Comments on Feeding the Kidney Patient: The Low Protein Diet Myth

I had a brother and sister team of kitties from the age of eight weeks. They never grew more than seven pounds tops. The male, Snow, we lost at 16 as he developed nystagmus and other neuro issues, and then wasting. He received IV fluids at two visits because of dehydration as he was entering renal disease. I believe multiple surgeries with anesthesia for tooth issues caused by root resorption contributed to his failure. He ate canned, dry and human foods such as ham, lox, shrimp, raw chopped meat (his favorite), butter, cheese, steak, etc. I did not know then what I know now about raw feeding - but it was obvious by his love for raw meat.
I stopped vaccinating about five years earlier as I saw no need for indoor cats to be continually vaccinated, and again, did not know what I know now about vaccines, titers, etc. I did forego rabies as well, not realizing they were immunized anyway from the earliest shot.
His sister, Bear, was diagnosed at that time with "old kidneys" which were described as very small, and the beginning stage of renal disease as well. She, too, enjoyed human food, dairy being her favorite but she also enjoyed raw chopped meat. I was told about going to a low protein diet and given the k/d diet which she detested. I did some research, found out the basics about quality of protein and phosphorous. My vet did say, when I asked, that it was true that it mattered about the quality of the protein than just protein itself being the bad guy. I was appalled at the ingredients of the wet k/d food and was feeding her better quality food already. We stuck it out, never got to the IV fluids, gave her whatever she liked, and she hung around until two weeks past her 21st birthday. I think her liver failed her at that point as she had a yellowish hue and was shutting down. She was going from water dish to potty, no longer eating, and then asked me to let her go. It went down hill fast in five days and at five pounds.
When another cat comes into our home, I will feed them raw and give minimal vaccines, excluding most offered. I really only did rabies in case they got out and lost. Maybe a stupid question, but do you use nosodes on cats as well as dogs?

Does this apply to dogs with Protein-Losing Nephropathy (PLN)
Owning a Wheaten terrier, this is always a concern for the breed.
I know the vet who is the go to person for this in Wheatens, always recommends a prescription kibble diet. Goes against the grain for me, no pun intended, but like to be able to know if raw is still ok to feed to my dog if he developed PLN.
My dog has been on a raw diet from eight weeks and only puppy vaccines.

Also what is your opinion on vegan cat food, like Ami or Evolution?

Hello, I do have a senior kitty with kd and I am prevention-oriented for my other cats. We caught the kd early and last bloodwork much to my surprise her numbers actually improved. Despite my vet's urging to feed her low-protein Rx foods (she doesn't like them anyway) I do choose canned food from Dr. Pierson's and Tanya's charts choosing the ones that have the lowest phosphorus, carb and sodium levels. I also give her fluids every other day, SP Renal Support and Arginex supplements.
My question is -- short of feeding a raw balanced diet, is there a canned brand that you would recommend? I know this sounds silly, but I myself am a vegan and handling actual raw flesh is so viscerally uncomfortable for me. I know I'm in a delusional head-trip with the canned food but I can't at present make the leap to having real raw flesh into my home.

I am currently feeding my 3-year old cat Purina Focus for urinary tract infection (to keep him from getting it again). I chose that instead of Hill's because it looked like the ingredients were better and it is cheaper. Is there anything I can do homeopathically instead?

Hello,
Again, a raw diet is a great idea and I would like to gladly feed my pets this but the cost of the meats are quite expensive, is there any alternative to raw that could be more afordable and get get my pets health hedding in the right direction?
I now feed my dog Acana brand and feed Origen freeze dried treats also some frozen berries for treats at times, when i select a product i pay very close attention to the ingredients, what i have selected to feed them now was with careful thought and found this to be my best option, is this an acceptable diet?
It also is a little expensive but within my personal budget.
Mark, WI

This brought back some very sad memories of our precious dog Emma who suffered and died from kidney failure. That was back when we foolishly followed Dr. Whitecoat's advice on everything. She was in and out of the vet hospital, sick and suffered until we had to euthanize her as her kidneys and other organs were shutting down. She ended up with hind-end weakness (that's Dr. Whitecoat's description) and a host of other problems all related to her poor nutrition (prescription kidney diet he sold us) and the re-vaccination he insisted she had to have. I learned how to do daily sub-q fluids to help our girl. That was a good thing for her and for the cats of friends' I was able to do it on also. Throughout it all, she was the most loving, sweet and easy-going dog. So incredible!
Another superb article, Doc! You're an excellent writer and teacher; we all benefit from what you share. Thank you.

