Adding weight to a cat in kidney failure

First post here. A quick Googling didn't give me any answers, but I'm
happy to accept pointers to other threads if needed.

I have a cat, Weiz, who is 16 and has some kidney failure. He is on
Fortekor, and has had very little progression in the 3-ish years since
he's started it. Fortekor and a protein-limited diet is his only
treatment at this time.

He is free-fed dry food, and gets one meal a day of canned food. He's
always been a light eater, and the only lower-protein dry foods I can
find which are actually made with ingredients I wand my cats to
ingest, are also "Lite" formulas. His canned food is also as premium
as I can get while keeping the protein in some degree of check, and
are not "Lite", but he only eats about an ounce of the wet, at his own
choice.

As a result, he is pretty skinny. He is alert, happy, playful,
affectionate, etc, particularly relative to his age, but under his
fluff he's mostly bones. I know some of it is due to the restricted
protein, but a lot of it is likely being on "Lite" food and not eating
all that much of it. He's *interested* in food (particularly human
food), but he's not a real big eater, and never has been.

Compounding the problem is the fact that he will spend the better part
of fifteen minutes vomiting if he so much as *tastes* certain
palatabiliy enhancers like red meat juices. If we turn our heads a
moment and he gets just a tongue on a bit of red meat, we've got
twenty little barf puddles to look forward to, and he's miserable. I
actually worry he'll vomit himself into a stroke (which did happen to
one of our cats).

Anyhow, I would very much like to get a little weight on him, without
adding protein to his diet. We've tried some pure fats (cod liver
oil, lard, margarine, butter) and he might or might not ingest a pea-
sized amount of it, but he's clearly unimpressed.

He loves fresh fish (sushi) and roasted chicken, and would eat himself
full on those, but the protein thing kicks in.

Are there any recommendations for a high fat/calorie, low-protein cat
treat/food? I don't mind doing some grinding/chopping, and I don't
mind paying for the good stuff - I'd give the old guy foie gras if it
fit the bill. They already eat better than I do, so why stop now?

Any suggestions would be welcome. The old boy seems to have a whole
lot of life left in him, and I'd like him to make the most of it. (He
recently beat the snot out of our lunatic 5-year old cat twice his
size, when she tried to take him on. And that's in his present state
of muscle tone!)

Thanks in advance for any ideas.

Renee
and the gang

Part of your whole problem is that you are starving him by limiting his
protein his is now malnourished. 20 years ago the protocal as to limit
protien now with current dialysis patients you are encouraged to eat meat &
other protiens. Protiens keep you from developing malnutrition.

You really need to change the diet.

Celeste




"Smalph" wrote in message
oups.com...
First post here. A quick Googling didn't give me any answers, but I'm
happy to accept pointers to other threads if needed.

I have a cat, Weiz, who is 16 and has some kidney failure. He is on
Fortekor, and has had very little progression in the 3-ish years since
he's started it. Fortekor and a protein-limited diet is his only
treatment at this time.

He is free-fed dry food, and gets one meal a day of canned food. He's
always been a light eater, and the only lower-protein dry foods I can
find which are actually made with ingredients I wand my cats to
ingest, are also "Lite" formulas. His canned food is also as premium
as I can get while keeping the protein in some degree of check, and
are not "Lite", but he only eats about an ounce of the wet, at his own
choice.

As a result, he is pretty skinny. He is alert, happy, playful,
affectionate, etc, particularly relative to his age, but under his
fluff he's mostly bones. I know some of it is due to the restricted
protein, but a lot of it is likely being on "Lite" food and not eating
all that much of it. He's *interested* in food (particularly human
food), but he's not a real big eater, and never has been.

Compounding the problem is the fact that he will spend the better part
of fifteen minutes vomiting if he so much as *tastes* certain
palatabiliy enhancers like red meat juices. If we turn our heads a
moment and he gets just a tongue on a bit of red meat, we've got
twenty little barf puddles to look forward to, and he's miserable. I
actually worry he'll vomit himself into a stroke (which did happen to
one of our cats).

