Feline Kidney Disease

QUESTION:

I was just told that my 13-year-old cat has early feline kidney disease. Bailey's BUN was 45. What would you recommend for this problem?

I have been feeding her Iams Prohealth Formula. I have a problem with a family member giving pounce treats and I have now asked him to stop. Will I be able to continue the Iams Prohealth or do I need to change her diet?

I have 7 kids ranging from 2 to 13 and we free feed. I want her to live healthy, but I do not have the ability to stop the free feeding due to the other cats in the house. HELP!

Rachel

Hi, Rachel,

First, I want to point out that a BUN of 45 is barely elevated. Also, BUN can be elevated from things other than kidney failure. In addition, the most sensitive indicator of kidney function is not BUN, but creatinine. Did the vet tell you if the creatinine was elevated? Also, did they analyze her urine? The earliest sign of feline kidney disease is a decrease in the specific gravity (concentration) of the urine. That will occur before creatinine and/or BUN becomes elevated.

If these tests were not performed, they should be.

The value of feeding a low protein diet, such as Hill's prescription diet K/D, is somewhat controversial. Most vets, including myself, feel that a low protein diet is indeed beneficial. I have been treating cats with kidney disease for 20 years and my experience has been that those on a low protein diet feel better and live longer than those not eating a low protein diet.

K/D is not the only prescription low protein diet. Iams also has one as does Purina and other companies.

It is very difficult to feed one cat differently than the others when you have a multi-cat household. I have been in that situation myself as have many of my clients.

I have at times fed all my cats the low protein diet if one needed it and the others were not kittens or pregnant or nursing cats. You could also leave dry low protein food down all the time and supplement all except the kitty with feline kidney disease with regular canned food. At that same time, you can give the one with kidney disease low protein canned.

Other cat owners have gone to an all canned food diet so the kidney disease kitty can be fed low protein while the others eat regular, eliminating dry food altogether. This has the added benefit of offering more water due to the high water content of canned food. Increased water intake is beneficial to the urinary tract.

Others, including myself, have postponed any diet change when the kidney insufficiency is in such early stages. You are probably beginning to see there is no one right or wrong answer. It is still not completely known if feeding a low protein diet is helpful at all or if feeding a moderate protein diet is superior to a low protein one.

Discuss these issues with your vet, make sure all the tests have been run that I mentioned, provide fresh water at all times, and take your kitty for frequent rechecks. As kidney function changes over time, certain medications may be added that are very useful as well as other dietary changes or supplements and possibly fluid supplementation at home.

Best of luck with everything. Thank you for raising this very important question.

Best, Dr. Neely

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