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Re: [FH] Re: food dilemma

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  • savionna@aol.com
    Hi Linda, In a message dated 1/2/06 7:13:41 PM, irrgang@Houston.rr.com writes:
    Message 1 of 12 , Jan 3, 2006
      Hi Linda,

      In a message dated 1/2/06 7:13:41 PM, irrgang@... writes:

      << What would you say is the best food for my Pumpkin who is starting to have

      higher creatinine values? He needs a specialty food that is tailored to the

      needs of an HCM kitty and also best for his kidneys. >>

      Do you know why the creatinine values are rising? Are any other values out of
      range? Besides kidney insufficiency, creatinine can elevate for various
      reasons, incl urinary system infection, diet, dehydration, and metabolic disorders.
      If you suspect chronic kidney insufficiency (and other contributing factors
      are ruled out), then it's important to look at the cat's BUN, phosphorus,
      potassium, sodium, calcium, hematocrit, and urine specific gravity to get a fuller
      picture of the problem.

      The current thinking is that kidney cats require the same diet as other cats,
      incl those with heart disorders: a high-quality, low-carbohydrate,
      well-balanced, moisture-rich, meat-based diet that comes as close as possible to meeting
      a cat's nutritional needs. Cats with advanced (repeat: advanced) chronic
      renal failure may feel better when phosphorus is restricted, but that does nothing
      to halt progress of the disease. The recommendation to restrict protein (with
      such products as Hill's k/d) is now considered not only unnecessary but
      counterproductive for cats, as it contributes to malnutrition and muscle wasting
      and actually puts more stress on the kidneys. The low-protein theory was based
      on faulty interpretation of studies conducted in the early 1900s on rats and
      dogs, who have very diff. nutritional needs than do cats. There used to be
      several articles explaining this issue, but some are no longer available. One good
      one is: "Nutritional Management of Dogs and Cats with Chronic Renal Failure"
      by Kalkstein, DVM, DACVIM at www.southpaws.com/news/99-2-nutrition-CF.htm

      So, the answer is to feed the highest-quality species-appropriate diet
      possible. This eliminates all dry foods...and there is a short list of canned, incl:
      Wellness, www.oldmotherhubbard.com; Nature's Variety, www.naturesvariety.com;
      PetGuard, www.petguard.com; Felidae, www.canidae.com; Natural Balance,
      www.naturalbalanceinc.com; Innova, www.naturapet.com; and Eagle Pack,
      www.eaglepack.com.

      You can check the phosphorus content of many foods at:
      http://webpages.charter.net/katkarma/canfood.htm. // Rosemary
    • Linda Fischbach
      I agree that a cat in early CRF does not need a low protein diet, but I have to disagree about the phosphorus. The article you included discusses protein, not
      Message 2 of 12 , Jan 3, 2006
        I agree that a cat in early CRF does not need a low protein diet, but I have
        to disagree about the phosphorus. The article you included discusses
        protein, not phosphorus.

        As far as I know, there is no debate about that feeding CRF cats a low
        phosphorus diet is better, even in early CRF. Keeping the cat's phosphorus
        level as close to 4 as possible is important. There are good high protein
        foods with low phosphorus, and with high phosphorus. For instance Wysong's
        canned gourmet has low, but is also fairly high protein and low carb. But
        some premium foods are very high in phosphorus.

        Interestingly, cooked skinless chicken thighs (obviously high in protein)
        have about the same amount of phosphorus per 100 calories as K/D has per 100
        calories. So high protein doesn't always mean high phosphorus.

        Linda


        ----- Original Message -----
        From: <savionna@...>
        To: <irrgang@...>; <feline-heart@yahoogroups.com>
        Sent: Tuesday, January 03, 2006 8:32 AM
        Subject: Re: [FH] Re: food dilemma


