Feeding the Kidney Patient: The Low Protein Diet Myth

Low Protein Diets? Really?

The Skinny On Kidney Disease

Kidney disease. This one way street eventually leads to death. We see it in our cats most often, much less in dogs, and I suspect far, far less in horses. People die of this regularly. Unlike the liver, with its massive capacity for regeneration, the kidney simply doesn’t allow for renewal. Once kidney failure (or, more politely, CKD chronic kidney disease) is diagnosed in your animal, it means 75% or more of the kidneys’ capacity to filter wastes is now lost. Failure is the operant word, though. These two small organs are in failure and won’t pull out of it.

Luckily, homeopathy offers quite effective palliation.

Palliation means, in any treatment modality, that as long as treatment continues, the disease symptoms are minimized and the animal feels and acts pretty well. While we’d rather cure, in which the disease is, in Hahnemann’s words, extinguished, this organ doesn’t allow us this grace. What's damaged stays damaged, unfortunately.

Palliation, in our group experience among homeopathic vets and animal caregivers, is a close second to cure in these animals. We must find the best fitting remedy and give it repeatedly, usually once daily, and in so doing, these guys stay comfortable and happy. They slowly, ever so slowly, waste away, getting bonier spines and more haphazard appetites until they finally succumb, usually without fanfare. I’ve had renal failure cat patients live for five years or more on a remedy, fluids, and an appropriate diet.

More on that last piece in a minute. Myths abound about low protein diets being a necessity.

These animals show a steady increase in thirst and a paler and paler urine color on the way to the end. This is a function of the filtering capacity of the kidney being lost, damaged by inflammation. As the wastes are less efficiently eliminated, we see these animals:

  • Urinating more often, in larger quantity
  • Becoming increasingly thirsty
  • Vomiting more often
  • Getting dehydrated
  • Sleeping more of the time
  • Losing weight

But what causes this inflammation? For this, a story of vaccine development is necessary.

The Cats are Talking: Causation

All vaccine viruses need cells to grow on during their manufacture. Like growing those colonies of bacteria that you’ve seen on an agar plate, organisms of disease are cultured to be turned into an injection. In cats, who get this disease more than most, what cells were used as a culture medium?

Feline kidney cells!

And guess what kind of protein washes into the final product with the vaccine viruses that are harvested? You guessed it: feline kidney protein.

Inject someone else’s kidney protein into your cat, and what do you get? Right again: antibodies that are made to attack kidney cells! Here’s the study that proved that, from 2005.

Darn. Sounds a lot like we’re setting the poor cat up for kidney disease by vaccinating, doesn’t it? This is but one reason I call this your biggest decision ever.

The Low Protein Diet Myth

So, we see chronic kidney disease is yet another man made disease. Helped along by dry food, which you should stop feeding. Yesterday. Here are several reasons why.

But here’s the persistent myth:

Kidney failure patients must eat a low protein diet!

This is preached like gospel in every conventional veterinary practice on the planet. An impressive sounding line of foods called “Prescription Diets” has sprung up around manipulating foods to impact diseases, and Hill’s K/D is, you guessed, Kidney Diet. And it’s widely “prescribed” (catch the marketing angle there?) by well meaning vets if there’s even a remote chance that your animal has kidney disease.

It appears a rat study may have been the impetus for this myth to run rampant throughout veterinary medicine.

And rats are herbivores. The findings do not apply to cats, an obligate carnivore, with a completely different metabolism. Or even the dog, whose ancestors and wild cousins eat prey and do very well, thank you.

Here’s what we know, from some completely non-scientific but significant experiences in cat households.

What Happens Outside the Lab?

Cats in multiple cat households, who were diagnosed with kidney failure, often craved the healthy balanced raw diets that their cohorts were eating. A number of owners, knowing their cats had a fatal disease, thought, “Well, you’ve got a death sentence anyway, here, go ahead and enjoy some raw food along with your tribe.”

And, given the chance to eat raw, high protein, supposedly damaging to kidney diets, these cats flourished!

The kidney failure cats eating raw, high quality, high protein diets:

  1. Got shinier coats
  2. Lost their finicky appetites
  3. Had more energy
  4. Had less vomiting and nausea, a common effect of kidney disease
  5. Gained weight

When I learned this anecdotally from colleagues, did I wait for the double blind studies to come out to “prove” this? Hell no, I told it to everyone in my practice who brought me a kidney failure animal. And, apparently also not having read any studies to the contrary, every one of them has improved!

Why?

Perfusion: Get That Blood Moving

It’s widely known that relatively higher protein diets improve the blood flow through the kidney. Aka perfusion, that’s a good thing if your animal’s kidneys aren’t doing such a great job of filtering wastes. The more blood that gets into even a failing filter, the more chance there is to get the toxic waste products out.

And the opposite is true: low protein diets decrease this blood flow or perfusion. This actually showed up in the rat study linked to earlier. GFR is mentioned, and that stands for glomerular filtration rate, or the rate at which the tiny functional unit of every kidney, called the glomerulus, is doing its job of filtering.

In addition, kidney cell death increases when the circulation through the kidney is compromised, as you might imagine. Blood flow is a good thing in every organ. In with the good (oxygen, nutrients), out with the bad (waste products, toxins).

You’ll know when your animal is getting intoxicated from poor filtering of toxins. These are the cardinal signs that CKD animals show periodically throughout their illness:

  • Vomiting (You remember your young and foolish days with alcohol intoxication? Same idea.)
  • Lethargy
  • Poor appetites

Though this is beyond the intent of this post, these are indications to give your animal some subcutaneous fluids. It can be done at home with a bag of fluids and some instructions from your vet. Don’t miss the opportunity to do this. You will improve your animal’s health almost immediately by giving fluids when intoxication and/or dehydration has set it.

Crappy Protein vs. The Real Deal

A common observation in holistic vet practice is the vast improvement that comes from changing from a kibble to a raw diet. In any animal. But this is especially true for the little carnivores in your house, those cats. Add in renal disease, and it becomes even more significant.

Protein, being a necessary ingredient for everyday living, has degrees of quality. As you might suspect, highly processed sources of protein, like those in byproducts and extruded chunks of food-like particles (kibbles) are vastly different than what the wolf or bobcat eats when he eats prey.

So, here’s another truism, borne out by many years of animal observation in holistic vet circles:

The quality of protein you feed your animal in kidney failure makes a huge difference in how she acts and feels.