Anyhow, I would very much like to get a little weight on him, without
adding protein to his diet. We've tried some pure fats (cod liver
oil, lard, margarine, butter) and he might or might not ingest a pea-
sized amount of it, but he's clearly unimpressed.

He loves fresh fish (sushi) and roasted chicken, and would eat himself
full on those, but the protein thing kicks in.

Are there any recommendations for a high fat/calorie, low-protein cat
treat/food? I don't mind doing some grinding/chopping, and I don't
mind paying for the good stuff - I'd give the old guy foie gras if it
fit the bill. They already eat better than I do, so why stop now?

Any suggestions would be welcome. The old boy seems to have a whole
lot of life left in him, and I'd like him to make the most of it. (He
recently beat the snot out of our lunatic 5-year old cat twice his
size, when she tried to take him on. And that's in his present state
of muscle tone!)

Thanks in advance for any ideas.

Renee
and the gang

"Spot" wrote in message
news:jz63i.7547$vu2.5475@trndny01...
Part of your whole problem is that you are starving him by limiting his
protein his is now malnourished. 20 years ago the protocal as to limit
protien now with current dialysis patients you are encouraged to eat meat
& other protiens. Protiens keep you from developing malnutrition.

You really need to change the diet.
----------
I was going to say the same thing. I have been feeding Alex, my CRF kitty,
canned cat food (a combination of Wellness, Beef and Chicken flavor, and
Fancy Feast, Tender Beef Feast) and Purina OM dry food. Neither of the
aforementioned canned foods contains wheat gluten, BTW, and neither of them
has been recalled either. Before the CRF diagnosis, the vet had placed Alex
is on low carb diet due to his diabetes diagnosis which required insulin
injections. He stopped needing the insulin within weeks after a switch from
Weight Managment Iams, dry food only, to canned cat food with Purina OM dry.
He also lost weight. The recovery from diabetes is in all likelihood due to
the Lantus insulin and not to the diet change, but Alex hasn't needed any
insulin for nearly a year. Since the first sign we had that Molly (a cat we
had to euthanize last year due to endstage CRF) was sick was her weight
loss, I was understandably very nervous about Alex's weight loss (even
though the weight loss was intentional because of the diabetes). Even if
Alex didn't lose weight because of CRF, I know that all cats with CRF will
eventually lose weight in the endstage of the disease, so in the case of
early stage CRF kitties, it's better if they weigh a little more than a
little less.

To make a long story short, Alex has gained a half pound since December
eating a total of about about 4 or 5 ounces of canned cat food per day
(divided into two meals about 12 hours apart) in addition to dry Purina OM
(left out at all times for grazing). Now, I am cutting back on his canned
food a little bit since he has gained a lot of weight in a short time, and
his blood glucose has risen (from an average of about 80 to an average of
about 100). I don't know if the increased blood glucose is because of his
weight gain or not, but I intend to discuss it with the vet next month when
he goes for his repeat blood work. (There is nothing wrong with a blood
glucose of 100 per se. I am just concerned that it may be a trend).

At any rate, based on documentation that Phil sent me (from Dr. Polzin who
is an authority in this area), there is no conclusive evidence that a low
protein diet slows progression of CRF, but we know for sure that a low
protein diet results in muscle atrophy.

Just my 2 cents worth. I'm not a veterinarian.
Best regards,
---Cindy S.

On May 17, 8:37 pm, "Spot" wrote:
Part of your whole problem is that you are starving him by limiting his
protein his is now malnourished. 20 years ago the protocal as to limit
protien now with current dialysis patients you are encouraged to eat meat &
other protiens. Protiens keep you from developing malnutrition.

You really need to change the diet.