        > Hi Linda,
        >
        > In a message dated 1/2/06 7:13:41 PM, irrgang@... writes:
        >
        > << What would you say is the best food for my Pumpkin who is starting to
        > have
        >
        > higher creatinine values? He needs a specialty food that is tailored to
        > the
        >
        > needs of an HCM kitty and also best for his kidneys. >>
        >
        > Do you know why the creatinine values are rising? Are any other values out
        > of
        > range? Besides kidney insufficiency, creatinine can elevate for various
        > reasons, incl urinary system infection, diet, dehydration, and metabolic
        > disorders.
        > If you suspect chronic kidney insufficiency (and other contributing
        > factors
        > are ruled out), then it's important to look at the cat's BUN, phosphorus,
        > potassium, sodium, calcium, hematocrit, and urine specific gravity to get
        > a fuller
        > picture of the problem.
        >
        > The current thinking is that kidney cats require the same diet as other
        > cats,
        > incl those with heart disorders: a high-quality, low-carbohydrate,
        > well-balanced, moisture-rich, meat-based diet that comes as close as
        > possible to meeting
        > a cat's nutritional needs. Cats with advanced (repeat: advanced) chronic
        > renal failure may feel better when phosphorus is restricted, but that does
        > nothing
        > to halt progress of the disease. The recommendation to restrict protein
        > (with
        > such products as Hill's k/d) is now considered not only unnecessary but
        > counterproductive for cats, as it contributes to malnutrition and muscle
        > wasting
        > and actually puts more stress on the kidneys. The low-protein theory was
        > based
        > on faulty interpretation of studies conducted in the early 1900s on rats
        > and
        > dogs, who have very diff. nutritional needs than do cats. There used to be
        > several articles explaining this issue, but some are no longer available.
        > One good
        > one is: "Nutritional Management of Dogs and Cats with Chronic Renal
        > Failure"
        > by Kalkstein, DVM, DACVIM at www.southpaws.com/news/99-2-nutrition-CF.htm
        >
        > So, the answer is to feed the highest-quality species-appropriate diet
        > possible. This eliminates all dry foods...and there is a short list of
        > canned, incl:
        > Wellness, www.oldmotherhubbard.com; Nature's Variety,
        > www.naturesvariety.com;
        > PetGuard, www.petguard.com; Felidae, www.canidae.com; Natural Balance,
        > www.naturalbalanceinc.com; Innova, www.naturapet.com; and Eagle Pack,
        > www.eaglepack.com.
        >
        > You can check the phosphorus content of many foods at:
        > http://webpages.charter.net/katkarma/canfood.htm. // Rosemary
        >
        >
        >
        > Your reply will go to the author of this message. If you feel your reply
        > will benefit the entire group, please change the "To:" line to
        > feline-heart@yahoogroups.com
        > Yahoo! Groups Links
        >
        >
        >
        >
        >
        >
        >
      • Dana McCormick
        Linda, As a parent to 2 kidney kitties & lucky parent to 1 kidney transplant kitty, I can tell you it s best to feed the protein restricted food. My Creampuff
        Message 3 of 12 , Jan 3, 2006
          Linda,

          As a parent to 2 kidney kitties & lucky parent to 1
          kidney transplant kitty, I can tell you it's best to
          feed the protein restricted food. My Creampuff lived
          w/ CRF for 6.5 yrs & was on Hills K/D dry, she
          wouldn't eat the canned. I firmly believe she
          wouldn't have done so well for so long with a regular
          food. My Mouse also ate this, again, wouldn't eat the
          canned. They didn't love the food, but ate it. The
          reason you need this type of food is because it allows
          the kidneys to not have to work so hard. There is some
          debate on this issue, but all the kidney specialists
          I've spoken to go with the low protein theory.
          Mousie's surgeon & the other surgeons in this very
          limited field also go w/ the low protein & I would say
          their opinions are very relevant. What's Pumpkin's
          creatinine, BUN & PCV?

          Creampuff got Alternagel as a phosphorous binder,
          Mousie never needed it.

          Feel free to drop a line if you need more info.

          Dana

          --- Linda Cuéllar Irrgang <irrgang@...>
          wrote:

          > What would you say is the best food for my Pumpkin
          > who is starting to have
          > higher creatinine values? He needs a specialty food
          > that is tailored to the
          > needs of an HCM kitty and also best for his kidneys.
          > I have read a lot
          > about a lot of foods but wondered what everyone here
          > might have
          > experiencedÂ…..
          >
          >
          >
          > Thx for the help.
          >
          >
          >
          > Linda and Pumpkin
          >
          >
          >
          > -----Original Message-----
          > From: feline-heart@yahoogroups.com
          > [mailto:feline-heart@yahoogroups.com] On
          > Behalf Of turkishangoraathumanesociety
          > Sent: Saturday, December 31, 2005 3:46 PM
          > To: feline-heart@yahoogroups.com
          > Subject: [FH] Re: food dilemma
          >
          >
          >
          > Hi Ruthie...I think Nutro is a great brand (and
          > Authority right under
          > that) that you can get both at PetSmart (Nutro at a
          > number of stores).
          > Even better, though, I think, (and more expensive)is
          > Innova and
          > California Natural...a bit harder to find, but they
          > have a store
          > locator on their site. Smaller stores carry them,
          > independant pet
          > stores and health food stores for people. The store
          > locator can be
          > found at www.naturapet.com
          >
          >
          >
          >
          >
          >
          > Your reply will go to the author of this message. If
          > you feel your reply
          > will benefit the entire group, please change the
          > "To:" line to
          > feline-heart@yahoogroups.com
          >
          >
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        • Linda Fischbach
          Dana, if you need to give a phosphorus binder, you can buy containers of aluminum hydroxide dried gel powder, which is tasteless and odorless
          Message 4 of 12 , Jan 3, 2006
            Dana, if you need to give a phosphorus binder, you can buy containers of
            aluminum hydroxide dried gel powder, which is tasteless and odorless
            http://members.verizon.net/~vze2r6qt/supplies/binders.htm.

            Remember that phosphorus should be below 6, and as close to 4 as possible.

            Linda

            ----- Original Message -----
            From: "Dana McCormick" <danamcmk@...>
            To: <feline-heart@yahoogroups.com>
            Sent: Tuesday, January 03, 2006 12:52 PM
            Subject: RE: [FH] Re: food dilemma


            > Linda,
            >
            > As a parent to 2 kidney kitties & lucky parent to 1
            > kidney transplant kitty, I can tell you it's best to
            > feed the protein restricted food. My Creampuff lived
            > w/ CRF for 6.5 yrs & was on Hills K/D dry, she
            > wouldn't eat the canned. I firmly believe she
            > wouldn't have done so well for so long with a regular
            > food. My Mouse also ate this, again, wouldn't eat the
            > canned. They didn't love the food, but ate it. The
            > reason you need this type of food is because it allows
            > the kidneys to not have to work so hard. There is some
            > debate on this issue, but all the kidney specialists
            > I've spoken to go with the low protein theory.
            > Mousie's surgeon & the other surgeons in this very
            > limited field also go w/ the low protein & I would say
            > their opinions are very relevant. What's Pumpkin's
            > creatinine, BUN & PCV?
            >
            > Creampuff got Alternagel as a phosphorous binder,
            > Mousie never needed it.
            >
            > Feel free to drop a line if you need more info.
            >
            > Dana
          • savionna@aol.com
            Hi Linda, In a message dated 1/3/06 10:38:08 AM, fischbl@earthlink.net writes:
            Message 5 of 12 , Jan 4, 2006
              Hi Linda,

              In a message dated 1/3/06 10:38:08 AM, fischbl@... writes:

              << I agree that a cat in early CRF does not need a low protein diet, but I
              have

              to disagree about the phosphorus. >>

              I think we also agree about phosphorus...but I didn't express myself clearly
              in this complex issue. So thanks for picking up on this.

              << As far as I know, there is no debate about that feeding CRF cats a low

              phosphorus diet is better, even in early CRF. >>

              I agree. But a diet with a "low" level of phosphorus is appropriate for all
              cats...healthy, CRF, or cardiac...which is why I didn't call it out (but in
              retrospect should have). I think part of the muddle may be with the definition of
              "low."

              To back up a little...mineral levels and balance are important for all cats,
              esp the balance between phosphorus and calcium. And it's not a good idea for
              any cat to regularly eat a "high" amt of phosphorus (like over
              300-400mg/100kcal), even if it is balanced with calcium. The current recommendation is that a
              healthy adult cat needs about 65-70mg phosphorus per kg body weight. So the
              average 10 lb cat (4.5kg) needs about 300mg phosphorus daily.

              Many of the commercial foods with higher-quality nutrition (eg Wellness,
              Nature's Variety, Felidae, PetGuard) have flavors with about 1% phosphorus DM or
              about/under 200mg/100kcal. If the average healthy 10-lb adult cat eats 200
              calories of that food per day (to meet the average calorie requirement of 20
              cal/lb/day), then he's getting about/under 400mg phosphorus. (By comparison,
              typical prey animals...eg mouse, rat, rabbit, bird...have about 2-3% phosphorus DM
              or about 200-300mg/100kcal.)