Here’s a label excerpt from Hill’s K/D, marketed for cats with kidney disease (I’m showing you the dry version, as I’m fairly certain it’s the bigger seller than the canned):

Chicken, Brewers Rice, Corn Gluten Meal, Whole Grain Wheat, Pork Fat, Brown Rice, Wheat Gluten, Chicken Liver Flavor, Dried Beet Pulp, Flaxseed, Egg Product, Lactic Acid, Calcium Carbonate, Soybean Oil, Potassium Chloride, Choline Chloride, Potassium Citrate, DL-Methionine, Dicalcium Phosphate, vitamins (Vitamin E Supplement, L-Ascorbyl–2-Polyphosphate (source of Vitamin C), Niacin Supplement, Thiamine Mononitrate, Vitamin A Supplement, Calcium Pantothenate, Riboflavin Supplement, Biotin, Vitamin B12 Supplement, Pyridoxine Hydrochloride, Folic Acid, Vitamin D3 Supplement), Taurine, L-Lysine, Calcium Sulfate, minerals (Ferrous Sulfate, Zinc Oxide, Copper Sulfate, Manganous Oxide, Calcium Iodate, Sodium Selenite), Mixed Tocopherols for freshness, L-Tryptophan, Iodized Salt, Natural Flavors , Beta-Carotene

So, in addition to all the high heat and pressure it takes to pop out a piece of kibble (both of which change proteins dramatically), we have

  • spent white rice, left over after the beer brewers have taken their share
  • corn gluten meal, bringing sweets to your carnivore, and setting her up for diabetes later in life
  • gluten in two forms, an inflammatory protein since the 70’s “green revolution” changed it in the name of feeding the planet

Chicken doesn’t sound bad, though, does it? First ingredient. Nice. Or is it?

Here’s the ingredient list from a chicken wing:

  • chicken meat
  • chicken bone

Which food do you think would be more suitable for an animal who has wild genes most closely matching the wolf or bobcat?

Quality matters. Especially so if your animal has kidney trouble.

Feed the Need. The Patient vs The Lab Numbers

I’ve been recommending raw balanced diets for my kidney failure patients for over 25 years now, and I have yet to see anything telling me that’s been harmful. And I’m not alone in this. My holistic vet colleagues do this as well. And see similar results.

If you really want to buy into the low protein idea, it might have some merit at the very end stages of the disease. That occurs when the BUN, a common measure of kidney function, rises above 80 (normal range for the dog: 8.8 – 25.9; normal for the cat: 15.4 - 31.2, Merck Vet Manual).

I’ve not done this, particularly, and I’ve not seen negative effects from it. But it makes sense, and may be worth pursuing if you’re so inclined.

Similarly, animals in the latter stages of CKD have rising phosphorus levels in their blood. Phosphorus in excess hastens kidney disease, so conventional medicine offers phosphorus binding agents to feed cats. All of which have side effects.

Sigh.

News flash: I just brought this question to my homeopathic peers, and there's an alternative to lower phosphorus that appears to be free of side effects. The B vitamin niacin, in the form of niacinamide, appears to work without the toxic effects of the usual aluminum-based supplements, according to Dr. Lester Mandelker on VIN. Here's his dose recommendation:

  • Cats and small dogs: 250 mg twice daily
  • Large dogs: 500 mg twice daily

How to give it to cats, the fussy appetite guys? Sara Fox Chapman, DVM, MRCVS, veterinary homeopath who shared the above, says she puts it in the food or mixes the dose in butter and wipes it in/on the cat's mouth. They tolerate it quite well.

Have any experience with low protein diets in a kidney animal? Or the opposite? Tell us in the comments.

Photo attribution

81 Comments

  1. Marty on July 26, 2022 at 10:31 pm

    Superlative advice!
    Raw food
    And lots of it’. It’
    And just watch a renal failing dog scarf up that raw food!
    It will etch your mind forever!

  2. andrea r flinn on November 9, 2021 at 9:27 pm

    My 6 year old boxer, Nene was diagnosed with one functioning kidney. After ultrasound we found that one of kidneys looked as if it didn’t develop(lots of scarring and small). She was a rescue and I have no history of her first 2 years of life. As soon as I got her we put her on raw lots of immune supplements and at check up she was completely normal. We do blood work every year. This year we had a rise in SDMA and her BUN(we weren’t so concerned about BUN at first bc of the raw diet). We ran urine to test(protein ratio) and that was normal. I recently switched her to a home cooked diet(no carbs) and her numbers were bad(CREA was high which was previously normal and her BUN still elevated) but here SDMA was normal. This was a one month difference.
    What we did
    Ozone, Hyperbarics, home cooked, Standard process renal support, gastriplex, herbs, and acupuncture
    Now I switched her back to raw. Took away the Gastriplex looking for a good kidney support probitioc and any other supplement that will help her. I will likely move her acu up to weekly instead of bi-weekly and see if we can get more blood moving.
    Can anyone recommend someone to help me with diet and herbs that is the only thing I am missing…
    Thank you in advance, Nene thanks you.

  3. mary on January 29, 2021 at 10:51 am

    I thought the same on raw–put my stage 3 lab on it and his #’s went thru the roof. Got his raw from pet store–used stella’s and he got that and goat milk. He got worse in 3 weeks time. Now we are just giving him what he wants to eat within reason. Supplements for his kidneys and lots of love. This disease sucks.

    • Will Falconer, DVM on July 22, 2022 at 10:11 pm

      Two problems here likely at play: 1. Stage 3 means very advanced, so raw diet is not applicable, and 2. Canine renal failure is a bit of a different beast than feline. So, it’s not a “one size fits all” recommendation.

  4. Laurène on August 4, 2019 at 9:43 am

    Does anyone have any good sources of raw food? I have a stage 1 kidney kitty that has been on raw for over 6 years (since his diagnosis)… I had been feeding my cats Texas Tripe, (I’m in the Austin area) and they recently had FDA recalls on their food which had tested positive for salmonella and Listeria… I know that usually isn’t an issue with cats, but recently mine have been not eating it, or throwing up immediately after eating it or acting sick and lethargic. It happened in a few other cat households who purchased from this company too, so we are looking to change and having trouble finding anything suitable.

    • Pam Schroeder on July 24, 2022 at 9:42 am

      Tripe has to be natural, non-treated, not bleached. Usually the store bought is bleached. You have to get it straight from the processor if you can as it won’t be bleached. Might explain the throwing up. I use beef hearts too.

