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Cat Forum / Health and Behavior / December 2005Good afternoon, just a a question
Hope you all had a nice Thanksgiving. The question concerns Dufus, of course, our cat. A few weeks ago had him in for his checkup and the vet said the cretin, cratin level, whatever it is, in the kidneys was slightly elevated and put him on Hills K/D. Of course he doesn't like it at all, eats just enough to take away the hunger feeling I suppose. My question is, what is the difference in the K/D and his regular food? Must be lower levels of something in the K/D. Thanks folks.  SignaturePaul O. oplholik@gmail.com Does your vet just happen to sell that? Try pinging Phil- he's knowledgeable. -- Barb Of course I don't look busy, I did it right the first time. > Does your vet just happen to sell that? > [quoted text clipped - 4 lines] > Of course I don't look busy, > I did it right the first time. Yes, this is what he has. I'll wait to see if Phil reads this and chimes in. SignaturePaul O. My sig line is my disclaimer to any advice given Absolutely clueless when it comes to cats Learning more every day, but still clueless oplholik@hotmail.com > Does your vet just happen to sell that? > > Try pinging Phil- he's knowledgeable. Thanks, Barb. > Hope you all had a nice Thanksgiving. The question concerns Dufus, of > course, our cat. A few weeks ago had him in for his checkup and the [quoted text clipped - 3 lines] > My question is, what is the difference in the K/D and his regular > food? Must be lower levels of something in the K/D. Thanks folks. K/D is lower in phosphorus and protein than regular foods. Low phosphorus is what's especially important for cats in early stages of renal failure. I hope you're trying the canned version of K/D, the increased water content is a good thing for kidney patients too. There's a K/D with chicken that some cats like better than regular K/D. And there are other brands that have renal diets too, Purina NF is one. There are a few others as well, hopefully you'll find one your cat will eat willingly. for more CRF info, check out http://www.felinecrf.org/ and http://www.felinecrf.com/ This is different than the CRF, correct? He was on Waltham's Renal LP some time ago and apparently is ok on that. CRF is liver?, and now this is Kidney. SignaturePaul O. My sig line is my disclaimer to any advice given Absolutely clueless when it comes to cats Learning more every day, but still clueless oplholik@hotmail.com >> Hope you all had a nice Thanksgiving. The question concerns Dufus, of >> course, our cat. A few weeks ago had him in for his checkup and the [quoted text clipped - 15 lines] > http://www.felinecrf.org/ and > http://www.felinecrf.com/ > This is different than the CRF, correct? He was on Waltham's Renal LP some > time ago and apparently is ok on that. CRF is liver?, and now this is > Kidney. No, CRF stands for Chronic Renal Failure. Renal refers to the kidneys. Hugs, CatNipped > >> Hope you all had a nice Thanksgiving. The question concerns Dufus, of > >> course, our cat. A few weeks ago had him in for his checkup and the [quoted text clipped - 15 lines] > > http://www.felinecrf.org/ and > > http://www.felinecrf.com/ >> This is different than the CRF, correct? He was on Waltham's Renal LP >> some [quoted text clipped - 14 lines] >>but again not much. I guess he isn't going to starve himself but I don't >>want him losing a lot of weight either. SignaturePaul O. My sig line is my disclaimer to any advice given Absolutely clueless when it comes to cats Learning more every day, but still clueless oplholik@hotmail.com >>> This is different than the CRF, correct? He was on Waltham's Renal LP >>> some [quoted text clipped - 14 lines] >>>but again not much. I guess he isn't going to starve himself but I don't >>>want him losing a lot of weight either. I'm concerned you are not doing your cat any favours by trying to switch him to K/D. Did your vet do a urinalysis when the blood was analyzed? Your cat had very slightly elevated creatinine levels and normal urea levels. The only way you could say he has CRF at those levels is if he also has a low urine specific gravity (poorly concentrated urine). Even if his urine were poorly concentrated and he has CRF, it is still too early to be restricting protein. Urea levels have to be much higher before protein restriction is helpful and excessive protein restriction at this time could be detrimental. Even worse is the fact that he doesn't like K/D and his intake had decreased as a result. I usually recommend G/D or MediCal Mature for cats at this stage (assuming low urine specific