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Hill's T/D carbs - Thanks, Steve and Liz for the interestingdiscussion



 
 
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  #11  
Old July 3rd 03, 06:37 PM
Jean
external usenet poster
 
Posts: n/a
Default


Hi Jean,
I think it's great that you're researching the best diet for your cat. I think
the quality of the protein you feed is very important. While there are many
conflicting opinions on the phosphorous issue, I don't think anyone is
advocating a high phosphorous diet. I do think while phosphorous is important,
it is also very important to look at the entire diet and to feed a high quality
diet that is fit for a carnivore and that isn't grain based. I think you've
got it right, when seeing the cat as a whole being. That's the main philosphy
of holistic vets.
Best of luck with finding the right diet for your kitty

Lauren


Lauren -

Thanks for the encouragement. It'd be nice if things are more black and
white! But at the same time, it's the "standard treatment protocols"
that cause problems when there are multiple issues and conflicting
treatments. The more I've read, the clearer it is that the grain based
combinations that the cat food makers call protein are not usable in
cats the way they are in humans. It becomes even murkier because alot of
animal proteins also provide alot of phosphorous so it's important to
pick and choose carefully. Slowly but surely getting there!

Thanks again-
Jean

  #12  
Old July 3rd 03, 06:37 PM
Jean
external usenet poster
 
Posts: n/a
Default


Hi Jean,
I think it's great that you're researching the best diet for your cat. I think
the quality of the protein you feed is very important. While there are many
conflicting opinions on the phosphorous issue, I don't think anyone is
advocating a high phosphorous diet. I do think while phosphorous is important,
it is also very important to look at the entire diet and to feed a high quality
diet that is fit for a carnivore and that isn't grain based. I think you've
got it right, when seeing the cat as a whole being. That's the main philosphy
of holistic vets.
Best of luck with finding the right diet for your kitty

Lauren


Lauren -

Thanks for the encouragement. It'd be nice if things are more black and
white! But at the same time, it's the "standard treatment protocols"
that cause problems when there are multiple issues and conflicting
treatments. The more I've read, the clearer it is that the grain based
combinations that the cat food makers call protein are not usable in
cats the way they are in humans. It becomes even murkier because alot of
animal proteins also provide alot of phosphorous so it's important to
pick and choose carefully. Slowly but surely getting there!

Thanks again-
Jean

  #13  
Old July 8th 03, 01:15 PM
Phil P.
external usenet poster
 
Posts: n/a
Default


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

Sorry for coming in late -- just got back.


I've been in and out too -


I've been in and out of the country for the last few weeks - Two more months
of this.... ;( I think I have perpetual jet lag! At least I don't have
to keep
resetting my watch - I gain 12 hrs going and lose 12 comming back! .

There's nothing like being greeted by 5 cats! ...


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.


You should try the CRF support list - You'll get a lot of good information.
I'm sure someone can get you the URL.

Here's another site you may find helpful:
Chronic Renal Failure and Diabetes
http://www.petdiabetes.org/chronic_renal_failure.htm





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)


Here's one:

"Most veterinary nephrologists recommend that dietary protein reduction be
initiated when the animal's blood urea nitrogen concentration is between 60
and 80 mg/dI. Examples of commercially available diets that contain
reduced-quantity, high-quality-protein include Hill's Prescription Diet k/d,
Purina NF-formula diets, and Waltham Veterinarian medium- and low-protein
diets. Homemade reduced-protein diet recipes are also available." Gregory F.
Grauer, DVM, MS, Dipl. ACVIM, Professor and Section Chief, Small Animal
Medicine, Department of Clinical Sciences, Veterinary Teaching Hospital,
Colorado State University Fort Collins, Colorado (Excerpted from SAIM)


There are others, but that should suffice for now.





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.


Was your cat's hydration status determined? The elevated values might have
been due to prerenal uremia secondary to dehydration.


Kitty's been on K/D since Feb. but was just Dx with diabetes.