              So is about 1% DM or 200mg/kcal low enough? (I thought it was.) Or do you
              think a more severe restriction (like about 0.5% DM or 100mg/100kcal) is more
              appropriate for a cat with elevated creatinine (which may indicate early kidney
              insufficiency, tho I wasn't clear whether Linda's cat has CRF)? Are cats with
              very restricted phosphorus intake at greater risk for metabolic acidosis and/or
              anemia?

              << Keeping the cat's phosphorus

              level as close to 4 as possible is important. >>

              Yes. A blood level around 4 mg/dL is important for all cats. Do you think
              feeding a product with around 1% phosphorus DM would adversely affect the blood
              phosphorus level for most cats?

              << Interestingly, cooked skinless chicken thighs (obviously high in protein)

              have about the same amount of phosphorus per 100 calories as K/D has per 100

              calories. >>

              Also interesting is that cooked skinless chicken thighs contain about twice
              as much protein as k/d. 100kcal thighs = about 12.5g protein and 85mg
              phosphorus. 100kcal k/d = about 6.5g protein and 80mg phosphorus.

              And just to follow up on the low-protein issue for those juggling kidney and
              heart disorders...there are a number of articles that cover the evolution of
              the reduced-protein theory and why it's now considered inappropriate. They are
              mostly about dogs, but the information is by and large applicable to cats, who
              have a higher dietary protein requirement than do dogs and an essential need
              for certain amino acids. (The first 2 had disappeared from the net for a
              while, but are now available again in PDF format; click on the link below, then
              scroll to find the hot link for the article titles):

              1. "Mythology of Protein Restriction for Dogs with Reduced Renal Function,"
              by Kenneth Bovee, DVM, MMedSc (UPenn) at
              http://vetprof.com/clientinfo/KidneyDiseaseInDogs/diet.htm

              2. "Effects of Dietary Protein Intake on Renal Functions," by Delmar Finco,
              DVM, PhD (Univ of Ga) at
              http://vetprof.com/clientinfo/KidneyDiseaseInDogs/diet.htm

              3. "Dietary Protein and the Kidney" by Patricia Schenck, DVM, PhD (Michigan
              State Univ) at
              http://web.archive.org/web/20040205075757/http://www.cm-d.com/buckeye/tech_manual/8_28.html

              4. www.dogaware.com/kidney.html

              // Rosemary
            • Linda Fischbach
              Rosemary, I saved this and then never answered you. For a cat with CRF, a lower phosphorus died is best. 1%DM is really the highest one should feed, but 1%
              Message 6 of 12 , Jan 5, 2006
                Rosemary, I saved this and then never answered you. For a cat with CRF, a
                lower phosphorus died is best. 1%DM is really the highest one should feed,
                but 1% really isn't that low. The kidneys usually remove the phosphorus
                from the blood, but as CRF advances, the kidneys are more and more
                inefficient about removing the phosphorus, so it tends to increase in the
                blood.

                With advanced CRF, a cat can have a phosphorus level of 10-20, even eating
                very low phosphorus food. So phosphorus binders (aluminum hydroxide) are
                used to bind even the small amount that is eaten. Most peope use binders
                when a CRF cat's phosphorus gets above 6.

                I lost my first CRF cat in 2000; Mittens and Topaz, who both had CRF, died
                last year, but not from CRF. I fed Mittens and Topaz a moderately high
                protein diet, but as low in phosphorus as K/D. They also had some binders
                and their phosphorus level stayed close to 4.

                Now I have one cat with early CRF. I've been a member of CRF Support for
                over 6 years, and a mod for 5. And I own the Phosphorus Management group.

