Thursday, 20 December 2012

Oliver's story with Kidney Disease

Nutrition is the key element to improve health and to recover from illness.  To explain this fully I will use my own 19-year-old cat Oliver who has Renal Disease.

From the age of 3 months, Oliver was fed the best food recommended to me by his Veterinarian.  Over the next 12 to 14 years of his life he ate dry food and a variety of canned wet foods.  During this time he had countless trips to the Vets to be vaccinated each year, dental work, antibiotics for a variety of ailments and other medications for sinusitis, asthma, skin conditions and mild infections.  I also treated him on a regular basis with other medications including a commercially pet approved chemical applied on the skin, which treats internal and external parasites.  I was being the best pet owner possible.  I put my trust and faith in the Veterinarians treating Oliver.  I also trusted commercial pet food, always buying the highest quality I could find.

At about 12 years old he started to become stiff which was diagnosed as arthritis.  Again, he was given more medication, which eased the condition.  All this time I remained oblivious to the underlying cause of the ongoing ailments, until I received blood test results telling me his kidneys were not doing so good.  It was, for me, a big wake up call.  I started my research into why this illness is so prevalent in cats and it was like opening a big can of worms, totally impossible to put the lid back on.

Oliver is now 19 years old and the diagnosis of impaired kidney function was about 5 years ago.  At that time the test results showed that his kidneys were significantly damaged.  The Veterinarian advised me to change his diet to Royal Canin Dry and Wet Food specifically for Renal Failure.  However, the Vet was surprised Oliver appeared so healthy with such poor blood test results. 

Thankfully I had, by that time already started reading several animal nutritional books and was researching numerous websites in regards to Homemade Diets for Cats.  I slowly started to change Oliver’s diet, experimenting with new foods, supplements and herbs.  However, at this time I was very nervous to give my sick cat; foods the Vet had advised me against.  In fact every Vet I have spoken to in regards to a raw diet are against it, always telling me that commercial pet food is complete and balanced, homemade food is not.  

Eventually I gained enough confidence to change the diet completely.  I eliminated the commercial pet food and practically all of what Oliver has eaten over the last 3-4 years has been raw, human grade, high quality food.  Rather than being knocked down by my cat’s seemingly serious diagnosis, I was thankfully challenged to try and help Oliver cope with his impaired kidney function using nutrition as his medicine.

I wanted to give him the best support possible using natural methods to reduce or at least slow down the damage to the kidneys.
The work has certainly paid off.  Oliver is now strong, healthy, happy, eats well and has a high quality of life.  He still has Kidney Disease but I feel it is manageable with lots of live, raw food and a helping hand from several herbs and other supplements.

The cause of Kidney Disease is somewhat controversial.  Whilst some Holistic Veterinarians strongly claim it is the poor quality commercial pet food, others claim that it could be a variety of causes such as vaccinations, environmental toxins, genetics, veterinary medications and toxins in contaminated food.

Kidney disease (K.D.) is not usually detectable until more than two thirds of the kidneys have been compromised.  Most patients diagnosed with renal failure usually also have chronic periodontal disease, arthritis and low-grade dermatitis. (Lonsdale 2001)  Early warning signs of K.D (which is the second leading cause of death in cats) are frequent urination, increased thirst, loss of appetite, nausea and vomiting, which may last days at a time. (Brown 2006)
A blood test usually reveals elevated levels of creatinine and urea, both of which should be low if the kidneys are doing their job.  Fortunately, author and practicing Veterinarian, Dr. Goldstein believes that K.D. diagnosis does not have to be a death sentence.  Animals in his care have shown that kidney tissue and cells can and do regenerate. (Goldstein et al 2005)

Based on the advice most vets and commercial pet foods tell us, a cat diagnosed with K.D. should be put onto a low protein diet.  Most veterinary practices sell food specifically produced for ‘renal failure.’  There are dry and wet foods, all of which are very low in protein and very high in grains.  However, many holistic animal nutritionists advice that it is a very big mistake to restrict protein intake.

