Stage 2 kidney disease help

[Judystilldreamsofhorses]

We’ve had my MiL’s cat living with us since July while she renovates a new property she will move into. I noticed straight away that he seemed to wee an awful lot (rarely used a tray at MiL’s as he had 24/7 outside access) and he is also frequently sick. Long story short, he ended up at the out of hours vet the other week and was diagnosed with stage 2 kidney disease, and in an acute flare up - hence bringing him in.

He’s actually been fine since the vet, but we are struggling to get him to eat renal food. He happily eats the dry renal food (Hills, and looks identical to the Hills food he’s always had). His usual wet food is Blink. We got a “selection box” of renal food to try him with, so have been giving him some alongside his regular wet food. It just gets chucked. Not sure what to do for the best, does anyone have any ideas?

Cat is 10, generally pretty greedy, and it’s a struggle to keep him away from our cat’s food. Our boy is a grazer, MiL’s cat tends to eat everything in one go (except the renal food!) They are fed in separate rooms. I’ve looked at chip feeders but they are so £ given that he’s not going to be with us long term - MiL hopes to be in her new home before Christmas.

Thanks for reading if you did, any advice appreciated. Tax attached.

My 17yo cat is in Stage 2 chronic kidney disease - she will also eat the renal dry food but won’t touch the wet stuff. She mostly grazes on the dry food and I just give her a little bit of ordinary seniors wet food that I know she will eat to get her daily pill into her. I figure she’s an old lady and I might as well give her what she likes to eat, and I know she drinks plenty of water as she prefers to drink from a bedside water glass.

Cat tax attached.

Oh this brings back memories! Elton my poor little Mau boy had late stage CKD and I well remember the fight of trying to get food into him. It's good that you have found a renal dry food he will accept but the wet foods appear to be universally disgusting - I couldn't get Elton to eat any of them. What we did instead was use a phosphate binder on normal wet food to bring down the phosphate (which is the baddy in CKD). The one we used was Ipakitine which you can buy online. It's a powder that you just sprinkle on the food. There are also liquid binders but Elton roundly rejected these. There are lots of other supplements you can try (we had a whole shelf full) but at stage 2 it's probably not worth it yet. CKD progresses very slowly and with a bit of luck he will be fine - if a bit thirsty and pukey for a long while yet. Photo of my lovely little Elton attached.

I had the same with Boycat - complete refusal to go near Renal wet food though the dry was fine. His was a bit of a different case though - very sudden onset with him 100% at his MoT in April, stage 3 in September, PTS February - so we gave up on the wet renal and fed more dry.

One thing to be careful of is the dry renal food helps them keep weight on, and in the 5-6 months he was on that Girlcat put on almost a kilo! She was very chubby at the end, though the weight dropped back to normal after a few months back on the indoor and hairball.

Thanks for the replies, and the lovely photos! @SabrinaThwaite i have read that fed is fine, even if it’s not the renal fed. She’s a beauty.

I think this is hard because he’s not our cat, and if he was I would be asking to go in and speak to the vet in person to really go through options. I’d read about binders @Puppylucky but the vet didn’t mention that to MiL. @Allergictoironing that sounds awful, how old was your boy?

Today he’s had Blink wet food and renal biscuits, and the renal wet food was rejected (although of course Louie tried to eat it - it won’t hurt him will it?). He’s definitely thirsty and pukey, and has frequent big black hairballs. I’ve just got hold of a timed feeder for him as he often seems to barf about 5am so I am wondering if that might help.

Boycat was only 7 coming up for 8, he was Girlcat's litter brother and he was my soul cat.

That's how I ended up getting Tobias, as an indoor only cat who had lived with her brother all her life and me working at the office, she needed a companion and he was perfect for her. And look how that's worked out - FIV and severe chronic IBD, he's on borrowed time and not responsive to meds. He has a weigh in and steroid injection next week that should give us a better idea of progress, but it was 4 years ago next Feb that we lost Boycat, and Tobias will be 7 next spring.....

It won't harm Louie, but he'll likely turn into a right porker if he eats much renal food, too heavy to dance easily. It should come off again once he stops eating it.

