Disclaimer: the information provided below is not intended to replace or override the advice of your veterinarian. Both the author and the site owner assume that this information will be used to work with your vet in planning the best treatment plan for your cat

• WHAT IS CHRONIC RENAL FAILURE (CRF)?
• IS THERE AN EARLY WARNING SYSTEM FOR CRF?
• WHAT ARE THE SIGNS OF CRF?
• WHY WON'T MY CRF CAT EAT?
• WHAT SHOULD I FEED MY CRF CAT?
• WHAT CAN I DO TO TREAT CRF IN MY CAT?
• Herbs
• Supplements
• Homeopathy

WHAT IS CHRONIC RENAL FAILURE (CRF)?

CRF is an umbrella term classifying kidneys problems which eventually result in lost kidney function.  Kidney disease can take the form of nephritis, Bright's Disease, or a host of other renal problems.  Sometimes gravel/stones, and repeated attacks of cystitis/FLUTD, can set a cat up for CRF.

The term "chronic" is used in CRF because once kidney function is lost (for whatever reason), this will be an ongoing long-term problem for the kitty.  Cats, unlike humans, can live for years on decreased kidney function (40% is the number frequently mentioned by vets).  When kidney function is down to 25% or less, kitty is said to be suffering from CRF.

IS THERE AN EARLY WARNING SYSTEM FOR CRF?

A urinalysis (U/A) will show among other things, excess protein in the urine, the specific gravity of the urine, and glomerular filtration rate (GFR).  A U/A is an earlier indicator of kidney problems than blood work, which only shows raised levels of Blood Urea Nitrogen (BUN) and Creatinine -- both of which are waste products excreted in the urine -- after at least 70-75% of the kidney function is lost.  The best thing is to regularly have your kitty's urine tested. This is even more important after age 7 or 8, although it is not uncommon for cats as young as 2 years of age, to have failing kidneys.

Rule of thumb - if your cat's BUN is higher than 33 or so, and Creatinine is higher than 1.8 - 2.0 Mg/Dl (Note: Canadian measurements are different so cannot be directly compared to these numbers), less than 25% of kidney function is left.

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WHAT ARE THE SIGNS OF CRF?

Dull coat, listlessness, lack of appetite, increased thirst, and frequent urination.  Sometimes the signs are very subtle and thus easy to miss.  Also many of the symptoms of CRF match those of diabetes and hyperthyroidism.  But with Hyperthyroidism, kitty has a ravenous appetite, yet loses weight. A CRF kitty usually will not have a huge appetite.

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WHY WON'T MY CRF CAT EAT?

Because the kidney is not excreting toxins like it should, they are building up in the kitty's body (hence the high BUN level).  As the BUN level rises, you can imagine how uncomfortable this has to be for a CRF kitty.  They feel nauseous which robs them of their appetite.  You can try enticing them with their favorite treats on top of the food, but until you get at the cause of the problem, they will not have a good appetite.

Sometimes, a cat with CRF will stop eating altogether. Do not let this go on for more than 24 hours as cats can develop hepatic lipidosis (fatty liver disease).  Try to force-feed your kitty some Hills A/D (available at most vets' offices) or strained baby food (without onion powder which can cause Heinz body Anemia in cats) via syringe. See force-feeding info if you need more information on this. Often this is all it takes to jump start kitty's appetite because eating will make your cat feel better, and s/he will associate food with this so will eat on his/her own.  Depending on how well your kitty tolerates this, you can do this one or two times a day.  Syringes of water can also be given by mouth because cats in kidney failure can suffer from dehydration and often do not ingest enough water to counteract this problem. (For more on liver problems in cats, check out the Liver FAQ)

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WHAT SHOULD I FEED MY CRF CAT?

In the past, it was believed that a low protein diet was essential in controlling CRF.  The idea behind this is to cut down on the kidneys' load.  However, studies done on dogs in renal failure, show that a low protein diet did not help the GFR or BUN of said dogs.  Since cats have an even higher protein requirement than dogs, it seems unlikely that they could thrive on low protein diets.