  5. Hilde on June 29, 2018 at 3:18 am

    My 14yrs old cat is having IBD + HCM + high phosphorus (on normal range high border, while CREA is normal). I would like to try niacinamide, but worry about its possible side effect of abnormal heart beat, fast breathing as well as diarrhea. I read these side effects on human but will it be the same on cats?

    • Will Falconer, DVM on June 30, 2018 at 3:16 am

      No idea, Hilde. I’d suggest hiring a vet homeopath. Nothing chronic will yield to short term strategies for long.

  6. Cheri Odiorne on June 2, 2018 at 12:38 pm

    Hello Eowyn

    I too thank you for your story. I would love to hear how you both are doing since the diet change. Because I have been thinking about that too. My beloved 18 year old kitty has been recently diagnosed to my surprise with CKD. I only discovered it when I was getting her ready for a dental cleaning (and now I have read about the possible contributing factors of that for this disease 🙁 ) In mid march 2018 her creatinine was 2.2 and Phos 3.6 Bun 60. The conventional vet said as I was leaving she should start a kidney diet and to pick up a can. Since, I had been feeding her Rad Cat since 2014, I dismissed his comments. Btw he did not even give me values or reasoning just that she was an incredibly healthy 18 year cat and that she was cleared for a dental cleaning. Which I scheduled the following week. I have been trying to keep her oral health up to par so she could live a long vibrant life. (This would have been her 3rd cleaning. Her first in Oct 2016 creatinine 1.2 at that time…since then they have been slowly rising again with no comment from vets. I have only recently asked for all labs and found the pattern.) I was in a room waiting for the vet for about 30 minutes and there was a dog kennel just out side the room with constant barking. My poor cat was shaking badly and I decided to not have her go under anesthesia in this condition. I told them I would reschedule. I ended up taking her to another vet who specialized only in dental procedures 6 weeks later. I had tried to wait as she was not herself and I was trying to get her back to her normal vital self. Even though she was not her normal self, I attributed it to her accumulation of gingivitis in her mouth and the sooner that was taken care of the better. So May 1st we went to the dental specialist and he suggested another blood test to prior to the procedure. Thank goodness we did that. Her creatinine rose to 2.5, BUN 45 Phos 4.3 and he suggested we get to the bottom of what was going on before proceeding . I followed up with an appointment on May 4 with another local vet and gave her all her labs and she said that it was CKD and that she just needed to start the renal diet and gave me samples and encouraged me that many patients numbers go back to normal once the start the diet. I begged her to do another panel as she just had not been herself and she was drinking and urinating more and constipated. She did another panel and she called the next day and her creatinine had rose to 3.2, BUN 50 SDMA 14 Phos 4.9 I came in for fluids and asked her to take BP and an ultrasound to see if there was a kidney stone. She took xrays as they did not have an ultrasound. BP was high and xrays clear. She is now on amlodepine (sp?) I scheduled and appointment with an ultrasound vet practice and found that her kidneys were normal size, L 3.2cm R3.3 cm. smoothly marginated with decrease in corticomedullary definition. Blunting of the renal papilla, mild renal pelvic dilation, and thickening of the ureteral walls on the left. No ureteral dilation or obstruction was identified. But they did also find a thickening in the small intestine and nodules in the liver and recommended a biopsy. Ugh!!! So, after talking to specialist and the procedures to test for cancer, I have put that off as I attempt to stabilize her.

    I have been seeing a holistic vet for 4 weeks now. She has given her acupuncture, VOM, Ozone therapy and renal supplements, omega 3s, (nordic naturals), catnip and aloe vera juice to calm inflammation in small intestine. I also give her fluids every other day. She recommended slightly cooking the rad cat to ease the work of the kidney.

    Her vitality is mostly back (she goes through waves of being tired) and her constipation has been relieved quite a bit. She still does not poop every day though. BUT I just did her blood work again and she has increased in creatinine. now to 3.3. BUN 47 Phos 4.9 SDMA 22. I was sure that her numbers were going to be better.

    My thoughts are perhaps I could use a moderate level of protein instead of high to see if the creatinine could clear and perhaps be flexible in her daily protein consumption. There is a lot of discussion on the value of high quality protein for cats, which makes sense in their biological makeup. What I have never seen brought up is the natural fasting that occurs in the wild when food is not found. Wild cats have to go for days without food sometimes. Does this help conserve their kidney function? Does anyone have any information on this?

    Also, has anyone experience good results with photobiomodulation on the kidneys?

    I don’t know anything about homeopathic medicine and would like to hear if it could be helpful for my kitty.

    Thank you for reading my very long post. I am reaching out for help and encouragement to do the right thing for my kitty. With gratitude…

    • Pam on July 24, 2022 at 9:52 am

      I haven’t read your whole post yet but I have been giving my cat raw forever she’s in her 20’s and as long as I give her a raw piece of chicken – this has cleaned her teeth. Dogs if their not allergic to chicken the same or I have a 1 day bone day – which is beef bones or bone marrow to clean their teeth. I even got a Bernese Mt’n dog that was 1 yr and 2 mos – his teeth were horrible. I immediate put his on raw and his tartered teeth came back to being pearly white. If you don’t have to – don’t put any animal through a unnecessary dental cleaning when good raw bones do the exact same thing. Try it an see what you think. But, if you do put them through a cleaning use activated charcoal in their food later to get the anesthesia out of their system. Good rule for humans as well. You can buy it at your local drug store in the gas section – just break it down to put into food.

      • Will Falconer, DVM on August 3, 2022 at 12:29 am

        While oral activated charcoal is harmless, even if not doing anything, please know that it ONLY acts locally, in the gut. It can’t reach the rest of the body, where anesthesia is being processed, like the liver, lungs, and kidneys. That’s where a system wide approach makes more sense, hence my recommendation of QRF Detox.

        Yes to bone feeding! Best “toothbrush” for every dog and cat, no question.

