Published by: Ingrid King. Last Updated on: January 25, 2023 by Crystal Uys


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 than 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!

Phosphorus 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 kcal. 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 muscles 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.

Editor’s note: We cannot verify the veracity or accuracy of information or recommendations provided in reader comments.

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.

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250 Comments on Kidney Disease Diet for Cats: The Right Things to Look For

  1. My 15 year-old cat has kidney failure and she is currently on Hills k/d. She’s been on this food for 3 weeks now, but she won’t gain her ideal weight back, that she’d lost in a short time because of her condition. I am considering trying out high-quality senior food instead, because she needs to gain weight. Do you think senior food could be a better alternative to a prescription diet in this case?

    • Our vets do not recommend changing her food without speaking to her veterinarian for advice as kidney prescription diets are usually the best we can do for our cats. The feeding amounts on the packets are guidelines only and some cats may need to eat more to gain weight. Hills k/d comes as dry, pouches and tins.

  2. My 10 year old cat has been at the vets all week had a sudden onset of AKI last week, with no previous history of this , has been on IV fluids all week had a bladder the size of an orange the vet said when i took him there. He is a fussy cat with his food and acting on advice from previous vet I have only fed him dry food on the occassion a little wet food but has a preference to tuna taste. The vet said when he comes home he will need to be on a wet diet, can someone please help me with suggestions as I think the human tinned tuna will be a no no,even though he liked that on occassions.he is my first cat and i am at a loss as he will refuse to eat any form of tinned food unless it has a tuna taste and then he is fussy.His Pathology levels are becoming normal which is a good sign , i just want to do the best I can for him Thankyou for your help .

    • Since you’re referring to tinned food, I assume you’re in the UK, so I can’t help you with specific brand recommendations, but the advise in this article applies regardless of brand. Canned tuna is most definitely not a good choice, as it’s not a complete food for cats. As for getting your cat transitioned to wet food, you may find these articles helpful: and

    • All cat food is low in Taurine. Cats are becoming deficient and causes them all there health issues. I have been adding Taurine in my wet cat food (Fancy Feast pate hearts & Liver and a few othera & purely FF seabass and shrimp in broth . I add extra purified water to make a soup thick consistency. I open a capsule and sprinkle (a small amount) on the food. This has helped my 15 yr old cat with IBS and kidney issues. Helped her constipation and stopped her howling and crying everytime she ate. She even started to put some weight on. I stopped all the prescription food, which she hated. Hope this helps.

  3. You might consider sraying Feliway in your kitty carrier about 15 minutes before leaving for the vet. It is a cat pheromone that helps relax the cat a bit.

  4. Just a thought on cats choosing food to eat.
    I think cats not only are aware of taste etc etc ..(all listed) … but also I more than believe that cats also know when a food is … good for them.. and I truly believe once they “know” … they “stick with it”.
    It is a “feeling good” over “feel good” thing. (I think .. ?)

  5. My 14-year-old cat has advanced kidney failure. My vet say other than that, he is in perfect condition (heart, lungs, etc.). He will not eat prescription cat food, and will not take liquid medication, (can clinch his teeth so that it is impossible to get medicine dropper in his mouth. He also will not eat if powder med is in his food. You seem to talk a lot about protein levels, but my vet says his has the kind of kidney failure that involves lowering rather than protein (????) Would appreciate any suggestions on what I can give him or feed him. I will do anything it takes to keep him with me a few more years. I also have a 15-year-old that has crystals in bladder. All the vet will let him eat dry SO. I am not in favor of any dry food.

    • Unless your cat is in the late stages of renal failure, protein restriction is usually not indicated, as explained in this article. You are absolutely right, dry food is the worst food for cats with urinary tract issues. You will also find lots of information on both topics on Dr. Pierson’s site You may want to consider working with a vet who is well-versed in feline nutrition.

    • You have to be your cats best advocate. I take my cat to a vet who has been in practice 30+ years. I don’t always follow her advice. I have a 14 year old cat with kidney disease. He was diagnosed 3 years ago. He has been on a raw diet the whole time. He won’t eat powder either. I bought him a ceramic fountain to help him drink more water than what’s in his food. I feed him chicken, turkey, duck and a little fish. He is healthy other than his kidney disease. I have his blood checked every 6 months, his numbers stay consistent.


        • Does the commercially raw made food have bones in it? How do you feed it do you add binders or anything to counter the phosphorus. I have newly diagnosed ckd cat he was on raw I have him on prescription can food but really want to get him back on raw. I’m just to overwhelmed with the lack and conflicting info on raw food. My vet is no help at all

          • Darwin’s offers a raw diet for cats with kidney disease. If you feed other raw diets with ground in bone, you’re probably going to want to add a phosphorus binder, but be aware that they can cause constipation in some cats.

          • The Commercially made raw food does have bones in it. My cat would not eat the “phos-bind”. I stuck to poultry and rabbit as those are easiest to digest. I understand the confusion with conflicting info. I can Share Rumble’s story. He was diagnosed at stage one. I had him on Rad-Cat, it had no phosphorous and very low salt. his numbers continued to go up a little bit over a year and a half. Rad-Cat closed their doors overnight. Rumble would not eat phos-bind. I kept him on raw, his numbers stayed stable for another year and a half. I recently had to let him go due to hind end paralysis. Nothing to do with CKD. His numbers looked good, at his last dental cleaning he didn’t have any teeth extracted.
            This comment has stayed with me
            A Cat can have good numbers and be in poor health on the outside. A Cat can also have terrible numbers and look great on the outside. Treat the cat, not the numbers.
            Ingrid Mentioned Darwin’s. I would check out their Yelp reviews before buying. On yelp they can not edit or delete only respond. They also had a recall recently. Dr. Royal who created the RX formulas for Darwin’s has a clinic in Chicago. I am not sure if you can make it there. She is the best vet I have ever met, and I have met a lot of them. I hope this helps.

          • I’ve been feeding Darwin’s with confidence for many years, and I would caution you to get your information about them from more reliable sources than Yelp reviews. I had a long conversation with Darwin’s president after some of the recalls a while back, and I continue to feel confident feeding and recommending this brand. One of the things that is important to understand when it comes to raw food recalls is that the FDA’s “zero tolerance” policy for raw pet food is much stricter than the USDA’s comparable policy for meat for human consumption. Darwin’s feels that it’s almost impossible to meet this, which might explain partially why there have been so many raw food recalls of raw food brands lately, not just Darwin’s. They will do everything they can to meet the standards. Their big challenge is that they feel strongly that they don’t want to go to HPP processing because they feel that it impacts the integrity of the raw food, thus negating some of the benefits of raw feeding. They are actively investigating alternate methods.

          • My 14yr old cat has lost significant muscle mass with weight loss. Recent CKD diagnosis. What I am trying to understand is appetite. She was never a big eater and now all she wants to do is eat. Recently started her on the Rx food, and it is not filling her up . She is starving all day. I was giving her 4-530z cans daily. Her weight increased by 1lb but I am looking to change her to a higher protein diet due to her needs. She is all skin& bones. I have a good understanding of adding the phos binder if need be. I am just trying to find the best quality of a raw dehydrated/rehydrated food which is working for their cat. I am grateful for any advise .

          • hi julie, few days ago my 14 yr old was diagnosed too. she has lost 2 lbs in a few months, and had lost muscle mass last year. she’s constanly vomiting, has constipation (has been “cleaned out” 3 times in less than yr)!
            I’m at wits end, vet wants her on RX but she wont eat it no matter what I do, also has her on lactulose, miralax, pepcid and another constipation drug that they took off market for people! so, hav you found a good food for your baby, hows he doing, and any suggestions? oh, world war 3 for meds, cant fool her with them in food, and so on. good luck, hope you might have some advice, vets dont seem to take classes in nutrition….they just get kickbacks when they prescribe RX foods…as bad as feeding dry food.

          • Follow the advice in this article, Kat. Ideally, look for a food that’s low in phosphorus, but it’s more important that your cat eats than what she eats, as is also stated in the article.

          • Darwins is great and has intelligent design for kidney disease. My cat has been on it for about 3 years. Now that my boy is 20 his creatine and BUN levels have slightly increased. So, I need to find a way to either modify Darwins or some other solution. I can’t help but think Darwins intelligent design can be a good foundation for whatever I need to add to supplement or for dilution. Any thoughts?

    • I think vets have a lot of different opinions on how best to handle managing kidney disease. And that cats have many different responses and prognosis to “treatment” whether it’s medicine, food, etc.

      My vet also put my cat on kidney disease prescription food, and she ended up not eating and lost 30% of her body weight. It was really scary. I took her to the vet and he said to continue with the diet. At this point, I gave up on the prescription foods and pretty much am giving her whatever she wants. I give her a new can of cat food everyday cause she is picky and doesn’t like to eat the same thing 2-3 times in a row. I also have dry food on the side if she likes that. After 6 months of doing this, I had her blood checked again and her condition was stable.

      So all in all…there are a lot of ways to go about it. But I also agree with Tanya that keeping your cat’s weight up in the most important thing. If you feel like she’s getting emaciated. I would just feed her whatever she wants.

      • While I agree that there are different approaches, and certainly different opinions, to treating kidney disease, especially when it comes to diet, I find it unacceptable for a vet to tell a pet owner to continue with a diet that the cat is not eating when that cat has lost a third of its body weight! The bottom line is that while in some cases, a particular diet may be indicated, the most important thing for a cat with kidney disease is that she eats, not what she eats.

        • Ya I know!!! I don’t get it. I mean I’ve been with him for a very long time and he came up with effective treatment for my now deceased kitty for IBD. Not like he’s incompetent, but maybe he was trained that ckd cats have to stick to a strict diet.

          I’d love for her to eat the ckd food but even so, she’s lead a long happy life. (18 yrs and counting). If it’s a little shortened by feeding her whatever she wants, I’d rather her be happy eating delicious than suffering for a few extra months On gross food and starving to death

        • After reading that your vet said to let them keep eating the prescription diet. I would have taken the cat to another vet… my male cat was sick and I didn’t do all the test but they gave me kidney care food for my cat and he didn’t like it… I have researched a lot online and I did change his food … my poor cat was nauseated everyday and has severe constipation… the nasea has completely gone away … here is what worked and didn’t work for me so I can help anyone that’s in the same predicament..

          I cut all dry foods out and snacks…

          Only wet food
          With no phosphorus I n it … this helped a lot
          Also the food I gave him are like salmon / turkey/ beef/ chicken

          Whiskars perfect portions… he loves this and it has fish oil which I think help his nausea a lot…

          I choose pate only

          I recently added nutiva virgin coconut oil into the food and this too has helped with his energy level. I wanted it for constipation but it hasn’t helped in that department..

          Also he loves turkey so I bought him wellness pate turkey also because it has flax in it and it’s a good healthy product.

          I give my can distilled of demineralization water.

          And for constpation it’s been a struggle
          I had to give him laxatone petroleum base like everyday but it’s bad so I tried other healthy ways but nothing was helping… still watingbto see if the flax works plus I bought a new one by Nutrivet salmon flavour that is veg/ soy/ coconut ingredients so hopefully that will help if not it’s back to the other stuf…

          I had taken my cats urine and did a dipstick test and after trying Miralax it made him have hemolysis in his urine .. so never never use Miralax I read everyone saying this from vets online that this works and it’s been bad and it never helped in that department…
          I also tried bran not good either and I tried olive oil not too good and I tried canned pumpkin he didn’t like it.

          Also I bought him lately nutrivet wild askalan salmon fish oil and this helps tremendously too.

          So the best stuff is eliminat dry food and phosphorus

          Add fish oil and coconut oil like I mentioned above

          Distilled water

          Read the labels and research good products

          And give your furry friend a lot of love and patience… ❤️

          • It also may be a possibility that kitty may be a bit dehydrated. It wouldn’t hurt to give him 50 ml of fluids. That should get his juices flowin’

      • Im having the same problem. Vet says not to feed her anything else other than prescription food, but my cat will just lick some and walk away. I can feel her bones now. Super worried. She starves herself. I gave her cooked chicken meat, liver and heart and she happily eats them. Im probably just going to give her cooked food for now and hopefully her readings are atleast stable/improving. I think it better to let her live to eat rather than eat to live, you know. But i really hope she lives long.

        • Make sure you add something to the cooked meats like EZ Complete to make sure she has a balanced diet. It’s low in phosphorous, too!

        • None of my cats would ever eat the Rx foods, no matter what they were for. The ingredients, IMO, are awful. The Kidney foods are reduced protein/phosphorus, but older cats NEED the protein.

          Every cat’s situation IS different. BUT, if the cat isn’t eating, it could be worse than losing kidney function. IF you feed any dry food, try to eliminate that. Get her eating again and perhaps mix some of the kidney food in with regular food sometimes (one way to use it up.) If she won’t eat that, pitch it or return it.
          1999 – Found/adopted as a very young kitten
          2015 – SDMA 15, just started kidney decline
          **About this time I eliminated dry food for ALL cats. They were getting canned and dry before then.
          2016 – Hyperthyroid. Tried using meds, lost about 5# anyway
          2017 – RadioIodine treatment, successful but never gained much weight back.
          2018 – xray/scan found lower lung spots
          Between age, wt loss and kidneys, did not operate
          2019 – late in the year, possible kitty dementia!
          Oct 2020 – Katie passed, not quite 22yo.
          She NEVER stopped peeing. It wasn’t the kidneys that took her from me!

