Phil P. wrote:
"Jean" wrote in message
...

Sorry for coming in late -- just got back.

I've been in and out too - spending alot of time on the feline diabetes
message board and forgetting to keep up with other things :-) This is a
great discussion though and *very* relevant to what's going on with my
kitty right now.



I'm certainly no expert and am reading and asking alot of questions.
Seems like the jury is still out on the carb question diabetes, as
well as on the protein/phos question, kidneys. I've run across an
awful lot of conflicting information - all from some kind of expert or
another.

That's precisely why I would err on the side of caution and follow the
thinking of the majority of the mainstream veterinary community regarding
lowing phosphorus intake. Protein, however, shouldn't be reduced until the
BUN reaches 60 mg/dl.

(do you have any references for this? I'm not doubting it - it fits with
what things I've read that don't give numeric guidelines. A professional
reference would be helpful to have when discussing this with my vet)

I completely agree. My problem has been that my kitty's current BUN is
only 32 after a 34 reading in February. Creatinine is only 1.6 after a
2.4 in Feb. Lab upper normal limits were 34 and 2.3. Kitty's been on K/D
since Feb. but was just Dx with diabetes. That's what puts a whole
different spin on the relative value of K/D which is very low protein,
vry low phos and very high carb and fat. My vet wants him to stay on KD
but I'm thinking it would be better to go for something with moderate
protein, low phos and much lower carb in order to treat the diabetes
better. The choices are a little limited, but there are some foods out
there that meet that criteria. The other problem I'm seeing with KD is
how high in fat it is - 50%. My kitty is 16, has a bit of a weight
problem and high cholesterol


Here's where there seems to be a bit of confusion. The reason for
implementing a kidney or lower phosphorus diet isn't to "prevent" CRF but to
*delay* the onset of *clinical* CRF and slow the progression of subclinical
CRF.. As you're aware, kidney values usually don't rise until ~75% of renal
function has been lost. IOW, many cats are *already* in *subclinical* CRF
well *before* CRF is detected by routine blood/USG tests.

In fact, based on data submitted to the Veterinary MedÂ*ical Data Base at
Purdue, 37% of cats with CRF were less than 10 years old. The mean age of
diagnosis was 7.4 years for cats. Another survey at VMDB, showed 53% of
affected cats were over 7 years old and 47% were less than 7. That means
CRF can begin at 4 or 5 or even younger in some cats. The cats
ranged in age from 9 months to 22 years. IOW, without highly specialized
tests, we never know when CRF actually begins. Therefore, lowering
phosphorus intake early in life will more than likely delay the onset of
clinical CRF and slow the progression of subclinical CRF in cats with
undetected CRF. There's absolutely no benefit in feeding high phosphorus
diets.

Good points. I'm seeing another vet tomorrow for a second opinion about
a good diet, considering the diabetes as well as any sub-clinical kidney
disease. Seems like paying the most attention to low carb (better for
the diabetes) and low phos (better for the kidneys) will address both
needs the best - we'll see what he has to say. I really need advice
that's geared to the "whole cat" so that I'm not making one problem
worse or creating a whole new problem while trying to treat only one of
several. Who knows, since the diabetes developed within 3 months of
starting KD, maybe the high carb content even contributed to that.

Thanks for the thoughts -
Jean