The Right Diet for Cats with Kidney Disease


Guest post by Dr. Elizabeth Colleran

Frequently, the first advice guardians of a cat who was just diagnosed with kidney disease hear from the veterinarian is that the cat should eat a renal “prescription diet”. That’s because there are research trials that have shown that restricted protein diets can prolong renal function. However, there is more to feeding a cat with compromised kidney function than simply restricting protein. The consequences of making poor dietary choices in these cats can be dire.

Cats are hypercarnivores

Cats are unique among carnivores in that they are “hyper-carnivores.” They cannot survive, let alone thrive, without protein. Adequate, high quality protein is essential for a functioning immune system, hormone production and a world of other uses for the building blocks of protein, amino acids. Unlike other mammals, in addition to all that, cats can’t efficiently make energy from anything other protein.

When protein is inadequate, cats’ bodies start to use the protein they have – the muscle they carry on that lovely frame. Even overweight cats may lose muscle mass if they are getting too many calories from fat and carbohydrates. Several recent research studies have shown that cats who lose muscle in this way die sooner, acquire more and more severe diseases, and have a poorer quality of life.

How protein restriction impacts healthy body condition

In addition to protein restriction, renal diets contain additional potassium, lower sodium, low phosphorus and, in some cases, added Omega-3 fatty acids. All of these components are good for cats with kidney disease. What may not be desirable is the limited protein.

One recent study showed that cats require 40-45% protein on a dry matter basis to maintain good body condition. Another study shows that cats over 12 years of age, just about the time that their kidneys may be working less well, become less efficient at metabolizing fat and protein. This study concluded that cats over 12 may require 25% more calories and protein to maintain their body condition than younger cats.

There is no single diet that is right for all cats with kidney disease

We need to stop thinking that any one diet is good for all cats with chronic progressive kidney disease. The far more important question to ask may not be how much protein, but how good the protein is.

In addition, as cats have more progression of their kidney disease sometimes appetites diminish a bit. Since cats choose food based upon three characteristics: texture or “mouth feel”, aroma and taste, we must live by the golden cat rule: “it is more important that she eats than what she eats.” Attempting to impose our ideas about good food can imperil them should they not agree. Choose the best canned food your cat will enthusiastically consume.

Cats in the wild are wary of change. They will sniff a new prey before consuming it and if that food is perceived to cause discomfort or an upset tummy, they will NEVER eat it again. Some cats experience a bit of nausea from their kidney disease. It must be treated so that they don’t associate that discomfort with the food you offer. If they do, that food will end up in the garbage along with any other variety you may select in the future.

The importance of water for cats with kidney disease

Water consumption is one key to preserving as much functioning kidney tissue as possible and thereby preserving quality of life. Though cats with kidney disease consume lots of water, it is in large part because their kidneys cannot retain it as efficiently as they used to. So the universal truth is “the more moisture the better” – that means no or as little dry food as possible, flavored waters like tuna juice, clam juice, chicken broth, and canned food exclusively if possible. Some cats don’t mind “soupy” food so warm broth or water can be added to it. A water fountain and/or multiple places around the house to drink may be helpful. The other rule is “whatever way your beloved cat will drink”. Like us, they have their preferences!

Phosporus restriction and kidney disease

Restricting phosphorus may be even more important for cats with kidney disease than restricting protein. We know that the high phosphorus content found in higher protein diets can accelerate the decline of function when it gets trapped in the “work unit” of the kidney.

There are two ways that phosphorus is reported in food. Look for 0.3-0.6% on a “Dry Matter Basis” (DMB) or 0.7-1.26 grams per 1,000 calories. Phosphorus content is generally not available on food labels, but can be obtained by calling the food’s manufacturer. For easy reference, Dr. Lisa Pierson offers both a Phosphorus in Cat Food Chart and a Protein/Fat/Carbs Chart  on her site

Kidney values should be checked regularly, and the panel should include calcium and phosphorus levels. If the product of Calcium X Phosphorus is greater than 70 or Phosphorus is greater than 5 mg/dl in the blood, a phosphorus binder is needed. This binds the phosphorus from food in the gut rather than allowing it to be filtered by the kidney, which will often allow us to feed a protein replete diet that keeps cats well-muscled.

22-year-old Woody’s case

My 22-year-old Woody was diagnosed with early stage kidney disease in 2007. He gets a high protein diet with a phosphorus binder in each meal. He is also hyperthyroid and a handful. So I decided many years ago to try an iodine restricted diet rather than medication. After a time, I noticed that I could feel the bones on the top of his back, a sure sign that he was using up his muscle for energy. I had neglected to check the protein content which was less than 35%. His new diet is about 50% protein between the canned and dry formulas he likes and is willing to eat. He got all of his muscle back.

The importance of maintaining good muscle condition in older cats cannot be overstated. The ways we do that may vary from beloved cat to beloved cat, but the goal should always remain the same.

Dr. Elizabeth Colleran is a 1990 graduate of Tufts University School of Veterinary Medicine. She holds a Masters of Science in Animals and Public Policy, also from Tufts University School of Veterinary Medicine. In 2011, she was the President of the American Association of Feline Practitioners (AAFP). She is a Diplomate of the American Board of Veterinary Practitioners, Specialty in Feline Practice. As the spokesperson for the AAFP initiative Cat Friendly Practice, she speaks at major conferences around the country. Dr. Colleran owns the Chico Hospital for Cats in Chico, CA and the Cat Hospital of Portland in Portland, OR.