          Up until 2018, we monitored the kidney values. They did get worse, slowly, but not enough to impact her.

          Again, every cat is different, but it IS important that your kitty EATS, and preferably ONLY canned or raw food, no dry food.

    • What are the options for a 16 year old cat with early kidney disease who has a past of obesity and 12 years ago had pancreatitis? These foods have very high fat content especially the kidney fry foods they recommend he had success all these years on the Hills W/D dry and I/D wet due to its very low fat content of 7.5% these K/d foods have 17 to 20% what is my option if we help slow kidney disease but irritate the pancreas after years of basically successful renmission. I don’t want him on dry food but he is a grazer and I know his appetite is always good and looks for his dry food even though I add water even to his dry not just his wet. My vet really has not given me any options

  6. YG: A few questions and some suggestions.

    When you say diagnosed with kidney failure – do you have actual results from the test? If not, get a copy from the vet. Knowing the numbers is important.

    It used to be called renal/kidney failure, but that has changed to Chronic Kidney Disease (CKD). If the test done was the SDMA, the tests results I have show up to 14 is considered “normal” and 15-20 is stage 1 (once there, this is when they say function is 75% reduced, but they can survive for a long time on 25%.)

    The first inkling we had was about 3 years ago – Katie was very early stage then, also became hyperthyroid and was treated for that (medicine first, but weight loss continued so the RadioIodine method was done). Since then her numbers have gradually crept up, hitting 16 in July 2018. Back in April 2018 we found she has growths in her lungs, but given her age (20 sometime this month), the CKD and that she never gained back all the weight lost on medicine, surgery was not considered for her. But, my main point is she is still going despite all she had to deal with and the CKD is now almost 3 years since first “found.” I have NOT used Rx foods.

    DRY food was eliminated for all cats here about 5 years ago. This is the best thing anyone can do for cats, especially those with CKD. This has been helpful here in MANY ways (cured bowel issues two came with from shelter at age 4, hypercalcemia cured , no diabetes or fat cats in the house!)

    My vet also tries to recommend the Rx foods, but 1) many cats won’t eat it 2) eating something is better than nothing and 3) I detest the ingredients in these foods, esp the reduced protein. Unfortunately phosphorus is linked to the meat itself, so the choice is reducing protein (BAD for older cats!) or using phosphorus binders if it becomes an issue. All of Katie’s tests up to August 2018 showed no issue with phosphorus. She is considered a solid stage 2 at last testing (due next in April.) She is very picky about food, so WHATEVER canned food she wants to eat is fine by me!!! She will sometimes eat one type over and over and then suddenly not want that, so several “favs” are kept on hand for her.

    What other, if any, testing has been done? I have not dealt with FIV, but quick lookup says many cats can survive and have good quality life with this (as you already know, avoiding infections!) However, one of the “symptoms” listed was weight loss. But, you do say he’s “acting fine, he’s eating, he’s happy and seemingly energetic” That does say a lot. Also, after typing the above, I see you say “…despite eating the medical dry food” – is there any way to NOT feed him dry food? If he is CKD, he really should not eat dry food. If he doesn’t like it, he may not be eating enough of it (and the Rx stuff IS reduced protein, which could cause some weight loss) and as a result will lose weight. Given you also say he won’t eat the Rx canned food, get the best canned food you can that he likes – read the ingredients and look out for grains, potatoes, rice, starches! Best = the most meat and the least (none if possible) fruits, veggies, grains, etc. I did find Fancy Feast has none of this garbage cats do not need (at least that sold in the US.) It is unfortunate that he is a fish addict, but can you find any just salmon, or some fish mixed with other proteins?

    “My vet says its the losing battle every CKD cat owner must face, and there’s nothing else we can do, and she cant really evaluate him since he’s HORRIBLY stressed when I take him to the vet and has to be sedated, and with his kidneys, he CANT be sedated.”

    Unfortunately there is no cure for CKD, but managing it can prolong a quality of life. It is not really an immediate death sentence (unless the cat never gets tested and it is found at a very late stage, which doesn’t sound like it applies to you.)

    As for vet visits – most of mine get uptight, Katie in particular hates the car ride (she’s more or less ok at the vets, depending on how much they have to do!) and generally pukes every time on the way. Instead of sedation, have they considered any kind of anti-anxiety meds? Any medication would not be good for kidneys, but he doesn’t have to take it all the time, just sometime before the vet visits. There are several options, but one that calms Katie is Gabapentin (it only comes in 100mg, which is currently too much for her, aka she sleeps way too much and walks like a drunk!) – however I have opened the capsule and using part of a pill pocket have used about 1/2 the dose. IF this works for him, they can possibly have it compounded in a much lower dose – again, only used for vet trips, hopefully only a few times/year!

    It is good to read “the last blood values gathered showed no need of phosperous binders btw.)

    I’m not a vet, but mention of UTI a few months ago – often dry foods result in more UTIs, especially male cats. Ditch any dry if you can! Although you also said there was protein in the urine, there are many causes, including the UTI. He really needs to be tested again to get a thorough idea of where he is in general AND in the CKD path. I do understand that it stresses him (as it does many cats), and you, but rather than sedation, if you could medicate him before the visit, it might take the edge off.

    You ask: “is there anything I can add to his diet to make him gain the weight back?
    I would love to add some high quality protein to his diet but I dont know HOW.”

    You mentioned giving him cooked chicken – have you considered making food for him (be sure to get a legit recipe – the one at is good, NOT raw but NOT fully cooked – read the page “making cat food”, however you would have to buy a grinder and all the vitamins and minerals needed, which you can get online if not available in stores. Big expense, especially if he decides he doesn’t like the food! Do not used store ground meats unless you plan to thoroughly cook it!

    If you want to try making some, but not buy a grinder, you could try boneless chicken and use a food processor/blender (I would bake the chicken minimally per catinfo instructions and then cut it up so as not to bind up the blender.) Freeze any that won’t be used in a day or two. Some places sell a “mix” with all the vitamins, minerals and even ground bone that can be added to boneless meat you provide (I have not tried these, so check online for reviews and/or perhaps someone reading these comments can suggest some – most are available for online order.)

    Otherwise, so long as he is getting at least 5-6 ounces of regular good CANNED cat food (again, ditch the dry if you can!), to ensure he gets his usual vitamins and minerals, I don’t see why giving him cooked chicken (better to bake than boil, to retain more nutrients) between meals or at the end of the day after his regular meals are done would hurt – some extra REAL protein.

    As a final note, as much as it pains you, I would certainly encourage you to find a way to get him back for regular testing! Ask your vet about any anti-anxiety meds. Try them at home first, well before the visit, to see how it affects him. Get copies of the current and previous results, so that you know what they are (ask questions/look up what the ranges are) AND can track his progress. Keep in mind that results can vary from one visit to the next – focus on those that increase or decrease by a lot. YOU are your kitty’s advocate!

  7. My cat is 7 years old, sadly FIV positive for the last 5+ years (that’s when it was checked and confirmed) and has been diagnosed with kidnay failure almost for almost a year now.My vet said hemust eat medical food but it’s been a battle to get him used to that. he used to eat a LOT of canned food (fancy feast) and he hates anything with internal organs (it makes him gag and run away) and vastly prefers fish flavours to chicken or meat.
    I’ve tried all the available vet foods available to me, which are purina’s NF, royal canine’s three Renal flavours and Hill’s KD.
    his tastes change rapidly and so I keep all available. I had no success with medical wet food unfortunatley as notihng tha’ts available here is fish flavored and he wont touch it.

    The major problem is, that despite eating the medical dry food (in various amounts and various brands, changing daily) he keeps losing weight. he used to be about 6KG. I have a real problem weighing him but if he’s above 5 now i’d be happy. he’s getting bony and I dont know what to do. My vet says its the losing battle every CKD cat owner must face, and there’s nothing else we can do, and she cant really evaluate him since he’s HORRIBLY stressed when I take him to the vet and has to be sedated, and with his kidneys, he CANT be sedated. I really dont know what to do, he’s acting fine, he’s eating, he’s happy and seemingly energetic, but he’s getting thinner and thinner and I fear soon he’ll start to lose quality of life. is there anything I can add to his diet to make him gain the weight back?
    (the last blood values gathered showed no need of phosperous binders btw. he had a UTI a few months ago and the urine showed a TON of protein though, so I dont know how bad the kidneys are at the moment and as I said, checking might do him more harm)

    • It sounds like he’s losing muscle mass, which may be due to the restricted protein in the so-called kidney diets. This article explains:

      • I’ve realized that he needs soemtihng more than the CKD food he gets now. unfortunately in my country most vets are not nutritionists and the variety of foods available is not great.
        I would love to add some high quality protein to his diet but I dont know HOW. I also dont know how bad his kidneys are and I cant even check because he stresses out so much when he’s brought to the vet and has to be sedated to draw blood. (its not the vet, she’s great with cats and was great with my late older cat. he’s just like that. )
        all I know is that he’s not tot he stage of excessive vomiting and refusing to eat yet. he eats, its just not enough and I;m afraid to give him cooked chicken or sometihng like that because I dont know if I’ll be hurting himor not. his FIv is beating his body to boot, so he’s not allowed a raw diet because it contains germs that with ihs lack of immune system, can kill him.
        I dont know what to do.

        • YG – My attempt to post response to your comments posted instead as a separate comment – please check it out! I am not a vet, but have a CKD kitty. Hoping your little guy is doing well!

        • Hello! I’m so sorry to hear about your cat’s CKD. I’m not a vet, but I am hoping that my experience with my own CKD cat will maybe help your cat start putting back on some weight.

          Once I found out my cat has CKD, I put her strictly on CKD prescription foods. I literally tried EVERY flavor of CKD food from Royal Canin and Science Diet. I tried getting her to eat, but it was really difficult to get her to love and eat much of the foods. (Except for one discontinued flavor of course) She ended up losing 2 lbs, from 10lb to 8lbs. I could feel all her bones, she was lethargic, and her hair wasn’t as soft and shiny. I felt so guilty….I brought her to the vet to figure out why she wasn’t eating, but her blood results didn’t show any change in her stage 2 CKD (which btw her BUN and Creative levels were just slightly worse than the normal range).

          I then went on a rampage to find her ANY canned or dried food she would eat to get her to gain the weight back. It’s shown that cats under 8 lbs have a much lower survival weight so I was terrified. I started accepting that maybe she only had a year max by how quickly she seemed to be thinning out and low energy levels. She ended up liking canned fancy feast and purina renal (not prescription) and gained back around half a pound. However with these foods came chronic diarrhea, which I chalked up to her CKD.

          Note: I would DEFINITELY not feed my cat Fancy Feast again. EVERYTIME she stopped getting diarrhea is when I took away Fancy Feast.

          After realizing that the diarrhea wasn’t going away with Fancy Feast, I have since switched her over to chicken thigh/drumstick + 1/2 cup dried Solid Gold brand food. Miraculously she’s much better now after having eaten this diet around a month. She’s gained back much of her energy and weight back! I’m shocked and delighted. I include the dry food because I do not mix additional calcium or any other supplements into the chicken.

          I don’t know if this is the best diet for the long run, but I highly recommend pan frying some chicken to see if your cat will eat it.

          At this point, I’ve given up on fancy prescription diets, canned foods, fancy cooked or raw foods you can purchase at the pet store. Just panfried/airfried chicken and dry food for now since she is doing so much better! I find that she doesn’t care much for the boiled chicken, but she loves the fried chicken. I don’t use any oil or spices.

    • Find foods that have a dry matter content of 40 to 45% protein, 30 – 35% fat, .30 or less sodium ( lower the better). The phosphorous is ok so you may have a little wiggle room in your choice of foods. I would still stay under 1%. Even better would be to stay under .8%. For some cats they either need a binder with the food or try and get the food at .6 and under for phosphorous. I don’t know what choices of foods are available to you. I feed a combination of 2 foods – Weruva Cats in the Kitchen Chicken Frick a Zee and Whole Earth Farms grain free Duck. He gets different things from both foods that he needs and it adds variety. The new formulated Daves Restricted Phosphorous looks really good. They use to terribly restrict the protein but they have greatly improved the protein and ingredients. My cat is also diabetic and the carb % on dry matter is 19%. So a bit much for him. The dry matter #’s for this food is – protein 45%, sodium .14%, fat 22%, phosphorous .39%. These are really good #’s. If your cat also likes Weruva, you can take some of the bigger chunks of meat out and still be left with decent protein amounts. Again, I dont know what’s available to you. I would add at least 3 supplements –

      fish oil (Nordic Naturals Omega 3 Pet)

      B-complex – (Country Life Basic B) ( Jarrow B- Right) 1/10 of the capsule

      Probiotics (Renew Life)

      Of course, whatever brands are available to you.

  8. I emailed Whole Foods to get the phosphorus amount in their Whole Paws food, and it sound too good to be accurate. Has anyone else seen info on Whole Paws?

