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Elizabeth Blake
December 6th 05, 09:29 PM
Tiger went to the vet on Sunday. She had peed in several places that
were not her litterbox, and her skanky ears were bothering her again.

I called just now to see if her test results were back. The vet said
the urine culture wasn't done, so I don't know about that yet. She
said that her urine had a low concentration(?) and that her creatinine
was slightly elevated. She said the normal range is .8 - 2.3 and
Tiger's was 2.4. On Sunday, she said that her left kidney felt really
small. So, it looks like Tiger is heading for kidney failure.

The vet suggested giving her extra fluids 2-3 times a week, so I'm
going to bring her in next week to learn how to do that. She also
suggested putting her on a prescription diet. She said they carry
Eukanuba and Science Diet prescription foods for kidney problems. Does
anyone have an opinion about them, which is better? Tiger has been
eating only canned food for the last couple of years and I'd like to
stay with that. Also, I have another cat and forgot to ask if he would
be able to eat the prescription food as well. I know that no matter
how hard I try, they will end up getting into each other's bowls.

Currently Tiger is eating & drinking well. She actually seems to be
eating more, or at least cleaning her bowl faster. She's always been a
good drinker. I had her shut in the bathroom for a couple of days
before her appointment while I was at work, and had a bowl of water in
there for her. One day after I let her out I forgot to remove the
bowl, and she kept making special trips into the bathroom to drink from
it, as well as the Drinkwell in the kitchen.

I'm hoping that we caught this early and Tiger will be around for
awhile, but she is already 15 1/2 years old. She had a tumor removed
last year. Other than that, she's been a healthy cat except for the
skanky, waxy buildup that tends to form in her ears. I have some
medication for that from the new vet.

--
Liz

December 7th 05, 12:51 AM
Is the skanky stuff fungal? My cat that passed away recently had a
fungal problem with his ears. Brown waxy stuff - the vet had him on a
medicine in a tube,,, sorry but the name escapes me.

J. Martin
December 7th 05, 12:56 AM
"Elizabeth Blake" > wrote in message
oups.com...
> Tiger went to the vet on Sunday. She had peed in several places that
> were not her litterbox, and her skanky ears were bothering her again.
>
> I called just now to see if her test results were back. The vet said
> the urine culture wasn't done, so I don't know about that yet.

It was a wise decision for your vet to run a urine culture. Cats with
kidney disease are more predisposed to urinary tract infections and if the
infection spreads to the kidneys it can accelerate progression of kidney
disease.


She
> said that her urine had a low concentration(?) and that her creatinine
> was slightly elevated. She said the normal range is .8 - 2.3 and
> Tiger's was 2.4. On Sunday, she said that her left kidney felt really
> small. So, it looks like Tiger is heading for kidney failure.
>

She is just in the early stages of kidney disease, she could still have
years of life left.


> The vet suggested giving her extra fluids 2-3 times a week, so I'm
> going to bring her in next week to learn how to do that.

Seems like fairly aggressive treatment for early kidney disease. The
purpose of subcutaneous fluids is to ensure she is taking in enough fluids
to compensate for extra fluid loss in her urine. Thus SQ fluids are
important for cats that are not taking in enough fluids from eating and
drinking. I recommend adding extra water to canned food to increase fluid
intake and make sure you have multiple large water bowls with fresh water
available throughout the house. The drinkwell water fountain is a great
idea too.



She also
> suggested putting her on a prescription diet. She said they carry
> Eukanuba and Science Diet prescription foods for kidney problems. Does
> anyone have an opinion about them, which is better?


Science diet G/D is a good food for this stage of kidney disease. Most
premium senior diets would be appropriate as well. Diets specifically
designed for kidney disease (e.g. K/D or Euk Multistage Renal) are too
protein restricted for cats with early kidney disease. I usually don't
recommend them until BUN values are significantly elevated.



Tiger has been
> eating only canned food for the last couple of years and I'd like to
> stay with that.

Good idea

Also, I have another cat and forgot to ask if he would
> be able to eat the prescription food as well.

Your other cat shouldn't be fed a kidney diet, but neither should Tiger at
this point.

Ask if her blood potassium level was tested. Potassium supplementation
should be started if potassium levels are in the low end of normal range.
There is evidence that potassium supplementation at this stage will prolong
kidney function. I find the powdered potassium supplements are the easiest
to give.


J. dvm

Elizabeth Blake
December 7th 05, 02:34 AM
> wrote in message
oups.com...
> Is the skanky stuff fungal? My cat that passed away recently had a
> fungal problem with his ears. Brown waxy stuff - the vet had him on a
> medicine in a tube,,, sorry but the name escapes me.

I'm not sure. I know it's been tested for various things in the past but I
don't know what. I was just always told that it's "nothing". It's thick,
brown & waxy and drives her crazy. When pressed, a couple of vets had given
me medication in the past (Animax? and something else) but the stuff always
returned. I have to say that after the last deep cleaning (October 2004)
until now, her ears have stayed cleanest the longest. The stuff still came
back but not as much, and one ear stayed almost completely clear until just
recently, when she began scratching it again. The medication this new vet
gave me is for mites, I think - Tresaderm.

--
Liz

Elizabeth Blake
December 7th 05, 02:49 AM
"J. Martin" > wrote in message
.. .
>
> "Elizabeth Blake" > wrote in message
> oups.com...
>> Tiger went to the vet on Sunday. She had peed in several places that
>> were not her litterbox, and her skanky ears were bothering her again.
>>
>> I called just now to see if her test results were back. The vet said
>> the urine culture wasn't done, so I don't know about that yet.
>
> It was a wise decision for your vet to run a urine culture. Cats with
> kidney disease are more predisposed to urinary tract infections and if the
> infection spreads to the kidneys it can accelerate progression of kidney
> disease.

She said that there doesn't seem to any infection but I guess I'll find out
for sure when the culture is completed. I forgot to ask when that would be.
When she had urination problems in the past (starting when she was young) I
was always told she didn't have an infection.


>> The vet suggested giving her extra fluids 2-3 times a week, so I'm
>> going to bring her in next week to learn how to do that.
>
> Seems like fairly aggressive treatment for early kidney disease. The
> purpose of subcutaneous fluids is to ensure she is taking in enough fluids
> to compensate for extra fluid loss in her urine. Thus SQ fluids are
> important for cats that are not taking in enough fluids from eating and
> drinking. I recommend adding extra water to canned food to increase fluid
> intake and make sure you have multiple large water bowls with fresh water
> available throughout the house. The drinkwell water fountain is a great
> idea too.

The vet said it was up to me. She said that Tiger's skin was "tenting" when
I had her in. When they pull up on the skin, it remians that way for a few
seconds before returning to normal. I just pulled her skin myself, and it
doesn't stay that way for more than a second or so. I'm still going to
bring her in on Tuesday to learn how to give her fluids, because I'm sure I
will eventually need to know and I might as well learn now. It will be up
to me to decide if I want to give them to her or not. I have a feeling I
will put it off for now. Tiger does get plenty of fluids. She *loves* to
drink and she eats wet food. I'm going to put a bowl of water back in the
bathroom, since she was also going in there to drink when I left it down. I
think my other cat, Otto, prefers a bowl over the Drinkwell. I rarely see
him drinking. Before I got the fountain, I'd see a lot of fur at the bottom
of the water bowls because he would stick his paw in and then lick the water
off his paw. When I open a can of food in the morning, I leave it in the
sink full of water because he likes drinking water out of the dirty dishes
in the sink. But I have never had to worry about Tiger getting enough.
Recently, even before she began peeing outside the box, I've noticed the
reservoir in the fountain was emptying faster.

> She also
>> suggested putting her on a prescription diet. She said they carry
>> Eukanuba and Science Diet prescription foods for kidney problems. Does
>> anyone have an opinion about them, which is better?
>
>
> Science diet G/D is a good food for this stage of kidney disease. Most
> premium senior diets would be appropriate as well. Diets specifically
> designed for kidney disease (e.g. K/D or Euk Multistage Renal) are too
> protein restricted for cats with early kidney disease. I usually don't
> recommend them until BUN values are significantly elevated.

Right now she's eating regular (adult, not senior) Wellness, Petguard &
Science Diet. Chicken, turkey, beef combinations mostly. She's never been
a picky eater and as long as the canned food is pate style, she's eaten it.
She's also become a treat fanatic, running over every time she hears a bag,
or what she thinks is a bag or treats getting rattled. Tonight she came
running as I was testing my blood sugar, because she thought the vial of
strips sounded like treats. She's always liked treats but has never been
pushy about it. Is her increased appetite related to her kidneys? She's
even eating more at regular mealtimes.


> Also, I have another cat and forgot to ask if he would
>> be able to eat the prescription food as well.
>
> Your other cat shouldn't be fed a kidney diet, but neither should Tiger at
> this point.
>
> Ask if her blood potassium level was tested. Potassium supplementation
> should be started if potassium levels are in the low end of normal range.
> There is evidence that potassium supplementation at this stage will
> prolong kidney function. I find the powdered potassium supplements are
> the easiest to give.
>
>
> J. dvm

I can put her in the bedroom or bathroom at mealtime. I had her in the
bathroom for several days last week and that's when I realized how quickly
she emptied her bowl. I'll ask about the rest of her blood test results
when I go next week, and will also ask about her potassium levels.

--
Liz

J. Martin
December 7th 05, 07:17 AM
"Elizabeth Blake" > wrote in message
.net...
> "J. Martin" > wrote in message
> .. .
>>
>> "Elizabeth Blake" > wrote in message
>> oups.com...
>>> Tiger went to the vet on Sunday. She had peed in several places that
>>> were not her litterbox, and her skanky ears were bothering her again.
>>>
>>> I called just now to see if her test results were back. The vet said
>>> the urine culture wasn't done, so I don't know about that yet.
>>
>> It was a wise decision for your vet to run a urine culture. Cats with
>> kidney disease are more predisposed to urinary tract infections and if
>> the infection spreads to the kidneys it can accelerate progression of
>> kidney disease.
>
> She said that there doesn't seem to any infection but I guess I'll find
> out for sure when the culture is completed. I forgot to ask when that
> would be.

Results usually take about 3 days.

>SNIP>

> pushy about it. Is her increased appetite related to her kidneys?

No, appetite decreases as kidney disease advances, so a good appetite is a
good sign.

Phil P.
December 7th 05, 03:44 PM
"Elizabeth Blake" > wrote in message
.net...

> The vet said it was up to me. She said that Tiger's skin was "tenting"
when
> I had her in. When they pull up on the skin, it remians that way for a
few
> seconds before returning to normal.

She's a 15 year-old cat! What does he expect? Older cats often have reduced
skin turgor and delayed skin return even without dehydration because their
skin losses elasticity with age. A 15-year-old cat is physiologically
equivalent to a 76-year-old person. Hasn't he ever noticed the flaccid
"chicken skin" on elderly people? Its like Silly Putty. Same principal
applies to elderly cats.

Fluid therapy should only be used to prevent dehydration in cats that aren't
getting enough water from food and drinking to keep up their urinary losses,
or on a *short-term* basis to promote diuresis to lower uremic
toxins in the blood during acute decompensation. Chronic fluid therapy
actually promotes the progression of CRF because it makes the kidneys work
harder and also increases single-nephron GFR and promotes glomerular
hyperfiltration- which can also promote progression.

If she's eating canned food, she's meeting almost her entire daily water
requirement from her food and only needs to drink a little extra water.




> > She also
> >> suggested putting her on a prescription diet. She said they carry
> >> Eukanuba and Science Diet prescription foods for kidney problems. Does
> >> anyone have an opinion about them, which is better?

Her kidney values are *far* too low to begin protein restriction. All she
needs right now is a canned senior diet that's low in phosphorus and a
potassium and an omega-3 supplement. Protein restriction shouldn't begin
until her BUN is at least 60-80 mg/dl or if she develops clinical signs of
uremia.

Between premature protein restriction and unnecessary fluid therapy, some
vets are actually hastening CRF cats' premature demise.

How's Harriet?

Phil

Phil P.
December 7th 05, 03:45 PM
"J. Martin" > wrote in message
.. .

> Ask if her blood potassium level was tested. Potassium supplementation
> should be started if potassium levels are in the low end of normal range.
> There is evidence that potassium supplementation at this stage will
prolong
> kidney function. I find the powdered potassium supplements are the
easiest
> to give.

Hi Doc,

I'm glad to see you back! You've been sorely missed.

I have an excellent paper by Drs. Steven Dow and Martin Fettman on the
benefits of potassium supplementation in renal cats: "RENAL DISEASE IN CATS:
THE POTASSIUM CONNECTION". I'd be happy to send it to you if you'd like to
read it.

Phil

J. Martin
December 8th 05, 01:36 AM
"Phil P." > wrote in message
k.net...
>
> "J. Martin" > wrote in message
> .. .
>
>> Ask if her blood potassium level was tested. Potassium supplementation
>> should be started if potassium levels are in the low end of normal range.
>> There is evidence that potassium supplementation at this stage will
> prolong
>> kidney function. I find the powdered potassium supplements are the
> easiest
>> to give.
>
> Hi Doc,
>
> I'm glad to see you back! You've been sorely missed.
>
> I have an excellent paper by Drs. Steven Dow and Martin Fettman on the
> benefits of potassium supplementation in renal cats: "RENAL DISEASE IN
> CATS:
> THE POTASSIUM CONNECTION". I'd be happy to send it to you if you'd like
> to
> read it.
>
> Phil
>
>
Thanks Phil, I'd like to read that. I'll send you my email address
privately



>
>
>

Elizabeth Blake
December 8th 05, 04:09 AM
"Phil P." > wrote in message
k.net...

> Fluid therapy should only be used to prevent dehydration in cats that
> aren't
> getting enough water from food and drinking to keep up their urinary
> losses,
> or on a *short-term* basis to promote diuresis to lower uremic
> toxins in the blood during acute decompensation. Chronic fluid therapy
> actually promotes the progression of CRF because it makes the kidneys work
> harder and also increases single-nephron GFR and promotes glomerular
> hyperfiltration- which can also promote progression.
>
> If she's eating canned food, she's meeting almost her entire daily water
> requirement from her food and only needs to drink a little extra water.

I'm still going to bring her in next week to learn how to give her fluids,
but won't actually start doing so until she needs it. She always has liked
water so I was surprised when they said she was a little dehydrated. Like
you said, it's probably not dehydration but just normal aging.

>> > She also
>> >> suggested putting her on a prescription diet. She said they carry
>> >> Eukanuba and Science Diet prescription foods for kidney problems.
>> >> Does
>> >> anyone have an opinion about them, which is better?
>
> Her kidney values are *far* too low to begin protein restriction. All she
> needs right now is a canned senior diet that's low in phosphorus and a
> potassium and an omega-3 supplement. Protein restriction shouldn't begin
> until her BUN is at least 60-80 mg/dl or if she develops clinical signs of
> uremia.

I started buying some senior cat food for her before Otto showed up,
probably when she was around 9 years old. She began to lose weight rapidly
with it, so I put her back on her regular foods. I'm willing to try it
again. Any brand(s) you recommend? Right now she's getting adult Petguard,
Wellness & Science Diet.

>
> How's Harriet?
>
> Phil

Harriet is doing much better, although today I caught her in one of the
rooms burying something. I found a couple of turds on the floor but don't
know how long they had been there. They weren't fresh. She has been going
regularly in the box, is eating better and hasn't been attacking anyone for
several weeks.

--
Liz

blkcatgal
December 8th 05, 04:36 AM
Try the Science Diet Senior canned foods. My 16 year old is about the same
as your cat....kidneys starting to decline even though his BUN and
creatinine are within normal but USG in the low range. I've been feeding
him the Science Diet Senior foods, turkey and chicken mostly. He also likes
the Nutro Senior canned food too.

"Elizabeth Blake" > wrote in message
k.net...
> "Phil P." > wrote in message
> k.net...
>
>> Fluid therapy should only be used to prevent dehydration in cats that
>> aren't
>> getting enough water from food and drinking to keep up their urinary
>> losses,
>> or on a *short-term* basis to promote diuresis to lower uremic
>> toxins in the blood during acute decompensation. Chronic fluid therapy
>> actually promotes the progression of CRF because it makes the kidneys
>> work
>> harder and also increases single-nephron GFR and promotes glomerular
>> hyperfiltration- which can also promote progression.
>>
>> If she's eating canned food, she's meeting almost her entire daily water
>> requirement from her food and only needs to drink a little extra water.
>
> I'm still going to bring her in next week to learn how to give her fluids,
> but won't actually start doing so until she needs it. She always has
> liked water so I was surprised when they said she was a little dehydrated.
> Like you said, it's probably not dehydration but just normal aging.
>
>>> > She also
>>> >> suggested putting her on a prescription diet. She said they carry
>>> >> Eukanuba and Science Diet prescription foods for kidney problems.
>>> >> Does
>>> >> anyone have an opinion about them, which is better?
>>
>> Her kidney values are *far* too low to begin protein restriction. All she
>> needs right now is a canned senior diet that's low in phosphorus and a
>> potassium and an omega-3 supplement. Protein restriction shouldn't begin
>> until her BUN is at least 60-80 mg/dl or if she develops clinical signs
>> of
>> uremia.
>
> I started buying some senior cat food for her before Otto showed up,
> probably when she was around 9 years old. She began to lose weight
> rapidly with it, so I put her back on her regular foods. I'm willing to
> try it again. Any brand(s) you recommend? Right now she's getting adult
> Petguard, Wellness & Science Diet.
>
>>
>> How's Harriet?
>>
>> Phil
>
> Harriet is doing much better, although today I caught her in one of the
> rooms burying something. I found a couple of turds on the floor but don't
> know how long they had been there. They weren't fresh. She has been
> going regularly in the box, is eating better and hasn't been attacking
> anyone for several weeks.
>
> --
> Liz
>

Steve Crane
December 9th 05, 02:50 AM
J. Martin wrote:

> She also
> > suggested putting her on a prescription diet. She said they carry
> > Eukanuba and Science Diet prescription foods for kidney problems. Does
> > anyone have an opinion about them, which is better?
>
>
> Science diet G/D is a good food for this stage of kidney disease. Most
> premium senior diets would be appropriate as well. Diets specifically
> designed for kidney disease (e.g. K/D or Euk Multistage Renal) are too
> protein restricted for cats with early kidney disease. I usually don't
> recommend them until BUN values are significantly elevated.