“Low protein diets can harm any cat, including one with declining kidney function…lower protein foods don’t help and can, in fact, exacerbate muscle wasting.” (Arora 2006)

In support of this controversial claim, author (and veterinarian) of ‘Your Cat,’ advices that when cats are sick, their protein requirements are very high,
“The cat on a protein restricted diet cannot repair its own ailing body or produce enough energy to meet its needs.”  (Hodgkins 2007)

More support comes from author of ‘Raw and Natural Nutrition for Dogs,
older dogs and dogs with compromised kidneys can easily digest high quality proteins.  If given in high enough doses these proteins kill bacteria in the kidneys and create an acidic condition that promote organ health, fighting off infections and bacteria in the dog’s system” (Olson 2010)
This is of course based on dogs not cats, however there is no reason why this finding doesn’t also apply to our feline friends.

Most Holistic Veterinarians and animal nutritionists do however tend to agree that when presented with the diagnosis of K.D. the diet should indeed be changed and there are several things to avoid if possible including:
- Dry foods
- Foods containing preservatives
- Colouring agents
- Chemicals used for internal and external parasites
- Pollutants
- Medications
- Vaccinations
- Unfiltered water
- Herbicides, pesticides, toxins found in poor quality foods

There are several diets that I have tried and tested on my cat Oliver.  The cooked diets have failed, as he prefers raw, however I do believe there is a place for cooked foods especially when faced with a sick cat that has a loss of appetite.  Author of ‘The Holistic Cat, advices that whatever the diet, there are several additions that should be incorporated into the diet to assist the renal failure.  They include:

- Lots of greens, including peas, red clover, spirulina, barley and wheat grass, sea greens (to boost immune system, supply vitamins, minerals, antioxidants, enzymes and amino acids whilst detoxifying the body.)
- Dandelion leaves (which act as a natural diuretic assisting to flush the kidneys)
- Probiotics (increase absorption of essential nutrients, kill harmful bacteria in the gut, maintain healthy gut flora)
- Vitamin B6 (rids the body of excess water whilst assisting to balance sodium and potassium, 5-10mg/day)
- B complex (to replace those B vitamins lost in urine)
- Vitamin C (boosts the immune system, keeps urine acidic, destroys any bacteria and as its water soluble it needs to be replaced) (Pitcairn et al 2005)
- Cranberry (acidifies urine, destroys bacterial build up in the urinary tract)
- Lecithin granules (assists to reduce inflammation of the kidneys and tissue repair. Dosage for an adult cat is ½ tsp/day)
- Pots of fresh wheatgrass to chew on (Coscia 2009)
- Small amount of odourless garlic to keep away parasites
- Kelp (high in minerals, benefits kidneys)
- Fresh parsley (a natural diuretic providing relief for the kidneys, high in vitamin C) (Brown 2006)
- Omega 3 such as salmon oil and flaxseed oil. (reduces inflammation and improve blood flow)
- Omega 6 such as borage seed oil, evening primrose oil, blackcurrant oil. (Messonnier 2001)
- Vitamin A supplement 1000iu/day (acts as a lubricant for the kidneys) (Goldstein 1999)
- Alfalfa

The diet I regularly make for Oliver consists of raw chicken meat and chicken bones.  I usually buy the chickens whole without the skin and put the whole lot through a meat mincer.  He enjoys it, in particular mixed with green peas and brown rice baby food plus the supplements I add to boost his health, immune system and hopefully to support his impaired kidneys.  Whilst not utilizing all of the above suggestions from the variety of texts, I certainly give Oliver most of them.

Over the last 3 years in particular Oliver has improved in the following ways:

- Less frequent asthma attacks
- Very infrequent sinusitis (and when he does get it, we can treat it far better at home with natural supplements and a wonderful nose flush that clears his air passage ways almost immediately.  He no longer needs antibiotics from the Vet.
- A hugely improved stronger immune system
- Hardly any trace of arthritis and he hasn’t had any arthritis medication for approximately 5 years
- Very rarely he vomits (unsure whether it is toxin build up from impaired kidneys or just something didn’t agree with him), its never prolonged
- He no longer has any vaccinations (last one was about 6 years ago)
- I don’t give him any medication for internal or external parasites (instead I use a herbal formula called ‘Costat’ from ‘Metagenics’ as advised by an Animal Naturopath in South Australia)
- His teeth and gums are in better health than before, however there is still a build up of tartar from not being willing to knar on a raw chicken neck (this is a work in progress).  I clean his teeth with a pet enzymatic toothpaste.