    They told me:
    Beef & Chicken Dinner (3oz): 0.26%
    Chicken & Whitefish Dinner (3oz): 0.31%
    Turkey, Chicken & Giblets Dinner (3oz): 0.33%
    Shredded Salmon & Chicken Dinner in Gravy (5.5oz): 0.31%
    Shredded Whitefish, Chicken & Tuna Dinner in Gravy(5.5oz): 0.33%
    Shredded Chicken Dinner in Gravy (5.5oz): 0.30%

    • These numbers are highly unlikely what you need to know. These are most likely “as fed” or “guaranteed analysis” numbers. You always need to ask for the “dry matter content” of phosphorous, carbs, etc. I would tell you to look on Tanyas Kidney Support website for a list of foods and their phosphorous content, but some of the numbers need to be updated (mainly the non therapeutic foods). Never assume that the numbers on a chart are correct. Manufactures can always change the composition of a food, which can change the % of numbers. If you see a food that looks good, always contact the company for dry matter #’s. If you go on, a lot of people ask questions about particular #’s of certain foods. Most of the time, Chewy will have or will get that info from the manufacturer and will then post it below your question. Hope this helps!

      • Thanks! I figured that out now. Translated the beef is 1.18. Not under 1, but also not crazy high like a lot of food.

    • Emily – has your kitty been diagnosed with CKD or some other condition like diabetes? If not, phosphorus levels should not be a really big concern. It is good to get educated, in the event you ever need to go there. Sometimes there is GOOD information out there that your vet may not know about. One cat here had idiopathic hypercalcemia (idiopathic because we tested for all the reasons it occurs and none applied.) My vet wanted me to give him Fosamax, which I was familiar with because they wanted ME to take it. Nope. I found a reputable endocrinologist who wrote about this condition and suggested dry food (in particular acidifier changes they made to all formulas to try to prevent crystals or other urinary tract problems.) She let me try this, we tested him regularly and his values returned to and stayed NORMAL! She went on to suggest this alternative to others who WERE foisting this nasty drug on their cats.

      Anything should be in moderation, so foods exceptionally high (or exceptionally low) in phosphorus should likely be avoided by anyone. Too high/low can cause other issues. Also you would be better off calling the manufacturer than emailing for this information (and know what to ask in advance). The problem with the numbers you have posted (that they provided to you) is they do not indicate what they are a %age of. Did they indicate this was DMA (dry matter analysis)? If not, then as Stephanie indicated, those numbers are likely useless or even worse they are trying to delude or deceive you into thinking their food is MUCH lower in phosphorus, thus convincing you to buy it. This brand is not listed in either Helen’s “Tanya” page of foods ( OR Dr. Pierson’s food content chart (and she lists mg phosphorus/100 kCals, a completely different measurement.) Given that Helen’s listing of renal Rx foods are HIGHER on DMA than many of your numbers, it clearly is not DMA %age. (The lowest range of phosphorusas % of DMA on the felinecrf website ranges from 0.39 up to as high as 0.77 – note these are MOSTLY if not all the CKD “Rx” foods.) The %age they gave you is way too low to believe these numbers represent DMA. Nor is it mg/100 kCals… a little more on this to come… next post…

      • My cat is hyperthyroid, diabetic, and has been fighting back the rise in kidney #’s. As far as finding the right food for him, there are so many things that have to be considered. Most foods that are really low in phosphorus, are high in carbs. The carb filling ingredients take the place of meat (phosphorus source). You don’t want something extremely low in protein because of muscle wasting. You also don’t want too much protein because all protein will create waste that can raise BUN waste #’s. You also look at sodium, fat, and calories. I also look at ingredients that I try to avoid as far as with the hyperthyroidism. There are a couple of brands that would be pretty low in phosphorous and carbs that I can give him, but the protein is too high. My cat eats 7 to 8 small meals a day. He’s prone to digestive issues. He does great on this schedule. He has had these issues going on for a little more than 3 years. I’m constantly researching to do everything I can for him. Earlier on, he went from 15lbs. down to 9lbs. He’s now at a steady, strong 13.5lbs. and has a great appetite. He had high BUN #’s ( upper 40’s – 50) and creatinine was up to 3.2. I know some cats #’s can be worse than this. I have him on 6 meals of Merrick limited ingredient diet grain free duck (1 to 1.2oz each meal) and 2 meals of the Wysong Epigen turkey. His BUN came down to a 41 and his creatinine down to a 2.2. The merrick duck is low carb, high fat, relatively low sodium & a decent amount of calories. The phosphorous is .8 dry matter. The protein on dry matter is 30%, but the fat plays a big part for my cat. I also throw in 2 meals of the wysong because its 45% protein and .6 phosphorous on dry matter %. That 45 is just in case he needs a little extra protein for any reason he that he may need it. Would not give more of this food because its not complete and balanced and it would be too much protein overall. I believe bringing down the BUN waste helped bring down the creatinine. The strange thing is the issue with his phosphorous. I had him on the epikatin and it had brought his phosphorous # down from a 6 to a 4.8. Two months later it’s like the epikatin was useless. Started him on an aluminum binder ( Rx vitamins Phos – Bind). Was giving what was suggested on Tanyas kidney website. I had him rechecked and phosphorous went back up to an 8. BUN & creatinine came down and phosphorous went up – weird! I doubled his aluminum binder dose. I was originally using a minimum amount. I hope it helps. I’m always looking out for foods that are lower than a .8 in phosphorous and that fits his other issues, but he’s doing so goid overall that I would hate to change anything. Just hope binder brings it down. I have a traveling vet that comes to the house to get blood and check his numbers. Believe it or not, it’s cheaper that taking him to the vet. The main reason for her coming to the house is because my cat gets so stressed that I literally worry for his safety. His sugar skyrockets when she comes. This is the 2nd time where, recently, his thyroid T4 # has read around 6 and his free T4 is in the normal range. I’m wondering if stress is causing the rise in the reading of his T4 #? It wouldn’t surprise me. I’m sure his cortisol level is shooting through the roof when the vet is here. The thyroid controls everything, even phosphorous. I’m wondering if it’s stupid to think that stress could cause the thyroid to boost his phosphorous #? I’m trying to limit the vets visits and do what I think is best based on his physical and emotional state. With everything he has going on, he is doing really well.

        • wow, Stephanie, that’s a lot to deal with, especially in one cat!! Do this to treat this, mess up that…

          You did not say how old your boy is. Is he not a candidate for treating the thyroid? I suppose with those numbers maybe they might turn him down. Vet scared me off spending that money with fears about heart and then kidney issues, so we opted for the transdermal – during that time is when she lost the 5 lbs! When I could feel her spine, I said that is IT, I want this done! She was just wasting away…. I discovered after the fact that the damn thyroid could have been causing those other issues, which is most likely since the heart murmur did go away and the kidneys did not get worse (a little better actually)

          Other than that, just monitoring the kidney #s for now. I have about 2.5 years of most values, and except for BUN jumping at a recent specialist visit (we discovered lung masses), she’s just chugging along. Drinks a lot, eats a lot of small meals (sometimes have to try multiple foods before I find one she’ll eat. other times she will gobble up what is still lying around, even what the other cats left behind!

          The good side is we’ve been together for over 19 years! The bad news is the kidneys or the tumors are going to take her away. 🙁 I also lost a 15 yo a few months ago. He was only showing really early kidney disease last fall, but suddenly became ill. They tried to treat, hoping it was either kidney infection or a crash, but despite perking up a little bit that night, by the next morning he had produced no urine despite getting fluids all night. He had the “big kidney little kidney” issue (little is what Katie has now, both) and the big one was rather dense, so they suspect perhaps he had a tumor.

          So, just like with people, we never know. We can only do what we think best. For now Katie is stable, people cannot believe she is 19, and other than the numbers, the xrays and lots of drinking and peeing, one would never suspect anything is wrong! I wish we could get a traveling vet – she doesn’t mind people or too much poking at the vet’s, it is the car ride that gets her – she pukes every time!
          Best of luck Stephanie – hope you can keep him stable for a long time to come!

          • Thanks Marge, my baby boy is 15 yrs. He’s on the methimazole tablets, which he has never had any problems with. I break his tablet into 1\8ths & 1\16ths just trying to give him precisely what he needs. With all his issues, I cant imagine he would be a good candidate for the radio treatment. I cant imagine what that whole process would do to him physically and mentally. If something happened to make him worse, I could never forgive myself. I also have him on B complex, B12, nordic naturals fish oil, ubiquinol, taurine, and renew life probiotics. He’s doing well and I’ll continue to do all the best for him. – Thanks!

        • Cat food is so difficult. It always stresses me out because nothing is perfect, and now the phosphorus is another factor. I won’t do too low of protein, no sense in giving him diabetes and I have another cat. Since his levels are just slightly high I’m going to stay away from the fancy feast types and rotate Halo impulse chicken and guinea fowl, Instinct protein rabbit and original duck, and the whole foods beef. He will only eat pate, so no weruva. I used to make them food and add cat vitamins, but there seems no way of knowing then how much phosphorus he would be eating.

        • thank you stephanie. my caramia piccola is a maine coon about 18yo need to call to verify. i wish we had access to a vet who came out. it not only stresses me emotionally to take her in which i havent done for a long time. i need to increase her weight as she has been on science k/d for years and accepts it. her intake is about 6oz day which i am starting to supplement with some quality refrigerated fish oil as well as plain roasted chunks of chicken. here appetite is good. she drinks more water now with chronic rf. where do you get your merricks? amazon? i think could help her with her weight. she has always been a lean thinner maine coon but this is too low now. thank you for your time and info as i am emotionally stressed from the thought of losing her.

          • Hi Denise, hopefully my info on the Merrick and Whole Earth Farms can duck was posted. I get both for If They ever happen to be out of stock, you can get it on Same prices and free shipping over $49 on both sites. Chewy is a little quicker – 1 to 2 days and PetFlow is about 2 to 3 days. I also have my cat on Nordic Naturals Fish Oil – Omega 3 Pet ( can get on Chewy). He’s also on B-complex, taurine, vit. E, ubiquinol, vit. C, Dr. Mercolas Spirugreen, 1/4 of an 81mg aspirin every 3 days and an aluminum binder. Whole Earth Farms Duck has more protein and fat on dry matter. I hope that my other comment on this was posted.

      • Yes, he’s at the beginning stages of ckd. We caught it because of another issue where blood work was done. The two lists are great resources, but they are not completely current so I have been cross checking with manufacturers.

    • I’m looking for a “pate” type cat food I can buy otc for a cat w kidney disease… any suggestions would be greatly appreciated by me and my boy Rusty. Thank u all so much in advance. Rob

      • Hi, you should look on Tanyas CRF kidney support website. Click on – USA can food data list. Look for phosphorous below .8 ( even better is to get down as close to a .5 as possible.) It also helps to look for sodium below a .5. It’s good to have protein between 30 to 40%. You don’t want it lower or higher than that. Too much protein, even good quality, can cause BUN #’s to rise. BUN is the toxic waste that protein creates. Puts more pressure on kidneys to deal with this and to get rid of it. It’s also good to have a food that has a good amount of fat – above 35%. Fat doesn’t do much of any harm to the kidneys. If you see a food on her list that you like, you should email the company and ask for their latest – dry matter analysys #’s. Formulations can change and you will want the most recent #’s for the food. Tanyas list may not be updated. But, her list points you in the right direction. All the best,

  9. Hi, I wanted to do a CKD consultation with Lisa Pierson for my girlfriend’s cat, but it’s just too much money right now. She’s unemployed, we’re moving across country, and I’m nearly broke.
    I value what she’s doing and understand there’s no one diet for all cats with CKD. But.. is there anywhere out there I could get a basic decent homemade diet recipe to get started until I can consult with her later? I figure even an imperfect version of her diet must be better than the commercial kidney crap we’ve resorted to. We normally fed her organic canned stuff, but can’t find any kind of organic food for kidney issues.
    Thanks for pointing me in the right direction if possible!

    • I’m not a fan of the Rx foods because of the ingredients and the fact that many cats will not eat it. The two important things to consider is NOT using dry foods AND ensuring they EAT, preferably a good quality canned food. While homemade might be slightly better, gauging the age of kitty along with symptoms and test results are a must!

      My 19yo has been very slowly going down this path, but I do NOT feed her the Rx foods. It is also recommended to only start the Rx foods in the later stages (some recommend at least sometimes using it earlier, just so they will ‘get used to it’.) It has been over 2 years we have been monitoring the stats, as she has only just drifted over the high end of a normal SDMA test. Latest test was 16, but phosphorus is still normal (I will consider the binders they have for that, as increase in phosphorus will make her feel crappy.)

      The other concern I have is that she lost 5 pounds while we were “treating” her thyroid (vet scared me off the radioiodine treatment with the CKD and heart issues, but it turns out the thyroid can CAUSE these!) We did the radioiodine Feb 2017 and she’s been fine with that since. Trying to get the weight back was the issue there – so far only about 1 lb. Dr. Mark Peterson makes note in his blog about concerns with much older cats who naturally get into weight loss and concerns with muscle wasting, so he leans away from the protein restriction. Most kidney food restrict protein along with phosphorus (they are somewhat “married”), so it really is not a good option for my girl.

      How old is your kitty and how “bad” are her test results? If she’s older and only in the early stages, no dry foods, lots of water available! There is also a non-Rx food which is less restricted (maybe not the greatest ingredients, but I at least tried it) called Hi-Tor Neo available on Amazon and Chewy at least. But again, I’m just giving her the better canned foods, the sloppier the better (more moisture), whatever she will eat the most of!