  7. Eowyn on March 13, 2018 at 12:31 am

    I agree that protein should not be restricted and that phosphorus is an issue. Blood perfusion is critical, and prescription diets for lack of a better word are crap. By the way, I worked in the veterinary field for 15 years, and the wet food is pushed by vets more often than the dry, if that matters to you.
    Claiming that a raw food diet will address kidney needs and other nutritional needs in cats as you have has made it sound all inclusive. I agree that many cats have responded well to such a diet. But this does not take into account that all meats made for pet food have problems. All meat made for humans share the same issues. Yes, all. You can not mass produce that amount of death and not make sacrifices. Proving that every single animal being slaughtered has zero disease factors and has had high quality nutrition all their lives is not viable economically. The customer is being sold the same bill of goods for our pet’s foods as we are for ours. We get a lot of promises and good sounding words like “organic: or “free range”, but those are not the questions we should be asking. Did each turkey get a full blood screen done before being killed? Of course not. There in lies a big problem that we continue to choose to ignore because why? Our cats are carnivores, as we are doing the best we can? Well, I believe we should do better – much better.
    Let’s start by addressing blood perfusion. This is markedly increased by the use of omega fatty acid supplementation. I would have liked you to talk about this. A heavy metal tested free fish oil supplement would do wonders for any kidney patient.
    Also, B vitamins work best when all are together in the right portions. A superior B Complex created by the top natural nutritional company would be a great addition for kidney patients. Both of these supplements would have to be made for humans with proof of testing for contaminants, bottle contents the same as on label, and absorption backed up by clinical trials published in medical journals. Even the supplements used by holistic veterinarians that are human grade can not offer this kind of proof, because when tested they fail. Shaklee has been the only company that can do this.
    I want to say that I appreciate this article and hope it gets more and more notice in the coming years. You answer a lot of questions and point out flaws in what is happening in the veterinary industry. That is needed! Thank you.
    Let me end with a personal story. I have lost 2 cats to kidney disease despite being on the most premium holistic diets all their lives. My current cat is 17 and facing the same fate. Last year due to this article and encouragement from an enlightened veterinarian, I switched him to Rad Cat raw. Indeed, I saw an increase in energy for a while. However, it did not last long. Current blood work shows the biggest increase in kidney values yet. That is not what I had hoped would be the results of the diet change. So what now? I figure at this point in the game I have nothing to lose. If I put him on a kidney diet, he will die quickly on horrible nutrition. If I keep him on the raw, he will continue to decline. If I do something else, he may also continue to decline. But what if…
    So, going against everything I was taught, I have decided to give him a chance on something that lacks all the scientific data that I usually demand. Like I said, if it doesn’t work, we are no worse off. He will be on Evolution canned and Ami Cat dry for treats. Yes, it’s vegan. But no diseased or malnourished animal tissue will be infecting him. I don’t need to hear about how crazy this is. I used to preach it. He’s my child, and I am doing the best I can for him out of love.

    • Will Falconer, DVM on March 13, 2018 at 10:00 am

      Thanks for your thoughtful comment, Eowyn. As to the cat currently facing challenges, I’d be much more focused on his clinical state (how he’s feeling and acting, interacting, grooming, not vomiting, having an appetite) than I would on his BUN. That rises even in healthy, non-renal animals eating raw diets, as you likely know.
      I rarely chase or push numbers. I look at how my patient is doing, first and foremost. If he was clearly failing on the raw meat diet, sure, try the vegan. Just not because his kidney values were rising.
      All the best.

  8. Jill on November 14, 2017 at 4:24 pm

    My 19 year old cat needs to eat a renal or kidney friendly diet. He has been on a mostly gluten free diet for years. He recently started medication for hyperthyroid. My question, I will be traveling for long periods at a time and need to find canned and dry cat food, cannot ask the pet care giver I am hiring to prepare special food. Problem as I have learned about the brands of prepared food are less than satisfactory, low protein, gluten or wheat and other products. I’ve been researching to find a brand and I came across your website but. Please, can you recommend a canned and dry food for the renal or k/d diet?

    • Will Falconer, DVM on November 14, 2017 at 6:10 pm

      Hey Jill,
      The “low protein kidney diet” is a myth, nothing more. We learned this in a few ways, but the most striking was when caregivers decided to give in and allow a balanced raw diet to their renal cats along with the rest of the household and, lo and behold, these cats bloomed! So, for ease of use for a caregiver, I recommend Steve’s Real Food — there’s a chicken recipe in their offering, suitable for both dogs and cats.

  9. Lloyd Nicolas on August 19, 2017 at 8:21 pm

    What about the risks of raw meat? Giving raw meat, especially pork can be very dangerous! It can cause the animal to die within a few days because of the Aujeszky virus.

    • Pam on July 27, 2022 at 6:10 pm

      If a pig is infected – yes. But, it is human grade food so it should not be infected! I used to keep in freezer for over a week but it’s not really necessary…

  10. Heather Scott on February 12, 2017 at 10:29 pm

    Hi. I have a 9 pound male Bichon Frise who is almost 9 years old and I was told he has a kidney stone. Vet pushed Hill’s S/d canned food but he won’t eat it. I have been feeding him cooked chicken, rice, veggies, and cottage cheese. His pH is 7 and vet says he needs to be about 6 or 6.5. How should I feed him to get rid of stone (S)?
    Thanks!
    Heather

  11. Erik Philippus on November 11, 2016 at 2:22 pm

    The last feedback of Dr. Falconer was more than a year ago – so it seems to me it doesn’t make sense to ask questions here.

  12. Erik Philippus on November 1, 2016 at 3:02 am

    Dear Dr. Falconer,
    Interesting article! My 14 year old Bengal Dalí was diagnosed with kidney failure a year ago. He was in a quite bad condition at the time, so I started to give him infusions – which I believe saved him. And I started feeding low-protein diet, together with Amlodipine and Fortekor/Semintra. Dalí is doing quite well now, he is stable and enjoys a good quality of life. The only thing is that he has lost 1,5 kg the last year: he is skin and bones now, while he is eating much more than ever before in his life….
    So for some time, I have this question: is weight loss a inevitable side-effect of the illness, or is it the low-protein diet that is contributing to the weight loss? It is not a brain twister to understand that it is important to feed a kidney patient high-quality protein leading to minimal kidney burden. But most canned kidney diets are low protein, ranging from 6 to 8% – which translates into a daily intake of less than 3 g of protein/day. This troubles me…. His underweight seems to become a more serious problem than the kidney failure.
    So I was thinking: what if I supplemented Dalí with small portions of high-quality protein from a source that matches his natural intake? What would be good protein sources which lead to minimum kidney load? If I remember well, poultry and haze are good candidates. What would be your advise?
    Many thanks for sharing your insights!
    All the best,
    Erik Philippus & Dalí

  13. Brenna on April 13, 2016 at 11:59 am

    Hi Dr. Falconer-
    Does all of this information also pertain to puppies with congenital kidney disease? I have a 5.5 month old Rhodesian Ridgeback who is struggling to put on weight and has developed bad breath and excessive urination – more frequently and lots of it, even occasionally while sleeping. Results of her urinalysis yesterday weren’t good – the vet said there was evidence of renal tubules (I think that’s what he said) in her urine and that it was highly diluted. We’re still waiting on the results of her blood work. She has no other symptoms. She is very active and LOVES to eat. She continues to be VERY motivated by food. Currently, we feed her dry dog food – Nutrisource, grain-free quail. Any advice is much appreciated.
    Thank you!