Dr. Martin - I would have to disagree, the recent studies have been
pretty overwhelming that the sooner k/d is started, the better the
results. k/d contains more than enough protein for a normal healthy
cat, let alone a renal failure cat.

This below from Dr. Joe Bartges on the AAVN Listserver today:

"based on the cat study by Barber and Elliot (and the dog study by
Jacobs,
et al) - I place dogs and cats on "renal failure" diets when they are
diagnosed with azotemic renal failure - regardless of degree of
azotemia,
hyperphosphatemia, acidosis, etc."

joe

Joe Bartges, BS, DVM, PhD, DiplACVIM, DiplACVN
Professor of Medicine and Nutrition
The Acree Chair of Small Animal Research
Department of Small Animal Clinical Sciences
C247 Veterinary Teaching Hospital
College of Veterinary Medicine
The University of Tennessee

> Also, I have another cat and forgot to ask if he would
> > be able to eat the prescription food as well.
>
> Your other cat shouldn't be fed a kidney diet, but neither should Tiger at
> this point.
>
> Ask if her blood potassium level was tested. Potassium supplementation
> should be started if potassium levels are in the low end of normal range.
> There is evidence that potassium supplementation at this stage will prolong
> kidney function. I find the powdered potassium supplements are the easiest
> to give.

Which are already contained in the k/d diet......

J. Martin
December 9th 05, 04:12 AM
"Steve Crane" > wrote in message
ups.com...
>
> J. Martin wrote:
>
>> She also
>> > suggested putting her on a prescription diet. She said they carry
>> > Eukanuba and Science Diet prescription foods for kidney problems. Does
>> > anyone have an opinion about them, which is better?
>>
>>
>> Science diet G/D is a good food for this stage of kidney disease. Most
>> premium senior diets would be appropriate as well. Diets specifically
>> designed for kidney disease (e.g. K/D or Euk Multistage Renal) are too
>> protein restricted for cats with early kidney disease. I usually don't
>> recommend them until BUN values are significantly elevated.
>
> Dr. Martin - I would have to disagree, the recent studies have been
> pretty overwhelming that the sooner k/d is started, the better the
> results. k/d contains more than enough protein for a normal healthy
> cat, let alone a renal failure cat



>
> This below from Dr. Joe Bartges on the AAVN Listserver today:
>
> "based on the cat study by Barber and Elliot (and the dog study by
> Jacobs,
> et al) - I place dogs and cats on "renal failure" diets when they are
> diagnosed with azotemic renal failure - regardless of degree of
> azotemia,
> hyperphosphatemia, acidosis, etc."
>
> joe
>
> Joe Bartges, BS, DVM, PhD, DiplACVIM, DiplACVN
> Professor of Medicine and Nutrition
> The Acree Chair of Small Animal Research
> Department of Small Animal Clinical Sciences
> C247 Veterinary Teaching Hospital
> College of Veterinary Medicine
> The University of Tennessee
>

It definitely is a controversial issue. Yes, there is no question that Dr
Bartges is a believer in protein restriction for early CRF yet other equally
reputable veterinarians advocate delaying protein restriction. If studies
overwhelmingly proved the benefits of early protein restriction then there
would be no controversy. I would be interested in reading these studies to
which you referred. Can you post some abstracts or summaries?

J.

5cats
December 9th 05, 01:58 PM
J. Martin wrote:

>
> "Steve Crane" > wrote in message
> ups.com...
>>
>> J. Martin wrote:
>>
>>> She also
>>> > suggested putting her on a prescription diet. She said they carry
>>> > Eukanuba and Science Diet prescription foods for kidney problems.
>>> > Does anyone have an opinion about them, which is better?
>>>
>>>
>>> Science diet G/D is a good food for this stage of kidney disease.
>>> Most premium senior diets would be appropriate as well. Diets
>>> specifically designed for kidney disease (e.g. K/D or Euk Multistage
>>> Renal) are too protein restricted for cats with early kidney
>>> disease. I usually don't recommend them until BUN values are
>>> significantly elevated.
>>
>> Dr. Martin - I would have to disagree, the recent studies have been
>> pretty overwhelming that the sooner k/d is started, the better the
>> results. k/d contains more than enough protein for a normal healthy
>> cat, let alone a renal failure cat
>
>
>
>>
>> This below from Dr. Joe Bartges on the AAVN Listserver today:
>>
>> "based on the cat study by Barber and Elliot (and the dog study by
>> Jacobs,
>> et al) - I place dogs and cats on "renal failure" diets when they are
>> diagnosed with azotemic renal failure - regardless of degree of
>> azotemia,
>> hyperphosphatemia, acidosis, etc."
>>
>> joe
>>
>> Joe Bartges, BS, DVM, PhD, DiplACVIM, DiplACVN
>> Professor of Medicine and Nutrition
>> The Acree Chair of Small Animal Research
>> Department of Small Animal Clinical Sciences
>> C247 Veterinary Teaching Hospital
>> College of Veterinary Medicine
>> The University of Tennessee
>>
>
> It definitely is a controversial issue. Yes, there is no question
> that Dr Bartges is a believer in protein restriction for early CRF yet
> other equally reputable veterinarians advocate delaying protein
> restriction. If studies overwhelmingly proved the benefits of early
> protein restriction then there would be no controversy. I would be
> interested in reading these studies to which you referred. Can you
> post some abstracts or summaries?
>
> J.
>

What do you consider "restricted" protein? I looked at the K/D cans and
bag and they do have the AAFCO statement for adult maintenance, so is
that considered "restricted" or just low protein?

I've been sticking with the canned K/D for my cat because of the very low
phosphorus and no one seems to disagree with the need for low phosphorus,
if it's not really enough protein for her I was thinking about adding
some chopped egg whites to it. She does get some pieces of T/D as a
dental treat every day.

J. Martin
December 9th 05, 02:49 PM
"5cats" > wrote in message
...
>
> What do you consider "restricted" protein? I looked at the K/D cans and
> bag and they do have the AAFCO statement for adult maintenance, so is
> that considered "restricted" or just low protein?
>

I use the terms interchangeably. I would refer to K/D as either a
restricted protein diet or a low protein diet.

> I've been sticking with the canned K/D for my cat because of the very low
> phosphorus and no one seems to disagree with the need for low phosphorus,
> if it's not really enough protein for her I was thinking about adding
> some chopped egg whites to it. She does get some pieces of T/D as a
> dental treat every day.
>
>
I would not recommend adding egg white to supplement protein. Proper
nutrient and mineral ratios in diets are important (particularly calcium and
phosphorus) and supplementing with single ingredients could throw off those
ratios.

I hope my comments have not been interpreted as a condemnation of K/D cat
food. The folks at Hills did the cat world a great favour when they
introduced K/D. It is an excellent diet when used appropriately and has
improved the quality and quantity of lives of countless cats with renal
disease. In addition I too sometimes prescribe K/D or similar 'renal diets'
for cats with early renal disease. If I expect a client to be unlikely to
pursue regular follow up lab testing (for financial or other reasons) in
order to determine when best to change to a renal diet I believe their cats
are best served by changing to a renal diet earlier rather than never.

J.

Steve Crane
December 9th 05, 03:05 PM
I believe this is scheduled for full publication mid 2006. It's
important to note that creatinine concentration is particularly
insensitive indicator of GFR in early CKD. For example a 50% reduction
in GFR results in an increase in serum creatinine from 1.0 mg/dl to 2.0
mgs/dl. A further 50% reduction drives the values up to 4.0 mgs/dl.


ACVIM Proceedings 2005
Clinical Evaluation of Effects of Dietary Modification in Cats with
Spontaneous Chronic Renal Failure

S. Ross1; C. Osborne1; D. Polzin1; S. Lowry2; C. Kirk3; L. Koehler1
1College of Veterinary Medicine, University of Minnesota, St. Paul,
MN;2Hill's Science and Technology Center, Topeka, KS; 3 College of
Veterinary Medicine, The University of Tennessee, Knoxville, TN


A double-masked, controlled, randomized, clinical trial was designed to
determine if a renal diet (modified in protein, phosphorous, sodium,
and lipid composition) was superior to an adult maintenance diet in
minimizing uremic episodes and mortality rate in cats with mild to
moderate chronic renal failure. Cats were chosen based on a criteria of
having creatinine concentrations equal to or greater than 2.1 mg/dl.
Forty-five client owned cats were randomly assigned to a maintenance
diet or a renal diet and evaluated tri-monthly for up to 24 months.
Kaplan-Meier survival analyses were used to evaluate efficacy of the
renal diet compared to the maintenance diet in minimizing uremia,
renal-related mortality, and all causes of mortality. Rec

Events Renal diet (%) Maintenance diet (%) P-value
Uremic crises 0/22 (0) 5/23 (22)
0.02
Renal cause mortality 0/22 (0) 4/23 (17) 0.03
All causes of mortality 3/22 (14) 9/23 (39) 0.06

Serum urea nitrogen concentrations were significantly lower and blood
bicarbonate concentrations were significantly higher in the group fed
the renal diet at baseline and during the 12- and 24-month intervals.
Cats fed the maintenance diet had a significantly greater number of
uremic episodes (22%) compared to cats fed the renal diet (0%). A
significant reduction in renal-related mortality was observed in cats
fed the renal diet. The renal diet evaluated in this study was superior
to an adult maintenance diet in minimizing uremic episodes and
mortality rate in cats with mild to moderate spontaneous chronic renal
failure.

Steve Crane
December 9th 05, 03:26 PM
5cats wrote:
> What do you consider "restricted" protein? I looked at the K/D cans and
> bag and they do have the AAFCO statement for adult maintenance, so is
> that considered "restricted" or just low protein?
>
> I've been sticking with the canned K/D for my cat because of the very low
> phosphorus and no one seems to disagree with the need for low phosphorus,
> if it's not really enough protein for her I was thinking about adding
> some chopped egg whites to it. She does get some pieces of T/D as a
> dental treat every day.

I would nix the idea of adding egg whites. A cup of egg whites would
add 32 mgs of phosphorus to the diet while adding 25 grams of protein.
Fairly low phos, and perhaps not greatly problematic, but then you have
altered the intake of many other nutrients at the same time. Replacing
calories with egg white necessarily means the number of calories
ingested from the food declines, and so too does the amount of Omega 3
fatty acids and antioxidant vitamins which are key nutrients in a renal
failure diet.

Some caution on adding the t/d kibbles - a quarter cup of t/d would add
140 mgs of phosphorus to the diet. I'm not sure what "some pieces of
t/d" equals and perhaps it's far less than 1/4 cup and there isn't any
problem.

Phil P.
December 9th 05, 03:55 PM
"Steve Crane" > wrote in message
ups.com...
>
> Dr. Martin - I would have to disagree, the recent studies have been
> pretty overwhelming that the sooner k/d is started, the better the
> results. k/d contains more than enough protein for a normal healthy
> cat, let alone a renal failure cat.

What? 1/2 gram above the bare minimum protein requirement? That means the
cat must lick the dish clean to get her minimum daily protein
requirement. Know a lot of renal cats with hearty appetites that beg for
k/d, do you, Steve? The low protein, phosphorus and sodium content makes
k/d unpalatable to many (most) renal cats.

What about protein for renal cats that constantly lose protein in their
urine? There's also no safety margin built into k/d for cats that won't eat
their entire ration.

It doesn't matter how "perfectly" formulated a diet is if the cat won't eat
the entire ration.


>
> This below from Dr. Joe Bartges on the AAVN Listserver today:
>
> "based on the cat study by Barber and Elliot (and the dog study by
> Jacobs,
> et al) - I place dogs and cats on "renal failure" diets when they are
> diagnosed with azotemic renal failure - regardless of degree of
> azotemia,
> hyperphosphatemia, acidosis, etc."


Carl Osborn:

"Current evidence suggests that protein restriction probably has only a
minimal effect, if any, on progression of renal failure." (in Ett. 5th)


Gregory F. Grauer, DVM, MS, Dipl. ACVIM (SAIM)

"Researchers have established that the minimum protein requirements for dogs
and cats with CRF are higher than those of normal dogs and cats. Ideally,
dogs with CRF should receive a minimum of 2 to 2.2 g and cats a minimum of
3.3 to 3.5 g of protein per kilogram per day."

or 13.2 to 14 g/day for a 4 kg cat. Do the math- k/d contains 6.6 g of
protein /100 kcal. - which translates into about 12 g/day for a 4 kg cat.
Don't forget to consider urinary protein losses. Sure looks like a negative
nitrogen balance on my calculator.


"A good recommendation to effectively achieve dietary protein reduction is
to feed the maximum amount of high-biologic-value protein that the animal
can tolerate at its level of renal function."

"Most veterinary nephrologists recommend that dietary protein reduction be
initiated when the animal's blood urea nitrogen concentration is between 60
and 80 mg/dL"

"A reduction in dietary protein intake has long been the cornerstone of
management in dogs and cats with CRF. The benefits of this include decreased
serum urea nitrogen and phosphorus concentrations. There are, however, also
undesirable effects. Specifically, if dietary protein is restricted in
relation to the animal's protein needs, reduced renal hemodynamics, protein
depletion (decreased body weight, muscle mass, and serum albumin
concentration), anemia, and acidosis can occur or be aggravated. Just as
increased dietary protein intake results in increased glomerular filtration,
restricted intake is associated with a reduction in the GFR. The anemia of
CRF is exacerbated because protein depletion further compromises
erythrogenesis. Dietary protein restriction also decreases renal
ammoniagenesis, and therefore renal acid excretion."

The *only* advantage of switching to a renal diet in the very early stages
of CRF is because switching the cat over to an less palatable renal diet
later in course of disease will be much more difficult and might lead to
protein malnutrition if the cat doesn't adapt to diet.

J. Martin
December 9th 05, 03:59 PM
Thanks for posting that Steve. I'll be sure and read the full paper when it
is published.

J.


"Steve Crane" > wrote in message
ups.com...
>I believe this is scheduled for full publication mid 2006. It's
> important to note that creatinine concentration is particularly
> insensitive indicator of GFR in early CKD. For example a 50% reduction
> in GFR results in an increase in serum creatinine from 1.0 mg/dl to 2.0
> mgs/dl. A further 50% reduction drives the values up to 4.0 mgs/dl.
>
>
> ACVIM Proceedings 2005
> Clinical Evaluation of Effects of Dietary Modification in Cats with
> Spontaneous Chronic Renal Failure
>
> S. Ross1; C. Osborne1; D. Polzin1; S. Lowry2; C. Kirk3; L. Koehler1
> 1College of Veterinary Medicine, University of Minnesota, St. Paul,
> MN;2Hill's Science and Technology Center, Topeka, KS; 3 College of
> Veterinary Medicine, The University of Tennessee, Knoxville, TN
>
>
> A double-masked, controlled, randomized, clinical trial was designed to
> determine if a renal diet (modified in protein, phosphorous, sodium,
> and lipid composition) was superior to an adult maintenance diet in
> minimizing uremic episodes and mortality rate in cats with mild to
> moderate chronic renal failure. Cats were chosen based on a criteria of
> having creatinine concentrations equal to or greater than 2.1 mg/dl.
> Forty-five client owned cats were randomly assigned to a maintenance
> diet or a renal diet and evaluated tri-monthly for up to 24 months.
> Kaplan-Meier survival analyses were used to evaluate efficacy of the
> renal diet compared to the maintenance diet in minimizing uremia,
> renal-related mortality, and all causes of mortality. Rec
>
> Events Renal diet (%) Maintenance diet (%) P-value
> Uremic crises 0/22 (0) 5/23 (22)
> 0.02
> Renal cause mortality 0/22 (0) 4/23 (17) 0.03
> All causes of mortality 3/22 (14) 9/23 (39) 0.06
>
> Serum urea nitrogen concentrations were significantly lower and blood
> bicarbonate concentrations were significantly higher in the group fed
> the renal diet at baseline and during the 12- and 24-month intervals.
> Cats fed the maintenance diet had a significantly greater number of
> uremic episodes (22%) compared to cats fed the renal diet (0%). A
> significant reduction in renal-related mortality was observed in cats
> fed the renal diet. The renal diet evaluated in this study was superior
> to an adult maintenance diet in minimizing uremic episodes and
> mortality rate in cats with mild to moderate spontaneous chronic renal
> failure.
>

cybercat
December 9th 05, 04:40 PM
"J. Martin" > wrote :
>
> I hope my comments have not been interpreted as a condemnation of K/D cat
> food. The folks at Hills did the cat world a great favour when they
> introduced K/D. It is an excellent diet when used appropriately and has
> improved the quality and quantity of lives of countless cats with renal
> disease. In addition I too sometimes prescribe K/D or similar 'renal
diets'
> for cats with early renal disease. If I expect a client to be unlikely to
> pursue regular follow up lab testing (for financial or other reasons) in
> order to determine when best to change to a renal diet I believe their
cats
> are best served by changing to a renal diet earlier rather than never.
>

It's great to have your measured and intelligent input on the controversial
topic of food. So many factors must be weighed when choosing a food
for a particular cat (particularly one with medical conditions) it seems to
me that no reasonable person would take your comments as a blanket
condemnation of K/D.

blkcatgal
December 10th 05, 12:37 AM
The only problem that I have with K/D is that my cat doesn't want to eat it!
Even the chicken K/D. And my cat is usually not a picky eater. I wish they
would develop a prescription diet food that cats like (or at least my cat
liked).