    • Try Merrick Limited Ingredient Diet grain free Real Duck Recipe pate can food. Dry Matter#’s :
      Protein – 30.40
      Sodium – .30
      Fat – 52.40
      Carb. – 5.54
      Calories – 26.20
      Phosphorous – .80

      Good quality ingredients. The little bit lower protein will help to bring down the BUN waste #. The high fat will help to put on or maintain a better weight. Sodium is well below a .50, which is good. Low carb is always good. Decent calories but the fat will play a big part in the weight of your cat. I would like to see the phosphorous lower in this food, but add an aluminum binder ( Rx Vitamins Phos – Bind.) Hopefully, this will bring down the phosphorous #.

      • Click to open expanded view


        i am overwhelmed as i too am an old hen like my feline. these calculations are too much for me . lol is this what you are talking about?
        CRUDE PROTEIN 8.0% min
        CRUDE FAT 4.0% min
        CRUDE FIBER 1.4% max
        MOISTURE 78.0% max
        ASH 3.0% max
        TAURINE 0.2% min
        i realize this is in wet form but seem so low for fat and protein. need to add lots of weight in a healthy way for her rf kidneys and would like to supplement her science k/d diet with this.

        thank you i am at a loss. denise
        Merrick Limited Ingredient Diet Grain-Free Real Duck Pate Recipe Canned Cat Food, 5-oz, case of 24 By Merrick

      • What is the phosphorus content on a dry matter basis?
        The Phosphorus content for this formula is 0.80%.

        By on Mar 31, 2018 Report

        I wrote the company, Merrick, and they told me that the phosphorous on a dry matter is 0.16% and magnesium is 0.02%. So….who is right?

        stephanie do you know about this regarding the above food you mentioned? good news if this is correct about phosphorous. what is ideal sodium intake for chronic rf cats?

        • Even therapeutic kidney diets only go down to about a .5 in phosphorous. Looks like they’re giving you some other #’s. The magnesium is a .07 on dry matter. Boy, that would be great if phos. was a .16. But that’s impossible. They sent a spreadsheet to me, by email with only dry matter #’s. I’m doing something slightly different with his food now. Merrick Limited Ingredient grain free Duck and Whole Earth Farms grain free Duck are made by the same company. The dry matter #’s for these 2 foods are almost exactly the same with the exception of protein and fat. The protein for the Merrick is 30% and fat is about 52% dry matter and the Whole Earth is 40% protein and fat is about 40% dry matter. They are both .8 phosphorous and .30 sodium dry matter. I am mixing these 2 foods half and half at each meal. I felt that my cat needed a slight bump in protein. So, if you are mixing a 30% and a 40%, you’ll average it to a 35%. I felt 30% was becoming too low. With the amount of fat and the 35% protein, I feel this works for him. He’s very solid and is dping great. If your cat really needs to gain muscle mass, it may be a good idea to have him on just the Merrick at 40% protein with 52% fat. As far as sodium, you always want it to be below .5 on dry matter. As low as possible, while still trying to provide your cat with all the other right #’s. I feel these 2 brands of food for the best with all of my cats needs. The sodium for both foods is a .3 dry matter. Because of my cats extreme stress, I’m no longer having any of his #’s checked. I literally fear for him when the vet is here. I am doing the most and best that I can with everything. I will go by his physical and emotional state. Also, go by everything I know and research I’ve done, dealing with his diabetes, hyperthyroidism and kidney issues. He’s doing wonderfully. I pray that my Allie and all the other cats out there, who are dealing with these and other issues, will have a happy and healthy New Year!

          – Best to all

  10. This is great info, and now I’m really concerned. My cat was eating Orijen dry, when the vet said he was in kidney failure, and prescribed Hill’s k/d. He eats it both dried and pureed (often off my fingers), and he’s been losing weight. I assumed it was the course of the disease. I’m glad to know I might be able to do something about this, but I’m kind of horrified, too.

    I will take a look at your recommended list to see what I can get here, and then dive into making his food.

    He likes nutritional yeast. Is this okay for him?

    Thank you!

    • Nutritional yeast does contain phosphorus, which can be a concern for cats in renal failure. According to homeopathic feline veterinarian Andrea Tasi of Just Cats Naturally, “the typical dose of 1/4 to 1/2 teaspoon would only add about 14 mg of Phosphorus. This would only matter if a cat is in advanced renal failure, or if the diet is otherwise high in phosphorus.”

      • Thank you! I’m encouraged after giving my cat his first bit of much-better food. He loved it. Sadly, I think he was hungry for something good.

    • Hi Tanya I live in Australia, a lotof the foods recommended are not available here. My cat Jazz had crystals in the bladder he ate a little dry food this I believed to cause the problem.
      Now Jazz is on a diet of kangaroo and chicken raw this it has now been 12 months without any more problems, now trying to get him to eat the cat mince bit of a test of wills there. Good luck.

    • Did your vet tell you what stage CKD? Do you have/been monitoring the test results?
      The one concern I would have is that my vet first identified heart issues (we did the cardio check, results given, but required no treatment at that time), then the early CKD results… however when she started losing weight, we discovered she had hyperthyroidism! THIS can cause heart, kidney and other organs to run overtime and damage them. Had she not initially scared me off the Radio Iodine treatment with the heart and kidney issues, my poor girl would not have lost FIVE pounds on medication!!! We are now 2.5 years after that first thyroid diagnosis and I keep track of her test results. She is slowly creeping up the CKD charts, but still within Stage 2.
      It is (presumably) good that you got off the dry food – you don’t specify if the Hill’s is canned or dry, If dry, please try canned food and ditch the dry!!

      • P.S my girl was about 18yo when we did the Radio Iodine, still stable and is now 19.5yo. Because of her age, it is hard to regain the lost weight, but she is up about 1 lb, which my vet was impressed with.

  11. seems that all renal diet prescription cat food is not good. I have been searching for low sodium grain free wet cat food and have not had any luck. My cat recently had fluid in the lungs and kidneys levels are not good, Vet gave me furosemide, which attacks the kidneys. What can I do? Right now I’m feeding him Nature variety Instinct grain free pate food. Should I keep him on this, seems a lot better ingredients than other foods?

    • Since you’re dealing with multiple issues, I would recommend working with a holistic vet who is well versed in feline nutrition to help you find the right diet, or help you formulate a homemade diet, Ann.

        • As I told Ann, I recommend working with a holistic vet who is well versed in feline nutrition to help you formulate a homemade diet, Trish. I do not have a recipe.

  12. My cat Peanut has been diagnosed with beginning renal failure. He was losing weight and no longer interested in his dry special diet he had been on for crystals in his urine. He doesn’t care for wet food but he was losing weight so we gave him meat baby food and he has filled back out. The vet insists on the Royal Canin diet and we are trying but he only eats a little of the dry. The vet said the baby food was bad for him. I don’t know what to do. His numbers did go up to over 60 on the baby food. Suggestions?

    • Baby food is not a complete and balanced diet, so at best, that’s a temporary solution. I would discuss this article with your vet, or find a vet who is better educated when it comes to feline nutrition.

      • The most important thing for a CKD cat is that s/he eats, and a cat food, for nutritional balance. There are many things you can do to work on your cat’s appetite. But your cat MUST eat. I suggest Googling “Tanya” and “CKD”–you’ll find a free website with huge amounts of information to help your cat.

  13. You say 50% protein but on the labels of, say, hills kd, it is a lot less than that. Is 11% on the label okay? It is higher than the kd but still not 50%. Confused.

        • Typically if you need/want this kind of information, you would have to call the manufacturer (hoping that they will provide this.)

          Several people have done some of this leg work for you, although some of the data may be from several years ago, it is better than nothing. It also is not clear in a quick look at this data how and what is being compared (Helen calculated on “the basis of dry matter”, Dr. Pierson used “typical nutrient analysis” – one or the other may require doing some calculations using the numbers provided (these values are NOT the GA nor are the values the same. I highly recommend you follow the links and read the pages in depth yourself, so that you understand it all, not just the numbers.)

          (Helen, the creator of this web site, states: “These data are calculated on the basis of dry matter analysis (DMA).”

          Hi-Tor Veterinary Select Neo
          Phos: 0.72
          Prot: 36.54
          Sod: 0.43
          Fat: 43.18
          Carbs: na
          Cals: na
          Obtained: 24-July-14

          She does list a number of other foods and is not promoting any of them, just providing the information.

          Dr. Pierson of lists “Typical nutrient analysis data provided by the respective companies” and updated March of last year. The page can be found at:

          Prot: 26
          Fat: 69
          Carbs: 4
          Phos/100 kcals: 198
          Cal: 205

          It is more than you have from the can, but again you may need to digest or calculate some more based on these values.

          I did purchase the Hi-Tor Neo a while back, but only randomly have fed this. I chose this one because the ingredients seemed better than the prescription foods (I balk at almost ANY Rx food!) It is also less expensive and can be purchased without an Rx from the vet.
          The comparison I did at the time indicated that the protein content was higher than the Rx foods, but based on everything I have read about older cats, muscle wasting, best diet for all cats and CKD, my girl will NEED more protein. Her kidney numbers are not that bad yet, and so I don’t really push the kidney food. I prefer that she eats what she likes so she can gain back the weight lost to hyperthyroidism. If her phosphorus level ever does rise (it is still normal) then I would opt for a good protein sourced food and request the binders that can be used. But that’s me…

          • Thank you so much for the information. I tend to just give her what she will eat because it is better than not eating at all but I try to keep it kidney friendly. She is starting to eat a little bit so that is good but her last numbers were super high so I am giving her sub fluids twice a day. She usually rallies after a crash but it is taking longer this time 🙁

  14. My polo is 16 years old.
    After a visit to the vets we have found out she has a tumar on her kidney. She drinks a lot and her wee smells quite strong. Apart from that she seems fine and eating well. She is on a sensitive dry food.
    The vet has recommended her to go on a special kidney diet food which she has turned her nose up at. I have tried putting it with a sensitive wet food and she through it straight back up.
    My question is would am I be better off just keeping her on the sensitive food of keep trying with others. There is no cure for her And I don’t want her to get stressed out trying loads of food

    • Sorry to hear that abbout Polo. IMO, definitely switch to a diet that puts the minimun amount of pressure on her kidneys. Now, there are tons of different wet and dry kideny food brands out there, try them one by one and see which one she’d eat. Have your priority with that since kidney problems can be very aggressive in cats so the sooner you reduce her kidney’s work, the better. Maybe if she’s one of those more stubborn ones, either mix some of her normal food with her kidney food temporarily and then cut the normal one or if she didn’t eat the new food at all give her a small portion of her normal food and then again try the new one to make sure she won’t get stressed or annoyed or crossed with you.

      • Protein restriction, as explained in this article, is not indicated until the final stages of kidney disease. Furthermore, cats with kidney disease (or all cats, for that matter) should never eat dry food. Please refer to the importance of water discussed in this article.

    • Carrie – first of all, mostly what Ingrid said. Please review the original article again. I can always learn more from a second or more reading of something myself!

      Personally if I could convince all cat care-givers to ditch dry food, or at least make it a VERY small part of their diet, I would be delighted! Dry food is not good for cats (some will say their cat lived to be 20 and had no issues, but why play darts with kitty’s health?) You can find a lot of information at (probably won’t be able to take it all in at one sitting!) – and you don’t need to worry about making your own food (Dr. Pierson has a recipe, but making cat food isn’t for everyone and not all cats here will eat it.) The important lessons from her website is to understand the many adverse health issues that dry food can lead to. Dry food is convenient for the care-giver, but not so good for the kitties. I was able to cure ideopathic hypercalcemia by eliminating dry chow. Vet wanted me to give him a really nasty drug!!

      Another good source on this topic is Dr. Mark Peterson, endocrinologist (his article on ideopathic hypercalcemia got me started!) If you search for his name followed by CKD you will find his dietary recommendations. He has a wealth of information on multiple topics not just CKD, and is especially known for his thyroid treatments.

      That said, in your case the situation is a little different in that you mentioned a tumor, not CKD. There are a number of factors that might be different:

      * First question I would ask the vet is why does s/he say there is no cure? Can the tumor be removed? Treated medically? If not, why not? An internist might be able to prescribe some surgery or chemotherapy. I suspect that is out of your vet’s expertise. I went that route when the vet I had at that time was out of his league! What about taking the whole kidney out (assuming there is a second healthy kidney)? Or has this spread already. Many questions to ask your vet.

      * As Ingrid and Dr. Peterson indicate, the special kidney diets should be reserved for when kitty is in the later stages of kidney disease. One reason kitty Polo might turn her nose up is taste – it is protein restricted, so they have to monkey with these foods and despite that, in the end they are not very palatable. I will NOT feed this stuff to my cat unless we get to that ‘no other option’ (she is 19 with the beginnings of kidney disease, but the numbers really have not changed much in the last 2+ years. Dry food was eliminated about 4 years ago – I was not able to “wean” all my cats off the dry stuff, just finally cold-turkeyed them! It was a little easier for me because I fed a mix of canned and dry.) In your case, you would need to introduce (if she does not already eat canned food) wet food and find several good foods that she especially likes and work from there. Less and less dry available as she eats (hopefully) more canned food. Even if a cat reaches that later stage of CKD, if they refuse to eat the kidney diets, ANYTHING they eat is MUCH BETTER than nothing!