  14. Alina on April 8, 2016 at 4:46 am

    Hello, Dr. Falconer. Thank you for that article and the tip about niacinamide as a phosphorus binder.
    My cat of 13.5 years old at the last bloodwork had the serum phosphorus almost at the upper limit of normal and creatinine slightly above normal, but BUN in the middle of normal range. The vet didn.t prescribe renal diet or phosphorus binder but i feel that we need it. Cat had such values after a month of feeding mostly with commercial pet food and immediately after i switched her back to raw turkey breast meat.
    The problems is that she has a mammary cancer which i treat with IP-6 and curcumin and it seems to work and keeps cancer in control. But IP-6 is high in phosphorus, as well as turkey breast, so i think i need to give her some phosphorus binder at least to cut phos coming from meat.
    Would B3 accelerate cancer growth and metastasis?
    Can i use injections of nicotine acid instead of niacinamide?
    Thank you

  15. sarah on July 22, 2015 at 6:40 pm

    Question for you Dr….I have a 12 year old femail that had major kidney stone blockages in both ureters June 14. She had stents put in both ureters & did great until Jan 15. She ended up with Stones in one ureter again & when they went in for surgery they saw the kidney was so damaged they just removed it. Both my cats are solely on canned food only now (they were on dry their whole lives up til this, I didn’t know better!) 🙁 Since her surgery in January she is doing great, but is still on a feeding tube with KD low protein “gruel” 3 times a day. The doctor says it’s not only to help her one kidney but because she produces so many stones that the low protein will help that stone production as well. So it’s been 6 months now and she still has her feeding tube. She seems very happy, getting alittle wobbly now & then but overall has a great spirit. What do you think about the low protein “way” for kidney stone production? Do you feel it’s beneficial? I’d rather her have a happy life on canned food than a not so great life with a tube in her neck if all things are equal, but the stone production/blockage issue has me terrified! We’ve spent 10’s of thousands of dollars on her surgeries so I don’t want to put her thru more of them, but also want her quality of life to be good! thank you!

    • sarah on July 22, 2015 at 6:41 pm

      clarification…her original blockages were June 2014….

    • Will Falconer, DVM on July 23, 2015 at 12:50 pm

      Hi Sarah,
      I’m so sorry your older cat has been through such stress. The propensity for making stones is a separate issue from protein content. There’s something amiss in 1. diet composition and/or 2. the cat’s metabolism that allows the formation of stones. As you’ve probably learned, this, like most chronic diseases, is a man made illness entirely. So, your next generation of cats will benefit from your experiences here, and likely be either raw fed or at least, healthy can plus amendments fed.
      As to where her protein level should be, it more depends on how much kidney reserve she has left. The BUN gives us some idea of that. If it’s over 80 and staying there for weeks, she’ll probably benefit from staying on low protein diets. If it’s under that and staying so, she could likely benefit from some more healthy raw protein and might even want to eat it, if it’s made tempting enough.
      I hope this helps. Getting off the kibble was probably the best step to keep crystals from returning, but it may not be the only necessary one.

      • sarah on July 31, 2015 at 12:51 pm

        thank you for your reply. Her BUN was elevated (80+) as was the creatanine after her surgery but came down. We were doing ultrasounds & blood work once a month since January & in March it plateaued to I think 60’s/3.1. Her readings in early May were surprisingly lower, I believe high 40’s or low 50’s & createnine was 2.6 or so. The doctor was happily surprised as we expected no “improvement” per se just to stay static. She has a 3 month checkup in Aug so we’ll do another ultrasounds to make sure no stones are blocking and more bloodwork. Her doctor is a top notch Nephrologiest at UC Davis and is always amazed at the “rock quary” of stones she has sitting in her kidney pelvis. She says so long as they don’t all drop at once Maizy will be ok. They’ve passed a one by one (can see them on ultrasound) but no group droppings since her surgery (fingers crossed). I purchased some frozen raw chicken months ago & they’ve been in the freezer this whole time. I’ve been worried about introducing/switching them to that if it would increase her chance for the kidney stones to be promlematic. I am also afraid to take out her feeding tube since it is such a great life line to feed her & give her a lot of water whether she likes it or not 🙂

        • Will Falconer, DVM on August 1, 2015 at 5:14 pm

          Hi Sarah,
          It’s unclear to me if she’s making new stones, but she sure has a lot up there in the kidney pelvis, it sounds like. That sounds like a surgery waiting to happen.
          You might do better to use your raw food on your other cat. No need to be nervous about creating problems there. You’ll only do good for her.
          As you might imagine, cats in the wild (the big cats being the most useful model to study) aren’t needing stone surgeries. And they eat one food: prey. The closer you come to that in your domestic cats, the healthier they’ll be. But start with the low hanging fruit: your cat who’s not made stones yet. Stop back after a month of feeding like this, and I’ll bet you’ll have an inspiring story to tell!

          • sarah on August 6, 2015 at 12:31 pm

            Thank you doctor. Don’t know if she’s making new stones either, just passing them randomly here & there. Being as old as she is & what she’s already been thru the kidney is too fragile & we can’t afford to try to get them out of there. We’ll just manage with her best we can now & moving forward.
            So with Maizy (feeding tube/stones) you suggest sticking with her feeding tube/low protein kidney friendly “gruel” as her food source & not switching to the raw food?
            I will introduce the raw to Cintron (our ginger tabby boy) who is healthy & happy with a great appetite!
            Thanks for your input



  16. Tish Monte on June 12, 2015 at 9:31 am

    Wondering what Trans Factor to buy from my cat. She has fibrosarcoma a 6 year old stray I saved.
    Doing a lot better with the cur cumin, krill & fish oil, but the drug for her pain I hate. Located on her leg they wanted to amputate, she has started to walk on it! Still has quality of life , but I do not know how long she has had this. the 4.5 years I have had her NO VACS from me! I have not vaccinated anything since 1992!!!
    Really need a trans Factor at this point…..

