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Cat Forum / Health and Behavior / May 2007Adding weight to a cat in kidney failure
First post here. A quick Googling didn't give me any answers, but I'm happy to accept pointers to other threads if needed. I have a cat, Weiz, who is 16 and has some kidney failure. He is on Fortekor, and has had very little progression in the 3-ish years since he's started it. Fortekor and a protein-limited diet is his only treatment at this time. He is free-fed dry food, and gets one meal a day of canned food. He's always been a light eater, and the only lower-protein dry foods I can find which are actually made with ingredients I wand my cats to ingest, are also "Lite" formulas. His canned food is also as premium as I can get while keeping the protein in some degree of check, and are not "Lite", but he only eats about an ounce of the wet, at his own choice. As a result, he is pretty skinny. He is alert, happy, playful, affectionate, etc, particularly relative to his age, but under his fluff he's mostly bones. I know some of it is due to the restricted protein, but a lot of it is likely being on "Lite" food and not eating all that much of it. He's *interested* in food (particularly human food), but he's not a real big eater, and never has been. Compounding the problem is the fact that he will spend the better part of fifteen minutes vomiting if he so much as *tastes* certain palatabiliy enhancers like red meat juices. If we turn our heads a moment and he gets just a tongue on a bit of red meat, we've got twenty little barf puddles to look forward to, and he's miserable. I actually worry he'll vomit himself into a stroke (which did happen to one of our cats). Anyhow, I would very much like to get a little weight on him, without adding protein to his diet. We've tried some pure fats (cod liver oil, lard, margarine, butter) and he might or might not ingest a pea- sized amount of it, but he's clearly unimpressed. He loves fresh fish (sushi) and roasted chicken, and would eat himself full on those, but the protein thing kicks in. Are there any recommendations for a high fat/calorie, low-protein cat treat/food? I don't mind doing some grinding/chopping, and I don't mind paying for the good stuff - I'd give the old guy foie gras if it fit the bill. They already eat better than I do, so why stop now? Any suggestions would be welcome. The old boy seems to have a whole lot of life left in him, and I'd like him to make the most of it. (He recently beat the snot out of our lunatic 5-year old cat twice his size, when she tried to take him on. And that's in his present state of muscle tone!) Thanks in advance for any ideas. Renee and the gang Part of your whole problem is that you are starving him by limiting his protein his is now malnourished. 20 years ago the protocal as to limit protien now with current dialysis patients you are encouraged to eat meat & other protiens. Protiens keep you from developing malnutrition. You really need to change the diet. Celeste > First post here. A quick Googling didn't give me any answers, but I'm > happy to accept pointers to other threads if needed. [quoted text clipped - 50 lines] > Renee > and the gang > Part of your whole problem is that you are starving him by limiting his > protein his is now malnourished. 20 years ago the protocal as to limit > protien now with current dialysis patients you are encouraged to eat meat > & other protiens. Protiens keep you from developing malnutrition. > > You really need to change the diet. ---------- I was going to say the same thing. I have been feeding Alex, my CRF kitty, canned cat food (a combination of Wellness, Beef and Chicken flavor, and Fancy Feast, Tender Beef Feast) and Purina OM dry food. Neither of the aforementioned canned foods contains wheat gluten, BTW, and neither of them has been recalled either. Before the CRF diagnosis, the vet had placed Alex is on low carb diet due to his diabetes diagnosis which required insulin injections. He stopped needing the insulin within weeks after a switch from Weight Managment Iams, dry food only, to canned cat food with Purina OM dry. He also lost weight. The recovery from diabetes is in all likelihood due to the Lantus insulin and not to the diet change, but Alex hasn't needed any insulin for nearly a year. Since the first sign we had that Molly (a cat we had to euthanize last year due to endstage CRF) was sick was her weight loss, I was understandably very nervous about Alex's weight loss (even though the weight loss was intentional because of the diabetes). Even if Alex didn't lose weight because of CRF, I know that all cats with CRF will eventually lose weight in the endstage of the disease, so in the case of early stage CRF kitties, it's better if they weigh a little more than a little less. To make a long story short, Alex has gained a half pound since December eating a total of about about 4 or 5 ounces of canned cat food per day (divided into two meals about 12 hours apart) in addition to dry Purina OM (left out at all times for grazing). Now, I am cutting back on his canned food a little bit since he has gained a lot of weight in a short time, and his blood glucose has risen (from an average of about 80 to an average of about 100). I don't know if the increased blood glucose is because of his weight gain or not, but I intend to discuss it with the vet next month when he goes for his repeat blood work. (There is nothing wrong with a blood glucose of 100 per se. I am just concerned that it may be a trend). At any rate, based on documentation that Phil sent me (from Dr. Polzin who is an authority in this area), there is no conclusive evidence that a low protein diet slows progression of CRF, but we know for sure that a low protein diet results in muscle atrophy. Just my 2 cents worth. I'm not a veterinarian. Best regards, ---Cindy S. > Part of your whole problem is that you are starving him by limiting his > protein his is now malnourished. 