Perhaps I should clarify... he isn't on an *extremely* restricted
protein intake. The food isn't prescription low-protein. The "Lite"
dry food is at 28%, and the canned foods range from 8-11%. For
reference, the prescription diet foods (which don't seem to contain
actual *food*, so I prefer not to feed them) are at 26% for dry and 8%
for canned. The food we fed prior to his diagnosis was roughly 32%
(dry) and 8-12% (canned). The foods he's eating are just premium
brands which offer lower-than-average protein (in the case of the dry
food) and average protein (for the canned).

He is, in other words, on the same menu plan that a zillion other non-
CRF cats are on. This is the exact food that the lunatic 5 year old
is eating, and she's in terrific shape and weight - because she's not
a dainty eater (she'd probably be darn hefty if I switched to
non-"Lite" dry food). Weiz is, and always has been. He has never been
more than "slender". Additionally, he will vomit up the higher-protein
(33%) dry food I sneak my youngest (18 months, a rescue, under 5
pounds, HCM). Even if he only gets a few kibbles.

I do understand why you'd be concerned, if you thought I was totally
starving him of protein. I also understand that it'd be dumb to be
trying to guard his kidneys while atrophying his muscles so that he
can't enjoy the good life! He actually seems to have pretty good
muscle tone, to tell the truth, and he runs around and has no trouble
jumping where he wants to go. If you were just watching him, you
wouldn't guess he was 16, or had any veterinary issues.

But I don't want to bump him up to *high* protein, under his vet's
recommendation (and barf risk). What he needs is calories in a more
concentrated form, since he doesn't eat enough volume to compensate
for being on the "Lite" food (and would vomit up the non-"Lite" food).
He *is* somewhat malnourished, but it's a caloric intake issue, and
I'm hoping folks have some recommendation on high-calorie foods that
won't wonk up his kidneys and/or make him vomit.

Thanks very much for the comments so far!

Renee

"Smalph" wrote in message
ups.com...

snip

He is, in other words, on the same menu plan that a zillion other non-
CRF cats are on. This is the exact food that the lunatic 5 year old
is eating, and she's in terrific shape and weight - because she's not
a dainty eater (she'd probably be darn hefty if I switched to
non-"Lite" dry food). Weiz is, and always has been. He has never been
more than "slender". Additionally, he will vomit up the higher-protein
(33%) dry food I sneak my youngest (18 months, a rescue, under 5
pounds, HCM). Even if he only gets a few kibbles.

I do understand why you'd be concerned, if you thought I was totally
starving him of protein. I also understand that it'd be dumb to be
trying to guard his kidneys while atrophying his muscles so that he
can't enjoy the good life! He actually seems to have pretty good
muscle tone, to tell the truth, and he runs around and has no trouble
jumping where he wants to go. If you were just watching him, you
wouldn't guess he was 16, or had any veterinary issues.
-----------
It's common veterinary practice to put CRF kitties on low protein diets. My
previous vet wanted me to put Alex on prescription NF, which is a low
protein formulation for kitties with CRF. (I recently started seeing a new
vet because the previous vet, whom I liked a lot, left the practice). My
impression was that Celeste (aka Spot) was thinking (and I was too) that
this was what was going on, and she was intending to be helpful.

One of the problems with Usenet is that we can only see people's words and
not their facial expressions or tone of voice, and it's so easy to
misconstrue someone's intent. I think Celeste was trying to say: "You have
good intentions and are probably feeding your cat a low protein diet because
your veterinarian advised you that CRF kitties should be on low protein
diets, but I think your vet is wrong because low protein = muscle atrophy,
and you may not realize but a low protein diet = malnutrition." You OTOH
understood Celeste to be saying "You idiot! You are starving your cat!
What's wrong with you ???!!" And so you understandably responded
defensively. But I really don't think Celeste meant to be accusatory in any
way. I know I didn't.