    • Will Falconer, DVM on June 14, 2015 at 4:23 am

      Hi Tish,
      In cancer cases, I use both TF Feline (or Canine, or Equine, as the case may be) at a full label dose. Then, after a few days to a week, I add in TF Plus Tri-Factor Formula, the human capsule that I take daily. For a cat, I’d start with 1/2 cap twice a day, graduating to a cap twice a day after a week. Be sure to hit me up for my bonus ebook on how to dose for all kinds of conditions when you buy through my store.
      All the best. Tough form of cancer that likes to keep growing, even after surgery.

  17. Linda Williamson on May 30, 2015 at 7:41 am

    I have a 12 yr old English Cocker Spaniel who has Kidney failure and is currently treated with Benazecare. She came to me as a two year old with vaccine history, I put her straight onto a raw diet as she had previously been fed with a low quality Greyhound Kibble. Her coat was stained a shade of orange around her throat area. Over the years I worked out through dowsing that she and her son (who I also have) are very sensitive to chicken or chicken derivatives.
    Over the last year her breath has become somewhat less that sweet and her upper Canines have tartar build-up along with a couple of lower teeth on either side. She has been fed bones as part of her diet all these years and as recreational bones. I am assuming that the Vaccines have softened her teeth in some way, I have tried to scrape the tartar off by myself, she is not the most cooperative and I don’t push her. My vet won’t entertain a scale and polish due to her Kidney failure and wants me to put her on a prescribed Kidney diet. My rational before I read your article was to keep her on protein rich raw diet by way of fish and other high quality sources as she is losing protein in her urine she needs to get it from some where. I have recently discovered she also has a small tumour on her left anal gland, she is not in any pain and still enjoys her walks etc. I recently consulted a ‘Zoopharmacognosist’ and Teal only chose Incense and Rose in essential oil form, not in the least interested in Arnica and other pain or anti-inflammatory which was good news. I have opted to treat her Palliatively and as long as she still enjoys life and does not appear to be in pain tats the path I shall follow.
    Thank you for the article

    • Will Falconer, DVM on May 30, 2015 at 5:51 pm

      Bravo, Linda. It sounds like you are very tuned in to her needs and life can be quite good with palliation until it finally isn’t any longer.
      You’re doing fine and will know when it’s time. These animals can often die quietly at home, treated like you’ve been doing with her.
      All the best.

  18. Donna on May 2, 2015 at 10:27 am

    Thank you SO much for the above article. Fortunately, when my (then) 13yo feline lad was diagnosed with CKD in Sept ’14, I was on a good forum which pointed me in the direction of high protein and a phos binder rather than the usual vet advice of low protein. I have had a concern, however, over the ingredients of the phos binder so am very interested in your alternative option of niacinamide. However, finding this in powder form the UK is proving difficult but I have been able to locate Nicotinamide. Doing some searching it would appear that these two names are actually for the same compound – please could you confirm if this is the case.
    Additionally, we are also giving an ace inhibitor – Fortekor – and I have just found out that I must give this at least 2 hours apart from the phos binder as the binder prevents proper absorption. Would the Niacinamide / Nicotinamide have the same restriction? I am out at work 9hrs a day so am having a problem with the timing of this. I also give Slippery Elm Bark to minimise his stomach acid and, it too, cannot be given within 2 hours either side of other meds. So, as you can see, timings are tight.
    Thank you in advance for your input and advice.

    • Will Falconer, DVM on May 6, 2015 at 7:11 pm

      Hi Donna,
      You’re correct: nicotinamide and niacinamide are identical. Odd that you can’t find one but the other is available.
      The other drugs are beyond my ken, I’m afraid. I’m a homeopath, and I rely on knowing my remedies well, not on studying all the tangled interactions of drugs. Perhaps you can find an “integrative vet” who keeps a foot in two canoes to help you sort this out. Too unstable for me.
      Good luck and thanks for stopping by the Natural Path!

  19. Ellen on April 17, 2015 at 2:37 pm

    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?

    • Will Falconer, DVM on April 18, 2015 at 11:56 am

      Wow, a great story, Ellen. Bear making it to 21 was a testament to your doing things right, contrary to what you were advised. You followed your instincts and learned from both cats what helped. Bravo.
      I use nosodes only in a youngster’s first nine months of life, when they are susceptible. In cats, that’s just Panleukopenia. I hardly ever see kittens these days, so it sits untouched in my homeopathic pharmacy.

  20. michelle on April 16, 2015 at 9:11 am

    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.

    • Will Falconer, DVM on April 17, 2015 at 10:47 am

      Hi Michelle,
      I think there’s a need to stay lower protein with these, as they are worsened with high protein, something about the place of their pathology. I’m not an expert, so I’ll refer you to those who’ve studied it more than I.
      But, that being said, I see no reason you couldn’t successfully feed the protein that you do raw. Just likely have to use some well cooked grains or sweet potatoes or something besides the meat, to bring your overall protein down. Anything homemade, as long as it’s balanced, will always beat a kibble. Grains cooked to mush on your stove are very different than those extruded under heat and pressure to make a kibble.
      Now: do you not have this disease? If true, I’d not worry about it at all. It’s not caused by a high protein diet, you understand. As I recall, it’s autoimmune disease, so avoiding further vaccinations and chemical heartworm treatments, and bolstering his immune system will likely prevent it. See the story on Showing Without Any Vaccinations (can’t recall the title exactly, but that’s close!)

      • michelle on April 18, 2015 at 10:52 am

        Actually they identified a gene that triggers it. He is clear of the gene. 🙂
        And I do avoid all unnecessary vaccines and chemical products.
        Thank you for the good info.

        • Will Falconer, DVM on April 18, 2015 at 11:49 am

          Excellent, Michelle. You are on a great trajectory for a worry-free, Vital Animal!
          Carry on.

  21. Paula on April 15, 2015 at 10:19 pm

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

    • Will Falconer, DVM on April 17, 2015 at 10:40 am

      Vegan food for an obligate carnivore is a mistake. You won’t see it in the short term, but it’ll come back to bite you later.