Oh gosh, that’s so sad he was so young. I really hope Tobias’s review brings good news for you.

Louie’s a nightmare around the food, he’s up on the counter sticking his head in it while I dish up (whatever the food is, I don’t think it’s that he especially fancies the renal stuff) then will go and hang about the bowls. He tends to graze on his own food, so I think it’s largely “sport” for him rather than being hungry. I’ll make sure his dancing days aren’t in jeopardy!

What I found @Judystilldreamsofhorses in our long CKD journey, is that we were often educating the vets when it came to CKD, so I wouldn't necessarily wait for the vet to be proactive in terms of recommending stuff apart from diet. Because CKD is normally a disease of older cats (although @Allergictoironing and I can vouch to it also occurring in younger cats like Boycat and Elton), I think a lot of vets are fairly disinterested in exploring too many treatment options. I would definitely speak to your MIL about binders though - Epakitin is really easy to administer and not expensive.

@Puppylucky i looked that up and it sounds really useful - it’s hard when I’m not the one dealing with the vet. Mil was basically told try the renal food and bring him back in six months unless there’s an acute episode in the meantime. She’s happy with that because that’s what the vet says.

He really does like those renal biscuits though. I could hear him purring and crunching away at the same time last night!

That's fair enough - and if he's happy on dry renal for now then that's good. Hope all goes well for him and your MIL.

I’m keeping going through the multipack of different wet foods, but no joy so far. If he was my cat I would be pushing to explore all the options - but I feel a bit stuck because he isn’t so I need to just step back I suppose.

If you feel he's lacking in wet nutrition with a dry only diet you could try supplementing his meals with a cat soup or the Purina hydration liquid . Elton loved the Smilla cat juice sold in Zooplus and it was a way of getting some wet nutrition into him.

I’m still giving him his non kidney wet food (Blink) but not sure if that’s wrong. He drinks a lot - we have a fountain plus two stainless steel bowls, and I see him drinking out of the (probably not very sanitary) birdbath outside too.

The thing I was always told is that keeping CKD cats fed is more important than anything. They can lose weight very quickly and that's a problem. If he will only eat Blink as wet food then letting him do that is much better than not. Also try not to worry too much about the diagnosis. Stage 2 CKD is infinitely manageable for quite a while. The disease only gets serious at stage 4 which can take years to get to. He will want to drink a lot so just make sure he has plenty of water bowls. The Purina hydration fluid I mentioned above can also help.

We had the same with our oldies. We've ended up with pro plan for wet food and hills for dry. It's odd but if I mash the wet food so it's more of a pate texture they tuck in but if I don't they lick the gravy and leave the chunks. We tried a few options with lots of waste but this seems to be working and they've stayed at stage 2 for 3 years so far. That's a very long way of saying try mashing the wet food!

After me posting that, he didn’t want his Blink wet food tonight, ate up all the Hills renal biscuits I gave him instead, then puked them all up about 30 minutes later. That spare bed has been laundered more in the last three months than it has in the last ten years 🤷🏻‍♀️

That’s reassuring to hear that stage 2 could be a long way until stage 4. I am such a worrier.

@goodnessidontknow he won’t go near any of the wet we’ve tried so far, never mind lick gravy 😔

I agree that if he'll eat the dry hills that's good enough. If you can encourage him to drink a bit more with Purina liquid that would help.

I feel like he’s always drinking. When he came here I said pretty much straight off that I thought he had kidney issues as he was drinking and weeing remarkable amounts! MiL says from when he was a kitten he’s always been a big drinker, but because he pretty much exclusively toileted outside didn’t realise about the weeing. I can definitely order those sachets though if they will help.

The whole situation is making me so anxious because he’s not my cat but it feels like it’s me who is the one trying to “solve the problem”. MiL says he’s always been a sicky cat and is pretty laid back, but she’s not the one scrubbing carpets and changing duvets (in fairness that is usually DP, but we’ve both had what I think is Covid this week and he’s currently in the very poorly phase, I’m a couple of days ahead and more able tonight). MiL wants to host Christmas at her new house so I know she is hoping to be in there quite soon - I feel awful saying this as I’m really fond of the old lad, but I think it will be good for my MH to have him return to her.