gravity) and start transitioning towards a more canned food based diet. If cats don't like these food then I recommend a premium senior diet. I would recheck blood work (at least urea, creatinine, electrolytes and phosphorus), and do a urinalysis and perhaps a urine protein:creatine ratio (to assess protein loss thru kidneys) in 2-3 months in order to determine the rate of progression and the possible need for further therapeutic measures (diet, supplements, medications). J. dvm >>Not sure if he did do a urinalysis, wouldn't that be done on a reguar >>checkup? I have a copy of the blood tests with a lot of abbreviations on >>two sections of the copy of tests and not sure what to look for for what >>you are referring to. Thanks. SignaturePaul O. My sig line is my disclaimer to any advice given Absolutely clueless when it comes to cats Learning more every day, but still clueless oplholik@hotmail.com > > I'm concerned you are not doing your cat any favours by trying to switch [quoted text clipped - 21 lines] > > J. dvm >>>Not sure if he did do a urinalysis, wouldn't that be done on a >>>reguar checkup? I have a copy of the blood tests with a lot of >>>abbreviations on two sections of the copy of tests and not sure >>>what to look for for what you are referring to. Thanks. Assuming anyone can tell where that advice might be hidden. In other words, are your comments top posted and second-level quoted? Wow. > Absolutely clueless when it comes to cats > Learning more every day, but still clueless [quoted text clipped - 45 lines] > Date: Sun, 27 Nov 2005 17:27:58 GMT > Xref: newsmst01b.news.prodigy.com rec.pets.cats.health+behav:416082 > Assuming anyone can tell where that advice might be hidden. In other > words, are your comments top posted and second-level quoted? Wow. ah the poopy smelling troll Jesus John go wash your hands! Troll > Path: newssvr27.news.prodigy.net!newsdbm04.news.prodigy.com!newsdst02.news.prodigy.com!newsmst01b.news.prodigy.com!prodigy.com!newscon06.news.prodigy.com!prodigy.net!border1.nntp.dca.giganews.com!nntp.giganews.com!postnews.google.com!o13g2000cwo.googlegroups.com!not-for-mail > From: "whitershadeofpale" <bigbadbarry adelphia.net> [quoted text clipped - 24 lines] > > Jesus John go wash your hands! >>>Not sure if he did do a urinalysis, wouldn't that be done on a reguar >>>checkup? I have a copy of the blood tests with a lot of abbreviations on >>>two sections of the copy of tests and not sure what to look for for what >>>you are referring to. Thanks. Regular checkups do not necessarily include a urinalysis, nor blood tests for that matter. Look on your paper work for terms such as "urinalysis" "urine" or "U/A". The results would be listed separately from the blood results. Urine specific gravity is sometimes abbreviated as "S.G." and is a number between 1.000 and 1.060. >> I'm concerned you are not doing your cat any favours by trying to switch >> him to K/D. [quoted text clipped - 21 lines] >> >> J. dvm Thanks J. Don't see anything like that listed. SignaturePaul O. My sig line is my disclaimer to any advice given Absolutely clueless when it comes to cats Learning more every day, but still clueless oplholik@hotmail.com >>>>Not sure if he did do a urinalysis, wouldn't that be done on a reguar >>>>checkup? I have a copy of the blood tests with a lot of abbreviations on [quoted text clipped - 32 lines] >>> >>> J. dvm > Hope you all had a nice Thanksgiving. The question concerns Dufus, of > course, our cat. A few weeks ago had him in for his checkup and the vet said [quoted text clipped - 3 lines] > is the difference in the K/D and his regular food? Must be lower levels of > something in the K/D. Thanks folks. I agree with the other posters...Phil P knows a lot about this. I had to put one of my cats on the kidney diet, too. He hated the regular KD, but would eat the chicken flavor. I did give him some other foods, too, just to keep him happy and eating well, but I really studied the phosphorus levels and picked the lowest ones. Phil recommended some that Dmitri really did like. Here are two sites that list phosphorus levels of food: http://webpages.charter.net/katkarma/canfood.htm http://www.sugarcats.net/sites/jmpeerson/canfood.html There seems to be disagreement over whether or not low protein is important in early stage renal failure. But keeping the phosphorus low is critical. Juls SignatureEmail (remove annoying hyphens) j-u-l-i-AT-e-c-t-DOT-o-r-g > There seems to be disagreement over whether or not low protein is > important in early stage renal failure. But keeping the phosphorus low > is critical. Hi Juls, The tradition of restricting protein in cats (and dogs) was originally based on older studies in rats. Later studies in cats found that the mechanisms that can affect the progression of CRF in the rat don't have the same effect in the cat (or dog). It just goes to show you how long it takes for many vets to give up old traditions. Restricting protein is important in the later stages of CRF- but only to ameliorate clinical signs of azotemia because as CRF progresses the cat's kidneys lose the ability to filter all the uremic toxins from the blood. Restricting protein doesn't actually slow the progression of CRF. In fact, prematurely restricting protein in cats can be inherently dangerous because of their higher protein requirement and inability to readily adapt to low-protein intakes. Thanks for pointing out this fact. Phil > Hope you all had a nice Thanksgiving. The question concerns Dufus, of > course, our cat. A few weeks ago had him in for his checkup and the vet said > the cretin, cratin level, whatever it is, in the kidneys was slightly > elevated and put him on Hills K/D. Paul, K/d is better suited for a cat in mid- to end-stage kidney disease. The protein content of k/d is too low for a cat in the early stages of CRF. You really don't want to restrict protein in a cat until the BUN reaches 60-80 mg/dl. Prematurely restricting a cat's protein intake can have some deleterious consequences. You might want to speak your vet about g/d or x/d- preferably x/d. They're similar in composition as k/d but contain more protein and slightly more phosphorus. X/d is less acidic than g/d and almost identical to k/d's acidity. Of course he doesn't like it at all, eats > just enough to take away the hunger feeling I suppose. I understand why he doesn't like k/d- it contains barely enough protein to meet a cat's daily minimum protein requirement. It doesn't matter how perfectly formulated a kidney diet is supposed to be if the cat won't eat it. Purina ( NF Kidney Function) and Eukanuba (Multi-Stage Renal) are kidney diets with similar formulations as k/d.. My question is, what > is the difference in the K/D and his regular food? Must be lower levels of > something in the K/D. Thanks folks. Kidney diets usually contain less protein, phosphorus, sodium and acidity. In early stage kidney disease I would be more concerned about restricting phosphorus and acidity than protein. For this, x/d is the best. I've seen renal cats make dramatic comebacks after switching to x/d from k/d. Surprisingly, x/d even reduced the BUN in some cats. Best of luck, Phil >> Hope you all had a nice Thanksgiving. The question concerns Dufus, of >> course, our cat. A few weeks ago had him in for his checkup and the vet [quoted text clipped - 19 lines] > > Phil Thanks Phil. Gonna have to go to the vet this morning and get more food this morning so will try to speak to the vet then and will question the protein amount. Not sure if he had x/d. The cat had been on Waltham's Renal LP in the past and am now wondering why the vet didn't put him on that again. How does this food compare with the Hills. SignaturePaul O. My sig line is my disclaimer to any advice given Absolutely clueless when it comes to cats Learning more every day, but still clueless oplholik@gmail.com > Thanks Phil. Gonna have to go to the vet this morning and get more food this > morning so will try to speak to the vet then and will question the protein > amount. Not sure if he had x/d. The cat had been on Waltham's Renal LP in > the past and am now wondering why the vet didn't put him on that again. How > does this food compare with the Hills. Waltham's is lower in protein (and potassium) than k/d. The energy density is higher because it contains more fat. Its a good mid- to end-stage CRF diet, but I wouldn't feed it to a cat in the early stages. X/d is a calcium oxalate diet, so your vet probably carries it. I'd go with the canned version. While you're there, ask your vet about a potassium supplement. Good luck, Phil Just returned from the vet and got more info. The vet is staying with the k/d. He does have the x/d, but says it's not as good, pointing out the higher protein level, and at this point I didn't push it cause the cat probably wouldn't like it any better I'm thinking. He did get me some a/d to mix in with the k/d to hopefully make it more palatible. I noticed on the can of a/d that the protein is higher in the a/d. I also got a copy of the results for the blood test. The creatin(sp?) level which has a reference range of .8 to 2.4 was 2.8. The Bun reference range is 16 to 36 and was 29mg/dl. So the only thing on his blood test that was out of normal was the creatin. Not sure at this