Hello, Tracie. Was wondering if you had any advice for kitties (and their owners!) with CRF. My cat Freeway’s levels continue to elevate, and he is battling constipation. He eats only K/D wet and dry, gets lactulose and sub-q fluids daily, at 150 cc’s. We recently switched him to W/D, as it is pretty close in protein and phosphorus, but tastes better and has more fiber. He is eating more, and hopefully will be pooping more as well. I have also begun to give him organic baby green pea food, and he likes it.

There is a lot of controversy around low protein diets, and processed vs. raw diets. Any insights? One site suggested chlorella as a supplement, and as he keeps trying to eat the grass outside, maybe chlorella would help him out…

Any help would be appreciated. Peace and light.

From: DeeAnn, via the Internet

Dear DeeAnn,

I’ve consulted with Lynette Ackman at Feline Outreach, Inc. (www.felineoutreach.org) to make sure you had a thorough explanation. Here’s her response:

Ditch the dry food. Think about it… feeding dry food and giving sub-q fluids? Sub-q fluids are good for the kidneys -- kidneys need moisture. So why feed a cat a moisture-deficient dry food? Feed all wet food. ALL wet food. The kidneys need that moisture desperately.

Feed a nice high quality canned food. If you choose one that’s higher in phosphorus, or if the kitty’s phosphorus levels are elevated (over 4, and definitely if over 6), use a phosphorus binder, such as Epakitin.

Studies indicate that low-protein diets elevate Creatinine levels, and exacerbate the anemia and muscle wastage commonly secondary to CRF. I have a dear kitty, Afer, who’s about eighteen years old, and was diagnosed with DRF in August, 2004. He kidney values are stable. She gets an all wet and raw diet, and a phosphorus binder. She also gets sub-q fluids, and is on Benazapril. (Dr. Hodgkins does not recommend sub-q fluids until later stages, as an all wet diet is typically enough, but I like the added comfort of the fluids, and Afer loves them.)

As to the lactulose -- constipation is commonly secondary to CRF, because the animals get dehydrated. Fiber might help, but you have to be very cautious with fiber, as it can make the problem worse. Fiber bulks up the stool. A better solution is to add some fat, which will lubricate the GI tract -- a little virgin olive oil, salmon oil, or even butter.

If you’re thinking supplements, omega fatty acids are definitely good for the kidneys. Also, if you’d like to add Coenzyme Q10 (30 mg. every other day, to start), I’d stick with it for life. It’s wonderful for the heart. So wonderful, you may not be aware of a heart problem while they’re on it, and if you stop or decrease the dose, you may find the problem existed the hard (and very sad) way.

Consider logging on to our site. We have a whole section on CRF, with some very good links.

Kidney Disease Link

I have a friend with two cats who suffer from CRF. She also uses fluids, an all wet diet, and Benazapril. She’s also using Calcitriol, which may be beneficial.

Good luck.

So, DeeAnn, there’s a pretty comprehensive answer. I wish you and Freeway the best, and I’ve posted this on the website for all to view and benefit from.

Tracie Hotchner