                Linda

                ----- Original Message -----
                From: <Savionna@...>
                To: <feline-heart@yahoogroups.com>; <fischbl@...>
                Sent: Wednesday, January 04, 2006 11:26 AM
                Subject: Re: [FH] Re: food dilemma


                > Hi Linda,
                >
                > In a message dated 1/3/06 10:38:08 AM, fischbl@... writes:
                >
                > << I agree that a cat in early CRF does not need a low protein diet, but I
                > have
                >
                > to disagree about the phosphorus. >>
                >
                > I think we also agree about phosphorus...but I didn't express myself
                > clearly
                > in this complex issue. So thanks for picking up on this.
                >
                > << As far as I know, there is no debate about that feeding CRF cats a low
                >
                > phosphorus diet is better, even in early CRF. >>
                >
                > I agree. But a diet with a "low" level of phosphorus is appropriate for
                > all
                > cats...healthy, CRF, or cardiac...which is why I didn't call it out (but
                > in
                > retrospect should have). I think part of the muddle may be with the
                > definition of
                > "low."
                >
                > To back up a little...mineral levels and balance are important for all
                > cats,
                > esp the balance between phosphorus and calcium. And it's not a good idea
                > for
                > any cat to regularly eat a "high" amt of phosphorus (like over
                > 300-400mg/100kcal), even if it is balanced with calcium. The current
                > recommendation is that a
                > healthy adult cat needs about 65-70mg phosphorus per kg body weight. So
                > the
                > average 10 lb cat (4.5kg) needs about 300mg phosphorus daily.
                >
                > Many of the commercial foods with higher-quality nutrition (eg Wellness,
                > Nature's Variety, Felidae, PetGuard) have flavors with about 1% phosphorus
                > DM or
                > about/under 200mg/100kcal. If the average healthy 10-lb adult cat eats 200
                > calories of that food per day (to meet the average calorie requirement of
                > 20
                > cal/lb/day), then he's getting about/under 400mg phosphorus. (By
                > comparison,
                > typical prey animals...eg mouse, rat, rabbit, bird...have about 2-3%
                > phosphorus DM
                > or about 200-300mg/100kcal.)
                >
                > So is about 1% DM or 200mg/kcal low enough? (I thought it was.) Or do you
                > think a more severe restriction (like about 0.5% DM or 100mg/100kcal) is
                > more
                > appropriate for a cat with elevated creatinine (which may indicate early
                > kidney
                > insufficiency, tho I wasn't clear whether Linda's cat has CRF)? Are cats
                > with
                > very restricted phosphorus intake at greater risk for metabolic acidosis
                > and/or
                > anemia?
                >
                > << Keeping the cat's phosphorus
                >
                > level as close to 4 as possible is important. >>
                >
                > Yes. A blood level around 4 mg/dL is important for all cats. Do you think
                > feeding a product with around 1% phosphorus DM would adversely affect the
                > blood
                > phosphorus level for most cats?
                >
                > << Interestingly, cooked skinless chicken thighs (obviously high in
                > protein)
                >
                > have about the same amount of phosphorus per 100 calories as K/D has per
                > 100
                >
                > calories. >>
                >
                > Also interesting is that cooked skinless chicken thighs contain about
                > twice
                > as much protein as k/d. 100kcal thighs = about 12.5g protein and 85mg
                > phosphorus. 100kcal k/d = about 6.5g protein and 80mg phosphorus.
                >
                > And just to follow up on the low-protein issue for those juggling kidney
                > and
                > heart disorders...there are a number of articles that cover the evolution
                > of
                > the reduced-protein theory and why it's now considered inappropriate. They
                > are
                > mostly about dogs, but the information is by and large applicable to cats,
                > who
                > have a higher dietary protein requirement than do dogs and an essential
                > need
                > for certain amino acids. (The first 2 had disappeared from the net for a
                > while, but are now available again in PDF format; click on the link below,
                > then
                > scroll to find the hot link for the article titles):
                >
                > 1. "Mythology of Protein Restriction for Dogs with Reduced Renal
                > Function,"
                > by Kenneth Bovee, DVM, MMedSc (UPenn) at
                > http://vetprof.com/clientinfo/KidneyDiseaseInDogs/diet.htm
                >
                > 2. "Effects of Dietary Protein Intake on Renal Functions," by Delmar
                > Finco,
                > DVM, PhD (Univ of Ga) at
                > http://vetprof.com/clientinfo/KidneyDiseaseInDogs/diet.htm
                >
                > 3. "Dietary Protein and the Kidney" by Patricia Schenck, DVM, PhD
                > (Michigan
                > State Univ) at
                > http://web.archive.org/web/20040205075757/http://www.cm-d.com/buckeye/tech_manual/8_28.html
                >
                > 4. www.dogaware.com/kidney.html
                >
                > // Rosemary
                >
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