How can I get my cat to eat his prescription kidney food
May 10, 2012 9:54 PM   Subscribe

My cat has to eat a special kidney friendly diet. How can I encourage him to eat?

He has early stage kidney disease. He is meant to eat both dry food (for the calories) and wet food (since the extra moisture is good for him). Both are prescription diets that are lower in protein and other things that aren't hard on the kidneys.

I have tried heating the food, adding water, mixing the dry and wet food. The thing that helps the most is feeding him by hand but it's still a struggle to get him to finish his food, and his vet does not want him to lose any weight.

For those of you who have had a cat with kidney problems, what helped stoke their appetite? I take it that the prescription food isn't very tasty.
posted by davisnot to Pets & Animals (21 answers total) 2 users marked this as a favorite
If allowed, you can mix in just a little juice/water from canned tuna or chicken? I have a cat but have not gone through this specific issue.
posted by Occula at 10:15 PM on May 10, 2012

Have you talked to your vet about this?

I have had luck with weaning the cats onto new food (they understand that the new food is in fact food after a week or so of mixing them), and also had luck with mixing a little bit of juice from tuna, bonito flakes, etc. If you haven't yet, you should talk to your vet, because they've surely dealt with reluctant-to-eat cats before and know about your particular cat's problems.
posted by Kutsuwamushi at 10:30 PM on May 10, 2012

Definitely talk to your vet about what's acceptable to mix in, but I'd bet bonito flakes are a good option. Even my most picky cat would tear through a bag to get to them, and they're such a concentrated flavor without packing too much protein or other kidney-disease-unfriendly parts.

I say this as a person with kidney disease, but little experience with feline kidney disease.
posted by WasabiFlux at 10:33 PM on May 10, 2012

my boyfriend's cat has kidney trouble, and the vey has actually prescribed her small doses of antidepressant that work well to stimulate her appetite. Let me know if you'd like me to find out excactly what she's been prescribed. He has a devil of a time getting her to take the pills, but once she's had them she eats a lot more
posted by 5_13_23_42_69_666 at 10:41 PM on May 10, 2012 [1 favorite]

What's worked for my cat is the juice from other cans of cat food. I have two cats, and the other one doesn't have kidney disease, so I open their food together and then pour the juice of the tasty food (Tiki Cat) out onto the special kidney food. Then I mix it gently with a spoon and serve it. This has the added effect of getting more liquids into her diet, which is important for cats with kidney failure. If this doesn't work, I have bonito flakes in reserve.

Note that cats with kidney problems tend to waste away. I think feeding a small amount of whatever it takes to get them to eat as much as possible of the special diet is better than being an ultra-purist -- the diet won't help if they don't eat it. I'm on year three of doing this, and my cat was only expected to live for one, so it's been a good trade-off for us.

If you're worried, check with your vet before you supplement.
posted by vorfeed at 11:05 PM on May 10, 2012 [2 favorites]

This page for getting cats with CKD to eat may be useful.

To roughly second vorfeed, my vet at one point told me she didn't care if I fed my cat salmon if that is what would get my cat to eat...the point being getting the cat to eat is more important than strictly adhering to the low protein content of the prescription food. At various times I used my cat's favorite treats, baby food (as a topper, not as the main meal), eggs, canned chicken, chicken broth...whatever would encourage her to eat.

Good luck to you and your cat.
posted by faineant at 11:13 PM on May 10, 2012

I agree with faineant--making sure your cat eats is more important at this point than what he eats. My cats absolutely love tuna, and feeding tuna to my oldest kitty on a regular basis got her eating again quickly after an illness.

What kind of prescription food does he get? When my white cat was diagnosed with CKD, he was on Royal Canin LP, which is high in fat and low in protein, and he loved it...for a while, at least.

Be careful using human food--a lot of canned things like baby food use onion for flavoring, which is toxic to cats. Gerber has straight pureed chicken and lamb, no added ingredients.

Whatever you give him, try warming the food up in the microwave for 10-15 seconds (careful not to get too hot) to release the scent of the food, which will make it more appetizing to him.

Good luck. CKD can be hard to treat, and every cat responds differently to different things.
posted by tully_monster at 12:03 AM on May 11, 2012

I was just about to look for the very page faineant linked you about getting crf cats to eat.

