Snufkin’s Renal Diet

In October 2006, Snufkin was diagnosed with renal insufficiency. Her bloodwork indicated that she had already lost perhaps 70% of her kidney function. The loss is irreversible. To slow it down, she was ordered to go on a prescription diet that is low in protein, phosphorus and sodium, and high in potassium.

I had previously tried to provide Snufkin with high-quality food that wasn’t tested on animals (click here to read about these choices). Her diagnosis created a further ethical dilemma. Only a few companies manufacture renal formulas, and I wasn’t thrilled about supporting any of them. But it was obvious that Snufkin’s health was my top priority, so I quickly set the dilemma aside and started researching her options.

(1) Wet food

In order to maximize her water intake, I feed Snufkin mostly wet food, as recommended by her vets. Because she demands variety, and it is imperative that she continue to eat, I have bought several types of wet food to keep her interested. They are listed in order from most to least preferred, although this order changes quite frequently. Links are to manufacturers’ product pages where available.

Hi-Tor Neo Diet for Cats
This is a non-prescription renal formula, low in phosphorus and sodium. (It’s not low in protein.) It’s manufactured by Triumph Pet Industries and is supposed to be “all natural”. Snufkin now prefers this to the prescription formulas, although she didn’t at first.
Hill’s Prescription Diet: k/d with Chicken
She will eat this, though without great enthusiasm.
She used to prefer the plain k/d to the k/d with chicken, but then stopped eating the k/d (which is no longer being manufactured).
Hill’s Pet Nutrition is owned by Colgate-Palmolive.
Royal Canin Veterinary Diet: Modified Formula
This was her favourite of the prescription foods for perhaps a year, but she now eats very little.
Royal Canin has replaced the Modified Formula with the “Renal LP Modified Formula” (immediately below).
Royal Canin is owned by Mars.
(No image yet)
Similar to above,
but navy blue
instead of yellow.

Royal Canin Veterinary Diet: Renal LP Modified
This is a canned food that replaces the Modified Formula canned food. Snufkin has not tried it yet.
Royal Canin Veterinary Diet: Renal LP pouches
At first Snufkin was excited that this food came in pouch form, having previously enjoyed gravy-type foods. But after a couple of months she would not touch it at all. I tried it again after a break of about three months, and she seemed interested, although only once. Variety and trickery are the key. In future I will buy only very small quantities of these, if any.

Royal Canin has two different moist prescription renal formulas since their acquisition of the IVD and Waltham’s labels. The Renal LP pouches are from the Waltham’s line; the Modified Formula was from the IVD line.
Purina Veterinary Diets: NF Fomula
Snufkin ate almost none of this, so after three tries I donated the remaining 21 cans to a local no-kill cat shelter (which has several cats with kidney disease).
Purina is owned by Nestlé.

Of the four manufacturers above, all except Triumph are known to test on animals (see the detailed report by the British Union for the Abolition of Vivisection). Another renal formula is sold by Eukanuba/Iams, but I couldn’t bring myself to buy it. Even though most of their competitors also conduct animal tests, Eukanuba/Iams and their parent company, Proctor & Gamble, have particularly egregious records on this score. If Snufkin’s condition worsens and she starts boycotting the other prescription foods, I may try Eukanuba as a last resort.

Q: Are prescription foods really better?

Ironically, although prescriptions foods are marketed as the healthiest option for cats with chronic medical conditions, and the renal formulas above do restrict the amount of substances (such as phosphorus) that can damage the kidneys, they contain poor-quality ingredients compared to the food that Snufkin was eating pre-diagnosis. For example, every formula above contains meat by-products, listed very high in the ingredient list.

How do the prescription / specialty formulas listed above fare on this criterion?

  • Hi-Tor Neo (cans): “meat by-products” listed first, after water.
  • Royal Canin Renal LP Modified (cans): “pork by-products” listed first, after water.
  • Royal Canin Renal LP (pouches): “chicken by-products” and “meat by-products” listed first and second, respectively, after water.
  • Hill’s k/d (cans): “pork by-products” listed third, after water.

Hill’s k/d comes out the winner here, but still a long way behind the non-prescription foods Snufkin was eating before her diagnosis.

So for those days when Snufkin turns up her nose at the prescription foods, I keep plenty of high-quality, by-product-free non-prescription wet food on hand so that she can continue to enjoy her food, keep her weight up, and reduce the risk associated with ingesting meat by-products, meat meal, wheat gluten, grains, additives, preservatives, and other nasty surprises — even sodium pentobarbital from euthanized animals. (Read an FDA report on pentobarbital in dog food here; conclusion: “Adverse health effects unlikely for a dog eating dry dog food”. What about a cat eating wet cat food, which has much higher protein content?)

(2) Dry food

Snufkin has Hill’s Prescription Diet k/d dry food as back-up for those days when she doesn’t feel like eating her prescription wet food. She seems to like it moderately well, and I occasionally hear her crunching away in the middle of the night. I’ve decided not to worry about by-products in this, since she eats such a small quantity of it.

(3) Treats

I have found two brands that are suitable for a cat with Snufkin’s condition.

Royal Canin Veterinary Diet: Feline Treats
These are available by prescription. They are indicated for cats with heart disease, kidney disease, diabetes mellitus, liver disease and gastrointestinal disease. They are low in protein, sodium and potassium. They come from Royal Canin’s IVD line.

Snufkin likes these enough that sprinkling them on her prescription wet food can sometimes tempt her into eating.
Stewart Fiber Formula treats
These are available without a prescription but are formulated for cats with “special dietary needs”, e.g., those (like Snufkin) on sodium-restricted diets.
Stewart Pet Products, Ltd., is owned by MiracleCorp.

Snufkin was extremely excited when I first gave these to her, but her interest has cooled somewhat, probably due to over-exposure.

(4) Potassium supplements

As of summer 2009, Snufkin is taking two 468mg potassium tablets every day. She is due for another blood test in November; we’ll see then whether the increased dosage brings her electrolytes back within normal range. She is a very good girl about being pilled on the kitchen counter twice daily, and only rarely kicks up a fuss.

Q: So, how is Snufkin doing on this regimen?

Thank you for asking! As of summer 2009, Snufkin is doing quite well. Her BUN and creatinine are well within normal limits. (She has only ever had one abnormal creatinine reading, which was a hair above normal.) Her weight, which was down to 7 lbs 1 oz (3.20kg) in January 2007, has bounced back to 8 lb 1 oz (3.66kg) in July 2009, past her stable adult weight of 7 1/2 lbs. Her vet would like her to put on a couple more ounces so she has a good margin of safety, but is generally very pleased with her condition. Her coat is as silky as ever. She continues to run, jump, catch, groom, meow, and purr just as before, though she is perhaps a little harder of hearing now.

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