Dear Most Esteemed and Knowledgeable Kitties:
I have a small cat that just turned 22 years old and was recently put on a prescription diet for her kidneys. She has always been underweight and is a picky eater with no real interest in food. I’ve tried every brand of kidney formula, both dry and wet food, and she absolutely refuses to eat any of it. So, my question is, if you had to choose between these three formulas which she does like, which one would be the best? Should I feed her kitten formula since she is underweight, or would it be better to feed her senior cat food since she is so old? She also likes the metabolic formula but not sure if diet food is a good idea since she is already underweight. Any advice would greatly appreciated. I want her to be as healthy as possible without being miserable.
Thomas: Well, Lili, it’s always tricky trying to get a cat to eat new food, especially when she has a history of being a picky eater.
Bella: But we think we can offer you some advice.
Tara: First of all, let’s talk about the prescription diet for kidney disease. Prescription diets for this condition are often designed with low protein because there is some research that shows restricting protein helps to prolong health in cats with chronic renal disease.
Thomas: However, a growing body of work suggests that low protein contributes to low body weight, which can be a problem in kidney kitties, because they already have a tendency to be underweight.
Bella: In this post by veterinarian Dr. Elizabeth Colleran, she makes the case that a low-protein diet may not necessarily be the best choice for cats with kidney disease. One reason for that is because cat are obligate carnivores and need to eat meat to stay healthy.
Tara: Our vet feels the same way. She hasn’t prescribed him a special food for kidney disease, even though Thomas is in stage 3 renal disease, because she feels that protein is necessary for keeping weight on.
Thomas: Another thing our vet told Mama is that it’s really important for me to get all the liquids I can get in order to stay hydrated. That’s why Mama gives all of us, and especially me, a wet food diet. She even puts extra water in mine!
Bella: Dr. Colleran also says that there is no single right food for cats with kidney disease. The most important thing is the quality of the protein.
Tara: And of course, it’s crucial that your kitty eats, and that she eats anything at all! Cats that don’t eat–and many don’t when they’re made to eat new food–can develop serious health problems.
Thomas: With that in mind, we’d suggest you start by feeding your cat anything she’ll eat! As lay-kitties (we’re not vets, so please don’t think we’re prescribing anything), we’d suggest feeding her a higher calorie food since she’s already underweight.
Bella: Also, because both our vet and Dr. Colleran recommend it, we’d recommend a diet high in protein in order to maintain her muscle mass and help her keep weight on. The prescription diet for kidney disease will typically not meet these requirements.
Tara: Please read Dr. Colleran’s article for more information about why protein is so critical for kidney kitties. This could be a launch pad for discussing diet with your veterinarian. You might want to suggest that he or she read Dr. Colleran’s post (she’s a past president of the American Association of Feline Practitioners and has lots of impressive credentials, including being board certified in internal medicine).
Thomas: Some vets are not receptive to “I read it on the internet” clients, but when you’re able to share a legitimate article written by a board-certified vet recommending something other than a prescription diet, it could be a real help.
Bella: Please remember that we ourselves are not veterinarians! We’re just trying to point you in the right direction by leading you to an article from an authoritative source.
Tara: So, Lili, our advice to you is to start out by feeding your cat whatever she’ll eat. Then talk with your veterinarian and share Dr. Colleran’s post to start a discussion about diet.
Thomas: At your cat’s age, the prescription diet may not be the best choice for her. But we’ll leave that to you and your veterinarian to make the final call.
Bella: One more thing: A lot of kidney kitties experience nausea because of the buildup of toxins in their blood. Your vet may also be able to prescribe an anti-nausea medicine and an appetite stimulant to get her eating.
Tara: We hope this helps, Lili, and best of luck to you and your lovely and venerable kitty.
Thomas: What about you other readers? Have you had a cat with kidney disease, and how did you get–or keep–him or her eating? What did your vet recommend, and did you discuss diet with your vet? What was the result? Please share your experiences in the comments!
This is kind of an old list – it’s from 2012 – but it’s a list of cat food with low phosphorous levels. Low phosphorous, I’ve heard, is good for cats with kidney issues. Binga gets some food listed at the top of this list. Fortunately she also likes the premium food we all also eat (Nature’s Variety Instinct), which is also apparently lower phosphorous.
My cat wouldn’t eat the prescription food for kidney cats that most vets carry . He would barely eat it. A friend recommended brand that also carries prescription food for feline renal failure , the brand initials are R.C. . I don’t know if they want brand names on this blog but people need to know that if the cats refuse to eat the one kind it’s because they don’t like it .
I got a prescription for the second brand from the vet and just got the food delivered today. My cat gobbled it up like he was starving , when he was just eating a few bites of the other. he loves it.
When my Karma was diagnosed with Kidney disease, he was 18 and refused the prescription diet and the medications that I was supposed to add to his food. I had been looking into a raw diet but hadn’t made the plunge yet but did do a lower carb, high protein canned food and went to my vet. She agreed with the Paws & Effect gang. What matters most is getting Lili to eat! My other thought was.. my cat is 18 he’s 80 something in human years, he’s lived a wonderful life and I’d love him to live with me forever, but do I want him miserable the last years I have him or do I want a happy cat. I opted for happy, and thankfully my vet agreed. First and foremost, kitty needs to eat. I was able to get Karma to eat the half pill of Pepcid my vet suggested, but again, check with your vet.. oh.. and he lived to be 21! I only lost him then due to a stroke. :) Sending you and your baby lots of love!