      * Another issue, touched on by Dr. Peterson, is that older cats (and your baby is up there!) tend to start muscle wasting, so for “geriatric” cats, it is best to feed a HI-QUALITY protein, not restrict it (until as noted the later stages). My poor girl lost too much weight while being “treated” for hyperthyroidism – had I known that thyroid issue was behind the scary heart and kidney issues the vet was spouting, I would have gone for the radioIodine treatment much sooner (she dropped from 12.5 lbs to 7.5 lbs, and a year after the “cure” she has only gained .6 lbs back.)

      * You mention your baby drinking a lot – any cat on strictly dry food WILL drink more than other cats. IF she were drinking excessively, there should be signs of her urine not being concentrated – the more water, the more dilute. IF that were the case, I would not expect her “wee” to smell as strong. One of the problems with normal cat urine is the strong odor (because it IS concentrated and is why most litter boxes STINK after a while and when there is soiling outside the box, it can be a bear to get rid of the smell!) Has your vet done the older age kitty blood and urine tests? Did s/he give those results to you?

      If you can get Ms Polo to eat a good, high quality canned food (non kidney diet!), it could help, and certainly should not hurt. Just remember to be sure she is eating enough before eliminating the dry food – cats cannot go very long without any food.

      I would also recommend you ask a LOT of questions, some listed above, at your vet’s. If s/he cannot answer them, it is time for another opinion – if you do seek another opinion, I would recommend a larger animal hospital who has specialists and find the one who can better diagnose and possibly treat, or even better, cure, Ms. Polo.

  15. Hi, my cat of 14 years is diagnosed with CKD last week and as her vet doesn’t talk much I think she had an acute crash last week when she started vomitting and not eating at all for three days until she couldn’t walk without wobbling. She’s still hospitalized after about a week receiving IV fluids. Her Creatinine and Urea were INSANELY HIGH (everything else was fine and healthy) and after a week of IV fluids there was no significant sign of improvement (her Creatinine slightly decreased about like 0.10 and her Urea went even 30 higher, she still wasn’t eating at all). I’m devastated from the first second I heard what was wrong with her and I almost need an IV fluid therapy myself now (I simply cannot eat out of grief, shock and unacceptance). We’re continuing the IV fluid therapy at least for another week non-stop. So I was wondering if anyone else experienced some persistant numbers for these two waste products but after a while (more than a few days) they suddenly saw an actual improvement? And her Dr. checks her heart regularly (once every two days) to make sure no heart problems are resulting from too much fluids but has anyone continued IV fluids for more than 10 days and was it safe? I’m just desperately trying to convince myself that she will come home after her first and hell of an aggressive ‘episode’ but the numbers and pace of things are killing me here … I can’t even give her Sub-Q fluids at home where I am, not that that’d be wise due to her two sky-high numbers …

    • My cats was diagnosed this week and I am in a similar situation (cannot eat myself too out of grief). I have found (Tanya’s comprehensible guide to CKD). This site is a gold mine. Have a look. It is worth it.
      Wishing you the best possible outcome for your kitty and yourself.

      • My cat Jazz had 2 visits to the vet last years to clear crystals from her bladder cost a little over $3000.
        Jazz now has a diet of raw chicken and kangaroo no dry food.
        He is now really healthy.

    • My cat crashed mid-Oct. Creatinine and BUN were unmeasurable (>12 and >150). It took a over a week at the vet, on IV fluids, before they dropped into a measurable range. It was touch-and-go for a while, but after a few weeks, her numbers came down significantly, though they are still too high (4.7 and 49).

      We’ve settled into a routine of twice-daily sub-q fluids (~60ml each), 1/4 Pepcid @night, 1/4 Cerenia (anti-nausea) every other day, and Epogen every 2 or 3 weeks to bump-up her red blood cell count. She loves her heating pad, and I think that’s good for blood flow to the kidneys.

      Early on, she didn’t like the “H”-brand renal canned food, so we tried their dry renal-formula and her numbers started getting WORSE again. I mixed canned pumpkin with “FF”-brand pate and numbers got better again, surprisingly. Switched to Royal C renal canned food, which she (mostly) likes, and the numbers got much better.

      I try to supplement with other food, as well, just so she gets variety of flavors and nutrients. I add a phosphorus blocker to non-renal formula foods.

      Her numbers are still those of a very sick cat, but she looks good and is acting happy again, like she feels well. She jumps for (kidney-friendly) treats again.

      It has been, at points, very stressful, because the nature of the illness is that animals can go from acting normal to looking and behaving like they’re in distress or even near death in a matter of hours. It was a roller coaster, but for now, we’ve found a good rhythm.

      I hope your cat was able to make it through the crash. I wanted to put this message out there for others who may have just received this scary diagnosis. I was an emotional mess until I found some encouraging stories online (mostly about sub-q fluids).

      There is hope, even when it sometimes seems like a hopeless situation. She is my little baby and I’m committed to doing whatever I can to keep her happy and as healthy as is possible. I don’t know how much time we have left (but really, we never do in life), so I try to live each day with joy and gratitude so that she will know she is much loved and there will be no regrets.


    This premix is formulated to prepare a diet reduced in phosphorus. With the addition of recommended vegetables and butter it can be used to prepare a diet reduced in phosphorus and protein, as it is often recommended for cats suffering from problems associated with kidney disease. This SPECIAL FORMULA is useful in helping to remedy constipation in some adult cats.

    Grass-fed New Zealand Whey Protein Isolate (GMO free, rBGH free, BSE free); Calcium Carbonate, Taurine; Canadian freeze-dried Krill; Xanthan Gum (natural thickener);Vitamin B Complex with Methylcobalamin (B12), Vitamin E succinate; Vitamin A palmitate (Retinol); Vitamin D3.
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    “useful as a dietary tool for certain conditions where a diet reduced in Phosphorus is helpful”.

    • in your comment, this is stated: “reduced in phosphorus and protein”. This is the problem, and is consistent with the Rx diets – restricted protein! I also have issue with the “addition of recommended vegetables” – cats do not have the capability to properly digest vegetables. Unlike Peter Rabbit, they will not be found in your garden munching veggies (or fruits)!

      Dry food was eliminated in the household some years ago – one of the worst things one can feed cats (urinary issues, hypercalcemia and a host of other maladies can result). Over baked, dry, water depleted – read Dr. Pierson’s postings on this ( Personally I cured one cat of hypercalcemia (we tested all known causes, nothing there) by eliminating dry food (Dr. Mark Peterson has a blog on this issue, which is what I used to push back on the vet who wanted to use Fosamax – another “treatment” that I flatly refused as the doctors wanted ME to take this and after reading up on it, refused it and will NEVER take it!)

      My oldest girl developed hyperthyroidism, but because the vet was harping on the kidney results (only the SDMA was out of whack, which is a pre-kidney test of sorts) and heart murmur, etc, we did not consider the radio-iodine thyroid treatment. I was not informed about all this, but did my research over time after the Dx. We opted for the transdermal thyroid medication, which is not cheap since you must keep testing and adjusting, AND it does not cure the problem. What I did not know is the thyroid issue can impact ALL organs. The best example to use is that it would be like starting your car, but leave it in park and put your foot to the floor on the gas. Not only would you run out of gas sooner, you can damage various engine parts!

      Her heart issue “resolved” after the elimination of dry food! The murmur did come back, but again the thyroid can cause all this. My wish is that we did the thyroid treatment sooner, before she lost so much weight (dropped to about 7.5 from 12.5.) I finally choose to get the treatment (she was almost 18 at that time). It has resolved the thyroid issue, but getting weight back on a cat this old is not easy!
      The vet will still try to talk about “kidney diets” but no way – I’ve read the ingredients and know it is too much garbage cats do not need, and not enough protein.

      I have opted for a combination of raw and canned and feed her as often as I can (changing/offering multiple foods, etc), however she only eats a little each time and if I am not watching the other cats will eat hers. It has taken months (treated in Feb) but finally her spine is no longer prominent.

      Her phosphorus level is still in the normal range, so until that changes I am avoiding the binders. Save that for when we need it! For what it is worth, the SDMA is supposedly showing that her kidneys are about 60% I believe. She drinks a lot and her urine is not “well-concentrated” but otherwise she is doing well for now. She’ll be 19 in the spring and has been with me since she was a kitten. Hopefully we can have a few more good years before this rears its ugly head!

      • What is the name of the combination of raw and canned foods you feed your cat?
        My kitty will be 19 in April. She’s pretty much blind. She has lost some muscle tone in her hind legs and needs to gain some weight.

        • Sorry Clay – I tried to respond right away via the phone, but it kept popping up some kind of ad or signup thing, taking away the keypad!

          If she is otherwise healthy, it might just be “normal” muscle wasting that happens in older seniors. A change in diet *might* help, but no guarantees! I would hope that you make sure she is checked by a vet before experimenting with foods! My vet is still old school and tries to push those Rx foods, but I have read the ingredients and wouldn’t feed that stuff unless there was nothing else available anywhere! At least she does not push me too hard… 🙂 I think she knows by now how I feel about those foods…

          The raw food is Nature’s Variety frozen raw medallions – they have chicken and rabbit (there is a little fruit/veggie but not much). I prefer the medallions to the bites as they are easier to thaw in the microwave. I have to thaw many at a time, so you’ll have to play with the time it takes to warm it but not cook it. I use power level 4 to thaw it slower and usually flip the “burgers” at least once to even the thawing some. With only one cat, you could also take enough out for the day and keep it in the fridge, so they only need a quick zap. If you work you can also leave one out in another bowl for later so it will thaw at room temp – I would wait to see if Miss Kitty will eat it, start with one medallion and/or canned here and there between other regular meals. She might not like it right away and/or quick food changes can upset tummies… We don’t want that! Or if she is like my cats, oooh, something new, yum yum, but the next day, what? THAT? I had that yesterday, I’m not eating THAT again… sigh…

          For most of the other cats I also have to add “sprinkles”, which is Nature’s Variety Raw Boost Mixers – crumbled on top of the raw. If that doesn’t work, sometimes a little Forti Flora (not the whole packet) – there’s something in that which many cats think is great! Katie gets hers plain. The ones who get sprinkles often will not start eating until the “sprinkles” are added!! Catz are funny!!

          Any really good quality canned food would be good. I have been using Nature’s Variety Pride (chicken, rabbit and tuna). I’m trying to switch to the regular Nature’s Variety to get away from the “gravy” foods (quite a few here have even now after years of eating it turned nose up to the Pride chicken!)

          I know all the Nature’s Variety is available at Petco, including the raw. Petsmart might have this as well, but I cannot say for sure – I get mine through an independent source. They should have the cans as well. For ingredients and %ages, you can check online – Nature’s Variety lists them (don’t care for what you have to go through to get to the detail!), but any online retailer who sells any canned food should list that as well. Dr. Pierson of spent months/years compiling lists of the finer details, calling all the manufacturers, so you could also check her list. I also have made Dr. Pierson’s home-made recipe – it is not for the faint hearted, but I wish ALL my cats would eat it – then I KNOW what is in their food, but alas only a few will eat it and not consistently. sigh again

          I have started using Chewy for the canned and litter, but online ordering for you would have to wait until you see what she likes. No sense ordering in bulk if she won’t eat it! Shop around once you find what she likes and is better quality too (less fruit/veggie, if any at all, meat-by-products *can* be okay, but NOT as a first ingredient – I’d prefer none myself, certainly no grains, potatoes etc)

          For my old gal, many many meals, sometimes multiple bowls of different flavors or kinds (I even bought the NV kitten) is put out for her – she eats little here, little there and because of the others I have to be sure she always has something throughout the day for when she IS hungry (despite having food in their bowls, often the same food, they will sneak over and eat hers!)

          If your Miss has kidney issues, be sure there is a LOT of water around. Katie drinks a LOT (and pees a lot too!) Problem with kidney is as it progresses it can cause nausea which will put them off eating. This may be why Katie eats such little bits, sometimes coming back minutes later for a little more, a little more a little MORE.

          Don’t go overboard buying the foods I’ve used. She may not take to them.
          My guys were all on this stuff before the thyroid issue was identified – before we found the thyroid issue, she had heart ultrasound before and after I ditched the kibble and what was reported after the first test was GONE in the second test! Try a few cans, either the ones I’ve mentioned or other good brands – find what she likes! She is old enough to be pampered too!

          I hope you can find a good mix of foods to help Miss gain weight and if anything I have suggested works, great! If not, try other foods, you’ll find something she likes that just might be good for her too!

      • Regarding my comment about the dry foods – not only was the hypercalcemia cured, but two sisters adopted from a shelter at age 4 NEVER had normal BMs, either in the shelter or here UNTIL I took away the kibble! Unfortunately it is not easy to do this and I finally just had to cold turkey everyone, but it was for the best!! Normal BMs are a GOOD thing!

        Super soft fur was a side benefit. No one has been sick since, and it seemed to help my old thyroid girl’s heart issue (of course the radio-iodine was still needed to cure the thyroid issue). Most recently I have been declining the distemper shots – these are a *MUST* for kittens and for cats with unknown history, but what was recommended as not less than three years has morphed into GET it at three years. They should not need that many (if any) boosters once those first few are given (no I am NOT an anti-vaxxer, my kids had all the available vaccines – today it is almost scary how many they inject though!) As Dr. Pierson ( recommends, your money at the vet would be better spent getting their teeth cleaned!