Was you cat's diabetes confirmed with either fructosamine or glycosylatated
hemoglobin tests? Glycosylated Hb shows the average glucose control over
the past couple of months and the fructosamine test reflects average glucose
control for the past 1-3 weeks. These test distinguish true diabetes from
physiologic (stress) hyperglycemia ("white coat effect"). The trip to the
vet is usually enough to cause physiologic hyperglycemia in many cats.
From the time you put the cat in the carrier, the car ride (cats generally
don't like car rides), the vet's office with the scents of many past and
present animals, restrained for blood collection, and getting poked with a
needle ---- which all could take as much as an hour -- is more than enough
time and stress to trigger the cat's
defensive mechanisms and for physiologic hyperglycemia to develop. Many of
our cats tested "diabetic" at the clinic and normal a few hours later back
at the shelter.



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.


For awhile I was a proponent of high-protein, low-carb diets for diabetes -
until a few cats became azotemic. I was able to wean several cats off
insulin completely but I don't think it's worth the risk. After a lot
of research and discussions with vets, I'm now back to the conventional
treatment - fiber blend, and insulin when necessary.



The other problem I'm seeing with KD is
how high in fat it is - 50%.


Actually, the fat content of canned k/d is 7.6% (As fed) and 26.7% (dry
matter basis).and 20.6% (AF) - 22.3% (DM) for the dry. The higher fat
supplies non-protein calories to meet the cat's energy needs while producing
less waste products from protein catabolism


My kitty is 16, has a bit of a weight
problem and high cholesterol


Obesity can cause a reversible insulin resistance in cats which often
resolves after the cat's ideal weight is reached.




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.


What where you feeding your cat before?


Thanks for the thoughts -


Before you set off on any therapeutic plan, I'd have the diabetes confirmed
with fructosamine or glycosylatated hemoglobin tests.

Best of luck.

Phil


Jean







  #14  
Old July 8th 03, 01:15 PM
Phil P.
external usenet poster
 
Posts: n/a
Default


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

Sorry for coming in late -- just got back.


I've been in and out too -


I've been in and out of the country for the last few weeks - Two more months
of this.... ;( I think I have perpetual jet lag! At least I don't have
to keep
resetting my watch - I gain 12 hrs going and lose 12 comming back! .

There's nothing like being greeted by 5 cats! ...


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.


You should try the CRF support list - You'll get a lot of good information.
I'm sure someone can get you the URL.

Here's another site you may find helpful:
Chronic Renal Failure and Diabetes
http://www.petdiabetes.org/chronic_renal_failure.htm





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)


Here's one:

"Most veterinary nephrologists recommend that dietary protein reduction be
initiated when the animal's blood urea nitrogen concentration is between 60
and 80 mg/dI. Examples of commercially available diets that contain
reduced-quantity, high-quality-protein include Hill's Prescription Diet k/d,
Purina NF-formula diets, and Waltham Veterinarian medium- and low-protein
diets. Homemade reduced-protein diet recipes are also available." Gregory F.
Grauer, DVM, MS, Dipl. ACVIM, Professor and Section Chief, Small Animal
Medicine, Department of Clinical Sciences, Veterinary Teaching Hospital,
Colorado State University Fort Collins, Colorado (Excerpted from SAIM)


There are others, but that should suffice for now.





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.


Was your cat's hydration status determined? The elevated values might have
been due to prerenal uremia secondary to dehydration.


Kitty's been on K/D since Feb. but was just Dx with diabetes.


Was you cat's diabetes confirmed with either fructosamine or glycosylatated
hemoglobin tests? Glycosylated Hb shows the average glucose control over
the past couple of months and the fructosamine test reflects average glucose
control for the past 1-3 weeks. These test distinguish true diabetes from
physiologic (stress) hyperglycemia ("white coat effect"). The trip to the
vet is usually enough to cause physiologic hyperglycemia in many cats.
From the time you put the cat in the carrier, the car ride (cats generally
don't like car rides), the vet's office with the scents of many past and
present animals, restrained for blood collection, and getting poked with a
needle ---- which all could take as much as an hour -- is more than enough
time and stress to trigger the cat's
defensive mechanisms and for physiologic hyperglycemia to develop. Many of
our cats tested "diabetic" at the clinic and normal a few hours later back
at the shelter.



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.