Thank you for sharing Dr. Colleran’s post and for spreading the word about this important issue. There’s so much misinformation out there about nutrition for cats with kidney disease even among veterinarians.
Thanks for this great article. Our CKD kitty is very glad that some of these veterinarians have finally concluded that meat protein is essential for him and other kitties that have this condition. He also wants to stress the importance of regular blood work and urine tests to carefully watch the progression of this disease, which will give our vets the necessary information to “tweak” our diets. Our vet also reminds us that it is essential for cats to eat, so she suggests that we feed our kitty anything that he wants to eat, as LONG as he does eat. And for raw feeders, we just learned recently that Darwin’s Raw diet has created a food that is specially designed for cats with CKD. We sent a link to the product to our vet who highly approved it. She did suggest, however, to saute the meat lightly rather than feeding it totally raw.
I was fortunate in my cat Punkin ate almost everything! I gave him the prescription renal food dry but he also got wet food he loved! I did dilute it more with warm water and that made it easier for him.
Happy to see that more and more cat parents ( and veterinarians ) understand that prescription diets are not always appropriate. Actually , if you read the labels on some of them you might even consider them junk ;) My 17 year old’s lab tests are starting to show signs of kidney stress so I have complied partially with my vet’s suggestion to switch him to a “senior” diet by feeding him a mix of what he was accustomed to and the “senior formula” and he is happy with that and eating well. My struggle is to convince him to eat wet food. He came to me when he was already 14 and had never been offered wet food. Amazingly, he came to me in great health despite what I consider a substandard diet. I add warm water to his wet food because what he really wants is the “gravy”. And he is always good about drinking his plain water. I agree that feeding them what they will eat is the way to go. And encourage fluid intake anyway you can. And congratulations to Lili for doing such a great job already that her cat has reached 22 !
My feeling is that if your kitty is 22 years old, let her eat whatever she wants. If she likes a cat food (soft or hard) that is terrible for her health, so be it. Most cats never see the age of 22. I had an 18 year old who, at 16, was diagnosed with kidney failure. The vet said he could order special food but most cats don’t like it anyway. I just fed her what she would eat. My one kitty loved a raw meat diet specially made for cats. You could try that. Just whatever makes her happy. She has lived a long kitty life.
Hello ! The best dry and canned food for a cat with kidney disease is Royal Canin “Urinary S/0. It works all the time. It’s why is prescribed by vets : https://www.royalcanin.com/products/royal-canin-veterinary-diet-feline-urinary-so-dry-cat-food/3901
Vets have chosen this one, because it’s like a medication. And cats love it. 5 stars and 700 voters. Cats heal even from kidney pbs when they were poorly nourrished (stray cats). With an old cat it’s another story, but almost all senior cats loooove this food.
There are TWO diffrent bags of Royal canin, urinary so, regular and moderate calories. If the kitty is slim, like the one here, no moderate calories but regular.
My cat does not love Royal Canin. Or any other prescription food. Sorry, but there it is; It’s not as if I havent tried, hard. She hates it all, and would prefer to starve herself to death. Rather than have her do that, and be miserable while she does it, I’m going with the advice here to feed her what makes her happy in her final year or so.
My two cats (12, with digestive issues) & 15 (slightly overweight for her leg length, and had a kidney stone a few years ago) have been prescribed wet & dry foods–both Royal Canin & Hill’s Prescription–and detest them both. The only wet food they’ll eat is pate–no shreds, slices, broths, chunks, etc. Royal Canin Urinary Mod. Cal. S/O is chunk style, and even if I puree it the 15-yr old turns up her nose at it. She hates the Hill’s pate style too. The 12-yr old (an occasional puker who may have IBD), hates the Hill’s I/D and eventhe Royal Canin Select Protein (rabbit & pea). But he will eat the 15-yr-old’s Urinary S/O kibble (hates his own R.C. hydrolyxed kibble) and any wet food she leaves over. The 15-yr-old loves commercial “cat crack” wet (Friskies, FancyFeast, PurinaOne, some Blue Buffalo and Whole Foods chicken) but turns her nose up at fish. She also hates Sheba but he adores it. And she will no longer touch kibble of any kind–though she used to steal the 12-yr-old’s commercial kibble when he was allowed to eat it.
I’m inclined to let them eat what wet food they want in small portions–the 12-yr-old tends to puke if he gobbles down too much of the 15-yr-old’s Urinary S/O kibble. My vet had me order the Hill’s & Royal Canin on subscription, and I am at my wit’s end–will ask her if she can prescribe the ProPlan. If not, I will let the chips fall where they may. I know IBD can progress to lymphoma, so if the 12-yr-old has only 3-5 yrs left (statistical lifespan for those diseases), he should enjoy the time he has left.