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The approach to nutritional management of chronic kidney disease (CKD) in cats has changed significantly over the past 2 decades. In the past, cats typically were diagnosed as having late-stage kidney “failure,” or what would now be classified as International Renal Interest Society (IRIS; iris-kidney.com) later stage
Chronic kidney disease is defined as abnormal renal structure or function, or both, that has persisted for 3 months or more.8 More than 50% of cases of CKD in cats are idiopathic.9,10 In most cats with CKD, the kidneys are damaged by inflammation and progressive fibrosis of the tubules.9,11-14 This is in contrast to CKD in dogs, in which primary
- Evidence Supporting Effectiveness of Kidney Diets in Cats with CKD
- Phosphorus and Kidney Diets
- Is The Protein Content of Kidney Diets Optimal For Cats with CKD?
- The Importance of Nutritional Assessment
- Implementation of Dietary Therapy
- Recommendations to Help Increase Acceptance and Intake of Kidney Diets
- Conclusion
- References
Several studies address the effectiveness of feline kidney diets compared to typical feline maintenance diets in mitigating uremic crises and extending survival. The consistent findings in these studies using different diets and methodologies and performed in different countries by independent groups of researchers strongly support the conclusion t...
In order to compensate for the decline in phosphorus excretion with advancing CKD, dietary intake of phosphorus must be reduced. Most maintenance diets contain substantial quantities of phosphorus, with protein typically contributing significantly to the phosphorus content. It is perhaps a common misconception that the purpose of renal diets is pro...
Recently, use of kidney diets in treating cats with CKD has become controversial, weighing the potential benefits of these diets in mitigating the clinical consequences of CKD versus the purported risk of protein malnutrition. Much of this debate has been focused specifically on cats, as they are considered to be obligate carnivores and thus have i...
Serial evaluations of nutritional status are a key part of CKD patient management, and a nutritional plan should be performed for every patient including a specific recommendation for caloric intake. A nutritional assessment should include body weight, body condition score, muscle mass score, adequacy of caloric intake (including open ended questio...
The way in which a therapeutic food is introduced to the patient, and more importantly to the owner, has a profound effect on patient acceptance. While some patients easily transition from one diet to another, many cats are very selective and may require more coaxing to encourage diet change. In general, it is probably best to recommend that diet c...
The most important factor in the success of diet transition is the education of the owners. If the owners understand the importance of the kidney diet as a medical intervention, not just a food, th...Transition to a kidney diet from the patient's original food over at least 3 weeks. A typical protocol is:To minimize confusion and maximize compliance, ask the owner to bring in the cat's previous diet and make pre-mixed bags labelled with the appropriate week. Additionally, once the owners see the de...Follow-up phone calls (at least weekly) to check on the progress of the owner and pet during the transition phase from the original diet to a kidney diet, will increase compliance and emphasize the...Clinical trials of feeding kidney diets to cats with spontaneous CKD have shown them to be effective in improving survival, reducing uremic crises, and improve blood urea nitrogen and phosphorus concentrations. It has also been shown that when food intake is adequate, kidney diets can maintain body weight and body condition scores for up to two yea...
2014 AAFCO Dog and Cat Food Nutrient Profiles. Available at : http://www.aafco.org/Portals/0/SiteContent/Regulatory/Committees/Pet_Food/Reports/ Pet_Food_Report_2013_Midyear_Proposed_Revisions_to_AAFCO_Nutrient_Profiles.pdf Adams LG, Polzin DJ, Osborne CA, O'Brien TD, Hostetter Influence of dietary protein/calorie intake on renal morphology and fun...
Metacam 0.5 mg/ml oral suspension has been granted a licence in the EU for the alleviation of inflammation and pain in chronic musculoskeletal disorders in cats. The registered dose is 0.1 mg/kg on the first day followed by 0.05 mg/kg orally once daily. This is the first NSAID licensed for long-term use in cats.
a therapeutic kidney diet or their owners did not want to change their diet. Feeding a therapeutic kidney diet helped reduce plasma phosphate, blood urea nitrogen, and parathyroid hormone concentrations. The median survival time for cats receiving a therapeutic kidney diet was 633 days (1.7 years) compared with 264 days (0.7 years) for
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Chronic kidney disease (CKD) is a common diagnosis in cats presented to first opinion practices and renal disease is the most common cause of mortality in cats of more than five years of age (O’Neill et al, 2015). Figure 1. Every cat entering the clinic should have a weight and body condition score recorded. Slight weight loss may be the only ...
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When a cat or dog won’t eat a diet. While cats and dogs on commercial diets for renal disease have significantly better survival than those on maintenance diets, some pets will refuse to eat a renal diet. In one study, only about half of the cats with CKD were on a veterinary therapeutic diet for renal disease (Markovich et al, 2015).
