One question I get a lot is “What should I feed my CKD cat?” (CKD stands for chronic kidney disease. It’s also called CRF, chronic renal disease.)
Not having a definitive answer, I requested an interview with one of my favorite cat experts, the holistic vet, Dr. Jean Hofve.
She provided some surprising and helpful answers!
Dr. Jean, if you had a cat diagnosed with kidney disease (or were treating one), what kind of diet would you want the cat to be on?
“Well, I have that cat, my own 15-year old boy Flynn. And he’s on the same diet he’s always eaten. The cats get a mixture of homemade raw, frozen raw, and/or dehydrated raw, with appropriate supplements, and a sprinkling of various high-quality canned food. He’s doing great, maintaining weight, and acting absolutely normal.
The thing is, CKD kitties need high-quality protein to maintain their body weight and system functions. Restricting protein (the point of which is really to restrict phosphorus) ultimately causes loss of body condition.
I’m going for maximum quality of life, rather than simply extending life, which is what the kidney diets do. They treat one aspect of physiology while neglecting the needs of the rest of the body. Now, he may not live as long as he could if I put him on a restricted diet. But when it’s time to let him go, I’ll know he’s had the maximum gusto and enjoyment from his life that I have the ability to give him. That’s just my personal preference. It’s not for everyone.
I haven’t changed Flynn’s food… He’s got a great appetite, his weight is stable, and he is not symptomatic. He does get a number of supplements, plus the blood pressure medicine (like mother, like son I guess!). He acts completely normal.”
[Note: See Dr. Hofve’s article on this topic for more information about the supplements she recommends.]
Very interesting. It’s great to hear how well your 15-year old CKD cat is doing!
So you do not specifically feed him a low-phosphorous diet. But if people can find a low-phosphorous cat food that has normal protein levels, is there any reason not to use it? Might it help?
“The phosphorus levels in a normal-protein cat food can vary widely, as you know, and sure, it’s a good idea to go with the lowest phosphorus foods you can find. However, be aware that those [phosphorus] levels will still be about double those of the more-restrictive veterinary renal diets.
The downside of the kidney diets is, cats don’t much like them, and, in my opinion, they don’t provide enough protein (or perhaps it’s just that cats won’t eat enough of them) to prevent muscle wasting.
I think the value of renal diets is for cats with significant symptoms, and in those cases they can help the cat feel better. Of course…extra fluids (IV or subcutaneous) will accomplish much the same thing, and fluids will also improve the cat’s appetite. Dehydration causes nausea and a nasty headache. I was exposed to an ammonia spill once, and I think it felt much like these kitties feel when the BUN (basically, ammonia) rises in their blood. I got an instant headache that felt like an ice pick going through my eye. While the acute dose of fumes I got was probably much worse than what the cats experience over time, I don’t doubt for a minute that they feel crappy!
I should mention that egg whites are pure protein with almost no phosphorus, so I got some organic egg whites and will be starting an experiment with adding egg whites to their food. Just to see what happens! It’s hell being the cat of a veterinarian!”
First, I want to thank Dr. Hofve for sharing her opinions and knowledge on this challenging subject in a straightforward and honest way. She demystified the phosphorous and protein issues and I really appreciated her point about how treating dehydration can make a huge difference in a CKD cat’s wellbeing and appetite.
Secondly, I want to thank you, cat-loving readers, for asking for fresh insights on this topic, as well as for any tips you might want to add here.
Resources for cat parents
- Dr. Hofve’s excellent, comprehensive article on feline CKD, which discusses some helpful supplements and providing subcutaneous fluids. (Dr. Hofve is no longer taking patients (she’s retired), but her site, Little Big Cat, is a gold mine for feline caretakers!)
- Feline CRF Information Center
- Phosphorous levels in various cat foods (only relevant IF your cat has CKD already):
- Dr. Lisa Pierson’s cat food phosphorous level tables
- Tanya CRF site tables and article on Phosphorous Control for cats with CKD