point what to do, the cat has to start eating more, maybe the a/d added will help. Thanks for your input, I appreciate it. SignaturePaul O. My sig line is my disclaimer to any advice given Absolutely clueless when it comes to cats Learning more every day, but still clueless oplholik@hotmail.com >> Thanks Phil. Gonna have to go to the vet this morning and get more food > this [quoted text clipped - 18 lines] > > Phil > Just returned from the vet and got more info. The vet is staying with the > k/d. He does have the x/d, but says it's not as good, pointing out the > higher protein level, and at this point I didn't push it cause the cat > probably wouldn't like it any better I'm thinking. He did get me some a/d to > mix in with the k/d to hopefully make it more palatible. Your vet didn't like the idea of feeding your cat x/d but told you mix in a/d- which contains more protein and almost twice the phosphorus as x/d? I think you should seek a second opinion. I noticed on the > can of a/d that the protein is higher in the a/d. I also got a copy of the > results for the blood test. The creatin(sp?) level which has a reference > range of .8 to 2.4 was 2.8. The Bun reference range is 16 to 36 and was > 29mg/dl. So the only thing on his blood test that was out of normal was the > creatin. Your cat's BUN/Creatinine levels are *much* to low to begin restricting protein! Much to low. I really think you should seek a second opinion. Restricting protein at this stage can have serious consequences. Not sure at this point what to do, the cat has to start eating > more, maybe the a/d added will help. Thanks for your input, I appreciate it. Most cats love a/d because its high in fat and protein- however, chronic feeding can cause diarrhea. A/d is also very high in phosphorus and negates the low-phosphorus benefit of k/d. The mixture of k/d and a/d probably equals, if not exceeds, the protein content and certainly the phosphorus content of x/d. You need to find another vet. Best of luck, Phil Thanks Phil. I think I will take the advice and seek a second opinion. My neighbor has 3 cats, and I will find out today who his vet is. Now I have a couple more questions. I hope they do not sound arguemenative(sp?) What might another vet do in this situation? If k/d is not the soloution, would another vet recommend another prescription diet that 'he' sells, that might be different in protein and phos. levels? Or might he recommend the k/d with a possible protein supplement of some sort? Are there other ways of going about all this? Just what might I expect from another vet? Thanks again for your input and time. SignaturePaul O. My sig line is my disclaimer to any advice given Absolutely clueless when it comes to cats Learning more every day, but still clueless oplholik@hotmail.com >> Just returned from the vet and got more info. The vet is staying with the >> k/d. He does have the x/d, but says it's not as good, pointing out the [quoted text clipped - 37 lines] > > Phil > Thanks Phil. I think I will take the advice and seek a second opinion. My > neighbor has 3 cats, and I will find out today who his vet is. Now I have a > couple more questions. I hope they do not sound arguemenative(sp?) What > might another vet do in this situation? As Dr. Martin recommended, find out if your vet checked your cat's urine specific gravity (USG). Failing kidneys lose their ability to conserve body water and concentrate urine. If your cat's USG is in the normal range, then the elevated creatinine could have been artifactual or a result of prerenal factors. A cat can have elevated kidney values without having kidney disease. Bloodwork with a USG gives you more information about kidney function than either test alone. If k/d is not the soloution, would > another vet recommend another prescription diet that 'he' sells, that might > be different in protein and phos. levels? As I said, your cat's kidney values are *much* to low to even think about restricting protein. Or might he recommend the k/d with > a possible protein supplement of some sort? Are there other ways of going > about all this? Just what might I expect from another vet? Thanks again for > your input and time. Before worrying about kidney diets and restricting protein, I think the most important step right now is to check your cat's USG and determine *if* your cat is even in the early stages of CRF. I can't believe I didn't mention this earlier! I should know better than to assume your vet checked your cat's USG. I'm thankful Dr. Martin brought it to your attention. Good luck. Phil > >> Just returned from the vet and got more info. The vet is staying with the > >> k/d. He does have the x/d, but says it's not as good, pointing out the [quoted text clipped - 37 lines] > > > > Phil >> Thanks Phil. I think I will take the advice and seek a second opinion. My >> neighbor has 3 cats, and I will find out today who his vet is. Now I have [quoted text clipped - 15 lines] > Thanks again, I am going to get a second opinion tomorrow. Could any of > this be caused by stress, such as taken him to a vet, by any chance? SignaturePaul O. My sig line is my disclaimer to any advice given Absolutely clueless when it comes to cats Learning more every day, but still clueless oplholik@hotmail.com > > Thanks again, I am going to get a second opinion tomorrow. Could any of > > this be caused by stress, such as taken him to a vet, by any chance? Could be. I've known older cats that became azotemic from a trip to the vet. However, in these cats the BUN was also elevated. The only times I've seen elevated creatinine without an elevation in BUN was either lab error/artifactual or in large muscular cats. Creatinine production is relatively proportional to the cat's muscle mass. IOW, cats with a large muscle mass usually produce more creatinine than cats with a small muscle mass. Eating meat before the blood sample is taken could also increase creatinine levels a little. Have you ever had bloodwork done on your cat before? Previous bloodwork could serve as a baseline for his normal values. This is why yearly bloodwork/urinalysis are so important- even if the cat isn't sick. I really think checking your cat's urine specific gravity should be your next step. Usually cats in the very early stages of CRF lose some ability to concentrate their urine before they lose the ability to excrete waste products from the blood. USG might give you all the answers you need. Btw, Heska makes a test called "E.R.D.-HealthScreen Feline Urine Test Kit" that's supposed to detect very early kidney disease in cats by detecting microalbuminuria. Although its not 100% specific for kidney disease it could alert you to other problems. Its a little more sensitive than routine urine protein tests. You might want to ask your vet about it. Let me know the results of the urinalysis when you get them- and be sure to get a copy of *all* of your cat's medical records. Best of luck, Phil >> > Thanks again, I am going to get a second opinion tomorrow. Could any of >> > this be caused by stress, such as taken him to a vet, by any chance? [quoted text clipped - 21 lines] >carbs, and a pate type food is better. That's about the jist of it and I >feel better about it. So we'll see how it goes. Thanks. SignaturePaul O. My sig line is my disclaimer to any advice given Absolutely clueless when it comes to cats Learning more every day, but still clueless oplholik@hotmail.com . > >Went to the other vet yesterday and he called with the results this > >afternoon. Don't have all the info in front of me, he is mailing it all. > >But his creatinine which was 2.8 a couple weeks ago from the first checkup > >is now 2.3. That's still a little high- borderline by my lab's reference range. Is he a muscular cat? He did the urinalysys also. The vet said he is fine. Needs to > >lose a little weight. He also said the k/d was a good diet but doesn't need > >to be on it. I was hoping he'd change his mind. He did tell me that I needed to change his regular diet from > >the nutro pouch type food because all the gravy type foods are loaded with > >carbs, and a pate type food is better. Try to find he likes that has a phosphorus content <.80% (DMB) or 0.20% "as fed". http://webpages.charter.net/katkarma/canfood.htm That's about the jist of it and I > >feel better about it. So we'll see how it goes. Thanks. Best of luck, Phil >> >Went to the other vet yesterday and he called with the results this >> >afternoon. Don't have all the info in front of me, he is mailing it all. [quoted text clipped - 5 lines] > a > muscular cat? > > Best of luck, > > Phil Yeh, I guess, he's a Maine Coon SignaturePaul O. My sig line is my disclaimer to any advice given Absolutely clueless when it comes to cats Learning more every day, but still clueless oplholik@hotmail.com >> >Went to the other vet yesterday and he called with the results this >> >afternoon. Don't have all the info in front of me, he is mailing it all. [quoted text clipped - 23 lines] > them trying to decide on what to go with, that I can get locally > hopefully. SignaturePaul O. My sig line is my disclaimer to any advice given Absolutely clueless when it comes to cats Learning more every day, but still clueless oplholik@hotmail.com
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