As an obligate carnivore, they need the nutrients only available from meat.  So one has to walk a fine line between making sure all the kitty's nutritional needs are met, and keeping the stress on the kidneys as low as possible.  Some people feed their cats with CRF the same food that their other healthy cats eat.  Either way, the bottom line is that the protein must come from an animal source, and must be of the highest quality i.e. no beaks, feathers, claws, etc.  The food should be digestible i.e. utilized by the cat's body so the kidneys do not have to process colors and preservatives such as BHA, BHT, etc.

Read the ingredients of commercial foods, and decide for yourself if this is what you think any cat (with CRF or not), should eat.  A good source of such information is the report put out by the Animal Protection Institute: http://www.api4animals.org/Petfood.htm

The best thing you can do for your CRF cat is to feed him/her a home-made diet from organic meat.  For recipes, check the Raw Food FAQ.  These recipes can be modified to be low protein by cutting back on the meat percentage.  Some people also believe it is good to restrict Phosphorous in the diet.

Here are examples of diets used by Sandy (regular or slightly higher protein %)  and Leah (slightly lower protein %) for their respective CRF cats.

Regular or slightly higher protein %

Except for the additional fat in Boo Boo's diet, all of Sandy's mountain cats eat this food. Booey would get this via syringe every day.  It really helped prevent the muscle wasting that is so commonly seen in CRF cats.

• 80-85%  organic meat (inclusive of organs and bones) - chicken, quail, turkey, pheasant, cornish game hen, duck,  goose, rabbit etc.
• 15-20%  organic veggies - carrots, zucchini, alfalfa sprouts, celery, broccoli, asparagus, or peas
• No grains

Slightly lower protein %

Leah’s basic proportions for her CRF kitty, Giddy.  Alter the levels of the various components when necessary :

• 60% protein (this will vary somewhat depending on the type of meat sources used for the protein; some suggestions would be raw chicken or turkey, raw beef with beef heart)
• 30% veggies (raw zucchini or carrots, cooked broccoli, asparagus or peas)
• 10% cooked grains (barley flakes, millet, amaranth or oats are some to consider)

• 3 cups of ground turkey
• 1 ½ cups of carrots or zucchini
• ½ cup of barley flakes
• 2 teaspoons of organic, non-fat plain yogurt
• sometimes a leaf or two of looseleaf lettuce thrown into the mix

http://www.dataweb.net/~sham/nutrient/index.html

http://www.ag.uiuc.edu/~food-lab/nat/mainnat.html

To insure that my kitty gets his daily requirement of taurine, I give him a prescription vitamin mineral supplement that contains 50 mg of taurine per tablet every day.  A supplement of a combination of oils should be added at each meal– possibly ¼ teaspoon of cod liver oil in the a.m. feeding and ¼ teaspoon of flax seed oil in the p.m. feeding.  I use the yogurt as both a flavor enhancer and to keep the friendly bacteria in his digestive system.  To enable him to better digest/metabolize his food,  he also gets a digestive enzyme supplement.

Giddy, who is 19 years old, is doing pretty well on this recipe.  His energy level is good (at least for his age/condition) and his coat is not dull or greasy.  Please e-mail me if you have any questions, comments or concerns.
 

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WHAT  CAN I DO TO TREAT CRF IN MY CAT?

CRF is not a death sentence!  Cat in renal failure can live for many years with a good quality of life.  Holistic non-invasive treatments have much to offer in this regard.  Listed below are some herbs and supplements than can be of help.  To read about how to prepare tea from loose dried herbs, go to http://www.acupuncture.com  Herbs can also be used in tincture form.  Add boiled water in a 2:1 ratio of water to tincture, and let it sit for a few minutes to dissipate the alcohol.   Then give 1/2 to 1 dropperful of the mixture to your cat.

For a list of retailers whose products we use on the list (Holisticat TM), click here: Products We Use  Please note that the list owner and the other authors of this FAQ do not have any commercial interest in any of the companies listed.