You are obviously trying very hard to do what's right for your cat. It's
always a guessing game. I drive myself crazy about Alex wondering if I
should try to keep his weight higher (because of the inevitable weight loss
that accompanies CRF) or lower (because of his prior diabetes and the risk
of requiring insulin supplement again). I think we're all on the same team,
all wanting to do right by our kitties. We're all just trying to help each
other.
Best regards,
---Cindy S.

On May 17, 11:03 pm, "cindys" wrote:
"Smalph" wrote in message

ups.com...

snip





He is, in other words, on the same menu plan that a zillion other non-
CRF cats are on. This is the exact food that the lunatic 5 year old
is eating, and she's in terrific shape and weight - because she's not
a dainty eater (she'd probably be darn hefty if I switched to
non-"Lite" dry food). Weiz is, and always has been. He has never been
more than "slender". Additionally, he will vomit up the higher-protein
(33%) dry food I sneak my youngest (18 months, a rescue, under 5
pounds, HCM). Even if he only gets a few kibbles.

I do understand why you'd be concerned, if you thought I was totally
starving him of protein. I also understand that it'd be dumb to be
trying to guard his kidneys while atrophying his muscles so that he
can't enjoy the good life! He actually seems to have pretty good
muscle tone, to tell the truth, and he runs around and has no trouble
jumping where he wants to go. If you were just watching him, you
wouldn't guess he was 16, or had any veterinary issues.

-----------
It's common veterinary practice to put CRF kitties on low protein diets. My
previous vet wanted me to put Alex on prescription NF, which is a low
protein formulation for kitties with CRF. (I recently started seeing a new
vet because the previous vet, whom I liked a lot, left the practice). My
impression was that Celeste (aka Spot) was thinking (and I was too) that
this was what was going on, and she was intending to be helpful.

One of the problems with Usenet is that we can only see people's words and
not their facial expressions or tone of voice, and it's so easy to
misconstrue someone's intent. I think Celeste was trying to say: "You have
good intentions and are probably feeding your cat a low protein diet because
your veterinarian advised you that CRF kitties should be on low protein
diets, but I think your vet is wrong because low protein = muscle atrophy,
and you may not realize but a low protein diet = malnutrition." You OTOH
understood Celeste to be saying "You idiot! You are starving your cat!
What's wrong with you ???!!" And so you understandably responded
defensively. But I really don't think Celeste meant to be accusatory in any
way. I know I didn't.

You are obviously trying very hard to do what's right for your cat. It's
always a guessing game. I drive myself crazy about Alex wondering if I
should try to keep his weight higher (because of the inevitable weight loss
that accompanies CRF) or lower (because of his prior diabetes and the risk
of requiring insulin supplement again). I think we're all on the same team,
all wanting to do right by our kitties. We're all just trying to help each
other.
Best regards,
---Cindy S.-

Heh heh heh... here is further evidence of that whole "words not
faces" issue. I'm honestly not offended or feeling picked on at all.
I've been on Usenet long enough to both have a thick skin anyhow, and
also understand that it's generally the most passionate people who
choose to respond. The advice I got was definitely not inappropriate
for the information I'd posted. I knew that posting more details than
just "got any low-protein, high-calorie treats?" would invite
comments, and that's great. I'm looking out for my boy Weiz, and
welcome people's input.

I just figured I'd clarify that while Weiz is on a somewhat lower
protein food than some, it's not a *LOW* protein diet. It's likely
that giving him more protein would help his muscling somewhat, but he
can't seem to tolerate higher protein. Vomiting is, of course,
counterproductive to gaining weight. So getting him some nice
palatable calories that aren't excessively proteiney would be, I hope,
good for him.

Neither of you were accusatory, and I apologize if it sounded like I
was, well, accusing you of that! No hard feelings, I hope.

So does anyone have any suggestions for some nice fatty snax that
won't make him upchuck everywhere?

Renee

"Smalph" wrote in message
oups.com...