For awhile I was a proponent of high-protein, low-carb diets for diabetes -
until a few cats became azotemic. I was able to wean several cats off
insulin completely but I don't think it's worth the risk. After a lot
of research and discussions with vets, I'm now back to the conventional
treatment - fiber blend, and insulin when necessary.



The other problem I'm seeing with KD is
how high in fat it is - 50%.


Actually, the fat content of canned k/d is 7.6% (As fed) and 26.7% (dry
matter basis).and 20.6% (AF) - 22.3% (DM) for the dry. The higher fat
supplies non-protein calories to meet the cat's energy needs while producing
less waste products from protein catabolism


My kitty is 16, has a bit of a weight
problem and high cholesterol


Obesity can cause a reversible insulin resistance in cats which often
resolves after the cat's ideal weight is reached.




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.


What where you feeding your cat before?


Thanks for the thoughts -


Before you set off on any therapeutic plan, I'd have the diabetes confirmed
with fructosamine or glycosylatated hemoglobin tests.

Best of luck.

Phil


Jean







  #15  
Old July 8th 03, 01:17 PM
Phil P.
external usenet poster
 
Posts: n/a
Default


"Liz" wrote in message
om...
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 luck.

Phil


I posted studies showing that phosphurus did not add to kidney damage
EVEN in cats with CRF



Steve already debunked all your BS - Either you're obtuse or in denial or
both to accept it. I think most people know who to believe... and it ain't
you. I don't intend to go through this all over again with you.

Tell you what... Post your phosphorus epiphany in the CRF support lists...
You should get a real warm welcome! LOL!



  #16  
Old July 8th 03, 01:17 PM
Phil P.
external usenet poster
 
Posts: n/a
Default


"Liz" wrote in message
om...
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 luck.

Phil


I posted studies showing that phosphurus did not add to kidney damage
EVEN in cats with CRF



Steve already debunked all your BS - Either you're obtuse or in denial or
both to accept it. I think most people know who to believe... and it ain't
you. I don't intend to go through this all over again with you.

Tell you what... Post your phosphorus epiphany in the CRF support lists...
You should get a real warm welcome! LOL!



  #17  
Old July 8th 03, 03:12 PM
Jean
external usenet poster
 
Posts: n/a
Default

Hi Phil -

There's nothing like being greeted by 5 cats! ...

And I'll bet they were glad to see *you* too!


You should try the CRF support list - You'll get a lot of good information.
I'm sure someone can get you the URL.
....
"Most veterinary nephrologists recommend that dietary protein reduction be
initiated when the animal's blood urea nitrogen concentration is between 60
and 80 mg/dI. Examples of commercially available diets that contain
reduced-quantity, high-quality-protein include Hill's Prescription Diet k/d..


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

I've posted a couple questions on the CRF board and done quite a bit of
reading. The problem is that Muffin's kidney values right now don't
qualify him for the CRF category. I've gleaned alot of pertinent info
though, which is what has led me to placing the most credence in
following a low phos diet, but one with lower carbs and higher protein
than k/d in order to treat the diabetes better. The felinediabetes.com
message board has been extremely helpful also.


Was your cat's hydration status determined?

Hydration was OK. I don't have the number for specific gravity - the vet
merely said that kitty was concentrating his urine pretty well.

Was you cat's diabetes confirmed with either fructosamine

Yes - 722
or glycosylatated
hemoglobin tests?

No

These test distinguish true diabetes from
physiologic (stress) hyperglycemia ("white coat effect").


No doubt about it, my kitty is stressed at the vet! Another factor is
that he's been on prednisone for about a year, which can either raise BG
and/or precipitate diabetes. I've been doing home BG testing before and
since changing kitty's diet to higher protein, lower carb and low phos.
The "second opinion" vet hinted that given kitty's current BG curves,
and all the other factors (pred & borderline kidney values) he *might*
be a cat who can be regulated through diet alone. His recommendation
(for now) was to
1. continue insulin - 1u PZI Vet BID
2. wean off the pred (for arthritis) and see if the cosequin (he's been
getting for a couple months now) is working well enough - if not, he'll
look into something besides pred for pain control.
3. feed a moderate protein, low carb, low phos diet
4. home test BG to keep a close watch on BG
5. re-check bloodwork frequently (in a month) to closely monitor kidney
values
6. re-evaluate diet if kidney values start to rise

"second opinion" vet now has a new client :-)

The higher fat
supplies non-protein calories to meet the cat's energy needs while producing
less waste products from protein catabolism


That's pretty much what the vet said - not to worry about fat content
since it doesn't cause the same problems in cats that it does in humans

Obesity can cause a reversible insulin resistance in cats which often
resolves after the cat's ideal weight is reached.