      • Paula on April 17, 2015 at 1:57 pm

        re: vegan cat food coming back to bite long-term … you’ve witnessed this personally as a vet? Can you elaborate?
        Also re: canned foods — I use alot of the Weruva from the charts I spoke of. That ok to the best of your knowledge?

        • Freya on June 15, 2015 at 9:03 am

          I have just taken on a foster cat that was rescued from death row. She was spayed,vaccinated,wormed and given flea and heartworm treatment,(even though we do not have heartworm in this area)
          She has had two previous homes in two months and I was told that she was suffering from chronic diarrohea that no-one had been able to correct. One carer had her on vegan Cat food,which consists mainly of soy and corn.
          The day before Grace came to me she was due for further vaccines and also antibiotics in an attempt to stop the diarrohea that was occurring within half an hour of every meal.’Dr.White Coat’ suggested that if the antibiotics didn’t work cortisone would be the next line of treatment. We requested that no treatment be given that day.
          Grace was so hungry,I have fed her a variety of raw meat with probiotics and a reputable brand of ‘Cat Mix’ Multi-Nutrient Formula.
          After one week her condition is already so much better,her fur is becoming shiny and the diarrohea has stopped.
          I have been a Vegetarian for 30 years and I also found it hard to give my cats meat but they are ‘true carnivores’
          and deserve to have a diet that will not only sustain them but set the groundwork for excellent health,wellbeing and longevity.
          I have seen so many cats suffering health problems due to the modern day invention of ‘dry cat kibble’.
          As someone said: ‘If you don’t want to feed a cat a species appropriate diet ,then get a rabbit or a guinea pig’.

    • Ellen on April 17, 2015 at 2:09 pm

      IMHO, cats are obligate carnivores and vegan diets should not even be considered. Those two brands, and any vegan diet, have to be heavily supplemented. Lack of the nutrients not found in the vegan diets will cause heart, brain, and organ failure leading to seizures, blindness, and death.
      Why do we need to change their ancestral diets and DNA to feed our human philosophies? They don’t have issues with factory farming – we do, and there are other sources from which to get your food. The majority of the comments on here refer to some form of meat protein, mainly raw, so I think it’s obvious about how contradictory it would be feeding either a cat or dog a vegan diet.
      I only know of one vegetarian fed dog, pulled from the NYC AC&C. A neglected, female pit bull mix, who presents with an immediate flare up of reactions in her ears whenever fed a meat protein of any type – cooked or raw. Just recently that finally developed into the hematoma that was destined to occur. She is fed pasta, veggies, coconut oil, a supplement, some type of anti-histamine from the vet, and kibble that is usually a fish based one, and very little of it. I personally believe she might have had a reaction to vaccines since once at the shelter, they are jacked up with them because of no prior history, and then immediately spayed. So many develop cancer in a short amount of time, it’s depressing.

  22. Paula on April 15, 2015 at 10:11 pm

    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.

    • Will Falconer, DVM on April 17, 2015 at 10:39 am

      Hi Paula,
      You can just be a good label detective, staying away from byproducts and unrecognizable species, and meat in the first couple ingredients. There are many to choose from (Wysong, Nature’s Recipe, I’ve honestly lost track).

  23. kris on April 15, 2015 at 6:43 pm

    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?

    • Will Falconer, DVM on April 17, 2015 at 10:37 am

      Hi Kris,
      Usually the special diets are not for urinary tract “infection” (in quotes, because these bladders usually culture negative) but rather to prevent crystals. Do you think that’s true of the one you mention? I’d guess so. Big Pet Food has been selling diets to manipulate urine pH for 30 years or more.
      The best answer for prevention is not homeopathy. It’s feeding a species appropriate raw food diet. Cats eating balanced raw food don’t get crystals in their urine.
      I’ve got some pages about making the transition under the Vital Path that may help you get there.
      All the best with your youngster.

  24. Mark on April 15, 2015 at 6:29 am

    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

    • Will Falconer, DVM on April 15, 2015 at 5:51 pm

      Hi Mark,
      I would try to cut your expenses by following one of Dr. Pitcairn’s recipes, which use a fair amount of healthy, very well-cooked grains along with the raw meat. This cuts the expense significantly, and, in his view, the pesticide/herbicide/toxic potential of a high meat diet, and is far better than any kibble.
      It didn’t sound like you’ve got kidney disease to deal with, so I think you have more latitude as to choices. Just remember, you’ll never go wrong with adding raw ingredients to even the best kibble or freeze dried food. I talk about this more on a page called The Missing Ingredient.
      All the best.

      • Mark on April 15, 2015 at 6:18 pm

        No kidney issues, but I will check out Dr. Pitcairn’s recipes and the missing ingredient, I will start adding raw to there diets for now.
        anyway thank you for your valued advice.
        Mark, WI

        • Tricia on April 18, 2015 at 3:23 pm

          Hi Mark,
          I’ve got two Great Danes that I feed Dr. Pitcairn recipes for FAR less than if I fed them kibble.
          Having said that you might want to try Sojo’s premix first. (orange bag) Its super easy to fix and balanced. Sojo’s plus meat on sale will be very close to what you’re paying now for kibble.
          If you’ve got more time than money- then I’d go with Dr. Pitcairn recipes. Just be sure to include the healthy powder and all the vitamins he specifies. You want it to stay balanced over the long term.
          I’ve had great luck with both for 6yrs now. Contact Dr. Falconer for my info if I can help you walk thru it.

          • Mark on April 19, 2015 at 12:20 pm

            Hi Tricia,
            sorry I didn’t answer your reply been busy with the new Chocolate lab puppy me and my wife just took in yesterday, lots of preperation I will most likely look into researching the Sojo’s we also have a 10yr old chihuahua, very healthy I take great care of his diet I have been working on it for some time, now he is on Acana I was planning switching them both over to Origen (higher protein content), due to the cooking process I’m supplimenting with probiotics and pure omega 3 oil from Nordic naturals and a little coconut oil (cold pressed) for skin health, Acceptable?
            anyway thanks for the info I’ll check it out always looking for the best option.
            Mark, WI



  25. Will Falconer, DVM on April 14, 2015 at 3:41 pm

    Thanks, Dede, it sounds like Emma soldiered on remarkably with her afflictions. I suspect life with your new pack will be free of kidney disease and most others. Emma was a good teacher, eh?

  26. Dede on April 14, 2015 at 3:28 pm

    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.