        • Thank you for sharing your experience with eliminating dry food, Marjorie – it truly is the one best thing you can do for your cat’s health. You’re also wise to turn down the distemper vaccine, Marjorie. There is some compelling evidence coming from a study conducted at The Center for Companion Animal Studies at Colorado State University that shows that the common FVRCP (feline viral rhinotracheitis, calicivirus and paneleukopenia) vaccine may cause long-term damage to cats’ kidneys that increases with every booster.

          • Ingrid – thanks for the vote of confidence! I did follow the link regarding vaccines, and found the posts are old, but added my thoughts to that thread as well – the Wikipedia page on feline vaccines is interesting food for thought, including the various WSAVA (World Small Animal Veterinary Association) recommendations, which seem to support our concerns.

            The one thing that still sticks out in my mind is that the recommendation of no SOONER than three year boosters has been taken as a hard line AT three years!! Consider that drug makers probably “push” this, just like the Rx pet food makers “push” their garbage foods (for those who are not aware of this, the FDA has NO role in determining if pet foods are prescription, the MANUFACTURERS decide this!!!)

            Do you have a thread that discusses the dry/kibble issue? I’d be more than happy to share my experiences with this!

          • If you enter “dry food” in the search bar in the sidebar, you’ll find plenty of articles about why cats should never eat dry food, Marjorie.

      • While posting on another thread, I recalled posting here that I use raw and canned, and then remembered while searching for the NVI raw online (no place yet) that if you just use “raw” in your search you get a list of DRY foods that are now promoting “raw”!!

        Caveat for all – I noted this on the other thread regarding “dry food”, but if I can enlighten more people posting is multiple times, it is worth it:

        BEWARE ALL: the marketing demons are now promoting RAW kibble. Do not fall for this trick. Kibble is kibble and none of it is good for your cats.

        First the manufacturers all got on board with kicking the grain out of cat food (yay) when they realized people were getting smart about that. Now its all about raw, so they are producing “raw” dry food, whatever that is!!!


      • I am well aware of cats inability to digest vegetables. I am also aware that reduced protein is controversial and PERSONALLY would not do so. However, I was simply posting info on this TC Feline product and should have said so using quotes. I myself have had two kidney disease cats. I agree with Dr. Lisa Pierson and in fact, spoke with her for four hours over the phone during a consult. It was actually from her wonderful website,, where I first learned about the TC Feline product line.

        • Chris – I meant no disrespect to you, just passing on what I have learned for others. There are people who do not understand that those “fruits and veggies” they put in cat food is a marketing ploy.

          I had not been on this site for a while but the kidney diet discussion brought me back. The current thinking is, at least for the earlier stages, good high quality protein and reduced phosphorus. No one makes such a food, and since the phosphorus is likely linked to the protein source, we probably will never have one.

          My girl, as noted in my other posts, has only “failed” the SDMA test and ingests/expels copious amounts of water. Since treating the thyroid with radio-iodine, the goal was to find this elusive product as she lost so much weight being “treated” with meds. Last check her phosphorus was fine, so I’m focusing on the good high-quality protein for now! I’m kind of annoyed at the vet because we could have treated the thyroid much sooner – she had me weighing the cost of the thyroid treatment vs kidney and heart issues, when in reality they were all because of the thyroid. Meanwhile, the kidneys are paying the price 🙁 It has taken many months, but she is finally putting some of the lost weight back on (lost 5#) At least I no longer feel all the vertebrae of her spine!

          Thanks for clarifying. I have not actually talked with Dr. Pierson, but have read most of her site and often go back again. I did email her about the vet attempting to treat another cat with Fosamax, which I absolutely refused (I knew about it because the docs wanted ME to take it – NEVER will that happen!) Dr Pierson does not like the pilling of cats and was horrified when I told her the vet had others buttering the lips to get the cats to swallow this nasty stuff! I found catinfo via Dr Mark Peterson when looking for an alternative treatment for hypercalcemia (losing the dry food did the trick! Better for the cat ALL around) Thanks again!

  17. We adopted a Siamese, Calico,Lynx mix at Best Friends two years ago at Best Friends (of course she is wonderful, total Siamese personality). We decided a few months later to adopt another one to keep her company even though she seemed fine. This cat was being kept in a home by Best Friends. Turned out she was pretty much feral(the notes on her said she must be kept in a home with other cats), but she & Annabelle hit it off immediately & are crazy about each other. Noticed Annie was peeing too much months later, took her to vet, who thought she looked very healthy, but found she has kidney desease.Put her on KD & bought some homeopathic kidney drops from Pet Wellbeing. In the beginning there was no problem with their eating, but gradually they have started eating the other’s food, & now they will barely touch their own food (Lucy’s is a different brand).Doesn’t matter if they eat in different rooms. They still gravitate to the others’. I am going to start Annie on Nutro Max Cat Chunks Duck Chunks in a couple of days (gradually). My question is would it be okay to feed Lucy the same thing? She is a handful so we can’t really take her to vet for another checkup yet as we would be shredded. We’re lucky to be able to pet her while she is eating, but slowly she is getting friendlier. Annie is very friendly. Sorry for such a long “note” but really worried about this food situation. They are both 4yrs old now, & we love them to pieces.Thank you so much. Love your webpage.

    • Unless you’re feeding Annie a protein restricted diet (which, as you learned from this article, is not indicated for cats with kidney disease until the very final stages), then both cats can eat the same food. Be sure to check phosphorus levels for the Nutro to make sure it’s low enough for Annie.

  18. I am foster to a senior cat diagnosed upon intake a year ago with CKD, and recently found this massive website. “Comprehensive Guide” is an understatement. I can’t imagine a more helpful, knowledgeable site for anyone struggling to find answers and guidelines to help their kitty maintain a positive quality of life for as long as possible.

    • Hi, I was told by my cat’s vet today that he is in 3/4 kidney function state. In 2010 I lost my baby Grace to this disease and other related complications. this time I want to be more informed and do better by my boy Sebastian. My email is [email protected] would you email me if you give your cat any kind of herbal or holistic supplement that can support his condition. I’m devastated, my worst nightmare has started again. Thank you so much

        FELINE CHRONIC KIDNEY DISEASE! And join the accompanying support group!!!

        • I’ll do that, it’s very over whelming to process all the info when your in state of grief…. thank you

          • I fully understand. I was in the same situation this past summer. I’d start by joining the support group and introducing yourself and your kitty. People there can tell you where to start–what to prioritize–so you’re less overwhelmed and can start helping your loved one live well for as long as possible. I think there’s also a page on that website that’s called “Where to Start” or something like that.

  19. Could you please clarify your phosphorous recommendation of 0.7-1.26 g/1,000 calories. Do you mean kcals or gram calories? The catinfo site you reference gives all phosphorous levels in foods in mg/100 kcals–which means having to convert your recommendation, in several ways, and that is quite confusing. Thank you.

    • Small (gram) calories or large calories (symbol: Cal)? Really, how can anyone follow this advice if it is not clear what measurements are being given?

      • Hi Ann,

        I noticed the same math error when I first read this article (see my comment from April 15, 2017 at 12:15 am below, for which the response was equally frustrating, although I understand it was written with good intentions of helping), and you are right. The math in this article is off by a factor of 1000.

        So, if you are looking for foods on Dr. Pierson’s chart that correspond to the values recommended in the above article, you would be looking for a number between 70 and 126 mg/100kcal phosphorus, which would correspond to the INTENDED recommended value in the article here on this page.

        Best of luck with your cat!

        • Thank you so much, Meredith! I so appreciate your help! But wow–so few of the foods on that extensive chart fall into this category. Oy.

          • Hi again Ann,

            In re-reading Dr. Colleran’s response to the comment I originally posted on April 15th, I do see that she used the units grams / 1000 kcal (and kcal is the same as Cal with a capital “C”, as you mentioned). And those units are correct, BUT they are indeed off by that factor of 1000 from what’s in the article above, which says grams / 1000 calories (with no “k” in front and no capital “C”). So, my apologies to Dr. Colleran for not reading her clarification comment correctly and thus feeling frustrated. However, with that clarification from Dr. Colleran in the books, the units in the article indeed should be updated to grams / 1000 kcal, and then everything is copacetic.

            You’re still looking for values in the 70-126 range on the CatInfo dot org website’s food chart if you want to follow the recommendations in this article. And no, there aren’t many foods in that range, and the only ones that ARE in that range are the vet Rx diets theoretically formulated to treat renal insufficiency (as Dr. Colleran also notes in her comment response, the AAFCO minimum of phosphorus for maintenance diets is 1.25 g/1000kcal, which would be 125 mg/100kcal, so that’s why only Rx diets are lower than that).

            However, I personally was not comfortable with the protein levels and ingredients in the Rx kidney diet foods, so I chose to feed my kidney patient two foods that are slightly outside the 70-126 mg/100kcal phosphorus range, but still fairly low for available foods, but have protein content and ingredients I personally felt were better for my cat. I chose to feed a combination of Weruva Cats in the Kitchen Chicken Frick a Zee and Wellness Healthy Indulgence Morsels with Chicken & Chicken Liver. However, I haven’t yet had repeat kidney bloodwork done for my cat so I don’t really have any comment on whether these food choices might be good or not, and it probably varies from cat to cat anyway. Please note I am NOT a vet, I’m just a fellow cat lover relating my own thoughts and experiences.

            Also, it is notable that the values in the CatInfo dot org food chart might not necessarily be 100% accurate, as the values change if the food formula changes. I discovered this when I called Wellness to ask about the Healthy Indulgence variety and was given a phosphorus number in the 150 range, whereas on Dr. Pierson’s chart it says something in the 120 range. Turned out Wellness had updated its formula for the food. (I had planned to email Dr. Pierson about this change but haven’t yet gotten around to it.)

            Anyway, sorry again for another long post. Just thought this info might be helpful, as we are all only trying to do the best we can at advocating for our feline family members in this tricky area of kidney decline. Good luck:)

          • Thank you for this, Meredith – I’ve updated the article. I forgot that Dr. Colleran previously clarified this issue in a comment. My apologies for not updating the article at that time, and for any confusion.

            Your approach seems well thought out to me. I would be interested to hear what your cat’s repeat bloodwork looks like if you’re comfortable sharing it here.

  20. I have a 3 1/2 year female cat that I adopted about a year and half ago. She was diagnosed with kidney disease in December and the vet had me start feeding her only Royal Canin Renal D canned food, which I’ve been doing since then.

    Well, I took her in again for a follow up blood test in July, only 7 months later and I was told that her kidney numbers were even worse than before. Which makes me think maybe this particular type of renal diet is not good for her.

    Now the vet wants me to bring her in for an ultrasound that costs $450. I can’t afford to do that at this time and I’m really concerned since she’s only 3 years old.

    Do you know anything about this particular brand of renal canned food? I’m definitely open to other suggestions or even homemade recipes. Thank you!

    • 3 years is very young and unusual for a cat to have kidney disease. I would definitely pursue additional diagnostics as soon as you can afford it.

      As for your question about diet, most so-called prescription diets for kidney disease are low in protein, and I assume that that’s the case with this Royal Canin formula as well.

      • Hi! I actually have a 4 year old pure bred Persian that was diagnosed with stage 2, almost stage 3 kidney disease a few months ago. Over the past year we’ve spent thousands of dollars on ultrasounds and lab tests due to his dark stools and it was not only until we brought him in for lab work needed before a teeth cleaning that my vet acknowledged his kidney disease. I have been trying to come up with the best diet that kind of encompasses the best of what everyone has told me – so far we do prescription kidney diet canned food in the morning and raw primal nuggets in the afternoon. Seems to be helping when he went in for a check up his levels hadn’t changed and he is still his spunky self. Now I find myself looking for other ways I can make sure he’s on an appropriate diet for his disease state!!!

        • Hi Megan sorry to hear about your cat. I too have a pure bred Persian who has just been diagnosed with Kidney disease and he is 4 years old. I live in Austria so a number of brands especially raw food ones will not be available to me here. But if you have any experience you are willing to share grateful if you could email me

        • Polycystic Kidney Disease (PKD) is a hereditary disease known in Persians, causing cysts on the kidneys. Have you investigated this?

          • Here’s more information on PKD:

      • my cat is not yet 2 years old and a rescue there is no way I will give him back but I do need help,
        he diagnosed with Kidney Damage. I want the best for him vet has said use Hills Prescription Diet wet food and dry.
        1…he Hates the dried kidney care food
        2…the wet food he loves especially the Beef I add extra water to help his kidneys and his well being.
        the packaging says
        protein 6.3% , fat 4.6%, Crude Fibre 0.53%,
        Crude Ash 1.1%, Moisture 79%, essential fatty acid 1.10%Calcium 0.15%, phosphorus 0.09%, sodium 0.05%,
        potassium 0.19%, magnesium 0.01% per Kilogram. I ask youhow good is that Protein to help with muscle growth. barely any protein per Kilogram in wet food.

        Can any one please tell me where I can get a cat food that is not 79% water oh! sorry moisture..

        I live in Scotland ( do not confuse with wee England ).

        • That formula is way too low in protein! Unfortunately, I’m not familiar with what’s available on the European market, perhaps one of our UK readers can help? A cat’s normal prey in the wild is 70 to 75% water, most canned food is around 78% water.