73 Comments on The Right Diet for Cats with Kidney Disease

  1. Mindy Looyenga
    April 24, 2017 at 11:11 am (5 days ago)

    Hello and thank you for this article!
    My 17 1/2 year old Rocky also has a hyperthyroid level of 5 (slightly elevated) and his kidney levels are waaaay high. About a year ago he stopped eating the hyperthyroid food, so went to a pet store and purchased grain free Weruva and Chicken Soup for the Soul which have more natural ingrediants. He started eating again, but now his kidney levels are terribly high. I am wondering what type of food you put your cat on-the dry and the wet that had the nice combination. The vet did perscribe the kidney food-either Hill or one other kind for kidneys. Recommendations on what to you think is best and why to give to my vet is much appreciated.
    Thank you kindly!

    • Ingrid
      April 24, 2017 at 11:34 am (5 days ago)

      I doubt that the high kidney levels are caused by the Weruva. I’m not familiar with the Chicken Soup for the Soul brand. I would definitely eliminate all dry food – never a good choice for any cat, let alone a cat with kidney issues.

  2. Cher Aiudi-Washenko
    April 23, 2017 at 7:34 pm (6 days ago)

    I am happy to find this website as I am going crazy with trying to find the right foods for my 15 year old Maine Coon. Puffy is a mini-Maine Coon in that she was the runt of the litter and only weighs 6 -something lbs. She has always been healthy, hearty,happy and active. But she has also always been a poor and fussy eater and underweight. About a year ago she started to LOSE weight. Her weight always varied from 6.2 lbs to 6.8 lbs. but last year 1st she went down to 6.0 lbs then down to 5.8 lbs. My vet put her on a/d canned food ( urgent care food.) She gained and maintained a few ounces. However her last two checkups show that one of her kidney enzymes has been getting worse and is now borderline, and that her urine is slightly less concentrated than it was a few months ago. I have been bringing her in for 6 month senior wellness exams since she was 7. Prior to that i brought her in for annual exams. The vet gave me a kidney diet starter kit with several types of wet and dry Rx kidney foods. I am trying the foods and so far she will eat most of them if i hand feed her ( Ive been hand feeding her since she went down to 5.8 lbs and it helps,) but still she only eats a little of the food. I have also been giving her a high calorie, high nutrition gel for underweight cats called nutricat that my vet said was kidney safe. I am worried to death that my cat is going to lose even more weight. My vet says she will put her on an appetite stimulant if that happens. Im wondering if i should take her to a cat-only vet for a 2nd opinion? Any ideas?

    • Ingrid
      April 24, 2017 at 5:12 am (6 days ago)

      As this article explains, phosphorus is a bigger concern than protein restriction, and the most important thing for your cat at this stage is that she eats, not so much what she eats. A second opinion from a more holistically oriented cat-only vet may be a good idea. You may also want to consider a nutritional consult with Dr. Pierson (

    • Tara Blade
      April 28, 2017 at 1:19 pm (1 day ago)

      I can’t believe what you said Cher about your cat will only eat if you hand feed her! Mine also. My cat is 11 years old little overweight has elevated kidney values just found out today. She also is prone to Struvite crystals. She is so fussy when it comes to her food I have tried every food out there I mean everything. Now they want her on K/D. She used to be on C/D for the crystals years ago but gained so much weight on that. JUNK I call it. So I feed only wet food mix water in it she likes it soupy. Grain free. But she will eat for a few weeks and then stop like it’s the most horrible food ever. Sometimes she will eat it and then throw it up. So stressed been going through this for so many years with her. Now she has an dental appt to clean her teeth and gums cause they are red and inflamed so much tartar. They want her in day before to give fluids to hydrate her before procedure(because of her kidney values). I am so nervous. I had to stop that C/D it was no good for her. Been feeding her the wet grain free and putting in wysong biotic ph- for cats prone to struvite crystals. Now they want her on K/D??? Help what should I do????? What should I feed her???

      • Meredith
        April 28, 2017 at 3:39 pm (1 day ago)

        Hi Tara, just wanted to mention that I read in my research that for cats with elevated kidney values it is a good idea to do dental cleanings using gas as the only anesthesia because gas is not metabolized by kidneys like other anesthesias are. You might want to talk to your veterinarian and ask them about this possibility.

        I don’t know if I’m allowed to post links here but I’ll give it a try:

        Good luck with your kitty!

      • Cher Aiudi-Washenko
        April 29, 2017 at 2:55 am (14 hours ago)

        Tara, I certainly sympathize with you. AND I wish i knew what we BOTH should do. Have you tried hand feeding her? Puffy also gets sick of food after awhile and stops eating it. So then i have to rotate it. My vet told me that sometimes kidney problems cause loss of appetite. But Puffy has always had a poor appetite.
        My vet gave me a “starter kit” with several different kinds of kidney food. I tried them one by one and used the checklist she gave me to record if Puffy loved it, liked it, or wouldn’t eat it. That was helpful. I bought a few different kinds of the ones she did like .But after reading in this website Im wondering if she needs more ( animal) protein than the kidney diets supply? Im going to keep reading ( on this website and others to learn as much as i can about feline kidney disease. It sounds to me like you are doing the right thing by getting her teeth taken care of. I honestly don’t know about the food. I do think wet food is good to feed, and the brand you are using provides plenty of nutrition, but i don’t know if the phosphorus level is low enough for a cat with kidney disease. Do you have a vet that you trust to ask? Im thinking of getting a 2nd opinion for Puffy from a cat-only the next town over.However she is not holistic. There is a holistic vet not too far from us, but he is not a cat-only vet. Have you thought about getting a 2nd opinion. If i learn anything useful in my readings, Ill post it on this website. God Bless you and your cat,Tara. I , too, get anxious when Puffy isn’t doing well.