He was up to 15lbs at one point, but is now down to 12.5

Before you set off on any therapeutic plan, I'd have the diabetes confirmed
with fructosamine or glycosylatated hemoglobin tests.


It's definitely been confirmed and I have already seen very positive
results from the insulin. He's *much* perkier/more active, coat is much
better and not peeing so much. From what the new vet has said, I'm just
keeping my fingers crossed that losing the pred and changing diet might
just do the trick without insulin and without sabotaging kidneys. Time
will tell!

Thanks for all your thoughts!
Jean


  #18  
Old July 8th 03, 03:12 PM
Jean
external usenet poster
 
Posts: n/a
Default

Hi Phil -

There's nothing like being greeted by 5 cats! ...

And I'll bet they were glad to see *you* too!


You should try the CRF support list - You'll get a lot of good information.
I'm sure someone can get you the URL.
....
"Most veterinary nephrologists recommend that dietary protein reduction be
initiated when the animal's blood urea nitrogen concentration is between 60
and 80 mg/dI. Examples of commercially available diets that contain
reduced-quantity, high-quality-protein include Hill's Prescription Diet k/d..


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

I've posted a couple questions on the CRF board and done quite a bit of
reading. The problem is that Muffin's kidney values right now don't
qualify him for the CRF category. I've gleaned alot of pertinent info
though, which is what has led me to placing the most credence in
following a low phos diet, but one with lower carbs and higher protein
than k/d in order to treat the diabetes better. The felinediabetes.com
message board has been extremely helpful also.


Was your cat's hydration status determined?

Hydration was OK. I don't have the number for specific gravity - the vet
merely said that kitty was concentrating his urine pretty well.

Was you cat's diabetes confirmed with either fructosamine

Yes - 722
or glycosylatated
hemoglobin tests?

No

These test distinguish true diabetes from
physiologic (stress) hyperglycemia ("white coat effect").


No doubt about it, my kitty is stressed at the vet! Another factor is
that he's been on prednisone for about a year, which can either raise BG
and/or precipitate diabetes. I've been doing home BG testing before and
since changing kitty's diet to higher protein, lower carb and low phos.
The "second opinion" vet hinted that given kitty's current BG curves,
and all the other factors (pred & borderline kidney values) he *might*
be a cat who can be regulated through diet alone. His recommendation
(for now) was to
1. continue insulin - 1u PZI Vet BID
2. wean off the pred (for arthritis) and see if the cosequin (he's been
getting for a couple months now) is working well enough - if not, he'll
look into something besides pred for pain control.
3. feed a moderate protein, low carb, low phos diet
4. home test BG to keep a close watch on BG
5. re-check bloodwork frequently (in a month) to closely monitor kidney
values
6. re-evaluate diet if kidney values start to rise

"second opinion" vet now has a new client :-)

The higher fat
supplies non-protein calories to meet the cat's energy needs while producing
less waste products from protein catabolism


That's pretty much what the vet said - not to worry about fat content
since it doesn't cause the same problems in cats that it does in humans

Obesity can cause a reversible insulin resistance in cats which often
resolves after the cat's ideal weight is reached.


He was up to 15lbs at one point, but is now down to 12.5

Before you set off on any therapeutic plan, I'd have the diabetes confirmed
with fructosamine or glycosylatated hemoglobin tests.


It's definitely been confirmed and I have already seen very positive
results from the insulin. He's *much* perkier/more active, coat is much
better and not peeing so much. From what the new vet has said, I'm just
keeping my fingers crossed that losing the pred and changing diet might
just do the trick without insulin and without sabotaging kidneys. Time
will tell!

Thanks for all your thoughts!
Jean


 




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