What brands are you trying? Maybe that's all the problem is. My own cat wasn't too crazy about Royal Canin, but Purina he snarfed no problem. Faineant's link also has info on certain flavors of Fancy Feast that would do in a pinch (the special diet is better, but if your cat just hates it, Fancy Feast at least gets him eating, and there are particular flavors that at least have a decent degree of nutritional requirements for kidney diets).
posted by EmpressCallipygos at 5:29 AM on May 11, 2012

Lots of good info here and here. Also, try different renal diets (there are several on the market that your vet can order for you: Purina NF, Hill's k/d, Royal Canin Renal LP, etc.). You often need to keep a menu available for renal cats, and the best food in the world isn't helping your cat if he won't eat it. Dry food is really not recommended for cats any more (by feline specialist practitioners).

There are also several other things which are almost as important as diet for renal cats, Calcitriol for one, and especially management of high blood pressure - if your vet is not monitoring your cat's blood pressure, you may want to seek out another vet with a more up to date kidney management protocol, renal failure and hypertension go hand in hand.
posted by biscotti at 5:32 AM on May 11, 2012

I just had to get my kitty eating again after a bout of illness, and what's worked well is this:

-Anything with gravy. It might not be ideal, but I gave her the Fancy Feast with gravy and she finally was intrigued by eating. After she would lap up the gravy, I would add a bit of tuna water and a tiny bit of unflavored Pedialyte (she was dehydrated and the vet feared she might be headed toward kidney problems if she wouldn't drink.)

-I'd bring the food to her when I thought she might just be too tired to get to the bowl. Sometimes just leaving it under her nose was enough after a bit to get her to smell it than eat.

-Is your kitty anemic? Mine was, mildly, and the shot of B12 the vet gave her was an appetite stimulant.

Good luck!
posted by skittlekicks at 5:34 AM on May 11, 2012

Try a different brand.

My vet prescribed Hill's special kidney failure diet. Tasted too horrible to eat, according to my cat. My vet sold only that one brand, apparently getting some kind of special deal or kickback or something.

So I called around to different area vets (this was before one could order pet food online) and found one who would sell me an entirely different brand of equally suitable kidney failure diet. My cat liked this one much better.

We also mixed Amphogel (aluminum hydroxide) from the pharmacy into her wet food to bind the extra phosphorous in her system that was making her nauseated. Seemed to help.
posted by Ery at 5:34 AM on May 11, 2012

Nthng tuna water. After my kitty had a kidney infection it was the only thing that would sell her on food. I would mix a little of her special wet food in with a LOT of tuna water (be sure to get the unsalted, no-oil kind) and warm it up. She loved it.
posted by AmandaA at 6:34 AM on May 11, 2012

I have a 19 year-old cat that had moderately elevated BUN and creatinine levels, indicating kidney failure. I tried the kidney diet, which she didn't like. She also has no teeth, so she was switched to an all canned (Friskies, of all things) diet. I had her bloodwork checked 6 months later and her BUN and creatinine are down to almost normal now (I think they were 1-2 points over the limits). YMMV, but just give the cat what it wants to eat. Canned food does seem to help, though. Good luck!
posted by bolognius maximus at 6:47 AM on May 11, 2012

I had a kitty who developed lymphoma; she lost her appetite during chemo. She took a lot more interest when I sprinkled dried catnip on her food. Check with you vet before you add anything, but catnip might be worth a try.
posted by workerant at 6:49 AM on May 11, 2012

Nthing mix it with tinned tuna or tuna water, the cheaper and stinkier the better. Make sure that tinned food isn't too cold if you care keeping it in the fridge once open that can put cats off. With the dry start with a mix of mostly the cats old food and then slowly increase the new food content until it's all new food. Cats hate change with a passion so sneak the new food up on him.
posted by wwax at 7:01 AM on May 11, 2012

First of all, do speak with your vet about recommendations, since she or he is the professional directing your cat's care and should be the best authority.

That said, if your cat has just started to show CRF symptoms, then take it slowly and mix in his old favorite food with the new kind, as suggested above. Sometimes a tapering mixture of the cat's old food with the new kidney formula will work to transition them -- that is, 90% old, 10% new for a few days, 75%/25% for the next few days, etc. And I have found the battle of the wills -- holding out for them to get hungry enough to eat the new kind -- usually does not work with cats, who are among the stubbornest creatures on earth.

As other have said, there are a number of brands of kidney diet foods out there for you to try. (I've had several elderly cats with CRF over the years -- every cat I've owned has seemed to have kidney problems in its late teens -- and if I recall correctly each preferred a different brand of kidney formula food.)

Where I live (northeast of U.S.) the three most easily available brands are Science Diet KD, Purina NF, and Iams Renal Plus. My current 17 y.o. cat, who has mild CRF so far, likes Science Diet canned food and Purina NF dry food. Two other brands I have heard of but which are not carried by my vet so I have never tried, are Royal Canin and Hi-Tor.