Sue
"cybercat" > wrote in message
...
>
> "J. Martin" > wrote :
>>
>> I hope my comments have not been interpreted as a condemnation of K/D cat
>> food. The folks at Hills did the cat world a great favour when they
>> introduced K/D. It is an excellent diet when used appropriately and has
>> improved the quality and quantity of lives of countless cats with renal
>> disease. In addition I too sometimes prescribe K/D or similar 'renal
> diets'
>> for cats with early renal disease. If I expect a client to be unlikely
>> to
>> pursue regular follow up lab testing (for financial or other reasons) in
>> order to determine when best to change to a renal diet I believe their
> cats
>> are best served by changing to a renal diet earlier rather than never.
>>
>
> It's great to have your measured and intelligent input on the
> controversial
> topic of food. So many factors must be weighed when choosing a food
> for a particular cat (particularly one with medical conditions) it seems
> to
> me that no reasonable person would take your comments as a blanket
> condemnation of K/D.
>
>

Steve Crane
December 10th 05, 12:56 AM
Phil P. wrote:
> "Steve Crane" > wrote in message
> ups.com...

> What? 1/2 gram above the bare minimum protein requirement? That means the
> cat must lick the dish clean to get her minimum daily protein
> requirement. Know a lot of renal cats with hearty appetites that beg for
> k/d, do you, Steve? The low protein, phosphorus and sodium content makes
> k/d unpalatable to many (most) renal cats.

Oh nonsense, k/d is more palatable than Friskies canned foods. We've
done the PAL studies so many times in so many places it's ridiculous.
The problem is not with the food, but with the practitioner. Any cat
which is sick, in the hospital, out of its comfort zone, and then
presented with a new food will do two things. 1) reject the food, and
2) associate the food with the hospital and being sick. Placing a CRF
cat on k/d while in the hospital is a mistake. Three or four more days
on _any_ food isn't going to affect the cat. Once home and once the
cat is feeling a bit better - THEN the food needs to be changed.

As for the 1/2 gram protein nonsense - You are assuming that cat owners
only provide the bare minimum of foods - yea right - that's why we have
such an epidemic of obesity in cats I suppose? The evidence is
overwhelming - place a cat on k/d, and do it early, and you will reduce
uremic crisis and extend the cats life substantially. There are now two
Grade 1 studies in cats and 1 in dogs - all arriving at precisely the
same conclusion.

5cats
December 10th 05, 01:53 AM
Steve Crane wrote:


> Some caution on adding the t/d kibbles - a quarter cup of t/d would
> add 140 mgs of phosphorus to the diet. I'm not sure what "some pieces
> of t/d" equals and perhaps it's far less than 1/4 cup and there isn't
> any problem.
>
>

Just 10 or 12 pieces of T/D, less than 1/8 cup. Just something for a mid-
day snack. She doesn't want K/D dry anymore, she only want the wet K/D now
that the main meals have been changed to canned.

Phil P.
December 10th 05, 04:15 AM
"Steve Crane" > wrote in message
ups.com...
>
> Phil P. wrote:
> > "Steve Crane" > wrote in message
> > ups.com...
>
> > What? 1/2 gram above the bare minimum protein requirement? That means
the
> > cat must lick the dish clean to get her minimum daily protein
> > requirement. Know a lot of renal cats with hearty appetites that beg
for
> > k/d, do you, Steve? The low protein, phosphorus and sodium content
makes
> > k/d unpalatable to many (most) renal cats.
>
> Oh nonsense, k/d is more palatable than Friskies canned foods.


Bull****! K/d is one of the most- if not the most- unpalatable diets on the
market. Hill's receives so many complaints about cats refusing to eat k/d
that they routinely recommend adding oregano. Even in this newsgroup and
especially in the CRF lists *many* people say they have a lot of trouble
getting their cats to eat k/d. More renal cats won't eat k/d than renal
cats that will. Save your sales bull**** for someone that doesn't know any
better. You're not helping yours or Hill's credibility.


We've
> done the PAL studies so many times in so many places it's ridiculous.


Yeah- with pres-selected cats who would eat anything. Maybe you should join
the CRF lists to learn what's happening in the real world with renal cats.
What would you do without Hill's studies? Think for yourself?



> The problem is not with the food, but with the practitioner. Any cat
> which is sick, in the hospital,


Now you're being stupid. I'm referring to cats fed at home by their owners-
and you know it. *Every* vet I know or have known have said most of their
clients' renal cats won't eat k/d.


>
> As for the 1/2 gram protein nonsense - You are assuming that cat owners
> only provide the bare minimum of foods - yea right - that's why we have
> such an epidemic of obesity in cats I suppose?


You're being stupid, again. Renal cats generally have poor appetites due to
azotemia. That's one of the reasons why so many renal cats lose body mass-
the other reason is the poor palatability of renal diets in general- and k/d
specifically.

blkcatgal
December 10th 05, 04:49 AM
My cat, who is usually not a picky eater, will not eat canned K/D. He may
eat a few bites of a freshly opened can, but that's about it. He does like
the dry though. But I would much rather feed him a canned diet.

I even wrote to Hills asking if they would consider offering the
prescription diet foods in a 3 oz size since I was throwing half a can away
all the time. I was told to add a little hot water to the cold food or
microwave it. My cat still refused to eat it.

My previous cat, who did have CRF, also refused to eat canned or dry K/D.

Sue

"Phil P." > wrote in message
k.net...
>
> "Steve Crane" > wrote in message
> ups.com...
>>
>> Phil P. wrote:
>> > "Steve Crane" > wrote in message
>> > ups.com...
>>
>> > What? 1/2 gram above the bare minimum protein requirement? That means
> the
>> > cat must lick the dish clean to get her minimum daily protein
>> > requirement. Know a lot of renal cats with hearty appetites that beg
> for
>> > k/d, do you, Steve? The low protein, phosphorus and sodium content
> makes
>> > k/d unpalatable to many (most) renal cats.
>>
>> Oh nonsense, k/d is more palatable than Friskies canned foods.
>
>
> Bull****! K/d is one of the most- if not the most- unpalatable diets on
> the
> market. Hill's receives so many complaints about cats refusing to eat k/d
> that they routinely recommend adding oregano. Even in this newsgroup and
> especially in the CRF lists *many* people say they have a lot of trouble
> getting their cats to eat k/d. More renal cats won't eat k/d than renal
> cats that will. Save your sales bull**** for someone that doesn't know
> any
> better. You're not helping yours or Hill's credibility.
>
>
> We've
>> done the PAL studies so many times in so many places it's ridiculous.
>
>
> Yeah- with pres-selected cats who would eat anything. Maybe you should
> join
> the CRF lists to learn what's happening in the real world with renal cats.
> What would you do without Hill's studies? Think for yourself?
>
>
>
>> The problem is not with the food, but with the practitioner. Any cat
>> which is sick, in the hospital,
>
>
> Now you're being stupid. I'm referring to cats fed at home by their
> owners-
> and you know it. *Every* vet I know or have known have said most of their
> clients' renal cats won't eat k/d.
>
>
>>
>> As for the 1/2 gram protein nonsense - You are assuming that cat owners
>> only provide the bare minimum of foods - yea right - that's why we have
>> such an epidemic of obesity in cats I suppose?
>
>
> You're being stupid, again. Renal cats generally have poor appetites due
> to
> azotemia. That's one of the reasons why so many renal cats lose body
> mass-
> the other reason is the poor palatability of renal diets in general- and
> k/d
> specifically.
>
>
>
>
>

Steve Crane
December 10th 05, 03:24 PM
Phil P. wrote:
Phil,
I can only rely upon the hard data that exists - not antecdotal
claims and internet mythology. Point in fact Feline k/d is the second
largest selling feline diet, fed to literally millions of cats around
the world. We handle over 400 calls each day from vet clinics who call
for advice, to get questions answered, and of course to complain. The
complaints on k/d palatability have gone so low since the new products
were introduced that they don't even fall into the Top 50 category
anymore. Those are simple facts. Considering that it is the second
highest volume diet - second only to c/d - logic would dictate that the
number of complaints on palatability would rank second - and it isn't
even close.
As for PAL testing, that has been done by the accepted methodology,
accepted by every researcher as the Gold Standard in PAL testing. That
testing has been done on colonies of cats in four different continents,
on cats that are not Hill's cats. The PAL on k/d vastly beat any other
manufacturer of any renal diet manufactured and in fact is tested
against Fancy Feast.
The reality is that cats that are sick, in uremic crisis, aren't
going to eat much of anything. To expect "kitty kandy" PAL with these
cats is fantasyland. An even better reason to put cats on k/d early and
avoid getting into uremic crisis when it isn't necessary.

Phil P.
December 11th 05, 06:06 AM
"Steve Crane" > wrote in message
oups.com...
>
> Phil P. wrote:
> Phil,

> I can only rely upon the hard data that exists -



I don't consider manufacturers' biased studies exactly "hard data". You've
got to learn how to balance clinical studies with real life.



Point in fact Feline k/d is the second
> largest selling feline diet, fed to literally millions of cats around
> the world.

What do you expect? K/d is the *only* kidney diet that's available from
most vets- Hill's makes sure of that by making vets offers that are hard to
refuse.

X/d or even g/d are much better diets for early stage CRF.

You used to have credibility- but now you sound like a used car salesman.

Steve Crane
December 11th 05, 05:15 PM
Phil P. wrote:
> "Steve Crane" > wrote in message
> oups.com...
> >
> > Phil P. wrote:
> > Phil,
>
> > I can only rely upon the hard data that exists -

> I don't consider manufacturers' biased studies exactly "hard data". You've
> got to learn how to balance clinical studies with real life.

I see then - Grade 1 Evidence Based, triple blinded, naturally ocurring
disease, clinical trial(s) (two of them now) conducted by a University
has less weight than your anecdotal evidence??? I'm surprised - you
have always held that clinical trials had more weight than Aunt Edith's
opinions expressed over the internet. Why the sudden change in opinion?


> Point in fact Feline k/d is the second
> > largest selling feline diet, fed to literally millions of cats around
> > the world.
>
> What do you expect? K/d is the *only* kidney diet that's available from
> most vets- Hill's makes sure of that by making vets offers that are hard to
> refuse.

Oh BS - that's utter BS in the extreme. Vets can choose from Purina,
Eukanuba, Royal Canin, IVD, and in Europe Leo. why do they choose k/d?
- because the data - in the form of clinical trials supports the
choice. Why do you think Purina has so much trouble selling NF - could
it be because they don't have a single Grade 1 published study to
support it? What offers does Hill's make? None, in comparison to what
the competition is offering. Purina, Eukanuba, Royal Canin are all
giving away tens of thousands of pounds in free product. We haven't had
a promotional program on k/d in over six years - back when we made
major changes to the canine products. That promotion was tied into the
newly announced Heska ERD kit. In contrast the other Big 3 - Purina,
Eukanuba and Royal Canin are giving away literally thousands of pounds
of food every week. Flat out giving it away free, no strings, in fact
the clinic hasn't even ordered it and doesn't even know it's coming,
the products just show up unannounced. I suppose you are going to fall
back on the utter nonsense that we pay the tuition for all the vets?
Let me know when you find a vet that agrees to that nonsense.

> X/d or even g/d are much better diets for early stage CRF.

No they are not - neither has any published data to support that
position. Neither has the unique nutrients required for treating CRF.
Are they better than Purina Pro Plan Ocean Fish and Crab in Aspic with
zero carbs and 2.1% phos - sure, but they are not the right choice for
CRF - at any stage where veterinarians can commonly diagnose it.

> You used to have credibility- but now you sound like a used car salesman.

Facts are facts Phil - Facts are that there are now two Grade 1
Evidence Based clinical trials that prove that k/d is the right choice
as soon as CRF is detected. One done in England and one done by Polzin
and Ross to be published later this year. This is a debate that you are
destined to lose, because the data is piling up against you. Over the
course of the next three years you will see further clinical trials
completed which further disprove your position, and that all those
Hi-Pro fanatics urging increased protein, are simply out to lunch.

Facts are facts in regards to the PAL issues as well. The facts are
that k/d is the second most commonly sold Prescription Diet and
literally millions of cats all over the world eat it without any
problems. Facts are Facts that k/d PAL issues are not even in the Top
50 reasons that praticing vets call about. This is quantifiable data -
not simply an "opinion". Quantifiable data always trumps anecdotal
opinions - at least it used to - unless you have decided to go over to
the dark side and accept internet mythology and Aunt Edith's anecdotal
opinions instead of quantifiable facts.

Phil P.
December 11th 05, 11:24 PM
"Steve Crane" > wrote in message
ps.com...
>
> Phil P. wrote:
> > "Steve Crane" > wrote in message
> > oups.com...
> > >
> > > Phil P. wrote:
> > > Phil,
> >
> > > I can only rely upon the hard data that exists -
>
> > I don't consider manufacturers' biased studies exactly "hard data".
You've
> > got to learn how to balance clinical studies with real life.
>
> I see then - Grade 1 Evidence Based, triple blinded, naturally ocurring
> disease, clinical trial(s) (two of them now) conducted by a University
> has less weight than your anecdotal evidence???


When my "anecdotal evidence" is based on my personal *direct first-hand
experience"-- absolutely!

Lets see if I understand you correctly: If a study tells you early renal
cats do better on k/d, but in real life you can actually see the cats
deteriorate. So you swtich the cats to a higher protein diet and all of
them have dramatic improvements in their clinical condition. Are you going
to ignore what your own two eyes tell you because of something you read in a
study? Are you really that weak-minded?

If a study tells you cats love k/d but in real life the cat won't touch it,
you'll still believe the cat loves k/d because the study says so and the
hell with what your own eyes tell you. LOL!

Hey Steve: "These aren't the droids you're looking for". lol




I'm surprised - you
> have always held that clinical trials had more weight than Aunt Edith's
> opinions expressed over the internet.


I'm not talking about Aunt Edit's opinions. Nothing and nobody carries more
weight for me than my own direct, first-hand experiences.



> Why the sudden change in opinion?



What are you talking about? I haven't had a change in opinion. I've been
saying k/d is too low in protein for early renal cats, and that most cats
find k/d unpalatable for years.



>
>
> > Point in fact Feline k/d is the second
> > > largest selling feline diet, fed to literally millions of cats around
> > > the world.
> >
> > What do you expect? K/d is the *only* kidney diet that's available from
> > most vets- Hill's makes sure of that by making vets offers that are hard
to
> > refuse.
>
> Oh BS - that's utter BS in the extreme. Vets can choose from Purina,
> Eukanuba, Royal Canin, IVD, and in Europe Leo. why do they choose k/d?


Because Hill's gives better kick-backs and perks- that's why. You know it
and I know it.



> > X/d or even g/d are much better diets for early stage CRF.
>
> No they are not -


Tell that to the cats that *improved* after switching to x/d from k/d.



neither has any published data to support that
> position.


There isn't any "published data" that refutes x/d either-


>
> > You used to have credibility- but now you sound like a used car
salesman.
>
> Facts are facts Phil -


Reality is reality- Steve. Your facts were tailor made for Hills.


This is a debate that you are
> destined to lose,


How can you say I'm destined to lose when I've already won- time and time
again with several early renal cats? You don't seem to understand, I have no
need to debate the issue because I've already seen cats deteriorate on k/d
and improve after switching to x/d.

What I don't understand is how you can argue over something you know nothing
about! You have no direct first hand experience- you're a *salesman*- and
you've never even tried x/d in an early renal cat- so how
the ****** do you know which is better? You've been relying on Hill's
funded studies for so long that you've lost the ability to think and reason
for yourself.

I've *seen* early renal cats improve after switching from k/d to x/d. That's
all there is to it. You don't have to like it. There's *nothing* that you
or anyone else can say that will change reality. What the hell is wrong
with you? How can you presume to tell me that our cats didn't improve on
x/d?



> because the data is piling up against you.


I wouldn't bet on that just yet, Steve. Here's a quote from your buddies
Polzin and Osborne from Ettinger's text:

"Current evidence suggests that protein restriction probably has only a
minimal effect, if any, on progression of renal failure."

David J. Polzin, DVM, PhD, Diplomate ACVIM
Professor, College of Veterinary Medicine University of Minnesota, St. Paul,
Minnesota

Carl A. Osborne, DVM, PhD, Diplomate ACVIM
Professor, Department of Small Animal Clinical Sciences, College of
Veterinary
Medicine, University of Minnesota, St. Paul, Minnesota



Here's a repost of Greg Grauer article in SAIM:

Gregory F. Grauer, DVM, MS, Dipl. ACVIM (SAIM)

"Researchers have established that the minimum protein requirements for dogs
and cats with CRF are higher than those of normal dogs and cats. Ideally,
dogs with CRF should receive a minimum of 2 to 2.2 g and cats a minimum of
3.3 to 3.5 g of protein per kilogram per day."

or 13.2 to 14 g/day for a 4 kg cat. Do the math- k/d contains 6.6 g of
protein /100 kcal. - which translates into about 12 g/day for a 4 kg cat.
Don't forget to consider urinary protein losses. Sure looks like a negative
nitrogen balance on my calculator.

PawsForThought
December 12th 05, 12:53 PM
Phil P. wrote:
> "Steve Crane" > wrote in message
> ups.com...
> >
> > Dr. Martin - I would have to disagree, the recent studies have been
> > pretty overwhelming that the sooner k/d is started, the better the
> > results. k/d contains more than enough protein for a normal healthy
> > cat, let alone a renal failure cat.
>
> What? 1/2 gram above the bare minimum protein requirement? That means the
> cat must lick the dish clean to get her minimum daily protein
> requirement. Know a lot of renal cats with hearty appetites that beg for
> k/d, do you, Steve? The low protein, phosphorus and sodium content makes
> k/d unpalatable to many (most) renal cats.