  3. Meredith
    April 15, 2017 at 12:15 am (2 weeks ago)

    Hi Ingrid,

    I very much appreciate the detailed info in this article as our senior cat was recently diagnosed with kidney disease and I am researching optimal foods for him.

    However, I have a question about the numbers you reference for the phosphorous content of cat foods. You state that a value of “0.7-1.26 grams per 1,000 calories” is the goal for cats with kidney disease. However, when I look at the food analysis chart on catinfo dot org, Dr. Pierson’s units are mg per 100 kilocalories, and all the values on her chart are mostly in the range of between approximately 80 to 600, depending on the food. So, when those values are converted to GRAMS per 1000 calories, they come out wrong it seems; for instance, we feed our cat an Earthborn variety that lists the phosphorous content as 240 mg per 100 kcal on Dr. Pierson’s site, but that converts to 0.0024 grams per 1000 calories, which is not even anywhere close to the values you reference in your article.

    So, what I’m wondering is if maybe you meant MILLIgrams / 1000 calories, because if I convert 240 mg/100 kcal to mg/kcal we get a number of 2.4, which seems more reasonable a phosphorous content, and also notably the foods listed on the chart that are marketed as specifically for treatment of renal failure mostly have phosphorous numbers approximately between 80-120 mg/100 kcal, and that converts to 0.8-1.2 MILLIgrams per 1000 calories, so that seems likely to be the correct units.

    Sorry this is a long post, but I’m just hoping you can clarify this in case I’m missing something. Reading cat food labels and nutrition info is tricky! Thanks again for your enthusiasm in helping!

    • Ingrid
      April 15, 2017 at 5:45 am (2 weeks ago)

      I’ll have to run this by Dr. Colleran, who authored this post. I’ll let you know when I hear back from her, Meredith.

      • Meredith
        April 15, 2017 at 9:48 am (2 weeks ago)

        Thank you!

        • Ingrid
          April 16, 2017 at 10:02 am (2 weeks ago)

          Meredith, this is what Dr. Colleran wrote:

          “Therapeutic diets for feline CKD usually provide below 1 g/1000 kcal. Since we have efficacy data with these diets, this level is what we usually recommend and then adjust individually according to serum phosphorus values (some cats might need further restriction to achieve the IRIS recommendations for each stage for serum phosphorus). However, CKD diets have other modifications that also play a role in disease management (high quality protein in moderate amounts, alkalinization, moderate sodium, extra potassium, additional B vitamins, some of them add omega 3 FA as well).

          Regarding maintenance diets, AAFCO minimum for phosphorus is 1.25 g/1000 Kcal, so, if you are looking for OTC diets, there will be none lower than that, so you can try to look for diets that are close to that value.”

          I hope this helps!

  4. Janice Franklin
    April 1, 2017 at 4:39 pm (4 weeks ago)

    Our cat Jazz is a 6 year Ragdoll male, who has lived on a diet of prawns and kangaroo raw meat this is not pet food but human variety with some dry food also.
    Jazz has just had two trips to the vets 2 weeks apart to have his bladder flushed out, crystals had formed.
    So far this has put Jazz in some amount of pain cost nearly $2000, is this going to be an ongoing expense for both of us.
    The vet has recommended the kidney diet tut tutting prawns and kangaroo.
    Yet our last vet approved of this diet.
    I am so confused about what to do. Do we cut out the prawns and encourage him to drink more, also brush him twice a day so as he is not getting so much fur into his system?

    • Ashley
      April 9, 2017 at 7:36 pm (3 weeks ago)

      Hi Janice,
      Best advice I can give you is to go over to Many vets are ignorant about proper cat nutrition unfortunately. The website is dedicated to proper cat nutrition and written by a vet who has done in depth research on cat nutrition. There is a cat food composition chart on the website as well which will help you find high protein/low carb cat food. It was referenced in the article above as well. It appears your cat is getting too much fish and the diet is not complete with proper nutrients for a cat. Wet cat food is high in moisture and helps to flush out their system. I have had cats my entire life and they are all on a high protein (meat protein not plant/vegetable protein)/ low carbohydrate diet. I feed almost no fish and limit the amount of beef as well. Most dry food is high is carbs, calories, low moisture content and has terrible ingredients. Reference this dry food comparison chart: The chart is updated with new foods all the time. If I feed any dry I feed EVO but my cats eat mostly wet food. Rad Cat makes a good raw cat food as well that we include in the rotation. Hope this helps. Let me know if you want any additional help. I firmly believe once your cat is on the correct diet all problems will resolve themselves.


      • Ingrid
        April 10, 2017 at 5:31 am (3 weeks ago) is an outstanding resource, and Dr. Pierson also has a chart that lists phosphorus levels: She also offers remote consultations for cats with kidney disease.

        I appreciate you sharing the dry food comparison chart, but I want to be very clear that I don’t consider ANY dry foods appropriate for cats, especially not cats with CKD.

      • Les
        April 10, 2017 at 5:47 am (3 weeks ago)

        Hi Ingrid, great article. May I ask which proteins are low-moderate and which ones are high eg lamb? in terms of raw feeding?

        • Ingrid
          April 10, 2017 at 5:59 am (3 weeks ago)

          Chicken and turkey are lower in the range, lamb is slightly higher, followed by beef and pork. I believe it also depends on the cut of meat, not just the source.

