don't know which one my cat will like. She likes a lot of gravy and doesn't tend to like pate'. She liked Hill's Tuna Vegetable Stew k/d before but then she started to get sick with inflamed bowel. I don't know if the food caused it or if she would have started it anyway. I do want to ask my vet about changing her diet if her glucose numbers continue to stay out of control. I am starting to think the k/d food she eats is not a good idea. Also, she likes dry food which I know everyone says is bad. However, she rarely finishes her wet food and prefers grazing. She does drink a lot of water. Almost too much water. The doctor said thats probably because of her diabetes.

Serephina

 

When I had a cat with ckd and my other with diabetes I fed bff in cans. It's low carb and around 250-260 phosphorus. What are your cats kidney values? (Creatnine and bun and phosphorus?)

 

Kd food is typically low in protien and too high in carbs for a diabetic. The tuna veg stew is 29% carb...... Not good for a diabetic.

 

That list is sortable. You could sort it from lowest to highest phosphorus, then pick the ones also low in carb to try.

 

I feed Elmo Whole Earth Duck pate which is low in phosphorus (130) and carbs ( 4) . For alternates I also feed Holistic Select Chicken or Turkey . They are bit higher phosphorus but within acceptable range . Hope this helps

 

Hi All,

Ok. Sorry to be difficult but this is really confusing after spending hours looking at these food charts!


My understanding is that I'm looking for the following numbers for a cat who has both kidney and diabetic issues

I looked at Tanya's k/d website as a reference. She has a reference to cats with k/d and diabetes.

Protein about 35 Dry Matter Value (Emerald's k/d prescription has 15)
Carb no more than 10
Phos no more than 200/100 kcal
Fat less than 40%

I keep looking at these charts over and over again. None of the foods has everything perfect. Something's gotta give here! I guess to find her a food lower in carbs than her current perception food would be fine. I can't see any that are even close to 35 DMV when I try that. The closest I got was Wellness Core but that one had a DMV protein level of about 54.

I'm frustrated and tired of staring at all this stuff.

Serephina

 

Focus mostly on the carbs and phosphorus. What stage kidney disease is your cat? What’s the creatinine, bun, and phosphorus?

 

My Oreo is liking the Purina Pro Plan Focus urinary tract formulas, as well as Tiki Cat manana grill. She loved the FF pates but they were all in the 300s or higher in phos.

 

Emerald's most recent test was done in May 2018.

BUN 25 (16-36)
Crea .8 (.8-1.8)
Gluc 415 (75-130)
K+3.98 3.6-4.6)mmo/L
Na+151.9 ((140-153)mmo/L
iCa2+1.29 (1.13-1.29)
Lac 1.2 mmo/L (.6-2.5)
PCV 29%
TS 9.2g/dL

Her most recent assessment is that her heart was under control as well as her kidneys. The biggest concern is her glucose numbers which at the last check were pretty much unchanged.
Serephina

 

Um, your cats kidney numbers are great! They are completely normal. I'm not sure why your vet said there was a problem. So just worry about a low carb food. Most of us feed fancy feast classic or Friskies pate foods.

 

@Janet,

Emerald's Kidney numbers were not always completely normal. Last year, she was considered stage 2 but the food really helped her. Then she had the inflamed bowel disease episode and was not able to keep any food down. She was started on Budesonide steroid which could be one of the reasons why her glucose went up. Also, the steroid caused heart problems so she had to take other meds. Emerald is complicated. It is quite tricky to keep her in the balance.

Serephina

 

The kidney problems last year were probably acute, not chronic. Could have been some kind of infection. Her levels now don't show ckd.

So go with a low carb food and add a little water to keep hydrated and keep the kidneys flushed.

Steroids have contributed to several peoples cats developing diabetes. The good news is is not uncommon for them to go into remission shortly after the steroids stop along with insulin.

 

@Serephina - this is a list I originally put together from the old catinfo.org list back in 2015 when I, too, needed to find low carb and low phosphorus options. I updated it when the new list was published on catinfo.org even though I no longer needed the list for myself, in the hope that it would help others. https://docs.google.com/spreadsheets/d/1nMBzt57Zi0PcAJ-gSt0NxrTyc3Twi7A0L8o2H2gGkoM/edit?usp=sharing All you need to do is find something on that list that your kitty likes - I know even that can be challenge enough - but at least you don't have to wade through the entire list to try to find the foods with the appropriate values.

 

@manxcat419,

I am thinking the protein levels on your chart are "as fed"? For a k/d cat, I believe that would need to be no more than 15% and unfortunately, none of the ones on that list match. This has been very difficult for us. On my most recent visit to the vet, she said for Emerald, because she has had so much going on, including 2 visits the the emergency room over the past 3 months for IBD and Heart Failure, we don't want to mess with anything. She couldn't handle getting her kidney numbers back to being worse because then she would have to have subq fluids. The heart disease prevents her from being able to handle subq fluids. (sigh).

My compromise in this situation is to have Emerald go on the lowest carb k/d food there is. I found out that the Royal Canin Renal support D wet food has a carb level of 16% which even though not ideal, is better than her dry food which is over 50%. I've ordered the wet food. I am praying she likes it!

Joanne

 

@Serephina - those are percentages of calories from each of the 3 nutrient groups...protein, fat and carbs. And no, I've never heard of sticking to under 15% protein on a dry matter basis for a CKD cat - there are no foods (prescription or otherwise) on the market that would meet those criteria apart from possibly one of the vegan foods which are absolutely not recommended by anyone. Less than 15% protein on a dry matter basis would cause huge amounts of muscle-wasting...and we also have to remember that the heart is also a muscle. The Royal Canin renal support feline D contains 6.5% - 9.5% crude protein, but also contains 79% moisture so the actual protein content on a dry matter basis is much higher than is listed on the can because only 21% of the food is actually "food" - the remainder is water. Overall, you'd be looking at it containing closer to 30% dry matter protein. Also to note is that protein is now thought to be less implicated in CKD for cats - the real issue is with phosphorus content as phosphorus causes the CKD to advance. The issue has historically been that protein tends to be where most of the phosphorus comes from, so it can take a little looking around to find a food that contains enough protein for a cat's requirements, with low enough phosphorus to prevent the kidneys being further damaged. The other thing to be careful of is that, if you restrict protein far enough to cause muscle wasting, you may actually see the creatinine fall over time - but at that point it isn't a true indicator of kidney function because creatinine is a by-product of muscle breakdown, so on a very low protein diet you would expect to see a creatinine spike as the muscles waste, followed by a fall in the value that would not accurately reflect the declining kidney function but would simply reflect the fact that there is little muscle left for the cat to break down at all.

 

@manxcat419

Should I assume that your chart protein values are dry matter values then?

Thanks,

Serephina

 

Not exactly. They're % of calories from protein. Which is often reasonably close to dry matter, but not exactly the same. If you're concerned about protein as well as phosphorus, stick to the ones that are lower % of calories from protein. The protein % isn't something that the majority of people with CKD and diabetic cats usually worry about as long as the phosphorus is being restricted. As an example, if you look at the Avoderm chicken - the first item on the list - the crude protein % is 10%, which is actually pretty close to the maximum 9.5% that's listed for your renal food. But the % from calories is 31%. However, to take one of the ones with a higher % calories from protein, if you look at the BFF Chicken and Tuna 4EVA, the crude protein % is 12%, but the % calories from protein is 69%. With that said, both come in under the 15% listed on the can that you were looking for - there are actually very few canned cat foods that would come in above 15% on that scale...it's just that it isn't really a meaningful measurement.