My vet had prescribed k/d for a cat I had that had CRF. She wouldn't
touch it. She would eat the a/d (I believe that's what it was called),
but unfortunately only for a couple of days, then she wouldn't touch
that either. I went back to feeding her Fancy Feast. Yes, I know that
the greatest food for a CRF cat, but at that point, I just needed to
get food in her.

PawsForThought
December 12th 05, 01:11 PM
Steve Crane wrote:
Oh nonsense, k/d is more palatable than Friskies canned foods. We've
> done the PAL studies so many times in so many places it's ridiculous.
> The problem is not with the food, but with the practitioner. Any cat
> which is sick, in the hospital, out of its comfort zone, and then
> presented with a new food will do two things. 1) reject the food, and
> 2) associate the food with the hospital and being sick. Placing a CRF
> cat on k/d while in the hospital is a mistake. Three or four more days
> on _any_ food isn't going to affect the cat. Once home and once the
> cat is feeling a bit better - THEN the food needs to be changed.

Mmm....my CRF cat definitely thought Friskies and Fancy Feast were
tastier than K/D. She was fed K/D at home, not at the vet's. I don't
think my experience is that different than a lot of people who have CRF
cats and try to feed K/D.

December 12th 05, 03:26 PM
PawsForThought wrote:
> Steve Crane wrote:
> Oh nonsense, k/d is more palatable than Friskies canned foods. We've
> > done the PAL studies so many times in so many places it's ridiculous.
> > The problem is not with the food, but with the practitioner. Any cat
> > which is sick, in the hospital, out of its comfort zone, and then
> > presented with a new food will do two things. 1) reject the food, and
> > 2) associate the food with the hospital and being sick. Placing a CRF
> > cat on k/d while in the hospital is a mistake. Three or four more days
> > on _any_ food isn't going to affect the cat. Once home and once the
> > cat is feeling a bit better - THEN the food needs to be changed.
>
> Mmm....my CRF cat definitely thought Friskies and Fancy Feast were
> tastier than K/D. She was fed K/D at home, not at the vet's. I don't
> think my experience is that different than a lot of people who have CRF
> cats and try to feed K/D.

What year was this, Lauren? Most people's cats will prefer grocery
store crap to k/d; especially with all of the salt that is normally
present in those foods. Years ago there used to be a palatabilty
issue, but not so much these days. It's interesting to note how people
will take an experience they have and extrapolate that to cover
millions of other people's cats! Also interesting is that I don't
recall Lauren EVER mentioning that she had a cat that experienced renal
failure, let alone ever being fed k/d from Hill's, the company she
hates! ;)

There are numerous circumstances impacting cats with renal failure.
There are 3 different versions of Feline k/d available. Most people
judge their experiences on one version that was fed many years ago.
Those examples ususally don't apply to what the situation is, TODAY.
Steve has a valid point here. Anyone else who had a cat that liked
something else may have a point as well. But, instead, it looks like
we are in for a fresh round of Hill's Hating.

5cats
December 12th 05, 04:22 PM
wrote:

>
> PawsForThought wrote:
>> Steve Crane wrote:
>> Oh nonsense, k/d is more palatable than Friskies canned foods. We've
>> > done the PAL studies so many times in so many places it's
ridiculous.
>> > The problem is not with the food, but with the practitioner. Any cat
>> > which is sick, in the hospital, out of its comfort zone, and then
>> > presented with a new food will do two things. 1) reject the food,
and
>> > 2) associate the food with the hospital and being sick. Placing a
CRF
>> > cat on k/d while in the hospital is a mistake. Three or four more
days
>> > on _any_ food isn't going to affect the cat. Once home and once the
>> > cat is feeling a bit better - THEN the food needs to be changed.
>>
>> Mmm....my CRF cat definitely thought Friskies and Fancy Feast were
>> tastier than K/D. She was fed K/D at home, not at the vet's. I don't
>> think my experience is that different than a lot of people who have
CRF
>> cats and try to feed K/D.
>
> What year was this, Lauren? Most people's cats will prefer grocery
> store crap to k/d; especially with all of the salt that is normally
> present in those foods.

That's what I see in my cats. They do eat K/D willingly, even the healthy
ones -- when/if I don't keep them away from it. But if I have both foods
out, they go to the Friskies canned first. (They get Friskies as a treat
only a couple times a year, I think of it as being equivalent to me
eating a Wendy's or McD hamburger once in a long while.)

But, it was Steve who said the opposite (unless maybe he meant something
other than grocery store Friskies)

>> Steve Crane wrote:
>> Oh nonsense, k/d is more palatable than Friskies canned foods. We've

Phil P.
December 12th 05, 05:30 PM
" > wrote in message
oups.com...

Most people
> judge their experiences on one version that was fed many years ago.

Only one out of 5 or 6 of our renal cats will eat *any* version of k/d-
regular canned, canned w/chicken or dry. The ones that do eat k/d, don't
eat enough of it to meet their caloric/protein needs and need to be
supplemented with g/d or mostly x/d. This is *now*- the *present*. A few
years ago, k/d was even more unpalatable.

Even though k/d is too low in protein for cats in early stage CRF, I
wouldn't have a problem with it if the cats would eat enough of it- but they
don't. It doesn't matter how perfectly formulated a diet is if the cat
won't eat it.

PawsForThought
December 12th 05, 06:02 PM
5cats wrote:
That's what I see in my cats. They do eat K/D willingly, even the
healthy
> ones -- when/if I don't keep them away from it. But if I have both foods
> out, they go to the Friskies canned first. (They get Friskies as a treat
> only a couple times a year, I think of it as being equivalent to me
> eating a Wendy's or McD hamburger once in a long while.)

I tried feeding it by itself, and with other foods. My cat was even on
Periactin and she still wouldn't eat the K/D. She did eat the A/D for
a couple of days though, but that's not a "renal diet". I would have
loved it if she ate the K/D but no such luck. Maybe they need to stink
it up more like their A/D is.

J. Martin
December 13th 05, 03:36 AM
"Steve Crane" > wrote in message
ps.com...
>
> Phil P. wrote:
..
>
>> X/d or even g/d are much better diets for early stage CRF.
>
> No they are not - neither has any published data to support that
> position. Neither has the unique nutrients required for treating CRF.


Steve,

I specifically recall a poster provided by Hills to veterinary clinics
listing medical conditions and appropriate diets. On that chart G/D was
listed as one of the diets appropriate for treating early renal disease.
Justification in the literature provided by Hills included slightly reduced
levels of high quality protein (higher density of essential amino acids),
decreased levels of sodium and phosphorus, elevated levels of omega 3 and 6
fatty acids and, I think, a balance of soluble and insoluble fibre that
decreased the amount of urea absorbed from the colon (Perhaps is was a sales
rep that mentioned the last one). That was a few years ago. Has Hill's
changed their tune about G/D and its use in early renal disease since then?
More importantly, have they changed the formulation? Perhaps I should be
speaking to the medi-cal/royal canin rep to find out if they offer a better
diet for my purposes. Bear in mind that I'm not trying to be
confrontational here, I just want to provide the best for my patients.

J.

J. Martin
December 13th 05, 04:20 AM
"Steve Crane" > wrote in message
oups.com...
>
.. We handle over 400 calls each day from vet clinics who call
> for advice, to get questions answered, and of course to complain. The
> complaints on k/d palatability have gone so low since the new products
> were introduced that they don't even fall into the Top 50 category
> anymore.

It's not been my experience K/D or any of the other renal diets are very
palatable to cats (although I do agree that the newer K/D formulations have
improved in palatability). Yet I can't think of too many vets that would go
through the trouble of calling Hills and complaining about it.

It would be more interesting if you had access to returns statitistics. In
Canada at least, Hills offers a palatability guarantee for all their
prescription diets. If someone's pet doesn't like the food they can bring it
back to the vet for a full refund. We just call Hills and tell them what
was returned and our account is credited. I'd be willing to bet that K/D
ranks pretty high on the list of returned food.

J.

Elizabeth Blake
December 14th 05, 03:46 AM
Phil P." > wrote in message
k.net...

> Even though k/d is too low in protein for cats in early stage CRF, I
> wouldn't have a problem with it if the cats would eat enough of it- but
> they
> don't. It doesn't matter how perfectly formulated a diet is if the cat
> won't eat it.

I brought Tiger back to the vet today, to learn how to give her the fluids.
I asked the vet whether it was the right thing to do, starting her so soon.
She kept insisting that it was, and that it was better to start now than
wait until she declines too much. She again pulled up Tiger's skin to show
me how it doesn't smooth out immediately, and said she's dehydrated. Now, I
live with this cat and I see her drink plenty of water. If I put 10 bowls
of water in different corners of my apartment, she'd make sure to visit all
10. When Harriet was staying with me, all Tiger wanted was to get into the
bedroom because she knew there was another water fountain in there. She
eats only wet food. So, the "dehydration" hasn't convinced me she needs the
extra fluids, but would the extra fluids be good for her kidneys?

She also recommended starting her on a Eukanuba prescription food, which she
said wasn't as protein restricted as the Hill's. I didn't get any food
today, because I'd like to read more about kidney problems. I did come home
with a bag of fluid and needles, but I told the vet I was going to do some
more research before deciding what to do.

Any good, basic web sites I can start with?

--
Liz

blkcatgal
December 14th 05, 04:35 AM
A couple of good sites about CRF.....felinecrf.com and felinecrf.org.

Sue

"Elizabeth Blake" > wrote in message
ink.net...
> Phil P." > wrote in message
> k.net...
>
>> Even though k/d is too low in protein for cats in early stage CRF, I
>> wouldn't have a problem with it if the cats would eat enough of it- but
>> they
>> don't. It doesn't matter how perfectly formulated a diet is if the cat
>> won't eat it.
>
> I brought Tiger back to the vet today, to learn how to give her the
> fluids. I asked the vet whether it was the right thing to do, starting her
> so soon. She kept insisting that it was, and that it was better to start
> now than wait until she declines too much. She again pulled up Tiger's
> skin to show me how it doesn't smooth out immediately, and said she's
> dehydrated. Now, I live with this cat and I see her drink plenty of
> water. If I put 10 bowls of water in different corners of my apartment,
> she'd make sure to visit all 10. When Harriet was staying with me, all
> Tiger wanted was to get into the bedroom because she knew there was
> another water fountain in there. She eats only wet food. So, the
> "dehydration" hasn't convinced me she needs the extra fluids, but would
> the extra fluids be good for her kidneys?
>
> She also recommended starting her on a Eukanuba prescription food, which
> she said wasn't as protein restricted as the Hill's. I didn't get any
> food today, because I'd like to read more about kidney problems. I did
> come home with a bag of fluid and needles, but I told the vet I was going
> to do some more research before deciding what to do.
>
> Any good, basic web sites I can start with?
>
> --
> Liz
>

December 14th 05, 02:55 PM
J. Martin wrote:
> "Steve Crane" > wrote in message
> oups.com...
> >
> . We handle over 400 calls each day from vet clinics who call
> > for advice, to get questions answered, and of course to complain. The
> > complaints on k/d palatability have gone so low since the new products
> > were introduced that they don't even fall into the Top 50 category
> > anymore.
>
> It's not been my experience K/D or any of the other renal diets are very
> palatable to cats (although I do agree that the newer K/D formulations have
> improved in palatability). Yet I can't think of too many vets that would go
> through the trouble of calling Hills and complaining about it.
>
> It would be more interesting if you had access to returns statitistics. In
> Canada at least, Hills offers a palatability guarantee for all their
> prescription diets. If someone's pet doesn't like the food they can bring it
> back to the vet for a full refund. We just call Hills and tell them what
> was returned and our account is credited. I'd be willing to bet that K/D
> ranks pretty high on the list of returned food.
>
> J.

I realize this is anecdotal, but I've asked several vets if they see
many returns on feline k/d and they said "not really". Almost all of
the comments were to the tune of "it seems to be much more palatable
than before"....

Phil P.
December 14th 05, 05:36 PM
" > wrote in message
oups.com...
>
> J. Martin wrote:
> > "Steve Crane" > wrote in message
> > oups.com...
> > >
> > . We handle over 400 calls each day from vet clinics who call
> > > for advice, to get questions answered, and of course to complain. The
> > > complaints on k/d palatability have gone so low since the new products
> > > were introduced that they don't even fall into the Top 50 category
> > > anymore.
> >
> > It's not been my experience K/D or any of the other renal diets are very
> > palatable to cats (although I do agree that the newer K/D formulations
have
> > improved in palatability). Yet I can't think of too many vets that
would go
> > through the trouble of calling Hills and complaining about it.
> >
> > It would be more interesting if you had access to returns statitistics.
In
> > Canada at least, Hills offers a palatability guarantee for all their
> > prescription diets. If someone's pet doesn't like the food they can
bring it
> > back to the vet for a full refund. We just call Hills and tell them
what
> > was returned and our account is credited. I'd be willing to bet that
K/D
> > ranks pretty high on the list of returned food.
> >
> > J.
>
> I realize this is anecdotal, but I've asked several vets if they see
> many returns on feline k/d and they said "not really". Almost all of
> the comments were to the tune of "it seems to be much more palatable
> than before"....

Most of the vets I work with complain about unpalatability of k/d and how
difficult patient compliance is to achieve.

How is it that you come in contact with "several vets"?

Steve Crane
December 14th 05, 05:48 PM
Dr. Martin,
If you take a look at the current Hill's Key - even one going back
a few years you will find that g/d is no longer recommended for early
renal disease, it is now recommended for renal insufficiency in
hyperlipidemic or obese prone patients. It is also a terrific early
cardiac diet We stopped recommending g/d in dogs for "early" renal
disease when the Polzin study came out several years ago.
There was no change to the g/d formulation, but there was a
significant change in the k/d formulation after we brought out l/d. k/d
was originally a dual purpose food for liver and renal disease. The
problem was that we needed increased protein in liver disease, but not
in renal disease. By bringing out the l/d product for liver disease we
no longer needed to keep the higher levels of protein in k/d. The
change in canine k/d ocurred in 1998 or 99.
I don't consider this in the least confrontational :-) By the way
Sheri Ross posted a note on the AAVN listserver this morning that
further adds to the reasons why k/d feline should be used as early as
renal disease is detected.

>From the AAVN listserver:

Dr. Sheri Ross just completed a clinical trial described below and she
had these comments regarding renal diets.

"We generally recommend that cats be gradually switched to a diet
formulated for the treatment of renal failure at the time of diagnosis.
We have recently completed a double-blinded, randomized, clinical trial
designed to determine if a renal diet is superior to an adult
maintenance diet in minimizing uremic episodes and mortality rate in
cats with stages 2 and 3 chronic kidney disease (serum creatinine 2.1 -
4.5mg/dl at the time of enrollment in the 2-year study). Throughout the
study we were unable to identify laboratory abnormalities that would
allow us to reliably predict which cats were at the greatest risk of
developing uremic crises, and therefore would have been most likely to
benefit from dietary modification. Since the results of our study
indicate that the renal diet prevented or delayed uremic crises and
death, we recommend that renal diets be initiated for all cats with
mild (serum creatinine concentration >2.0mg/dl) chronic renal failure.
The study manuscript is currently in the process of review and will
hopefully be published soon!"

Sheri Ross, DVM
Assistant Clinical Professor
Small Animal Internal Medicine (Nephrology/Urology)
University of Minnesota Veterinary Teaching Hospital
1365 Gortner Ave., Saint Paul, MN 55108

Steve Crane
December 14th 05, 06:02 PM
Phil P. wrote:
> "Steve Crane" > wrote in message

Posted this morning on the AAVN listserver.


"We generally recommend that cats be gradually switched to a diet
formulated for the treatment of renal failure at the time of diagnosis.
We have recently completed a double-blinded, randomized, clinical trial
designed to determine if a renal diet is superior to an adult
maintenance diet in minimizing uremic episodes and mortality rate in
cats with stages 2 and 3 chronic kidney disease (serum creatinine 2.1 -
4.5mg/dl at the time of enrollment in the 2-year study). Throughout the
study we were unable to identify laboratory abnormalities that would
allow us to reliably predict which cats were at the greatest risk of
developing uremic crises, and therefore would have been most likely to
benefit from dietary modification. Since the results of our study
indicate that the renal diet prevented or delayed uremic crises and
death, we recommend that renal diets be initiated for all cats with
mild (serum creatinine concentration >2.0mg/dl) chronic renal failure.
The study manuscript is currently in the process of review and will
hopefully be published soon!"

Sheri Ross, DVM
Assistant Clinical Professor
Small Animal Internal Medicine (Nephrology/Urology)
University of Minnesota Veterinary Teaching Hospital
1365 Gortner Ave., Saint Paul, MN 55108

Steve Crane
December 14th 05, 06:03 PM
Phil P. wrote:
> "Steve Crane" > wrote in message

Posted this morning on the AAVN listserver.


"We generally recommend that cats be gradually switched to a diet
formulated for the treatment of renal failure at the time of diagnosis.
We have recently completed a double-blinded, randomized, clinical trial
designed to determine if a renal diet is superior to an adult
maintenance diet in minimizing uremic episodes and mortality rate in
cats with stages 2 and 3 chronic kidney disease (serum creatinine 2.1 -
4.5mg/dl at the time of enrollment in the 2-year study). Throughout the
study we were unable to identify laboratory abnormalities that would
allow us to reliably predict which cats were at the greatest risk of
developing uremic crises, and therefore would have been most likely to
benefit from dietary modification. Since the results of our study
indicate that the renal diet prevented or delayed uremic crises and
death, we recommend that renal diets be initiated for all cats with
mild (serum creatinine concentration >2.0mg/dl) chronic renal failure.
The study manuscript is currently in the process of review and will
hopefully be published soon!"