        • Ernie, one good way of increasing protein for kidney cats is adding egg white. Has to be cooked if using fresh. Or use pasteurised powdered egg white, available in the baking section or health food shops.
          More info here: (a bit further down the page)

        • Ernie – as the other comment says, the moisture content is good. AND be happy that kitty doesn’t like the kibble/dry food. That stuff is one of the worst things in the world for cats!!! Personally I think ALL the Rx diets are crap – read the ingredients (science experiment ingredients) and the “quality” of the proteins used are questionable! One more note about Rx foods – the companies that MAKE these are the ones who determine it is Rx NOT the FDA. Because they do this, you can only get it from vet or with a vet Rx AND it is more expensive!
          I am actually trying to find a food that is high/good quality protein with lower phosphorus, but see it is noted in the article that apparently there is no such food. Having treated my hyperthyroid 19yo with meds because vet kept me worried about heart, kidneys and was undecided that she would need the radioIodine, but when her weight dropped to 7.5 from ~12 I decided to go for it (turns out the heart issue was thyroid related – what did I know then?) So far (as of last check in July) it is mainly the pre-kidney test (SDMA?) that is showing signs of kidney disease – that and she still drinks up a storm and her urine is not well-concentrated. I would like to see her put on more weight – still too skinny!!

      • Dr. Elizabeth Colleran, Im a fellow MAPP Alum(!) and a former vet tech. I have an 18 yr. old cat, Mya, who was diagnosed with kidney disease 2 years ago. I put her on a renal diet immediately, having lost 1 of my senior dogs to kidney disease only a few months before. I feed her wet and dry food simply because she’s never really been a fan of wet food…Ive had her since she was 9 weeks to the day. I live in a 3 story house, not including the basement, which she used to roam around all day. That stopped when I lost my other 2 cats 2 years ago…the same summer I lost 1 of my dogs (oral cancer, gastrointestinal cancer, and kidney disease…May-September…it was horrible). One of the cats was actually her son and despite being adults, they always stayed, VERY MUCH, mother and son. Anyway, she mostly stays in my room now (pet central)…everyone eats and drinks in here. I have 3 automatic water bowls just in my room. She has a heart murmur so sub q fluids aren’t an option. I would prefer she eat more wet food because she is literally skin and bones. Shes always been small, no more than 6 lbs; now shes 4 lbs and you can feel every bone in her body. She still jumps and goes to the bathroom to use the litterbox though, and fights like hell when I give her her daily pill to prevent a brain aneurysm and her pepcid, but I’m trying to find a way to put weight on her. I adopted a young cat a year ago and she was always trying to eat her food…she was even trying to eat the dog food. Everyone now has a bowl that only opens for the chip around their collar, but what is safe to give my 18 year old cat who’s been in kidney failure for 2 years now so she stops wasting away? She still eats her food and has a great appetite but I feel like she needs more.

  21. Hi, can you tell me the name of cat food that is high in protein and low in phosphorus? The article mentioned it %50 with a phosphorus binder. I just need the name of the food and binder.
    I have an 18yr old tabby, cant see very well. She’s getting skinny, but her appetite is good. I need to ‘fatten” her up and get some of her muscle tone back.

    • Yes please!! I have a 15 year old cat who is on ProVet kidney diet from Purina. I have serious doubts about the food, but my cat refuses wet food!! Any help would be wonderful!

    • She likes the ‘protein’ drink from Clinicare RF. It’s about $8-$10 a can. It has a bunch of vitamins etc, if she doesn’t like the wet food. She just needs to regain muscle tone. Also since she is pretty much blind, she doesn’t move around much. – Thanks

      • Clay – I responded to your question on another thread about the foods I was using. It sounds like your Miss Kitty has CKD? Is she getting any treatment at all via the vet? If she is CKD and losing sight, it could be high blood pressure, which can be treated.

        For you or anyone else interested, check out

        There is a LOT of CKD information, sometimes almost too much, but the loss of sight is discussed on that page. Also, the phosphorus binders are discussed on her site – LOTS of information!!! There is a ‘contact me’ at the bottom of the left side menu, if you have specific questions that she might be able to answer. None of us (that I know of) is qualified to treat your baby, but armed with more info you can seek out help at the vet office (Helen does not dismiss the Rx diets, but as many others have said, save it for the later stages, but most important, find what kitty will eat, as many will not eat the Rx foods – it ismore important for kitty to eat than what she eats!)

  22. Thanks for this info in this article. My 17 year old mainecoon was just diagnosed with kidney failure and has lost several pounds. Our vet of course prescribed kd food but my cat won’t have anything to do with it besides licking the gravy. I have more than exhausted my budget on multiple types of prescription food this month and have been searching the Internet for alternatives. I read info on raw food and decided to give that a try. I was going to try darwins prescription diet but because the smallest amount they will sell me is 70/80$ I just couldn’t spend that at the moment without a guarantee that my cat will eat it. So I went to my local pet food store and they gave me samples of Rad Cat to try and he seems to really be responding to chicken and turkey (I mix in epakitin). I’m thinking of going and buying some from them and maybe when i can afford it try the darwins. My question is will this be too rough on his kidneys? I’m kinda just happy he will eat something to be honest but I want to make sure I’m not giving him anything that will progressively cause damage. There is quite a bit of conflicting info about raw diets. Thanks.

    • You’re going to want to check with Radcat to find out what the phosphorus content is in their formulas. Also, I’m pretty sure Darwin’s will guarantee their food if your cat won’t eat it – check with them before ordering.

      • I spoke with Darwin’s and they didn’t tell my anything about a guarantee. They just said the smallest I could order is 10 pounds @73$$ and if my cat didn’t like it I could cancel their auto ship. I just sent a message to radcat. But what I’m gathering from their website (I am a totally beginner at this so I could be wrong) the phosphorus levels are .80 in both the chicken and turkey. What is the max that he is supposed to get per day? thanks for you help.

        • As this article states, look for phosphorus levels of 0.3-0.6% on a “Dry Matter Basis” (DMB) or 0.7-1.26 grams per 1,000 calories. You’ll need to get clarification from Radcat on whether the 0.8 they quoted you is DMB or per 1K calories. I hope this helps.

          • IMPORTANT!! Look at the postings above from Ann and Meredith on September 12 and 13. According to these two posts the numbers included in the article are incorrect and off by a factor of 1000. Please review and evaluate these posts carefully to ensure you have the correct information.

          • I’ve asked Dr. Colleran for clarification and will post her answer as soon as I hear from her. My apologies for any confusion.

      • Hi, I need advice. My cat is 12 and really healthy but blood tests came in and vet said same level kidney as 2 years ago and some liver enzymes slightly elevated but she’s not worried yet said he’s 12 so it’s a bit normal for kidneys to be a bit more tired. Advised me to feed his prescription vet senior food ( I only feed can since my other cat developed diabetes I went on a mission about cat nutrition and was shocked. My cat ended up dying. ) my current cat has had recurring issues with struvites but not since I switched to can only for the past 3 years. I’ve been feeding him GO by petcurrean and absolutely love that company. He’s been having chicken turkey duck and duck only can food. The nutritionist at petcurean recommended Weruva, a competitor which I was pleasantly shocked by and said it’s low in phosphorus but I do need some phosphorus due to his urine crystals issues in the past. He’s not in kidney failure but I’m all about prevention. Can’t afford raw unfortunately and don’t have enough confidence in making it myself. I’m against feeding fish as I know that can cause thyroid issues, I read somewhere that beef should also be avoided at best. I don’t want carrageenan and am strict on BPA free cans which is what I like about GO but I need low phosphorus and sadly they don’t offer. I’m wondering should I go with Weruva, I called them and they said most flavours are low and stick to non fish. Is there any brands you could recommend for my cat, I also have another senior 15 in perfect health that I want to start him on low phosphorus. My brain hurts from the research and I don’t understand charts and numbers and am terrible at figuring that out even if I did check on Weruva mentioned most cans are between 0.10 to 0.18% phosphorus level but that means nothing to me and the chart is not by percentage so would love recommendations. Thank you for your info, it helps save lives.

        • You can find my recommendations here, Sindy, but you’ll have to contact each brand you consider for phosphorus levels:

          • Thank you. I’m just not sure what is an acceptable amount as in what is the limit in % or other form of measurement.

      • I ordered Darwin’s originally. They do not offer refunds. They would rather loose customers than refund money. They also don’t guarantee the quality of their product. See what others have said on Yelp. Com. This was my experience. I appreciate that my local pet store will at least do exchanges. As far as rad cat, according to the charts it has almost no phosphorus and very low sodium.

        • That’s odd I complained about the beet content in the last order and they gave me half my money back at least

    • Darwin’s has a deal that the first 10 pounds are only $14.95, you can pick the proteins you want as well its just a trial but hope it helps. Its great food my dog loved it before he passed. Raw food is the best thing you can do for him in my opinion I have seen it work miracles in my own home. My freezer is actually full of Darwins right now.

  23. I’m pursuing making my own homemade cat food. One of my cats is 19 and just recently was diagnosed with very early signs of compromised kidney function. Recipes I’ve come across include adding a vitamin/mineral supplement pill. Is there a vitamin supplement that is low sodium/low phosphorous that you recommend, please? I’m having a hard time finding one…. 🙂

    • I would work with a holistic vet with experience in nutrition to formulate a homemade diet for your cat, Carol. Alternately, if you’re feeding raw, Darwin’s offers a complete raw diet for cats with kidney disease.

    • My cat Billie jean is around 12 years old, he is in early renal kidney failure. I’m having a hard time getting him to eat anything on his own. My mom and I have tried almost all veterinary brands and most grocery store brands and the most he does is maybe take a few licks at best. I love her and I’m trying my best to help him get better. I have taken him to the vet and he said it “may” be early R.K.F but he would need a ultra sound and biopsy to further find out what exactly the problem is. As a young adult I don’t I the resources to further her medical treatment to that degree, however I did get medication. So now my question is I want to start him on a raw food diet. I’m thinking of making a smother type drink consisting of liver and eggs and maybe another type with coconut milk & avacodo… are these things good for cats in her condition?? And if not please tell me specific thing I could blend up and then give to him. Please!! I really need help thank you


      • What you’re proposing is not a complete and balanced raw diet, Chanel. Darwin’s makes a raw diet for cats with kidney issues, that may be a good choice for you:

        You may also want to try some of the tips in this article to entice your kitty to eat:

      • I honesty can’t afford to get the Darwin’s cat food doo I’m looking for natural items that I can feed my cat ..

        • You can find information on making your own food here: but you’ll still need to get guidance from a holistic vet and/or nutritionist on how to properly formulate a homemade diet for a cat with kidney disease.

      • This post is to Chanel. I just got 4 recipes from my vet for my 2 cats who are both in early renal failure. I would be happy to send them to you by email if you contact me at [email protected] It will cost a bit to get started as you need to supply taurine (an amino acid that cats need), bone meal, salt substitute, vitamin K, and a multivitamin with minerals. I bought all items at a health food store. The other ingredients are a lean meat, white rice, and canola oil. There are probably other oils you can use, you should ask your vet. In fact your vet should be able to supply you with some recipes as mine did.

        • Dear Gael, I’m in a similar situation and would really appreciate more options for feeding my renal cat, Holly! Would you mind if I emailed you for the recipes too?


        • I would also love to get these recipes. I ‘m in tears every day because my cat doesn’t like the renal support cat food the vet recommended and I can’t seem to find anything else that I can afford. I’d spend the extra time and money to get started if it meant my baby would eat the food. Thank you so much.

  24. Hello,

    My Holden is coming up on ten years, and while he is a larger cat, he’s always been fairly healthy. We took him to the vet for a check up recently and most of his blood work came back really good, except it showed his protein levels were a little high. Since he is entering in to his more senior years, and I want to keep him around as long as possible, I don’t want to overload his little(ish) body with too much protein and cause kidney issues. Can you recommend a good quality food that has good proteins, but levels that aren’t too high? Or what I should be looking for. He could stand to lose a few pounds, so something that could help with that would be great, too (though the protein levels are the biggest concern.) Thank you for your help!

    • Senior cats may actually need more protein, not less, Kathryn. Here’s more information:

  25. WE just found out 8 days ago that our beloved cat ,”Zeke” ,a Male orange tabby about 9-10 years old ,has chronic kidney failure. After spending about $1000 at the vet, we are now home injecting him with sodium Chloride every day. He had gone about 4 days without eating ,so we have been feeding him Gerber Baby food with a small syringe a few times a day. He growls during feeding ,but at least we are getting some food in him. The only flaors they have left are chicken and gravy ,turkey and gravy ,and beef with gravy. All the other Baby foods now seem to be mostly fruit based. We raised 3 children ,and I am not sure what happened with baby foods, but I have also tried to give hum Tuna in water ,and in oil ,but he wont eat. I am not being naive ,as I realise this is probably the end. But I wont give up.