20 years ago the protocal as to limit > protien now with current dialysis patients you are encouraged to eat meat & > other protiens. Protiens keep you from developing malnutrition. > > You really need to change the diet. Perhaps I should clarify... he isn't on an *extremely* restricted protein intake. The food isn't prescription low-protein. The "Lite" dry food is at 28%, and the canned foods range from 8-11%. For reference, the prescription diet foods (which don't seem to contain actual *food*, so I prefer not to feed them) are at 26% for dry and 8% for canned. The food we fed prior to his diagnosis was roughly 32% (dry) and 8-12% (canned). The foods he's eating are just premium brands which offer lower-than-average protein (in the case of the dry food) and average protein (for the canned). He is, in other words, on the same menu plan that a zillion other non- CRF cats are on. This is the exact food that the lunatic 5 year old is eating, and she's in terrific shape and weight - because she's not a dainty eater (she'd probably be darn hefty if I switched to non-"Lite" dry food). Weiz is, and always has been. He has never been more than "slender". Additionally, he will vomit up the higher-protein (33%) dry food I sneak my youngest (18 months, a rescue, under 5 pounds, HCM). Even if he only gets a few kibbles. I do understand why you'd be concerned, if you thought I was totally starving him of protein. I also understand that it'd be dumb to be trying to guard his kidneys while atrophying his muscles so that he can't enjoy the good life! He actually seems to have pretty good muscle tone, to tell the truth, and he runs around and has no trouble jumping where he wants to go. If you were just watching him, you wouldn't guess he was 16, or had any veterinary issues. But I don't want to bump him up to *high* protein, under his vet's recommendation (and barf risk). What he needs is calories in a more concentrated form, since he doesn't eat enough volume to compensate for being on the "Lite" food (and would vomit up the non-"Lite" food). He *is* somewhat malnourished, but it's a caloric intake issue, and I'm hoping folks have some recommendation on high-calorie foods that won't wonk up his kidneys and/or make him vomit. Thanks very much for the comments so far! Renee snip > He is, in other words, on the same menu plan that a zillion other non- > CRF cats are on. This is the exact food that the lunatic 5 year old [quoted text clipped - 12 lines] > jumping where he wants to go. If you were just watching him, you > wouldn't guess he was 16, or had any veterinary issues. ----------- It's common veterinary practice to put CRF kitties on low protein diets. My previous vet wanted me to put Alex on prescription NF, which is a low protein formulation for kitties with CRF. (I recently started seeing a new vet because the previous vet, whom I liked a lot, left the practice). My impression was that Celeste (aka Spot) was thinking (and I was too) that this was what was going on, and she was intending to be helpful. One of the problems with Usenet is that we can only see people's words and not their facial expressions or tone of voice, and it's so easy to misconstrue someone's intent. I think Celeste was trying to say: "You have good intentions and are probably feeding your cat a low protein diet because your veterinarian advised you that CRF kitties should be on low protein diets, but I think your vet is wrong because low protein = muscle atrophy, and you may not realize but a low protein diet = malnutrition." You OTOH understood Celeste to be saying "You idiot! You are starving your cat! What's wrong with you ???!!" And so you understandably responded defensively. But I really don't think Celeste meant to be accusatory in any way. I know I didn't. You are obviously trying very hard to do what's right for your cat. It's always a guessing game. I drive myself crazy about Alex wondering if I should try to keep his weight higher (because of the inevitable weight loss that accompanies CRF) or lower (because of his prior diabetes and the risk of requiring insulin supplement again). I think we're all on the same team, all wanting to do right by our kitties. We're all just trying to help each other. Best regards, ---Cindy S. > snip > [quoted text clipped - 44 lines] > Best regards, > ---Cindy S.- Heh heh heh... here is further evidence of that whole "words not faces" issue. I'm honestly not offended or feeling picked on at all. I've been on Usenet long enough to both have a thick skin anyhow, and also understand that it's generally the most passionate people who choose to respond. The advice I got was definitely not inappropriate for the information I'd posted. I knew that posting more details than just "got any low-protein, high-calorie treats?" would invite comments, and that's great. I'm looking out for my boy Weiz, and welcome people's input. I just figured I'd clarify that while Weiz is on a somewhat lower protein food than some, it's not a *LOW* protein diet. It's likely that giving him more protein would help his muscling somewhat, but he can't seem to tolerate higher protein. Vomiting is, of course, counterproductive to gaining weight. ;) So getting him some nice palatable