hi just stumbled upon this article. I have a 9 year old female cat just diagnosed with early stage KD and of course put on Prescriotion Hills K/D diet. I can't even pronounce half the ingredients on that label! Her BUN was 45. Her creatinine 2.2. Urine normal. Phosphorus normal. No clinical symptoms. Kidneys "small and plump" according to the X-ray. I have spent hours on the Internet researching this. I'm trying to put her on a more moderate high quality protein diet. I have two other cats, both younger...I've read too high of a protein diet can cause crystals in relatively inactive cats! What % of protein is considered "low" vs "high? is there a canned food I can feed to all three cats? My head is spinning from all this info I would appreciate any help you could give me. Thank you!

Your article is spot on accurate. We know that senior cats absorb less protein from the gut than a younger cat. We have about 7 years of data correlating muscle condition scores with high quality meat based protein diets to various IRIS staged renal cats. The cats fed a meat based protein do very well and live longer. Many mature and senior cats have inflammatory cells in their kidneys. These cells cause slow but irreversible damage to the filtration units in the kidney. Once these units are damaged they are replaced with scar tissue. We have found that rutin does help slow and even reverse the long term kidney function values. The cooking process creates foodstuffs the cat has never seen in their 20000 years of recorded human association. This feline kidney failure has gotten worse since WWII when dry food became very popular.

I just lost my 20 year-old cat to CRF in January. He was diagnosed about two years before and I was told the same thing: low-protein food and potassium supplements I had to shove down his throat every night. After nearly a year of battling weight loss he got so skinny I knew I had to do something. After a lot of internet research, I found out about the low-protein controversy and switched him to a raw diet that was as low in phosphorous as I could find. After a week or two of touch and go eating (and throwing out a LOT of expensive food), he started devouring his meals. Immediately gained muscle, his cloudy eyes cleared up, and he had WAY more energy. In his last months, he was slowly starting to deteriorate and we decided to do sub-Qs. Unfortunately, his heart had also been failing and that pushed him over the edge. With kidney AND heart failure, I decided to have him put down as we were at home visiting my family at the time and I knew there was no place he'd rather be. I wish I had switched his food earlier, as low protein levels can cause muscle wasting and I wonder if that contributed to his heart failing. I can't say enough good things about switching to raw. It was more hassle and WAY more expensive but worth every bit of the negative for the quality of life it gave my best friend at the end. I was able to do a commercial frozen raw food I bought at a really great local pet store in Austin and that made it a lot easier.

Is there anything we can do to prevent kidney disease? it's scary to think that there's 75% damage done by the time symptoms show up.

My little cancer patient Pookie had bad numbers in her blood work last year, in fact a few values were so high the machine couldn't read them! In my research, I found the B vitamin treatment you mention, and it has really done her a lot of good. I got the liquid, sublingual form, gluten wheat & dairy free, and started giving three drops in each meal, because she only weighed 5.5 lbs.
Now she only goes to the box twice a day, and she's a lot more active than she was when she was so terribly sick from the rabies vaccine. I can't say the B 12 alone caused improvement, because I've been doing other things. She's still on Essiac drops, milk thistle, vitamin C and essential vitamins and minerals, and apricot seeds which are high in B 17. I give her Silver Bullet, because of an infected tooth. Basically it's all in about ten small meals a day, an hour or two apart, each with a different thing added, because of the synergistic aspect. Tiny amounts, too. I do mix the vitamin C & B, but D3 I give alone. If she has kidney disease, she has no symptoms at this point, but we'll know more after blood work in May.
Pookie won't eat raw voluntarily, I have to sneak a percentage of raw into her cooked meals, which are pretty darn good. Quail, turkey and grass fed organic beef, gently boiled or roasted with pink Himalayan salt and organic butter. She doesn't get any carbs except for a little organic raw pumpkin to relieve constipation, some pulsed peas, etc. She eats like a pig, doc. She's stopped wasting and the last weight check was 8 lbs. Diet and natures pharmacy plus the B complex are working. BTW, I eat those apricot kernels myself. Get 'em at Amazon. I grind them a few at a time in a Krupps until they're a powder so I can measure tiny doses out, and refrigerate it. I feel B complex vitamins may be responsible for her increased energy level, as well as general kidney improvement.
There is always so much great info here! (and beautiful photos, too.) Thanks, doctor Falconer.