Sheri Ross, DVM
Assistant Clinical Professor
Small Animal Internal Medicine (Nephrology/Urology)
University of Minnesota Veterinary Teaching Hospital
1365 Gortner Ave., Saint Paul, MN 55108

Steve Crane
December 14th 05, 06:03 PM
Phil P. wrote:
> "Steve Crane" > wrote in message

Posted this morning on the AAVN listserver.


"We generally recommend that cats be gradually switched to a diet
formulated for the treatment of renal failure at the time of diagnosis.
We have recently completed a double-blinded, randomized, clinical trial
designed to determine if a renal diet is superior to an adult
maintenance diet in minimizing uremic episodes and mortality rate in
cats with stages 2 and 3 chronic kidney disease (serum creatinine 2.1 -
4.5mg/dl at the time of enrollment in the 2-year study). Throughout the
study we were unable to identify laboratory abnormalities that would
allow us to reliably predict which cats were at the greatest risk of
developing uremic crises, and therefore would have been most likely to
benefit from dietary modification. Since the results of our study
indicate that the renal diet prevented or delayed uremic crises and
death, we recommend that renal diets be initiated for all cats with
mild (serum creatinine concentration >2.0mg/dl) chronic renal failure.
The study manuscript is currently in the process of review and will
hopefully be published soon!"

Sheri Ross, DVM
Assistant Clinical Professor
Small Animal Internal Medicine (Nephrology/Urology)
University of Minnesota Veterinary Teaching Hospital
1365 Gortner Ave., Saint Paul, MN 55108

Phil P.
December 14th 05, 07:10 PM
"Steve Crane" > wrote in message
oups.com...
>
> Phil P. wrote:
> > "Steve Crane" > wrote in message
>
> Posted this morning on the AAVN listserver.
>
>
> "We generally recommend that cats be gradually switched to a diet
> formulated for the treatment of renal failure at the time of diagnosis.
> We have recently completed a double-blinded, randomized, clinical trial
> designed to determine if a renal diet is superior to an adult
> maintenance diet in minimizing uremic episodes and mortality rate in
> cats with stages 2 and 3 chronic kidney disease

>
> Sheri Ross, DVM
> Assistant Clinical Professor
> Small Animal Internal Medicine (Nephrology/Urology)
> University of Minnesota Veterinary Teaching Hospital
> 1365 Gortner Ave., Saint Paul, MN 55108
>
>

Chapter 260 pages 1773 - 1785 Chronic Kidney Disease
TEXTBOOK OF VETERINARY INTERNAL MEDICINE, SIXTH EDITION
0-7216-0117-0 Copyright 2005, Elsevier Inc.

David J. Polzin
Carl A. Osborne
Sheri Ross


"Although the ideal quantity of protein to feed dogs and cats with CKD
remains unresolved, a general consensus of opinion supports the fact that
reducing protein intake ameliorates clinical signs of uremia in CKD and is
therefore indicated for stage ****4**** CKD."

"The concept of reducing dietary protein intake in CKD patients that do not
have clinical signs of uremia has been questioned. Limiting protein intake
has been advocated for these patients to slow progression of CKD. This
suggestion derives from studies in rats indicating that dietary protein
restriction limits glomerular hyperfiltration and hypertension and slows the
spontaneous decline in kidney function that follows reduction in kidney
mass. Studies in humans have supported the concept that protein restriction
slows progression of CKD, albeit this effect may be small. In contrast,
multiple studies have failed to confirm a beneficial role for protein
restriction in limiting progression of kidney disease in dogs or cats."

"Although a role for protein restriction in slowing progression of canine
and feline CKD has not been entirely excluded, available evidence fails to
support a recommendation for or against protein restriction in patients with
stage 3 CKD."

Give it a rest, Steve.

Phil P.
December 14th 05, 07:10 PM
"Steve Crane" > wrote in message
oups.com...
>
> Phil P. wrote:
> > "Steve Crane" > wrote in message
>
> Posted this morning on the AAVN listserver.
>
>
> "We generally recommend that cats be gradually switched to a diet
> formulated for the treatment of renal failure at the time of diagnosis.
> We have recently completed a double-blinded, randomized, clinical trial
> designed to determine if a renal diet is superior to an adult
> maintenance diet in minimizing uremic episodes and mortality rate in
> cats with stages 2 and 3 chronic kidney disease

>Sheri Ross, DVM
>Assistant Clinical Professor
>Small Animal Internal Medicine (Nephrology/Urology)

Chapter 260 pages 1773 - 1785 Chronic Kidney Disease
TEXTBOOK OF VETERINARY INTERNAL MEDICINE, SIXTH EDITION
0-7216-0117-0 Copyright 2005, Elsevier Inc.

David J. Polzin
Carl A. Osborne
Sheri Ross


"Although the ideal quantity of protein to feed dogs and cats with CKD
remains unresolved, a general consensus of opinion supports the fact that
reducing protein intake ameliorates clinical signs of uremia in CKD and is
therefore indicated for ****stage 4**** CKD."

"The concept of reducing dietary protein intake in CKD patients that do not
have clinical signs of uremia has been questioned. Limiting protein intake
has been advocated for these patients to slow progression of CKD. This
suggestion derives from studies in rats indicating that dietary protein
restriction limits glomerular hyperfiltration and hypertension and slows the
spontaneous decline in kidney function that follows reduction in kidney
mass. Studies in humans have supported the concept that protein restriction
slows progression of CKD, albeit this effect may be small. In contrast,
multiple studies have failed to confirm a beneficial role for protein
restriction in limiting progression of kidney disease in dogs or cats."

"Although a role for protein restriction in slowing progression of canine
and feline CKD has not been entirely excluded, available evidence fails to
support a recommendation for or against protein restriction in patients with
stage 3 CKD."

Give it a rest, Steve.

Phil P.
December 14th 05, 07:10 PM
"Steve Crane" > wrote in message
oups.com...
> Dr. Martin,
> If you take a look at the current Hill's Key - even one going back
> a few years you will find that g/d is no longer recommended for early
> renal disease, it is now recommended for renal insufficiency in
> hyperlipidemic or obese prone patients. It is also a terrific early
> cardiac diet We stopped recommending g/d in dogs for "early" renal
> disease when the Polzin study came out several years ago.
> There was no change to the g/d formulation, but there was a
> significant change in the k/d formulation after we brought out l/d. k/d
> was originally a dual purpose food for liver and renal disease. The
> problem was that we needed increased protein in liver disease, but not
> in renal disease. By bringing out the l/d product for liver disease we
> no longer needed to keep the higher levels of protein in k/d. The
> change in canine k/d ocurred in 1998 or 99.
> I don't consider this in the least confrontational :-) By the way
> Sheri Ross posted a note on the AAVN listserver this morning that
> further adds to the reasons why k/d feline should be used as early as
> renal disease is detected.
>
> >From the AAVN listserver:
>
> Dr. Sheri Ross just completed a clinical trial described below and she
> had these comments regarding renal diets.
>
> "We generally recommend that cats be gradually switched to a diet
> formulated for the treatment of renal failure at the time of diagnosis.
> We have recently completed a double-blinded, randomized, clinical trial
> designed to determine if a renal diet is superior to an adult
> maintenance diet in minimizing uremic episodes and mortality rate in
> cats with stages 2 and 3 chronic kidney disease

>
> Sheri Ross, DVM
> Assistant Clinical Professor
> Small Animal Internal Medicine (Nephrology/Urology)
> University of Minnesota Veterinary Teaching Hospital
> 1365 Gortner Ave., Saint Paul, MN 55108
>




Chapter 260 pages 1773 - 1785 Chronic Kidney Disease
TEXTBOOK OF VETERINARY INTERNAL MEDICINE, SIXTH EDITION
0-7216-0117-0 Copyright 2005, Elsevier Inc.

David J. Polzin
Carl A. Osborne
Sheri Ross


"Although the ideal quantity of protein to feed dogs and cats with CKD
remains unresolved, a general consensus of opinion supports the fact that
reducing protein intake ameliorates clinical signs of uremia in CKD and is
therefore indicated for ****stage 4**** CKD."

"The concept of reducing dietary protein intake in CKD patients that do not
have clinical signs of uremia has been questioned. Limiting protein intake
has been advocated for these patients to slow progression of CKD. This
suggestion derives from studies in rats indicating that dietary protein
restriction limits glomerular hyperfiltration and hypertension and slows the
spontaneous decline in kidney function that follows reduction in kidney
mass. Studies in humans have supported the concept that protein restriction
slows progression of CKD, albeit this effect may be small. In contrast,
multiple studies have failed to confirm a beneficial role for protein
restriction in limiting progression of kidney disease in dogs or cats."

"Although a role for protein restriction in slowing progression of canine
and feline CKD has not been entirely excluded, available evidence fails to
support a recommendation for or against protein restriction in patients with
stage 3 CKD."

Give it a rest, Steve.

Phil P.
December 14th 05, 07:11 PM
"Steve Crane" > wrote in message
oups.com...
>
> Phil P. wrote:
> > "Steve Crane" > wrote in message
>
> Posted this morning on the AAVN listserver.
>
>
> "We generally recommend that cats be gradually switched to a diet
> formulated for the treatment of renal failure at the time of diagnosis.
> We have recently completed a double-blinded, randomized, clinical trial
> designed to determine if a renal diet is superior to an adult
> maintenance diet in minimizing uremic episodes and mortality rate in
> cats with stages 2 and 3 chronic kidney disease
>
> Sheri Ross, DVM
> Assistant Clinical Professor
> Small Animal Internal Medicine (Nephrology/Urology)
> University of Minnesota Veterinary Teaching Hospital
> 1365 Gortner Ave., Saint Paul, MN 55108
>


Chapter 260 pages 1773 - 1785 Chronic Kidney Disease
TEXTBOOK OF VETERINARY INTERNAL MEDICINE, SIXTH EDITION
0-7216-0117-0 Copyright 2005, Elsevier Inc.

David J. Polzin
Carl A. Osborne
Sheri Ross


"Although the ideal quantity of protein to feed dogs and cats with CKD
remains unresolved, a general consensus of opinion supports the fact that
reducing protein intake ameliorates clinical signs of uremia in CKD and is
therefore indicated for stage ****4**** CKD."

"The concept of reducing dietary protein intake in CKD patients that do not
have clinical signs of uremia has been questioned. Limiting protein intake
has been advocated for these patients to slow progression of CKD. This
suggestion derives from studies in rats indicating that dietary protein
restriction limits glomerular hyperfiltration and hypertension and slows the
spontaneous decline in kidney function that follows reduction in kidney
mass. Studies in humans have supported the concept that protein restriction
slows progression of CKD, albeit this effect may be small. In contrast,
multiple studies have failed to confirm a beneficial role for protein
restriction in limiting progression of kidney disease in dogs or cats."

"Although a role for protein restriction in slowing progression of canine
and feline CKD has not been entirely excluded, available evidence ****fails
to
support**** a recommendation for or against protein restriction in patients
with
stage 3 CKD."


Give it a rest, Steve.

December 14th 05, 07:37 PM
"Steve Crane" > wrote:

> If you take a look at the current Hill's Key - even one going back
>a few years you will find that g/d is no longer recommended for early
>renal disease, it is now recommended for renal insufficiency in
>hyperlipidemic or obese prone patients.


That's strange. My vet just got off the phone yesterday after talking
to a Hills' Vet and the vet at Hills said that GD is a good diet for
my cat recently diagnosed with a higher than normal Urea (14.6 mmol/L
normal 5.0 - 13.0). Cat is almost 16yrs with all other tests in normal
range. He is also concentrating his urine quite well.

He is a fussy eater and the concern was he may not like KD so my Vet
asked if GD is suitable.

-mhd

Steve Crane
December 14th 05, 10:00 PM
wrote:
> "Steve Crane" > wrote:
>
> > If you take a look at the current Hill's Key - even one going back
> >a few years you will find that g/d is no longer recommended for early
> >renal disease, it is now recommended for renal insufficiency in
> >hyperlipidemic or obese prone patients.
>
>
> That's strange. My vet just got off the phone yesterday after talking
> to a Hills' Vet and the vet at Hills said that GD is a good diet for
> my cat recently diagnosed with a higher than normal Urea (14.6 mmol/L
> normal 5.0 - 13.0). Cat is almost 16yrs with all other tests in normal
> range. He is also concentrating his urine quite well.
>
> He is a fussy eater and the concern was he may not like KD so my Vet
> asked if GD is suitable.
>
> -mhd

Not strange - did your vet diagnose renal failure? Higher than normal
BUN and still concentrating urine well isn't a diagnosis of renal
failure.

December 15th 05, 02:04 AM
"Steve Crane" > wrote:

>
wrote:
>> "Steve Crane" > wrote:
>>
>> > If you take a look at the current Hill's Key - even one going back
>> >a few years you will find that g/d is no longer recommended for early
>> >renal disease, it is now recommended for renal insufficiency in
>> >hyperlipidemic or obese prone patients.
>>
>>
>> That's strange. My vet just got off the phone yesterday after talking
>> to a Hills' Vet and the vet at Hills said that GD is a good diet for
>> my cat recently diagnosed with a higher than normal Urea (14.6 mmol/L
>> normal 5.0 - 13.0). Cat is almost 16yrs with all other tests in normal
>> range. He is also concentrating his urine quite well.
>>
>> He is a fussy eater and the concern was he may not like KD so my Vet
>> asked if GD is suitable.
>>
>> -mhd
>
>Not strange - did your vet diagnose renal failure? Higher than normal
>BUN and still concentrating urine well isn't a diagnosis of renal
>failure.

We are for now treating it as an early sign since kidney disease is
usually well advanced before showing up on a test. To further clarify
things, the urine concentration was tested 4 weeks ago and the blood
tests were 3 days ago. Next round of blood tests (2 months) we will do
a urine test during the same visit. He has started drinking more than
he used to as well and he has lost a little weight (11 lb 14oz down to
11 lbs 8 oz in 4 months). Of course it would be nice if it isn't renal
and just a temporary elevation.

-mhd

December 15th 05, 05:57 AM
Phil P. wrote:

> Most of the vets I work with complain about unpalatability of k/d and how
> difficult patient compliance is to achieve.
>
> How is it that you come in contact with "several vets"?

I think you already know the answer. ;) I walk in, just like you do.

Most vets will take a situation from years ago and apply it to today.
It's human nature. Plenty of people whom you have vehemently disagreed
with on this ng have done the same thing.

Phil P.
December 15th 05, 07:03 AM
" > wrote in message
ups.com...
>
> Phil P. wrote:
>
> > Most of the vets I work with complain about unpalatability of k/d and
how
> > difficult patient compliance is to achieve.
> >
> > How is it that you come in contact with "several vets"?
>
> I think you already know the answer. ;)


No, I don't. You don't work with cats AFAIK. I don't know if you even have
a cat.


> I walk in, just like you do.


I don't just walk in. I work with shelter and feral cats. Therefore I
work with several vets, specialists and labs, and must discuss
treatment options. So, once again, how is it that you come in contact with
"several vets" and have the opportunity to discuss patient compliance and
return statistics for k/d?


>
> Most vets will take a situation from years ago and apply it to today.


That's the point. The theory of restricting protein to slow the progression
of CRF in cats is an outdated myth based on studies in *rats*. Present
research has discovered that mechanisms that can alter the progression of
renal disease in the rat do not have the same effect in the cat or dog.



> It's human nature. Plenty of people whom you have vehemently disagreed
> with on this ng have done the same thing.


Yes, and I endeavor to correct the outdated and erroneous information.

PawsForThought
December 15th 05, 01:32 PM
Phil P. wrote:
> " > wrote in message
> ups.com...
> >
> > Phil P. wrote:
> >
> > > Most of the vets I work with complain about unpalatability of k/d and
> how
> > > difficult patient compliance is to achieve.
> > >
> > > How is it that you come in contact with "several vets"?
> >
> > I think you already know the answer. ;)
>
>
> No, I don't. You don't work with cats AFAIK. I don't know if you even have
> a cat.
>
>
> > I walk in, just like you do.
>
>
> I don't just walk in. I work with shelter and feral cats. Therefore I
> work with several vets, specialists and labs, and must discuss
> treatment options. So, once again, how is it that you come in contact with
> "several vets" and have the opportunity to discuss patient compliance and
> return statistics for k/d?
>
>
> >
> > Most vets will take a situation from years ago and apply it to today.
>
>
> That's the point. The theory of restricting protein to slow the progression
> of CRF in cats is an outdated myth based on studies in *rats*. Present
> research has discovered that mechanisms that can alter the progression of
> renal disease in the rat do not have the same effect in the cat or dog.

Hi Phil,
Haven't you heard? Gaubbie Boy is now a shill for Hill's. Since he's
now a salesman for the company he's infatuated with, I suspect his
contact with vets comes from his door to door sales techniques. Having
said that, I still don't think he knows diddly squat about cats, and is
just as obnoxious as ever.

December 15th 05, 03:30 PM
PawsForThought wrote:

>
> Hi Phil,
> Haven't you heard? Gaubbie Boy is now a shill for Hill's. Since he's
> now a salesman for the company he's infatuated with, I suspect his
> contact with vets comes from his door to door sales techniques. Having
> said that, I still don't think he knows diddly squat about cats, and is
> just as obnoxious as ever.

Lauren, I see you are now best buddies with one of your sworn enemies?
As it regards Hill's, you are so far off base, and you don't even know
it! LOL! Please refute anything I've actually said instead of trying
to smear me. Once again, you still haven't answered the questions I've
asked you in this very thread. In case anyone else doesn't know,
Lauren hates Hill's with a passion and will say anything (even if it
contradicts her previous statements) to knock Hill's. When I call you
out on the carpet for some of her remarks, she responds with name
calling and hate speech. If you must know, I am more of a liason
between vets in my area and Hill's, than a "salesman". So before you
attempt to smear me, perhaps you had better get your facts straight.