So does anyone have any suggestions for some nice fatty snax that
won't make him upchuck everywhere?
------------
How does he do with carbohydrates? The Pet Promise pet food (which does not
contain wheat products) does contain potatoes and brown rice. My vet
discouraged this food for Alex because of his propensity toward diabetes,
but it is a really good quality cat food without any byproducts or
antibiotics or factory farmed meats or dyes or additives. It comes in only
three flavors: Chicken, salmon and ocean fish. None of the flavors contains
any red meat or red meat juices.

http://www.petpromiseinc.com/products_cat.htm

Another possibility that may help your kitty gain weight is kitten food,
which tends to be high calorie.
Best regards,
---Cindy S.

"Smalph" wrote in message
ups.com...
On May 17, 8:37 pm, "Spot" wrote:
Part of your whole problem is that you are starving him by limiting his
protein his is now malnourished. 20 years ago the protocal as to limit
protien now with current dialysis patients you are encouraged to eat
meat &
other protiens. Protiens keep you from developing malnutrition.

You really need to change the diet.

Perhaps I should clarify... he isn't on an *extremely* restricted
protein intake. The food isn't prescription low-protein. The "Lite"
dry food is at 28%, and the canned foods range from 8-11%.

Hi Renee,

I'm not sure if you know how to compare the nutrient values of dry food to
canned food. When comparing foods that have different moisture contents the
foods must be compared on a dry matter basis-- taking the moisture out of
the equation and leveling the battlefield. IOW, the canned food with 8%
protein actually contains more (36%) protein (dry matter basis) than the dry
food with 28% protein (31% DMB). The canned food with 11% protein "as fed"
contains over 50% protein (dry matter basis) --assuming the food contains
78% moisture.

For a more detailed explanation, please visit my site
http://maxshouse.com/feline_nutrition.htm Scroll down to "TERMS USED TO
DESCRIBE FELINE NUTRITION".


I do understand why you'd be concerned, if you thought I was totally
starving him of protein. I also understand that it'd be dumb to be
trying to guard his kidneys while atrophying his muscles so that he
can't enjoy the good life!

That's not even the half of the deleterious effects of premature protein
restriction in cats! In addition to decreased plasma protein levels and
muscle wasting, protein deficiency results in impaired immunological
response and resistance to infection, reduced hemoglobin production and
anemia. Restricting protein in cats can also decrease GRF (the rate the
kidneys filter blood) which can actually drive the BUN up.

The theory of restricting protein to slow the progression of CRF in cats was
based on old studies in rats. Its now known that the mechanisms that can
alter the progression of CRF in the rat don't have the same effect in the
cat- or even the dog. Protein shouldn't be restricted in cats until the BUN
reaches 60-80 mg/dl- and then only to control azotemia. The detrimental
effects of protein restriction is particularly important in cats because
they can't readily adapt to reduced-protein diets.

It would be better for him to eat more canned food than dry. The higher
water content of canned food will help keep him hydrated and will also help
flush uremic toxins from his system.

Best of luck,

Phil

"Smalph" wrote in message
ups.com...
What he needs is calories in a more
concentrated form, since he doesn't eat enough volume to compensate
for being on the "Lite" food (and would vomit up the non-"Lite" food).
He *is* somewhat malnourished, but it's a caloric intake issue, and
I'm hoping folks have some recommendation on high-calorie foods that
won't wonk up his kidneys and/or make him vomit.

.............offer food 4 times a day if you can. It wasn't clear to me if
the roasted chicken your cat loves makes him vomit. If not, add some to
each feeding. Fat also works.

buglady
take out the dog before replying

On May 18, 1:44 am, "Phil P." wrote:
"Smalph" wrote in message

Perhaps I should clarify... he isn't on an *extremely* restricted
protein intake. The food isn't prescription low-protein. The "Lite"
dry food is at 28%, and the canned foods range from 8-11%.