calories that aren't excessively proteiney would be, I hope, good for him. Neither of you were accusatory, and I apologize if it sounded like I was, well, accusing you of that! No hard feelings, I hope. So does anyone have any suggestions for some nice fatty snax that won't make him upchuck everywhere? Renee > So does anyone have any suggestions for some nice fatty snax that > won't make him upchuck everywhere? ------------ How does he do with carbohydrates? The Pet Promise pet food (which does not contain wheat products) does contain potatoes and brown rice. My vet discouraged this food for Alex because of his propensity toward diabetes, but it is a really good quality cat food without any byproducts or antibiotics or factory farmed meats or dyes or additives. It comes in only three flavors: Chicken, salmon and ocean fish. None of the flavors contains any red meat or red meat juices. http://www.petpromiseinc.com/products_cat.htm Another possibility that may help your kitty gain weight is kitten food, which tends to be high calorie. Best regards, ---Cindy S. > > Part of your whole problem is that you are starving him by limiting his > > protein his is now malnourished. 20 years ago the protocal as to limit [quoted text clipped - 6 lines] > protein intake. The food isn't prescription low-protein. The "Lite" > dry food is at 28%, and the canned foods range from 8-11%. Hi Renee, I'm not sure if you know how to compare the nutrient values of dry food to canned food. When comparing foods that have different moisture contents the foods must be compared on a dry matter basis-- taking the moisture out of the equation and leveling the battlefield. IOW, the canned food with 8% protein actually contains more (36%) protein (dry matter basis) than the dry food with 28% protein (31% DMB). The canned food with 11% protein "as fed" contains over 50% protein (dry matter basis) --assuming the food contains 78% moisture. For a more detailed explanation, please visit my site http://maxshouse.com/feline_nutrition.htm Scroll down to "TERMS USED TO DESCRIBE FELINE NUTRITION". > I do understand why you'd be concerned, if you thought I was totally > starving him of protein. I also understand that it'd be dumb to be > trying to guard his kidneys while atrophying his muscles so that he > can't enjoy the good life! That's not even the half of the deleterious effects of premature protein restriction in cats! In addition to decreased plasma protein levels and muscle wasting, protein deficiency results in impaired immunological response and resistance to infection, reduced hemoglobin production and anemia. Restricting protein in cats can also decrease GRF (the rate the kidneys filter blood) which can actually drive the BUN up. The theory of restricting protein to slow the progression of CRF in cats was based on old studies in rats. Its now known that the mechanisms that can alter the progression of CRF in the rat don't have the same effect in the cat- or even the dog. Protein shouldn't be restricted in cats until the BUN reaches 60-80 mg/dl- and then only to control azotemia. The detrimental effects of protein restriction is particularly important in cats because they can't readily adapt to reduced-protein diets. It would be better for him to eat more canned food than dry. The higher water content of canned food will help keep him hydrated and will also help flush uremic toxins from his system. Best of luck, Phil > "Smalph" <sma...@yahoo.com> wrote in message > > Perhaps I should clarify... he isn't on an *extremely* restricted > > protein intake. The food isn't prescription low-protein. The "Lite" [quoted text clipped - 10 lines] > contains over 50% protein (dry matter basis) --assuming the food contains > 78% moisture. While I wasn't aware of the exact math, I did realize that "as fed" or "as labelled" proportions would be skewed by the water content. I can't imagine a cat living on 8% protein overall. ;) > For a more detailed explanation, please visit my sitehttp://maxshouse.com/feline_nutrition.htm Scroll down to "TERMS USED TO > DESCRIBE FELINE NUTRITION". [quoted text clipped - 10 lines] > anemia. Restricting protein in cats can also decrease GRF (the rate the > kidneys filter blood) which can actually drive the BUN up. Just based on the fact he is getting commercial cat food (and the kind that has actual, you know, *food* in it!), which is certified, I've been operating under the assumption that he's getting an acceptable level of protein (and other nutrients). While his foods are on the lower end of the protein scale, they're not specifically protein- reduced. And my other adult cat is on the same foods and is in great shape. (the youngster does get some higher protein food, since she's ostensibly still growing). Another poster suggested giving Weiz kitten food, but unfortunately even one or two kibbles of that and he spends the next fifteen minutes barfing everywhere. (It would be nice if cats didn't feel the need to run all over the house to barf in as many locations as possible) > The theory of restricting protein to slow the progression of CRF in cats was > based on old studies in rats. Its now known that the mechanisms that can [quoted text clipped - 3 lines] > effects of protein restriction is particularly important in cats because > they can't readily adapt to reduced-protein diets. I did know that cats *need* protein, and in non-insignificant amounts. (btw, I'm not meaning to sound defensive. My tone is intended to be conversational!). I'll check with the vet next time he's in, but his bloodworks for the last 3-ish years have been very much