          • Les
            April 10, 2017 at 6:18 am (3 weeks ago)

            Great to know, thank you

  5. Dominique
    March 28, 2017 at 9:26 am (1 month ago)

    My 3 year old Ragdoll was diagnosed recently with stage 2 CKD (Creatinine level 190). I had bloodwork done after I heard his mother had died of CKD at age 6. He’s on Royal Canin Kidney dry kibble and I also feed a pouch of Hills K/D daily (he likes his gravy). The vet told me not to give any other food, but he’s very young and active and I don’t want him to loose muscle mass. I’ve been reading about feeding CKD cats but now I don’t know what to believe anymore. Vets here in Belgium are very much in favor of dry cat food and a lot of the brands that are advised on websites aren’t available here. I’ve been thinking of starting to prepare myself but how do I know what the phosphorus content of the meat I use is? My second cat is his younger half brother, same mother, so I guess I should have him tested too.

    • Ingrid
      March 28, 2017 at 1:03 pm (1 month ago)

      You may want to work with someone who can help you formulate an appropriate homemade diet for cats with kidney disease, Dominique. I can recommend Jodi Ziskin

  6. Bridget
    March 24, 2017 at 5:18 pm (1 month ago)

    I have a 12 1/2 year old male cat whom is the apple of my life and recently took him to a vet for blood tests and urinary test ONLY because he was constantly licking metal on my balcony So the test results showed according to vet he had a minor urinary tract infection and very early stages of kidney disease I was shocked with the news considering I’ve had him on a veterinary prescribed diet (wet and dry) for almost 7 years because he did have severe FUS (not a cheap diet either) which I was told this would prevent it from reoccurring However it was the early stage of kidney disease that through me a loop As I said I’ve fed him both dry and wet food daily My concern now is the Vet put him on Hills veterinary prescribed diet for kidney care He took well to the wet but threw up every time he ate the dry kidney care food This went on for a few days so the vet changed his dry to a prescribed gastrointestinal dry food (which he was having in wet prior to changing to kidney care diet) however the same result I want to venture into a holistic dry food for him but no longer as a regular part of his meals only as a small portion treat as he has always had dry in his diet with the wet He hasn’t shown signs of failing with his health except exhausted and a week belly from the past few weeks of vomiting and he didn’t have a normal bowel movement for a close to 48 hr period until this morning early which was not in his litter box which is very unusual I feel he was trying in the box until the vomiting took over I did contact his vet today with my concerns after listening to the instructions I was given by him this past Monday I suggested I would like to look into a holistic dry food replacement for my baby but the vet replied he had no knoweledge regarding Holistic Food Heath diets and ended my call with him quite abruptly I need some honest good advise to give my beautiful honourable cat the best possible diet of dry food under the circumstances to help maintain his early kidney disease diagnosis (which will not take presidence of the wt food diet) Please help me to maintain the best quality of life advise for a healthy maintenance diet of dry for him I refuse to except a death sentence for him at this time PLEASE HELP!!!

    • Ingrid
      March 25, 2017 at 5:09 am (1 month ago)

      There is no such thing as a “best possible diet of dry food” for cats, Bridget, especially not for cats with urinary tract issues. Stop feeding dry food and feed a premium raw or grain-free canned diet. You can find my recommendations here: You’ll need to check phosphorus levels for the foods you decide to try since he is in the early stages of kidney disease.

    • Chris Pometta
      March 25, 2017 at 10:49 pm (1 month ago)

      For excellent info on what to feed and not to feed, you MUST visit Dr.Lisa Pierson addresses the matter of “prescription” diets being inappropriate EVER! Kidney disease is a complex disease and there is a great deal that must be learned in order to help CKD cats. When both of my cats were diagnosed, I went on a learning journey that spanned more than two years. Another excellent site is CKD often leads to other equally as serious as kidney disease. It is important to recognize and treat each as they occur.

  7. Felipe
    January 16, 2017 at 12:11 pm (3 months ago)

    Dr. Colleran, I live in Brasil and I am unemployed right now, unfortunatelly I can’t pay for vets and for special foods like Hills.

    My cat is 17 year old and she is diagnosticated with kidney disease (from a time I could pay for vet) unfortunatelly she also lost her teeth and she refuses to eat dry solid food, she only eats moisted/gel food and even soo she appear to get bored very quickly and stop eating and only lick the food to get the juice from it.

    I am really worried because despite the fact that I have been able to keep her situation stable for some time, now she started to loose a lot of mass and also show that she can’t even stand on her legs sometimes. I can’t for example drop her even a few inches from the ground, as she lay down and have difficult to stand up, I need to actually put her on the ground.

    My question is, what kind of unprocessed food can I give to her? I heard chicken liver is very rich on protein, can I give it to her? What other kind of unprocessed food can I give to her? Thanks a lot!

    • Erika
      January 25, 2017 at 11:36 am (3 months ago)

      Oi Felipe,
      I am in Portugal and I also have a cat suffering from this terrible problem. She will also only lick food and is very picky.
      I’ve cooked her chicken meat and skin and then processed it in a soup (even with a bit of olive oil, as she is a gourmet cat) and she enjoyed it.
      But what she prefers is chicken livers, cooked only with water until soft, then processed and with a bit of olive oil in the end too. I freeze the soup in small containers and I heat up small portions at a time.
      She’s gained weight, she’s hidrated and looks really well for a cat that was almost dying almost 2 months ago. She’s only 7 years old but one kidney is totally dead and the other one is full of stones too 🙁
      If you want to exchange ideas and experiences, email me at enunes2011 at
      Boa sorte!