December 15th 05, 03:36 PM
Phil P. wrote:
> " > wrote in message
> ups.com...
> >
> > Phil P. wrote:
> >
> > > Most of the vets I work with complain about unpalatability of k/d and
> how
> > > difficult patient compliance is to achieve.
> > >
> > > How is it that you come in contact with "several vets"?
> >
> > I think you already know the answer. ;)
>
>
> No, I don't. You don't work with cats AFAIK. I don't know if you even have
> a cat.
>
>
> > I walk in, just like you do.
>
>
> I don't just walk in. I work with shelter and feral cats. Therefore I
> work with several vets, specialists and labs, and must discuss
> treatment options. So, once again, how is it that you come in contact with
> "several vets" and have the opportunity to discuss patient compliance and
> return statistics for k/d?

Sorry, Phil, I thought you recognized me. We've shared a few emails
back and forth a couple of years ago. I'm aware of what you do and I
find it admirable. A lot of good information that I glean from this ng
comes from your posts and while it's been a while since I've been to
your website, I've perused it from time to time. At least you cite
studies, unlike most.

Phil P.
December 16th 05, 12:45 AM
"PawsForThought" > wrote in message
> Hi Phil,
> Haven't you heard? Gaubbie Boy is now a shill for Hill's. Since he's
> now a salesman


Are you sure about that? I find it very hard to believe. What does he
sell? It *can't* be prescription diets! Perhaps he simply takes phone
orders from retail stores. I don't think Hill's would hire anyone without
some training in nutrition to deal directly with vets and stores.

Phil

Phil P.
December 16th 05, 12:46 AM
" > wrote in message >
> Lauren, I see you are now best buddies with one of your sworn enemies?


Lauren and I aren't "sworn enemies", we just have diametrically opposed
opinions concerning diets and nutrition. Raw v.commercial diet debates
always usually end up in flames- that's why they're banned on most lists.
Lauren and I actually agree on most, if not all other areas of caring for
cats.


If you must know, I am more of a liason
> between vets in my area and Hill's, than a "salesman".

That seems rather vague and could mean you might simply take phone orders.
What *exactly* do you do at Hill's?

P

December 16th 05, 02:20 AM
Phil P. wrote:
> " > wrote in message >
> > Lauren, I see you are now best buddies with one of your sworn enemies?
>
>
> Lauren and I aren't "sworn enemies", we just have diametrically opposed
> opinions concerning diets and nutrition.

WOW! You had me fooled. I'd hate to see how you two act towards people
whom you completely disagree with.

Raw v.commercial diet debates
> always usually end up in flames- that's why they're banned on most lists.

Well, then I guess what you're really commenting on is the maturity of
the contestants involved. It is possible to disagree without resorting
to the types of tactics that are employed here on a relatively frequent
basis.

Steve Crane
December 16th 05, 06:49 PM
Phil P. wrote:
> " > wrote in message
> That's the point. The theory of restricting protein to slow the progression
> of CRF in cats is an outdated myth based on studies in *rats*. Present
> research has discovered that mechanisms that can alter the progression of
> renal disease in the rat do not have the same effect in the cat or dog.

I should have caught this before - but nobody has said anything about
"restricting protein" as a solution to CRF cats - at least not in the
last 20 years that I know of. It is the phosphorus that comes with the
protein that is being heavily restricted. I haven't seen anyone who
recommends that protein has as much to do with the progression of the
disease as other factors in decades. Supplying more protein than is
required necessarily increse the levels of phos in the diet, it is next
to impossible to get around this issue.

Phil P.
December 17th 05, 01:17 AM
"Steve Crane" > wrote in message
oups.com...
>
> Phil P. wrote:
> > " > wrote in message
> > That's the point. The theory of restricting protein to slow the
progression
> > of CRF in cats is an outdated myth based on studies in *rats*. Present
> > research has discovered that mechanisms that can alter the progression
of
> > renal disease in the rat do not have the same effect in the cat or dog.
>
> I should have caught this before - but nobody has said anything about
> "restricting protein" as a solution to CRF cats - at least not in the
> last 20 years that I know of. It is the phosphorus that comes with the
> protein that is being heavily restricted. I haven't seen anyone who
> recommends that protein has as much to do with the progression of the
> disease as other factors in decades. Supplying more protein than is
> required necessarily increse the levels of phos in the diet, it is next
> to impossible to get around this issue.

You're stating the obvious. No one is arguing that phosphate shouldn't be
restricted. Since phosphate is difficult to restrict without restricting
protein, we should try to strike a balance between adequate protein and
acceptable phosphate.

X/d contains 34% more protein than k/d but only 24 mg. more phosphorus.
X/d's 0.53% phosphorus is certainly an acceptable level for stage 1-2 CRF-
*especially* since phosphate restriction isn't recommended until stage 3 and
4 CRF.-- unless of course you care to dispute the researchers you've been
quoting...

"Available evidence supports a recommendation for dietary phosphate
restriction for dogs and cats in stages 3 and 4 CKD."

Carl A. Osborne, David J. Polzin, Sheri Ross
Chronic Renal Disease, In Textbook Veterinary Internal Medicine, Sixth ed.
pg 1773-1785 (c) Elseiver 2005.

Phil P.
December 17th 05, 08:33 PM
"Steve Crane" > wrote in message
oups.com...
> Dr. Martin,
> If you take a look at the current Hill's Key - even one going back
> a few years you will find that g/d is no longer recommended for early
> renal disease,

Are you sure about that? Better check your company's website, Steve:

"Feline g/d is formulated to be helpful in older cats and is a nutritional
aid in managing heart disease and heart failure. The reduced sodium level
helps to control the clinical signs associated with fluid retention, and
added taurine helps maintain normal heart function. ***In addition, the
reduced phosphorus level helps slow the progression of early renal
disease***, and the reduced sodium helps minimize high blood pressure."

http://tinyurl.com/b2jn6

Steve Crane
December 17th 05, 09:25 PM
Phil P. wrote:

> "Researchers have established that the minimum protein requirements for dogs
> and cats with CRF are higher than those of normal dogs and cats. Ideally,
> dogs with CRF should receive a minimum of 2 to 2.2 g and cats a minimum of
> 3.3 to 3.5 g of protein per kilogram per day."
>
> or 13.2 to 14 g/day for a 4 kg cat. Do the math- k/d contains 6.6 g of
> protein /100 kcal. - which translates into about 12 g/day for a 4 kg cat.
> Don't forget to consider urinary protein losses. Sure looks like a negative
> nitrogen balance on my calculator.

I must have missed this one. Phil, you've made a fundamental and basic
error in your calculations. The values you apply above - 2 to 2.2 grams
per day - were developed based upon typical and normal digestibility
levels of protein in typical cat foods. Your end values of 13.2 to 14
grams per day are based on average digestibility of average pet foods.
That creates a huge fundamental calculation error.

To illustrate the error - consider opposite ends of the spectrum - egg
vs. meat & bone meal. Egg considered to be ~100% digestible versus meat
& bone meal at ~55% digestibility. The values you quote above are based
on standard protein digestibility in typical cat foods which run ~70%.
14 grams of protein that is 100% digestible (egg) yields 14 grams of
protein
14 grams of protein that is 70% digestible (average cat foods) yields
9.8 grams of net protein.

Your calculations are fundamentally flawed because you are assuming the
protein in k/d is equal in digestibility to the protein used in the
studies that established the net protein needs of a cat. This forces a
fundamental and basic error in your calculations of >25% . Adding just
a 20% difference in digestibility of protein to your calculations puts
k/d above the 14 equivalent grams of protein per day.

December 17th 05, 09:29 PM
"Phil P." > wrote:

>
>"Steve Crane" > wrote in message
oups.com...
>> Dr. Martin,
>> If you take a look at the current Hill's Key - even one going back
>> a few years you will find that g/d is no longer recommended for early
>> renal disease,
>
>Are you sure about that? Better check your company's website, Steve:
>
>"Feline g/d is formulated to be helpful in older cats and is a nutritional
>aid in managing heart disease and heart failure. The reduced sodium level
>helps to control the clinical signs associated with fluid retention, and
>added taurine helps maintain normal heart function. ***In addition, the
>reduced phosphorus level helps slow the progression of early renal
>disease***, and the reduced sodium helps minimize high blood pressure."
>
> http://tinyurl.com/b2jn6
>
>

As I said in a recent post in this thread, a Hill vet during
consultation with my vet last week suggested g/d may be a good
candidate for Zak's early indication of kidney problems.

-mhd

Steve Crane
December 17th 05, 09:41 PM
Phil P. wrote:
> You're stating the obvious. No one is arguing that phosphate shouldn't be
> restricted. Since phosphate is difficult to restrict without restricting
> protein, we should try to strike a balance between adequate protein and
> acceptable phosphate.
>
> X/d contains 34% more protein than k/d but only 24 mg. more phosphorus.

x/d may provide only 34% more protein but it also provides 32% more
phosphorus, not just "24 mg" more phosphorus.

k/d canned provides 78 mg / 100 kcal
x/d canned provides 109 mg / 100 kcal 28% more phos
g/d canned provides 123 mg / 100 kcal 36% more phos

> X/d's 0.53% phosphorus is certainly an acceptable level for stage 1-2 CRF-
> *especially* since phosphate restriction isn't recommended until stage 3 and
> 4 CRF.-- unless of course you care to dispute the researchers you've been
> quoting...

Sure x/d and g/d are better than the average food for CRF - but they
are _not_ the best food for CRF.

You quoted Ross - and it is Ross's work, a short piece of which I
posted earlier that arrived at the >2.0 creat - early stage - as the
level to begin using k/d.

Phil P.
December 18th 05, 01:48 AM
> wrote in message
...
> "Phil P." > wrote:
>
> >
> >"Steve Crane" > wrote in message
> oups.com...
> >> Dr. Martin,
> >> If you take a look at the current Hill's Key - even one going back
> >> a few years you will find that g/d is no longer recommended for early
> >> renal disease,
> >
> >Are you sure about that? Better check your company's website, Steve:
> >
> >"Feline g/d is formulated to be helpful in older cats and is a
nutritional
> >aid in managing heart disease and heart failure. The reduced sodium level
> >helps to control the clinical signs associated with fluid retention, and
> >added taurine helps maintain normal heart function. ***In addition, the
> >reduced phosphorus level helps slow the progression of early renal
> >disease***, and the reduced sodium helps minimize high blood pressure."
> >
> > http://tinyurl.com/b2jn6
> >
> >
>
> As I said in a recent post in this thread, a Hill vet during
> consultation with my vet last week suggested g/d may be a good
> candidate for Zak's early indication of kidney problems.

Absolutely. X/d would be even better because its higher in protein with
about the same phosphorus. X/d is also less acidic- almost identical to
k/d- which is a concern for CRF cats.

Best of luck,

Phil

Phil P.
December 18th 05, 01:50 AM
"Steve Crane" > wrote in message
oups.com...
>
> Phil P. wrote:
> > You're stating the obvious. No one is arguing that phosphate shouldn't
be
> > restricted. Since phosphate is difficult to restrict without
restricting
> > protein, we should try to strike a balance between adequate protein and
> > acceptable phosphate.
> >
> > X/d contains 34% more protein than k/d but only 24 mg. more phosphorus.
>
> x/d may provide only 34% more protein but it also provides 32% more
> phosphorus, not just "24 mg" more phosphorus.



>
> k/d canned provides 78 mg / 100 kcal
> x/d canned provides 109 mg / 100 kcal 28% more phos
> g/d canned provides 123 mg / 100 kcal 36% more phos


Gee, x/d is even better than g/d for early stage CRF.How about that! The
acidity of x/d is also almost identical to k/d. Thus, x/d is the *ideal*
diet for early stage CRF.


>
> > X/d's 0.53% phosphorus is certainly an acceptable level for stage 1-2
CRF-
> > *especially* since phosphate restriction isn't recommended until stage 3
and
> > 4 CRF.-- unless of course you care to dispute the researchers you've
been
> > quoting...
>
> Sure x/d and g/d are better than the average food for CRF - but they
> are _not_ the best food for CRF.


They, especially x/d, certainly are better for early stage (1-3) CRF. I've
*seen* an overall improvement in cats after switching to x/d from k/d- you
haven't- thus you really don't know what you're talking about.



>You quoted Ross - and it is Ross's work, a short piece of which I
>posted earlier that arrived at the >2.0 creat - early stage - as the
>level to begin using k/d.

No, Steve. Dr. Ross was referring to *dogs*. Creatinine = 2.1-5.0 mg/dL is
stage 3 CRF for *DOGS* not cats. Stage 3 CRF for cats is creatinine =
*2.8*-5.0 mg/dL. Stage 2 CRF in cats = Creatinine 1.6-2.8 mg/dL; stage 4
in cats = Creatinine > 5.0 mg/dL.

Thus, Drs. Ross, Osborne, and Polzin are recommending protein and phosphate
restriction in *cats* when creatinine reaches *2.8* mg/dL *not* 2.0 mg/dL.
Cats are not small dogs, Steve. Do try to learn the difference between the
species- they have different physiologies and nutritional requirements. Its
really easy to tell them apart- dogs drool and cats rule!

"Available evidence supports a recommendation for dietary phosphate
restriction for dogs and cats in stages 3 and 4 CKD." (Carl A. Osborne,
David J. Polzin, Sheri Ross).

Do you understand, now? Stage 3 CRF in cats is creatinine = *2.8*-5.0
mg/dL; stage 3 CRF in dogs is creatinine = 2.1-5.0 mg/dL.

I hope you're not telling vets to whom you sell k/d to begin a renal diet in
cats based on criteria for dogs! Maybe so many vets are so poorly educated
in nutrition because they've been educated by confused pet food company
sales reps!

Phil P.
December 18th 05, 01:51 AM
"Steve Crane" > wrote in message
oups.com...
>
> Phil P. wrote:
>
> > "Researchers have established that the minimum protein requirements for
dogs
> > and cats with CRF are higher than those of normal dogs and cats.
Ideally,
> > dogs with CRF should receive a minimum of 2 to 2.2 g and cats a minimum
of
> > 3.3 to 3.5 g of protein per kilogram per day."
> >
> > or 13.2 to 14 g/day for a 4 kg cat. Do the math- k/d contains 6.6 g of
> > protein /100 kcal. - which translates into about 12 g/day for a 4 kg
cat.
> > Don't forget to consider urinary protein losses. Sure looks like a
negative
> > nitrogen balance on my calculator.
>
> I must have missed this one.


You seem to be missing a lot lately.


Phil, you've made a fundamental and basic
> error in your calculations. The values you apply above - 2 to 2.2 grams
> per day - were developed based upon typical and normal digestibility
> levels of protein in typical cat foods. Your end values of 13.2 to 14
> grams per day are based on average digestibility of average pet foods.
> That creates a huge fundamental calculation error.


I don't think so, Steve. Even if k/d was 100% digestible and 100%
metabolizable, the cat would *barely* meet her daily protein needs- assuming
she licked the plate clean. You're also completely ignoring the fact that
CRF cats are constantly losing protein in their urine.

Phil P.
December 18th 05, 03:42 AM
"Steve Crane" > wrote in message
oups.com...
>
> Phil P. wrote:
>
> > "Researchers have established that the minimum protein requirements for
dogs
> > and cats with CRF are higher than those of normal dogs and cats.
Ideally,
> > dogs with CRF should receive a minimum of 2 to 2.2 g and cats a minimum
of
> > 3.3 to 3.5 g of protein per kilogram per day."
> >
> > or 13.2 to 14 g/day for a 4 kg cat. Do the math- k/d contains 6.6 g of
> > protein /100 kcal. - which translates into about 12 g/day for a 4 kg
cat.
> > Don't forget to consider urinary protein losses. Sure looks like a
negative
> > nitrogen balance on my calculator.
>
> I must have missed this one. Phil, you've made a fundamental and basic
> error in your calculations. The values you apply above - 2 to 2.2 grams
> per day - were developed based upon typical and normal digestibility
> levels of protein in typical cat foods. Your end values of 13.2 to 14
> grams per day are based on average digestibility of average pet foods.
> That creates a huge fundamental calculation error.

Just to straighten you out on a few things: the nutritional requirements
(NRC-1976-86) for cats was originally based on *purified* diets which were
much *more* digestible than commercial diets. Thus your argument is utter
nonsense.

The AAFCO increased the minimum requirements because commercial diets aren't
as digestible as purified diets used in the original studies, thus the new
AAFCO MDRs take into consideration the variations in the availability of
protein in commercial diets and provide additional protein to offset the
variations.

"Rounding this value, a minimum protein (N 6.25) of 140 g/kg diet is
recommended for the adult cat." (NRC 1986 p 9 "Protein". )

K/d contains 1279 kcal/kg @ 6.6 g/100 kcals. or 84.4 g. protein/kg. A
little light, wouldn't you say?

The AAFCO *minimum* level for adult maintenance is 26% (DMB). K/d contains
28.6%. Thus, my estimation was *correct*.

The only error in my calculation was I might have ***overestimated*** k/d's
ability to provide sufficient protein for CRF cats.

Now I understand why so many vets give bogus information about nutrition!
Look whose educating them: double-talking petfood company sales reps!

Steve Crane
December 18th 05, 05:28 PM
Phil P. wrote:
> >You quoted Ross - and it is Ross's work, a short piece of which I
> >posted earlier that arrived at the >2.0 creat - early stage - as the
> >level to begin using k/d.
>
> No, Steve. Dr. Ross was referring to *dogs*. Creatinine = 2.1-5.0 mg/dL is

No Phil - the piece I provided was an abstract due for publication
later this year on CATS. I'll repost the abstract below. In subsequent
conversation on the nutrition listserver Dr. Ross further commented
that once creat is >2.0, then a renal diet was the correct choice.