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HERBS:

• Dandelion Leaf: This is high in Potassium and will help flush kitty's kidneys without leading to loss of elements such as potassium.  If you do nothing else, please read up on the benefits of this wonderful food herb we get from Mother Nature, and consider giving it to your CRF cat.  Parley can be used but it is not as high in potassium, so not advisable on a long-term basis.  Dandelion, on the other hand, can be used daily.  However, as with all herbs, it is best to give a few days on, and a few days off, to let the body rest.
• Cornsilk: This herb is very soothing to the urinary tract so can be given on a regular basis if needed.  It is also a good herb for incontinence, which some CRF cats suffer from.
• Peppermint: It soothes the stomach and helps prevent nausea; it is a cooling herb. This is a better herb to use than Ginger because ginger can burn the ulcers in a CRF cat's mouth.

• Do not use Uva Ursi, also known as Bearberry on a cat with CRF because it has a strong astringent effect, and in any case, is only indicated for short-term use, like with a bout of cystitis.   Also do not give a CRF cat the herb Juniper Berries because it can irritate the kidneys.
• Cats with CRF are prone to high blood pressure so stay away from Licorice and Horsetail as well.

SUPPLEMENTS:

• Potassium: Cats with CRF suffer potassium (K) loss so it is very important to monitor the potassium level via a CBC, and if needed, supplement with either potassium gluconate or potassium citrate.  It is possible for a cat to have normal potassium readings on a CBC and still have low potassium levels in the tissues.  But very high K levels can stop a heart, so again work with your vet to make sure you are giving enough to help your cat's muscles while not jeopardizing the biggest muscle of all - the heart.
• Vitamins: Be aggressive with supplementation of water-soluble vitamins - C, and B-Complex. Be more cautious with fat-soluble vitamins such as A, D, E, and K which are stored in the liver.
• Fish Oils: Cats, being carnivores, benefit a great deal from fish body oils such as salmon.  These can be obtained from any health food store in capsule form.  The advantage of using fish oils, is that they DHA and EPA, which are not contained in flax seed oil.  But flax seed oil is much higher than fish oils in Omega 3.  Some list members use either flax seed oil (which should always be kept refrigerated) or grind flax seeds fresh each day (flax seed oil, and ground flax seed can get rancid quite easily) and add to all their cats' food daily.  Currently, there is no reliable data as to whether cats can utilize the Omega 3s in flax seed oil, but it is unlikely to hurt a cat so some of us use it.

Cats can also benefit from cod liver oil, which is high in Vitamins A and D. The dosage has to be adjusted if kitty is also getting either of these two vitamins separately as part of his/her regimen.
• Kidney Glandulars or PMG products:   These products can help a great deal to assist the body in detoxifying and in some cases help with renewal of the kidney.  PMGs (protomorphogens) are slightly different from glandulars in that they are extracted from the organ/gland cell nucleus; the glandulars are taken from the whole gland itself.  These PMG type products essentially help normalize gland function by removing interference from immune system assault. Ideally, they should be administered on an empty stomach or at least 20-30 minutes before/after a meal; it allows them to work more efficiently.  In some cases, these have helped keep some of the CBC kidney values of concern within a reasonable range in CRF cats.
• In addition, here are recipes for Dr. Goldstein's radiation cocktail and fresh juices

HOMEOPATHIC REMEDIES:

There are many homeopathic remedies to consider for this problem.  Ideally, one should go by the totality of the cat's symptoms. To learn more about homeopathy and how to use it for your cats, read the Homeopathy FAQ.

Some commonly used remedies for this problem are:

• Apis Mellifica
• Arsenicum Album
• Bellis Perennis
• Cantharis
• Lycopodium
• Mercurius Corrosiv
• Natrum Muriaticum
• Nux Vomica
• Terebene

To read detailed lists of symptoms/rubrics for each remedy, try Boericke's online version at: http://www.homeoint.org/books/boericmm/default.htm

To read about Booey's valiant battle with CRF and Hypertrophic Cardiomyopathy (HCM),  read Booey's Story
 
 

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