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Getting a cat to eat a prescription diet can be tricky. Learn about prescription foods for kidney disease, and what you can do to get a cat to eat, in this week's post.

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.

~ Lili

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!

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