S. Ross1; C. Osborne1; D. Polzin1; S. Lowry2; C. Kirk3; L. Koehler1
1College of Veterinary Medicine, University of Minnesota, St. Paul, MN;
KS; 3 College of Veterinary Medicine, The University of Tennessee,
Knoxville, TN

A double-masked, controlled, randomized, clinical trial was designed to
determine if a renal diet (modified in protein, phosphorous, sodium,
and lipid composition) was superior to an adult maintenance diet in
minimizing uremic episodes and mortality rate in cats with mild to
moderate chronic renal failure.
Forty-five client owned cats were randomly assigned to a maintenance
diet or a renal diet and evaluated tri-monthly for up to 24 months.
Kaplan-Meier survival analyses were used to evaluate efficacy of the
renal diet compared to the maintenance diet in minimizing uremia,
renal-related mortality, and all causes of mortality.


Events Renal diet (%) Maintenance diet (%) P value
Uremic crises 0/22 (0) 5/23 (22) 0.02
Renal cause mortality 0/22 (0) 4/23 (17) 0.03
All causes of mortality 3/22 (14) 9/23 (39) 0.06

Serum urea nitrogen concentrations were significantly lower and blood
bicarbonate concentrations were significantly higher in the group fed
the renal diet at baseline and during the 12- and 24-month intervals.
Cats fed the maintenance diet had a significantly greater number of
uremic episodes (22%) compared to cats fed the renal diet (0%). A
significant reduction in renal-related mortality was observed in cats
fed the renal diet.
The renal diet evaluated in this study was superior to an adult
maintenance diet in minimizing uremic episodes and mortality rate in
cats with mild to moderate spontaneous chronic renal failure.

Steve Crane
December 18th 05, 05:37 PM
Phil P. wrote:
> I don't think so, Steve. Even if k/d was 100% digestible and 100%
> metabolizable, the cat would *barely* meet her daily protein needs- assuming
> she licked the plate clean. You're also completely ignoring the fact that
> CRF cats are constantly losing protein in their urine.

Phil - once again you missed the entire point - the data you are using,
the values you are using - are BASED on the LOW digestibility rate of
typical commercial foods - get it????? If the values you are using -
the 13-14 gms/day are BASED on 70% digestibility in the first place -
the values of 13-14 grams ONLY apply to foods with the same protein
digestibility levels. Do the math -

70% digestibility of 14 grams of protein = 9.8 grams of actual
available protein.
85% digestibility of 12 grams of protein = 10.2 grams of actual
available protein.

Steve Crane
December 18th 05, 05:49 PM
Phil P. wrote:
> "Steve Crane" > wrote in message
> Just to straighten you out on a few things: the nutritional requirements
> (NRC-1976-86) for cats was originally based on *purified* diets which were
> much *more* digestible than commercial diets. Thus your argument is utter
> nonsense.

No Phil - the data you provided - the calculations you made - that set
13-14 grams per 4kg cat - that value did not derive from the 40 year
old NRC values based on "purified diets".

Do you prefer data from over 40 years ago?? do you think we may have
learned a couple things since then???


> The AAFCO increased the minimum requirements because commercial diets aren't
> as digestible as purified diets used in the original studies, thus the new
> AAFCO MDRs take into consideration the variations in the availability of
> protein in commercial diets and provide additional protein to offset the
> variations.

Again data based on 30+ year old technology. One would assume that
since you quote the AAFCO data you must also accept the AAFCO feeding
trials - which k/d passes with no problems.

Phil you're going to lose this argument - the data that will be coming
out over the next 2-3 years is going to utterly bury this erroneous
concept of insufficient protein in renal diets.

Phil P.
December 19th 05, 03:40 AM
"Steve Crane" > wrote in message
ups.com...
>
> Phil P. wrote:
> > I don't think so, Steve. Even if k/d was 100% digestible and 100%
> > metabolizable, the cat would *barely* meet her daily protein needs-
assuming
> > she licked the plate clean. You're also completely ignoring the fact
that
> > CRF cats are constantly losing protein in their urine.
>
> Phil - once again you missed the entire point - the data you are using,
> the values you are using - are BASED on the LOW digestibility rate of
> typical commercial foods - get it?????


I don't think *you* get it. I said: "Even if k/d was 100% digestible and
100% metabolizable, the cat would *barely* meet her daily protein needs-
assuming she licked the plate clean."


> 70% digestibility of 14 grams of protein = 9.8 grams of actual
> available protein.
> 85% digestibility of 12 grams of protein = 10.2 grams of actual
> available protein.

Ah so! K/d provides even *less* protein than I estimated! Thanks for
reinforcing my position.

Phil P.
December 19th 05, 03:40 AM
"Steve Crane" > wrote in message
oups.com...
>
> Phil P. wrote:
> > "Steve Crane" > wrote in message
> > Just to straighten you out on a few things: the nutritional requirements
> > (NRC-1976-86) for cats was originally based on *purified* diets which
were
> > much *more* digestible than commercial diets. Thus your argument is
utter
> > nonsense.
>
> No Phil - the data you provided - the calculations you made - that set
> 13-14 grams per 4kg cat - that value did not derive from the 40 year
> old NRC values based on "purified diets".


You missed my point. My estimate was based on AAFCO recommendations. The
AAFCO increased the minimum requirements for cats because commercial diets
aren't as digestible as the diets used in the original NRC studies.


> Do you prefer data from over 40 years ago??


err- I used the AAFCO 2005 Official Publication for minimum protein
requirements for cats.


> Phil you're going to lose this argument - the data that will be coming
> out over the next 2-3 years

Great. Lets continue this argument in 2-3 years when you can back up your
claims.

I think you're so hell bent on pushing k/d that I don't think you even
understand the point of my argument.

Phil P.
December 19th 05, 03:40 AM
"Steve Crane" > wrote in message
oups.com...
>
> Phil P. wrote:
> > >You quoted Ross - and it is Ross's work, a short piece of which I
> > >posted earlier that arrived at the >2.0 creat - early stage - as the
> > >level to begin using k/d.
> >
> > No, Steve. Dr. Ross was referring to *dogs*. Creatinine = 2.1-5.0 mg/dL
is
>
> No Phil - the piece I provided was an abstract due for publication
> later this year on CATS. I'll repost the abstract below. In subsequent
> conversation on the nutrition listserver Dr. Ross further commented
> that once creat is >2.0, then a renal diet was the correct choice.

So, you're trying to tell me she's contradicting herself, Osborne, and
Polzin? I don't think so. I think I'll trust documentation than I can
verify and that's supported by IRIS.


"Currently available data supports recommending therapy with appropriately
modified diets in dogs and cats in stages 3 and 4 CKD. The value of diet
therapy in stages 1 and 2 CKD has not been established; therefore no
evidence supports a recommendation for or against diet therapy in these
patients." (Osborne, Polzin, Ross)

Once again, Stage 3 CRF in cats begins when creatinine reaches 2.8 mg/dl;
Stage 3 in dogs begin when creatinine reaches 2.1 mg/dl. You've always had
a habit of extrapolating data for dogs to cats.

Stages of Feline Chronic Kidney Disease

Stage 1 (Nonazotemic)

a.. Markers of renal disease present
b.. Creatinine < 1.6 mg/dL (< 140 ?mol/L)
c.. Proteinuria: Classify-P/NP/BP
d.. Hypertension: Classify-Hc/Hnc/NH/BH/HND

Stage 2 (Mild Renal Azotemia)

a.. Markers of renal disease present
b.. Creatinine 1.6-2.8 mg/dL (140-250 ?mol/L)
c.. Proteinuria: Classify-P/NP/BP
d.. Hypertension: Classify-Hc/Hnc/NH/BH/HND

Stage 3 (Moderate Renal Azotemia)

a.. Creatinine 2.8-5.0 mg/dL (251-440 ?mol/L)
b.. Proteinuria: Classify-P/NP/BP
c.. Hypertension: Classify-Hc/Hnc/NH/BH/HND

Stage 4 (Severe Renal Azotemia)

a.. Creatinine > 5.0 mg/dL (> 440 ?mol/L)
b.. Proteinuria: Classify-P/NP/BP
c.. Hypertension: Classify-Hc/Hnc/NH/BH/HND



Stages of Canine Chronic Kidney Disease

Stage 1 (Nonazotemic)

a.. Markers of renal disease present
b.. Creatinine < 1.4 mg/dL (< 125 ?mol/L)
c.. Proteinuria: classify-(P/NP/BP)
d.. Hypertension: classify-(Hc/Hnc/NH/BH/HND)

Stage 2 (Mild Renal Azotemia)

a.. Markers of renal disease present
b.. Creatinine 1.4-2.0 mg/dL (125-180 ?mol/L)
c.. Proteinuria: classify-(P/NP/BP)
d.. Hypertension: classify-(Hc/Hnc/NH/BH/HND)

Stage 3 (Moderate Renal Azotemia)

a.. Creatinine 2.1-5.0 mg/dL (181-440 ?mol/L)
b.. Proteinuria: Classify-(P/NP/BP)
c.. Hypertension: Classify-(Hc/Hnc/NH/BH/HND)

Stage 4 (Severe Renal Azotemia)

a.. Creatinine > 5.0 mg/dL (> 440 ?mol/L)
b.. Proteinuria: Classify-(P/NP/BP)
c.. Hypertension: Classify-(Hc/Hnc/NH/BH/HND)

Steve Crane
December 19th 05, 02:55 PM
Phil P. wrote:
> "Steve Crane" > wrote in message
> oups.com...
> >
> > Phil P. wrote:
> > > >You quoted Ross - and it is Ross's work, a short piece of which I
> > > >posted earlier that arrived at the >2.0 creat - early stage - as the
> > > >level to begin using k/d.
> > >
> > > No, Steve. Dr. Ross was referring to *dogs*. Creatinine = 2.1-5.0 mg/dL
> is
> >
> > No Phil - the piece I provided was an abstract due for publication
> > later this year on CATS. I'll repost the abstract below. In subsequent
> > conversation on the nutrition listserver Dr. Ross further commented
> > that once creat is >2.0, then a renal diet was the correct choice.
>
> So, you're trying to tell me she's contradicting herself, Osborne, and
> Polzin? I don't think so. I think I'll trust documentation than I can
> verify and that's supported by IRIS.

No, I'm telling you that like all good researchers, when they learn new
information they don't remain stuck in the past. You keep reverting to
data from +30 years ago in NRC, AAFCO sources, and data published in
textbooks that are out of date before they are printed. Much of the
data you are reverting to is derived from old surgically induced renal
disease studies, which is far less reliable than data derived from
naturally ocurring renal disease. In all three such studies - 2 in cats
and 1 in dogs, the creat value >2 clearly demands the use of a renal
diet. All three are Grade 1 Evidence Based medicine clinical studies.
Ross' new Grade 1 evidence based medicine study, in naturally ocurring
disease, will be published later this year. I won't bother commenting
further until it's out where you can read it.

Steve Crane
December 19th 05, 03:03 PM
Phil P. wrote:
> "Steve Crane" > wrote in message
> > Do you prefer data from over 40 years ago??
>
>
> err- I used the AAFCO 2005 Official Publication for minimum protein
> requirements for cats.

Which is based on what Phil? - come on, time to be honest here - the
AFFCO values are based on what? - it's right there in your AAFCO manual
- NRC values from materials published _prior_ to 1975-1981. PUBLISHED
before 1975 - means studies that are well over 30 years old, some could
be over 50 years old. Data from 1981 comes from studies well over 25
years old.

Even the new NRC guidlines - if they are even officially published -
are based on data published before 2002 - which would not include all
of the new Grade 1 clinical trials in renal disease.

Phil P.
December 19th 05, 08:31 PM
"Steve Crane" > wrote in message
oups.com...
>
> Phil P. wrote:
> > "Steve Crane" > wrote in message
> > oups.com...
> > >
> > > Phil P. wrote:
> > > > >You quoted Ross - and it is Ross's work, a short piece of which I
> > > > >posted earlier that arrived at the >2.0 creat - early stage - as
the
> > > > >level to begin using k/d.
> > > >
> > > > No, Steve. Dr. Ross was referring to *dogs*. Creatinine = 2.1-5.0
mg/dL
> > is
> > >
> > > No Phil - the piece I provided was an abstract due for publication
> > > later this year on CATS. I'll repost the abstract below. In subsequent
> > > conversation on the nutrition listserver Dr. Ross further commented
> > > that once creat is >2.0, then a renal diet was the correct choice.
> >
> > So, you're trying to tell me she's contradicting herself, Osborne, and
> > Polzin? I don't think so. I think I'll trust documentation than I can
> > verify and that's supported by IRIS.
>
> No, I'm telling you that like all good researchers, when they learn new
> information they don't remain stuck in the past. You keep reverting to
> data from +30 years ago in NRC, AAFCO sources, and data published in
> textbooks that are out of date before they are printed.


The minimum protein requirements I cited were from the AAFCO's *2005*
Official Publication, Einstein, and the article I quoted by Dr. Ross came
from Ettinger's TBVIM *6th* ed- hot off the press a few months ago. I also
have an online update subscription for TBVIM, so, I get all updates *months*
to *years* before they're printed. So, slick, my information is *current*.
The cat hasn't evolved so much in the past few months (or even centuries or
even *millennia*) that her protein needs have decreased.

You're so hell-bent on pushing k/d that you don't even understand what my
argument is even about! I *agree* with all the virtues of k/d except the
*protein content*. I really don't think you know enough about feline
physiology to understand why sufficient dietary protein is so important for
cats.

Let me educate you a little: The cat's protein-catabolizing enzymes
function at high rates and can't adapt to decreases in protein intake. This
causes the cat to catabolize a good chunk of protein after eating
*regardless* of how much protein is in the food. The cat also doesn't have
the ability to conserve nitrogen from the body's general nitrogen pool, so,
if the diet doesn't contain ample protein, the cat will catabolize *body
proteins* which results in muscle wasting- That's why so many cats fed k/d
look emaciated- because they *are*.

It gets worse: Since creatinine is formed in muscle, the loss of muscle mass
*reduces* serum creatinine levels which in turn *underestimates* the amount
of renal damage. So, slick, one of the reasons why some cats fed k/d *seem*
to being well based on serum creatinine levels is because they have reduced
muscle mass and therefore less creatinine production- and not because
they're "doing better"! They seem to be doing well for awhile, then crash
or deteriorate rapidly. This is why protein should *not* be restricted
until the cat's serum creatinine levels reach at least *2.8 mg/dL*.

Since we can't restrict phosphorus without restricting some protein, we
should try to strike a balance between an acceptable phosphorus content and
an acceptable protein content. Since x/d has almost the identical
acidity as k/d and contains reduced sodium and phosphorus and increased
potassium and PUSFAs, x/d is the *ideal* diet for early stage (1 and 2 and
even early Stage 3) CRF. X/d also accustoms the cat to a lower phosphorus
diet which makes the transition to k/d later, much easier.



>I won't bother commenting further until it's out where you can read it.


I sure hope so because you sound like a used car salesman trying to push a
lemon.

See ya in a few months! lol!

Phil P.
December 19th 05, 08:31 PM
"Steve Crane" > wrote in message
oups.com...
>
> Phil P. wrote:
> > "Steve Crane" > wrote in message
> > > Do you prefer data from over 40 years ago??
> >
> >
> > err- I used the AAFCO 2005 Official Publication for minimum protein
> > requirements for cats.
>
> Which is based on what Phil? - come on, time to be honest here - the
> AFFCO values are based on what? - it's right there in your AAFCO manual
> - NRC values from materials published _prior_ to 1975-1981.

That's one of the reasons why the AAFCO *increased* the NRC's minimum
protein requirement. The NRC recommendations were minimum nutrient
requirements for cats, not recommended allowances for inclusion in cat
foods. You should stick with the NRC- they make k/d seem better because the
NRC protein requirements were lower than the AAFCO!

So, you're trying to tell me that the cat evolved so much in the past few
months that her protein requirements have *decreased* and the AAFCO 2005
recommendations are no longer valid? LOL!

The fact that Hill's funds Dr. Ross's studies wouldn't have anything to do
with your trying to manipulate the context of her published data in
Ettinger's 6th ed., would it?

What happened? I though you weren't going to respond to this thread anymore
until you could back up your dubious claims with published, peer-reviewed
data?

Steve Crane
December 21st 05, 04:06 AM
Phil P. wrote:
> "Steve Crane" > wrote in message
> > No Phil - the piece I provided was an abstract due for publication
> > later this year on CATS. I'll repost the abstract below. In subsequent
> > conversation on the nutrition listserver Dr. Ross further commented
> > that once creat is >2.0, then a renal diet was the correct choice.
>
> So, you're trying to tell me she's contradicting herself, Osborne, and
> Polzin? I don't think so. I think I'll trust documentation than I can
> verify and that's supported by IRIS.

Oh come off it Phil - since when did any researcher stick with old data
when new data supports a change in position. When the piece is
published you can come back and apologize - which I will accept
gracefully as usual.

Steve Crane
December 21st 05, 04:17 AM
Phil P. wrote:
> "Steve Crane" > wrote in message
> oups.com...
> >
> > Phil P. wrote:
> > > "Steve Crane" > wrote in message
> > > > Do you prefer data from over 40 years ago??
> > >
> > >
> > > err- I used the AAFCO 2005 Official Publication for minimum protein
> > > requirements for cats.
> >
> > Which is based on what Phil? - come on, time to be honest here - the
> > AFFCO values are based on what? - it's right there in your AAFCO manual
> > - NRC values from materials published _prior_ to 1975-1981.
>
> That's one of the reasons why the AAFCO *increased* the NRC's minimum
> protein requirement. The NRC recommendations were minimum nutrient
> requirements for cats, not recommended allowances for inclusion in cat
> foods. You should stick with the NRC- they make k/d seem better because the
> NRC protein requirements were lower than the AAFCO!