to the vet's satisfaction, other than the early CRF. Everything else is good, and other than being skinny, he's a pretty healthy fella. I don't know his BUN off the top of my head, but I'm thinking it can't be particularly alarming since the vet isn't particularly concerned at the moment. > It would be better for him to eat more canned food than dry. The higher > water content of canned food will help keep him hydrated and will also help > flush uremic toxins from his system. I would love for him to eat more canned. I buy the best stuff I can find in my area (I'm in Canada, and the brand another poster recommended doesn't seem to be here). The trouble is that he's always been a light eater, and even if I put out some nice stinky food, he just has a few bites and wanders off. If it's a very moist food (either the gravy-ful foods that were recalled, or if I add water to firmer ones) he'll drink the gravy/water and leave the solids. He drinks a fair bit, though not alarming quantities. He should be flushing pretty well. ;) I just want the little brute to eat more! The only things he's near-frantic to eat that I'm willing to let him eat (pizza and oniony soups are not on that list, but he wants them badly) are sushi (snapper, in particular) and rotisserie roasted chicken. He seems to tolerate them pretty well, too, so I guess I'll make little snack packs for him. If anyone cares, he's the orange and white one at http://www.smalph.com/photo.htm A handsome boy, no? > Best of luck, Thanks very much! He is doing very well, really. Rules the roost, to boot. Renee Yes you are feeding him protien but the type of protien is what makes the difference. He really needs high end protien not that processed stuff in canned cat food. I would go with cooked chicken, turkey,beef or even some fish. Actual meat like you or I would eat. I'm not suggesting you give up what's working so far just adding some better meat to it. I know since the pet food scare I quit buying canned dog food and now cook for my dogs. They still get kibble but by making this change I can see a difference in their coat and my overweight dog is loosing a few pounds. He's getting the nutrition he needs the difference is he's not getting all that fat and fillers that was in the processed canned food. Added to their kibble they get either cooked turkey, chicken stew, occasionally ground beef and yesterday I added mackeral. I wasn't sure how well it would go over but the dogs love it as much as my cats do. I even did a way with milkbones and make a dog biscuit for them now so that's one less fatty food in their diet,. Celeste What he needs is calories in a more > concentrated form, since he doesn't eat enough volume to compensate > for being on the "Lite" food (and would vomit up the non-"Lite" food). > He *is* somewhat malnourished, but it's a caloric intake issue, and > I'm hoping folks have some recommendation on high-calorie foods that > won't wonk up his kidneys and/or make him vomit. ............offer food 4 times a day if you can. It wasn't clear to me if the roasted chicken your cat loves makes him vomit. If not, add some to each feeding. Fat also works. buglady take out the dog before replying > > Part of your whole problem is that you are starving him by limiting his > > protein his is now malnourished. 20 years ago the protocal as to limit [quoted text clipped - 41 lines] > > Renee As long as your cat isn't diabetic, the best way to build calories is to feed some lightly sugared water. As a simple carbohydrate, it will not challenge the cat's kidneys and will provide energy sustenance. The simplest carb would be glucose, honey is a good source. Do not overfeed. Dissolve well in water, not more than 5%. Make only enough for the day's servings, because it can ferment. Also, if the kidneys are failing, read your catfood labels and try to avoid potassium. Also, out of an abundance of caution, use distilled water.-J I'm curious, are your cat's kidneys victim of the melamine tainted petfood problem?-Jitney > As long as your cat isn't diabetic, the best way to build calories is > to feed some lightly sugared water. I would strongly disagree. It's as if to say that a human who needs to gain weight should supplement his diet with soda pop. >As a simple carbohydrate, it will > not challenge the cat's kidneys and will provide energy sustenance. Empty calories. > The simplest carb would be glucose, honey is a good source. Do not > overfeed. Dissolve well in water, not more than 5%. Make only enough > for the day's servings, because it can ferment. Complex carbohydrates will not challenge the cat's kidneys. Carbohydrates are digested in the small intestine with the assistance of insulin which is produced in the pancreas. Carbohydrates are not a source of calories for cats in nature but if someone wants to feed a cat carbohydrates, potatoes and rice (or cat food which contain these substances) would be a much better choice than sugar water. >Also, if the kidneys > are failing, read your catfood labels and try to avoid potassium. Cats with kidney problems generally need *supplemental potassium* because it's all being lost in their urine. Avoiding potassium would be the last thing you would want to do for a cat with renal problesm. Perhaps you are thinking of phosphorous? > Also, out of an abundance of caution, use distilled water.-J Distilled water could upset the electrolyte balance and create more problems. Best regards, ---Cindy S. > I'm curious, are your cat's kidneys victim of the melamine tainted > petfood problem?-Jitney |
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