We have had several critters, cats and dogs, with failing kidneys. And every time, our conventional veterinarians tell us to use the "kidney, low protein, canned food". We feed our babies fresh raw food, and so I tell the vets, every time, that when the health of the animal is compromised, that is NOT the time to feed inferior food. We had a cat who was diagnosed with kidney disease when he was 13...with sub cutaneous fluids, supplement support and homeopathy, he lived to be 21. Like the previously mentioned cat, he was a boney old man, but he was happy and very noisy when he wanted something. He loved the heated beds that we have for the cats, and I think the heated beds contributed to his long life. That and good human and cat and dog friends!

I adopted a silver tiger cat with the largest eyes ever with feline leukemia. I took him to the vet to be neutered and the vet said he has feline leukemia so best to kill him as he will die within 6 months. Without any help, I took him home and gave him canned fish and cat vitamins. He didn't have an immune system so he did get sick frequently but I purchased pet insurance to help pay for any illnesses. He thrived on the fish and cat vitamins and lived way past the 6 months the vet had said. Around 8 or 9 years old he was diagnosed with failing kidneys and hyper thyroid disease. The vet prescribed a medicine for the hyper thyroid, but too much it would hurt the kidneys. When we increased the medicine he gained weight, but the kidney tests, said to lower the dosage for the hyper thyroid. I continued to feed canned fish and cat vitamins with natural pysilliam fiber powder to help prevent chronic diarrhea and beano to prevent smelly gas and to prevent very smelly poop. He was vaccinated when I adopted him, and vaccinated maybe twice in his life when he was flown across the country when we moved twice from coast to coast. So he was vaccinated about 3 times when he was under 10 years old. His teeth all rotted out around 9 years old so we had all his teeth removed, vet said it was caused by the feline leukemia, again pet insurance paid most of that. At 19 years old he almost died from the worst flu ever and so congested he could not breath and was put in an oxygen tank, he was at the Pet Emergency Hospital for about a week and several thousand dollars later, he came home and got well. The last few months we did fluids and he would only eat Jack in the Box Chipotle burger meat paddy, he would not eat anything else. So we all lived on Jack in the Box chipotle burgers for the last 3 months of his life. He was a trooper, he looked like a little shrunken old man with no teeth for years and he had a fire engine voice, must have been part siamese, as he was very loud if he didn't get attention. He made it to 19 with feline leukemia, hyper thyroid and failing kidneys. I think he lived so long because he knew he had been saved from near death at the animal shelter and had a strong will to live. He knew I saved his life from certain death. He seemed very happy up to the end. He mostly slept that last year and we had to put him in a 8 panel exercise dog pen on the hard floor when not at home to prevent him from jumping on the kitchen counters, as we were afraid he would crash to the floor and break his ribs if no one was home to lift him down. We got him a very good chair cushion for a bed to sleep on and put that beside his extra low sides litter box, so he could get out of bed and potty every 2 hours and could get back on his cushion to sleep. He didn't like the cat litter getting on his toes anymore, so we used newspaper sections and just cleaned the box several times a day and a big bowl of fresh water twice daily as he had to drink a lot all the time between sleeping and the potty.
I plan to soon adopt another 2 older senior cats, two that must stay together, and this time I plan to do more of a raw diet for health and to use a holistic vet.

11yr old female corgi diagnosed with protein in urine. UC Davis gave her a VERY low protein diet. 60 grams chicken breast, 375 grams brown rice. In a short time she wouldn't eat it. The brown rice was whole in her poop. I changed it to 3 oz. chicken breast and 1.75 oz barley. She loves it. She was also diagnosed with diabetes. She's on 8.5 insulin and losing her eyesight. Surely there's something better!