This page (with its stylish 1990s vintage web design) has a lot of good resources that were useful years ago when our previous cats' CRF got more advanced.

Echoing others' comments that it's more important they eat than that they eat exclusively the prescription diet, particularly at this early stage. Every ounce they keep on now will be important later on when their disease progresses and they get more inappetent.

This may only be my cat, but maybe also have your cat checked for B12 deficiency -- since we've been giving her supplements (bi-weekly injections, not as hard as it sounds, into the loose skin over her back the way sub-Q fluids are given) her appetite has been very good.

Good luck! -- in some ways I've found managing the diet the most challenging part of caring for cats with kidney failure -- more so perhaps than in part because of how frustratingly easy it is to put cats off their eating routine with changes.
posted by aught at 7:10 AM on May 11, 2012

Canned food does seem to help, though.

It's definitely my understanding that dehydration can contribute to elevated kidney values. To the OP -- make sure you give your cat lots of fresh water to drink. If your cat just drinks from one bowl, change it several times a day (as CRF progresses, their saliva can get smellier, which makes the water in the bowl get a little gross as they drink from it -- though this is more a problem with advanced CRF cats).
posted by aught at 7:16 AM on May 11, 2012

If you pretend to eat the food in front of your cat he or she may decide to eat some.
posted by quanti at 9:41 AM on May 11, 2012 [1 favorite]

Agreed on talking to your vet. It's all about getting your cat to eat, as much as it is about the low protein diet. Once appetite dips, then you want to give them whatever gets them to eat. My boy hated the prescription kidney foods, so we gave up on that pretty quick. I am a hardcore catfood snob, who feeds my kitties high protein, human-grade ingredients type stuff, but I had to let go of that because I found he liked certain flavors of Fancy Feast. Somewhere on that felinecrf site that faineant linked is a guide to the protein content of different brands and flavors of non-prescription food. There were a few flavors of Fancy Feast my boy loved, so I would go and buy those for him.

Don't worry too much about the low protein, and make sure your cat eats.
posted by Joh at 9:54 AM on May 11, 2012

OP, I'm on the same journey with my oldest cat right now, and so here's what I know so far.

Biscotti recommended calcitriol in her post, and this is a strong seconding. My cats-only vet says that since they've started prescribing it, four or five years now, cats aren't dying of CKD. Please investigate with your vet, or find a vet that has experience with it. My cat is staying symptom-free on it. If your cat is a candidate, I can't recommend it strongly enough.

Here are the cat food analysis tables Joh mentioned. Two things to keep in mind; it is particularly phosphorus rather than protein you need to keep low, though some resources say relatively lower protein and higher fat are easier on the kidneys. Oh, third, thing. You need to keep your cat eating. Slow transitions to new food are helpful. Pepcid can be given if stomach acid upset is causing problems; there are also appetite stimulants you can discuss with your vet. Fancy Feast has an appealing scent to many cats that can be enhanced by gentle warming; you can look up its relative values in the table linked above.

Adequate water intake is crucial; best to feed canned food only and add water to it. A water fountain can help cats drink more (I use ceramic or stainless Precise fountains).

If your cat refuses to eat for more than 24 hours, either give him something anything he will eat or hand feed cat food, or get him to the vet ASAP.
posted by vers at 6:01 PM on May 11, 2012 [1 favorite]

A water fountain can help cats drink more (I use ceramic or stainless Precise fountains).

Yes, that's right. Even a less-expensive plastic fountain would be a huge improvement over bowls of still water. (We currently have the Drinkwell Platinum model, which I think I got at Petsmart for ~$50.)

Just clean it out every few days (or weekly) with a little bleach diluted in water (and rinse thoroughly after) and change the filters every six weeks or so. Cats love running water, and you can keep it cold and fresh by adding ice cubes occasionally. It definitely encouraged Finnegan, my late lamented CKD sufferer, to drink more, and my 17-year-old grande dame Vanessa, who is starting to show mildly elevated kidney numbers, loves it.

Be prepared, though: at some point, hopefully in the far future, no matter how much your kitty drinks, it won't be enough to keep him hydrated. You may need to look into subcutaneous fluids--the first time is hard, but once you get the hang of it it's very easy and can keep him comfortable and feeling good for a day or two at a time. That's the thing about CKD or any chronic, incurable disease--the most important thing is to keep them comfortable and happy for as long as possible.
posted by tully_monster at 2:29 PM on May 12, 2012

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