Tiger's kidneys

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.

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.

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.

"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.

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.

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.

"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.

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.

"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.

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.