Hi Renee,

I'm not sure if you know how to compare the nutrient values of dry food to
canned food. When comparing foods that have different moisture contents the
foods must be compared on a dry matter basis-- taking the moisture out of
the equation and leveling the battlefield. IOW, the canned food with 8%
protein actually contains more (36%) protein (dry matter basis) than the dry
food with 28% protein (31% DMB). The canned food with 11% protein "as fed"
contains over 50% protein (dry matter basis) --assuming the food contains
78% moisture.

While I wasn't aware of the exact math, I did realize that "as fed" or
"as labelled" proportions would be skewed by the water content. I
can't imagine a cat living on 8% protein overall.

For a more detailed explanation, please visit my sitehttp://maxshouse.com/feline_nutrition.htm Scroll down to "TERMS USED TO
DESCRIBE FELINE NUTRITION".

I do understand why you'd be concerned, if you thought I was totally
starving him of protein. I also understand that it'd be dumb to be
trying to guard his kidneys while atrophying his muscles so that he
can't enjoy the good life!

That's not even the half of the deleterious effects of premature protein
restriction in cats! In addition to decreased plasma protein levels and
muscle wasting, protein deficiency results in impaired immunological
response and resistance to infection, reduced hemoglobin production and
anemia. Restricting protein in cats can also decrease GRF (the rate the
kidneys filter blood) which can actually drive the BUN up.

Just based on the fact he is getting commercial cat food (and the kind
that has actual, you know, *food* in it!), which is certified, I've
been operating under the assumption that he's getting an acceptable
level of protein (and other nutrients). While his foods are on the
lower end of the protein scale, they're not specifically protein-
reduced. And my other adult cat is on the same foods and is in great
shape. (the youngster does get some higher protein food, since she's
ostensibly still growing).

Another poster suggested giving Weiz kitten food, but unfortunately
even one or two kibbles of that and he spends the next fifteen minutes
barfing everywhere. (It would be nice if cats didn't feel the need to
run all over the house to barf in as many locations as possible)

The theory of restricting protein to slow the progression of CRF in cats was
based on old studies in rats. Its now known that the mechanisms that can
alter the progression of CRF in the rat don't have the same effect in the
cat- or even the dog. Protein shouldn't be restricted in cats until the BUN
reaches 60-80 mg/dl- and then only to control azotemia. The detrimental
effects of protein restriction is particularly important in cats because
they can't readily adapt to reduced-protein diets.

I did know that cats *need* protein, and in non-insignificant amounts.
(btw, I'm not meaning to sound defensive. My tone is intended to be
conversational!). I'll check with the vet next time he's in, but his
bloodworks for the last 3-ish years have been very much to the vet's
satisfaction, other than the early CRF. Everything else is good, and
other than being skinny, he's a pretty healthy fella. I don't know his
BUN off the top of my head, but I'm thinking it can't be particularly
alarming since the vet isn't particularly concerned at the moment.

It would be better for him to eat more canned food than dry. The higher
water content of canned food will help keep him hydrated and will also help
flush uremic toxins from his system.

I would love for him to eat more canned. I buy the best stuff I can
find in my area (I'm in Canada, and the brand another poster
recommended doesn't seem to be here). The trouble is that he's always
been a light eater, and even if I put out some nice stinky food, he
just has a few bites and wanders off. If it's a very moist food
(either the gravy-ful foods that were recalled, or if I add water to
firmer ones) he'll drink the gravy/water and leave the solids. He
drinks a fair bit, though not alarming quantities. He should be
flushing pretty well. I just want the little brute to eat more!
The only things he's near-frantic to eat that I'm willing to let him
eat (pizza and oniony soups are not on that list, but he wants them
badly) are sushi (snapper, in particular) and rotisserie roasted
chicken. He seems to tolerate them pretty well, too, so I guess I'll
make little snack packs for him.

If anyone cares, he's the orange and white one at http://www.smalph.com/photo.htm
A handsome boy, no?

Best of luck,

Thanks very much! He is doing very well, really. Rules the roost, to
boot.

Renee