    • Try some of these tricks to entice Zeke to eat, Mike:

  26. Thank-you for your wonderful article, we so appreciate it! Our little cat Dustie came to us as a stray and we think she is around 17years old, was losing weight, so we suspected Hyperthyroidism, and we took her to our local vet here on the OR Coast…they were not going to even do a blood draw until my husband Jeff insisted they check…and the results showed yes she needed a medication…she started vomiting more often so when we took her back to the vet we had her blood checked again and the dosage she was given was too high and she was around 6 1/4 pounds…went up to around 7 pounds…then they decreased her medication to half the original amount. After a total of 18 mo. she became slow and was not eating well and we had to hand feed her with syringes then took her again to the vet and it was found she had a bladder infection and kidney disease so then they switched her thyroid food to kidney food…now her weight is down to around 5 pounds and I think it is because of the prescribed kidney food she has been on for the last 6 months…I also noticed a pinkish-orange tinge to a large drop of urine she dripped on the floor so we had some oral antibiotics for cats and I am a Nurse Practitioner, so I gave this according to her weight daily for 10 days, and she perked up and was more her usual self…now though, I am quite concerned as I can feel all her bones in her back and also her hind legs, the lower part near her paws there is no muscle tissue between those bones and it was shocking to feel that…she is part Persian so has long fur but if she did not have long fur I am sure we would had noticed sooner. Dustie is a sweet girl…a love-sponge…she lives for love and pets…we would do anything we can for her and even though she is in a weakened state she follows us to bed and sleeps between us purring while we pet her before we all nod off to sleep…I placed a small carry-on suitcase to make it easier for her to come up to the bed and we think she has become noticably weaker since on this kidney canned prescribed food…she likes to lick the olive oil off my husband’s plate of cheese and crackers and she loves little tiny pieces of cooked ham. What kinds of food do you recommend out tiny Dustie-girl with her combination of hyperthyroidism, kidney disease, and recurrent bladder infection knowing she is, at best, now 5#, and perhaps a bit less? Any advice would be so greatly appreciated by us! Mattie & Jeff

    • Since you’re dealing with multiple issues, I would recommend consulting with a holistic veterinarian, Mattie. Dr. Lisa Pierson at offers remote consultations.

  27. Hello all,

    Have a question what is a good iodine free food to feed my 15 year old cat (child)?
    She has been diagnosed as hyperthyroidism an started the mexamoltional medicine not sure od correct spelling. Want yo get her off tge medicine an feed her a raw healthy diet. Which companies make raw food diets without iodine products (kelp, calcium update)? Would rad raw diet be a good or Darwin’s? Also is their a pre mix for hyperthyroidism to as s to raw diets?

    Thank You for helping me an this great blog of information you have put up. Just AWESOME ! Sincerely, Mercedes the cat an Tonya aka mommy

    • Since iodine and calcium levels are not disclosed on pet food labels, you’d have to contact each manufacturer to get the information, Tonya.

    • If you take away the meds, you will either have to have the surgery or radioIodine treatment (the latter being the best course, surgery can bring up other issues).
      We used the meds as a compound to rub in the ear – this helps avoid some of the tummy upset, HOWEVER it is NOT a cure and eventually this condition can ravage kitty’s organs (think of your car in neutral with your gas pedal pushed to the floor!)
      A raw diet (or ANY diet) will NOT take care of the thyroid condition. If you can afford it (if you do not have one, consider a CareCredit card, which will spread the payments out over 6 months) I highly recommend the radioIodine treatment. Read Dr. Mark Peterson’s blogs about hyperthyroidism – he’s a well-known endocrinologist.

      I only wish my vet had not scared me off this treatment with worries about a heart condition, kidneys starting to fail, etc, when the hyperthyroid was likely the culprit behind it all along!! I, in hindsight, wish we had done this much sooner, as trying to get weight back on a 19 yo is hard enough, but she lost 4.5 or 5 lbs while ON medication.
      Please do check out your options for treating Miss Kitty – the radioIodine is the only real “cure” and is well worth the cost!!!

  28. This information is so useful. My Snickers, who is 13, has been diagnose with kidney and pancreatitis. The vet wants to put him on the Hills diet. I wasn’t really pleased to see it had grain in it. They told me to put him on a low protein and low phosphate diet. Trying to find a low P&P diet that is grain free hasn’t been easy. I’m pleased to see that I only need to look for a low phosphate now.

    • Never mind the grains (icky enough they are), but the unpronounceable ingredients!!! There’s so much in these Rx foods, that the print is tiny and you cannot even read them sometimes!! I personally consider them all crap – expensive crap.

      I would like a high protein (good quality at least) with low phosphorus, but have not found one and in reading this article it does not appear that anyone makes one.

      I did find an alternative to the Rx foods: Hi-Tor NEO – it is NOT prescription and the Protein is 8%, Phosphorus .10% (both minimums). So the protein is a bit more than the Rx foods, as is the phosphorus, and I’m not pleased with a lot of the ingredients, but it is something you could try. Most online websites that offer foods also have a link for the ingredients, so you could compare them.

      At this time I only feed this to her on occasion – especially when she seems “off” her food (something NEW today? mmmm! Tomorrow? Wait, I just had that, I do not want that now… sound familiar??? =^..^=).

  29. HI All,

    My cat Ramses was taken to the vet for a cough, which I suspected was asthma. I had to put my other cat to sleep two years ago because she also had asthma and we were never able to get her stable.
    Ramses is 15yrs old. He weighed 13lbs two years ago. At his check up last year he was 11.5. At this visit he was 10.8. He has been drinking a lot of water and going often. I do have another cat, so I could not be sure which one was doing it. After labs and xrays, it was determined that he does have asthma. His blood levels showed higher levels for his liver and urine tests confirmed that he is at 1.8. I was told that he is in stage 2 of Kidney disease. The vet gave me a vitamin(huge horse pills that he is supposed to have two of daily), omega 3 oil that I have to pour over his food every other day. He also prescribed k/d dry and wet food. They have always eaten both (fancy feast small can in the am and pm w/ a handful of dry purina). The other cat, Ra, is overweight(17) so I decreased their dry food from free feed to the handful in an attempt to wean them off completely. After reading all of this information, I am so confused. I don’t know what to feed him. Before reading this, I switched both rather quickly to the k/d and they liked it the first day. Day two they wouldn’t touch it. They are back on the regular food. Because I was trying to make Ra lose weight, that’s why I actually thought Ramses was losing instead of him.
    I need help on making a decision about what to feed the kitties. I also saw Azodyl tablets that I was considering. I am afraid to try a Raw diet and home cooked seem quite confusing. I work a lot and barely feed myself. sorry to ramble. My vet seems to be adamant about the K/d protocol. I don’t know the phosphorous level, but I will ask tomorrow.

    • Unfortunately, most vets still recommend k/d even for early stage kidney disease. As you can see from this article, that may be a poor choice.

      • Hi Ingrid,
        Yes from what I can read I see that they aren’t.
        I saw your list of suggestions. Would those be appropriate for a CKD kitty as well?

  30. Very informative article, thank you. I have an 8 month old kitten who, via ultra sound, has “markedly abnormal in appearance” kidneys. I don’t know that abnormal kidneys are treated the same as kidney disease. His first blood test on 3/22/17 revealed BUN: 77 (high) Creatinine: 2.2 BUN/Creatinine ratio (high): 35 Phosphorus 8.0. His 4/25/17 test revealed BUN: 59 (high) Creatinine 2.7 (high) BUN/Creatinine ration 22 Phosphorus 10.9 (high). I just started him on a phosphorus binder about two weeks ago. The vet gave him sub/q fluid (I’m not sure his numbers warrant sub/q on a regular basis but she wanted to show me how to give them.) She also wanted to start him on Royal Canin dry kidney food. Brown rice, animal liver, hydrolized soy protein were in the first three or four ingredients. I cannot fathom that giving a kidney compromised cat a dry food with chemically altered soy protein can possible be a good thing for him. Ripley shows zero signs of anything, eats like a pig, is growing, does drink a bit more water than expected for a cat that only eats canned food, except that he’s developed some kind of reaction to something, as he’s licking/itching/biting to the point of fur loss. He’s always been a licky/itching cat but I’m wondering if it’s something in his current food (Merrick Purrrfect Bistro canned food). He had a needle biopsy (he was given propofal) a month ago and the symptoms developed about two to three days after the procedure. A rather short round of prednisone helped but symptoms returned when done. Anyway, I’m also of the inclination that restricted protein may not be the best way to go. Of course, what do I know. Any input from anyone would be appreciated.

    • From your description, it sure sounds like he’s dealing with an allergic reaction. Here’s more information on feline allergies in general and on food allergies

      • Thanks for the links, I appreciate it. The vet really thinks he’s reacting to flea bites. How he’d get bit is beyond me. We have two dogs who have flea controlled applied, and another indoor only cat besides Ripley (the ckd cat). She said a flea could latch onto a pant leg or come in on one of the dogs. I asked wouldn’t that create a flea problem and cause the cats to have fleas (neither are treated with any flea treatment atm). She said no, just a stray flea or two could just bite but not set up house. I don’t know, that sounds really out of bounds to me. I did switch his food to a pork only (canned, freeze dried raw, raw) two days ago because I don’t know if it’s the food causing the problem. Vet says likely not but I had an older cat who was always itchy when he was on dry food. Ripley isn’t just itchy, his skin is red, blistery, oozy in spots, little red dots that look like they’ve ‘burst’ in other places – def reacting to something. He gobbled up the new food. Took him back to the vet yesterday and told her that 1 tab/2x day of prednisone really helped calm the skin reaction down so she gave me an two week rx. Got that into him yesterday and he is finally getting relief. But this morning he is refusing to eat. He is just sleeping. Absolutely out of character for him. So – is it the new food, too much protein? Is he just exhausted from not sleeping a lot due to itching for so long? Is he sick? Okay, he just went to the litter box – some diarrhea and he just threw up water. He’s drinking now but isn’t ready to eat yet. Maybe I’m doing too much and should just concentrate on a good quality canned food rather than any type of raw. Very challenging. Thanks again for the links.

  31. 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!

    • 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.

    • I have had two cats that have had kidney disease.  As a result, I made it a priority to learn all I could about the nutritional needs of  CKD cats. I learned a great deal and I feel that the best food they can be fed, is homemade.
      You can make it from scratch, (using individual vitamins) or choose a premix for CKD cats.
      The one I use is excellent. In part, here is what they say about their product:

      “Useful as a dietary tool for certain conditions where a diet reduced in Phosphorus is helpful”.

      And…here’s where you can learn more, from the lady who created the product line:
      And here’s where you can buy it in the U.S.:

      • I like that TC Feline discloses phosphorus content on their website – so few manufacturers do that. I’d run this by your vet to be sure that phosphorus levels are within the limits advised for your cat’s stage of CKD. For those who want to feed raw, but don’t want to make their own food, Darwin’s offers a complete raw diet formulated for CKD cats:

  32. 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?

    • 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 (

    • 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???

      • 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!

        • It is true that anesthesia can be tailored to be as safe as possible for cats with kidney disease, and vets should oose a protocol based on each cat’s individual situation. You may also want to take a look at this article, Tara:

      • 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.

      • And what do we do if they simply DO NOT eat wet food? My baby who’s suffering at the moment has always been an extremely stubborn one and NOTHING I did over the years has helped! She even let’s chicken dry in the air and then eats it! What am I, who is also tormented by her problem, supposed to do? And yes, I did read the related page here …

        • This!!! I have a cat that simply refuses to eat wet food. She will not even eat canned stuff that has dried. She is 15. I’m trying to find a dry within the limits (sulfer content) but I am not understanding the label. Hobbes is 15 and is the most picky cat I have. I want off the prescription diet as I have 7 other cats who seem to think it is a wonderful thing. 😛 Right now Wellness Core Indoor is the only one I have found with a semi-low phosphorus level… I believe it is 2 grams per 1000 calories. I have no idea if it is the right thing, but I need to try something. She, of course hates it. I’m trying to mix and hopefully wean her to it, though.

          • Yeap, that’s why I always wished that I could move all her possible sicknesses and pains to myself; I’m a human, I can voice what’s bothering me and I do know what might be happening with me and especially in this case I’d COOPERATE in treating my condition or sickness both when at the vet and in terms of limitations and considerations for a new lifestyle … but nope, no one cared about what I was wishing for and now my baby’s very sick and there’s almost nothing I can do other than taking her to the vet and listening to them complain that she’s “very hard to handle and administer necessary meds to” which I have to confess is true … as soon as she’s back I need to make sure she eats and eats a kidney friendly diet and I still have no clue how … I really don’t want to give her her old dry food since the numbers in her blood test are insane … 🙁

  33. 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!

    • 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, 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!

  34. 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?

    • 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.


      • 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.

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

  35. 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.

    • 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

  36. 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!!!

    • 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.

    • 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.

  37. 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!

    • 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!

  38. 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.” 🙂

  39. 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!

    • You can find my recommendations here, Jen: You’ll need to check the ones you decide to try for phosphorus content – it should be on the low end for your older kitty.

    • 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

  40. 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

    • 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.

    • 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.

    • 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.

  41. Hello,

    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)

    • 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.

      • 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

    • 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.

      • 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!

        • 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!

          • 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!

        • 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.

          • 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.

          • 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.

      • 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..

    • 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.

      • 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.

        • 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.

          • 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.

          • 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.

          • 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.

  42. 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?

  43. 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.

    • Tammy,
      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

      • 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.

  44. 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

  45. 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.

    • 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.

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

  47. 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?

    • 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!

      • 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.

        • I know it’s frustrating, Joyce. That’s why I provide articles like this one. You can find my general recommendations here: I would also be happy to schedule a consultation to help you sort through it all.

      • 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.”

  48. 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.

  49. 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.

  50. 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.

    • 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.

  51. 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.

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