I ordered a big bag of the Hills biscuits for him earlier, they are so £ so he had better not go off them!

We’ve currently got a cat in stage 3 CKD and have nursed others through it. It’s so stressful!

Wet renal food would be ideal but if he’s a good drinker and not showing signs of dehydration then dry renal food will be better than wet non-renal food as I understand it.

Some tips:
If you want to try more wet foods, we’ve had some success with Royal Canin and Animonda (available from zooplus) renal food.

Zooplus also sell a renal-friendly equivalent of lick-e-lix called kattovit - our boy LOVES this stuff and it’s a bit of extra hydration (great for hiding medicine too).

We also freeze Oralade renal formula in an ice cube tray and defrost in microwave to get him to drink extra on hot days or if he’s under the weather. (https://amzn.eu/d/0biM08K2)

Several water bowls around the house.

Our vet recommended Porus One supplements - this isn’t a phosphate binder like someone mentioned above (although those are available for cats who won’t eat renal food and have high phosphate levels) but binds uremic precursors to stop toxins building up in the blood and making them feel ill.

Renal kitties tend to shed a lot so we try to give him a brush regularly to prevent hairballs/vomiting.

If you can split his food up into more frequent, smaller meals it might help with the puking in short term?

It sounds like you’re doing a brilliant job already tbh - hopefully you can hand him back to MIL soon and breathe a big sigh of relief!

My Ian is CKD stage 2 and we actually managed to bring him back down to stage 1! He’s on Royal Canine renal- he likes it, but he LOVES the Select version.

We also found that a full renal diet was too much for him and left him with unbalanced calcium- we consulted a specialist as he’s an otherwise well cat and wanted him to have the best shot possible. With their advice he’s on 60% renal diet for biscuit version and then his usual wet food which is low in Phosphate so not too bad for his kidneys. His levels actually improved on this balance!

@user1471548941 Which usual wet food that is low in phosphate do you use? Mine is Stage 2 CKD and she’s on mostly Hill’s renal dry with some of the Royal Canin oral biscuits mixed in, and I’m rotating round senior cat foods for wet food.

She flatly refused any renal wet food (local cat rescue were delighted with getting several boxes minus a couple of sachets though).

Thanks for these posts - I’m finding it all quite overwhelming so it’s really helpful. I fell down a hole on Reddit where people are talking about sub-cutaneous fluids which actually scared me to death! This is probably a stupid question but why is senior food better? (Or just because these kidney cats tend to be older? He was ten in August.)

Today he’s eaten all his breakfast (non renal wet and Hills renal dry) and is out sitting in his favourite spot on top of next door’s shed which is prime cat real estate round here.

@SabrinaThwaite our (non kidney disease) cat prefers dry to wet, and when we adopted him I think we tried every wet food on the market, from the fancy ass raw stuff right through to Whiskas. Our vet gave me a right telling off when I mentioned it to her and essentially said pick a lane, stop pandering to him, and he will eat it - and that chopping and changing was confusing his gut. Our CP lady was gutted to stop having the massive bags of his rejects on a regular basis! (And right enough, he eats up his Untamed now…)

As I understand it, senior cat food has slightly lower phosphorus and sodium and better quality digestible protein to help older cats.

I know I pander to her but I’d rather she ate a bit of wet food with her steroid in it rather than keep giving her the same stuff that she’s picky over. She only likes fish in gravy type foods, so she just gets 2 or 3 variations on a theme.

@SabrinaThwaite i totally get it, our own boy was a stray kitten so I have no idea why he is such a fussy little monkey. I got really in my head that “he must eat wet food” and was bankrupting myself trying all the options on the market for no real reason. We got him from CP so they definitely got the benefits of his fussiness!

We use HiLife the flakes in jelly. It’s not “complete” but his biscuits are so that’s okay basically. But he loves it and it keeps his appetite up!

Thanks both, much appreciated.