<snip links>

Thanks!

I think it's interesting that you think I'm in denial.  I may be, but I
don't think so.  This is why:

--Ginger is a weird cat.  She has a lot of issues, and is probably very
inbred.  Her kidneys are congenitally small.  We've not done bloodwork on
her before, and my vet believe that she could have had labs like this for a
very long time.  More "renal insufficiency" rather than "renal failure."

--Ginger just came off antibiotics for a bad kidney or bladder infection.
While her urine looks great now (some blood--cystitis) the vet and I agree
that the infection could have affected her kidney values, and they could
take a bit more time to come down.

--Ginger also had one dead tooth in a mouth full of great looking teeth that
was removed a couple weeks ago.  The bacteria could have contributed to her
kidney failure/insuffiency, and again--perhaps it's going to take some time
for the kidney values to drop.

--She has NO symptoms, and is acting better now than I think I've ever seen
her.

--I AM changing her food to something lower protein with less phosphorus,
and adding sub-q fluids.  My vet recommended this to help flush out her
kidneys.  Since all those links say cats with CRF are in a state of chronic
dehydration ranging from slight to severe, I think this is just to cover the
bases.

--My vet, whom I respect greatly (and I am one picky client) is concerned,
but not overly so about Ginger.  He called me to inquire about the protein
and phosphorus content about what she was eating, and to suggest some sub-q
fluids.  He's not pushing the panic button just yet.

--And, finally, unrelated to Ginger, I just went on a hellish rollercoaster
concerning bloodwork with another one of my cats, so I'm a little wary of
jumping to conclusions without several data points.  Dropping Ginger's
protein by 13%, the phos by 0.4 (IIRC) and adding fluids is a reasonable
first step.  I can evaluate in a month, and make any changes depending on
what her labs look like after that.

BUN was slightly elavated..  Other bloodwork was normal.

Urine was normal, except for blood, which can be attributed to idiopathic
cystitis.

Thanks for the link!  I'll check it out :)

Corey

That's part of the problem. Most cats can be in what is called
"sub-clinical" (can't see any symptoms) for a long time. Once the
symptoms are visible it is too late, in fact it's too late now to do
anything but slow the progression of the disease down. Sorry that's not
a very nice way to put it, but that's the way the disease works. we
cannot "fix" it, we can only slow it's progression. In your case the
cat already has a high creat and BUN and that means the cats is beyond
the "sub-clinical" stage and the disease is now "clinically" evident in
the blood work.

Renal failure can be slowed and the progression of the disease can be
greatly reduced. The number of uremic crisis can be reduced and the
onset of these delayed by feeding a food designed specifically for
renal failure.

To do so means you have to begin looking at nutrients and learn to
ignore ingredients. Ingredients are nothing but carriers of nutrients
the cat needs. Analyzing a food based on the ingredients is kind of
like third grade elementary math - simple addition and subtraction.
It's important to move up to at least high school math and begin
analyzing a food based on the nutrients. The next step (kind of college
math) would be looking at a food based upon the grams, mgs, mcgs of any
given nutrient provided per 100 calories of energy. That's difficult
and you probably don't need to go there.

Ingredients can also be very confusing. suppose a food lists "chicken"
as an ingredient. What do you know about the quality of the "chicken"?
Basically nothing. Unless you look at the nutrients - you will never
know what quality of "chicken" the manufacturer is using. It is
possible to buy expensive "chicken" that is low in "ash" (ground up
bones primarily) or a cheap chicken that is 20% ash. It is also
possible to buy chicken by-product meal that is more expensive that
plain chicken meal - again based on the ash content. A low ash chicken
by-product meal will be a more expensive meat meal than a low grade
high ash chicken meal.  You can't tell that from the label, you can
only determine that by looking at the nutrients. In this case the
calcium level can be an indicator that the company is using inexpensive
chicken. Pure chicken muscle meat contains only 0.01% calcium - so a
food that ends up with 1.5% calcium in the finished product has a lot
of ground up bone tissue in it.

Renal failure can be controlled by controlling VERY carefully several
nutrients. First we must reduce phosphorus levels drastically.
Prescription Diet k/d  contains 0.37% (can) 0.49% (dry)  Royal Canin
Feline LP21 contains 0.49% (can) 0.55% (dry). Purina NF 0.41% can,
0.52% dry. Eukanuba Multi Stage renal 0.54% dry, 0.76% can. These are
all dry matter basis values. While it may seem that the difference
between 0.5% phos and an average grocery store food which contains 1.0%
is very small - the difference in the cats longevity is huge.

Phosphorus is only one of several things that must be managed. Sodium
content must be reduced, Omega 3 fatty acids must be greatly increased
to reduce renal tubule damage, the protein must be extremely digestible
so that limiting the protein does not adversely affect the cat.

The most recent grade 1 evidence based clinical trial clearly shows
that cats on a renal failure diet will live twice as long and have half
as many uremic crisis as cats fed a typical average food.  (Ross et al,
to be published later this year)

It looks like there are some new folks here that do not know who I am,
so it's probably a good time for the legalese.

While I have been an employee of Hill's Pet Nutrition Inc for nearly 25
years, anything I post here is my personal opinion only - and should
not be considered in any way the position or opinion of the company I
work for.

Steve Crane