  8. JaneA
    January 1, 2017 at 3:45 pm (4 months ago)

    Thank you, Dr. Colleran, and thank you, Ingrid, for sharing this article. I’ve linked back to it in my Paws and Effect post today because my reader has a cat with kidney disease who won’t eat her prescription diet. I’ve recommended this article as a starting point for discussing diet with her vet. I like the fact that Dr. Colleran has such impressive credentials, because that will lend more credence than “hey, I found this on some random website.” 🙂

  9. Jen
    November 13, 2016 at 2:57 pm (6 months ago)

    Hello ! I have two younger , healthy, Siamese cats and one older tabby who is was at the beginning of renal insufficiency at her last appointment. She is on medication. Is there a food out there that I can safely feed all three? Thank you!

    • Angie
      December 19, 2016 at 1:10 pm (4 months ago)

      Hi Jen, my 3 cats, one with CKD and two without have all done well on Weruva Steak Frites(canned high protein low phophorus no grain) and Hi-Tor Neo (canned paté low phosphorus with grain) Maybe check out this sight also

  10. maureen
    November 11, 2016 at 8:23 am (6 months ago)

    My Manx was just diagnosed with kidney failure at 4 years old. He was a rescue cat, I found him under my dock about two years ago covered in ulcers, mange, fleas, mites in his eyes and ears and matted fur. He was a mess. got him cleaned up and healthy, he’s been fine. last week I noticed he had lost weight. a few days later I noticed he had stopped eating and was lethargic so took him to the vet. yesterday he spent all day 12 hours on a IV drip of water/electrolytes. He drinks excessively, always has. his numbers dropped a little. today he go through it again. I started him on KD hills dry food , he doesn’t like wet and he doesn’t like the KD stuff. so now what? do I just give him what he wants and quality of life or do I force feed him food he hates just to keep him alive. I just went through this with my father (kidney failure) so I am very familiar with the whole diet thing. my heart is aching

    • Ingrid
      November 11, 2016 at 9:43 am (6 months ago)

      I’m so sorry, Maureen. As stated in the article, it’s far more important that cat with kidney disease eat, than what they eat.

    • Angie
      December 19, 2016 at 1:01 pm (4 months ago)

      My Little Girl just passed on from CKD a few days ago. I struggled to find her good food, that she would regularly eat, for quite some time.; I did tho. I see it’s been over month since you’ve written, so hopefully you’ve found a food that he’ll eat. Here is a sight that you may know about but it’s helped me out A wet food guide is there as well. I found 2 that I rotated. Try to find wet food if possible. I know you know.. And I understand the desire for dry in some, as my 15 yr old guy loves it, and turns up nose to most wet foods. I wish you all the best. Bless your caring heart, big time.

      • Ingrid
        December 19, 2016 at 2:46 pm (4 months ago)

        I’m so sorry, Angie.

    • dani
      April 2, 2017 at 7:39 pm (4 weeks ago)

      We also have a manx that did exactly what yours did! We have tried to feed her KD Diet and she hates it. All she wants to eat is human food!! haha so I started giving her ck liver and ground chicken with rice and a calorie supplement. I also give her slippery elm root. She is doing so much better and I definitely agree quality of live is more important than starving the cat.

  11. Lindsey
    September 13, 2016 at 11:59 am (8 months ago)


    My cat Otto is only 3 years old and already has what the vet considers stage 1 kidney disease (he’s at 80% function). The vet was surprised to find it this early, I took him in when he was acting a bit odd with his litter box habits and they found crystals in his urine and then the reduced function. The vet put him on a Rx diet of Hills Prescription C/D formula wet and dry food. He gets two wet cans a day and free feeds on the dry as he pleases. I took him in for a 6 month follow up of being on the food and all the crystals are gone, but his blood work is showing that his kidney function is still going down slightly. I’m not a huge fan of Hills, but it’s what he recommended. He’s doesn’t act differently at all, still eats like a champ and I believe he’s getting enough water (we have a dog and a cat who share a water bowl, so sometime hard to tell how much each is drinking) I’ve given Otto his own water bowl as well, but he likes the one the dog uses more, go figure. Since his diagnosis, I’m more paranoid about how much he’s drinking, but I haven’t been able to increase it and he doesn’t drink excessively that I’ve noticed.

    He’s due for his next follow up in February to see if his kidney function plateaus. If this visit results in the same decrease has his last 6 mo. visit, I want to try something else for his food. Do you have any recommendations for other food options knowing he is a young cat? I like to believe he still have a lot of life left for him and I want to do anything and everything I can to make sure he’s getting the right stuff! (Otto is a pure bred Siberian and is about 18 lbs, he has not lost any weight at all, in fact has still managed to gain since his breed is known to keep growing until they are about 5)

    • Ingrid
      September 13, 2016 at 12:04 pm (8 months ago)

      You may want to consider consulting with a holistic veterinarian to formulate a diet for Otto, Lindsey. In addition to managing his early stage kidney disease, the type of crystals he had in his urine will also need to be taken into consideration when it comes to determining what type of a diet he needs.

      • Gail P
        October 10, 2016 at 10:41 pm (7 months ago)

        Kristie Sanchez,
        What is the brand of the human grade food you found for your cat? My cat is sick and of course vet prescribed hills c/d she won’t eat it anyway. Please and thank you. Gail

    • Kristie Sanchez
      September 28, 2016 at 8:01 am (7 months ago)

      Dr. Lisa Pierson.!!! I have a 17 year old with pancreatitis, diabetes and urinary issues (crystals) … vets said take him off of his raw diet and onto c/d. 18 months later his urine is slightly dilute and he lost 8oz over the last 6 months. I consulted the referenced website and low and behold c/d is low in quality protein, high in carbohydrates and fat and calories. I found a human grade food with low phosphorus and ZERO carbs. HELLO!!! He immediately had more energy and his coat got super shiny. Will have labs run again and urine checked in a few months. Also was able to stop insulin. Seriously though … prescription diets are such a scam. Read Dr. Lisa’s site… it angered me to learn this stuff.

