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Old February 17th, 2009, 02:49 AM
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Quote:
Originally Posted by gkjones View Post
All looks good except that she is in the early stages of renal compromise (U.S. values: phosphorus normal at 3.9; bun elevated at 59; creatinine elevated at 3.6 -- CDN values, if I've done the calculations correctly: phosphorus 1.26, bun 19.28, creatinine 318.24 ... do the conversions look right?). The vet said to transition her to a low protein, renal support diet. As her phosphorus is okay, he didn't mention lower phosphorus (he might have been implying it by suggesting a "renal support" diet), but it sounds as if I should be avoiding higher phosphorus foods, too. I'm assuming that 7% - 10% is lower protein, which means that most of the wet Wellness and Nature's Variety meat versions are a-okay so that I can continue giving them to her, perhaps supplementing them with additional water (I should avoid the fish versions though, no?). We plan to recheck her in 3 months, unless problems develop sooner, and will consider subcutaneous fluids then if needed.

My question: I've read through this very useful thread but am sure I've missed something. Would some kind soul consider summarizing (a) what are the best wet foods with lower protein and low phosphorus, (b) what are acceptable dry foods to use, and (b) what are other treatment recommendations for early renal compromise elderly cats?

The summary would be great as a sticky!

Here's a great site for chemistry conversions: http://www.vin.com/scripts/labquest/converthtml.pl

You were almost all right your kitty's values look like this:
phos US 3.9 = 1.25 SI (CDN) units
BUN US 59 = 21.06 SI units
Creatinine US 3.6 = 318.24 SI units

What is your cat's Urine Specific Gravity (USG)?

Canned:

Kidney cats do not require low protein, but high quality protein low phos food. Removing too much protein from the cats diet makes it less palatable therefore they often refuse to eat, plus cats are carnivores they need meat protein to keep their bodies functions to the fullest.

Fish should be avoided when possible especially tuna, but fed on occasion 1-2 per month is still okay. Cats often become addicted to fish and will eat nothing else and tuna especially creates an imbalance in vit e levels.

When looking for a canned food look for quality ingredients, no fillers, actual meats ie chicken, turkey avoid anything that says "meat" meal cuz you don't know what the "meat" is, and low phos. Really read the ingredients in the food if there actual food listed in the first 6 ingredients and in the first 3 being specific meat or meal variety listed and there are not mostly chemicals it's a better quality food. Compare the ingredients in any can of Wellness to any can of the prescription foods which would you rather eat?

A listing of low phos canned can be found here however this list may not be up to date *formulas do change* and does not include Wellness Chicken 1.15% dm phos, Turkey 1.05% dm phos, Chicken & Beef 1.17% dm phos, Kitten 1.15% dm phos which are the lowest of the Wellness varieties, Nature's Variety Instinct Chicken @ 1.22% dm phos good for occasional meal, the other NV flavours are too high.

When looking at phos levels you want to convert to dry matter (meaning whats left if you remove all water) and find something as close to or lower than 1% phos dry matter.

Foods need to be compared using "dry matter amounts" instead of "as fed amounts" because there is so much difference in moisture content, therefore there is varying amounts of nutrients in different foods

This gives an explaination on how to convert to dm scroll down to "Converting dry matter basis"

It is always a good idea to add water to the canned food, this helps the cat get more fluids as healthy cats usually drink very little.

Dry food:

When you have an animal with compromised kidneys they should not be eating dry food. If absolutely necessary however there is a list here please note this list has not been updated since 2005.

Raw food:

Is far better than dry or canned for cats and dogs when it's done right, properly balanced, prepared and introduced.

Treatments:

Alot of that depends on how the cat is feeling and what the numbers are looking like. Some treatments that can be considered and must be discussed with your vet are:

species appropriate diet
adequate hydration
Subq fluids
phosphorus binders
calcitrol
anti-nausea meds
species appropriate vitamins
probiotics
ACE Inhibitors
essential fatty acids
immune boosters such as Transfer Factors
anti oxidants
GUNN IntraMuscular Stimulation (IMS) or acupuncture - two slightly different techniques
Classic Homeopathy Remedies - to be prescribed individually to suit your animal's needs

Other suggestions:
Discontinue all vaccines - any animal with compromised health should not be vaccinated this is also explicitly stated by the vaccine manufactures on the vaccine vials.

Raise the food and water dishes off the ground about 2-4 inches this will help keep the stomach acid in the stomach and reduce nausea while eating/drinking

Keep track of how much water you cat is drinking in a given number of days, this will aid your veterinarian in determining if/when subq's are necessary. IE: I have a water fountain for Duffy, the see-through resevoir holds 2 cups in addition to the bowl, so I make note of when the resevoir is filled and when the resevoir is empty then I know how many days it takes her to drink 2 cups of water.

Try to avoid stressful situations for the animal as much as possible.

You should have the full blood panel and urinalysis run every 3 months.
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