As variety in the diet is important long term to balance nutrients and to prevent boredom and lack of appetite in our pets, I collect and use ideas from a selection of cat nutrition books.  Here are two of them:

Diet recommended for cats with K.D. (recipe for 5-6 days)
By Dr Pitcairn (DVM)

1 ½ cups                        raw chicken meat
4 cups            cooked white rice (better digested than white rice, contains iron and lots of B vitamins)
4                                    cooked eggs
2 tbsp                                    safflower oil
3 tsp             calcium powder (rather than bone or bone meal which is high in phosphorus)
¼ tsp             iodized salt
1 tsp            chopped parsley
5000iu            Vitamin A
2000mg             Vitamin C
250mg            Taurine
50mg            Vitamin B Complex (Pitcairn et al 2005)

I tried this recipe and found it to be a little dry. 
My addition was a jar of pureed pumpkin baby food. 
As Oliver doesn’t like cooked eggs I made this recipe with only 2 raw eggs and a little chopped raw liver (which he adores). 
I’m not convinced with using white rice as a better option than brown rice. 
I have also made this recipe using cooked barley in place of rice, which works really well, also with lots of nutrients and fibre.
Cooked egg whites appear to be a popular choice of protein amongst the holistic cat nutritionists.  Egg whites are a high quality protein without the phosphate.  As phosphate is very difficult for damaged kidneys to eliminate, it can become a problem.  (Hodgkins 2007)  Cats with K.D. also have increased levels of Creatinine and Urea in the blood.  Creatinine is a by-product from protein metabolism, whilst Urea is formed by the liver.  The kidneys should filter both by-products.  (Goldstein et al 2005)  However when kidneys are impaired, high levels of urea and creatinine cause nausea and vomiting, the body’s own defense mechanism of trying to eliminate the build up of toxins.

K.D Diet for Cats
recommended by Dr Goldstein (DVM)

1                        egg yolk (raw)
½  cup                        chicken meat (raw)
1/3 cup            cooked brown rice or barley or oatmeal
2 cups                        filtered/bottled water
½ tsp                        finely minced parsley
½ tsp                        finely grated asparagus
1 tsp                        salmon oil
1                        multivitamin

my essential extras:
Calcium supplement to balance calcium and phosphorus
- Add 600mg calcium carbonate powder to every 300g raw meat
- Substitute half the water for some pureed baby food eg: pumpkin

optional additions:
small amount of liver
plain yoghurt

Every few days I give Oliver a meal with lamb meat and calcium powder plus all of the vegetables, oils and supplements.  However, with the knowledge that red meats have more phosphorus than white meat I limit the amount of meat and add more fibre such as oat bran, pumpkin and brown rice. (Arora 2006)

Arora, S 2006, ‘Whole Health for Happy Cats.’ Quarry Books USA
Brown, A 2006, ‘The Whole Pet Diet, Eight weeks to a Great Health for Dogs and Cats.’ Celestial Arts, USA.
Coscia, J. A, 2005, ‘The Holistic Cat, A Complete Guide to Wellness for a Healthier, Happier Cat.’ North Atlantic Books, USA.
Goldstein, M 1999, ‘The Nature of Animal Healing. The Definitive Holistic Medicine Guide to Caring for your Dog and Cat.’ Random House Publishing group.
Goldstein, R.S. V.M.D. & Goldstein, S.J. 2005, ‘The Goldstein’s Wellness & Longevity Program Natural Care for Cats and Dogs.’ TFH Publications USA.
Hodgkins, E.H, 2007, ‘Your Cat, Simple New Secrets to a Longer, Stronger Life.’ Thomas Dunne Books, USA.200
Lonsdale, T. 2001, ‘Raw Meaty Bones Promote Health.’ Rivetco P/L, Australia
Messonnier, S, 2001, ‘Natural Health Bible for Dogs and Cats’ Three Rivers Press, New York.
Olson, L 2010, ‘Raw & Natural Nutrition for Dogs, The definitive guide to homemade meals.’ North Atlantic Books, USA.

Pitcairn, R. H. & Pitcairn, S. H, 2005, ‘Dr. Pitcairn’s guide to Natural Health for Dogs and Cats.’ Rodale Inc, USA.

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