      • Lindsey
        September 28, 2016 at 3:11 pm (7 months ago)

        Please let me know what you find out when you get the labs back! Especially since mine is so young (only 3 yrs.old) I really don’t want to be compromising his health with the Rx diet just because my vet recommended it, I like my vet a lot but I don’t think this is his area of expertise. I feel like there are better ways to preserve his kidney function and make sure he’s getting what he needs!

        • Lindsey
          October 11, 2016 at 10:40 am (7 months ago)

          Update to my comment, I did a consult with Dr. Pierson, worth EVERY PENNY! I’m now transitioning Otto to homemade tailored to his needs!

          • Aggie
            November 2, 2016 at 11:13 pm (6 months ago)

            Lindsey, please keep us updated on Otto’s diet and how he’s doing. I have a 4 year old male with the exact same issues (crystals and now, after his follow up, the beginning stage of kidney disease). I have had my cat on Hills c/d for the past month and a half and he’s now clear of crystals, but now the vet is thinking I should switch him to k/d after the new test results. However, I’m worried about reducing the levels of protein when there is such mixed opinions out there (and by vets too) about whether this really helps. Ultimately, from what I keep reading, it seems really about reducing the levels of phosphorus. There is also the concern that if I make a switch, whether this would keep his crystals in check as well! After taking my cat into the emergency clinic for a urinary blockage about a month and a half ago (and $3,000 later!), I sure don’t want to face repeating that episode again!

        • Mei
          November 11, 2016 at 5:55 am (6 months ago)

          Lindsey, what is Dr Pierson’s fee? I am from Malaysia and am interested in a homemade food. My cat was just diagnosed with CKD and I don’t really like the Hill’s K/D diet he’s currently on.

          • Lindsey
            December 29, 2016 at 2:37 pm (4 months ago)

            I believe for me the TOTAL consultation was around $250, she charges by the hour and spent almost 2 hrs with me on skype going over EVERYTHING! Since I didn’t end up needing a custom recipe and could use the once from her site w/ a few tweeks it was less than it would have been if that service was needed. She does require very in depth medical records from you that you’ll have to get from your vet. All testing results, all notes, everything. After she analyzed all of that for Otto, she actually came to a different diagnosis than my primary vet. That probably wont happen for most! But, in my case, my vet was mainly placing his diagnosis off of the creatinine levels and not looking at the other indicators like the the urine specific gravity or the BUN. In Otto’s case, since he is a large cat (he’s a Siberian weighing in at 18 lbs…and still growing since they don’t stop until they are about 5 yrs old) he might just naturally have higher levels of creatinine similar to how a human with more muscle would have higher levels. Based on these indicators, Dr. Pierson doesn’t believe that Otto even has kidney disease and it was a misdiagnosis based on only one metric but not looking at the whole picture…which than angered her even more at my vet for putting him on an Rx diet. But I can safely say, everything I learned from her about what to fully look at in terms of kidney disease was priceless. She didn’t just go over that either, she also went over what to look for in vaccines and other medicines as well as all of the testing and what it actually means in term someone who did not go to veterinary school can understand! I felt infinitely more knowledgeable about CKD after talking with her for an hour than I did after doing weeks of research on my own. I highly recommend doing the consult, it was worth every penny in my opinion! And, Otto is going great on his new diet. He loves it and I have no complaints. I will do another full work up for him in February just to see if everything looks good (or at lease has leveled…and that the creatinine is the only thing that looks odd for him). But, after switching his food to the fully raw diet his coat looks healthier, he has put on more muscle again and he seems to have more energy as well! I did have to buy a meat grinder, but my husband and I decided to make raw food to mix in with the dry food for our dog as well, so it all worked out and now all the 4 legged children are happy.

          • Ingrid
            December 30, 2016 at 6:19 am (4 months ago)

            Thank you for sharing your experience with your consultation. This type of misdiagnosis happens more often than you think when vets fail to look at the whole picture.

      • Joyce
        September 29, 2016 at 4:47 am (7 months ago)

        Hi. I’m glad to hear your baby is doing well on the new food you found. I’m reading from my phone and not everything seems clear. Would you mind naming the food you found? I may have missed it if you said it but I also have trouble going online from my phone and am traveling right now. Thanks in advance..

      • Stacy
        November 16, 2016 at 12:17 pm (5 months ago)

        Hi Kristi,

        What was the human grade food that you found? Just learned my baby has the same problem! Thank you!

    • Chris
      December 29, 2016 at 4:58 am (4 months ago)

      Please see Dr.Lisa Pierson’s EXCELLENT site for info on feline nutrition. She clearly explains why “prescription diets” are the LAST thing that any cat should be fed.

      • Nora Lenz
        December 29, 2016 at 12:57 pm (4 months ago)

        Dr. Pierson’s advice to feed canned food over kibble has validity only in that canned food contains water like a cat’s food is supposed to. However, that’s where it ends. She says that canned food is “gently cooked”, which is not true at all. There can be nothing more thoroughly cooked and over-processed than canned cat food, except kibble. Why gently cook a food when UNcooked is what the body of a cat requires? It is only uncooked food that offers cats everything they need. The idea that feeding a cat raw is so difficult and mysterious that the normal cat owner can’t manage it is nonsense. This idea keeps cats sick, because it keeps cat owners in the dark. It is EXTREMELY easy to raw feed cats, and this is the ONLY diet that prevents and reverses CKD in cats.