  27. Carol Benedetto on April 14, 2015 at 10:05 am

    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!

    • Will Falconer, DVM on April 14, 2015 at 3:39 pm

      Hi Carol,
      Some perspective is in order here. First, crystals are formed from eating dry food, something no cat should be fed, ideally.
      As to percentages, you’re asking a lumper, so I don’t know. What percentage of prey is protein? Doesn’t matter to me. I know it’s real food and useful in this disease and most others, for that matter. Canned is better than dry, but it should be a healthy brand, no byproducts or unidentified species ingredients.
      Don’t worry about too much protein was the point of this article. Feed healthy protein, as close to prey as you can make it, and you should see benefits.

  28. Ron Gaskin DVM on April 14, 2015 at 1:30 am

    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.

    • Will Falconer, DVM on April 14, 2015 at 8:24 am

      Thanks for your feedback, Dr. Gaskin. I agree on the foreign foodstuffs, and it’s great to hear about rutin working for you. Do you see a clinical response in the cats, or just a decrease in numbers on blood work?
      How do you dose it? And do the cats accept it?
      Thanks again for stopping by.

  29. Katy on April 13, 2015 at 11:00 pm

    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.

    • Will Falconer, DVM on April 14, 2015 at 8:36 am

      Thanks so much for this encouraging tale, Katy. You saw first hand both sides of the diet myth. Very impressive.
      I’m sorry he had heart complications that ended up being his undoing, but what a story he’s told, and one that you can continue to share even though he’s gone.
      And yes, raw can be more work, more expense (depending on how you do it), but, as someone in the human health field said, “Pay me now (for healthy produce, etc.) or pay the doctor later.”
      Thanks so much for sharing this here, Katy.

    • Krista on December 13, 2015 at 8:47 pm

      Hi, Would you mind sharing what kind of raw food you ended up using and how you determined it was low in phosphorous?

    • Beverly on January 14, 2018 at 9:38 pm

      Hi Katy: It’s 2018 and I’m only now finding your post from 2015! I’m curious if you might share what raw diet you used? My little girl has been diagnosed with CRF (her kidneys are “dead” per the vet), but I want to give her every fighting chance I can. She’s my only “child”…my ONLY family. So this is important to us both. What might you recommend, please? Thank you in advance!

  30. Jackie on April 13, 2015 at 9:30 pm

    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.

    • Will Falconer, DVM on April 13, 2015 at 9:47 pm

      Great question, Jackie. I think the two most important are minimizing vaccines (early life, if you’re going to do them, and then stop), and fresh raw food that’s balanced and varied.
      A third would be avoiding all things poisonous, like the plague.

      • Jackie on April 14, 2015 at 7:32 am

        Thank you Dr. falconer!

  31. Nora on April 13, 2015 at 8:33 pm

    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.

    • Will Falconer, DVM on April 13, 2015 at 9:45 pm

      Way to go, Nora! That sounds like a great source of protein and wonderful fats. If you’ve stopped her wasting and actually see some gain, that’s huge in a cancer patient.
      I’ve been hearing more about the apricot kernels, which seemed so promising in the 70’s and then dropped off my radar.
      And B complex is a great point for failed kidneys. They are easily lost in that voluminous urine, so replacement is very helpful. I failed to mention it, but all my KI patients get a glandular called Feline Renal Support, which I suspect has a lot of whole food B complex.
      Thanks Nora. Keep us posted with Pookie. She sounds like a survivor!

      • Monica on April 15, 2015 at 2:21 pm

        Can I get more specific information on the niacinamide liquid, what is it called, and where can I get it? I’ve searched this website and found no mention. Thanks!

      • Carol on August 23, 2018 at 1:23 pm

        I have a kidney disease kitty and she has been on calcitriol and low phosphorus food for a year, and has improved. I would like to try the feline support drops you spoke of. Can it be added to her calcitriol protocol at this point?

        • Will Falconer, DVM on August 23, 2018 at 2:34 pm

          Hi Carol,

          Feline Renal Support is a tablet based on glandulars and whole foods. It can be crushed, mostly easily, and added to moist food. It won’t interfere with any other supplement. Normally only sold by practitioners, but I can get you hooked up to get it directly, if you’re interested. Just use my Contact link at the top.

  32. Jane Jones on April 13, 2015 at 8:28 pm

    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!

    • Will Falconer, DVM on April 13, 2015 at 9:37 pm

      Wow, Jane, that’s a lot of years with kidney failure! And don’t they love the heat? So very common, as kidney disease is a cold disease, at least according to TCM.
      Way to go. He’s a great natural path ambassador, even since he’s moved on. His story speaks volumes about your good choices in his care.
      Thanks for sharing his story here.

    • Samantha on February 13, 2017 at 8:16 pm

      Could you please advise on what you mean by fresh raw food? I have a cat with kidney disease and he is currently on the prescription low protein food and need to find a natural alternative

      • Kendra on January 12, 2018 at 8:19 am

        If you’re on Facebook, search for Cat CRAP (cats raw and proud). It’s a fantastic resource and provides much support to those transitioning and feeding a balanced, raw diet. For cats with kidney disease bone will be replaced with eggshells to keep the phosphorus low, but still providing good, high quality protein.
        The group members will also point you to CKD specific resources.

  33. b on April 13, 2015 at 8:02 pm

    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.

    • Will Falconer, DVM on April 13, 2015 at 9:33 pm

      Wow, B, what a trooper this guy was! He was lucky to have you and showed it by outliving all expectations!
      And the next guys will benefit from your learning curve he helped you through. And so it goes.
      Bravo.

    • Tía on October 26, 2016 at 2:16 am

      What a caring parent. Thanks, I could feel the love and dedication. My paper-thin 21yo is asleep on my chest. Appetite has become an issue. We are trying. Tonight he had poached salmon and organic milk with a bit of sardine for a hint of scent. Perhaps not balanced but consumed.

  34. Patricia Hill on April 13, 2015 at 7:51 pm

    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!

    • Will Falconer, DVM on April 13, 2015 at 9:29 pm

      Likely more going on here, and maybe a protein losing nephropathy, a different beast than the typical renal failure case. Great that you’re usually highly digestible protein, anyway.
      But she needs a good homeopath on her side, Patricia. This is serious chronic disease, and remember: conventional medicine doesn’t cure chronic disease. See my Resources page for the AVH list.
      Best of luck with her.

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