It doesn't matter which you accept - AAFCO is based on NRC, NRC data is
based on data from 25-40 years ago.


> So, you're trying to tell me that the cat evolved so much in the past few
> months that her protein requirements have *decreased* and the AAFCO 2005
> recommendations are no longer valid? LOL!

Oh Nonsense Phil - nobody said or suggested any such thing. Geesh Phil
- I didn't think you could possibly keep missing this. The AFFCO and
NRC data for minimum protein are based on common commercial pet foods
values - digestibility levels 20-35% LOWER than k/d protein
digestibility.

> The fact that Hill's funds Dr. Ross's studies wouldn't have anything to do
> with your trying to manipulate the context of her published data in
> Ettinger's 6th ed., would it?

Sure, anytime you think Ross, Osborne and Polzin and others would
deliberately deceive the veterinary community, pass a peer review
process to deliberately deceive the medical world, and do all this for
a few scheckles - You've got to be kidding me.

Once again it is NOT the data from Ettingers 6th ed, but newer material
not yet published anywhere except in abstract form for ACVIM. As you
well know a textbook is out of date before it get soff the printing
press. Nice place for basic info, but will never be the leading edge of
anything.

Phil P.
December 21st 05, 08:02 AM
"Steve Crane" > wrote in message
oups.com...
>
> Phil P. wrote:
> > "Steve Crane" > wrote in message
> > > No Phil - the piece I provided was an abstract due for publication
> > > later this year on CATS. I'll repost the abstract below. In subsequent
> > > conversation on the nutrition listserver Dr. Ross further commented
> > > that once creat is >2.0, then a renal diet was the correct choice.
> >
> > So, you're trying to tell me she's contradicting herself, Osborne, and
> > Polzin? I don't think so. I think I'll trust documentation than I can
> > verify and that's supported by IRIS.
>
> Oh come off it Phil - since when did any researcher stick with old data


Old data? Are you delirious? The paper I quoted is 4 months old and hasn't
been superceded by any weekly updates since.



> when new data supports a change in position. When the piece is
> published you can come back and apologize -


Hold your breath, ok? .


which I will accept
> gracefully as usual.


I thought you said you weren't going to comment again until your paper was
published. So much for your credibility.

Phil P.
December 21st 05, 08:06 AM
"Steve Crane" > wrote in message
oups.com...
>
> Phil P. wrote:
> > "Steve Crane" > wrote in message
> > oups.com...
> > >
> > > Phil P. wrote:
> > > > "Steve Crane" > wrote in message
> > > > > Do you prefer data from over 40 years ago??
> > > >
> > > >
> > > > err- I used the AAFCO 2005 Official Publication for minimum protein
> > > > requirements for cats.
> > >
> > > Which is based on what Phil? - come on, time to be honest here - the
> > > AFFCO values are based on what? - it's right there in your AAFCO
manual
> > > - NRC values from materials published _prior_ to 1975-1981.
> >
> > That's one of the reasons why the AAFCO *increased* the NRC's minimum
> > protein requirement. The NRC recommendations were minimum nutrient
> > requirements for cats, not recommended allowances for inclusion in cat
> > foods. You should stick with the NRC- they make k/d seem better because
the
> > NRC protein requirements were lower than the AAFCO!
>
> It doesn't matter which you accept - AAFCO is based on NRC, NRC data is
> based on data from 25-40 years ago.
>
>
> > So, you're trying to tell me that the cat evolved so much in the past
few
> > months that her protein requirements have *decreased* and the AAFCO 2005
> > recommendations are no longer valid? LOL!
>
> Oh Nonsense Phil - nobody said or suggested any such thing. Geesh Phil
> - I didn't think you could possibly keep missing this. The AFFCO and
> NRC data for minimum protein are based on common commercial pet foods
> values - digestibility levels 20-35% LOWER than k/d protein
> digestibility.

Bull****! The reason why the AAFCO increased the NRC's minimum protein
requirement is because the studies used in the NRC used *purified* diets
which were *more* digestible than commercial diets. Don't conjure up
bull**** to sell your angle.

You salesmen will say anything to sell your angle-- that's why very few
people trust the food industry. You're not helping consumer confidence in
Hill's.

I thought you said you weren't going to comment again until your paper was
published. So much for your credibility.

John Doe
January 1st 06, 02:28 AM
Another thread providing examples of this troll playing tough guy on
the Internet. This troll has no mental capacity to debate anything
without name-calling and a pretense of holiness.

"Phil P." <phil maxshouse.com> wrote:

> Path: newsdbm05.news.prodigy.com!newsdbm04.news.prodigy. com!newsdst01.news.prodigy.com!newsmst01b.news.pro digy.com!prodigy.com!newscon06.news.prodigy.com!pr odigy.net!border1.nntp.dca.giganews.com!border2.nn tp.dca.giganews.com!nntp.giganews.com!elnk-atl-nf1!newsfeed.earthlink.net!stamper.news.atl.earthl ink.net!newsread2.news.atl.earthlink.net.POSTED!5b e4e383!not-for-mail
> From: "Phil P." <phil maxshouse.com>
> Newsgroups: rec.pets.cats.health+behav
> References: <1133904580.360780.326330 g43g2000cwa.googlegroups.com> <Jqqlf.1921$PX2.199233 news20.bellglobal.com> <1134096603.690531.13500 g49g2000cwa.googlegroups.com> <iOhmf.1348$nm.378 newsread2.news.atl.earthlink.net> <1134176219.655593.30610 g47g2000cwa.googlegroups.com>
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> Xref: newsmst01b.news.prodigy.com rec.pets.cats.health+behav:417738
>
>
> "Steve Crane" <eodemolay cox.net> wrote in message
> news:1134176219.655593.30610 g47g2000cwa.googlegroups.com...
>>
>> Phil P. wrote:
>> > "Steve Crane" <eodemolay cox.net> wrote in message
>> > news:1134096603.690531.13500 g49g2000cwa.googlegroups.com...
>>
>> > What? 1/2 gram above the bare minimum protein requirement? That means
> the
>> > cat must lick the dish clean to get her minimum daily protein
>> > requirement. Know a lot of renal cats with hearty appetites that beg
> for
>> > k/d, do you, Steve? The low protein, phosphorus and sodium content
> makes
>> > k/d unpalatable to many (most) renal cats.
>>
>> Oh nonsense, k/d is more palatable than Friskies canned foods.
>
>
> Bull****! K/d is one of the most- if not the most- unpalatable diets on the
> market. Hill's receives so many complaints about cats refusing to eat k/d
> that they routinely recommend adding oregano. Even in this newsgroup and
> especially in the CRF lists *many* people say they have a lot of trouble
> getting their cats to eat k/d. More renal cats won't eat k/d than renal
> cats that will. Save your sales bull**** for someone that doesn't know any
> better. You're not helping yours or Hill's credibility.
>
>
> We've
>> done the PAL studies so many times in so many places it's ridiculous.
>
>
> Yeah- with pres-selected cats who would eat anything. Maybe you should join
> the CRF lists to learn what's happening in the real world with renal cats.
> What would you do without Hill's studies? Think for yourself?
>
>
>
>> The problem is not with the food, but with the practitioner. Any cat
>> which is sick, in the hospital,
>
>
> Now you're being stupid. I'm referring to cats fed at home by their owners-
> and you know it. *Every* vet I know or have known have said most of their
> clients' renal cats won't eat k/d.
>
>
>>
>> As for the 1/2 gram protein nonsense - You are assuming that cat owners
>> only provide the bare minimum of foods - yea right - that's why we have
>> such an epidemic of obesity in cats I suppose?
>
>
> You're being stupid, again. Renal cats generally have poor appetites due to
> azotemia. That's one of the reasons why so many renal cats lose body mass-
> the other reason is the poor palatability of renal diets in general- and k/d
> specifically.
>
>
>
>
>
>
>

Gold Finger
January 1st 06, 02:51 AM
Dogh boyee wrote:
> Another thread providing examples of this troll playing tough guy on
> the Internet. This troll has no mental capacity to debate anything
> without name-calling and a pretense of holiness.

troll much?

i think you're acting like a cremudgeon
(it's a step down from being a troll)

Gold Finger
January 1st 06, 02:53 AM
dick I MEAN RICHARD wrote:
> Another thread providing examples of this troll playing tough guy on
> the Internet. This troll has no mental capacity to debate anything
> without name-calling and a pretense of holiness.
>

AND a curmudgeon

John Doe
January 1st 06, 04:12 AM
"Phil P." <phil maxshouse.com> wrote:

> "Steve Crane" <eodemolay cox.net> wrote in message
> news:1135138664.637284.236440 g44g2000cwa.googlegroups.com...
>>
>> Phil P. wrote:

>>
>> > So, you're trying to tell me that the cat evolved so much in
>> > the past few months that her protein requirements have
>> > *decreased* and the AAFCO 2005 recommendations are no longer
>> > valid? LOL!
>>
>> Oh Nonsense Phil - nobody said or suggested any such thing. Geesh
>> Phil - I didn't think you could possibly keep missing this. The
>> AFFCO and NRC data for minimum protein are based on common
>> commercial pet foods values - digestibility levels 20-35% LOWER
>> than k/d protein digestibility.
>
> Bull****! The reason why the AAFCO increased the NRC's minimum
> protein requirement is because the studies used in the NRC used
> *purified* diets which were *more* digestible than commercial
> diets. Don't conjure up bull**** to sell your angle.
>
> You salesmen will say anything to sell your angle-- that's why
> very few people trust the food industry. You're not helping
> consumer confidence in Hill's.

As if they they would be better off employing a lunatic mudslinger.

>
> I thought you said you weren't going to comment again until your
> paper was published. So much for your credibility.

So Steve Crane is a salesperson and Phil P. is an unpublished lunatic
mudslinger.


>
>
>
>
>
> Path: newsdbm04.news.prodigy.com!newsdst01.news.prodigy. com!newsmst01b.news.prodigy.com!prodigy.com!newsco n02.news.prodigy.com!prodigy.net!nx01.iad01.newsho sting.com!newshosting.com!207.69.154.102.MISMATCH! elnk-atl-nf2!newsfeed.earthlink.net!stamper.news.atl.earthl ink.net!newsread2.news.atl.earthlink.net.POSTED!5b e4e383!not-for-mail
> From: "Phil P." <phil maxshouse.com>
> Newsgroups: rec.pets.cats.health+behav
> References: <1133904580.360780.326330 g43g2000cwa.googlegroups.com> <Jqqlf.1921$PX2.199233 news20.bellglobal.com> <1134096603.690531.13500 g49g2000cwa.googlegroups.com> <iOhmf.1348$nm.378 newsread2.news.atl.earthlink.net> <1134854755.826592.118780 g44g2000cwa.googlegroups.com> <vU4pf.6722$Dd2.1670 newsread3.news.atl.earthlink.net> <1134928164.696365.326370 g43g2000cwa.googlegroups.com> <AYppf.7371$Dd2.1938 newsread3.news.atl.earthlink.net> <1135004611.757823.180020 g14g2000cwa.googlegroups.com> <CMEpf.7075$3Z.6273 newsread1.news.atl.earthlink.net> <1135138664.637284.236440 g44g2000cwa.googlegroups.com>
> Subject: Re: Tiger's kidneys
> Lines: 57
> X-Priority: 3
> X-MSMail-Priority: Normal
> X-Newsreader: Microsoft Outlook Express 6.00.2800.1506
> X-MimeOLE: Produced By Microsoft MimeOLE V6.00.2800.1506
> Message-ID: <P18qf.8716$nm.748 newsread2.news.atl.earthlink.net>
> Date: Wed, 21 Dec 2005 08:06:07 GMT
> NNTP-Posting-Host: 151.198.114.242
> X-Complaints-To: abuse earthlink.net
> X-Trace: newsread2.news.atl.earthlink.net 1135152367 151.198.114.242 (Wed, 21 Dec 2005 00:06:07 PST)
> NNTP-Posting-Date: Wed, 21 Dec 2005 00:06:07 PST
> Organization: EarthLink Inc. -- http://www.EarthLink.net
> Xref: newsmst01b.news.prodigy.com rec.pets.cats.health+behav:418750
>
>

John Doe
January 1st 06, 04:20 AM
The tough guy wanna-be, mudslinging lunatic troll says "give it a
rest" as he posts the same exact message for the third time in a
row.

"Phil P." <phil maxshouse.com> wrote:

> Path: newsdbm04.news.prodigy.com!newsdst01.news.prodigy. com!newsmst01b.news.prodigy.com!prodigy.com!newsco n02.news.prodigy.com!prodigy.net!nx01.iad01.newsho sting.com!newshosting.com!207.69.154.102.MISMATCH! elnk-atl-nf2!newsfeed.earthlink.net!stamper.news.atl.earthl ink.net!newsread1.news.atl.earthlink.net.POSTED!5b e4e383!not-for-mail
> From: "Phil P." <phil maxshouse.com>
> Newsgroups: rec.pets.cats.health+behav
> References: <1133904580.360780.326330 g43g2000cwa.googlegroups.com> <Jqqlf.1921$PX2.199233 news20.bellglobal.com> <1134096603.690531.13500 g49g2000cwa.googlegroups.com> <iOhmf.1348$nm.378 newsread2.news.atl.earthlink.net> <1134176219.655593.30610 g47g2000cwa.googlegroups.com> <eDsmf.1810$nm.466 newsread2.news.atl.earthlink.net> <1134228266.328929.190380 g44g2000cwa.googlegroups.com> <XlPmf.2348$3Z.2210 newsread1.news.atl.earthlink.net> <1134321331.808613.8550 g47g2000cwa.googlegroups.com> <Wy2nf.2642$3Z.1192 newsread1.news.atl.earthlink.net> <1134582745.342291.221610 g44g2000cwa.googlegroups.com>
> Subject: Re: Tiger's kidneys
> Lines: 65
> X-Priority: 3
> X-MSMail-Priority: Normal
> X-Newsreader: Microsoft Outlook Express 6.00.2800.1506
> X-MimeOLE: Produced By Microsoft MimeOLE V6.00.2800.1506
> Message-ID: <n7_nf.4506$3Z.3283 newsread1.news.atl.earthlink.net>
> Date: Wed, 14 Dec 2005 19:11:15 GMT
> NNTP-Posting-Host: 151.198.114.242
> X-Complaints-To: abuse earthlink.net
> X-Trace: newsread1.news.atl.earthlink.net 1134587475 151.198.114.242 (Wed, 14 Dec 2005 11:11:15 PST)
> NNTP-Posting-Date: Wed, 14 Dec 2005 11:11:15 PST
> Organization: EarthLink Inc. -- http://www.EarthLink.net
> Xref: newsmst01b.news.prodigy.com rec.pets.cats.health+behav:418195
>
>
> "Steve Crane" <eodemolay cox.net> wrote in message
> news:1134582745.342291.221610 g44g2000cwa.googlegroups.com...
>>
>> Phil P. wrote:
>> > "Steve Crane" <eodemolay cox.net> wrote in message
>>
>> Posted this morning on the AAVN listserver.
>>
>>
>> "We generally recommend that cats be gradually switched to a diet
>> formulated for the treatment of renal failure at the time of diagnosis.
>> We have recently completed a double-blinded, randomized, clinical trial
>> designed to determine if a renal diet is superior to an adult
>> maintenance diet in minimizing uremic episodes and mortality rate in
>> cats with stages 2 and 3 chronic kidney disease
>>
>> Sheri Ross, DVM
>> Assistant Clinical Professor
>> Small Animal Internal Medicine (Nephrology/Urology)
>> University of Minnesota Veterinary Teaching Hospital
>> 1365 Gortner Ave., Saint Paul, MN 55108
>> rossx031 tc.umn.edu
>
>
> Chapter 260 pages 1773 - 1785 Chronic Kidney Disease
> TEXTBOOK OF VETERINARY INTERNAL MEDICINE, SIXTH EDITION
> 0-7216-0117-0 Copyright 2005, Elsevier Inc.
>
> David J. Polzin
> Carl A. Osborne
> Sheri Ross
>
>
> "Although the ideal quantity of protein to feed dogs and cats with CKD
> remains unresolved, a general consensus of opinion supports the fact that
> reducing protein intake ameliorates clinical signs of uremia in CKD and is
> therefore indicated for stage ****4**** CKD."
>
> "The concept of reducing dietary protein intake in CKD patients that do not
> have clinical signs of uremia has been questioned. Limiting protein intake
> has been advocated for these patients to slow progression of CKD. This
> suggestion derives from studies in rats indicating that dietary protein
> restriction limits glomerular hyperfiltration and hypertension and slows the
> spontaneous decline in kidney function that follows reduction in kidney
> mass. Studies in humans have supported the concept that protein restriction
> slows progression of CKD, albeit this effect may be small. In contrast,
> multiple studies have failed to confirm a beneficial role for protein
> restriction in limiting progression of kidney disease in dogs or cats."
>
> "Although a role for protein restriction in slowing progression of canine
> and feline CKD has not been entirely excluded, available evidence ****fails
> to
> support**** a recommendation for or against protein restriction in patients
> with
> stage 3 CKD."
>
>
> Give it a rest, Steve.
>
>
>
>
>
>
>
>

black-ip
January 1st 06, 05:00 AM
John Doe wrote:
> The tough guy wanna-be, mudslinging lunatic troll says "give it a
> rest" as he posts the same exact message for the third time in a
> row.


troll!

I gotta admit that kind of felt good