        • Ingrid
          December 29, 2016 at 1:19 pm (4 months ago)

          Raw feeding is not for everyone, and I believe that we’re doing cats a disservice by making those who can’t or won’t feed raw feel like they don’t have their cats’ best interest at heart. While it is without a doubt the best possible way to feed cats, it does exceed the comfort level for a lot of cat guardians. The next best thing to raw is a homecooked diet, followed by canned food, in terms of going from least processed to more processed. And while feeding an optimal diet may prevent CKD, CKD cannot be reversed. Once the kidneys are damaged, even the best diet won’t restore function, but an appropriately formulated diet, as explained in this post, can prevent further decline of kidney function.

          • Aggie
            December 29, 2016 at 1:44 pm (4 months ago)

            Thank you, Ingrid!

            To give people some context: My cat was exclusively fed a raw diet (a reputable, veterinary approved brand as well), and still ended up with a urinary blockage and kidney issues. It only proves that every cat is genetically different, and in the end it is just best to feed an appropriately formulated diet catered to you cat’s individual needs–whether it be a prescription canned diet, raw, homecooked or a quality “over the counter” store bought food.

          • Nora Lenz
            December 29, 2016 at 1:45 pm (4 months ago)

            There is no reason to think that kidneys cannot self-heal just like all other parts of the body. Many humans have reversed their kidney disease by eating properly, and I am currently working with a cat owner whose cat is healing from a CKD diagnosis. It’s fine to not want to make anyone feel bad but there’s no way to avoid it if people are going to feel bad about hearing the truth. The truth needs to be told for the benefit of those who are open to it. The vets and their followers aren’t telling people. We who advocate raw food are outnumbered by the millions. There are plenty of resources for those who prefer the status quo.

          • Nora Lenz
            December 29, 2016 at 1:50 pm (4 months ago)

            There are problems with commercially produced raw foods, and they can and do cause disease. Commercial raw foods are better than canned and kibble, but they are a far cry from optimal and optimal is what is needed by a cat that is perhaps predisposed to CKD. If you’d like I can offer more specific information about what is wrong with commercial raw cat foods, particularly if you will provide the brand name.

  12. Tammy
    February 18, 2016 at 7:00 pm (1 year ago)

    What a sweet story of Goldilocks, she was so lucky to have you.
    I wish for all cat parents the mystery of kidney disease could be figured out!
    I too am going through the ringer with this food, I look at the charts and its
    so confusing. Has anyone tried kidney glandular’s?

  13. Tammy
    February 18, 2016 at 6:50 pm (1 year ago)

    It would certainly be nice to know what food your cat would eat that was low in phosphorus and low in iodine and good protein. I have the same situation with my 13 year old cat, I have looked at the chart and I am experimenting with what she will eat out of the chart which is really hard to do!! She is a picky eater. This disease is terrible to deal with.

    • Barbar
      May 15, 2016 at 11:55 am (12 months ago)

      I have founf Purina Pro-Plan Urinary Tract health and Pro-Plan True nature to be low in phosphorous (.1) high in protein and low carb. My 16 year old girl with kidney disease and thyroid will eat this

      • Pat Guobis
        September 4, 2016 at 8:50 pm (8 months ago)

        My girl loves this. It may not be optimal in terms of comparing ingredients with high end food, which is what she used to eat. She had the Iodine 131 treatment and I’m continuing lower phosphorus simply because she is 14 1/2. Lizzie’s coat is smooth as silk, she loves this food and is thriving.

  14. Deziz World
    February 16, 2016 at 12:49 pm (1 year ago)

    Gweat posty. Mommy feeds sis Lexi a high quality, high protein diet wiff a Phosphorous binder and of course an antacid afur each meal. We have drinkin’ stations almost in every room. Our VET dusn’t agree wiff mommy’s treatment but he’s shocked she’s still alive and just tells mommy to keep duin’ what she’s duin.

    Luv ya’

    Dezi and Lexi

    • Marilena
      June 14, 2016 at 1:31 pm (11 months ago)

      Which antacid does Mom use?
      Ty 🙂

  15. Brie
    February 15, 2016 at 9:34 pm (1 year ago)

    This is all really good information, but I like many posters and scores of cat owners with kidney disorders need assistance with WHICH FOOD EXACTLY is good for our fur kids. God knows there are enough brands out there that someone in the know can say, these following foods are recommended for cats with kidney disfunction.

    • Ingrid
      February 16, 2016 at 5:53 am (1 year ago)

      You can start with my general recommendations, Brie. All the brands on this list are good brands with quality protein and no grains: Then refer to Dr. Pierson’s chart to find phosphorus levels for these brands, or contact the manufacturers for information, if phosphorus restriction is indicated for your cat. I hope this helps.

      • Brie
        February 16, 2016 at 6:35 am (1 year ago)

        Yes, THANK YOU, I really appreciate it.

  16. Jenny |
    February 15, 2016 at 3:28 pm (1 year ago)

    Excellent article – thank you to you and Dr. Colleran for sharing. I am going to link back to it, so readers have more info.

    • Ingrid
      February 15, 2016 at 5:11 pm (1 year ago)

      Thanks for sharing, Jenny!

  17. Pam
    February 15, 2016 at 1:29 pm (1 year ago)

    I’m a bit confused by my cat food labels after reading this. The Rad Cat raw food label says 12%-14% protein, and my premium canned cat food labels say in the range of 10% protein. Am I feeding my 17-year-old cat way too little protein?

    • Ingrid
      February 15, 2016 at 1:33 pm (1 year ago)

      The percentages in the post are on a dry matter basis, Pam. Labels typically list percentages on an as fed basis. Rad Cat has 55.82% to 69.82% protein on a dry matter basis, 12.9% to 14% on an as fed basis. I know it gets confusing!

      • Joyce
        February 15, 2016 at 2:53 pm (1 year ago)

        Seriously I am going a little nuts trying to read and decipher cat food labels. Why can’t they all just be standardized. X amt protein, Y = phosphorous Z for ash and along with everything else clearly marked how about the calories per serving?! I can’t figure this anymore! I am SO FRUSTRATED. One can measures calories this way, another can measures calories that way!! If I ask the vet they recommend that disgusting prescription diet because it’s all in the profit for them. I need a good amount of the right protein, sans the crap fillers, and lower in calories so my kid can stay healthy stop begging me for more food every time he sees me stand up from my desk. Hell he’s taken to meowing in my face if I don’t get up often enough. We play often (before meals & throughout the day) he runs after his feathers, runs up & down his tree houses, chases Maggie – she’s fast but he catches her – … but he’s overweight and is not eating the proper diet because I have failed to understand the complex labeling! What will it take? Where do I go to get clearly spelled out nutrition & calorie counts? I feel like such a failure and constantly changing his diet is NOT helping!! SO incredibly FRUSTRATING.

      • Pam
        February 15, 2016 at 4:36 pm (1 year ago)

        Thanks, Ingrid! That’s a relief!

        Sadly, I do believe that food manufacturers of all kinds intentionally operate in such a way as to keep consumers confused and not able to truly know what is in manufactured “food products.”

  18. Sometimes Cats Herd You
    February 15, 2016 at 5:56 am (1 year ago)

    It seems like there’s a slow, but steady change in the thinking about the appropriateness of the low-protein kidney diets available as prescription from vets, and it’s great that the needs of senior cats are being additional consideration. I’m sharing this.

  19. Fur Everywhere
    February 15, 2016 at 4:02 am (1 year ago)

    I chose not to feed Jewel a prescription kidney diet because she hated all of them, and my vet and I agreed that it was more important for her to eat than for her to eat kidney food. Now reading this, I’m glad I didn’t feed her the kidney diet. I would have hated for her to lose muscle mass due to a lack of protein. We used phosphorus binders to help with her high phosphorus, and that worked out well for her. Thank you for sharing this fantastic article.

  20. Lilo Huhle-Poelzl
    February 15, 2016 at 3:42 am (1 year ago)

    P.S. I think that Goldilocks lived so long with kidney because she drank excessively. Sassy drank normally. And Sunshine, unfortunately, drank very little.

    It might be a good idea to try to induce kidney-failure cats to drink from the faucet. Several of our cats love to drink from the faucet when it is turned on to produce a water flow that is as thin as a knitting needle. All our cats who drink from faucets usually drink much more than those who drink from water bowls. Another way to get cats to drink more is to use stainless-steel bowls. Plastic bowls smell like plastic, and some cats don’t like this.

    Furthermore, some cats are “childish”. Our Christmas drinks very little from bowls but loves to drink from watering cans and buckets with water on the patio or in the sun room, even though this water (intended for plants) is not as fresh as the water in the cats’ drinking bowls.

    • Joyce
      February 15, 2016 at 3:02 pm (1 year ago)

      Ain’t that the truth. I have a neighbor who has metal flowing fountains, as did I, but her cat chooses to drink from a tall champagne flute she fills with stones & water, that she leaves out for moisture. My kids loved the fountains at one time. But somewhere down the line they started to drink from the German Shepherds ceramic bowl. (She was always gooping up the fountain water so I gave her her own bowl) It’s hilarious. I love how cats train us & let us think it’s the other way around.

  21. Lilo Huhle-Poelzl
    February 15, 2016 at 3:33 am (1 year ago)

    During the past 5 years, we had several cats with kidney failure.

    Sunshine was put on renal diet and improved considerably. When my husband considered her cured after 9 months, he became slack and allowed her to sneak regular food on a regular basis. Sunshine went downhill and died a miserable death. The vet, whom we called to euthanize her, was out of town and arrived 40 min after Sunshine had died.

    Sassy went on hunger strike when put on renal diet. We gave up and fed her regular cat food. Sassy lived another 15 months. She, unfortunately, died while we were out of town. We tried to return home early when the petsitter informed us that Sassy was going downhill, but Sassy was found dead when the petsitter returned the following morning.

    When Goldilocks was diagnosed with kidney failure, in April 2012, and the blood test (as well as her history of excessive drinking) indicated that she had had this condition for quite some time. Our (new) vet told us that it was more important for Goldilocks to eat sufficiently than to eat a renal diet. So we didn’t even attempt to “torture” Goldilocks with renal diet. Goldilocks drank excessively but only when the water was fresh. She almost died when an irresponsible petsitter only poured onto the water but did not clean or refill the bowl with fresh water. Goldilocks was additionally diagnosed with a huge tumor in her belly, believed to be cancer, in Sept. 2013. She was put on Essiac tea to treat the cancer. Except for her excessive drinking, Goldilocks remained symptom-free until spring 2015, when she started losing weight. Goldilocks stopped eating and drinking in May 2015. 36 hours later, she died peacefully while being petted. Goldilocks was 20+ years old, and her gentle death (without nausea) indicated that she died neither of kidney failure nor of cancer but of old age.


Leave a comment

First time visitors: please read our Comment Guidelines.